Amal Ahmed: Prevention of future deaths report
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Date of report: 21/12/2023
Ref: 2023-0543
Deceased name: Amal Ahmed
Coroner name: Sean Cummings
Coroner Area: Milton Keynes
Category: Road (Highways Safety) related deaths
This report is being sent to: Milton Keynes City Council | National Highways
| REGULATION 28 REPORT TO PREVENT DEATHS | |
|---|---|
| THIS REPORT IS BEING SENT TO: [REDACTED] Chief Executive of Milton Keynes City Council [REDACTED] Chief Executive National Highways | |
| 1 | CORONER I am Dr Sean Cummings, Assistant Coroner for the coroner area of Milton Keynes |
| 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. |
| 3 | INVESTIGATION On 20 November 2023 I commenced an investigation into the death of Amal Mohamed AHMED aged 38. The investigation has not yet concluded and the inquest has not been heard. |
| 4 | CIRCUMSTANCES OF THE DEATH Ms Amal Mohamed Ahmed died on the A5 southbound Little Brickhill at or adjacent to the point where the A5 joins the “off” slip road. She appears to have been using a satnav directing her to Queensway, Bletchley. She entered the exit to the off slip road and drove the wrong way down the slip road, ultimately colliding with a vehicle travelling at speed on the A5 head on. Ms Ahmed died at the scene. The driver of the other vehicle died later at the John Radcliffe Hospital. A passenger of one of the vehicles required critical care treatment and suffered life threatening and changing injuries. |
| 5 | CORONER’S CONCERNS During the course of the investigation my inquiries revealed matters giving rise to concern. In my opinion there is a risk that future deaths could occur unless action is taken. In the circumstances it is my statutory duty to report to you. The MATTERS OF CONCERN are as follows: (brief summary of matters of concern) The exit point of the A5 “off” slip road at the Little Brickhill junction is wide. The signage indicating No Entry appears to be inadequate as there are two No Entry signs which are widely spaced at the junction. One is positioned to appear to forbid entry to the road over the bridge leading over the A5 and does not obviously relate to the slip road. The second is positioned such that it obliquely faces the road over the bridge and would not be visible to a driver turning right onto the slip road until they had completed the manoeuvre placing them at risk. There is a No Right Turn sign as the junction is approached. There is also No Entry in large white letters at the mouth of the slip road junction, however, this may be (1) obscured by vehicles leaving the slip road and (2) the junction is unlit and was said by a witness as being “pitch black”. After the collision attending police officers saw three further vehicles perform exactly the same manoeuvre as Ms Ahmed and attempt to travel down the slip road in the wrong direction. Local residents have contacted police and complained that it is a very common occurrence for drivers to mistakenly travel down the slip road in the wrong direction. The slip road is long and allows for the build up of considerable speed in turn facilitating what the police describe as a high energy impact. Following the collision, large temporary No Entry signs were positioned at the slip road junction. They were quickly removed apparently because the original signs were deemed to comply with necessary regulations. That seems wholly irrelevant to me because drivers are clearly commonly not seeing the signs because of the large numbers who mistakenly drive the wrong way onto the slip road. In my opinion, consideration should be given to alternative arrangements to prevent vehicles entering and travelling along the slip road in the wrong direction. |
| 6 | ACTION SHOULD BE TAKEN In my opinion action should be taken to prevent future deaths and I believe you (and/or your organisation) 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 February 14, 2024. 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 Chief Executive of Milton Keynes City Council Chief Executive National Highways I have also sent it to The families of the deceased who may find it useful or of interest. 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 | 21st of December 2023 Dr Sean Cummings Assistant Coroner for Milton Keynes |