Giuseppina Incisivo
PFD Report
All Responded
Ref: 2015-0303
All 1 response received
· Deadline: 25 Sep 2015
Sent To
Response Status
Responses
1 of 1
56-Day Deadline
25 Sep 2015
All responses received
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Coroner's Concerns
lorry, delay
(1) That whilst (he relevant EU Directives (2003/97/EC and 2005/27/EC) and associated legal requirements for some high-fronted goods vehicles require the of a 'front blind spot mirror' (Class VI) of a certain size, shape and resulting view, the actual shape (convex) and size of such mirrors does not provide sufficient visibility of slow moving pedestrians (especially the elderly) , or those not wearing highly visible clothing, especially when very close to the front of the vehicle: (2) That the lack of secondary 'front obstruction' warning systems, such as sensors which sound an audible alarm (similar to front parking sensors) , or show a redlamberlgreen 'safe to move' light in the cab, or a forward camera with a screen in the cab, which would supplement the mirror means that over-reliance is placed on the mirror when, patently it may not always serve its purpose, (3) That pedestrians, especially the elderly and children, whose height makes them difficult for drivers of such vehicles to observe may assume (wrongly) that a vehicle with a front 'blind spot' mirror 'must' see them when the reality is the opposite.
(4) That, it seems general lack of awareness may persist of the risk posed when passing in front of such vehicles and an assumption persist that because someone may be able to see the windscreen of the vehicle, that the driver 'must' be able to see them directly or indirectly_ am aware that other Coroners have reported similar concerns as regards older or other high fronted vehicles which need not have such mirrors This is the second inquest have heard into the death of an elderly person who, it seems assumed' the driver would or must see them, directly or indirectly:
(1) That whilst (he relevant EU Directives (2003/97/EC and 2005/27/EC) and associated legal requirements for some high-fronted goods vehicles require the of a 'front blind spot mirror' (Class VI) of a certain size, shape and resulting view, the actual shape (convex) and size of such mirrors does not provide sufficient visibility of slow moving pedestrians (especially the elderly) , or those not wearing highly visible clothing, especially when very close to the front of the vehicle: (2) That the lack of secondary 'front obstruction' warning systems, such as sensors which sound an audible alarm (similar to front parking sensors) , or show a redlamberlgreen 'safe to move' light in the cab, or a forward camera with a screen in the cab, which would supplement the mirror means that over-reliance is placed on the mirror when, patently it may not always serve its purpose, (3) That pedestrians, especially the elderly and children, whose height makes them difficult for drivers of such vehicles to observe may assume (wrongly) that a vehicle with a front 'blind spot' mirror 'must' see them when the reality is the opposite.
(4) That, it seems general lack of awareness may persist of the risk posed when passing in front of such vehicles and an assumption persist that because someone may be able to see the windscreen of the vehicle, that the driver 'must' be able to see them directly or indirectly_ am aware that other Coroners have reported similar concerns as regards older or other high fronted vehicles which need not have such mirrors This is the second inquest have heard into the death of an elderly person who, it seems assumed' the driver would or must see them, directly or indirectly:
Responses
Response received
View full response
Great Minster House 33 Horseferry Road Department London SWIP 4DR for Transport Web site: WWwgov ukldft Penelope A Schofield Senior Coroner Our Ref: MC/141198 Coroner's Office West Sussex Record Office 25 September 2015 Orchard Street Chichester West Sussex PO19 1DD Jeev Ms sckku, Thank you for your letter of 31 July, enclosing a Regulation 28 Report on the investigation into the death of Ms Giuseppina Incisivo. On conclusion of the inquest you made a finding that the size and the shape of the mirror gave insufficient visibility, and the lack of secondary 'front obstruction' warning systems, such as sensors or a forward facing camera with a screen in the cab, could have prevented the collision; Another factor is that pedestrians be unaware that the driver cannot see them clearly, putting themselves at risk am replying as Head of International Vehicle Standards Division of the Department for Transport, which has responsibility for road vehicle safety standards. would like to reassure you that the Department takes the safety of all road users seriously and will endeavour to explain the current legislation on vehicle construction matters and the steps being taken to address your concerns_ As you are aware, the technical requirements for new vehicles are set at international level by both the United Nations (UN) and the European Union (EU): The UN Regulation 46 sets the requirements for mirrors and is very similar to EU Directive 2003/97/EC which you mention in your report: The requirement in both these sets of legislation is for the driver to be able to see a ground plane area, and in the case of the area directly in front of the vehicle manufacturers can decide whether to use a mirror or a camera t0 cover this_ Their choice will depend on which products their customers require and their specific design as well as cost. In future it be possible for manufacturers to replace all mirrors with cameras Engineers in my team are working at both national and international level to improve the safety of HGVs Consideration is being given in EU Working Groups to improving direct and indirect vision for drivers, which we anticipate will help to prevent future collisions with vulnerable road users. We are also working closely with Transport for London (TfL) on safety measures. Research by the Transport Research Laboratory for TfL on range of technologies which can be fitted to HGVs to detect pedestrians and cyclists is currently being peer reviewed, and this could form the basis of advice to manufacturers and operators; in advance of changes to approval regulations for new vehicles being agreed in the EU, may very will
Although sensor technology is available to identify objects around a vehicle, the technology has not yet developed sufficiently to distinguish between people and street furniture or other vehicles. As the technology improves this may offer a solution in future_ You have correctly identified that there is also a role for pedestrians in understanding when it is safe to cross in front of a vehicle: You may be aware that adult (60+) pedestrian casualties have shown a steady decline in recent years. However; in 2014, the latest year for which statistics are available, there were still 191 fatalities and we are not complacent about this issue. The Department issued revised guidance in January 2014 aimed mainly at local traffic authorities who are responsible for setting speed limits on local roads. It has been designed to help explain to everyone why and how local speed limits are determined. This guidance was revised following full public consultation in summer 2012. Pedestrian walking speeds and crossing timings are matters for guidance rather than legislation, and the Department will be considering how best to update the guidance. can confirm that we intend to produce a new chapter of the Traffic Signs Manual on traffic lights and pedestrian crossings, bringing together and updating existing advice_ Unfortunately we are unable to give a precise date for publication: The Department is supporting the Living Streets organisation, who are campaigning on the safety of older pedestrians and are the UK charity for everyday walking; attach their website link http IWWWw livingstreets orgUkmake-&-changeltake-action-wilh-us/crossings will also bring this case to the attention of road safety colleagues in the Department to find out what more can be done, to raise awareness of drivers and pedestrians of the risks when they are in close proximity to one another: am grateful to you for raising this incident with me, and would appreciate you conveying my condolences to Ms Incisivo's family_ YaJ) Head of International Vehicle Standards Division
Although sensor technology is available to identify objects around a vehicle, the technology has not yet developed sufficiently to distinguish between people and street furniture or other vehicles. As the technology improves this may offer a solution in future_ You have correctly identified that there is also a role for pedestrians in understanding when it is safe to cross in front of a vehicle: You may be aware that adult (60+) pedestrian casualties have shown a steady decline in recent years. However; in 2014, the latest year for which statistics are available, there were still 191 fatalities and we are not complacent about this issue. The Department issued revised guidance in January 2014 aimed mainly at local traffic authorities who are responsible for setting speed limits on local roads. It has been designed to help explain to everyone why and how local speed limits are determined. This guidance was revised following full public consultation in summer 2012. Pedestrian walking speeds and crossing timings are matters for guidance rather than legislation, and the Department will be considering how best to update the guidance. can confirm that we intend to produce a new chapter of the Traffic Signs Manual on traffic lights and pedestrian crossings, bringing together and updating existing advice_ Unfortunately we are unable to give a precise date for publication: The Department is supporting the Living Streets organisation, who are campaigning on the safety of older pedestrians and are the UK charity for everyday walking; attach their website link http IWWWw livingstreets orgUkmake-&-changeltake-action-wilh-us/crossings will also bring this case to the attention of road safety colleagues in the Department to find out what more can be done, to raise awareness of drivers and pedestrians of the risks when they are in close proximity to one another: am grateful to you for raising this incident with me, and would appreciate you conveying my condolences to Ms Incisivo's family_ YaJ) Head of International Vehicle Standards Division
Action Should Be Taken
In my opinion action should be taken to prevent future deaths and believe you andlor your organisation, including the relevant vehicle agencies, have the power to take such action,
Report Sections
Investigation and Inquest
On 10 July 2014 the West Sussex Coroner commenced an investigation into the death of Giuseppina Incisivo, aged 79. The investigation concluded at the end of the inquest on 28 July 2015. The conclusion of the inquest was Road Traffic Collision.
Circumstances of the Death
Ms Incisivo was crossing North Street in the centre of Midhurst whilst the traffic was stoplstart: She moved in front of a medium sized (27 gross tonnes) very close to the front; when the traffic suddenly moved off. She was run over and suffered catastrophic, traumatic injuries, dying at the scene within minutes The driver's evidence was simply that he did not see her. Other witnesses suggested he could not have done so directly, and a reconstruction by the Sussex Police Forensic Collision Investigation Unit showed that Ms Incisivo would have come well under the height of the bottom of the windscreen. The vehicle had a front 'blind spot' mirror fitted and in good working order, but the evidence was that either The driver had visually swept the mirror (his evidence) but in the time before moving off Ms Incisivo had then moved in front of the vehicle, unobserved, or The size and shape of her image in the convex mirror, and lack of visual contrast between Ms Incisivo, a dark-haired, greying, lady around 5 feet tall, in light clothing, and the road surface, meant that she was insufficiently conspicuous (the Investigating Officer's expert opinion) In short;, the driver, even using the mirror when she was in its reflection, would have found it very hard to distinguish Ms Incisivo.
Similar PFD Reports
Reports sharing organisations, categories, or themes with this PFD
Related Inquiry Recommendations
Public inquiry recommendations addressing similar themes
Revise signal sighting standard to explicitly consider signal readability
Ladbroke Grove Inquiry
Hazardous road design
Define additional time required for reading gantry-mounted and complex signals
Ladbroke Grove Inquiry
Hazardous road design
Clarify "very short duration" definition within the signal sighting standard
Ladbroke Grove Inquiry
Hazardous road design
Identify and retrospectively review locations affected by "very short duration" ambiguity
Ladbroke Grove Inquiry
Hazardous road design
Clarify "overhead line equipment" in signal sighting standard to mean wires and droppers
Ladbroke Grove Inquiry
Hazardous road design
Define acceptable limits for temporary signal obscuration in sighting standards
Ladbroke Grove Inquiry
Hazardous road design
Explicitly define cab sight lines for signal positioning based on driver's eye
Ladbroke Grove Inquiry
Hazardous road design
Railtrack to conduct safety examination of Paddington station layout and operations.
Ladbroke Grove Inquiry
Hazardous road design
Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.