Driver, 91, who killed toddler may have had ‘undiagnosed dementia’, inquiry told

An elderly driver who killed a three-year boy after crashing into a shop may have been suffering from undiagnosed dementia, an inquiry has heard.

Xander Irvine died after he was hit by a red Kia car while walking with his mother, Victoria, on Morningside Road, Edinburgh, on June 30 2020, a fatal accident inquiry (FAI) at the city’s sheriff court heard.

The car was driven by Edith Duncan, 91, who accelerated as she performed a U-turn close to a crossing, the inquiry heard in a statement of agreed evidence.

Miss Duncan had cancelled her car insurance in March 2020 as she “only drove once a week and didn’t want to pay for it”, the inquiry heard.

Xander died in the Royal Hospital for Sick Children from “multiple injuries”, while Miss Duncan, who was facing prosecution, died a year later.

The inquiry will seek to establish if anything could be done to prevent a similar tragedy.

After the crash, grieving parents Mrs Irvine and husband Paul described their son as “a chatterbox” and a “happy, bubbly, intelligent little boy”.

In 2019, Miss Duncan had ploughed into a parked car in a supermarket car park, damaging the vehicle and causing injuries to the man inside, which was dealt with by insurance after she admitted fault, the court heard.

In January 2020, Miss Duncan renewed her licence, which was not restricted, but in February she called her insurance company to cancel the policy.

The court heard she said she “drove the car only once a week and did not wish to pay all that money”, and it was cancelled from March 2020.

The FAI was shown footage of the crash, which showed Miss Duncan emerging from the driver’s side of the car, while passers-by rushed to help.

Several witnesses gave evidence and said she was unaware of what had happened, and did not realise she had hit a child.

The day after the crash, Miss Duncan was visited by her GP, who did not have concerns about her cognitive function but described her as “isolated”, noting that most assessments for cognitive impairment were instigated by concerns from family members.

The court heard Miss Duncan was seen by dementia specialist Professor McPherson in 2021 who said the elderly woman may have had undiagnosed frontotemporal dementia as early as May 2019, however, Miss Duncan died before it was confirmed.

Clare Kavanagh, who was working in an office and went to help, told the inquiry: “She kept saying, ‘I have got new shoes, my foot must have slipped’.”

She added: “It was quite eerie – she was quite calm. She was saying, ‘I just came out for a toaster or a kettle’.”

She described seeing Xander “wedged” between the car and the shopfront, while Mrs Irvine had blood on her and was screaming.

Ms Kavanagh took Miss Duncan into the office, and the elderly woman spent about 45 minutes talking her concerns about losing her licence, attributing the cause of the crash to new shoes, and worrying about smashed eggs in the car.

Witness Sally Phillips, who also worked in the office, said: “She was confused, she said she needed to get something out the boot, it was a toaster or a kettle.

“She kept saying, ‘they are going to take my licence off me’ and something about eggs.

“She was very confused about what had happened. At that point she didn’t know that she had hurt anybody. She was quite frail.”

Ms Phillips added: “We knew an ambulance had been called and somebody had said a little boy had been hurt.

“She didn’t seem to have any empathy at all, she just thought she had crashed the car. She was pretty emotionless. There were a few of us in tears – there was a lot of hysteria – but she wasn’t like that.”

Procurator fiscal Martin Crawford asked if “she seemed detached”, and Ms Phillips agreed.

Police Constable John Laing said that evidence showed “the vehicle had been getting progressively faster”.

Sheriff Nigel Ross said: “Do you see the requirement or reliability of having a more joined up system?”

Giving evidence, Pc Laing said: “In my mind, it is streamlined – if we go to the central authority, the DVLA, their process is followed.”

He added: “We can all get distracted – hit the kerb or scratched an alloy, and it’s not all down to cognitive function. We don’t record damage-only collisions.

“For a minor non-injury collision, if we sense there is something wrong medically or cognitively, we submit a form to the DVLA.”

Dr Mark Stevenson, a GP at Braids Medical Practice, said he met Miss Duncan for the first time on July 1, after being contacted by police as “she did not have family or much local support”.

He said the only prior contact he had with Miss Duncan was a phone call in 2015, before he visited her the day after the crash.

Dr Stevenson said there was no reason to be concerned about dementia, and spoke to her again in September when Miss Duncan called due to “anxiety”, when she disclosed that her car insurance had lapsed.

During the meeting with her GP, Ms Duncan failed to disclose that she had been involved in a car accident in September 2019, the court heard.

When asked by procurator fiscal Mr Crawford if it was “possible she was masking her symptoms”, the GP conceded that it was.

Dr Stevenson said: “It’s possible – there was nothing in the medical records which caused me concern. It’s possible someone can appear better than they actually are.”

He checked his notes from the appointment in July 2020, which said, “tells me never had a car accident in the past”.

Mr Crawford asked if it would be helpful to have a box about recent car accidents on the licence renewal which Ms Duncan completed in January.

Dr Stevenson said: “Yes.”

The court heard that during a later test with a specialist, Ms Duncan scored 66 out of 100, suggesting cognitive impairment.

However, Dr Stevenson said the DVLA allow some people with a dementia diagnosis to keep their licence.

Dr Stevenson said: “The diagnosis in itself is not an end to them driving.”

Sheriff Nigel Ross said Ms Duncan “slipped the system” and asked if cognitive tests could mitigate this in future.

Dr Stevenson said it would be “challenging” to implement.

The inquiry continues.