Birmingham City County
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Source · Prevention of Future Deaths
Trevor Ridd
Ref: 2026-0305
Date: 16 Jun 2026
Coroner: Paramdeep Bains
Area: Birmingham and Solihull
Responses identified: 1 / 1
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Response deadline: 11 August 2026 (extracted from report).
Date
16 Jun 2026
56-day deadline
11 Aug 2026
Responses identified
1 of 1
Coroner's concerns
1. It is not clear why the sprinkler system generated two signals (one ‘fault’ and one ‘fire’) within seconds of one another and what the procedure was for handling this.
View full coroner's concerns
1. It is not clear why the sprinkler system generated two signals (one ‘fault’ and one ‘fire’) within seconds of one another and what the procedure was for handling this.
2. It remains unclear as to why the individual operator treated both signals as being part of the same incident and failed to raise a 999 call; it is not clear how a fault notification works alongside a fire notification.
3. It is not clear what training or instruction individual operators receive in relation to how they are to deal with situations where two notification signals are received in quick succession. It is also unclear what information alerts (if any) are communicated to individual operators in respect of the property from which the signals are received i.e. was it noted that the signals came from Mr Ridd’s property who was bed-bound and a known smoker with severe COPD where there had been a previous incident where he had singed his blanket from smoking in his bed?
4. The evidence at Inquest suggested that the two signals received were the wrong way around however it was not clear why this was and whether this has since been rectified.
5. There is no evidence of regular testing and maintenance of the sprinkler system.
6. It is not clear what individual operators have been ‘briefed’ on post-incident with regards to situations where two notification signals are received in quick succession from the same property.
7. It is not clear what communications have been issued to staff to reinforce the requirement to verify wording of any secondary signals, nor is it clear how staff are to verify the wording of secondary signals.
2. It remains unclear as to why the individual operator treated both signals as being part of the same incident and failed to raise a 999 call; it is not clear how a fault notification works alongside a fire notification.
3. It is not clear what training or instruction individual operators receive in relation to how they are to deal with situations where two notification signals are received in quick succession. It is also unclear what information alerts (if any) are communicated to individual operators in respect of the property from which the signals are received i.e. was it noted that the signals came from Mr Ridd’s property who was bed-bound and a known smoker with severe COPD where there had been a previous incident where he had singed his blanket from smoking in his bed?
4. The evidence at Inquest suggested that the two signals received were the wrong way around however it was not clear why this was and whether this has since been rectified.
5. There is no evidence of regular testing and maintenance of the sprinkler system.
6. It is not clear what individual operators have been ‘briefed’ on post-incident with regards to situations where two notification signals are received in quick succession from the same property.
7. It is not clear what communications have been issued to staff to reinforce the requirement to verify wording of any secondary signals, nor is it clear how staff are to verify the wording of secondary signals.
Responses
Report sections
Investigation and inquest
On 9 March 2026, I commenced an investigation into the death of Trevor John Ridd, aged 87 Years
The medical cause of death was 1a Chronic obstructive pulmonary disease 1b 1c 1d II Burns, Old Age
How, when and where – see below Conclusion The investigation concluded at the end of the inquest . The conclusion of the inquest was Accident.
The medical cause of death was 1a Chronic obstructive pulmonary disease 1b 1c 1d II Burns, Old Age
How, when and where – see below Conclusion The investigation concluded at the end of the inquest . The conclusion of the inquest was Accident.
Circumstances of the death
On 04 January 2026, Mr Ridd’s bedding caught fire however he was unable to leave his bed due to mobility issues. The sprinkler system activated a ‘fault’ signal and a ‘fire’ signal within seconds of one another. The Alarm Receiving Centre received both signals however the individual operator did not raise a 999 call as both signals were treated as being part of the same incident.
Mr Ridd lived in a one-bedroom self-contained flat in an 11 storey purpose-built residential block which was managed by Birmingham City Council’s sheltered housing team. West Midlands Fire Services mobilised at Mr Ridd’s property following a 999 call from a downstairs neighbour reporting a water leak, which was coming from the sprinkler system and damaging the electrics. When West Midlands Fire Services arrived, they heard the smoke alarm from upstairs and attended Mr Ridd’s property. Mr Ridd had been located in his bed in the living room which had been on fire and subsequently extinguished by the actuation of the sprinkler system. He had suffered burns to his lower body. Ambulance Services administered first response emergency care, however Mr Ridd began to decline and went into cardiac arrest. A decision was made not to resuscitate due to the ReSPECT form in place and he passed away. The West Midlands Fire Service Fire Report opined the fire was caused by the naked flame from a cigarette lighter which had ignited the bedding. Mr Ridd had a history of severe COPD and was bed-bound. He was a smoker and was known to smoke cigarettes whilst in bed.
Mr Ridd lived in a one-bedroom self-contained flat in an 11 storey purpose-built residential block which was managed by Birmingham City Council’s sheltered housing team. West Midlands Fire Services mobilised at Mr Ridd’s property following a 999 call from a downstairs neighbour reporting a water leak, which was coming from the sprinkler system and damaging the electrics. When West Midlands Fire Services arrived, they heard the smoke alarm from upstairs and attended Mr Ridd’s property. Mr Ridd had been located in his bed in the living room which had been on fire and subsequently extinguished by the actuation of the sprinkler system. He had suffered burns to his lower body. Ambulance Services administered first response emergency care, however Mr Ridd began to decline and went into cardiac arrest. A decision was made not to resuscitate due to the ReSPECT form in place and he passed away. The West Midlands Fire Service Fire Report opined the fire was caused by the naked flame from a cigarette lighter which had ignited the bedding. Mr Ridd had a history of severe COPD and was bed-bound. He was a smoker and was known to smoke cigarettes whilst in bed.
Action should be taken
In my opinion unless action is taken to address the above concerns then there is a significant risk of future deaths and I believe each of you have the power to take such action.
Copies sent to
I can confirm I have sent the report to: (please do not use individual’s names, but instead roles/titles)1. Birmingham City Council
Similar PFD reports
Report details
- Reference
- 2026-0305
- Date of report
- 16 June 2026
- Coroner
- Paramdeep Bains
- Coroner area
- Birmingham and Solihull
Responses identified
Responses identified
1 of 1
All listed responses identified
Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 11 Aug 2026.
Sent to
- Birmingham City Council