Ministry of Community Safety and Correctional Services :: Coroner

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Death Investigations

Office of the Chief Coroner

Publications & Reports


Copies of reports not available online can be obtained by contacting the Office of the Chief Coroner at 416-314-4000, 1-877-991-9959 or by email at occ.inquiries@ontario.ca

Review of Ornge Air Ambulance Transport Related Deaths

Office of the Chief Coroner Annual Reports

  • 2009-2011 – HTML / PDF – 1.16MB
  • 2008 – HTML / PDF – 335 kb
  • 2007 - available on request
  • 2005-2006 - available on request

Pedestrian Death Review

Cycling Death Review

Investigation into the Deaths of Four Residents of a Toronto Retirement Home

Death Review of the Youth Suicides at the Pikangikum First Nation

Drowning Report

Patient Safety Review Committee Reports

Reports of the Geriatric and Long Term Care Review Committee

  • 2012 – HTML / PDF – 1.98 MB
  • 2011 – HTML / PDF – 931 kb
  • 2010 – HTML / PDF – 262 kb
  • 2009 – HTML / PDF – 160 kb
  • 2008 – HTML / PDF – 336 kb
  • 2007 available on request

Reports of the Maternal and Perinatal Death Review Committee

  • 2012 – HTML / PDF – 1.65 MB
  • 2011 – HTML / PDF – 969 kb
  • 2010 – HTML / PDF – 680 kb
  • 2009 – HTML / PDF – 500 kb
  • 2008 – HTML / PDF620 kb
  • 2007 available on request

Reports on Inquests

  • 2011 – HTML / PDF – 3.36MB
  • 2010 – HTML / PDF – 222 kb
  • 2009 Report on Inquests - HTML / PDF – 164 kb
  • 2008 Report on Inquests - HTML / PDF – 172 kb
  • 2007 Report on Inquests – HTML / PDF – 764 kb
  • Archived reports (2004–2006) available on request

Reports of the Paediatric Death Review Committee and Deaths Under Five Committee

Domestic Violence Death Reviews: Case Reviews of Domestic Violence Deaths