In the matter of the Inquest into the death of Michael Richard Vaughan [2020] EWHC 3670 (Admin)
Sometimes within the simplest of cases lies a wealth of useful reminders and lessons for everyone. This superficially uncomplicated and uncontested application under s.13 Coroners Act 1988 is a treasure trove of learning for anyone who may find themselves seeking a fresh inquest.
The request for a fresh inquest here was well founded, and so one might expect the remedy to have been swiftly achieved. The deceased had died after a self-administered paracetamol overdose and had left a note that provided evidence of his intent. Unfortunately, that note was not put before the coroner: had it been her inquest conclusion of ‘misadventure’ would probably have been different. But, despite the bereaved raising their concerns about the accuracy of the conclusion and the absence of the note on the day the inquest ended, it took more than five years before a fresh inquest was ordered by the High Court