Prevention of Future Deaths reports · 2022
Regulation 28 report to prevent future deaths, reference 2022-0007, written 10 Jan 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.
| Date of report | 10 Jan 2022 |
|---|---|
| Reference | 2022-0007 |
| Deceased | Brendan Eccles |
| Coroner | Derek Winter |
| Coroner area | City of Sunderland |
| Category | Accident at Work and Health and Safety 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.
Derek Winter DL
Senior Coroner for the City of Sunderland
REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:
EKO-INVEST, POM-EKO, EURO-EKO
1
CORONER
I am Derek Winter DL, Senior Coroner for the City of Sunderland
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.
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made
3
INVESTIGATION and INQUEST
On 30th July 2018 I commenced an Investigation into the death of Mr Brendan Eccles,
who was born on 10th April 1957 and died at Jubilee Quay, Prospect Row, Sunderland
on 27th July 2018.
The Investigation concluded at the end of the Jury Inquest on 1st December 2021. The
medical cause of death was confirmed as: -
Ia Multiple Injuries
4
CIRCUMSTANCES OF THE DEATH
Brendan Eccles died 27th July 2018 at Jubilee Quay due to an explosion while working on a
pontoon, manufactured by Eko-Invest, which unknowingly to him had volatile organic
compounds contained within.
The Jury recorded a conclusion of Accident.
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: –
It was credible that a flammable range (100% Lower Explosive Limit) could easily be
Office of HM Coroner for the City of Sunderland, City Hall, Plater Way, Sunderland, SR1 3AA
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reached by the application of an external heat source (for example, oxy propane cutting
torch). This would evaporate volatile substances present within the pontoon. Volatile
organic compounds should not be within a pontoon.
6
ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I believe you 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 8th March 2022. 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 their Solicitors and Counsel
• Sunderland City Council and their Solicitors
• P&D Environmental Limited and their Solicitors and Counsel
• Health and Safety Executive
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
Dated this 10th day of January 2022
Signature
Senior Coroner for the City of Sunderland
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.
Law Firm 65-068 Zielona Góra, 3 Pod Filarami street Attorney at Law Lech Cieślak __________________________________________________________________________________ March 1, 2022 Regarding: regulation 28 Derek Winter DL Senior Coroner for the City of Sunderland Acting on behalf and with the authority of the President of the Management Board of POM-EKO, a limited liability company with its registered office in Szczecinek (Poland) further to the request in the letter of Mr. Derek Winter - Senior Coroner for the city of Sunderland of January 10, 2022 in the matter of actions taken to prevent accidents while using the modular steel pontoons made by POM- EKO limited liability company in Szczecinek, I explain the following: 1. The production modular steel pontoons in POM-EKO was launched in 2010 in cooperation with companies operating in the European Union, which have been professionally used and rented by companies for many years. Therefore, these companies have extensive experience in their construction process, technology and use. Until now, our company has made 1,600 pontoons that have been sold in the European Union. 2. When orders were carried out, the pontoons were always delivered with factory-made binding elements, such as forks and half rings. Although the clients of our pontoons are proof-of-the-art companies in this industry, familiar with the regulations and procedures as far as handling of these products is concerned, the principles of safe use were discussed at each trade meeting: such as the use of factory clamping elements, the use of original protective barriers that are twisted to the flanges on the rim of the pontoon as well as not making any unauthorized modifications, in particular welding and cutting off non-original parts. As a result, on our part, we did not allow to any design changes to the product to be made on their (the clients) own. 3. Despite the fact that, as we mentioned, our clients are professional companies in the pontoon industry, we decided to remind them in writing about the special safety rules while working on pontoons, in particular about the prohibition of using non-original fasteners for coupling, any modifications, avoiding hot works, and in case of their necessity about procedural obligations in European countries, including the territory of Great Britain, and included in the provisions of the Health and Safety. We have also decided to provide an extract from the Health and Safety Executive's leaflet for safety in welding, gas cutting and similar processes and for hot work on small tanks and drums with every pontoon we sell for the UK market. 4. In hermetically sealed tanks, such as steel pontoons, which are used in the sea water environment and at different ambient temperatures, water condensation is released outside, which causes rapid corrosion, therefore their inside must be protected with an effective anti-corrosion coating. The above requirement is discussed by clients when placing orders. As a result, their inside may contain traces of volatile organic compounds (VOCs) derived from the anti-corrosion coating. As well as under the conditions of high humidity, even the residual organic substances inside closed tanks can generate substances such as methane. Hence the need to always comply with the safety procedures described in the HSE, if it is necessary to conduct hot work. In such cases, the pontoon should be aired through the holes for screw plugs on its sides, e.g. with steam or inert gases, e.g. carbon dioxide CO2 or nitrogen N2. Such procedure is aimed at displacing even trace amounts of volatile organic compounds from the inside of the pontoon from the anti-corrosion coating or organic residues. However, it is safest to avoid hot work, and if necessary, outsource it to a professional company that will do it safely in compliance with the applicable procedures. It is known that pontoons should be tight, therefore in the final production process they are tested for tightness. For this purpose, air is forced inside at a pressure higher than atmospheric pressure and after several minutes it is let in through the holes for screw plugs, which additionally blows the inside of the pontoon. Moreover, in the process of manufacturing pontoons in our company, in order to remove even trace amounts of volatile organic compounds (VOC), we extended the interval between the anti-corrosion coating inside the pontoon and its closure with a primer to several days, which ensures virtually complete removal of volatile compounds. 5. At the same time, we would like to point out that the provisions of the HSE impose specific obligations on employers, who are legally obliged to assess risks in the workplace and to take all reasonable precautions to ensure the safety of employees and other individuals who may be exposed to risks while performing works. Any hot work should be supervised by an experienced manager or supervisor who has knowledge of how to perform it, the related risks and precautions that should be taken before starting the work. 6. The actions taken by our company to increase the safety while using our products and the absolute compliance of users with health and safety regulations will prevent similar accidents in the future. [illegible signature] Attorney at Law Lech Cieślak Attached: Power of Attorney
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