A pothole which caused the death of an elderly woman after she got her walking frame caught in it and fell over was not big enough to repair, an inquest has been told.
Beryl Barrett was crossing the road in Church Street, Warsop, near Mansfield, on December 19 last year when her wheel lodged in a broken section of the road.
The 87-year-old lost her balance, fell over and broke her hip in the incident, before being taken to A&E at King’s Mill Hospital in Sutton-in-Ashfield.
She died six days later, on Christmas Day.
Her inquest at Nottingham Coroner’s Court on Monday, 20 July heard that the defect in the road surface was “not actionable” at the point of the fall and was “not considered to be an active defect”.
Ms Barrett’s death was first reported after Mansfield Labour MP Steve Yemm raised the issue in Parliament in January.
He told former PM Keir Starmer that Ms Barrett had died after she “tragically fell into an unrepaired pothole”, and asked him whether it was “time the council took action to repair our roads”.
At the inquest, evidence was heard from Steve Walton, pre-construction director at Via, the firm which looks after Nottinghamshire’s roads on behalf of Nottinghamshire County Council.
He explained that Church Street was reviewed by inspectors on a monthly basis at the time of the incident, and had been inspected on October 2, November 3 and, finally, on December 1, before Ms Barrett’s fall.
No defects were identified on any occasion.
To be actionable, as per guidelines set by the UK Roads Leadership Group, a defect must be 20 mm deep if it is on a pavement or crossing, or 40 mm deep if it is on a road.
After Ms Barrett’s ultimately fatal incident, video footage from the December 1 inspection was reviewed by Via’s highways inspection risk manager.
Mr Walton told the hearing that the footage showed one of the defects on the pedestrian crossing used by Ms Barrett which should have been flagged for repair.
However, it was not because the inspector was wrongly looking for 40 mm defects, due to the area being on a road, rather than 20 mm defects, as he or she should have been because it was a crossing.
It was thought that this was the pothole that caused Ms Barrett’s fall.
However, later in the inquest, Coroner Nathanael Hartley identified that it was, in fact, a much smaller defect in the surface that had caused the fall – one less than 20 mm deep, which did not require repair.
The coroner ruled Ms Barrett’s death accidental.
He concluded that it had resulted from pneumonia, but that she would not have contracted it if she had not fallen, as her immobility in hospital would have been a risk factor for the build-up of fluid in her lungs.
Ms Barrett was also suffering from COPD, severe heart disease and diabetes when she died, the inquest was told.
Paying tribute, Beryl’s family said: “She loved life. She was independent – she went out every day; she couldn’t stand being in. She played bingo several times a week, went out with friends to Skegness, and we had family holidays together.
“She was involved with the community, the church and local groups for older people. She was active, she was fit, she kept herself going and she had no interest in healthcare. Within days of coming out of hospital, she would have been sacking carers as she said she could do it herself.
“Even going into hospital, she was in good spirits. For us, that’s the worst bit. If she’d gone in because of her COPD and just died, it would have been the natural end. We feel this wasn’t a natural way to go.”
The coroner said that, despite his findings, he still had two “areas of concern” after hearing the evidence.
The first was that Nottinghamshire County Council and Via do not have a process in place to ‘triage’ pothole reports from members of the public and push them up the priority list if they are suspected to have caused an injury.
It took nearly two weeks, albeit over the Christmas period, for the pothole suspected to have caused Ms Barrett’s fall to be repaired on January 2.
The second concern was that there was no reference in the national road repair guidelines to road users such as those using walkers or scooters.
The coroner said he would be issuing a Prevention of Future Deaths notice to Nottinghamshire County Council, Via and the UK Roads Leadership Group.
By Joseph Connolly, Local Democracy Reporter