RECORD OF INVESTIGATION INTO DEATH (WITHOUT INQUEST)
Coroners Act 1995
Coroners Rules 2006
I, Timothy John Hill, Coroner, having investigated the death of
Brendan Kenneth ANDERSON
WITHOUT HOLDING AN INQUEST
I have decided not to hold an inquest into the death because the investigations into the death have sufficiently disclosed the identity of the deceased person, the time, place, cause of death, relevant circumstances concerning the death and the particulars needed to register the death under the Births, Deaths and Marriages Registration Act 1999.
I do not consider that the holding of an inquest would elicit any information further to that disclosed by the investigations conducted.
FIND THAT :
(a) The deceased identified as Brendan Kenneth ANDERSON died on or about 26 September 2010 at 200 Mersey Main Road Spreyton.
(b) Brendan Kenneth ANDERSON was born in Latrobe, Tasmania on 13/05/1993 and was aged 17 years.
(c) Brendan Kenneth ANDERSON was a single person whose occupation at the date of death was unemployed.
(d) I find that the deceased died as a result of multiple injuries from an ATV collision with a train
Circumstances Surrounding the Death:-
The deceased Brendan Kenneth Anderson was the son of Paul Anderson and Deearne Burns. Brendan resided with his mother and her husband at 3 Bovill Street, East Devonport.
Brendan had ridden motorbikes with his friends for the past three years of his life, although he did not own a motorbike of his own. Brendan held a learners permit for a motor vehicle but did not hold a licence for a motorcycle.
On Saturday 25th September 2010 Brendan stayed the night at a friend Cameron Rand’s house at 200 Mersey Main Road, Spreyton. Brendan would often ride motorbikes with Cameron at his house. Cameron described Brendan “as a bit experienced or gung –ho. He would think he could do stuff on the bike but would always seem to crash".
The following day Sunday 26th September 2010, Brendan and Cameron decided to go for a ride on the motorbikes in a nearby paddock. Brendan was riding a Suzuki 230 four wheeler (ATV) and Cameron was riding a Yamaha YZ 250F two wheeler dirt bike. Two other friends, Jessica Clarke and Maddison Monaghan, were also present.
At approximately 12:15pm Jessica’s mother Patsy–Anne Clarke arrived at 200 Main Mersey Road, Spreyton to collect her daughter and Maddison. She then drove down the driveway of the property in her white Toyota Camry towards the road. She noticed that Brendan was following her on the ATV and Cameron was behind him on the two wheeler dirt bike. Both boys were wearing approved motorcycle helmets and appropriate protective clothing.
The driveway of the property situated at 200 Main Mersey Road, is a gravel road. There is a slight incline on the road leading to a level railway crossing, known by TasRail as KPW124.3. It is a passive level crossing with no active signals. The crossing is governed by a “Stop” sign located on either side of the tracks. The pole also has a “Railway Crossing” sign and “Look for Trains” sign attached. The signs are on the left hand side of approaching vehicles and are all clearly visible. The view of the train lines in both directions for approaching vehicles was clear and extensive although there is a concrete wall on the property adjacent to the train line and it is possible that the train blended in with that wall to some extent.
As Mrs Clarke approached the crossing, she stated that she believed that she looked for trains and then crossed the crossing. As she was crossing she looked in her rear vision mirror and noticed a train travelling behind her, narrowly missing her vehicle. The train then came to a halt clearing the crossing. Mrs Clarke stopped her vehicle and got out. She could see Cameron who had got off his motorbike and was taking his helmet and top off. She could not see Brendan or his motorbike.
The train was owned by TasRail and known as the 106 cement train. It consisted of a 2010 locomotive which was controlled via remote control from a driving van at the opposite end of the locomotive and was towing 15 concrete carriages. The train was travelling between Devonport and Railton. At the time the carriages were empty on the way back to Railton. The total weight of the entire train at the time was 346.5 tonnes. The train was being driven by Russell Gilbert.
Mr Gilbert has been a train driver for a period of 26 years. He stated that prior to crossing a main crossing at Sheffield Road, he activated the train’s horn as required which is a four second blast followed by a one second blast. The only standard in Australia, (which is required on the mainland) is for the horn to be sounded a minimum distance of 400 metres prior to the train crossing however trains in Tasmania do not travel fast enough for this standard to be applied. Activation of the horn also activates flashing white lights to warn traffic and draw attention to the approaching train.
As the train was approaching the crossing adjacent to 200 Mersey Main Road, Spreyton, Mr Gilbert sounded the train’s horn for four seconds as required. As he did this, he observed Mrs Clarke’s white Toyota travelling down the gravel road adjacent to the crossing. He also observed the motorbikes being driven by Brendan and Cameron. As the train neared the crossing he sounded the horn in a continual blast. He could see that the vehicle was about to cross the crossing but knew that the ATV following would not make it. He immediately activated the emergency brake of the train. He stated that he did not believe that the driver of the vehicle slowed or noticed the approaching train.
Brendan followed the path of the vehicle on his ATV however he was unable to clear the crossing prior to the train impacting with the bike. The train continued along the track approximately 230 metres before coming to a halt.
Engaging the emergency brake on the train automatically sends a signal to the Launceston Train Control. Upon activation of this signal Mr Gilbert was contacted via radio and he informed them that he had hit a person on a motorcycle. As a result emergency services were contacted to attend the scene.
Members of Tasmania Police attended the scene and confirmed that the rider of the ATV was deceased.
A post mortem examination conducted by Dr Richey, pathologist, found that Brendan died as a result of multiple traumatic injuries associated with an ATV collision with a train.
The circumstances surrounding the death of Brendan were investigated by members of the crash investigation services section of Tasmania Police. The investigating officers concluded that had Mrs Clarke stopped at the stop sign as required. This could have forced the deceased to stop as well in order to avoid a collision with her vehicle. Officers also conducted that Mrs Clarke failed to pay attention to the train line, and that the deceased also failed to maintain a proper lookout and failed to stop for the oncoming train.
COMMENTS & RECOMMENDATIONS –
Having considered all the evidence it is clear that Brendan did not hear or see the train until it was too late for him to stop. I am satisfied that he was not keeping a proper lookout and was most probably concentrating on the vehicle in front of him driven by Mrs Clarke.
I am satisfied that the train driver Mr Gilbert sounded the horn in accordance with accepted practice as he approached the railway crossing and that he sounded it continuously when he saw that the vehicles were approaching the crossing. In my opinion no blame attaches to Mr Gilbert for this collision.
Had Mrs Clarke braked as she approached the crossing it is probable that Brendan would have observed this and done likewise.
The independent body SKM engaged by Tas Rail to investigate this matter made several recommendations which I believe are appropriate.
The train involved in the crash did not have a recording device which would confirm that the horn had been activated. On the evidence Tas Rail has addressed this issue.
I would also recommend that Tas Rail negotiate with the owners of the shed adjacent to the crossing to have the shed painted a colour which would contrast with the colour of trains which use this line.
There is evidence to suggest that the train horn may not be audible to drivers if the windows of their vehicles are up and there is other noise (eg. a radio) inside the vehicle. A similar problem may exist for motorcycle riders wearing helmets. I would recommend that Tas Rail conduct appropriate tests to ascertain whether the decibel level of the existing horn needs to be increased.
I note that Mrs Clarke was prosecuted for failing to stop at a level crossing. She was convicted and fined the prescribed penalty of $110 and awarded 3 demerit points. Whilst her action in not slowing down or stopping at the crossing may have been a contributing factor the primary cause of the collision was Brendan’s failure to keep a proper lookout and driving in front of the train.
The circumstances of this crash are a tragic reminder to all road users of the care and attention that is required by all drivers when approaching and crossing train lines.
Before I conclude this matter I wish to convey my sincere condolences to the family of the deceased.
This matter is now concluded
DATED: 4th April 2012 at Launceston in the state of Tasmania
Timothy John Hill