Mr. Joseph Sarkozy · Prevention of Future Deaths report

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Issued 12 Feb 2016•Avon

Published report and response evidence

This report’s concerns and statements found in recipients’ published responses. Statements are included even where no link to an individual concern is recorded. A link shows an evidence connection; it does not assign responsibility.

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Concerns
1

Raised in this report

Recipients
3

Named on the report

Responses found
1

Of 3 recipients

Stated actions
4

Described in responses

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

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Report evidence summary

Concerns raised1

  1. Failure to require positive evidence before concluding that dust on light fittings caused smoke and burning smell

Stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.4

  1. Avon Fire and Rescue Service

    Include the incident scenario in operational crew training beginning in the next training year as an ongoing awareness programme.

  2. Avon Fire and Rescue Service

    Amend the Domestic and Residential Fires Risk Card following the review.

  3. Avon Fire and Rescue Service

    Review the Domestic and Residential Fires Risk Card for incident information and operational guidance.

  4. Avon Fire and Rescue Service

    Disseminate incident information to operational personnel through the Fire Alert system and to the wider fire service community through CFOA.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure to require positive evidence before concluding that dust on light fittings caused smoke and burning smell

Wider context from the report

“(1) The fire officers who attended the premises concluded that the ceiling lights in the kitchen were the most likely source of the smoke and smell which had been detected. (2) This conclusion was reached as no other source of the smoke and smell was found. (3) This conclusion was reached notwithstanding there had been no report of any previous problems with the light fittings; no smoke or smell could be detected coming from the light fittings when inspected; the boxes in the room above the light fittings had been dislodged some time before the smoke and smell was detected; and no obvious layer of dust was observed in the room above the light fittings. (4) The fire service should disseminate nationally the learning from this incident to ensure that other fire officers and fire fighters are aware of the risk of concluding that dust on light fittings can be the cause of smoke and burning smell in the absence of any positive evidence. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Include the incident scenario in operational crew training beginning in the next training year as an ongoing awareness programme.

Verbatim wording from the response

“I have considered your report and detail below actions taken, or to be taken by the service to help prevent future deaths. Information relating to this incident will be shared throughout AF&RS in the following manner:”

Source location

Avon-Fire-PFD-response
Page 1 · response
Published 12 February 2016

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Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Amend the Domestic and Residential Fires Risk Card following the review.

Verbatim wording from the response

“• Initial information provided for use at incidents to crews within our Risk Card system has also been reviewed. Some amendments will be made to the Domestic and Residential Fires card.”

Source location

Avon-Fire-PFD-response
Page 1 · response
Published 12 February 2016

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Review the Domestic and Residential Fires Risk Card for incident information and operational guidance.

Verbatim wording from the response

“• Initial information provided for use at incidents to crews within our Risk Card system has also been reviewed. Some amendments will be made to the Domestic and Residential Fires card.”

Source location

Avon-Fire-PFD-response
Page 1 · response
Published 12 February 2016

Open published response

Source evidence

How this respondent action was interpreted

PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

PFD Monitor interpretation

Disseminate incident information to operational personnel through the Fire Alert system and to the wider fire service community through CFOA.

Verbatim wording from the response

“I have considered your report and detail below actions taken, or to be taken by the service to help prevent future deaths. Information relating to this incident will be shared throughout AF&RS in the following manner:”

Source location

Avon-Fire-PFD-response
Page 1 · response
Published 12 February 2016

Open published response
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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Official responses located
1/3

Data last updated 7 September 2026