Bram Luke Radcliffe · Prevention of Future Deaths report

On 24/11/17 I opened an inquest into the death of Bram Luke Radcliffe who, at the date of his death was aged 2 years old. The inquest was resumed and concluded on 15/2/19
I found that the cause of death to be:-
1a. Head Injury

I arrived at a narrative conclusion as follows:
On 8 November 2017 Bram Luke Radcliffe was found unresponsive with a serious head wound in the living room of his home address at ████████ West Yorkshire, after he was struck by a fire surround which had become detached from the wall. When taken to hospital, notwithstanding treatment, he succumbed and died later the same day from his injuries. Although the person or persons responsible for fitting the fire surround cannot be traced, it is found more likely than not that its installation was substandard and dangerous.

On the morning of 8/11/17, during a very brief moment upstairs Bram’s mother was alerted by a loud crash coming from the downstairs living room. Upon re-entering the living room she found Bram unresponsive on the living room floor surrounded by the marble fireplace which had become detached from the wall. Upon the arrival of the ambulance urgent CPR was carried out and he was rushed to hospital, but it was there given the extent of his head injury he succumbed and passed away, later the same morning.

During the inquest I heard evidence to indicate that the installation of the fireplace surround was both substandard and dangerous, and that there is currently no British Standard for the fixing of stone fireplace surrounds only for the manufacture. I was informed that the provision of a fire surround is not ‘building work’ as defined by Regulation 3(1) of the Building Regulations 2010 (as amended), therefore would not be the subject to Building Regulations and subject to guidance provided by the manufacturer/supplier and good building practice.

• To review the existing BSI 1251 ‘Open-replace Component’s, which deals with the manufacture of the components and to consider whether it is appropriate to extend it to the installation of the components.
• Since the key issue relates to the quality and reliability of workmanship linked to the installation of stone fireplace surrounds, consider the appropriateness of reviewing existing regulations and codes of practice to ensure compliance and guidance and suitable measures in order to prevent further similar incidents occurring.
• Consider whether provision of a fire surround should be regarded as ‘building work’ such that it be subject to the building regulations.