Prevention of Future Deaths reports · 2015
Regulation 28 report to prevent future deaths, reference 2015-0125, written 16 Mar 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 16 Mar 2015 |
|---|---|
| Reference | 2015-0125 |
| Deceased | Joshua Booth |
| Coroner | Stuart Fisher |
| Coroner area | Lincolnshire (Central) |
| 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.
HM CORONER Central Lincolnshire REGULATION 28 REPORT TO PREVENT FUTURE DEATHS THIS REPORT IS BEING SENT TO: 43 a «i: Operating Officer, Lincolnshire County Council CORONER | am Stuart P G Fisher, Senior Coroner, for the coroner area of Central Lincolnshire, Lindum House, 10 Queen Street, Spilsby, Lincolnshire, PE23 5JE. 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. http://www. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 http://www. legislation.gov.uk/uksi/2013/1629/part/7/made INVESTIGATION and INQUEST On 22" September 2014 | commenced an investigation into the death of Joshua David Booth, Aged 22 years. The investigation concluded at the end of the inquest on 11" March 2015. The conclusion of the inquest was that Mr Booth died as a result of a Road Traffic Collision, the medical cause of death being: fda. Multiple Injuries CIRCUMSTANCES OF THE DEATH On 14" September 2014, Mr Booth was travelling westbound along a road which runs parallel with Fodder Drain. When he was approxiametely 275 metres east of Hobhole Drain he drove over a heavily subsided section of road which, in part, caused him to lose control of his Peugeot 206 Motor Vehicle resulting in him leaving the road to his offside, following which the vehicle collided with a wooden post at the foot of the bank and somersaulted into Fodder Drain. Mr Booth sustained fatal injuries. Full details of the incident and investigation are set out in Police Constable Holloway's report, a copy of which has been made available to Officers of your department. 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. — (I) The subsided section of road is seriously substandard and a danger to passing motorists and formed a contributory factor to Mr Booth's death. The section of road requires immediate repair. (Il) Appropriate signage needs to be erected to warn of the imminent danger of the road subsidence. The signage needs to be closer to the section of road in question and should include an appropriate advisory speed limit. 1 (Ill) The posts at the foot of the bank constitute a serious danger to vehicles leaving this section of road. An Armco barrier should be erected along this section of the road to provide security to passing motorists. 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. YOUR RESPONSE You are under a duty to respond to this report within 56 days of the date of this report, namely by a1 May 2015.1, 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 (a) (b) | 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. 16 Match 2015 al [sone S P G Fisher nN Senior Coroner
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.
11 MAY ang Lincolnshire’ COUNTY COUNCIL Ref: | Date: 7 May 2015 Chief Operating Officer, Development Services Mr S P G Fisher 4" Floor, City Hall, Senior Coroner Lincoln Lindum House LN1 1DN 10 Queen Street Email: SPILSBY Tel: (01522) 553002 PE23 5JEl . Dear Mr Fisher, REGULATION 28 REPORT - JOSHUA DAVID BOOTH (DECEASED) Thank you for your Regulation 28 Report dated 16 March 2015 issued following the inquest investigating the death of the late Mr Joshua David Booth. As required under Section 7 of your report, | make the following response. The County Council in considering your concerns would respond as follows:- 1. The discrete section of road identified in your report which had been subject to subsidence has now been levelled with bituminous material to provide a more regular surface for the public. 2. Signage exists at regular intervals along the section of Fodderdyke Bank between Stickney and Friskney. Temporary signage was erected which includes the area which has now been repaired. This signage advising of uneven road surface has been left in place and supplements the existing permanent signs. The "uneven road" signage in the area is subject to regular inspection and review. 3. Following an earlier review there is an advisory speed limit of 40 mph on Fodderdyke Bank which is signed accordingly. 4. The posts at the foot of the Bank have been placed by the Drainage Board to provide structural support to the embankment and the road construction above. This - type of support is standard practice and is present in numerous locations. Provision of Safety Barrier protection in this location now that the depression has been removed would increase the expectations for barriers in all other locations where toe piling has been placed. oe Yi County Offices, Newland, Lincoln LN1 1YL INVESTOR IN PEOPLE www.lincolnshire.gov.uk Due to the nature of the embankments (constructed from a mixture of clay, peat and silts in general) there is not enough strength to enable safety barriers to be erected without significant structural works to support the barrier. The cost of providing barriers would be excessive and divert resources from repairing the defects and failings in the road construction throughout the County and would not be best use of limited resources. | trust that the above response is satisfactory. Yours sincerely Steve Willis Chief Operating Officer, Development Services 4/4
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