The (mostly) ignored road toll

One morning recently, I was alerted to a not so agile wallaby laying on a nearby road. A fresh road kill from overnight. These creatures, graze on urban lawns and as from the pictures below are generally doing well, as is my lawn. Animals like small children aren’t able to recognize the risk from that moving box heading towards them, or they simply don’t look.

Each year in Australia many thousands of collisions occur between animals and motor vehicles, resulting in massive loss of animal life, vehicle repair costs and injury or death to drivers or passengers. There is however, no ambulance service for the animal. There is no vet or paramedic who rushes in to put in two large IV cannula, a chest tube, to start cardiopulmonary resuscitation, apply a pelvic binder, given analgesia and maybe a bag of blood, and scoop off to hospital for emergency care and surgery. Thankfully, there are groups like WIRES who provide care for some of these injured animals.

Generally, no one intentionally runs down an animal crossing the road. There are of course exceptions, this young man who ended up being arrested and justly charge with animal cruelty. Following a collision, you may have to face the time needed for healing of injuries and the cost of vehicle repairs. The cost to vehicles alone has been estimated by an Australian insurer to be around $21 million annually. Rowden et al in Road crashes involving animals in Australia shows that wallabies and kangaroos make up almost 45% of all road kill. These authors also discuss various counter measures including ultrasonic repellents and note there is little evidence for efficacy. Helena Bender did her Phd Thesis on such equipment if you would like more detailed reading. Apparently, a sound akin to a thumping kangaroo thump may make a better deterrent.

This diagram shows many of the interrelated factors that contribute to animal and vehicle collisions.

Roads by their very nature are hazardous to creatures. They divide native population ranges, act to funnel animals towards hazards, and water run off leads to greener vegetation and better grazing opportunities.  Food discarded by drivers attracts animals, and ultimately, an injured or killed animal may attract carrion feedings. As reported by the Guardian, Tasmania has recently launched a roadkill campaign to reduce 500,000 native animal deaths. Research from Tasmania suggests that dropping the speed from 100 to 80 km/hr at specific black spots, may reduce animal casualties by 50%, whilst only adding 3 minutes to a journey from Launceston to Hobart. Here is a very interesting infographic on animal victims with statistics from 2012 notes casualty figures amongst Tasmanian creatures, for example 3392 Tasmanian devils per year.

Taylor and Goldingay in a 2010 paper entitled Roads and wildlife: impacts, mitigation and implications for wildlife management in Australia discuss how far Australia is lagging in protecting it’s native fauna against carnage on the roads. Speed limits are one thing but infrastructure such as under and overpasses may well save animal lives. This article from a Singapore newspaper highlights the hazards to Australian animals and visitors; warns of outback roads littered by roadkill.

Intuition back up science by showing under drought conditions, more kangaroos appear alongside roads. Lee et al showed that kangaroo density increases 10 fold alongside roads with resulting increase in vehicle impact. Night time, corners and fences were all factors in accidents. In some species, they found more victims to be male, which place more pressure on populations. To me, better lighting, slower speeds seem to be sensible options to reduce fatalities and vehicle injuries. Of course, you could just apply a herbicide or predator scents up along the road verge but Australia is a big country.

Australia is not alone with road kill problems. In New Zealand, introduced possums litter the side of the roads. I gave up counting on one road trip. Some of course would suggest that this is not such a bad thing for an introduced species. In Canada it is moose, deer, bison, beer and foxes. In Africa, it includes all the zoo favourites such as lions, cheetahs and zebras and even elephants!

Conflict of interest

I have in my 30 years of driving all over Australia, accidentally collided with just two kangaroos, a cow, one dog, several birds (not emus) and no humans. My first occasion to hit a kangaroo was driving in a battered HQ station wagon to Coral Bay in Western Australia in 1985. This happened on a night where there was hundreds of kangaroos abounding. The unfortunate macropod dived into my only working headlight making the remainder of the journey quite slow using my parking lights. The second in a Pajero, on Kangaroo island, happened in steady rain with hindsight I was driving too fast for the conditions. The cow collision as driving back to Port Hedland from Newman on a very dark night. I had just dipped my high beam for oncoming traffic, when it’s rear-end appeared in from of me. I wasn’t hurt but the WA Health Nissan Pintara was totalled. 

I also have a friend who has published this book on how to prepare and present road kill for consumption.

Coronor reports

Reading a Coroner report, I sometimes feel part voyeur with a macabre interest but feeling guilty about invading someone’s death. However, I reconcile that by using a Coroner’s report as a way of learning. With my medical education, as I read the story unfolding, I sometimes think to myself. “no, no no, check the blood pressure”, or “He is clearly septic and the temperature means nothing. Give the antibiotics, Get him to ICU – now!” It is like when you watch a horror movie and the teenagers split up look around the haunted house alone. “No you stupid fools stay together”, except these are real people falling through the gaps and being harmed. I sometimes place myself in the deceased story and think would I have done that, omitted this? “If only…”

The office of the coroner dates from approximately the 12th century under the English judicial system. In its early years, the coroner’s duties were mainly administrative. The coroner kept the king’s records, and collected revenue. Over the years the role expanded to include investigating deaths. If a person was found dead the coroner was notified and a jury was assembled where the jury examined the body. Evidence was heard and the jury’s verdict taken. If a verdict of murder or manslaughter was returned the coroner seized his property for the king. For a discussion of the the early history of the coroner, this article by Charles Gross is informative. In Australia, the Coroner’s jurisdiction has been in place since the foundation of the NSW colony. In his commission of 2 April 1787 Governor Phillip was granted power to ‘constitute and appoint Justices of the Peace, Coroners Constable and other necessary officers’. The earliest recorded inquest in New South Wales dates from 1796 in which three magistrates including Samuel Marsden inquired into the death of a convict who had been shot.

Today, a Coroner investigates a death in order to determine the identity of the deceased and the date, place, circumstances and medical cause of death. It is stated that the Coroner’s role is to find out what happened, not to point the finger or lay blame.  To assist a Coroner will call upon experts in the field, police, and witnesses, including doctors and nurses who may have been involved in a deceased person’s care. Importantly, not all people who die are investigated by the Coroner. And sometimes findings are not disclosed to the general public. The Coroner after deliberation will makes recommendations to prevent the same think happening again, that is to avoid a preventable death. In the past I have seen arguments about how impractical some of these recommendations are. For example,  one Coroner suggested GP’s should not prescribe fentanyl, which was an interesting statement to make when an non-GP had prescribed the medication that lead to the person’s death. Some reports are more controversial than others. Newspapers have the habit of summarising a Coroner’s report to sell a story, so journalist’s reports should never relied upon to make an opinion without reading the original report. The Inquest into the death of Hamid Khazaei recently completed by the Queensland Coroner, Terry Ryan provides so much more than what can be gleaned from various newspapers. As there is a delay between death and the Coroner’s recommendation, the media may speculate all sorts of stories. A Coroner report can provide closure to family and friends of the dead person.

I have been involved in the death of a number of patients whilst working within the hospital system and had to present evidence to the Coroner in one case. That information is all on public record. Back in October 2002, a man fell from his bed in hospital and died shortly afterwards from a massive intracranial haemorrhage. I was the intern on the team looking after him on that final admission. Reading back through the Coroner’s report today, I can see essentially how all the holes in the Swiss cheese lined up which lead to a preventable death.

To ensure that the as many as possible are informed of coroner recommendations, many reports are available for reading. Of course, some of these reports pertain to deaths due to violence, misadventure and have no medical staff intervention at all.

If you have an interest, here are the links to public Coroner reports.

ACT

https://www.courts.act.gov.au/magistrates/judgment

(to see coroner reports, type “coroner” into text search)

New Zealand

https://coronialservices.justice.govt.nz/findings-and-recommendations/

Northern Territory

https://justice.nt.gov.au/attorney-general-and-justice/courts/coroners-findings

NSW

http://www.coroners.justice.nsw.gov.au/Pages/findings.aspx

Queensland

https://www.courts.qld.gov.au/courts/coroners-court/findings

South Australia

http://www.courts.sa.gov.au/CoronersFindings/Pages/All-Findings.aspx

Tasmania

https://www.magistratescourt.tas.gov.au/about_us/coroners/coronial_findings

Victoria

http://www.coronerscourt.vic.gov.au/home/coroners+written+findings/

WA

https://www.coronerscourt.wa.gov.au/I/inquest_findings.aspx


edit 9/10/18

The Clinical Communiqué is an electronic publication containing narrative case reports about lessons learned from Coroners’ investigations into preventable deaths in acute hospital and community settings. The Clinical Communiqué is written, edited, published and distributed by the Department of Forensic Medicine, Monash University and the Victorian Institute of Forensic Medicine.