Coroner in Tears as Inquest into Death of Australian Eventers Concludes

The final week of the inquest into the deaths of Australian event riders Olivia Inglis and Caitlyn Fischer had moments of high emotion and confrontation.

It’s been three years since young Australian eventers Olivia Inglis and Caitlyn Fischer died as the result of falls on the cross country course, at separate events.

By: Pippa Cuckson | July 30, 2019

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you're listening to an article from horse sport.com. coroner in tears as inquest into death of australian eventers concludes by: pippa cuckson |. the final week of the inquest into the deaths of young australian event riders olivia inglis and caitlyn fischer had moments of high emotion – and confrontation. it is over three years since olivia died at scone and caitlyn at the sydney international, in spring 2016. the joint inquest was finally slated for two weeks in may this year, but ran out of time and reconvened last week. coroner lee will deliver his findings on october 4th. last wednesday, the sydney courtroom had the unexpected sight of derek lee, new south wales’s hugely experienced deputy state coroner, in tears after the families described how the loss of their daughters had affected them. advertisement scroll to continue with content in contrast, on the last day of the three-week hearing bruce hodgkinson, counsel for equestrian australia (ea’s) insurers, asked the coroner to disregard the evidence of olympian paul tapner. the vice-president of the eventing riders association had strongly criticised the construction of the fence at scone where olivia died and said he would not have wanted to jump it. but dr peggy dwyer, counsel assisting the coroner, said tapner was a rider and would be heard; the other expert witnesses probably had not wanted to criticise a fellow course designer. she recalled that all of them said they would have built the fence differently. hodgkinson also insisted that the training and equipment of the scone medic was the responsibility of the health provider, a now defunct private ambulance service. this was also refuted by dwyer. olivia was still alive after she fell, but the ambulance was not carrying advanced airway equipment and the medic was only an enhanced first-aider. the resumed inquest painted a further picture of poor communications within australia’s equestrian sport administration ; confusion over accountability and the hierarchy of various governing bodies including the fei; and minimal medical provision. there was discussion about whether the words “must” and “should” in fei guidelines meant it was mandatory to have a doctor on site. there was ambiguity over who designed the scone cross-country. new zealander john nicholson was listed but not present, with daryl burgess “standing in” on the day. at the end of the may hearing, health and safety professional samantha farrar alleged that ea shut her out of the very investigation they had asked her to undertake, then altered her report. farrar was denied access to key personnel including nicholson, burgess and the fei technical delegate matthew bates after she began to query the distance between the two elements of the fatal fence – four and a half strides. last week this was put to further witnesses, including judy fasher, former chairman of ea, who revealed the ea board had never even discussed the first tragedy. the causes of caitlyn’s fatal fall at an un-pinned table were harder to isolate. witnesses spoke of her horse being distracted on the approach – in videos, he can be seen looking up. reports of a drone have not been confirmed. her mother ailsa carr is a nurse and was one of the first on the scene; she could immediately see that caitlyn was dead. failure to take her statement was one of many procedural oversights that have now come to light. in final submissions, dr dwyer said while ea was to be commended for the steps it had since taken, at the time there were “deficiencies” in the level of care available to riders. she was not blaming, but trying to identify causal, systemic factors. the families hoped ea would become a world leader in safety, as had britain after a series of tragedies in the late 1990s. the coroner was visibly moved by the parents’ impact statements. ailsa carr spoke of caitlyn’s verve for life and her plans to travel to europe, having cultivated a three-page “bucket list” of the places she hoped to explore. arthur inglis spoke of his daughter’s strong values, describing her as the “balancing force” in their family. “nothing feels complete without her,” he said.

The final week of the inquest into the deaths of young Australian event riders Olivia Inglis and Caitlyn Fischer had moments of high emotion – and confrontation.

It is over three years since Olivia died at Scone and Caitlyn at the Sydney International, in spring 2016. The joint inquest was finally slated for two weeks in May this year, but ran out of time and reconvened last week. Coroner Lee will deliver his findings on October 4th.

Last Wednesday, the Sydney courtroom had the unexpected sight of Derek Lee, New South Wales’s hugely experienced deputy state coroner, in tears after the families described how the loss of their daughters had affected them.

Scroll to continue with content

In contrast, on the last day of the three-week hearing Bruce Hodgkinson, counsel for Equestrian Australia (EA’s) insurers, asked the coroner to disregard the evidence of Olympian Paul Tapner. The vice-president of the Eventing Riders Association had strongly criticised the construction of the fence at Scone where Olivia died and said he would not have wanted to jump it.

But Dr Peggy Dwyer, counsel assisting the coroner, said Tapner was a rider and would be heard; the other expert witnesses probably had not wanted to criticise a fellow course designer. She recalled that all of them said they would have built the fence differently.

Hodgkinson also insisted that the training and equipment of the Scone medic was the responsibility of the health provider, a now defunct private ambulance service. This was also refuted by Dwyer.

Olivia was still alive after she fell, but the ambulance was not carrying advanced airway equipment and the medic was only an enhanced first-aider.

The resumed inquest painted a further picture of poor communications within Australia’s equestrian sport administration; confusion over accountability and the hierarchy of various governing bodies including the FEI; and minimal medical provision. There was discussion about whether the words “must” and “should” in FEI guidelines meant it was mandatory to have a doctor on site.

There was ambiguity over who designed the Scone cross-country. New Zealander John Nicholson was listed but not present, with Daryl Burgess “standing in” on the day.

At the end of the May hearing, health and safety professional Samantha Farrar alleged that EA shut her out of the very investigation they had asked her to undertake, then altered her report. Farrar was denied access to key personnel including Nicholson, Burgess and the FEI technical delegate Matthew Bates after she began to query the distance between the two elements of the fatal fence – four and a half strides.

Last week this was put to further witnesses, including Judy Fasher, former chairman of EA, who revealed the EA board had never even discussed the first tragedy.

The causes of Caitlyn’s fatal fall at an un-pinned table were harder to isolate. Witnesses spoke of her horse being distracted on the approach – in videos, he can be seen looking up. Reports of a drone have not been confirmed.

Her mother Ailsa Carr is a nurse and was one of the first on the scene; she could immediately see that Caitlyn was dead. Failure to take her statement was one of many procedural oversights that have now come to light.

In final submissions, Dr Dwyer said while EA was to be commended for the steps it had since taken, at the time there were “deficiencies” in the level of care available to riders. She was not blaming, but trying to identify causal, systemic factors.

The families hoped EA would become a world leader in safety, as had Britain after a series of tragedies in the late 1990s.

The coroner was visibly moved by the parents’ impact statements. Ailsa Carr spoke of Caitlyn’s verve for life and her plans to travel to Europe, having cultivated a three-page “bucket list” of the places she hoped to explore.

Arthur Inglis spoke of his daughter’s strong values, describing her as the “balancing force” in their family. “Nothing feels complete without her,” he said.