Prevention of Future Deaths reports · 2021

Shane Gilmer

Regulation 28 report to prevent future deaths, reference 2021-0140, written 5 May 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 May 2021
Reference2021-0140
DeceasedShane Gilmer
CoronerProfessor Paul Marks
Coroner areaCounty of the East Riding of Yorkshire and City of Kingston-Upon-Hull
CategoryPolice related deaths · Product related deaths · Product related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

ANNEX A 

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. The Right Honorable Priti Patel, Her Majesty’s Principal Secretary of State for the 
Home Department. 
2. Kit Malthouse, Minister of State for Crime & Policing 

1 

CORONER 

I am Professor Paul Marks, H.M. Senior Coroner for the County of the East Riding of 
Yorkshire and City of Kingston-Upon-Hull 

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 

Following an Inquest opened on the 13 January 2018 and an inquest hearing at HM 
Coroner's Court on the 12 April 2021 heard before Professor Paul Marks, BA LLM MD 
FRCS in the Coroner's Area for The City of Kingston upon Hull and the County of the 
East Riding of Yorkshire, the jury concluded that Shane Adrian Gilmer was 
unlawfully killed. 

4 

CIRCUMSTANCES OF THE DEATH 

 Main Street 

Shane Adrian GILMER was shot by a man using a crossbow at 
Southburn, in the East Riding of Yorkshire on the evening of Friday 12th January 
2018. The injuries sustained from the crossbow caused damage to the right forearm, 
liver, kidney and lumbar spine in which the head of the bolt was firmly lodged and 
these injuries resulted in catastrophic blood loss. He was transported to Hull Royal 
Infirmary by ambulance and despite treatment at the scene, whilst en route and at the 
hospital suffered a cardiac arrest from which he could not be resuscitated and died at 
00:15 on Saturday 13th January 2018. 
The medical cause of death determined by a Home Office Forensic post mortem 
examinations was: 
1(a) Crossbow bolt wounds to torso and right arm 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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:  –  

Evidence was heard from all police witnesses who were called, that unlike shotguns 
and firearms, which are subject to regulation and a record of ownership, no such 
provision applies to crossbows. The Crossbows Act 1987, as amended, controls the 
possession of crossbows by persons under 18 years throughout the United Kingdom. 
Once sold there is no on-going control, record or licensing requirement for these 
weapons, unlike those in place for firearms and shotguns, pursuant to the Firearms 
Act 1968 as amended. The police have no record of who owns crossbows, how they 
are stored, the number that are in circulation in the community and so forth, yet 
evidence was heard about the power and lethal capabilities of these weapons, as well 
as the fact that they are essentially silent. Over the last few years, there have been 
some high profile incidents and killings that have involved the use of these weapons 
and the present case is unfortunately another example. 

6 

ACTION SHOULD BE TAKEN 

In my opinion, action should be taken to prevent future deaths and I believe you and 
your ministers have the power to take such action. 

In my opinion, you should consider a review of existing legislation, including the 
Crossbows Act 1987 and the Offensive Weapons Act 2019 with the intention of 
regulating the sale and possession of these lethal weapons, which can currently be 
purchased over the counter or via the internet by any person over the age of 18 years. 
Currently, they are not subject to any form of license or certificate or requirement for 
their sale and possession to be recorded and details held by the police, as is the case 
with shotguns and sporting rifles.  I believe that you and your Department 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 30th June 2021. 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 and to the following Interested 
Persons- 
Family and Yorkshire Ambulance Service. I have also sent it to the following who may 
find it useful or of interest. 

 of Ison Harrison representing 

, The Gilmer 

, Labour Shadow Home Secretary  

, Chief Constable Humberside Police 
, Police and Crime Commissioner for Humberside  

1. 
2. 
3. 
4. Councillor 
5. Councillor 
6. Dr 
7. 
8. 
9. Graham Stuart, MP for Beverley and Holderness 

, Hull City Council Leader 
, East Riding Council Leader 
, Faculty of Forensic and Legal Medicine   

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 10. Andrew Percy, MP for Brigg and Goole 
11. The Rt.Hon. Sir Greg Knight, MP for East Yorkshire 
12. 
, Hull West and Hessle 
13. The Rt.Hon. David Davis, Haltemprice and Howden 
14. 
15. Karl Turner, MP for Hull East 
16. Diana Johnson, MP Hull North 

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 

5th May 2021                                               

3

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