Prevention of Future Deaths reports · 2014
Regulation 28 report to prevent future deaths, reference 2014-0338, written 23 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 | 23 Jul 2014 |
|---|---|
| Reference | 2014-0338 |
| Deceased | Kenneth Paul |
| Coroner | ARW Forrest |
| Coroner area | South Lincolnshire |
| Category | Road (Highways Safety) related deaths |
| Source | judiciary.uk record · original PDF |
| Responses published | none published |
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.
A R W Forrest im, ercp, FRcPath GMC Number: 1333523 Her Majesty's Senior Coroner for South Lincolnshire 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. The Right Honorable John Hayes MP, Minister of State for Transport, Great Minster House, 33 Horseferry Road, London SW1P 4DR 1 | CORONER Wale: | am ARW Forrest, Senior Coroner for the Coroner's area of South Lincolnshire. : id i 2 | 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. 3 | INVESTIGATION and INQUEST if On 6" December 2013 | commenced an investigation into the death of Kenneth John PAUL, age 61. The investigation concluded at the end of the inquest on 22™ July 2014. The conclusion of the inquest was ACCIDENT 4 | CIRCUMSTANCES OF THE DEATH Kenneth Paul was a man with a number of medical problems. In particular, he had impairment of his peripheral vision and unsteadiness of his gait due to strokes affecting the left side of his body. Shortly before 11am on the morning of 29" November 2013 he left his home To as he did most days. His usual practice was to walk diagonally across Hallgate to the side opposite his house on his way into the town centre. a UPS driver, had just collected parcels from 1 Stukeley Road, at its junction with Hallgate. He then reversed along Hallgate Road towards the town centre for a distance of around 25 metres, intending to turn left into Church Road. During that traverse, probably at the beginning of it,his vehicle travelled over Mr Paul. It is not Za ; known whether or not Mr Paul was upright or prone when the rear of BF crc AR W Forrest iu, rrcp, FRcPath GMC Number: 1333523 Her Majesty's Senior Coroner for South Lincolnshire passed over him. Mr Paul sustained fatal injuries. 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. ° That the delivery vehicle, a Mercedes Sprinter that collided with Mr Paul, a vehicle with no windows behind the driver's position, was not fitted with an audible warning device that operated automatically when reverse gear was engaged and there is no legislative requirement for such a device to be fitted to light commercial vehicles of this type. ACTION SHOULD BE TAKEN In my opinion action should be taken to prevent future deaths and | believe you and/or your organisation 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 16" September 2014. |, 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. COPIES and PUBLICATION | have sent a copy of my report to the Chief Coroner and to the following Interested Persons: 3. DAC Beachcroft Claims Ltd, 3 Hardman Street, Manchester, M3 3HF 4. Inspector [E”’ Floor, Witham House, The Pelham Centre, Canwick Rd, Lincoln, Lincolnshire,_LN5 8HE 23” July 2014 AR W Forrest iw, rrcp, Frcpath GMC Number: 1333523 Her Majesty's Senior Coroner for South Lincolnshire 5. Cllr Nick Worth, Email: : ! 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. ARW Forrest H M Senior Coroner for South Lincolnshire Unit 1, Gilbert Drive, Endeavour Park, Boston PE21 7TQ Tel: 01522 553374 Fax: 01522 516717 Email: HMCoroner_Southlincolnshire@lincolnshire.gov.uk
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