Prevention of Future Deaths reports · 2019

Darren Wilson

Regulation 28 report to prevent future deaths, reference 2019-0418, written 5 Dec 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Dec 2019
Reference2019-0418
DeceasedDarren Wilson
CoronerTimothy Brennand
Coroner areaLincolnshire
CategoryRoad (Highways Safety) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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.

Timothy BRENNAND
HM Senior Coroner
County of Lincolnshire

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Lincolnshire County Council, Highways and Planning
2. Highways England

CORONER

| am Timothy BRENNAND HM Senior Coroner for the coroner area of Lincolnshire, 4 Lindum Road,
Lincoln, Lincolnshire, LN2 1NN. :

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:/Avww.legislation.gov.uk/uksi/2013/1629/part/7/made

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INVESTIGATION and INQUEST

On 30/04/2019 | commenced an investigation into the death of Darren WILSON, aged 46. The
investigation concluded at the end of the inquest on 12/11/2019. The conclusion of the inquest was
that Darren WILSON died as a result of Road Traffic Collision, the medical cause of death being:

1a. Multiple Injuries
1b.

lc:

2:

CIRCUMSTANCES OF THE DEATH

On the 20" April 2019, whilst driving his motor vehicle along the A159 Gainsborough Road Scotter,
Lincolnshire, the deceased performed an overtaking manoeuvre to attempt drive past the offside of
a stationary vehicle positioned in the centre of the road, pointing in the same direction.

This car was signalling, about make a proper right turn onto the C229 road, when the deceased's
car collided into the turning car having struck head on a second vehicle that had been approaching
being correctly driven along the opposite carriageway, the presence of which the deceased had
failed to observe.

The deceased sustained multiple un-survivable injuries and notwithstanding attempted resuscitation
was to be pronounced dead at the scene.

Attending police officers established the deceased had not been wearing his safety at the time of
the impact.

CORONER’S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In my opinion

Timothy BRENNAND
HM Senior Coroner
County of Lincolnshire

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. —

ie The Inquest heard from a Forensic Collision Investigator and a local resident
who was also a former Highways Officer who both confirmed that the location
of the collision was a notorious accident "hotspot", in that whilst there had
been no previous fatalities, there had been innumerable "near misses" as well
as non-fatal road traffic collisions;

ii. The inherent danger of the location arose because of a lack of traffic calming
measures such as a reduction of the speed limit at this location as well as
deployment of double white lines to inform drivers of the potential hazard and
to prevent overtaking;

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
29/01/2020. |, 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
EEE 0010
(b) Collision team
| 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: 05/12/2019

Timothy BRENNAND
HM Senior Coroner
County of Lincolnshire

Timothy BRENNAND
HM Senior Coroner

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