Closer attention to the risk posed by cardiovascular problems among professional drivers is possible after Assistant Coroner for Berkshire Ian Wade submitted a Prevention of Future Deaths Report relating to an incident involving a coach driver in September 2022.
James Baxter, 78, suffered an acute right coronary artery thrombosis secondary to plaque rupture due to severe ischaemic heart disease while driving on the M25. A passenger was able to bring the coach to a halt, but Mr Baxter died at the scene.
He had renewed his PCV licence in December 2021 and his cause of death was a natural one. Mr Wade notes that Mr Baxter’s medical history did not make clear that he was medically unfit to hold such a driving licence.
However, among his concerns, the Deputy Coroner notes that “aged 78, with chronic and poorly controlled diabetes and high blood pressure, the circumstances in which he would develop ischaemic heart disease and be at risk of suffering a serious coronary episode… appeared to be established.”
Mr Wade adds that DVLA commissions functional cardiac stress testing for drivers with known cardiovascular disease, or those with symptoms suspected to be related to cardiac disease. That occurs only when such conditions are declared, and there is said to be no mechanism to diagnose asymptomatic individuals via those tests.
The Deputy Coroner has seen evidence that a risk-based stratification system that takes account of age and comorbidities (rather than just cardiac symptoms), thereby prompting consideration of cardiac stress testing, was feasible to reduce incidents such as that involving Mr Baxter.
As an alternative, he notes that a periodic cardiac stress test related to age “was suggested as a means of ameliorating risk.” Mr Wade also heard that the medical D4 form should have provision to include cholesterol and average blood sugar levels over the previous three months, as obtained from a general practitioner.
Those areas of concern have been forwarded to Secretary of State for Transport Mark Harper in the Prevention of Future Deaths report. It outlines the Deputy Coroner’s opinion that action should be taken.
Mr Harper is under duty to respond by 20 July, unless Mr Wade extends that deadline. The minister must detail action taken or proposed to be taken, or explain why no action is proposed.
Prevention of Future Deaths report here.
