There have been several other deaths in New Zealand at bar crossings, Coroner Matthew Bates said in his findings, stressing the importance of boater education and organised rescue procedures.
“The busy summer boat season is fast approaching, which will see an increase in the number and frequency of bar crossings.”
Starnes, his son, daughter-in-law and two grandchildren launched the boat on the morning of January 5.
Starnes’ son piloted the boat on their return trip, when he was told there were two people in a tandem kayak who appeared inexperienced and were approaching the Tairua/Pauanui sandbar, known for its treacherous conditions.
Starnes’ son, a trained surf lifesaver, swam to the assistance of the kayakers, and Ronald Starnes took control of the boat.
Witnesses soon saw the boat drift towards rougher water in the channel, where it capsized and became lodged on the sandbar.
Starnes and his grandchildren were trapped under the boat, which became suctioned to the sandbar.
Starnes was rescued, resuscitated and taken to Waikato Hospital, but died the following day. The grandchildren were also rescued and taken to hospital for further treatment.
Starnes was an experienced recreational boater who had a history of heart conditions and had been hospitalised in late December 2021 for chest pains, just a little over a week before the accident. He was found to have died of hypoxic brain injury and multiple organ failure.
Coroner’s findings
Bates noted Starnes’ boating experience and said, “it is difficult to understand why his boat was able to travel from the relative safety of the harbour channel, where he had been advised to keep it, to where it capsized on the sandbar”.
There was no evidence of any fault with the boat, the coroner found.
The coroner’s report found that Coastguard had difficulty accessing the bar during the incident as the main access channel was blocked due to sand build-up.
The coroner said it was uncertain if Starnes would have survived if the Coastguard could have arrived sooner, but “his tragic death serves as a warning that ... Coastguard require unimpeded access to and through harbour channels from their operations bases.”
Tairua-Pauanui Coastguard try to launch their rescue vessel during a tragedy unfolding on January 5, 2022 at Tairua Bar. Photo / Paul Andrew
When rescued from the capsized boat, Starnes was not wearing a lifejacket, although he had been earlier.
The coroner found it likely that Starnes removed his lifejacket and one of his grandchildren’s while they were trapped under the boat, to make escape easier.
Hato Hone St John had a laryngeal mask airway which a doctor at the scene offered to place on Starnes during the resuscitation efforts, but one of the Hato Hone St John officers declined as it was “not permitted under their protocols.”
The coroner said that, “I do not find any action or inaction on the part of Hato Hone St John contributed to Mr Starnes’ death,” and commended their service to the community.
Bates did recommend Hato Hone St John review training for new staff to be sure they are familiar with key protocols, including “when suitably qualified members of the public may be permitted to access equipment and to assist with resuscitation”.
Maritime New Zealand also reviewed the policies of the company which rented the kayak, and found it could make improvements to staff training and hiring kayaks during low tide.
Bates endorsed Maritime New Zealand’s recommendations for better safety messaging to skippers, including “before embarking on any water rescue, the skipper of a vessel must pause to identify hazards and associated risks.”
Increased dredging of the sandbar and channel from the wharf was also recommended.
The coroner also endorsed Maritime New Zealand’s recommendation for additional signage about water emergency procedures in the area and Waikato Regional Council’s reminders about bar crossing safety, along with other safety and signage recommendations for the sandbar.
The various council, water and emergency agencies were also advised to work closely together.
“A cohesive regional marine safety plan should be established that refers to combined planning for preventative education and awareness, operational planning, and emergency response,” the coroner found.
Bates said the findings of the report need to be shared to heighten awareness of “the very real, and too often realised, risks associated with bar crossings, particularly at low tide”.
