A coroner may make recommendations following an investigation that relate to public health and safety to help prevent similar deaths in the future.
Fatal facts is a unique NCIS service providing access to coronial recommendations from across all Australian states and territories.
Fatal facts contains cases closed by a coroner from 2000. The NCIS Unit is currently preparing cases closed from 2021 onwards.
Fatal facts is based on information available in the NCIS at the time of reporting.
Category tags are assigned by the NCIS Unit to each Fatal facts case based on the case circumstances and recommendations made.
| Category tag | Description |
|---|---|
| Adverse medical effects | Adverse effects from medical or surgical treatment, failure to comply with medical advice |
| Aged care | Incidents that occurred in an aged care or assisted living facility or residence, including a retirement village |
| Animal | Incidents where an animal was involved in the death |
| Child and infant death | Any case involving a child or infant |
| Domestic incident | Incidents as a result of a domestic injury or event |
| Drugs and alcohol | Deaths where drugs or alcohol or both made a primary or secondary contribution |
| Electrocution | Cases where electrocution contributed to death |
| Falls | Incidents where a fall was involved in the circumstances or cause of death |
| Fire related | Incidents where a fire was involved in the circumstances or cause of death |
| Geographic | Cases where the geographic region is significant to the death, such as a remote location |
| Homicide and assault | Deaths due to interpersonal violence |
| Indigenous | Cases where the indigenous status of a person was relevant to the circumstances of death |
| Intentional self-harm | Deaths determined by a coroner to be due to intentional self-harm |
| Law enforcement | Includes police pursuits, deaths in custody, legal or court issues and coronial investigation or police procedures |
| Leisure activity | Any leisure activity that directly influenced the circumstances of death |
| Location | Cases where the location type of either the incident or the discovery of the body is of significance. Does not refer to geographic location |
| Mental illness and health | Cases where mental health issues or their management were relevant to the death, whether diagnosed or anecdotal |
| Misadventure | Risk-taking behaviour such as train surfing |
| Natural cause death | Cases where the death was due to natural causes |
| Older persons | Cases where the agedness of a person was a factor in the death |
| Physical health | Cases where the existing physical health of the person contributed but was not necessarily the cause of death |
| Sports related | Cases where a sporting incident contributed to death |
| Transport and traffic related | Cases involving road, water and air vehicle incidents, motorised or naturally powered. Includes cases of pedestrians impacted by transport vehicles |
| Water related | Includes swimming, scuba, snorkelling, boating, fishing and all water-based activities in either a recreational or commercial context |
| Weather related | Cases where the environmental conditions such as heatwave or storm conditions contributed to death |
| Work related | Cases where a work incident is related to the death |
| Weapon | Cases where the involvement of a weapon is significant |
| Youth | Cases where the youth of a person was a factor in the death |
Fatal facts search
Fatal facts search is a tool to help you find coronial recommendations.
The Fatal facts search tool is currently unavailable until further notice. PDF Fatal facts editions remain accessible below.
Fatal facts editions
Fatal facts editions contain summaries of cases with coronial recommendations made by an Australian state or territory coroner within a three-month period.
New Zealand cases are not included from edition 37 onwards. New Zealand coronial recommendations are published by Coronial Services of New Zealand.
Edition 67: October – December 2020
Published June 2021
Edition 66: July – September 2020
Published March 2021
Published March 2021
Edition 64: January – March 2020
Published December 2020
Edition 63: October – December 2019
Published September 2020
Edition 62: July – September 2019
Published August 2020
Published August 2020
Edition 60: January – March 2019
Published July 2020
Edition 59: October – December 2018
Published June 2020
Edition 58: July – September 2018
Published June 2020
Published May 2020
Edition 56: January – March 2018
Published April 2020
Edition 55: October – December 2017
Published April 2020
Edition 54: July – September 2017
Published March 2020
Published February 2020
Edition 52: January – March 2017
Published January 2020
Edition 51: October – December 2016
Published December 2019
Edition 50: July – September 2016
Published December 2019
Published November 2019
Edition 48: January – March 2016
Published November 2019
Edition 47: October – December 2015
Published November 2019
Edition 46: July – September 2015
Published October 2019
Published October 2019
Edition 44: January – March 2015
Published October 2019
Edition 43: October – December 2014
Published October 2019
Edition 42: July – September 2014
Published October 2019
Published September 2019
Edition 40: January – March 2014
Published September 2019
Edition 39: October – December 2013
Published July 2019
Edition 38: July – September 2013
Published June 2019
Published March 2019
Edition 36: January – March 2013
Published June 2018
Edition 35: October – December 2012
Published July 2017
Edition 34: July – September 2012
Published March 2017
Published January 2017
Edition 32: January – March 2012
Published October 2016
Edition 31: October – December 2011
Published August 2016
Edition 30: July – September 2011
Published June 2016
Published April 2016
Edition 28: January – March 2011
Published February 2016
Edition 27: October – December 2010
Published December 2015
Edition 26: July – September 2010
Published September 2015
Published July 2015
The following special editions contain coronial recommendations relating to specific topics of interest where the case was closed by a coroner between 2008 and 2010.
Edition 24: Deaths of children in care/children identified at risk
Published May 2014
Edition 23: Deaths in police presence and mental health services
Published February 2013
Edition 22: Deaths in police custody or during police pursuit
Published May 2012
Edition 21: Deaths related to quad bikes
Published March 2011
Published March 2009
Earlier editions are available upon request.