any related underlying social, cultural and legal issues. Commissioner Muirhead said that his job entailed not just understanding how each person died, but why that person died. The Commission was established on 16 October 1987. Federal Court judge James Henry Muirhead was appointed Chair of the Commission and initially was the sole Commissioner (leading to the Commission sometimes being referred to as the "Muirhead Commission"). At the time, the number of deaths to be investigated were believed to be about 44, but after it was discovered that there was a much larger number of deaths needing investigation, a further five commissioners were appointed: D.J. O'Dea; Hal Wootten; L.F. Wyvill; Elliott Johnston; and Patrick Dodson. Wootten was a former judge of the Supreme Court of New South Wales; and Johnston was a judge of the Supreme Court of South Australia. Dodson was the only Indigenous Commissioner, but was not legally trained. Johnston replaced Muirhead as the national commissioner on 28 April 1989. Aboriginal activist Rob Riley was appointed Head of the Aboriginal Issues Unit of the Commission until Ruby Hammond replaced him in 1990. Among the 99 cases investigated by the Commission were the deaths of rugby player Eddie Murray in 1981 at the Wee Waa police station, and the death of John Pat, a 16-year-old Aboriginal boy, at Roebourne, Western Australia in 1983. Commissioner Johnston was critical of the lack of any disciplinary charges against the five officers implicated in the violent death of the Aboriginal boy, calling this "a most unsatisfactory state of affairs". The Commission held public hearings and community meetings where deaths occurred, with the Commission conducting internal and commissioned research. It also received submissions from organisations and individuals, including family members of victims, and delivered issues papers (46, of which 21 were produced by the Commission's research unit). The Commission's Interim Report was issued on 21 December 1988, and the Final Report in April 1991. Final report The Commission's final report was published in April 1991, and concluded that the 99 deaths investigated were not due to police violence: "... the immediate causes of the deaths do not include foul play, in the sense of unlawful, deliberate killing of Aboriginal prisoners by police and prison officers. More than one-third of the deaths (37) were from disease; 30 were self-inflicted hangings; 23 were caused by other forms of external trauma, especially head injuries; and 9 were immediately