Cornwall and the Isles of Scilly

Coroner Area
Reports: 137 Earliest: Oct 2013 Latest: 16 Feb 2026

80% response rate (above 62% average).

Response Status
Responded 110 No Response 3 Historic 23 Pending 1
AI Classification
Action Taken 59%
Action Planned 27%
Noted 11%
Disputed 3%
Based on 37 classified responses
Top Categories
Hospital Death (Clinical Procedure… (46) Other related deaths (26) Suicide (from 2015) (19) Alcohol, drug and medication relat… (18) Mental Health related deaths (15)
Quarterly Trend
Category Breakdown
How does this area compare?
vs South West average: +56 reports · +16pp response rate
vs national average: +54 reports · +18pp response rate
Clear 3 results
Izzah Ali
No Identified Response
2025-0622 11 Dec 2025
Education and Children’s Community Heal…
Child Death (from 2015)
Concerns summary The 'Essential Guide to feeding your Baby' is inadequate as it fails to explicitly warn against giving cow's milk to infants under one year due to the risk of anaemia.
Samuel Vass
No Identified Response
2025-0568 6 Nov 2025
[REDACTED] Service Director for Environment Cornwa…
Alcohol, drug and medication related deaths Road (Highways Safety) related deaths
Concerns summary The lack of speed enforcement on a specific A3083 road stretch has contributed to multiple fatal collisions caused by excessive speeding.
Paul Holmes
No Identified Response
2024-0344 27 Jun 2024
Cornwall Partnership NHS Foundation Tru… Royal Cornwall Hospitals NHS Trust
Road (Highways Safety) related deaths
Concerns summary Poor communication, lack of direct doctor-to-doctor handover, and unrecorded treatment plans during hospital transfer led to delayed administration of crucial intravenous fluids.