Coroner's Finding: CORNISH Olive Edna
Deceased
Olive Edna Cornish
Demographics
75y, female
Date of death
1998-10-14
Finding date
2001-09-10
Cause of death
Avulsion of the inferior vena cava from the heart due to severe crush injury of the chest, together with crush asphyxia and flail chest due to multiple rib fractures
AI-generated summary
A 75-year-old woman died from crush injuries sustained when her 1982 Mitsubishi Sigma sedan reversed unexpectedly whilst she was behind it. The vehicle's automatic transmission selector linkage had worn bushes, allowing the transmission to remain in Reverse even though the gear indicator showed Park. She was likely inflating a flat tyre when the engine, at high idle speed due to cold start, overcome brake resistance and propelled the car backwards, crushing her against her property's gates. This was not a medical case but rather a vehicle safety matter. The coroner recommended public awareness campaigns about regular transmission servicing and the risks of older vehicles with cabin-mounted inhibitor switches.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Contributing factors
- Worn transmission selector linkage bushes in 1982 Mitsubishi Sigma
- Transmission remaining in Reverse despite selector indicator showing Park
- High engine idle speed from automatic choke during cold start
- Flat rear tyre requiring inflation
- Vehicle design with inhibitor switch mounted on selector column rather than at transmission
Coroner's recommendations
- A public awareness campaign be conducted regarding automatic transmission safety, specifically that automatic transmission linkages should be serviced regularly and bushes checked
- Public awareness that unless regular servicing occurs, drivers may be misled into thinking the transmission has been disengaged when it has not
- Particular emphasis on the risks in older vehicles such as the 1982 Sigma where the inhibitor switch operates from the selector in the cabin rather than at the transmission itself
- Public awareness that automatic chokes on older cars can cause the engine to operate at speeds that can propel the car forward at relatively rapid rates
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