Investigation and inquest
An investigation into the death of Julia Luxmore Peto commenced on the 22 October 2018. The inquest concluded at the end of the inquest on 27 March 2019. The conclusion of the inquest was that the medical cause of death was 1(a) Head Injury. The conclusion was “Road Traffic Accident”.
Circumstances of the death
On Sunday 16 September 2018, at about 16:53 pm., Julia was using a pedestrian crossing over the Eastbound carriageway of Deptford Broadway, SE8 (A2), when a bus collided with her causing a catastrophic head injury. She died in hospital the following day. She was aged 27 years and did not have significant health problems or disabilities. She was crossing from the Northside of Deptford Broadway to the Southside.
The three lanes of the Eastbound carriageway had split phasing of traffic light signals. When crossing the first two lanes of the Eastbound carriageway the traffic had stopped at red traffic light signals. When she entered the third lane of the Eastbound carriageway, which was a filter lane for vehicles turning right, the traffic light was green in favour of the approaching bus when the collision occurred. At the time she crossed the three lanes of the Eastbound carriageway the pedestrian signal was red. There was a pedestrian island between the second and third lanes.
CCTV footage, from inside the bus, showed that she was looking to her left and when she stepped into the road she did not see the bus which was approaching from her right hand side.
The Eastbound carriageway consisting of three lanes was the first part of a ‘two stage’ crossing, the Westbound carriageway being the second stage.
At the time she was crossing the Eastbound carriageway a green pedestrian light was displayed on the far side of the Westbound carriageway. Based on the available evidence it was not possible to establish, on the balance of probabilities, that Julia had been confused by this particular green pedestrian signal.
The CCTV footage from the bus showed Julia moving at a pace, which was faster than walking, but not running, across the first and second lanes and continuing into the third lane where the collision occurred.
The driver of the bus passed eyesight breath and drug tests at the scene. He was travelling well below the speed limit of 30 mph through a green light, in his favour, and had applied the brakes before the collision occurred. The estimated speed of impact was below 4 mph. There were no mechanical problems with the bus.
Coroner’s concerns
I recorded in section 3 of the Record of Inquest that it was not possible to establish, on the balance of probabilities, that Julia had been confused by a green pedestrian signal on the other side of the Westbound carriageway of a ‘two stage’ crossing. Nonetheless I remain concerned that there is a strong possibility that she was distracted or confused by the green pedestrian light for the Westbound carriageway.
Transport for London (TfL) who are responsible for the signals, on the junction in question, have subsequently taken remedial measures to minimise the possibility of a recurrence of the accident by modifying the green pedestrian signals with louvres to reduce the risk of ‘see-through’ for pedestrians on the staggered pedestrian crossing.
TfL informed me, at the inquest, that they are putting in place “Look Left” and “Look Right” markings on the road to inform pedestrians on the direction of approaching traffic (A copy of the TfL report to me is appended for ease of reference. This contains a useful plan and photographs). From the evidence I heard I am satisfied that these particular changes would not have a wider impact on traffic flow but would improve the safety of pedestrians.
I was pleased to hear that TfL had taken proactive practical measures to reduce the risk at this particular junction but I remain concerned that there are likely be other “two stage” pedestrian crossings throughout England and Wales which also do not currently have louvres to prevent pedestrian ‘see-through’ and road markings to warn pedestrians of traffic direction.
I am therefore of the view that I am under a duty to report this wider concern to the Department of Transport to take appropriate action to reduce the risk of fatalities and serious injuries at two stage crossings throughout England and Wales.