Prevention of Future Deaths reports · 2014

John Grooby

Regulation 28 report to prevent future deaths, reference 2014-0054, written 7 Feb 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Feb 2014
Reference2014-0054
DeceasedJohn Grooby
CoronerSean McGovern
Coroner areaWarwickshire
CategoryRoad (Highways Safety) related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Chief Executive - Warwickshire County Council f

4

CORONER

lam S McGovern, Senior Coroner, for the coroner area of Warwickshire

CORONER’S LEGAL POWERS

| make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

INVESTIGATION and INQUEST

On 8 November 2013 | commenced an investigation into the death of John William
GROOBY. The investigation concluded at the end of the inquest on 7 February 2014.
The conclusion of the inquest was Accidental Death.

CIRCUMSTANCES OF THE DEATH

Mr Grooby was a motorcyclist who was struck by a deer on the A3400 between
Tredington and Shipton on Stour on 24 October 2013.

CORONER’S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths will occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) Lack of any signage to warn motorists that deer use this area as a “game track”.

| __
ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you as Chief
Executive of the Trust have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 6" October 2013. |, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out

the timetable for action. Otherwise you must explain why no action is proposed.

8 | COPIES and PUBLICATION

Lhave sent a copy of my report to the following Interested Persons Oo ‘|
(Widow)

| am also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, the coroner, at the time of your
response, about the release or the publication of your response by the Chief Coroner.

9 | 7” February 2014 i
Senior Coroner S McGovern

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Warwickshire County Council (PDF)
Your ref: Warwickshire

Our ref: ME17451/Grooby Cou nty Council
Resources Group
F.A.O. Sally Hunt P.O. Box 9, Shire Hall
* i Warwick, CV34 4RR
Coroner's Office DX 723362 Warwick 5

Warwickshire Justice Centre
Newbold Terrace

Leamington Spa Head of Law and Governance

CV32 4EL
Tel: 01926 412319 Fax: 01926 412946
E-mail

20 March 2014

Dear Ms Hunt

Response of Warwickshire County Council to Report to Prevent Future Deaths issued
by Mr McGovern, Senior Coroner dated 7 February 2014 following an inquest into the
death of John William Grooby

Mr Grooby died as a result of a road traffic collision on 24 October 2013. He was travelling
along the A3400, approximately 100m south of Puck Pits Farm near Shipston on Stour, on
his motorcycle at 14.30pm.

Notification of the collision was i ie County Council on or around 13 November
2013. Following this «is Road Safety Engineer, from the Traffic and
Road Safety Group attended the site with Of Warwickshire Police’s Road
Safety Team. This site visit is a normal procedure following any fatal road accident. The
notes of this visit indicated a lack of warning signs to alert drivers of the possibility of deer in
the road.

The County Council assesses the need for the introduction of road signs according to the
type of sign and the location. It also considers the cost benefit of introducing signs,
particularly with regard to the future prevention of road accidents.

pc EB vas notified by a colleague rca prior to the site visit, that there

were records of non-injury related accidents along this stretch of road involving deer. PC
had recorded 5 previous incidents since 2010. This information was new to the
County Council, and informed officers of the tendency for deer to be present in the road at
this location.

The accident data base has been interrogated to determine the frequency of collisions with
wild animals across the county and the locations where such accidents occur. The
information for the last 5 years (01/02/2009 to 31/1/2014) shows there have been 29
recorded injury crashes with animals. Of these crashes 10 were recorded where a vehicle
has hit a deer in the road. Of these 10 crashes, seven involved motorcyclists. It is clear from
this evidence that motorcyclists are particularly vulnerable when in collision with deer in the

road.
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There are no previously recorded injury accidents involving deer at this location.

The total cost of improvements requested in a year exceeds the budget available by many
times. The council determines the Casualty Reduction Scheme budget each year by
balancing the need to reduce road casualties against its other priorities. The casualty
reduction scheme budget is prioritised by cost effectiveness — that is the schemes which are
expected to prevent the most casualties for each thousand pounds invested.

The cost of introducing deer warning signs in this location is approximately £600.

The guidance provided by the Department for Transport in the Traffic Signs Regulations and
General Directions 2002, Chapter 4 (2013) Warning Signs, states that:

Signs to Diagram 551 (wild animals) may be used wherever such animals are likely to be
found in the road.

There are no legal duties to erect signs warning of Deer or other wild animals in the road; it
is left for the Highway Authority to determine if it is relevant or necessary on a case by case
basis.

Warwickshire County Council has reviewed the evidence supporting the Coroner’s view that
action should be taken to prevent future similar deaths by introducing signs to warn motorists
that deer use this area as a ‘game track’ and the decision has been taken to introduce signs
on this section of the A3400. An instruction has been passed to the Council’s contractors to
install two signs. These signs are in accordance with the Traffic Signs, Regulations and
General Directions 2002, signs to diagram 551 “Wild animals likely to be in the road”.

The order for the installation of the signs was raised on 12 February 2014. An estimated time
for installation is approx. 6-8 weeks.

Yours sincerely

Head of Law & Governance

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