Prevention of Future Deaths reports · 2014
Regulation 28 report to prevent future deaths, reference 2014-0314, written 2 Jul 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 2 Jul 2014 |
|---|---|
| Reference | 2014-0314 |
| Deceased | Beryl Brinkman |
| Coroner | Lisa Hashmi |
| Coroner area | Manchester North |
| Category | Road (Highways Safety) related deaths |
| Source | judiciary.uk record · original PDF |
| Responses published | 1 |
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) REGULATION 28 REPORT TO PREVENT FUTURE DEATHS THIS REPORT IS BEING SENT TO: 41. Road Safety Casualty Reduction Team, Rochdale MBC CORONER 1am Assistant Coroner for the coroner area of Manchester North CORONER’S LEGAL POWERS | make this report under paragraph 7, Schedule 5, of the Coroner's and Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013 INVESTIGATION and INQUEST On the 10" January 2014 | commenced an investigation into the death of Miss Beryl Brinkman. Miss Brinkman died on the 10" January 2014 at the Royal Oldham Hospital. The medical cause of death was 1a) multiple injuries and whilst not causative but contributory 2) ischaemic and valvular heart disease and bronchopneumonia. CIRCUMSTANCES OF DEATH On the 8" January 2014 shortly before 8 pm, Miss Brinkman was driving her car and emerged from a side road (an un-adopted highway known locally as ‘the ramp’) onto the main road (an adopted highway known as the A58 Featherstall Road, Littleborough). She was subsequently involved in a serious road traffic collision. The deceased suffered catastrophic injuries, with another driver suffering serious but non-life threatening injuries. Two others people (including a child) were involved in the crash; they were unhurt. It was found, on the balance of probabilities, that the deceased did not ‘give way’ due to the phenomenon of involuntary acceleration. Irrespective, during the course of the evidence at inquest and as a result of the serious collision unit investigation it became apparent that the driver's view from ‘the ramp’ of the oncoming traffic travelling on the A58 (particularly from the right hand side) would have been significantly impaired by the presence of a number of parked vehicles . The vehicles in question were legitimately parked in pre-marked bays. Greater Manchester Police explained that they were aware of this hazard and that they had been trying to engage the Local Authority, with a view to reviewing the appropriateness/proximity of the parking bays in relation to the junction. However, the Local Authority's view was that as ‘the ramp’ is an un-adopted highway there was little, if anything, that it could do. For clarity, the parking bays in question are on the A58 which is an adopted highway. The area itself is busy, residential and the ramp leads to community facilities including a Church and a Hall. There are also small retail businesses in the vicinity. 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 proximity of the parking bays to the junction, resulting in a marked reduction of driver visibility when emerging on to the A58/parked cars are present. 2. The serious risk of harm/death to road users/pedestrians. 3. The appropriateness of the parking bays. 4. Whether ‘the ramp’ ought to be designated as an adopted highway. ACTION SHOULD BE TAKEN YOUR RESPONSE You are under a duty to respond to this report within 56 days of the date of this report, namely the 28" August 2014, |, the Assistant 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. COPIES and PUBLICATION | have sent a copy of my report to the Chief Coroner and to the following Interested Persons namely: - the Deceased’s family - Greater Manchester Police Traffic Unit - Chief Executive (Rochdale MBC) - The Deceased’s motor insurers lam 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 from. 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. 4. Date: 2™ July 2014 Signed: phkwo—
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.
Economy and Environment Service Director Mark Widdup x Highways & Engineering Service ROCH DAL E aS yp Head of Service Floor 4, No.1 Riverside, FAO Simon Nelson Smith Street, Rochdale, OL16 1XU HM Coroner’s Court ld The Phoenix Centre polephone: L/Cpl Stephen Shaw MC Way Web Site: www.rochdale.gov.uk Heywood OL10 1LR Our Ref. Enquiries: Extension: Date: 14” July 2014 Dear Mr Nelson, Re: Road Traffic Collision - Beryl Brinkman | write in response to your Regulation 28 notice issued on 2nd July 2014, As with any serious and fatal collision, it is normal protocol that on receipt of the Police Incident Report the Road Safety Team carries out a full review and site visit to determine any possible highway issues which may have had an impact on the accident. In relation to this event, a copy of the Serious Incident Police Report was received on Friday the 10th January 2014, with a follow up Fatal Report on the 13th January 2014. In order to build up a picture of any previous incidents the accident database was reviewed and results showed that there had been only one recorded personal injury accident at this junction in the last 12 years, as such; the site was not on the priority list for action. Reviewing the report and looking at the junction in question, it appeared that parked vehicles could have played a part in restricting the visibility in the westerly direction. After communication with Fs (the church representative) an the Road Safety Officer met with on site on the 22nd January to discuss the possibility of removing the parking bays and the introduction of ‘At Any Time’ restrictions on the A58. A commissioning form was submitted to Pennines Township for funding on the 23rd January and received approval on the 18th February. The Network Management Team is currently working on the scheme and the introducing the waiting restrictions. Site visits have been undertaken and a report is to be presented at the next available traffic Management Unit Meeting, legal orders will be drafted and advertised for a period of 28 days after this meeting. Subject to any formal objections being received it is anticipated that this process will be completed and proposed restrictions introduced within the next four months. The proposals are to remove the existing parking bays and introduce ‘At Any Time’ waiting restrictions for a minimum distance of 15metres on the A58 to the westerly side of the access road. Similar restrictions are already in place on the easterly side of the access road along the A58. With regard to the Greater Manchester Police statement that they approached the Local Authority prior to the incident, | have made enquiries within the department and we have no record as to any approaches being made with regard to problems at this location. There is no record via the monthly Traffic Management Unit Meetings (which the Police attend) or any other channel into the department. Greater Manchester Police raised the issue with the Highway Authority at the Traffic Management Unit Meeting on the 20th February, after the incident. Yours Sincerely Head of Property, Highways and Facilities Management
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