Ross, Matthew Trent
Deceased
Matthew Trent Ross
Demographics
25y, male
Date of death
2013-07-11
Finding date
2018-04-13
Cause of death
Electrocution
AI-generated summary
Matthew Ross, 25-year-old carpenter, died from electrocution at 5:07 PM on 11 July 2013 while installing guttering on construction scaffolding. His body completed an electrical circuit between a metal scaffold pole (hands) and metal guttering (legs). A damaged light fitting (Light Fitting Z) connected to a photo-electric cell activated at dusk was found to be the likely source. The coroner determined that if an RCD (safety switch) had been installed on the circuit, it would have detected the fault and prevented Matthew's death. Critical investigative lapses included failure to immediately seize the light fitting as evidence, loss of evidence continuity, delays of 2.5 years completing the investigation, and confusion regarding the scope of electrical isolation for modified demolition work. No RCDs were mandated on this existing circuit at the time.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Clinical conditions
Contributing factors
- Damaged light fitting (Light Fitting Z) in contact with metal water pipe and scaffolding
- Light fitting connected to photo-electric cell activating at dusk, timing coinciding with incident
- Defective transposed earth and neutral conductors at Light Fitting Y on same circuit
- Absence of Residual Current Device (RCD/safety switch) on circuit
- Confusion regarding scope of electrical isolation when roof trusses were added to demolition work
- Light fitting left unattached in eave cavity following soffit removal, unclear how it became disconnected
- Failure to obtain new electrical isolation certificate when scope of work changed from initial demolition
- Simultaneous contact between conductive scaffold and metal guttering completing circuit
Coroner's recommendations
- The Electrical Safety Office reconsider various options for mandatory fitting of Residual Current Devices (RCDs/safety switches), including cost benefit analysis, and circulate draft discussion paper to stakeholders and public for consultation prior to finalising policy position or advice to State Government
- The Office of Industrial Relations in conjunction with the Electrical Safety Office review circumstances and consider amendments to Demolition Work Code of Practice 2013 and Managing electrical risks in the workplace Code of Practice 2013 to mandate: an electrical isolation certificate be obtained by principal contractor for any demolition or dismantling work in building structures; any isolation certificate include clear plan and description of precise isolated area including cabling and fittings removed and details of isolation method including lockout and tag-out means and testing to prove de-energised protocols; that a further electrical isolation certificate be mandatory where there is any extension of scope of demolition and dismantling work
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