NT Health charged over death of mental health patient at Royal Darwin Hospital

The Northern Territory's health department has been charged over the death of a mental health patient who inhaled aerosol at Royal Darwin Hospital.

Aboriginal and Torres Strait Islander readers are advised that this article contains the name of an Indigenous person who has died.

NT WorkSafe charged NT Health with three counts of failing to comply with a health and safety duty, alleging the 22-year-old patient was able to access and inhale the contents of an aerosol deodorant can, causing their death, while under the department's care in 2022.

In a statement on Monday, an NT WorkSafe spokesperson said the department could face a fine of up to $4.5 million if it was found guilty of all charges.

"Despite the health organisation's knowledge of the risks, the patient was able to access an aerosol can within the organisation's facility and inhale the contents, causing fatal injuries," they said.

A 2024 coronial inquest into the patient's death found they purchased the aerosol deodorant from the hospital's pharmacy while under the supervision of a security guard hours before they died.

The patient, referred to in court as Ngalarina, was found unresponsive in a bathroom on a general ward with an empty aerosol can beside them and could not be resuscitated.

In her findings, Territory Coroner Elisabeth Armitage said NT Health had conceded there was an "absence of clear procedures to guide staff in managing mental health patients in general wards" and that Ngalarina's death was preventable.

The court heard the 22-year-old was involuntarily admitted to Royal Darwin Hospital less than two weeks before they died by an on-call psychiatry registrar, who documented them as having a "behavioural disturbance in context of VSA [volatile substance abuse]".

The registrar recorded that their admission was necessary to "further assess and contain risk of harm to self and others, misadventure".

Judge Armitage said Ngalarina was moved from the hospital's Joan Ridley Unit, a high-risk secure ward for acute psychiatric patients, to a general orthopaedic ward due to COVID-19 protocols 12 days after their admission.

Soon after, they were granted "grounds leave", allowing them to walk around the hospital under the supervision of a security guard.

Judge Armitage found that aerosol deodorants were "freely" available for purchase from two publicly accessible pharmacies at the hospital at the time of Ngalarina's death.

The inquest heard the products had since been removed from shelves and were now available behind the counter.

The coroner's sole recommendation was for the health department to consider extending the ban on aerosol cans hospital-wide, or for them to be kept securely if medically necessary.

NT Health will face the Darwin Local Court tomorrow.