Recurring concern

Unreliable safety planning for organised dance music events

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First reported 14 Jan 2015•Latest report 18 Jul 2018

Definition

What this concern includes

Includes failures in the dedicated safety-planning arrangements for organised dance music events, including stakeholder consultation, event-specific safety guidance, staffing and security requirements, searches, first-aid provision, emergency arrangements and recording or assurance controls where these directly support event safety.

Not included

Excludes general event regulation, licensing or oversight failures where no deficient safety-planning arrangement for an organised dance music event is identified.
Excludes generic staffing, training, communication or documentation deficiencies unless they directly impair safety planning for an organised dance music event.
Excludes the underlying behaviour of attendees, isolated incidents or individual security or first-aid failures where no continuing event-safety planning deficiency is asserted.
Excludes safety arrangements for other event types unless the assertion explicitly supports the same organised dance music event process.

Reports: 2
Individual concerns: 8
Date range: 2015–2018
Stated actions: 0

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Reports about this concern sent to each recipient.

Department of Health and Social Care1

Hoults Limited1

Nbhd Group Limited1

Concerns and responses across reports

Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.

18 Jul2018
Newcastle upon Tyne
Concerns raised7
1. Lack of written guidance on the required extent of searches of ticket holders by security staff
2. Lack of written guidance on scrutiny of the licence to operate status of security staff
3. Lack of written guidance on robust recording of items seized during searches
1. Lack of written guidance on the required numbers of security staff at dance music events
2. Lack of a robust internal consultation protocol for planning and holding similar dance music events
3. Lack of written guidance on robust recording by first aid staff of patients attended and action taken
4. Lack of written guidance on the numbers and qualifications of first aid staff at dance music events
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
AI-generated summary

Ellie Mae Knowles · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Ellie Mae Knowles attended a dance music event on 5 November 2016, consumed MDMA, became unwell, and later died due to methylenedioxymethamphetamine toxicity. The report identified concerns about event search procedures, record-keeping, staffing and future planning of similar events, including the continued existence of a licence for such events at the premises.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on the required extent of searches of ticket holders by security staff
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on scrutiny of the licence to operate status of security staff
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on robust recording of items seized during searches
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on the required numbers of security staff at dance music events
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of a robust internal consultation protocol for planning and holding similar dance music events
Wider context from the report
“Although evidence was given on behalf of Hoults Ltd that no further similar events are to be held within Warehouse 34, Hoults Yard, a licence permitting such events in the future remains in force. (1) That Hoults Ltd should establish a robust internal protocol requiring consultation with Northumbria Police Licensing Officer, Newcastle City Council Licensing Officer and all other appropriate stakeholders as a precondition to the planning and holding of similar dance music events within their premises at any future time. ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on robust recording by first aid staff of patients attended and action taken
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Lack of written guidance on the numbers and qualifications of first aid staff at dance music events
Wider context from the report
“Although oral evidence of remedial action and change in practice was provided by Shindig Events Ltd, the Coroner remained concerned as detailed below: (1) No evidence was provided of written guidance/direction for Shindig Events Ltd employees and/or those with whom they subcontract of standards required in respect of: a. Numbers and qualifications of first aid staff to be provided at dance music events b. Robust recording by first aid staff of patients attended and action taken c. Numbers of security staff required at dance music events d. Scrutiny of the licence to operate status of security staff e. Extent of search of ticket holders required to be undertaken by security staff f. Robust system for recording items (including controlled drugs) seized at search and safe storage of those items ”
Source location
Ellie Mae Knowles · Prevention of Future Deaths report
Page 2 · concerns
Open source report
14 Jan2015
Inner South London
Concerns raised1
1. Failure to provide on-site medical assistance at unlicensed raves
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.

No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
AI-generated summary

Max Carlton-Smith · Prevention of Future Deaths report

This summary was generated using AI from the published report. Please read the original report for the complete account.

Report summary

Max Carlton-Smith died after taking MDMA at an illegal rave and collapsing when emergency medical assistance was not summoned immediately. The rave had no on-site medical assistance, inadequate ventilation, and unregulated fire exits and procedures; the report also raised concerns about delays in calling an ambulance and the authorities’ ability to intervene at the squatted commercial premises.

Read the report on judiciary.uk
Source evidence
How this individual concern was interpreted
PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation
Failure to provide on-site medical assistance at unlicensed raves
Wider context from the report
“The organizers of the unlicensed rave had not provided on-site medical assistance and had spent between 12 and 42 minutes before calling the ambulance service, when the deceased collapsed. There was inadequate ventilation for a very hot venue, and fire exits and procedure had not been regulated. The organizers had taken over an empty squatted commercial building and barricaded against those who attempted to enter, (including police, who attended and spoke earlier to a security man and then later following complaints of noise). I concluded that had the event been licensed and normal facilities and regulation in place, he would probably not have died when he did. ”
Source location
Max Carlton-Smith · Prevention of Future Deaths report
Page 1 · concerns
Open source report

Data last updated 7 September 2026

What this concern includes

Not included

Reports over time

Concerns raised7

Lack of written guidance on the required extent of searches of ticket holders by security staff

Lack of written guidance on scrutiny of the licence to operate status of security staff

Lack of written guidance on robust recording of items seized during searches

Lack of written guidance on the required numbers of security staff at dance music events

Lack of a robust internal consultation protocol for planning and holding similar dance music events

Lack of written guidance on robust recording by first aid staff of patients attended and action taken

Lack of written guidance on the numbers and qualifications of first aid staff at dance music events

Concerns raised1

Failure to provide on-site medical assistance at unlicensed raves