Kathleen Erica Holme · Prevention of Future Deaths report

On 20/04/2017 I commenced an investigation into the death of Kathleen Erica Holme. The investigation concluded at the end of the inquest on the 29th August 2017.

The Inquest conclusions, as recorded on the attached Record of Inquest was

The cause of death:
1.a. Burns and smoke inhalation
1.b. Fire at her home

The circumstances that were found to have been proved were:
Mrs Holme liked to use candles in her bedroom and also an automatic aerosol air freshener. On the 26 March 2017 there was a fire in her bedroom at her home address. She was rescued and taken to the Royal Lancaster Infirmary, but was certified dead there. She died from burns and smoke inhalation.

The conclusion of the inquest was that:
Mrs Holme died an accidental death

Mrs Holme and her son had been drinking alcohol on the 25 March 2017 in a public house in Kendal. The amount that she had to drink may have affected her ability to save herself when the house was on fire.

After leaving the public house they went home and subsequently Mrs Holme went to bed. She was a frequent user of candles in her bedroom, and had some on a tray on the floor. In her bedroom she used a Glade automatic air freshener.

There was a fire at her home in the early hours of the 26 March 2017, and neighbours tried to rescue her. Fire officers attended and were able to extract her from the house, but she died of burns and smoke inhalation.

████████ Fire Investigator with the Cumbria Fire and Rescue Service attended and investigated the fire. The seat of the fire, where Mrs Holme was found, was near to the door from the bedroom into the upstairs hallway. At the seat of the fire they found the tray with candles and also in the immediate vicinity, a Glade automatic battery operated air freshener and some clothes, all of which were badly burned in the fire. A number of other Glade air freshener aerosols for use in the automatic air freshener, were found in other areas of the bedroom and some had been burnt.

Tests undertaken at the Barrow Fire Station found that if the contents of the automatic air freshener were sprayed across a naked flame then a large flame was produced approximately 20cm long (approximately 8 inches). The evidence from ████████ given at the Inquest, was that in view of the position of the candles, the automatic air freshener and the clothes, the spray from the automatic air freshener could have been ignited by the candles and the resultant flame then ignited the clothes. I have spoken again ████████ and he said that they found in their tests that even if the distance between the candle and the air freshener was further extended, it was possible to get a flame 12 inches or more long, and that could ignite flammable materials. The nearer the distance the stronger the flame, and the further away the more likely that the flame would be a flash flame.

I have seen that both the box containing a new Glade automatic air freshener and the aerosol itself have warning signs and words, warning that the spray is not to be used near naked flames.

(1) Whether the manufacturer is aware and understands the extent of the risks of the use of a Glade Automatic Air Freshener Spray near to naked flames, and specifically the distance which the flame can extend.
(2) Whilst there are both warning signs and wording on the box containing a new spray and on the aerosol to be fitted to it, I am concerned that the words warning of the dangers of use near a naked flame is not sufficiently large and prominent to draw the dangers to a users attention.
(3) There were no warning signs on the body of the automatic air freshener. Once the box containing the new air freshener was discarded a user would have only the information printed on the aerosol as a warning.