Inquest Reveals Shocking Details of Custody Death
A coronial inquest into the death of Tammy Shipley while in police custody has heard the shocking revelation that she drank approximately 67 cups of water in the hours before her death from water intoxication. The 47-year-old mother of five died while being held on remand at Silverwater women's correctional centre in New South Wales on December 20, 2022, following her arrest on minor shoplifting charges.
Mental Health History and Systemic Failures
The inquest, which resumed under State Coroner Teresa O'Sullivan, heard that Shipley had a long history of mental health illnesses, including schizophrenia and bipolar disorder, along with substance abuse and suicide attempts. Peggy Dwyer SC, counsel assisting the coroner, emphasized that New South Wales police failed to inform either the corrections department or custody management officers about Shipley's acute mental health conditions.
This critical omission occurred despite previous interactions with police where Shipley had been sectioned under the mental health act due to concerns about delusions regarding her neighbors. During her arrest, Shipley told officers she was hearing voices in her head that "wouldn't stop talking in her mind," yet she claimed she did not suffer from any mental health conditions.
The Final Hours and Excessive Water Consumption
Dwyer detailed that on the day of her death, Shipley was recorded on CCTV drinking from a red cup at least 67 times between 12:33 AM and 11:51 AM. The cup could hold 300ml of water, meaning Shipley likely consumed at least 20 liters of water on December 20 alone. She had also been observed drinking excessive amounts of water in the two days prior.
"In between that time, Tammy seemed to be consuming water from the tap," Dwyer told the court. "It's not possible to calculate the amount of water she consumed leading up to that."
Delayed Response and Tragic Outcome
At 11:55 AM, Shipley collapsed on her bed, vomiting and defecating. CCTV footage showed her "spasming" in her cell. Prison guards did not notice her condition until 1:15 PM, despite officers walking past her cell at 12:27 PM and 12:41 PM. Dwyer explained that their view was obstructed by blinds, but if someone had looked inside, they would have seen Shipley seizing on the bed.
It was not until a prison officer opened the hatch on the cell door and attempted to speak to Shipley that the alarm was raised. A prison psychiatrist attended as part of a scheduled visit, followed by two prison nurses at 1:35 PM. They discovered Shipley was non-responsive, and despite attempts at CPR, she could not be revived.
Autopsy Findings and Ongoing Investigation
An autopsy determined Shipley's cause of death was hyponatremia, caused by extremely low sodium levels due to polydipsia (unquenchable thirst) and complications of schizoaffective disorder. The coroner is now examining whether adequate mental health indicators exist in police and custodial management systems to assist in managing individuals with complex mental health issues.
The inquest suggests the system could be updated to notify police, similar to protocols used for family violence history warnings. The investigation follows a Supreme Court ruling that the coroner's jurisdiction extends to the circumstances in which Shipley came to be and remained in custody while mentally unwell.
The inquest is ongoing, highlighting systemic issues in custodial care for individuals with mental health conditions. Indigenous Australians can contact support services such as 13YARN, Lifeline, Mensline, or Beyond Blue for crisis assistance.
