In November 2016, a toddler at Black Head Bowling Club with her family to attend a 50th birthday at a club with extended family and friends, was killed by a monument that fell on her. The NSW Coroner has now released a finding resulting from the inquest into the death of Indy Henderson.

Are existing standards of construction for such structures adequate to meet the needs of public safety?

(Extract from the Coronial Inquest finding)


  • The current edition of the 1989 Loading Standard is AS/NZS 1170.1 2002 2016. It is not materially different to the 1989 version.
  • Counsel for the Henderson family Ms Gerace noted that AS 4204 and AS 4425 are currently under review. She submitted that this presented an opportunity to consider whether its operation should be extended to comparable structures outside the cemetery setting. Alternatively, could there be utility in developing a new standard that applied specifically to monuments outside the cemetery setting?
  • The inquest heard evidence about the process involved in preparing a new Standard and bringing it into force. Mr Adam Stingemore, General Manager of Strategy and Engagement at Standards Australia Ltd, explained that his agency does not initiate proposals for the development of standards. It relies on stakeholders to submit a proposal which demonstrates net benefit and broad stakeholder support. 
  • When a standard is developed, the standard of itself does not create an obligation to comply. This is created when governments choose to reference the standard into legislation, or when the standard is made the condition of planning consents or contracts.
  • According to submissions made on behalf of Standards Australia, due to the existence of relevant and applicable Australian Standards there was not a need in this case for new standards to be developed or existing ones to be extended. Counsel for Standards Australia relied upon Mr Gohil’s opinion, strongly expressed at the inquest, that there was no practical need for a specific code for memorials constructed outside the cemetery setting. In Mr Gohil’s opinion the current edition of the 1989 Loading Standard provides sufficient guidance as to stability, together with the reference points provided by AS 4204 and AS 4425.  This was also the submission of Counsel Assisting. 
  • I accept the submission of Counsel Assisting, that on the evidence heard at inquest there already exists a current engineering standard which guides the construction of structures such as the Anzac memorial. This standard has been incorporated into the consent pathway processes, as described above.  Other standards, namely AS 4425 and AS 4024, serve as reference points for memorial construction.  Taken together these provide sufficient guidance for the stability and durability of such structures.   
  • For the reasons given above, in my view it is not necessary or desirable to make any recommendations to extend existing Australian Standards in this area or to develop new ones. For the same reasons there would not be utility in providing a copy of these findings to the stakeholders involved in the current review of AS 4204, as proposed in the family’s submissions.

Read the full finding