Finding into death of LX
A 31-year-old man subject to a post-sentence supervision order died from mixed drug toxicity (methadone, diazepam, pregabalin, promethazine, pizotifen) at a residential facility. He was a vulnerable person with acquired …
Deceased
ADRIAN JAMES KEATLEY
Demographics
48y, male
Coroner
Coroner John Olle
Date of death
2013-02-08
Finding date
2013-11-15
Cause of death
hanging
AI-generated summary
Adrian Keatley, aged 48, died by hanging at a roadside location. Police had contact with him the day before his death at the same location but had no welfare concerns. A suicide note was found at the scene. The post-mortem revealed incidental findings of liver cysts of uncertain significance and a hydrocele. This case highlights the importance of thorough risk assessment during police welfare checks, particularly when individuals are found in isolated locations with vehicles present over extended periods. Enhanced mental health screening and engagement with support services may have been beneficial, though the coroner did not identify specific preventable failures in clinical care.
AI-generated summary — refer to original finding for legal purposes. Report an inaccuracy.
Court Reference: COR 2013 / 0578
Form 37 Rule 60(1) Section 67 of the Coroners Act 2008
Inquest into the Death of: ADRIAN JAMES KEATLEY
Delivered On: 15 NOVEMBER 2013
Delivered At: Level 11, 222 Exhibition Street Melbourne 3000
Hearing Dates: 15 NOVEMBER 2013
Findings of: JOHN OLLE, CORONER
Police Coronial Support Unit Leading Senior Constable Tracey Ramsey
lof3
I, JOHN OLLE, Coroner having investigated the death of ADRIAN KEATLEY
AND having held an inquest in relation to this death on 15 November 2013
at MELBOURNE CORONERS COURT
find that the identity of the deceased was ADRIAN JAMES KEATLEY
born on 20 September 1964
and the death occurred between 7 February and 8 February 2013
at Intersection of Luptons Track and Tynong North Road, Tynong North 3813
from: 1 (a) HANGING
in the following circumstances: L. Adrian Keatley was aged 48 years at the time of his death. He lived at 2 Edney Court, Noble Park.
The coronial brief has fully addressed the tragic circumstances of death Mr Keatley.’
At inquest a summary of evidence was read by my assistant. I am satisfied the summary is
an accurate reflection of the material contained in the inquest brief.
Post mortem medical examination
Forensic Medicine, performed an examination on the body of Adrian James Keatley.
“According to details outlined in the Victoria Police Report of Death Form No. 83, over the two days preceding the deceased’s death, his vehicle was reported by passers-by as a suspect vehicle at the intersection of Tynong North Road, Camp Road and Lupton’s Track, Tynong North. Police spoke to the deceased at 18:22 hours on 7th February 2013 at this location. Police had no concerns for his welfare, but suggested he camp at a designated camping ground. At 08:00 hours on 8th February 2013, a witness discovered the deceased’s car on Tynong Road North
adjacent to Lupton’s Track facing in a southerly direction. The deceased had hitched
' Copy of the coronial brief will remain on the court file
2 of 3
a red octopus strap around his neck securing the other end to a roll bar on the back of his vehicle’s cabin. He has then hung himself. There are no other signs of violence.
A search of the deceased’s vehicle revealed car keys, a wallet, last Will and suicide note. The deceased was found lying on his side with the octopus strap still attached
to his neck and the roll bar.
External examination revealed a red octopus strap around the deceased’s neck with
an underlying ligature mark. No other injuries were identified.
Post mortem CT scan revealed a right sided hydrocele and multiple cysts in the liver.
Cysts were not identified in other organs. The cysts in the liver may represent multiple cystic metastases, however a primary tumour is not visible and there is no evidence of lymphadenopathy. A post mortem examination would be necessary in
order to determine the nature of the cysts.””
Finding
I find the cause of death of Adrian Keatley to be hanging.
I direct that a copy of this finding be provided to the following: The Family of Adrian Keatley
Signature:
? Dr Bakers post mortem report
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