Gavin Roberts — PFD report 2014-0120

Date of report	14 Mar 2014
Reference	2014-0120
Deceased	Gavin Roberts
Coroner	Nicola Mundy
Coroner area	Rotherham
Category	Road (Highways Safety) related deaths
Source	judiciary.uk record · original PDF
Responses published	1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

ANNEX A

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. Highways Division, Rotherham Metropolitan Borough Council

1

CORONER

I am NJ. Mundy, Senior Coroner, for the coroner area of Rotherham.

2

CORONER’S LEGAL POWERS

I 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.

3

INVESTIGATION and INQUEST

On 30th October 2013 I commenced an investigation into the death of Gavin Anthony
ROBERTS, age 25 years. The investigation concluded at the end of the inquest on the
12th of March 2014. The conclusion of the inquest was Accidental death - on 24 of
October 2013 Gavin Anthony Roberts was riding his motorcycle along Hollings Lane
only days after having passed his test. Significantly underflated tyres were a major
factor in loss of control of his motorcycle which led to a fatal collision with an oncoming
vehicle. The medical cause of death was 1a) traumatic cerebral and multi-organ injuries
and fractures, 1b) road traffic collision.

4

CIRCUMSTANCES OF THE DEATH

Gavin Anthony Roberts was travelling along Hollings Lane in the direction of Thrybergh
on his motorcycle. The road narrows to a bridge on the Hollings Road prior to which the
road first bends slightly to the right before straightening and bending to the left. Visibility
of oncoming vehicles on the approach to the bridge is extremely restricted due to the
high walls and fencing of the bridge, hedging and the bends in the road. Mr Roberts had
completed an overtaking manoeuvre on the approach to the bridge, lost control on the
left hand bend and came off his motorcycle directly into the path of an oncoming vehicle,
the driver of which had no prior warning of the presence of Mr Roberts on the road due
to the limited visibility described. Shortly prior to the bridge in both directions the speed
limit increases from 40 to 60 miles per hour. There are street lights along this stretch
albeit more than 187 metres apart. Although under inflated tyres on the motorcycle was
a significant factor in these events, the collision investigator gave evidence that he had
calculated that the maximum speed at which the bend can be safely negotiated is 48
miles per hour (despite there being a 60 mile per hour speed restriction in place).
Despite warning signs with ‘slow’ painted on the road and warning signs on the
approach to the bridge in each direction, there have been 25 collisions at this location in
the last 5 years.

1

5

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) The current speed restriction of 60 mph is higher than the maximum speed at which
The bend can safely be negotiated.
(2) The speed restriction actually increases from 40 mph to 60 mph on the approach to
the bridge.
(3) The of warning signs appear to be inadequate in the presence
of (1) and (2) above given the number of recorded incidents at this location.

6

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe Rotherham
Metropolitan Borough Council’s Highway Division have the power to take such action.

7

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by the 8th of May 2014 .I, 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

I have sent a copy of my report to the Chief Coroner and to the following Interested
parents. I have also sent it to PS A.
Persons
Noble, South Yorkshire Police who may find it useful or of interest.

I 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

[14.03.2014] [Ms N J Mundy Senior Coroner]

2

3

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 Rotherham Metropolitan Borough Council

Rotherham »
Metropolitan
Borough Council

Where  Everyone  Matters

R E C E I V E D

0 1 bW 20W

30 April 2014

Bm1225
Environment & Development Services
Riverside House| Main Street | Rotherham] S60 1AE

My Reference 

Your Reference 

Please ask for

Ms N J Mundy
Senior Coroner
South Yorkshire (East District)
Coroner’s Court and Office
5 Union Street
Off St Sepulchre Gate West
DONCASTER 
DN1 3AE

Dear Ms Mundy

Gavin  Anthony Roberts, deceased

I refer to your letter dated 18 March 2014 and the attached report regarding the inquest
into the death of Gavin Anthony Roberts.

We have noted your concerns about the speed limit and warning signs currently in place
on the  section of Rollings Lane where the fatal collision took place. As a result we have
carried out an investigation that has involved looking at the number and circumstances of
collisions that have taken place, the speed of traffic, the suitability of the current speed
limit and the  adequacy of existing warning signs.

In terms of collisions our database, which contains details of injury collisions supplied by
South Yorkshire Police, shows there have been 7 collisions in the last 5 years (2009 to
2013 inclusive) involving injury on the section of Rollings Lane where the national speed
limit currently applies. Two  of the collisions resulted in a fatal and a serious injury being
sustained with the other five involving slight injuries. Four of the seven collisions involved
a vehicle losing control on the bend near the bridge when travelling towards Thrybergh,
with one of these being the fatal collision involving Gavin Anthony Roberts. The other 3
collisions at this location resulted in slight injuries being sustained. All of the drivers
involved in these 4 collisions were 25  years of age  or younger.

Speed surveys have been carried out on 2 sections of Rollings Lane, location A - 110
metres east of the bridge where the national speed limit applies and location B - 440
metres east of the bridge where the speed limit is 40 mph. At location A the  85th percentile
speed (the speed at which 85 per  cent of motorists travel at or below and which is used
when setting speed limits) was found to be 44mph towards Thrybergh and 46mph towards
Ravenfield both of which are within the speed limit. Measurements taken at location B
show speeds to be 49mph in each direction which are in excess of the posted speed limit.

In order to reduce the number of collisions taking place and to ensure the speed limit is
more appropriate to the characteristics, environment and measured speeds on the  road, it
is proposed to amend the speed limit to 50 mph, subject to cgigS| the necessary
approvals and  agreements, as shown on the attached plan. EQUALITY

r

i 
www.rotnerham.gov.uk 

I 

■ 

\ 

f 
INVESTORS  I  r
M.  V  i\i  ppnpi  E  Gold 
IN  r t U H L t   I 

FRAMEWORK
FOR LOCAL
GOVERNMENT
EXCELLENT

 Bm1225

- 2 -

This will involve reducing the speed limit where the national speed limit currently applies
and raising a short section of the existing 40 mph limit so that the 40 mph limit
commences on the Thrybergh side of the car repair garage.

In addition, it is planned to improve the warning of the bend near the railway bridge when
travelling towards Thrybergh by providing a new bend warning sign, reflective verge
marker posts around the bend and repainting an existing ‘SLOW’ marking. These
proposals are also shown on the attached drawing.

An order will be issued to our contractor to implement the signing improvements in the
next two weeks. Changing the speed limit will take longer to achieve due to the need to
prepare legal orders and carry out consultations with interested parties and could take up
to 9 months.

If you require further information or clarification of any issue please do not hesitate to
contact me.

Yours sincerely

Senior Engineer, Transportation & Highway Projects
Streetpride Service

Enclosure

 £/

_
_
_
_
_
_
_
_
_
_

'

Y

,

e
g
n
a
h
c
d
e
s
o
p
o
r
P

t
i

m

i
l

d
e
e
p
s

n

i

/

i
:

/
(cid:127)
(

/

l

s
e
c
h
e
v

i

e
l
t
i
T

f

o

d
e
e
p
s

e

l
i
t

n
e
c
r
e
p

h

t

5
8

,

h
p
m
9
4

h
p
m
9
4

n
m
u
o
c

l

g
n

i
t

h
g

i
l

t

e
e
r
t
s
g
n

i

i
t
s
x
e

n
o
d
e

t

n
u
o
m
2
1
5
m
a
r
g
a
D
o

i

t

.

V

\

v VV

u

?
IIII

IIII

h
p
m
0
5
d
e
s
o
p
o
r
P

t
i

m

i
l

d
e
e
p
s

d
e
v
o
m
e
r

e
b

o

t

e
g
n
a
h
c

i

i

n
g
s
g
n
n
r
a
w
d
n
e
b

d
n
a
h

t
f

e
L

d
e

t

i

n
a
p
e
r

e
b

o

t

i

g
n
k
r
a
m

W
O
L
S
g
n

i
t
s

i

x
E

4
2
0
1
m
a
r
g
a
D

i

l

s
e
c
h
e
v

i

f

o

d
e
e
p
s

e

l
i
t

n
e
c
r
e
p

h

t

5
8

f

:

h
p
m
6
4

h
p
m
4
4

r
o

,

n
o
d
s
a
G
y
b

l

t
s
o
p
X
R

r
e

t
s
a
m
e
g
r
e
V

k
c
a
b

e
h

t

t

a
s
e
r
t

e
m
5

y
r
e
v
e
d
e
c
a
p
S

.

d
e
v
o
r
p
p
a
r
a

l
i

m
s

i

.
y
a
w
o
o

t

f

f

o

t

n
e
m
e
v
o
r
p
m

i

y
t

e

f

a
s
d
a
o
r
d
n
a

t
i

m

i
l

d
e
e
p
s
h
p
m
0
5

l

a

i
t

n
e

t

o
P

s
e
r
u
s
a
e
m

h
g
r
e
b
y
r
h
T

,

e
n
a
L
s
g
n

i
I
I

o
H

0
0
0
2

:

1

y
b

.

d
h
C

I

.

v
e
R

4
1
0
2

l
i
r
p
A

n
o

i
t
p

i
r
c
s
e
D

l
i

c
n
u
o
C
h
g
u
o
r
o
B
n
a
t
i
l

o
p
o
r
t
e
M
m
a
h
r
e
h
t
o
R

s
e
c

i

v
r
e
S
t
n
e
m
p
o

l

e
v
e
D
&

t
n
e
m
n
o
r
i

v
n
E

,

d
a
o
R
h
s
r
a
m
w
a
R

,

e
s
u
o
H
y
e

l
i

a
B

D
T
1
0
S
S

m
a
h
r
e
h
t
o
R

&

t
n
e
m
n
o
r
i

v
n
E

i

s
e
c
v
r
e
S

t
n
e
m
p
o

l

e
v
e
D

I
-
T
T
R
M
L
F
T
M

)
s
n
o
H

(
c
s
B
y
b
s
r
a
t
r
a
B

t
r
a
K

r
o
t
c
e
r
i
D
c
g
e
t
a
r
t
S

i

Related reports

Other reports by Nicola Mundy

See all →

More reports categorised “Road (Highways Safety) related deaths”

See all →

Track Road (Highways Safety) related deaths

See every Prevention of Future Deaths report matching Road (Highways Safety) related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.