Coroner to examine response to snakebite death of young boy, not child safety system

News.com.au

27-05-2025

The circumstances surrounding the death of 11-year-old Tristian James Frahm will remain the central focus of a coronial inquest set to begin next month.
However, in a hearing on May 12, the Coroners Court ruled that broader concerns raised by his maternal family about alleged systemic failures in Queensland's child protection system will not be investigated.
Although the coroner has ruled that certain phone records from key witnesses will form part of the evidence, as they may shed light on the events surrounding Tristian's death.
Tristian, who died in November 2021 after being bitten by a brown snake on a remote property near Murgon in Queensland's South Burnett region, had moved to the area in 2020 to live with his father, Kerrod Frahm, who was initially charged with his manslaughter – a charge later discontinued.
Coroner Ainslie Kirkegaard said the maternal family had sought to expand the scope of the inquest to examine whether Child Safety failed to remove Tristian from his father's care 'before a serious incident occurred'.
Tristian's father opposed the move.
The maternal family had submitted that Tristian's death was foreseeable and pointed to previous incidents involving lack of supervision, unsafe conditions, and inadequate medical care.
They argued these factors should be examined in light of systemic flaws in how Child Safety assesses risk and manages cross-jurisdictional concerns.
But the Ms Kirkegaard concluded that while these concerns were serious, they were not causally proximate to Tristian's death.
During a pre-inquest hearing in April, Counsel Assisting the Coroner Sarah Ford outlined the harrowing events of Tristian's final hours.
Ms Ford said that on the afternoon of November 20, 2021, Mr Frahm and Tristian were at the property for a birthday gathering with Mr Frahm's friends, Rachelle Dorman and Jacob Bryant. Two other boys were also at the property.
Ms Ford said on that afternoon, Tristian and another boy were riding a mower on a rural property when Tristian fell off and told the boy he had been bitten by a snake.
The boy returned to the house for help, and Tristian's father, Mr Frahm, went to check on him.
However, Mr Frahm reportedly believed his son may have been concussed or intoxicated rather than bitten, telling police that Tristian appeared 'a little dazed or concussed.'
Despite various witness recollections, some stating Tristian mentioned a snake bite - others recalled he later said it was a stick, no immediate medical assistance was sought.
'Mr Bryant recalls that Tristian was barely able to stand and was trying to half talk but was slurring his words,' Ms Ford said.
Instead, the adults reportedly assumed Tristian was drunk after being told he had 'stolen some beers' from Mr Frahm's Esky.
He was told to 'sleep it off' and lay down in a donga, a temporary accommodation unit, before vomiting and later rejoining the group.
By late that evening, the boy was in clear distress.
Two other boys staying at the property said Tristian complained of stomach pain, vomited repeatedly, and at one point fell out of the donga door.
The boys attempted to wake Mr Frahm, who was asleep on a couch, and later spoke with Mr Frahm's friend, Ms Dorman, who allegedly believed Tristian was simply 'grog sick.'
She told the boy to give Tristian some water and 'lie him on his side'.
The following morning, at about 7am, Mr Frahm reportedly found Tristian lying face down outside the donga, covered with a blanket.
'Unable to rouse Tristian, Mr Frahm realised he had passed away,' Ms Ford said.
She told the court that Mr Frahm did not immediately call triple-0.
Instead, he got into a car and drove toward town, phoning his mother on the way.
She made the emergency call at 8.56am, almost two hours after Tristian was discovered.
Paramedics arrived to find five patches of vomit within 20 metres of Tristian's body.
Two marks on his right ankle were later confirmed to be snake bite puncture wounds.
An autopsy determined the cause of death was brown snake envenomation.
Ms Ford told the court an expert would testify that immediate medical attention could have likely prevented Tristian's death.
Ms Kirkegaard said Tristian's upbringing was marked by instability, with periods spent living with both parents and extended relatives.
Child Safety had previously been notified of concerns, including possible exposure to domestic violence and emotional harm.
In May 2021, six months before Tristian's death, his father was involved in a physical assault that triggered renewed departmental involvement.
However, by August that year, Child Safety determined that Tristian was not in need of protection, referring the family to intensive support services.
Ms Kirkegaard acknowledged the complex and painful history between Tristian's parents, noting that both sides of Tristian's family had accused each other of 'domestic and family violence, substance misuse, excessive discipline, and child neglect'.
She said a systemic child death review conducted after Tristian's death identified 'missed opportunities' for child safety officers to better understand the domestic and family violence risks.
However, she noted the review did not find grounds to remove Tristian from his father's care.
'The snake bite tragically occurred in the context of a young boy who was enjoying his time with family on the property, doing something that made him happy,' Ms Kirkegaard said.
'It did not occur because of his father's domestically violent behaviours.'
Reports from Child Safety, police and the Department of Education indicated none of the agencies had reason to suspect Tristian was at substantial risk.
The coroner also pointed to the Department of Education's review, which described Tristian's love for his father, his protective relationship with his father's partner, and his strong school attendance.
'On the evidence before me, I consider the additional potential systemic issues proposed by the maternal family lack sufficient proximity and causal relevance,' Ms Kirkegaard said.
Applying a 'common sense test', the coroner said she found no sufficient causal connection between alleged systemic failings and the specific event – the snake envenomation.
However, Ms Kirkegaard did accept seven issues raised by Tristian's maternal family as relevant to the inquest, including that mobile phone data from Mr Frahm, Ms Dorman, and Mr Bryant should be added to the inquest brief.
She dismissed objections from Tristian's father, who argued the records were irrelevant, finding instead that the communications could shed light on the actions of the adults present between November 20 and 21, 2021 – the period when Tristian was bitten by a snake and later died.
At the beginning of the hearing, Ms Kirkegaard acknowledged the young boy at the centre of the inquest. She had earlier invited family members to share reflections so the court could better understand who Tristian was beyond the circumstances of his death.
'Tristian was an 11-year-old First Nations boy with striking blue eyes who felt a deep connection with animals and loved spending time in nature. He was full of energy and adventure,' Ms Kirkegaard said.
'A young boy who, according to the maternal family's Family Statement, was known for his deep connection to the earth, and his love of outdoor activities including riding bicycles and motorbikes.'