Other related deaths

PFD Category
Reports: 783 Areas: 72 Earliest: Aug 2013 Latest: 14 Apr 2026

76% response rate (above 63% average). 34% of classified responses show concrete action taken. Reports fell 26% from 91 (2023) to 67 (2024).

PFD Reports
174 results
Hans-Peter Schmidt
Historic (No Identified Response)
2018-0145 14 May 2018 Cornwall& the Isles of Scilly
Cornwall Council Heritage Attractions Ltd Lands End Resort
Concerns summary (AI summary) Lack of barrier maintenance, absent permanent barriers, inadequate international warning signs, and insufficient staff training at cliff hot spots create significant safety hazards.
Miriam Roach
Historic (No Identified Response)
2018-0096 6 Apr 2018 Cornwall and the Isles of Scilly
NHS Kernov Clinical Commissioning Group
Concerns summary (AI summary) There are concerns regarding the aftercare or transition arrangements for those discharged from hospital to home with a moderate to high risk of self-harm and/or suicide, and specifically the obligations for putting in place contact arrangements for such patients.
Leigh Wilde
Historic (No Identified Response)
2018-0085 12 Mar 2018 Manchester (South)
IMI (Institute of the Motor Industry) LTE Group
Concerns summary (AI summary) The company lacked documented rationale for employee suspension, failed to consider risk factors or offer support services, and kept inadequate meeting records, raising concerns about employee welfare.
Antony Coughtrey
Historic (No Identified Response)
2018-0014 15 Jan 2018 Milton Keynes
HM Inspectorate of Probation
Concerns summary (AI summary) The Probation Service failed to conduct an internal investigation or Serious Incident Review after a prisoner's death on licence and had a procedural failure in referring licence breaches back to the Parole Board.
Ruth Thompson
Historic (No Identified Response)
2017-0297 12 Oct 2017 Manchester (West)
Insure and Co
Derek Dudley
Historic (No Identified Response)
2017-0284 21 Sep 2017 Surrey
CSS Telecare Service Elmbridge and Ewell Borough Council Tandridge District Council
Concerns summary (AI summary) A community alarm operator ended a call with an elderly man who had fallen before he could get up, without checking for emergency contacts. This raises concerns about fall response protocols and subsequent safety.
Liam Hall
Historic (No Identified Response)
2017-0242 27 Jul 2017 Newcastle Upon Tyne
Sunderland City Council
Concerns summary (AI summary) A lack of appropriate warning signage about water risks, especially with inflatables, and no lifeguard supervision contributed to the death in Roker Harbour.
Steffan Bonnot
Historic (No Identified Response)
2017-0450 14 Jul 2017 West Sussex
Ofsted
Concerns summary (AI summary) Inadequate and undocumented disclosure of a child's background information to prospective foster carers caused anxiety and posed a risk to informed placement decisions.
Sousse (Tunisia)
Historic (No Identified Response)
2017-0206 7 Jul 2017 London (West)
ABTA Civil Aviation Authority Department for Transport +1 more
Concerns summary (AI summary) Travel companies lacked board-level security advisors and failed to prominently display government travel advice, leaving customers potentially uninformed about terrorism risks in destination countries.
William Wilson
Historic (No Identified Response)
2017-0186 12 Jun 2017 Manchester (South)
Church Inn
Concerns summary (AI summary) The establishment lacked a clear system for alerting the designated first aider, and staff who attended the deceased were unfamiliar with basic life-saving first aid techniques.
Lucy Goldstone
Historic (No Identified Response)
2017-0168 26 May 2017 Manchester (City)
Department for Transport Department of Health and Social Care
Concerns summary (AI summary) There are no Automated Electronic Defibrillators (AEDs) available on trams or at tram stops across the Metrolink network.
John Jaundoo
Historic (No Identified Response)
2017-0100 29 Mar 2017 Liverpool and Wirral
Liverpool City Council National Offender Management Service
Concerns summary (AI summary) Probation failed to appropriately place high-risk offenders and maintain dynamic risk assessments, while Adult Social Services lacked oversight, leading to unsuitable placements and missed public protection opportunities.
Antony Abbott
Historic (No Identified Response)
2017-0092 23 Mar 2017 Manchester (West)
Foreign, Commonwealth & Development Off…
Concerns summary (AI summary) Spanish Custody Officers, despite receiving first aid training for detainees, are not trained in Cardio Pulmonary Resuscitation (CPR), posing a risk in emergency situations.
Peter Norton
Historic (No Identified Response)
2017-0251 9 Mar 2017 Cornwall and the Isles of Scilly
Halfords Group PLC
Concerns summary (AI summary) The store lacked guidance, policies, and risk assessments for cycling indoors, including a safe designated area and helmet use, creating an unsafe environment.
John Atkin
Historic (No Identified Response)
2017-0064 6 Mar 2017 Surrey
Millbrook Healthcare Limited
Concerns summary (AI summary) There is a critical breakdown in communication regarding hazard assessment at service-user homes, with occupational therapists unaware of their role in informing delivery services about potential dangers, and no policy preventing drivers from entering without prior contact.
Roseleen O’Donoghue
Historic (No Identified Response)
2017-0007 3 Jan 2017 Manchester (South)
Your Housing
Concerns summary (AI summary) The installed stair lift does not stop in a safe position at the top, leaving the step plate suspended over the stairwell. This creates a falling risk for users and may affect other similar installations.
Edwin Flett
Historic (No Identified Response)
2016-0450 16 Dec 2016 London Inner (South)
Foreign, Commonwealth & Development Off…
Concerns summary (AI summary) This beach has an acknowledged high risk of death due to dangerous currents, yet specific warnings for tourists are insufficient, and no standardized risk classification system for swimming is in place.
Cameron Forster
Historic (No Identified Response)
2016-0436 8 Dec 2016 North Yorkshire (East)
Department for Transport
Concerns summary (AI summary) Parachutes were not supplied for a light aircraft flight, and there is no mandatory spin recovery training specific to aircraft types, increasing risks during aerobatics.
Ajvir Sandhu
Historic (No Identified Response)
2016-0436-wp25562 8 Dec 2016 North Yorkshire (East)
Department for Transport
Concerns summary (AI summary) Safety concerns include the lack of mandatory parachutes with static lines in certain aircraft and insufficient mandatory spin recovery training on specific light aircraft types for pilots.
Andrew Machin
Historic (No Identified Response)
2016-0349 7 Dec 2016 Coventry
National Offender Management Service
Concerns summary (AI summary) Limited support was provided to a prison employee during a prolonged disciplinary process, and no internal investigation was conducted into the dismissal circumstances following his death.
Flavio Pizarro
Historic (No Identified Response)
2016-0419 23 Nov 2016 Manchester (North)
Canal and River Trust
Concerns summary (AI summary) Lack of warning signs about swimming dangers and absence of safety aids at canal locks, despite previous assurances, creating ongoing risks for children playing near the water.
Michelle Lawrence
Historic (No Identified Response)
2016-0412 8 Nov 2016 London Inner (West)
DWF LLP Metropolitan Police MOJ +1 more
Concerns summary (AI summary) Key concerns include lack of independent investigations for deaths after private custody, inadequate concealment questioning, and insufficient strip-search facilities.
Karnel Haughton
Historic (No Identified Response)
2016-0339 23 Sep 2016 Birmingham and Solihull
Department for Education National Society for the Prevention of …
Concerns summary (AI summary) Uncensored online videos promote dangerous 'choking game' activities, yet there is no national guidance for schools or support for parents, risking further injuries and deaths.
David Phillips
Historic (No Identified Response)
2016-0334 16 Sep 2016 Swansea Neath and Port Talbot
Mitie NHS Wales South Wales Police
Concerns summary (AI summary) An inappropriate healthcare professional conducted the mental health assessment for a vulnerable older person, and the assessing professional lacked critical access to the detainee's medical records.
Christine Dryden
Historic (No Identified Response)
2016-0490 17 Aug 2016 West Yorkshire (West)
Incommunities
Concerns summary (AI summary) The absence of regular checks on installed smoke and heat detectors in properties presents a safety risk, necessitating a review of maintenance arrangements.