The death of Maurice Murtagh was, like so many deaths, a tragic waste of a life.
One can only hope that in death the young man will be able to effect change.
The tale heard in this week's Coroner's inquest was a sorry one. The 20-year-old was a known solventabuser and alcohol and drug addict who often slept rough on Rotorua's streets.
He was found unconscious alongside a lighter and two deodorant cans in a hotel carpark near the lake and was taken to hospital where he had a cardiac arrest.
He was later discharged into the care of hospice at his mother's house, where he died.
It's a sad and sorry tale for several reasons, not least because the various agencies involved in dealing with Maurice and cases like his felt restricted by process, red tape or inadequate resourcing.
Could more have been done to save him? That's the question Coroner Michael Robb is hoping to answer and we must hope he does.
Maurice was deemed an addict but did not meet the definition required of suffering severe mental illness. Even though he was clearly a danger to himself.
How frustrating must the roadblocks have been for the mental health team trying to help him. A social worker tried to get the necessary documentation for him to be admitted into a residential facility, but it was hampered for several reasons, including that he couldn't get a Work and Income benefit because some banks didn't want him as a customer.
There was also a shortage of detoxification beds, which would help him get into a rehabilitation facility.
Maurice was also reluctant to get help and would often miss medical appointments.
But that's not surprising behaviour from an addict and it doesn't lessen his dire need for help.
Coroner Robb said his findings would aim to improve the way social service and government agencies work together to reduce the risk to others.
When the findings are released, the powers that be need to ensure that aim hits its target.
