Prevention of Future Deaths reports · 2017
Regulation 28 report to prevent future deaths, reference 2017-0122, written 13 Apr 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 13 Apr 2017 |
|---|---|
| Reference | 2017-0122 |
| Deceased | Daniel Campbell |
| Coroner | Tony Brown |
| Coroner area | North Northumberland |
| Category | Railway 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.
Tony Brown LLM H M Senior Coroner 17 Church Street Berwick-upon-Tweed North Northumberland TD15 1EE Tel: 01289 304318 Fax: 01289 303591 REGULATION 28: REPORT TO PREVENT FUTURE DEATHS REGULATION 28 REPORT TO PREVENT FUTURE DEATHS THIS REPORT IS BEING SENT TO: Operations Manager Network Rail Parkgate 14 Park Lane Darlington DL1 5AE 1 | CORONER | | am Tony Brown, senior coroner, for the coroner area of North Northumberland 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 On 24th November 2015 | commenced an investigation into the death of Daniel Campbell aged 25 years. The investigation concluded at the end of the Inquest on 21st March 2017 with the following narrative conclusion:- On 24.11.15 at approximately 12.00 hours, Daniel Campbell took his life by stepping into the path of a high speed train between Spittal and Scremerston, Northumberland at a time when his mind and capacity for rational thinking were both affected by illness, and as a result he sustained multiple injuries from which he died instantly. 4 | CIRCUMSTANCES OF THE DEATH As described in the above narrative. 5 | CORONER’S CONCERNS During the course of the inquest the evidence revealed matters giving rise to concem. 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. — Disrepair of walls, fences or other barriers:- Photographs of the location where the death occurred, provided by British Transport Police show that various sections of fencing and walls separating the public footpath from the railway line were broken, missing or in disrepair. While more substantial fencing is unlikely to prevent the trespass and death of a person who is determined to take his own life, insubstantial fencing or barriers create an easy opportunity for persons who might not otherwise act impulsively on fleeting suicidal thoughts after they have passed. ACTION SHOULD BE TAKEN | believe that action should be taken to address the concerns raised by the circumstances of Daniel Campbell's death. YOUR RESPONSE You are under a duty to respond to this report within 56 days of the date of this report, namely by Friday 9th June 2017. |, 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:- | 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. DATE = 13 April 2017 TONY BROWN HM Senior Coroner for North Northumberland
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.
NetworkRail Network Rail York Rail Operating Centre Tony Brown LLM York Cam HM Senior Coroner Cinder Lane North Northumberland Off Leeman Road York 17 Church Street Y026 4AB Berwick-upon-Tweed TD15 1EE 23 November 2017 t. aeaeinninaatnelshatedl | Dear Mr Brown Further to your request for information dated 13 April as part of your investigation into Daniel Campbell’s death | apologise for the length of time this response has taken. This was due to oversight as it was believed this letter had already been sent. | can confirm that Network Rail has reviewed the active fencing proposals for upgrade on both sides of the track in the section where the incident occurred and have included these in our 2018 renewals plan. Stone walls are a specialist entity, which require specialist contractors. We will aim to repair/restore the smaller sections where possible, but large sections which have failed will be plugged with appropriate lineside fencing to maintain integrity. Network Rail has completed an extensive upgrade of our lineside fencing to the north of this location in conjunction with significant trespass and another suicide incident between Spittal and Berwick. In May, my team walked through the section between Scremerston and Spittal, whilst the fencing already meets Network Rail standards further works will be planned to improve the robustness of this boundary. If you require any further information, please do not hesitate to contact me Sincerely, a a Head of Maintenance (North) Network Rail Infrastructure Limited Registered Office: Network Rail, One Eversholt Street, London, NW/1 2DN Registered in England and Wales No. 2904587 www.networkrail.co.uk
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