Finding into death of E A

INTRODUCTION

1. was a 40-year-old man who lived at the Wesley Mission Victoria, Wesley Neurological Support Services (Wesley Mission), 515 Highbury Road, Burwood East at the time of his death. Mr Antonakos had an Individual Support Package through the Department of Health and Human Services. 1 Mr was found unresponsive in his bed at approximately 5.40am on 1 March 2.

THE PURPOSE OF A CORONIAL INVESTIGATION Mr. was 'a person placed in custody or care' for the purposes of the Coroners Act 3.

2008 as he was a person under the control, care or custody of the Secretary to the Department of Health and Human Services .. His death was therefore a 'reportable death' under the Act, and it was appropriately reported to the coroner.

4. The role of a coroner is to independently investigate reportable deaths to establish, if possible, identity, medical cause of death and surrounding circumstances. Surrounding circumstances are limited to events which are sufficiently proximate and causally related to the death. The purpose of a coronial investigation is to establish the facts, not to cast blame or determine criminal or civil liability.

5. Under the Act, coroners also have the important functions of helping to prevent deaths and promoting public health and safety and the administration of justice through the making of comments or recommendations in appropriate cases about any matter connected to the death under investigation.

6. After considering all the material obtained during the coronial investigation I determined that I had sufficient information to complete my task as coroner and that further investigation was not required. Whilst I have reviewed all the material, I will only refer to that which is directly relevant to my findings or necessary for narrative clarity.

7. I have based this finding on the evidence contained in the coronial brief. In the coronial jurisdiction facts must be established on the balance of probabilities.

1 Wesley Mission Neurological Services patient file: 2 This is subject to the principles enunciated inBriginshaw v Briginshaw (1938) 60 CLR 336. The effect of this and similar authorities is that .coroners should not make adverse findings against, or comments about, individuals unless

natural causes. Based on Dr Bedford's opinion expressed in his report, I consider that Mr EA's death was due to natural causes.

22. I express my sincere condolences to Mr family for their loss.

23. Having investigated the death, without holding an inquest, I make the following findings pursuant to section 67(1) of the Coroners Act 2008:

(a) The identity of the deceased was born May 1977;

(b) The death occurred on 1 March 2018 at Wesley Mission Victoria, Wesley Neurological Support Services, 515 Highbury Road, Burwood East from an unascertained cause; and ( c) The death occurred in the circumstances described above.

24. Pursuant to section 73(1B) of the Act, I direct that this finding be published on the Internet.

25. I direct that a copy of this finding be provided to the following:

(a) senior next of kin

(b) Constable Kristina Lucic, Victoria Police, Coroner's investigator Signature: SI N McGREGOR �

CORONER Date: 23 July 2019