Prevention of Future Deaths reports · 2017
Regulation 28 report to prevent future deaths, reference 2017-0192, written 13 Jun 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 Jun 2017 |
|---|---|
| Reference | 2017-0192 |
| Deceased | Russell Sherwood |
| Coroner | Philip Spinney |
| Coroner area | South Wales Central |
| Category | Community health care and emergency services related deaths |
| Source | judiciary.uk record · original PDF |
| Responses published | 1 |
Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.
REGULATION 28: REPORT TO PREVENT FUTURE DEATHS
REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT DATED 16 JUNE 2017 IS BEING SENT TO:
,
Chief Fire Officer,
South Wales Fire & Rescue Service
Forest View Business Park
LLANTRISANT
CF72 8LX
1
CORONER
I am Philip Charles SPINNEY, Area Coroner, for the coroner area of South Wales
Central.
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 6 December 2016 I commenced an investigation into the death of Russell Sherwood.
The investigation concluded at the end of the inquest on the 13 June 2017. The
conclusion of the inquest was a narrative conclusion as follows:
On 20 November 2016 unusual weather caused flooding on New Inn Road near to the
Dipping Bridge, Bridgend. The road posed a danger to road users. The Fire Service
attended the location and rescued a motorist. The flooding continued to pose a risk to
life. The Fire Service left the scene with the casualty, leaving the road without any
warning signs, on the understanding that this would be dealt with by the Highways
Authority. After the Fire Service left the scene Mr Sherwood drove along the road and
into the flood water which led to his death.
4
CIRCUMSTANCES OF THE DEATH
On 23 November 2016 Russell William Sherwood was discovered deceased in his
vehicle in the River Ogmore near to New Inn Road, Bridgend. His vehicle had been
swept away in flood water.
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
(1) The evidence revealed that having rescued a motorist from flooding, at a time
when the flooding continued to pose a risk to life, the Fire Service Unit departed
the scene before the Highways authority arrived and without closing the road or
leaving any warning signs.
(2) The evidence further revealed that South Wales Fire and Rescue Service Units
do not carry equipment to close highways and they only carry enough
equipment to make a road safe when dealing with an incident. Furthermore, it
was stated in evidence that the Fire Service rely on the Highways authority or
the Police to carry out road closures and Fire Service protocols do not permit
the closure of roads.
6
ACTION SHOULD BE TAKEN
(1) Consideration should be given to reviewing procedures related to incident
management where there is an ongoing risk to life.
(2) Consideration should be given to reviewing emergency equipment carried
by Fire Service Units to enable warning signs to be deployed where Units
are at the scene of an incident where there is an ongoing risk to life.
In my opinion action should be taken to prevent future deaths and I believe you and 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 11 August 2017. 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
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
SIGNED:
Mr Philip Spinney
HM Area Coroner
2
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.
Gwasanaeth Tén ac Achub Ww eZ South Wales
De Cymru 5, Fire and Rescue Service
Mr Philip Spinney Our Ref: SC/HE
HM Area Coroner Your Ref:
The Coroner's Court Date: 8 August 2017
Central Police Station
Cathays Park Contact: P|
CARDIFF CF103NN Tel:
Dear Sir
INQUEST TOUCHING THE DEATH OF RUSSELL SHERWOOD
REGULATION 28 REPORT
abovementioned Regulation 28 Report ("your
We write with reference to your
due consideration by the South Wales Fire and
Report") which has been given all
Rescue Service ("the Service").
We are pleased to confirm that your recommendations for action ("your
Recommendations"), as set out at paragraph 6 on page 2 of your Report, are
currently being considered by the Service as part of its overarching response to the
Fire and Rescue Services (Emergencies)(Wales)(Amendment) Order 2017 ("the
Order"). For your information, the Order creates a new statutory duty for Fire and
Rescue Authorities to make provision from 1 April 2017 for responding to flooding
and inland water emergencies which present a risk of death, serious injury or serious
illness to people.
The Service is in the process of conducting a comprehensive review of its operating
procedures, both in response to the Order and as part of the Service's regular
assessments of all operational activity. You have our assurance that full and detailed
consideration is being given to your Recommendations as part of this ongoing
review. We anticipate that the outcome of the review will be reported by the
Service’s Senior Management Team by 31 October 2017.
We trust that the above is of assistance to you.
Yours faithfully
Deputy Chief Officer
for Chief Fire Officer
Ffén 43 232( ¢ Ffacs 01443 23218 Telephone 0)| 443 232000 * Fax 0/443
Rydym yn croesawu gohebiaeth yn y gymraeg a'r saesneg - byddwn yn We welcome correspondence in Welsh and English - we will respond
ymateb yn gyfartal i’r ddau ac yn ateb yn eich dewis iaith heb oedi. equally to both and will reply in your language of choice without delay.
CODI YMWYBYDDIAETH - LLEIHAU PERYGL RAISING AWARENESS - REDUCING RISK
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