Bronson Rhodes' death was a "perfect storm" of events and a reminder of just how quickly a person can drown.
The 14-year-old Wauchope High School student went missing while swimming with two friends at Port Macquarie's Flynns Beach on December 16, 2017.
Magistrate Price made eight recommendations in handing down the results of the inquest in the Port Macquarie Coroner's Court on Friday, September 13, that will have far-reaching impacts on surf life saving practices across the state.
Surf Life Saving NSW and Port Macquarie Surf Life Saving Club have already addressed some of those recommendations, the magistrate noted.
Magistrate Price's four recommendations to the state body included:
- That a policy be developed and implemented that appropriately qualified and experienced persons be designated as an observer in an observation tower,
- Additional ongoing surveillance training be provided for members in the observation tower,
- Research be undertaken into the viability and reliability into the use of drones to deliver flotation devices, and
- Using the findings of this inquest to brief patrol members across NSW prior to the start of the 2019/20 patrolling season.
The four recommendations specific to the Port Macquarie Surf Life Saving Club were:
- That board cradles be used to hold boards, radios, tubes and other relevant rescue gear and be readily available at the water's edge,
- That IRB drivers and crew ensure that appropriately sized life jackets be located near the IRB at the start of the patrol,
- Members be reminded of the need for vigilance and for the avoidance of distractions while on patrol, and
- Members be reminded about the importance of ongoing and appropriate communications.
Bronson's mum Rachel was broadly supportive of the recommendations but said the impact (of the recommendations) could have gone a little further.
"I would have liked to have seen a little bit more instruction around specific training, the age and experience of surf club members (placed in the observation tower)," she said.
"But apart from that, I am happy most of the recommendations were handed down.
"I am also happy that the Port Macquarie surf club is placing a memorial board for Bronson at the beach."
Rachel is also continuing to negotiate with Port Macquarie-Hastings Council regarding a table and seats with a suitable inscription at the beach.
"And thank you to everyone involved in the search effort and the entire community for their support," she added.
Magistrate Price said it was clear that it is not one single factor that resulted in the death of Bronson.
"Rather it appears to be a combination of factors that created a perfect storm of conditions where Bronson was unable to be saved and his body unable to be recovered," the magistrate said.
"What is clear from the evidence is how quickly a person can drown.
"The window of opportunity to save somebody can be incredibly short; every second is precious.
"The tragic circumstances of the loss of Bronson again reminds us of the fragility of life.
"It is a reminder to those involved in surf life saving services that vigilance and communication are paramount."
Fifteen witnesses gave evidence to the four-day hearing.
Bronson went missing while swimming with two friends. The group swam between the flags but soon got into difficulty. A surfer and patrolling members were able to assist the two friends, however Bronson was missing, the magistrate said in her summary.
"Bronson's body was sighted but was unable to be retrieved because of the conditions.
"Despite ongoing searches, Bronson's body has never been found."
Surf Life Saving NSW CEO Steve Pearce said the findings were not just relevant to Port Macquarie Surf Club.
"We intend to push these recommendations out right across the state," he said.
"After listening to the first hearings, we initiated many of those draft findings.
"We have driven a significant amount of change in how we equip, maintain and ensure the confidence of patrol captains going forward.
"We are introducing new equipment on patrols as a result of these findings.
"As we heard, these findings have really touched everyone in surf life saving, and not just the life savers here in Port Macquarie."
Mr Pearce admitted it was "very difficult" to listen to the Bronson's mother give her perspective of the tragedy.
Surf club members are mums and dads and brothers and sisters, he added.
Mr Pearce said the state body was continuing to push more drones for use in surveillance into branches and clubs.
"We are still doing a lot of research and development in regards to drop capabilities - where we can drop flotation devices into the surf in a rescue situation," he said.
"We are also putting new equipment onto the beach to better coordinate members on patrol.
"As her honour stated, it was a perfect storm for this catastrophic event to occur.
"It is devastating for everyone," he said.
The state body, branches and clubs will take the lessons from this to ensure it doesn't happen again, he said.
"But listening to the evidence, everyone went above and beyond to save Bronson and his mates.
"Again, with the conditions, it was just so tragic how quickly Bronson disappeared.
"The surf club will be providing a suitably inscribed memorial for Bronson at the beach."
Also making news:
While you're with us, you can now receive updates straight to your inbox from the Port Macquarie News. To make sure you're up to date with all the news, SIGN UP HERE.