Coroner's Finding: Brown, Teresa & Brown, Jim

MAGISTRATES COURT of TASMANIA

CORONIAL DIVISION Record of Investigation into Death (Without Inquest) Coroners Act 1995 Coroners Rules 2006 Rule 11 I, Leigh Mackey, Coroner, have investigated the deaths of Teresa Anne Brown and her son, Jim Royden Brown. Mrs Brown and Jim were the driver and front seat passenger, respectively, of a motor vehicle involved in an accident that caused their deaths. It is appropriate that I consider the investigation into that accident and make findings as to their deaths jointly as the circumstances of their deaths are common between them.

First Class Constable (as she then was) Cassandra Richardson was charged with causing death by dangerous driving and driving whilst disqualified as a result of her actions that led up to the accident that caused the deaths of Mrs Brown and Jim. Ms Richardson was stood down from her duties as a member of Tasmania Police from 31 October 2022 upon being charged, and from 2 November 2022 was suspended from duty. The charges against Ms Richardson were heard in the Magistrates Court before Magistrate McKee between 10 October 2023 and 16 April 2024.

On 30 August 2024 Ms Richardson was found guilty of the charges of causing death by dangerous driving, a conviction for each of the deaths of Mrs Brown and Jim, and driving whilst disqualified. On 10 September 2024 she resigned from her employment with Tasmania Police.

Ms Richardson was sentenced in respect of the convictions on 29 November 2024 to serve a term of 6 months imprisonment commencing on 29 November 2024 which was wholly suspended on the condition that, for a period of 12 months, she not commit another offence punishable by imprisonment and be of good behaviour. Her driver’s licence was cancelled for a period of 12 months to commence on 29 November 2024. An appeal lodged by Ms Richardson against her conviction and sentence was discontinued by her on 29 January 2025.

Teresa Anne Brown Mrs Brown was born on 12 March 1971 and was 51 years of age at the time of her death. She had a medical history of depression and cardiac issues. Mrs Brown had a difficult start in life.

She was abandoned by her parents as an infant and spent a large part of her life in foster care.

She had her first child, Nicholas, as a 17 year old and worked in vineyards and at an IGA. She married Clayton Brown on 26 November 1988 and had three more children, Samantha, Joel and Jim. The family lived in the Campania area of Southern Tasmania.

The marriage was volatile and by the time of her death Mrs Brown and Clayton had separated.

Mrs Brown enjoyed a particularly close relationship with Jim who remained living with her after his parents’ separation. On 8 May 2022 Clayton was involved in a serious single vehicle accident and at the time of Mrs Brown and Jim’s deaths was an inpatient in hospital receiving medical care in respect of the injuries he suffered in that accident.

On 10 May 2022 at approximately 4.50pm Mrs Brown was driving along Brinktop Road toward Campania after having collected Jim from Penna. Jim was in the front passenger seat of the vehicle. Both Mrs Brown and Jim were wearing seatbelts. Mrs Brown was driving a red Daewoo Lanos (Daewoo). The Daewoo was owned by Mr Mitchell Crowe, a friend of Jim and was not fitted with airbags.

Following her death, blood was taken from Mrs Brown and tested. The tests revealed a greater than normal range of carboxyhaemoglobin, nitrazepam at a subtherapeutic level, and the absence of alcohol or other illicit substances. The presence of carboxyhaemoglobin was possibly caused by exposure to the motor vehicle’s exhaust, or cigarette smoke.1 Nitrazepam is a prescribed medication used in the treatment of insomnia and can cause sedation and impair coordination and reaction times.2 Jim Royden Brown Jim was born on 26 July 2005. He was 16 at the time of his death. He lived at home with his mother, Mrs Brown, and worked for his brother, Nicholas, at Pro Stop Plaster. Jim was diagnosed with type 1 diabetes as a child and was insulin dependent but was otherwise healthy at the time of his death. Jim enjoyed a close relationship with his mother.

On 10 May 2022 Jim had been with his brother, Nicholas, at Shark Point Road in Penna. Jim had worked with Nicholas that day and it was the intention that he stay with him that night, however Jim had changed his mind and decided to return home.3 He called his mother to collect him. They were on the journey home to Campania when the accident occurred. Jim was travelling as the front seated passenger in the Daewoo and was wearing a seatbelt.

Cassandra Joy Richardson Ms Richardson was a First Class Constable employed by Tasmania Police and a trained paramedic having completed a Bachelor of Paramedic Practice at the University of Tasmania.

She graduated from the Tasmania Police Academy in December of 2018 and worked at the Hobart and Glenorchy Police Stations before commencing at the Bellerive Police Station in 1 Affidavit of Neil McLachlan-Troup Forensic Science Service Tasmania sworn 25 May 2022 p1.

2 Affidavit of Neil McLachlan-Troup Forensic Science Service Tasmania sworn 25 May 2022 p2.

3 Affidavit of Samantha Lee Brown sworn 8 June 2022.

2021. On 10 May 2022 she worked a 6.00am to 4.00pm shift at the Bellerive Police Station.

After completing her shift she was the only occupant of her vehicle, a grey Toyota Hilux (Hilux) travelling to her home in Orielton. Ms Richardson drove from Bellerive Police Station to Orielton via Brinktop Road heading toward Sorell.

Ms Richardson’s shift on 10 May 2022 was routine as demonstrated by a review of the incidents to which she responded on that day. No major incidents or events were identified on the Emergency Services Computer Aided Dispatch System (ESCAD) that would have given rise to fatigue. However witnesses refer to Ms Richardson becoming visibly shaken upon hearing the description on a scanner of an incident unfolding in Glenorchy of an attempted self harm. Ms Richardson commented to Constable Pagano that she had been “triggered” by the incident as she had Post Traumatic Stress Disorder.4 The incident was reported at 12.42pm and completed at 1.53pm. Ms Richardson was spoken to by her shift supervisor, Sergeant Adam Forrest who was satisfied that she remained fit for continuing her duties. It is relevant to note that, at this time, Ms Richardson was in a relationship with Sergeant Forrest, however I do not find that his assessment of her fitness for duty was influenced by that relationship. I find that the evidence does not disclose any deficit in Ms Richardson’s rostering or any aspects of her work day that provide an explanation for or contributed to the manner of her driving on her journey home following the conclusion of her shift.

Ms Richardson was an experienced driver having received advanced driver training as a paramedic and in her employment as a constable with Tasmania Police. Witness affidavits describe her as being a competent driver.

As at 10 May 2022 Ms Richardson was disqualified from driving a vehicle. The disqualification arose from her detection by speed camera on 18 December 2021 exceeding the speed limit by 45 km/h or more. The disqualification was automatic given the extent to which the speed detected exceeded the limit. The disqualification was for the period 23 March 2022 to 22 July

2022. Ms Richardson exceeded the speed limit on this occasion as part of her operational duties as a police officer urgently attending a domestic incident in Penna. She was informed of the detection, completed a statutory declaration identifying herself as the driver of the vehicle but failed to respond further when, on 23 February 2022, a notice of disqualification was sent to her address. Despite the notice and the disqualification she continued driving in the course of her duties as a constable for Tasmania Police and also privately. She explains this as resulting from her mistaken belief that given the infringement occurred during an urgent duty drive in the course of her duties as a Tasmanian Police Officer she was exempt from the disqualification.

4 Transcript of record of interview of Pagano.

Following the accident Ms Richardson provided a blood specimen for analysis. Fluoxetine was detected in the sample. It is an anti-depressant agent and would not have impacted Ms Richardson’s driving performance.5 Jacqueline McGarry Ms McGarry was driving along Brinktop Road towards Sorell. She was following the Hilux. Ms McGarry was driving a white Toyota Rav4 (Rav4) and had been following behind Ms Richardson’s Hilux from when she had entered Bridge Street after leaving the Ampol Petrol Station in Richmond. She followed behind the Hilux as it travelled along Bridge Street, crossed the Richmond Bridge and entered Brinktop Road. Ms McGarry recalls observing the Hilux to, on occasion, drift out of its lane and the driver take corrective action. She observed this to occur a number of times over the centre line and twice into the gravel verge of the road before the accident. She notes that the Hilux and her vehicle were travelling between 90 – 100 km/h. The distance between the Ampol Service Station and the accident site is 5.8 kilometres and would take just under five minutes to drive to the accident scene if travelling at the speed limit.6 As Ms McGarry and the Hilux travelled past the stables located at 466 Brinktop Road she observed the Hilux to again travel onto the oncoming lane and noted, in her rear vision mirror, the Daewoo which was travelling in the opposite direction, take evasive action to avoid the Hilux and enter the gravel verge of the road, over correct, and enter the wrong lane coming into collision with the vehicle driven by Ms Parremore.

Helen Parremore Ms Parremore was driving a blue Holden Cruze (Cruze) on Brinktop road toward Sorell. Her son, Benjamin, was a front seat passenger in the vehicle. Ms Parremore’s vehicle was travelling behind the Rav4 driven by Ms McGarry. Her vehicle was struck by the Daewoo. A sample of Ms Parremore’s blood was taken for analysis which did not reveal the presence of alcohol or drugs or any other substance that would have impaired to any extent her driving.

The Magistrates Court Proceedings A number of facts relevant to the circumstances of the accident were either agreed by Ms Richardson before the hearing of the charges against her in the Magistrates Court or found as fact by the Court following the hearing of the evidence in the matter. The relevant facts agreed prior to the hearing were: 5 Affidavit of Mr McLachlan-Troup, Forensic Scientist, concerning toxicology regarding, Ms Richardson, p2.

6 Collision Analysis report dated 10 May 2022 p17.

1. On Tuesday 10 May 2022, shortly after 4.00pm Ms Richardson left her workplace at Bellerive Police Station having completed a 10 hour shift and drove to Richmond via the B31. She then drove in an easterly direction along Brinktop Road (C351) toward Sorell, intending to turn left at the intersection of the A3 toward Orielton;

2. Ms Richardson was driving the Hilux and was the sole occupant of the vehicle;

3. At the same date and time Mrs Brown, age 51, was driving west on Brinktop Road Penna towards Richmond;

4. Mrs Brown was driving the Daewoo and her son Jim Brown was seated in the front passenger seat;

5. At approximately 4.45pm as she approached the stables Mrs Richardson glanced to her left to see the horses;

6. At about the same time Mrs Brown was approaching the stables;

7. Mrs Brown’s vehicle was involved in a collision and Mrs Brown and Jim Brown were killed in the collision;

8. At the location of the collision the lanes of Brinktop Road were separated by a solid continuous white line;

9. The relevant speed limit was 100km/h; and

10. Neither drugs nor alcohol impaired the driving of Ms Richardson or Ms Parremore nor caused of contributed to the cause of the collision.7 Following a hearing of all the evidence Magistrate McKee made further findings of fact:

11. As they were travelling in opposite directions along Brinktop Road, Ms Richardson toward Sorell and Mrs Brown toward Richmond, their vehicles passed one another. Mrs Brown’s vehicle has then undertaken a path of travel: a. Leaving the roadway; b. Entering the gravel shoulder; c. Re-entering the roadway; d. Entering onto the incorrect side of the roadway; and e. Colliding with a vehicle being driven by Ms Parremore (the Cruze).

12. Ms Richardson was travelling on Brinktop Road heading towards Sorell at approximately 90 km/h;

13. Mrs Brown was travelling on Brinktop Road heading towards Richmond; and

14. Just past the stables on Brinktop Road Ms Richardson’s vehicle (the Hilux) has left the lane she had been travelling in and entered the lane Mrs Brown’s vehicle was travelling in; 7 Director of Public Prosecutions v Cassandra Richardson, Reasons for Decision para 6.

15. Ms Richardson’s vehicle crossed over the continuous white dividing line by at least half the width of her motor vehicle; and

16. Mrs Brown was required to take evasive action to avoid Ms Richardson’s motor vehicle.8 Magistrate McKee concluded that Ms Richardson’s driving was negligent in that she failed to maintain proper control of her vehicle when she entered Mrs Brown’s lane by up to half a car’s width, by crossing over a continuous white line, she did not keep a proper look out, and drove into the path of Mrs Brown’s vehicle as it approached her vehicle.9 As noted earlier in these findings Ms Richardson was convicted and sentenced on the charges of causing death by negligent driving and driving whilst disqualified. I do not find, however, that the fact that Ms Richardson was at the time of the accident driving whilst disqualified contributed in any meaningful sense to the cause of the accident.

The investigation Mrs Brown and Jim both died at the scene of the accident. Members of the public who were present provided significant assistance in its immediate aftermath. This would have been a distressing situation, and their efforts deserve commendation.

Ms Richardson, having appreciated an accident had occurred from her rear vision mirror view, pulled over to the side of the road and returned to the accident scene. She was in distress. Witnesses heard her state “what have I done”,10 that she had “killed two people”,11 it was “her fault”12 and she had “fallen asleep”.13 Emergency responders from the SES, Tasmanian Fire Service, Tas Ambulance, and Tasmanian Police attended the scene.

It was quickly appreciated that Ms Richardson was a serving member of Tasmania Police and as a result the investigation of the accident was undertaken by Professional Standards.

The accident was investigated by the traffic crash investigator, Senior Constable Cordwell.

In her assessment of the scene she noted that Brinktop Road had a generally east to west orientation and provided for single lane travel west toward Richmond and east toward 8 Director of Public Prosecutions v Cassandra Richardson, Reasons for Decision para 148.

9 Director of Public Prosecutions v Cassandra Richardson, Reasons for Decision para 187.

10 Affidavit of Chloe Rappl sworn 16 June 2022.

11 Affidavit of Sarah Castle sworn 19 June 2022 p2, Affidavit of Helen Louise Parremore sown 13 May 2022, Affidavit of Benjamin Cameron Parremore sworn 13 May 2022 p2, Affidavit of Michael Stoop sworn 17 June 2022 p1.

12 Affidavit of Michael Stoop sworn 17 June 2022 p2.

13 Affidavit of Sarah Castle sworn 19 June 2022 p2, Affidavit of Benjamin Cameron Parremore sworn 13 May 2022 p2, Internal investigations recorded video interview of Ashley Gregory p5, Statutory Declaration of Melissa Hocken declared 26 May 2022 p2.

Sorell.14 The lanes were 2.9 metres wide and were divided by a single continuous white line. The road edges on both sides of the road were bordered by sealed shoulders. The northern edge of the east bound lane had a small section of loose gravel 1.6 metres wide before leading onto grass and a drain. The southern edge of the west bound lane had a deep drain located 3.6 metres south of the sealed edge.15 The Daewoo driven by Mrs Brown was travelling on the west bound lane and the Hilux driven by Ms Richardson, on the east bound lane.

Crash investigators located a tyre mark in a section of loose gravel on the southern edge of the west bound lane which was identified as a yaw mark16 consistent with having been made by the left rear tyre of the Daewoo, and a tyre mark measuring approximately 7.9 metres commencing on the southern side of the centre line and continuing into the east bound lane consistent with being made by the front right tyre of the Daewoo. Senior Constable Cordwell concluded that the Daewoo was initially travelling west toward Richmond in its correct lane of travel.17 The left wheels of the Daewoo have left the road surface and entered the gravel on the southern side of the road before the Daewoo began to rotate in a clockwise direction and went into yaw.18 With control of the Daewoo lost it sideslipped into the incorrect side of the road and came into collision with the Cruze.19 The yaw mark was found to be consistent with the Mrs Brown applying excessive right hand steering input.20 It is understandable that she did so faced with the Hilux’s incursion into her lane of travel, and the proximity of a deep drain on the western side of the road.

Analysis of the speed at which the Daewoo and Hilux were travelling at the time of the accident was undertaken by Senior Constable Hall. In his report he identifies the yaw mark left by the Daewoo and uses it to calculate that at the time the Daewoo began to side slip it was travelling at an average speed of 76 km/h.21 Analysis of the speed at which the Cruze was travelling was calculated from data recovered from its airbag control module and puts the speed at between 99 – 101 km/h 2.5 - 0.5 seconds prior to the collision.22 As noted earlier in these findings, the conclusion of Magistrate McKee after hearing all the evidence was that the Hilux was travelling at approximately 90 km/h at the time of the accident.

14 Collision Analysis report dated 10 May 2022 p4.

15 Collision Analysis report dated 10 May 2022.

16 A mark left by a vehicle’s tyres showing sideways movement of a vehicle in another direction than that in which it is headed.

17 Collision Analysis report dated 10 May 2022 p18.

18 Collision Analysis report dated 10 May 2022 p18.

19 Collision Analysis report dated 10 May 2022 p18.

20 Collision Analysis report dated 10 May 2022 p18.

21 Speed Analysis report dated 10 May 2022 p5.

22 Speed Analysis report dated 10 May 2022 p9.

The applicable speed limit for the area of Brinktop Road at which the accident occurred was 100 km/h.

The Daewoo, Cruse and Hilux were all inspected by Mr Shepherd, Transport Safety and Investigation Officer. Each of the vehicles had some aspects of noncompliance. Noncompliant matters detected on the Hilux and Cruze were not of a nature that would have contributed to the accident. Non-compliant matters identified on the Daewoo involved its tyres, specifically tread depths, mismatched tyre sizes across axle-groups and worn front disc brakes.23 Whilst I find that the aspects of the Daewoo that were non-compliant did not cause the accident they likely hindered Mrs Brown’s ability to respond to the emerging threat of the Hilux entering her lane in a controlled manner.

Mrs Brown had carboxyhaemoglobin and nitrazepam, the latter at a subtherapeutic level, in her blood at the time of the accident. The evidence does not, however, support a finding that Mrs Brown’s driving was impaired to any extent because of the presence of either substance in her blood. She reacted swiftly and understandably to the perceived and real threat presented to her by the Hilux entering, by half of its width, into her lane. Ms Richardson and Ms Parremore were similarly unaffected by substances in their blood at the time of the accident. The speed of the Daewoo, Cruze and Hilux also did not contribute to the accident nor were there any environmental factors including the weather, visibility and road conditions that were causative.

The facts agreed by Ms Richardson and found by Magistrate McKee referred to earlier in these findings, accurately depict the circumstances of the accident. I find the accident was caused by the inattention and manner of driving of Ms Richardson which resulted in the Hilux entering onto the incorrect side of the road, causing Mrs Brown to take evasive action which in turn resulted in a loss of control. The Daewoo entered the gravel at the southern edge of the road, went into yaw, and entered the oncoming, east bound, lane colliding with the Cruze and causing the deaths of Mrs Brown and Jim.

I Find, pursuant to Section 28(1) of the Coroners Act 1995, in respect of Teresa Anne Brown that a) The identity of the deceased is Teresa Anne Brown; b) Mrs Brown died as a result of multiple (head, trunk (chest) and limb) injuries due to a motor vehicle crash; 23 Affidavit of Craig Shepherd Transport Safety and Investigation Officer sworn 10 June 2022.

c) Mrs Brown’s cause of death was multiple (head, trunk (chest) and limb) injuries; and d) Mrs Brown died on 10 May 2022 at Penna, Tasmania.

And I Find, pursuant to Section 28(1) of the Coroners Act 1995, in respect of Jim Royden Brown that a) The identity of the deceased is Jim Royden Brown; b) Jim died as a result of multiple (head, trunk and limb) injuries due to a motor vehicle crash; c) Jim’s cause of death was multiple (head, trunk and limb) injuries; and d) Jim died on 10 May 2022 at Penna, Tasmania.

In making the above findings I have had regard to the evidence gained in the investigation into both deaths. The evidence includes:

• The Police Reports of Death for the Coroner;

• Affidavits confirming identity;

• Opinions of the forensic pathologist regarding cause of death;

• Affidavits of Mr McLachlan-Troup, Forensic Scientist, concerning toxicology regarding Mrs Brown, Jim, Ms Richardson, Ms Parremore;

• Tasmanian Health Service medical records of Mrs Brown;

• Affidavit of Ms Samantha Brown;

• Internal investigations recorded video interview of Ms McGarry, Alanna Richardson, Robert Klingsporn, Ashley Gregory, Damien Minehan, Constable Adam Forrest, Constable Simon Jaenke, Ms Richardson, Constable Martin Scott, Sarah Robinson and Constable Casey Pagano;

• Affidavit of Sarah Castle;

• Affidavit of Chloe Rappl;

• Affidavit of Helen Parremore;

• Affidavit of Benjamin Parremore;

• Statutory Declaration of Matthew Smith declared 27 May 2022;

• Statutory Declaration of First Class Constable Timothy James declared 24 May 2022;

• Statutory Declaration of Senior Constable Raymond Guy declared 23 May 2022;

• Statutory Declaration of Senior Constable Brett Bowering;

• Statutory Declaration of First Class Constable Joshua Woods declared 26 May 2022;

• Statutory Declaration of Melissa Hocken declared 26 May 2022;

• Statutory Declaration of Constable Michael Hinchen declared 1 June 2022;

• Statutory Declaration of Detective Inspector Michael Smith declared 25 May 2022;

• Statutory Declaration of Inspector Gavin Hallett declared 24 May 2022;

• Statutory Declaration of Inspector James Semmens declared 25 May 2022;

• Affidavit of Senior Sergeant Adam Archer sworn 21 June 2022 and drone footage;

• Affidavit of Heidi Woodhead sworn 20 May 2022 and photographs;

• Speed Analysis Report dated 10 May 2022 and footage;

• Collision Analysis Report 10 May 2022;

• Body worn camera footage and 000 call recordings;

• Affidavit of Craig Shepherd Transport Safety and Investigation Officer sworn 10 June 2022;

• Timeline for 10 May 2022 from CCR and phone analysis of Ms Richardson;

• Tasmania Police Subject Report re: infringement notice and application for withdrawal;

• Tasmania Police Subject Report re: speed camera infringement notice;

• Letter of the Commissioner’s Office dated 17 May 2022 re: suspension of police driving permit;

• Notice of disqualification from Department of State Growth to Ms Richardson dated 23 February 2022;

• Ms Richardson’s work roster and ESCAD incident summary;

• HQ cardholder activity report;

• Certificates and documents relevant to driving qualifications;

• Maps of Brinktop Road;

• Incident report;

• Traffic Crash Report ESCAD 000231 - 10052022;

• Memorandum of Sentence;

• Facts for prosecutor; and

• Notice of Discontinuance of Appeal.

Comments and Recommendations I extend my appreciation to investigating officer Detective Inspector Luke Horne for his investigation and report and to crash investigators Senior Constable Cordwell and Senior Constable Hall for their crash and speed analysis and reports.

The circumstances of Mrs Brown’s and Jim deaths are not such as to require me to make any comments or recommendations pursuant to Section 28 of the Coroners Act 1995.

I convey my sincere condolences to the family and loved ones of Mrs Brown and Jim.

Dated: 3 June 2025 at Hobart, in the State of Tasmania.

Leigh Mackey Coroner