Finding into death of Robert William Keith

Rule 60(1)

FORM 37

FINDING INTO DEATH WITH INQUEST

Section 67 of the Coroners Act 2008

Court Reference: 2434/2010 Inquest into the Death of Robert William Keith

Delivered On: Delivered At: Hearing Dates: Findings of:

Representation:

Place of death/Suspected death:

Counsel Assisting the Coroner

28 June 2011 Sale

28 June 2011 Ms F. Hayes

Site 8, Stratford on The River Tourist Park, McMillan Street, Stratford VIC 3862

Senior Constable Alisha Weel

Rule 60(1)

FORM 37

FINDING INTO DEATH WITH INQUEST

Section 67 of the Coroners Act 2008

Court Reference: 2434/2010

In the Coroners Court of Victoria at Sale

I Ms F. Hayes, Coroner having investigated the death of:

Details of deceased:

Surname: Keith First name: Robert William Address: ~ Site 8 Stratford on River Tourist Park

McMillan Street Stratford VIC 3862

AND having held an inquest in relation to this death on'28 June 2011

at Sale find that th and death

at Site 8, Stratford on The River Tourist Park, McMillan Street, Stratford VIC 3862

from

he identity of the deceased was Robert William Keith

occurred on or about 28 June 2010

la Unascertained

in the following circumstances:

Mr Robert Keith was aged 34 years when on 28 June 2010,

" he was located in the area of the caravan where he lived

alone. Ambulance officers attended but were not able to assist Mr Keith. Police investigated the scene and found no evidence of foul play.

Mr Keith was last seen on the previous evening at about 10.00pm.

Mr Keith had a medical history which included treatment for paranoid schizophrenia. At the time of his death Mr Keith was subject to a Community Treatment Order, and was prescribed medication in the form of fortnightly Respiradone Consta injections and oral medication. Mr Keith had regular reviews of his condition and had been subjected to Community Treatment Orders for some years, Mr Keith was last seen by his.case manager on 7 June 2010.

On that occasion, no paranoid ideation was present and he reported sleeping and eating well.

In April 2010, Mr Keith was admitted to hospital for management of metabolic alkalosis, secondary to an episode of vomiting.

A full post mortem examination was conducted by Dr Melissa Baker, Forensic Pathologist, of the Victorian Institute of Forensic Medicine, who formulated the cause of

Mr Keith’s death as “unascertained”, She did not find any evidence of natural disease, which may have caused or contributed to his death, Dr Baker noted that post mortem biochemistry “revealed an elevated urea and creatinine consistent with dehydration and/or renal impairment”, She also noted that Mr Keith had previously been treated, with multiple hospital admissions, for “vomiting leading to hypokalaemia, hypochloraemia and metabolic alkalosis with associated renal impairment.” She stated “electrolyte disturbances such as hypokalaemia can lead to cardiac arrhythmias.”

In her report and in her evidence, Dr Baker stated it had been previously noted that Mr Keith had a long QT interval on his ECG at hospital, for which there can be many causes, including electrolyte disturbances such as Mr Keith had experienced on many occasions, Some anti-psychotic medications can also lead to the prolongation of the QT interval and predispose to fatal cardiac arrhythmias. Long QT interval can also be genetically based and Dr Baker recommended that there be family follow up. It is not nown what was the cause of Mr Keith’s long QT interval, but it was certainly consistent with his presentations in relation to renal impairment. .

Dr Baker found no evidence of any injury which may have caused or contributed to Mr Keith’s death.

Although it is not known what caused Mr Keith’s death, it is ikely that he was experiencing an episode of electrolyte disturbance, evidenced by the elevated creatinine and urea, which may have caused a prolongation of his QT interval, which in turn could have lead to a fatal cardiac arrhythmia,

There are no suspicious circumstances surrounding his death.

Signature:

Date: AB | & iy