Coroner's Court of Western Australia

Inquest into the Death of Anthony Nigel Axtell

Delivered on 20 March 2014 at Perth.

Finding of Coroner Linton.


The deceased was a 38 year old man who died on 13 September 2012 at Royal Perth Hospital after he became seriously ill while a remand prisoner at Casuarina Prison.

The inquest focused on the care provided to the deceased while a prisoner, both within the custodial environment and while he was admitted at Royal Perth Hospital.

The Coroner found the deceased died consistent with heart failure in a man with dilated cardiomyopathy and focal severe coronary artery atherosclerosis. The manner of death was natural causes.

Catch Words

Death in Custody : Prison : medical care : heart failure : natural causes.

Last updated: 19 July 2022

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