Prevention of Future Deaths reports · 2017
Regulation 28 report to prevent future deaths, reference 2017-0323, written 31 Jul 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 31 Jul 2017 |
|---|---|
| Reference | 2017-0323 |
| Deceased | Philip Clayton |
| Coroner | Alison Mutch |
| Coroner area | Manchester South |
| 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 REGULATION 28 REPORT TO PREVENT FUTURE DEATHS THIS REPORT !S BEING SENT TO: The Department of Transport CORONER lam Alison Mutch, Senior Coroner, for the coroner area of South Manchester 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 INVESTIGATION and INQUEST On 26" April 2016 | commenced an investigation into the death of Philip James Clayton .The investigation concluded on the 24" July 2017 and the conclusion was one of Road Traffic Collision . The medical cause of death was 1a Ruptured right atrium;1b Fractured thoracic spine On 24th April 2016, Philip James Clayton was a passenger in a Zcar Mini. The vehicle had been purchased earlier that day in a private sale by a member of Philip Clayton's family. The car had some defects and would not have passed an M.O.T. The vehicle went over the hatch markings and collided with another vehicle. Philip James Clayton died on 24th April 2016 at Buxton Road, High Lane, Stockport. 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. — The vehicle in question was a Z car which is a type of vehicle built using a kit and to which a high powered engine is fitted. There are a number of sellers of such vehicles in the country. None of these sellers have to provide any form of driving course in the use of such vehicles before they are sold. These vehicles once built have to undergo a rigorous test to comply with Driver & Vehicle Standards Agency under the Individual Vehicle Approval (IVA).This test is more a lot more involved than a normal MOT and checks things from the conformity of switches to the actual construction of the vehicle body and everything in between. Each item fitted to the vehicle is checked to ensure it conforms to the current legislation, if the vehicle passed the IVA then it is assigned a registration number more often than not a “Q” plate. However once this designation has been given it appears that the vehicles do not undergo such rigorous testing on a regular basis. In addition, the driver of the vehicle was relatively inexperienced and had very limited experience of driving vehicles such as the one involved in this case. The current legislation allows a person to drive any modified or powerful vehicle once they have passed a normal driving test within the UK. This contrasts with the position where a person passes a motorcycle test. In that case then they are restricted by age to ride a reduced power machine for a period of time ACTION SHOULD BE TAKEN In my opinion action should be taken to prevent future deaths and | believe you 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 24°" September 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. 8 | COPIES and PUBLICATION | have sent a copy of my report to the Chief Coroner and to the following Interested Persons namely (in! wife of the deceased, who may find it useful or of interest. 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 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. N Alison Mutch OBE HM Senior Coroner 31" July 2017 tla (
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.
ae Department CH for Transport Alison Mutch OBE Manchester South Coroner's Office Coroner's Court 1 Mount Tabor Street From the Parliamentary Under Secretary of State Jesse Norman MP Great Minster House 33 Horseferry Road London SW1P 4DR Tel: 0300 330 3000 Email: jasse.norman@dit gsi.gov.uk Web site: www.gov.uk/dit Stockport Our Ref: Inv/203448 SK1 3AG Your Ref: 4281/CH 1 1 OCT 29;7 Vena Meo Noa Thank you for your letter of 1 August regarding the Regulation 28 Report - Philip James Clayton. | was |sorry to hear of the tragic death of Philip James Clayton, and | send my sincere condolences to his family and friends. There are no current plans to limit the engine capacity of vehicles for young drivers, but the Government takes road safety very seriously and is actively exploring other ways to reduce the number of young drivers killed and injured in our roads. The Government operates within the framework set by the British Road Safety statement of 2015. It sets out the Department for Transport’s vision, values and priorities in relation to British road safety. This has led to a significant programme of activity including increased penalties for drivers using hand held mobile phones, consulting on allowing learner drivers on motorways and improving motorcycle training. The statement can be viewed online at: www.gov.uk/government/publications/road-safety-statement-working- together-to-build-a-safer-road-system As part of this action, we recently commissioned a £2 million research programme to explore the effectiveness of a range of measures designed to improve the safety of young and novice drivers, both before they take their test and after they have passed. The measures being researched are: * The setting of voluntary limits agreed between the young driver and a parent or guardian designed to reduce exposure to risky driving situations during the first months of solo driving. This is based on the ‘Checkpoints’ programme from the USA, whereby parents and new drivers can discuss potentially risky situations (e.g. driving at night or with peer-age passengers) and agree to adhere to limits that would gradually be relaxed as the driver gains more experience. « An increase in the amount and type of on-road practice that learner drivers obtain before taking their practical driving test. This will engage learner drivers, approved driving instructors and parents/guardians to target the number of on road practice hours and the amount of time spent in specific situations. (e.g. time of day, road type, traffic density) * Using telematics data (potentially through a black box or smartphone app) to ‘coach’ new drivers during their first 12 months of driving. The aim will be to influence novices to change their behaviour related to several risk factors, and in doing so reduce their risk of collision. * Hazard perception training (potentially using a computer or virtual reality) to increase skills in drivers. The reason behind this is that hazard perception skills have been shown to have a clear link with collision. ¢ Increased driver education potentially delivered over the course of a day in a classroom setting. This would look to cover, using evidence-based behaviour change techniques, a range of risks that drivers will face after they begin solo driving. The purposes of MOT and Individual Vehicle Approval (VTA) testing differ greatly, and the Department does not think it would be appropriate to mandate ongoing, regular IVA-standard testing for specific types of vehicles in the way suggested. This is because IVA looks at the vehicle for its projected life and ensures that it can meet specified safety, security and environmental standards before it is used on the road. IVA only applies to unregistered vehicles: IT IS a one off test that takes into account its design and construction, and takes no account of wear and tear (it's treated as a new vehicie). If a vehicle is assessed correctly at approval, unless major alterations are carried out to the vehicle the approval will remain valid. Where a vehicle is radically altered after registration, the owner is under a legal obligation to inform DVLA ~ this would include changing the body shell, altering large sections of the body shell or different drive train, etc. There is also a requirement to inform DVLA of certain other changes including where alterations such as an engine replacement or fuel type change have taken place. There is also a requirement to inform insurance companies of any changes to vehicles. Failure to do so could mean that the insurance was invalid and insurers may not pay out claims. High powered vehicles are likely to attract a higher premium which may be beyond the reach of most young drivers. The MOT test relates to the condition of the vehicle at the time of the test and should not be regarded as evidence of its condition at any other time, of the general mechanical condition of the vehicle, or that the vehicle fully complies with all aspects of the law. Finally, Neither MOT nor IVA tests should be regarded as a replacement for routine servicing or maintenance of vehicles in use, which are essential to ensure that vehicles remain safe on the road. dar eu JESS ee
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