Category: Coroners

Keyu and Others v Secretary of State for Foreign and Commonwealth Affairs and Another: SC 25 Nov 2015

The Court was asked whether the respondents should be required to hold a public inquiry into a controversial series of events in 1948, when a Scots Guards patrol was alleged to shot and killed 24 unarmed civilians in a village called Batang Kali, in Selangor.
Held: A requirement for a public or other inquiry was not imposed. (Baroness Hale of Richmond DPSC dissenting).
In the case of a death before the date on which the relevant state contracted to the Convention, two criteria must be satisfied before the article 2 investigation duty can arise, namely (i) relevant ‘acts or omissions’ after the critical date, and (ii) a ‘genuine connection’ between the death and the critical date. However the second criterion may be finessed where it is necessary to underpin ‘the underlying values of the Convention’. The evens had taken place before the Convention and there was no supervening event to create any obligation after the Convention came into effect. Customary International law had not developed to impose such an obligation, and even if it had, that could not be incorporated into our common law so as to displace clear statute obligations.
The Court considered the incorporation of customary international law into our own law: ‘Even if this conclusion turned out to be wrong, and it is now a principle of customary international law that a state must investigate deaths such as the Killings, even though they occurred as long ago as 1948, it would not be right to incorporate that principle into the common law. Parliament has expressly provided for investigations into deaths (i) through the coroners’ courts in the Coroners and Justices Act 2009, and its predecessors, and (ii) through inquiries in the 2005 Act, and its subject-specific predecessor statutes. It has also effectively legislated in relation to investigations into suspicious deaths through the incorporation of article 2 in the 1998 Act. In those circumstances, it appears to be quite inappropriate for the courts to take it onto themselves, through the guise of developing the common law, to impose a further duty to hold an inquiry, particularly when it would be a duty which has such potentially wide and uncertain ramifications, given that it would appear to apply to deaths which had occurred many decades – even possibly centuries – ago.’
An inquiry into the proportionality of a decision should not be confused with a full merits review: ‘a review based on proportionality is not one in which the reviewer substitutes his or her opinion for that of the decision-maker. At its heart, proportionality review requires of the person or agency that seeks to defend a decision that they show that it was proportionate to meet the aim that it professes to achieve. It does not demand that the decision-maker bring the reviewer to the point of conviction that theirs was the right decision in any absolute sense.’
Lord Neuberger, President, Lady Hale, Deputy President, Lord Mance, Lord Kerr, Lord Hughes
[2015] UKSC 69, [2016] AC 1355, [2015] 3 WLR 1665, [2015] WLR(D) 487, 40 BHRC 228, [2016] HRLR 2, UKSC 2014/0203
Bailii, WLRD, Bailii Summary, SC, SC Summary
European Convention on Human Rights 2, Inquiries Act 2005 1, Human Rights Act 1998, Coroners and Justices Act 2009
England and Wales
Citing:
Cited – In re McKerr (Northern Ireland) HL 11-Mar-2004
The deceased had been shot by soldiers of the British Army whilst in a car in Northern Ireland. The car was alleged to have ‘run’ a checkpoint. The claimants said the investigation, now 20 years ago, had been inadequate. The claim was brought under . .
At first instance – Keyu and Others v Secretary of State for Foreign and Commonwealth Affairs and Another Admn 4-Sep-2012
It was said that a squad of the British army had caused the deaths of 24 civilians in 1948 in Batang Kali (now part of Malaysia.
Held: No inquiry was required. It was a matter of discretion, and there were no sustainable reasons for . .
Appeal from – Keyu and Others v Secretary of State for Foreign and Commonwealth Affairs and Another CA 19-Mar-2014
In 1948, there had been an incident in what later became part of Malaysia, in a counter insurgency patrol, when 24 civilians were said to have been killed by a patrol from the Scots Guards. The claimant now appealed against the refusal of a further . .
Cited – McCaughey and Another, Re Application forJudicial Review SC 18-May-2011
The claimants sought a fuller inquest into deaths at the hands of the British Army in 1990 in Northern Ireland. On opening the inquest, the coroner had declined to undertake to hold a hearing compliant with article 2, and it had not made progress. . .
Cited – Silih v Slovenia ECHR 9-Apr-2009
(Grand Chamber) Article 2 imposes, in certain circumstances, a freestanding obligation in relation to the investigation of a death which applied even where the death itself had occurred before the member state ratified the Convention.: ”The court . .
Cited – Janowiec And Others v Russia ECHR 21-Oct-2013
ECHR Grand Chamber – Article 3
Inhuman treatment
Positive obligations
Alleged failure adequately to account for fate of Polish prisoners executed by Soviet secret police at Katyn in 1940: no . .
Cited – Blecic v Croatia ECHR 8-Mar-2006
The applicant alleged that her rights to respect for her home and to peaceful enjoyment of her possessions had been violated on account of the termination of her specially protected tenancy.
Held: Ratione temporis, the court had had no . .
Cited – Brecknell v The United Kingdom ECHR 27-Nov-2007
Allegations had been made about police collusion with killings in Northern Ireland.
Held: Where there was credible information as to a possible perpetrator of an unlawful killing, there was a duty to investigate that evidence. Here the . .
Cited – Varnava And Others v Turkey ECHR 18-Sep-2009
(Grand Chamber0 Turkey had failed to investigate the disappearance of individuals in Northern Cyprus in 1974. Turkey had ratified the Convention in 1954, but had only recognised the right of petition in 1987.
Held: (Grand Chamber) ‘the court . .
Cited – Halide Cakir And Others v Cyprus ECHR 29-Apr-2010
Admissibility. It was said of the events in Cyprus in 1974 there had been a failure by the state to investigate unlawful killings. The court repeated the Grand Chamber’s formulation of the relevant law in Silih and Varnava, and then pointed out that . .
Cited – Antonio Gutierrez Dorado and Carmen Dorado Ortiz v Spain ECHR 27-Mar-2012
. .
Cited – Jelic v Croatia ECHR 12-Jun-2014
ECHR Article 2-1
Effective investigation
Prosecution of officer with command responsibility, but not of direct perpetrators of killing: violation
Facts – In November 1991 the applicant’s . .

Cited by:
Cited – Al Rabbat v Westminster Magistrates’ Court Admn 31-Jul-2017
The claimant appealed against refusal of an application for judicial review in turn of a refusal to allow private prosecutions of Tony Blair, Jack Straw and Lord Goldsmith in respect of their involvement in the war in Iraq, and the alleged crime of . .
Cited – Youssef v Secretary of State for Foreign and Commonwealth Affairs SC 27-Jan-2016
An Egyptian national, had lived here since 1994. He challenged a decision by the Secretary of State,as a member of the committee of the United Nations Security Council, known as the Resolution 1267 Committee or Sanctions Committee. The committee . .
Cited – Poshteh v Royal Borough of Kensington and Chelsea SC 10-May-2017
The appellant, applying for housing as a homeless person, had rejected the final property offered on the basis that its resemblance to the conditions of incarceration in Iran, from which she had fled, would continue and indeed the mental . .
Cited – Michalak v General Medical Council and Others SC 1-Nov-2017
Dr M had successfully challenged her dismissal and recovered damages for unfair dismissal and race discrimination. In the interim, Her employer HA had reported the dismissal to the respondent who continued their proceedings despite the decision in . .
Cited – Bashir and Others, Regina (on The Application of) v Secretary of State for The Home Department SC 30-Jul-2018
(Interim Judgment) The respondent asylum seekers had been rescued in the Mediterranean and taken to an RAF base in Akrotiri on Cyprus, a sovereign base area. The court was now asked whether they were entitled, or should be permitted, to be resettled . .

Lists of cited by and citing cases may be incomplete.
Updated: 17 August 2021; Ref: scu.554900

Regina v Coroner for Western District of Sussex Ex Parte Homberg Roberts and Mannerss: QBD 27 Jan 1994

A Coroner’s enquires should be as to ‘how’ the death arose, and not into all the circumstances contributing to the death.
Simon Brown LJ said: ‘It is clear that the coroner’s over-riding duty is to inquire ‘how’ the deceased came by his death and that duty prevails over any inhibition against appearing to determine questions of criminal or civil liability . . Secondly, the cases establish that although the is word ‘how’ is to be widely interpreted, it means ‘by what means’ rather than ‘in what broad circumstances’ . . In short the inquiry must focus on matters directly causative of death and must indeed, be confined to these matters alone (save for ascertainment of the other specific details mentioned in r36(1)). The recent, 11th edition of Jervis on Coroners puts it like this: ‘The question of how the deceased came by his death is of course wider than merely finding the principal cause of death, and it is therefore right and proper that the coroner should inquire into acts and omissions which are directly responsible for the death.’ and ‘The duty to inquire ‘how’ the deceased dies does not to my mind properly encompass inquiry also into the underlying responsibility for every circumstance which may be said to have contributed to the death.’
‘It is the duty of the coroner as the public official responsible for the conduct of inquests, whether he is sitting with a jury or without, to ensure that the facts are fully, fairly and fearlessly investigated. He is bound to recognise the acute public concern rightly aroused when deaths occur in custody. He must ensure that the relevant facts are exposed to public scrutiny, particularly if there is evidence of foul play, abuse or inhumanity. He fails in his duty if his investigation is superficial, slipshod or perfunctory. But the responsibility is his. He must set the bounds of the inquiry.’
Morland J ‘In my judgment the purpose of such a jury inquest under s8(3)(d) is clear. It is so that lessons can be learned from the circumstanmces of the death so that in future the risk of injuries to health and safety arising from similar circiumstances should be prevented or reduced.’
Simon Brown LJ, Morland J
Independent 27-Jan-1994, (1994) 158 JP 357
Coroners Rules 1984 36(1)
England and Wales
Cited by:
Cited – Middleton, Regina (on the Application of) v Coroner for the Western District of Somerset HL 11-Mar-2004
The deceased had committed suicide in prison. His family felt that the risk should have been known to the prison authorities, and that they had failed to guard against that risk. The coroner had requested an explanatory note from the jury.
Cited – Middleton, Regina (on the Application of) v Coroner for the Western District of Somerset Admn 14-Dec-2001
The deceased had committed suicide whilst in prison. It was argued that the prison should have recognised that he was a suicide risk, and acted accordingly. The coroner had requested a note from the jury as to the cause of death. The court . .
Cited – In Re Neal (Coroner: Jury) QBD 17-Nov-1995
The father of the deceased sought to have the coroner quash the inquest. His daughter had died in Spain from carbon monoxide poisoning, apparently emanated from a faulty water heater in the apartment in which she had stayed. Her body had been . .
Cited – Takoushis, Regina (on the Application of) v HM Coroner for Inner North London and others CA 30-Nov-2005
Relatives sought judicial review of the coroner’s decision not to allow a jury, and against allowance of an expert witness. The deceased had been a mental patient but had been arrested with a view to being hospitalised. He was taken first to the . .
Cited – Regina v Inner West London Coroner Ex Parte Dallaglio, and Ex Parte Lockwood Croft CA 16-Jun-1994
A coroner’s comment that the deceased’s relative was ‘unhinged’ displayed a bias which was irreparable. ‘The description ‘apparent bias’ traditionally given to this head of bias is not entirely apt, for if despite the appearance of bias the court is . .

Lists of cited by and citing cases may be incomplete.
Updated: 07 August 2021; Ref: scu.86442

In Re Northern Ireland Human Rights Commission Northern Ireland: HL 20 Jun 2002

The coroner intended to hold an inquest into the deaths on the Omagh bombing. The Commission sought the right to be involved on the basis that human rights of interest to it might arise, and the coroner refused, saying that they had no standing to do so.
Held: It was the intention in the Act to extend the powers of the commission. There were no express powers in the Act to make such an intervention, and as a purely statutory body, it had only those powers given to it. However, it had general powers to do such things as were appropriate to promote understanding of Human Rights law, and that would include the power to become involved in an inquest in the way suggested.
Lord Slynn of Hadley, Lord Woolf, Lord Nolan, Lord Hutton and Lord Hobhouse of Woodborough
Times 25-Jun-2002, [2002] UKHL 25, [2002] HRLR 35, [2002] ACD 95, [2002] NI 236
House of Lords, Bailii
Northern Ireland Act 1998 69
Northern Ireland
Citing:
Cited – Attorney General and Another v Great Eastern Railway Company HL 27-May-1880
An Act of Parliament authorised a company to construct a railway. Two other companies combined and contracted with the first to supply rolling stock. An injunction was brought to try to restrain this, saying that such a contract was not explicitly . .

Cited by:
Cited – Human Rights Commission for Judicial Review (Northern Ireland : Abortion) SC 7-Jun-2018
The Commission challenged the compatibility of the NI law relating to banning nearly all abortions with Human Rights Law. It now challenged a decision that it did not have standing to bring the case.
Held: (Lady Hale, Lord Kerr and Lord Wilson . .

Lists of cited by and citing cases may be incomplete.
Updated: 25 July 2021; Ref: scu.174012

Tainton, Regina (on The Application of) v HM Senior Coroner for Preston and West Lancashire and Another: Admn 16 Jun 2016

The deceased had been a serving prisoner. He died of cancer of the oesophagus. There was concern as to his medical care. The claimant challenged the conduct of the inquest by the coroner.
Sir Brian Leveson P QBD, Kerr J
[2016] EWHC 1396 (Admin)
Bailii
England and Wales

Updated: 14 July 2021; Ref: scu.565722

Lagos, Regina (on The Application of) v HM Coroner for The City of London: Admn 14 Mar 2013

The claimant sought judicial review of decisions of the coroner at the inquest of his late wife, and in particular as to the non-disclosure by the coroner of the police report prepared for the inquest.
Held: ‘The police report is a document prepared specifically for the Coroner, which summarises the police investigation, the identity and evidence of any witnesses, and the provisional conclusions of the investigating officer. It is intended to assist the Coroner in understanding the issues and deciding which witnesses are to be called. Police reports are not adduced in evidence at inquests because they are not primary evidence.’
Lang DBE J
[2013] EWHC 423 (Admin)
Bailii
Coroners Act 1988 11, Coroners Rules 1984
England and Wales

Updated: 09 July 2021; Ref: scu.471739

Hurst v Coroner Northern District of London: Admn 4 Jul 2003

The deceased was killed by Mr Reid, a neighbour, who was convicted of his manslaughter.
Held: The court quashed the coroner’s refusal to accede to the application of the deceased’s father to resume an adjourned inquest into the death, at which his court would investigate the role played by the police and the local housing authority in relation to the death. The state’s duty to investigate a death was adjectival in the sense that it was ancillary to the main right to life recognised by Article 2. But it was nonetheless a freestanding right. The court stressed that Article 2 ranked as one of the most fundamental values of the Convention, enshrining (along with Article 3) one of the basic values of the democratic societies making up the Council of Europe. ‘The object and purpose of the convention as an instrument for the protection of individual human beings also requires that article 2 be interpreted and applied so as to make its safeguards practical and effective.’
Rose LJ, Henriques J
[2003] EWHC 1721 (Admin), [2004] UKHRR 139
Bailii
European Convention on Human Rights 2
England and Wales
Cited by:
Cited – Khan, Regina (on the Application of) v Secretary of State for Health CA 10-Oct-2003
The claimant’s child had died as a result of negligence in hospital. The parents had been told the result of police investigation and decision not to prosecute, and the hospital’s own investigation, but had not been sufficiently involved. There . .
Cited – In re McKerr (Northern Ireland) HL 11-Mar-2004
The deceased had been shot by soldiers of the British Army whilst in a car in Northern Ireland. The car was alleged to have ‘run’ a checkpoint. The claimants said the investigation, now 20 years ago, had been inadequate. The claim was brought under . .
Cited – Plymouth City Council v HM Coroner for the County of Devon and Another Admn 27-May-2005
The local authority in whose care the deceased child had been held challenged a decision by the coroner not to limit his inquiry to the last few days of the child’s life. The coroner had decided that he had an obligation to conduct a wider enquiry . .
Appeal from – Hurst, Regina (on the Application of) v Commissioner of Police of the Metropolis v London Northern District Coroner HL 28-Mar-2007
The claimant’s son had been stabbed to death. She challenged the refusal of the coroner to continue with the inquest with a view to examining the responsibility of any of the police in having failed to protect him.
Held: The question amounted . .

These lists may be incomplete.
Updated: 09 June 2021; Ref: scu.185638

McKerr v Armagh Coroner: HL 1990

It is for the coroner to decide how to adduce the necessary evidence as to death. Lord Goff discussed Rule 17 of the 1980 Rules: ‘Nor, in my opinion, does the mere fact that a rule restricts the power of a coroner as to the evidence which he may call prevent the rule in question from being one which regulates practice or procedure. In this connection, rule 17, concerned with documentary evidence at inquests, provides an apt illustration. I have already set out the text of that rule (as amended). A similar, though not identical, rule applies in relation to documentary evidence at coroners’ inquests in England and Wales: see rule 37 of the Coroners Rules 1984 (SI 1984 No 552). The general rule is that a coroner, who is conducting an inquisitorial process concerned to elicit certain facts, is not bound by the strict rules of evidence. Yet here, in rule 17, we find a rule which defines the power of a coroner to admit documentary evidence. I cannot, for my part, see why that fact should prevent the rule from being described as a rule which regulates practice or procedure at a coroner’s inquest. It plainly does, in that it regulates the manner in which the coroner shall, at an inquest, set about his task of eliciting the relevant facts.’
References: [1990] 1 WLR 649, [1990] 1 All ER 865
Judges: Lord Goff
Statutes: Coroners (Practice and Procedure) Rules (NI) 1980 17
Jurisdiction: England and Wales
This case cites:

  • Approved – Regina v South London Coroner ex parte Thompson 8-Jul-1982
    The court discussed the function of the coroner and his inquest.
    Lord Lane CJ said: ‘The coroner’s task in a case such as this is a formidable one, and no one would dispute that; that is quite apart from the difficulties which inevitably arise . .
    ([1982] 126 SJ 625)

This case is cited by:

  • Cited – In re McKerr (Northern Ireland) HL 11-Mar-2004
    The deceased had been shot by soldiers of the British Army whilst in a car in Northern Ireland. The car was alleged to have ‘run’ a checkpoint. The claimants said the investigation, now 20 years ago, had been inadequate. The claim was brought under . .
    (, [2004] 1 WLR 807, Times 12-Mar-04, , [2004] UKHL 12, Gazette 01-Apr-04, [2004] 2 All ER 409, [2004] UKHRR 385, [2004] NI 212, 17 BHRC 68, [2004] Lloyd’s Rep Med 263, [2004] HRLR 26)
  • Cited – In re McKerr (Northern Ireland) HL 11-Mar-2004
    The deceased had been shot by soldiers of the British Army whilst in a car in Northern Ireland. The car was alleged to have ‘run’ a checkpoint. The claimants said the investigation, now 20 years ago, had been inadequate. The claim was brought under . .
    (, [2004] 1 WLR 807, Times 12-Mar-04, , [2004] UKHL 12, Gazette 01-Apr-04, [2004] 2 All ER 409, [2004] UKHRR 385, [2004] NI 212, 17 BHRC 68, [2004] Lloyd’s Rep Med 263, [2004] HRLR 26)
  • Cited – Regina v HM Attorney-General for Northern Ireland and Another Ex Parte Devine CANI 1992
    An inquest was held into three deaths thought to be at the hands of British soldiers. The coroner had admitted written evidence from statements taken by British officers on the basis that the makers of the statements were not compellable as . .
    ((1992) NI 74)
  • Adhered to – Regina v HM Attorney-General for Northern Ireland and Another Ex Parte Devine, Same Ex Parte Breslin HL 1-Apr-1992
    The Coroner had held an inquest into the deaths of three persons who had been shot by soldiers. The Coroner had admitted statements made by the soldiers under Rule 17 of the Northern Ireland Rules. Those statements had been produced in evidence by . .
    (Gazette 01-Apr-92, [1992] 1 WLR 262)
  • Cited – Assistant Deputy Coroner of Inner West London v Paul and Another, Regina on the Application of CA 28-Nov-2007
    The coroner appealed a judicial review granted after he allowed into evidence, hearsay evidence contained in a written statemnent from a witness who could not attend the inquest.
    Held: Rule 37 does not allow the admission of a document, even . .
    (, [2007] EWCA Civ 1259, Times 11-Dec-07, [2007] Inquest LR 270, [2008] 1 All ER 981, [2008] 1 WLR 1335)

These lists may be incomplete.
Last Update: 27 November 2020; Ref: scu.194456

Devon and Cornwall Police v HM Coroner for Plymouth, Torbay and South Devon and Others: Admn 27 Nov 2013

The court heard an application by the police to restrain a question being put to an inquest jury. Two people had died after a police car had sought to persuade a driver to stop. He was thought to be at risk of committing suicide. The coroner sought to ask the jury whether any defect had been shown in the Police procedures.
Held: The question was not to be asked. This was an exceptional case allowing such an intervention, and, inter alia, ‘the jury would otherwise be asked to make findings that could have a substantial negative impact on PC Bickford in particular when, on the information available to me, he has had no proper opportunity to deal in evidence with the criticisms that would inevitably arise if the jury were to answer question 9 affirmatively. ‘
References: [2013] EWHC 3729 (Admin)
Links: Bailii
Judges: Stuart-Smith J
Statutes: Coroners and Justice Act 2009 5
Jurisdiction: England and Wales

Last Update: 23 September 2020; Ref: scu.518477

Secretary of State for Foreign and Commonwealth Affairs v Assistant Deputy Coroner for Inner North London: Admn 27 Nov 2013

The SS had claimed public interest immunity (PII) in respect of several documents requested for an inquest into the death of Alexander Litvinenko, a prominent Russian exile. The coroner had rejected the claim for several, and the SS now appealed.
References: [2013] EWHC 3724 (Admin)
Links: Bailii
Judges: Goldring, Treacy LJJ, mitting J
Jurisdiction: England and Wales
This case cites:

These lists may be incomplete.
Last Update: 23 September 2020; Ref: scu.518481

Regina v South London Coroner ex parte Thompson; 8 Jul 1982

References: [1982] 126 SJ 625
Coram: Lord Lane CJ
Ratio: The court discussed the function of the coroner and his inquest.
Lord Lane CJ said: ‘The coroner’s task in a case such as this is a formidable one, and no one would dispute that; that is quite apart from the difficulties which inevitably arise when feelings are running high and the spectators are emotionally involved and vocal. Once again it should not be forgotten that an inquest is a fact finding exercise and not a method of apportioning guilt. The procedure and rules of evidence which are suitable for one are unsuitable for the other. In an inquest it should never be forgotten that there are no parties, there is no indictment, there is no prosecution, there is no defence, there is no trial, simply an attempt to establish facts. It is an inquisitorial process, a process of investigation quite unlike a criminal trial where the prosecutor accuses and the accused defends, the judge holding the balance or the reins whichever metaphor one chooses to use.’
and ‘the function of an inquest is to seek out and record as many of the facts concerning the death as [the] public interest requires.’ The Broderick Committee exhaustively considered the role of the coroner’s inquest in modern society. The committee identified the following grounds of public interest which they believed that a coroner’s inquiry should serve:
(1) To determine the medical cause of death;
(ii) To allay such rumours or suspicion;
(iii) to draw attention to the existence of circumstances which, if unremedied, might lead to further deaths;
To advance medical knowledge;
(v) To preserve the legal inteersts of the deceased person’s family, heirs or other interested parties.
However ‘It is not the function of the Coroner’s inquest to provide a forum for attempts to gather evidence for pending or future criminal or civil proceedings.”
This case is cited by:

(This list may be incomplete)

Last Update: 28-Aug-16
Ref: 187755

Regina v HM Coroner, Lincoln, ex parte Hay; 19 Feb 1987

References: Unreported, 19 February 1987
This case is cited by:

Garnett v Ferrand And Another; 28 May 1827

References: [1827] EngR 492, (1827) 6 B & C 611, (1827) 108 ER 576
Links: Commonlii
Coram: Lord Tenterden CJ
No action will lie against the Judge of a Court of Record for an act done by him in his judicial capacity, and therefore trespass cannot be maintained against a coroner for turning a person out of a room where he is about to take an inquisition.
Lord Tenterden CJ said: ‘This freedom from action and question of the suit of an individual is given by the law to the Judges, not so much for their own sake as for the sake of the public, and for the advancement of justice, that being free from actions, they may be free in thought and independence in judgment, as all who are to administer justice ought to be.’
‘There is not any occasion to inquire into the power of the coroner before Magna Charta, for by c 17 his power to hold pleas of the Crown was taken away. ‘No sheriff, constable, escheator, coroner, nor any other our bailiffs, shall hold pleas of our Crown.’ Upon this, Lord Coke says, ‘And what authority had the coroner? The same authority he now hath, in case when any man come to violent or untimely death, super visum corporis, &e., abjurations and outlawries, &e., appeals of death by bill, &e. This authority of the coroner, viz. the coroner solely to take an indictment super visum corporis, and to take an appeal, and to enter the appeal ; and the count remaineth to this day. But he can proceed no further, either upon the indictment or appeal, but to deliver them over to the justices: and this is saved to them by Stat. Westm. 1, c. 10.’It may, however, be said, that as to some matters arising out of this inquiry, the inquest of the coroner is final, ex. gr., that the deceased was felo de se ; that a certain thing was deodand; that a certain person was guilty, and fled for it. There are one or two dicta in the books that these findings are not traversable. But it appears by the best authorities, that the inquests of the coroner are in no case conclusive, and that any one affected by them, either collaterally or otherwise, may deny their authority, and put them in issue .’