Finding into death of Peter Sarafino

IN THE CORONERS COURT OF VICTORIA AT MELBOURNE

Court Reference: COR 2010 003548

FINDING INTO DEATH WITH INQUEST

Form 37 Rule 60(1) Section 67 of the Coroners Act 2008

Inquest into the Death of: Peter SARAFINO

Delivered On: 27 June 2012 Delivered At: Coroners Court of Victoria Level 11, 222 Exhibition Street Melbourne 3000 Hearing Dates: 18 June 2012 Findings of: : Coroner Paresa Antoniadis SPANOS Representation: No appearances.

Police Coronial Support Unit Leading Senior Constable King TAYLOR

Los

I, PARESA ANTONIADIS SPANOS, Coroner, having investigated the death of PETER SARAFINO AND having held an inquest in relation to this death on 18 June 2012

at Coroners Court of Victoria, Melbourne

find that the identity of the deceased was PETER SARAFINO born on 1 March 1986 and that the death occurred on 11 September 2010

at Hammond Road, near the intersection with Dalgety Street, Dandenong South, Victoria 3175

from:

1 (a) MULTIPLE INJURIES

in the following circumstances:

Mr Sarafino was a 24 year old single man who was born in Sudan, was separated from his family as a result of war, and was reunited with his sister Ms J osephine Konga by chance in a refugee camp in Kenya. In 2002, Mr Sarafino and his sister migrated to Australia, and lived together in Noble Park for the first year or so. Ms Konga married and moved on. She noticed that her brother’s alcohol use was becoming problematic, and thought it would settle as he became more accustomed to life in Australia. Mr Sarafino appears to have struggled to find direction in his life. From about 2006, he began to come to the attention of the police. He

obtained some qualifications and was employed from time to time.

‘As at the date of his death, Mr Sarafino was unemployed, having returned to Victoria after some time in South Australia. He was residing with a friend in Dandenong. At about 10.22pm on 11 September 2010, Mr Sarafino was lying on the roadway in Hammond Road, approximately 17 metres south of the intersection with Dalgety Street, Dandenong South. He was lying on the southbound Janes when witnesses saw what appeared to be a Toyota sedan drive over Mr Sarafino, before slowing, stopping briefly and continuing to travel south. The driver of the Toyota did not stop to render assistance, provide his details to anyone else at the

scene or call the police.

Witnesses who were at the scene called “O00” and rendered assistance to Mr Sarafino until an ambulance and police officers arrived, Ambulance officers observed significant trauma to the

head and did not attempt resuscitation.

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The circumstances in which Mr Sarafino died were investigated by one of the attending police officers, Leading Senior Constable Roslyn Wilson from the Major Collision Investigation Unit at Glen Waverley. LSC Wilson conducted a thorough investigation and this finding is based on the comprehensive and detailed brief of evidence provided to the court. Based on the evidence in that brief I am satisfied that Mr Sarafino was significantly affected by alcohol when he was lying on the roadway, Witnesses at the scene described Mr Sarafino as walking onto the roadway, and then lying down for no apparent reason, He did not appear to them to collapse or fall. There is ample evidence that he was significantly affected by alcohol, including CCTV footage taken from various sites which shows him to be drinking and/or significantly affected by alcohol, the evidence of witnesses who interacted with him in the

hours immediately preceding his death and the toxicologist’s report mentioned below.

Another significant body of evidence, indicates that Mr Sarafino’s alcohol abuse was very problematic in that he presented to a number of public hospital Emergency Departments in the

two months immediately preceding his death with significant blood alcohol levels noted, as

follows —

28 August 2010 Monash Medical Centre 0.392/100mL

31 August 2010 Alfred Hospital 0.171g/100mL

4 September 2010 Dandenong Hospital 0.37g/100mL

6 September 2010 Datidenong Hospital _0.225g/100mL (some hours after presentation) 9 September 2010 Alfred Hospital 0,.3282/100mL

11 September 2010 Alfred Hospital 0.138g/100mL

I am also satisfied that despite extensive efforts made by LSC Wilson to identify the driver of the Toyota vehicle, he/she remains unidentified at this time. Given the circumstances it seems likely that the driver was aware of some impact but may not have been awarc that they had

struck or driven over a person lying on the roadway.

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An autopsy was conducted by Forensic Pathologist Dr Melissa Baker from the Victorian Institute of Forensic Medicine (VIFM), who reviewed the circumstances as reported by the police, the medical records relating to the above hospital presentations, post-mortem CT scanning of the whole body and the report of Consultant Radiologist Dr Chris O’ Donnell and a Neuropathology Report from Dr Linda Iles, and advised that it would be reasonable to attribute Mr Sarafino’s death to “multiple injuries”. Dr Baker found no evidence of any natural disease which may have caused or contributed to death. She did find multiple injuries involving the head, chest, abdomen, pelvis and left leg, and advised that the relative lack of blood associated with these very significant injuries (particularly the almost complete transaction of the descending thoracic aorta) indicates that death occurred rapidly or that the deceased was already dead prior to these injuries. (However, the latter would seem unlikely

given the witnesses observations.)

Dr Baker noted the results of toxicological analysis, also undertaken at VIFM, which indicated no commonly encountered drags or poisons other than ethanol/alcohol at an elevated level of 0,32g/100mL in blood and 0.38g/100mL in vitreous humour, which is more stable in the post-

mortem period than blood. In this regard Dr Baker made the following relevant comments ~

“Alcohol levels in excess of 0.15/100mL may cause significant central nervous system depression. The level detected in this man is at the lower limit of that seen in cases where death has been ascribed to acute alcohol intoxication. The effect of a particular alcohol level on an individual is difficult to predict due to the development of tolerance in those chronically exposed, The level detected ... is potentially toxic but this is difficult to determine in view of his past history of heavy alcohol use...freferring to his recent hospital presentations which] show a recent history of markedly elevated blood alcohol levels. On several occasions the level detected was higher than that detected post-mortem. This indicates that the deceased was likely to have developed some tolerance to the effects of alcohol although the effects at a

particular level remain difficult to predict.”

1 find that Mr Sarafino died from multiple injuries sustained when a vehicle drove over him

while he was lying on the roadway, largely due to the effects of alcohol intoxication.

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I direct that a copy of this finding be provided to the following: The deceased’s family c/o his sister Ms Josephine KONGA Leading Senior Constable Roslyn WILSON (#26031) clo O.LC, Major Collision

Investigation Unit - Glen Waverley

Signature:

Pps

PARESA ANTONIADIS SPANOS CORONER Date: 27 June 2012