Inquest into the death of Adam Moore

CORONER’S COURT OF NEW SOUTH WALES Inquest: Inquest into the death of Adam Moore Hearing dates: 11 November 2025 Date of Findings: 28 November 2025 Place of Findings: Coroner’s Court of New South Wales, Lidcombe Findings of: Magistrate Derek Lee, Deputy State Coroner Catchwords: CORONIAL LAW – New South Wales Police Force Safe Driving Policy, whether New South Wales Police officer engaged in pursuit, traffic stop File number: 2024/32036 Representation: Mr T Hammond, Counsel Assisting, instructed by Ms A Jeffares (Crown Solicitor’s Office) Mr M Short for the Commissioner, New South Wales Police Force, instructed by Ms C Waterhouse (New South Wales Police Force Office of the General Counsel) Findings: Adam Moore died on 25 January 2024 at Mount Pritchard NSW 2170.

The cause of Mr Moore’s death was multiple injuries.

Mr Moore was riding a motorcycle on a residential street when he was unable to negotiate a left hand turn and collided with a parked vehicle. Shortly prior to the collision Mr Moore had proceeded through a red traffic signal and was being followed by a New South Wales Police Force officer in a marked vehicle intending to perform a traffic stop.

Non-publication orders: See Appendix A

Table of Contents

1. Introduction 1.1 At around 12:06am on 25 January 2024, Adam Moore, a 38-year-old man, was riding a motorcycle northbound along Maxwells Avenue, Ashcroft towards an intersection with Elizabeth Drive. Mr Moore turned left onto Elizabeth Drive apparently against a red traffic signal. At the same time, Sergeant Samuel McDonald was travelling in a marked New South Wales Police Force (NSWPF) vehicle westbound on Elizabeth Drive. Sergeant McDonald observed Mr Moore make the left-hand turn and followed him, activating the warning lights on the NSWPF vehicle a short time later.

1.2 Both the motorcycle and NSWPF vehicle continued westbound on Elizabeth Drive. At the intersection with Meadows Road, Mr Moore crossed to the incorrect side of the road against a red traffic signal whilst the NSWPF vehicle stopped at the intersection. After proceeding through the intersection, Mr Moore turned left onto Tedwin Street and continued through a residential neighbourhood eventually turning left into Horton Street. After leaving the intersection at Meadows Road, Sergent McDonald also turned onto Tedwin Street.

1.3 At the intersection of Horton Street and Dartford Street, Mr Moore attempted to navigate a slight left hand turn and collided with a parked tipper truck. Sergeant McDonald arrived at the collision scene a short time later and found Mr Moore unresponsive and having sustained catastrophic injuries.

1.4 Emergency medical services were contacted and resuscitation efforts were commenced. However, Mr Moore could not be revived and was later tragically pronounced life extinct at the scene.

2. Why was an inquest held?

2.1 Pursuant to the Coroners Act 2009 (the Act) a Coroner has the responsibility to investigate all reportable deaths. This investigation is conducted primarily so that a Coroner can answer questions that they are required to answer pursuant to the Act, namely: the identity of the person who died, when and where they died, and the cause and the manner of that person’s death.

2.2 Certain deaths are reportable to a Coroner. Some examples of reportable deaths are where the cause of a person’s death is not due to natural causes, or where the cause or manner of a person’s death may not immediately be known. In Adam’s case an inquest was held to examine the manner of his death or, in other words, the circumstances leading up to his death. Relevantly, these circumstances involved the period of time between when Adam was first seen by Sergeant McDonald and the collision, and whether any actions taken during this period contributed to the collision and Adam’s death.

2.3 The inquest therefore sought to independently examine of the conduct of a NSWPF officer in discharging his duties and exercising the lawful powers available to him. Doing so serves a number of purposes, including ensuring that such powers are exercised appropriately and responsibly, and providing reassurance to the community.

2.4 In this context it should be recognised at the outset that the operation of the Act, and the coronial process in general, represents an intrusion by the coronial jurisdiction and inquest process into what

is usually one of the most traumatic events in the lives of family members who have lost a loved one.

At such times, it is reasonably expected that families will wish to attempt to cope with the consequences of such a traumatic event in private. The sense of loss experienced by family members does not diminish significantly over time. Therefore, it should be acknowledged that both the coronial process and an inquest by their very nature unfortunately compel a family to re-live distressing memories and to do so in a public forum.

3. Adam’s life 3.1 Inquests and the coronial process are as much about life as they are about death. A coronial system exists because we, as a community, recognise the fragility of human life and value enormously the preciousness of it. Understanding the impact that the death of a person has had on those closest to that person only comes from knowing something of that person’s life. It is hoped that what is set out briefly below acknowledges Adam’s life in a meaningful way.

3.2 Adam was born on 11 June 1985 to Lawrence and Patricia Moore. He had three older brothers, Matthew, Ben, and Brett and a younger brother, Jamie. Adam also had a sister, Melissa, who passed away when she was very young.

3.3 When Adam was 21 years old he met Tawnni Byrnes through mutual friends. They later formed a relationship and Adam became like a father to Tawnni’s son, Damon. Adam and Tawnni later had another son, Memphis, together. Adam was a loving father to his boys and gave all his heart to them.

3.4 Adam also had a strong and loving bond with his parents. When Adam’s father developed terminal cancer, Adam dedicated his life to ensuring that his father was safe, well cared for and still able to enjoy life. He spent any free time he had with his parents, enjoying Sunday afternoons at the local club, and going away on family getaways and fishing adventures. Adam selflessly gave much of himself to those closest to him, never wanting or seeking anything in return. Adam’s close friend, Peter Leese, describes Adam as having a heart of gold and always being family oriented.

3.5 Adam was known to be a social person who easily made friends. He brought joy to the lives of many and was always willing to lend a hand to help someone out or just listen. Adam was a true and loyal friend, someone who give away his last dollar to help someone in need. He is deeply missed by those who had the pleasure of meeting and knowing him.

3.6 Whilst Adam’s sudden and tragic loss has profoundly affected his family and friends, in the words of Tawnni, Adam’s smile will never fade.

4. Adam’s driving history 4.1 Adam had numerous interactions with the NSWPF with several of these interactions relating to driving offences. As a result of the interactions, Adam told his family and friends that he felt that the NSWPF had unfairly targeted him.

4.2 In June 2023, Adam was charged with a driving offence. He was later granted bail with one condition prohibiting him from occupying the driver’s seat of a vehicle. In September 2023, Adam was seen

driving a vehicle and subsequently charged with breaching his bail conditions and driving while his licence was suspended.

4.3 Over the next several months, NSWPF officers conducted multiple checks with Adam to ensure that he understood, and was compliant with, his bail conditions.

4.4 On the evening of 31 December 2023, Adam was driving a Holden Cruz in Busby when he was seen by a NSWPF officer to park at a residential address. After Adam exited the vehicle, the NSWPF officer gave Adam a verbal warning, which he acknowledged, not to drive the vehicle as his licence had been suspended due to fine default.

4.5 A short time later, he NSWPF officer saw the Holden Cruz travelling along a road in Busby with Adam in the driver’s seat. A pursuit was initiated and involved Adam’s vehicle reaching speeds of 100 kilometres per hour in a 60 kilometres per hour zone before the pursuit was terminated. NSWPF officers later attended Adam’s address to look for him but were unable to find him. The NSWPF officers spoke to Tawnni, advising her that Adam was suspected of having breached his bail conditions by driving and asking her to tell Adam to hand himself in to Liverpool police station.

4.6 Following this alleged incident, Adam’s mistrust of the NSWPF worsened. Adam expressed his fears of the NSWPF to those closest to him. For example, Adam told a close friend that he thought the NSWPF were going to kill him. On another occasion, Adam sent a text message to Tawnni which contained the following: …but I am petrified of police and I won’t let them take me back to jail they are gonna have to kill me before I go back… […] Cause my instant reaction is to run from police cause I’m that scared from all the trauma over the years… I don’t want to be like that cause it’s making me make wrong choices I can’t actually control from my fear of them.

5. The events of 25 January 2024 5.1 At around 12:06am on 25 January 2025, Sergeant McDonald was travelling north-west along Elizabeth Drive, Ashcroft in a fully marked NSWPF vehicle with callsign LP39. As LP39 approached an intersection with Maxwells Avenue, Adam was riding a motorcycle along Maxwells Avenue and turned left onto Elizabeth Drive, apparently disobeying a red traffic signal. Adam’s P1 Provisional Licence Class C remained suspended at this time.

5.2 Adam accelerated and continued riding along Elizbeth Drive. Sergeant McDonald followed after Adam as the speed of LP39 also increased. At a point between the intersections of Reservoir Road and Meadows Road, Sergeant McDonald activated the warning lights on LP39. It is unclear whether the warning siren on LP39 was also activated.

5.3 Adam continued travelling in a north-westerly direction along Elizabeth Drive. When he reached the intersection with Meadows Road, Adam proceeded through the intersection and onto the incorrect

side of the road. When Sergeant McDonald reached the same intersection, he stopped LP39 and turned off the vehicle’s warning lights.

5.4 After proceeding though the Meadows Road intersection, Adam turned left onto Tedwin Street and then proceeded to Hamel Road followed by Horton Street. After the traffic signal at the Meadows Road intersection turned green, Sergeant McDonald also turned onto Tedwin Street and followed the same route as Adam.

5.5 After entering Horton Street, Adam travelled south. Whilst negotiating a slight turn, Adam’s motorcycle collided with a parked truck in the northbound lane, near the intersection with Dartford Street.

5.6 Sergeant McDonald arrived at the location about 18 seconds later. After requesting assistance from other NSWPF car crews and NSW Ambulance, Sergeant McDonald commenced resuscitation efforts on Adam. These efforts were continued by paramedics who arrived on scene a short time later.

Tragically, Adam could not be revived and was later pronounced life extinct.

5.7 At about 1:50am, the NSWPF declared the matter to be a Critical Incident. Detective Senior Sergeant Anthony Holmes was appointed as the Senior Critical Incident Investigator and later formed a Critical Incident Investigation Team.

6. The post-mortem examination 6.1 A post-mortem examination was performed by Dr Issabella Brouwer, forensic pathologist, on 31 January 2024 at Forensic Medicine Sydney. The significant findings from the examination can be summarised as follows:

(a) Posterior fossa and upper cervical spinal subarachnoid haemorrhage;

(b) Extensive bilateral chest wall injuries, including rib fractures, pneumothoraces, pneumomediastinum, extensive pelvic fractures and traumatic pneumatoceles; and

(c) Toxicological analysis of post-mortem blood detected a concentration of methylamphetamine (0.49 mg/L) and its metabolite.

6.2 In the post-mortem examination report dated 4 March 2024, Dr Brouwer opined that the cause of Adam’s death was multiple injuries.

7. Outcome of the NSWPF investigation 7.1 It was later determined that the motorcycle that Adam had been riding had been stolen from an insurance storage facility in Wetherill Park sometime between 5 and 24 January 2024. There is no evidence to suggest that Adam was aware that the motorcycle had been stolen.

7.2 Personnel from the NSWPF Crash Investigation Unit examined the collision site, the motorcycle and LP39. This examination:

(a) did not identify any physical or environmental factor which contributed to the collision;

(b) did not identify any defect or fault with the motorcycle which may have contributed to the collision;

(c) found no sign of any damage to LP39 which was attributable to the collision.

7.3 Sergeant McDonald was subjected to a breath test at the collision and later provided a sample for urine testing. Both of these tests returned negative results for any drug or alcohol.

7. What issues did the inquest consider?

7.1 Prior to the commencement of the inquest a list of issues was circulated amongst the sufficiently interested parties, identifying the scope of the inquest and the issues to be considered. That list identified the following issues for consideration: (1) The date, time, manner and cause of Adam’s death.

(2) Whether the response by NSW Police officers was appropriate and in compliance with NSWPF policies and/or protocols, including the Safe Driving Policy.

(3) Whether it is necessary or desirable to make any recommendations in relation to any matter connected with Adam’s death.

8. Matters relevant to the appropriateness of the NSWPF response 8.1 Examination of this issue requires consideration of a number of matters including the applicable NSWPF policy framework, available CCTV footage, data extracted from LP39, the driving histories of Adam and Sergeant McDonald, and an account provided by Sergeant McDonald.

Policy framework 8.2 The version of the NSWPF Safe Driving Policy (Version 9.2, reviewed June 2021) (SDP) in force at the time relevantly provides: 6-1 It is permissible for police to perform traffic stops (including Bronze drivers), or reduce the distance to an offending vehicle without informing VKG.

[…] 6-3 If operationally or tactically necessary (such as while performing a check speed), maintaining a constant distance behind, or closing the distance to, an offending vehicle may be done without the activation of warning lights or the sounding of a siren. However, police must take reasonable care and it must be reasonable that warning devices are not used. (N.B. Bronze drivers cannot breach road rules in the execution of a traffic stop). When considering operational or tactical necessity police must take into consideration the provisions at 6-4.

[…] 6-5 Any direction to stop while utilising a police vehicle must be done by way of activation of the police vehicles warning lights and siren.

6-6 Should the driver of the other vehicle attempt to avoid apprehension or appears to be ignoring requests to stop and a decision has been made to pursue the vehicle, then a pursuit has commenced, and the Safe Driving Policy pursuit guidelines must be adhered to.

8.3 The SDP goes on to provide: 7-1 PURSUIT: It is an attempt by a police officer in a motor vehicle to stop and apprehend the occupant(s) of a moving vehicle, regardless of speed or distance, when the driver of the other vehicle is attempting to avoid apprehension or appears to be ignoring police attempts to stop them.

A pursuit commences at the time you decide to pursue a vehicle that has ignored a direction to stop.

7-1-1 A pursuit is deemed to continue if you FOLLOW the offending vehicle or continue to attempt to remain in contact with the offending vehicle, whether or not your police vehicle is displaying warning lights or sounding a siren.

8.4 Section 7-5-1 of the SDP also provides that drivers involve in a pursuit will “[i]nform the State Coordinator, the VKG Shift Coordinator of the pursuit” and provide certain information including the location and direction of travel, reason for pursuit, description of vehicle being pursued and frequent updates as to the “speed of the offending vehicle, instances of erratic, and or dangerous driving, and other pertinent information”.

CCTV footage and data from LP39 8.5 The Critical Incident investigation collected footage from several CCTV cameras located along the route travelled by Adam and Sergeant McDonald on 25 January 2024.

8.6 The CCTV footage establishes that Adam travelled along Maxwells Avenue towards the intersection with Elizabeth Drive. Whilst CCTV footage captures a red signal for traffic turning right onto Elizabeth Drive the traffic signal for traffic turning left onto Elizabeth Drive cannot be seen on the footage.

However, Adam is captured coming to an almost complete stop before turning left onto Elizabeth Drive.

8.7 Sergeant McDonald proceeded through the Maxwells Avenue intersection with no warning lights activated, approximately nine seconds behind Adam.

8.8 Data retrieved from the Mobile Data Terminal (MDT) fitted within LP39 and the NSWPF CAD system allows for a calculation of the speed that LP39 was travelling during the incident. The data indicates that LP39 was travelling about 84 kilometres per hour along Elizabeth Drive east of Maxwells Avenue before increasing its speed to 119 kilometres per hour at a point west of Maxwells Avenue.

8.9 CCTV footage from a residence on Lookout Drive (running approximately parallel to Elizabeth Drive) approximately 250 metres northwest of the Maxwells Avenue intersection, captures Adam continuing to travel northwest along Elizabeth Drive followed by Sergeant Moore approximately three seconds behind with the warning lights on LP39 not activated. At around this time the speed of LP39 ranged between about 117 to 132 kilometres per hour. At a point about 250 metres further west along Elizabeth Drive, the speed of LP39 ranged between 106 to 119 kilometres per hour.

8.10 CCTV from three service stations near the intersection of Meadows Avenue and Elizabeth Drive captured Adam proceed through the intersection against a red traffic signal, cross to the incorrect side of the road and continue travelling in a northerly direction in the southbound lanes. Adam travelled approximately 180 metres before turning left into Tedwin Street.

8.11 Approximately three seconds later, the CCTV footage shows Sergeant McDonald arriving at the Meadows Road intersection, with the warning lights of LP39 activated, and come to a stop. Sergeant McDonald remained stopped for about eight seconds before proceeding through the intersection.

After the traffic signal at the Meadows Road intersection turned green, Sergeant McDonald continued along Elizabeth Drive and turned left into Tedwin Street.

8.12 CCTV footage from a premises on Tedwin Street, approximately 300 metres from the Meadows Road intersection, captured Adam travelling southwest, about 16 seconds after Sergeant McDonald proceeded through the Meadows Road intersection. About nine seconds later, Sergeant McDonald drove past the same premises with the warning lights on LP39 having been deactivated about two seconds earlier. A calculation of the time taken to travel about 300 metres from the Meadows Road intersection to the location of the CCTV camera on Tedwin Street indicates that Adam was travelling at about 35 to 40 kilometres per hour and that Sergeant McDonald travelled at about 45 kilometres per hour. The designated speed limit along Tedwin Street at the time was 50 kilometres per hour.

8.13 About 10 seconds later, CCTV from a premises on Hamel Road captured Adam travelling in a generally westbound direction along Hamel Road. Sergeant McDonald travelled through the same point about 15 seconds later.

8.14 At a point near the intersection of Hamel Road and Horton Street, an approaching truck flashed its headlights at LP39, causing Sergeant McDonald to slow down. A calculation of the time taken to travel about 270 metres from the Tedwin Street CCTV camera to near the intersection of Hamel Road and Horton Street indicates that Adam was travelling at about 50 kilometres per hour at this point and that Sergeant McDonald travelled at about 33 kilometres per hour.

8.15 About 22 seconds after Adam was captured on Hamel Road, a CCTV camera captured Adam riding southwest along Hamel Road. Sergeant McDonald travelled through the same location about 19 seconds later. Calculations of distance travelled Hamel Road and Horton Street indicates that Adam was travelling at 65 kilometres per hour with Sergent McDonald travelling around 75km/h.

Account of Sergeant McDonald 8.16 Following the collision on 25 January 2024, Sergeant McDonald broadcast over NSWPF radio that he had found a male person who had fallen from a motorcycle and that assistance was required from

NSW Ambulance and other NSWPF officers. Sergeant McDonald made no mention of attempting to stop the motorcycle, engaging in a pursuit, or having any previous interaction with the motorcycle.

8.17 However, Sgt McDonald later provided an account to Sergeant Steven Drury and Acting Inspector Emma Grieg. In that account, Sgt McDonald reported that:

(a) he saw Adam’s motorcycle turn left from Maxwell Avenue onto Elizabeth Street, disobeying a red light signal;

(b) he followed the motorcycle at a distance, but near the intersection of Reservoir Road he “lit him up”;

(c) as a result the motorcycle “took off”;

(d) at the intersection with Meadows Road, he saw the motorcycle cross onto the incorrect side of the road before turning into Dawes Street (although it is understood that Sergeant McDonald meant Tedwin Street);

(e) he “looked” around the area where he last saw the motorcycle;

(f) as he travelled near the intersection of Hamel Street and Horton Street, an unknown truck flashed its headlights at LP39; and

(g) he continued driving until he came across the motorcycle following the collision.

8.18 Sergent McDonald was not called to give evidence during the inquest due to medical reasons.

Sergeant McDonald’s driving history 8.19 Prior to January 2024, Sergeant McDonald had been involved in four pursuits to which the SDP applied. Internal NSWPF reviews of these pursuits concluded that they were all conducted in accordance with the SDP.

8.20 In addition, as at January 2024, Sergeant McDonald had three recorded incidents/collisions on his NSWPF driving history. Internal NSWPF reviews indicate that Sergeant McDonald was found to be at fault on one of these occasions and not at fault on the remaining two occasions. Sergeant McDonald was provided with guidance and advice in relation to the one at-fault occasion with, it appears, no further action taken.

9. Was the NSWPF response on 25 January 2024 appropriate?

9.1 Determination of this issue requires consideration of whether Sergeant McDonald was engaged in a pursuit of Adam and, therefore, whether the provisions of the SDP applied to his actions. Even if the SDP did not apply, it is also necessary to consider whether Sergeant McDonald performed his duties inappropriately or in a manner which directly contributed to Adam’s collision.

Was Sergeant McDonald engaged in a pursuit of Adam?

9.2 The account provided by Sergeant McDonald indicates that he observed Adam disobey a left hand turn red traffic signal at the Maxwells Avenue intersection. This is consistent with the CCTV footage showing Adam come to an almost complete stop before turning left onto Elizabeth Drive. It is also consistent with the data retrieved from the MDT in LP39 and the CAD system which indicates that the speed of LP39 increased to about 119 kilometres per hour at a point just west of the Maxwells Avenue intersection.

9.3 Section 6-3 of the SDP provides that when performing a traffic stop a NSWPF officer may, if operationally or tactically necessary, maintain a constant distance behind, or close the distance to, an offending vehicle without acting any warning devices. The increase in the speed of LP39 after the Maxwells Avenue intersection suggests that Sergeant McDonald was attempting to perform a traffic stop having observed Adam turn left onto Elizabeth Drive against a red signal. Although the speed that Adam’s motorcycle was travelling is not known, it can be inferred that LP39 increased its speed to maintain a constant distance behind, or close the distance to, the motorcycle.

9.4 The critical period appears to be the stretch of Elizabeth Drive between the intersection with Reservoir Road and the intersection with Meadows Road, a distance of about 500 to 600 metres.

CCTV footage indicates that the warning lights on LP39 were activated at a point between the location of the Lookout Drive CCTV camera and the Reservoir Road intersection. Given Sergeant McDonald’s assertion that Adam had allegedly committed a traffic infringement at the Maxwells Avenue intersection and his reference that he “lit him up”, it is evident that Sergeant McDonald activated the warning lights on LP39 to signal to Adam to stop his motorcycle.

9.5 Section 7-1 of the SDP provides that a pursuit only occurs when the driver (or rider) of a vehicle is attempting to avoid apprehension or appears to be ignoring attempts to stop them. It further provides that a pursuit commences at the time that a NSWPF officer decides to pursue a vehicle that has ignored a direction to stop.

9.6 At the Maxwells Avenue intersection LP39 was about nine seconds behind Adam’s motorcycle. This time gap had decreased to about three seconds at the Lookout Drive CCTV camera. The three second gap remained at the Meadows Street intersection. This evidence suggests that whilst LP39 initially closed the gap to Adam’s motorcycle it maintained a roughly consistent distance behind Adam’s motorcycle from the point of the Lookout Drive CCTV camera.

9.7 The stretch of road between the Reservoir Road intersection and Meadows Road intersection is relatively straight. However, it is unclear whether Adam was aware that Sergeant McDonald had activated the warning lights on LP39 at some point in the vicinity of the Reservoir Road intersection for the following reasons:

(a) the approximately 600 metres between the Reservoir Road intersection and Meadows Road intersection, and the approximate three second gap between the motorcycle and LP39, may not have afforded Adam sufficient time to became aware of the warning lights;

(b) it is not known whether the warning siren of LP39 was also activated and whether, if activated, Adam could have heard it; and

(c) even if Adam was aware that the warning lights on LP39 had been activated and he understood that this amounted to a direction to stop his motorcycle, a motorist is permitted to slow down and find an appropriate place to stop their vehicle. Therefore, it was open to Sergeant McDonald to conclude that Adam was finding an appropriate place to stop his vehicle rather than ignoring a direction to stop.

9.8 It is evident that Adam travelled through the Meadows Road intersection against a red traffic signal.

This may suggest that Adam had seen the warning lights activated on LP39 and was aware that he was being directed to stop but had chosen to ignore this direction. Such a belief may have been informed by the fact that Adam knew that his license was suspended, that he had previously breached a bail condition and that he had previously sent a text message to Tawnni indicating that his “instant reaction is to run from police”. Further, as the post-mortem toxicology results identified a concentration of methylamphetamine in Adam’s blood sample, the effects of this drug may have had some bearing on Adam’s decision-making at the time.

9.9 Set against the above are the following matters:

(a) A short time earlier Adam had already apparently proceeded through a red traffic signal at the Maxwells Avenue intersection. At that time, it does not appear that Adam was aware of LP39 approaching the intersection along Elizabeth Drive. Therefore, Adam’s progression through the Meadows Road intersection against a red traffic signal would appear to be consistent with his riding conduct a short time earlier at the Maxwells Avenue intersection.

(b) The evidence clearly indicates that Sergeant McDonald stopped LP39 at the Meadows Road intersection and waited about nine seconds for the traffic signal to change from red to green. If Sergeant McDonald had considered that he was in pursuit of Adam at this time, it is likely that LP39 would have proceeded (safely) through the Meadows Road intersection without stopping in order to maintain an effective pursuit.

(c) Sergeant McDonald’s driving records establishes that he had previously been involved in four pursuits with no adverse finding made about his conduct following internal NSWPF review. This suggests that Sergeant McDonald was familiar with the requirements of the SDP in the context of a pursuit and that if he was in fact in pursuit of Adam he most likely would have communicated this in compliance with the requirement set out at section 7-5-1 of the SDP.

9.10 Conclusions: The available evidence is not sufficiently clear to allow a conclusion to be reached that Adam was aware of the activation of the warning lights on LP39, that this was a direction to stop his motorcycle, and that he ignored this direction. Given that Sergent McDonald stopped at the Meadows Road intersection for nine seconds and his familiarity with the SDP and the NSWPF policy requirements relevant to a pursuit, it is most likely that Sergeant McDonald was attempting to perform a traffic stop and was not engaged in a pursuit of Adam.

9.11 As section 7-1-1 of the SDP makes clear, a pursuit “is deemed to continue” if a NSWPF officers follows, or attempts to remain in contact with, an “offending vehicle” regardless of whether the warning devices of a NSWPF vehicle are activated. From Sergeant McDonald’s brief account, he turned from Elizabeth Drive into Tedwin Street and then “looked” for Adam.

9.12 Given that Sergeant McDonald had a short time earlier attempted to perform a traffic stop on Elizabeth Drive, it can be inferred that this remained his intention after turning off Elizabeth Drive.

Therefore, if Sergeant McDonald had been in pursuit of Adam at any point along Elizabeth Drive, his actions in turning into Tedwin Street in order to look for Adam could be regarded as following Adam, or continuing to remain in contact with him, and therefore amounted to a pursuit. However, as no pursuit occurred along Elizabeth Drive, there was therefore no continuation of the pursuit after Adam and Sergent McDonald turned into Tedwin Street.

Were Sergeant McDonald’s actions otherwise appropriate?

9.13 Irrespective of the SDP, it is necessary to also consider whether Sergeant McDonald otherwise acted appropriately in the performance of his duties. The following matters are relevant to the issue:

(a) Although Adam had previously expressed his fears of the NSWPF and that he was determined not to allow the NSWPF to take him into lawful custody, there is no evidence that Sergeant McDonald was aware of these matters. Although Sergeant McDonald previously had an interaction with Adam in the context of performing his NSWPF duties, there is no evidence to suggest that Sergeant McDonald was aware of the identity of the motorcycle rider he was following at any point prior to the collision.

(b) The CCTV footage indicates that at no point after Adam turned onto Tedwin Street was LP39 close enough for Sergeant McDonald to sight Adam’s motorcycle. This is consistent with Sergent McDonald’s account that after turning onto Tedwin Street he “looked” around for Adam. It is also consistent with the truck flashing its lights at LP39 in order to indicate to Sergeant McDonald that Adam had travelled in the opposite direction to the truck.

(c) Examination of LP39 did not identify any damage to the vehicle to suggest that it had ever come in contact with the motorcycle.

(d) There is no evidence from the CCTV footage or from Sergeant McDonald’s breath and urine test results to suggest that he was driving erratically or dangerously or in a manner which adversely affected Adam’s control of the motorcycle.

(e) Apart from one at-fault incident, there is no evidence from Sergeant McDonald’s NSWPF driving history, including four previous pursuits, to indicate that he drove or acted inappropriately on 24 January 2024.

9.14 Conclusions: There is no evidence to suggest that Sergeant McDonald acted inappropriately in the performance of his lawful duties on 24 January 2024, or that his actions directly contributed to the collision involving Adam.

10. Is it necessary or desirable for any recommendation to be made?

10.1 As the evidence establishes that Sergeant McDonald was not engaged in a pursuit on 24 January 2024, that there was therefore no breach of the SDP, and that Sergeant McDonald otherwise acted appropriately in the performance his lawful duties, it is neither necessary nor desirable for any recommendation to be made.

11. Findings pursuant to section 81(1) of the Act 11.1 I acknowledge and express my gratitude to Timothy Hammond, Counsel Assisting, and his instructing solicitors, Amelia Jeffares and Claudia Hill. The Assisting Team has provided exceptional assistance during the conduct of the coronial investigation and the inquest. I am extremely grateful for their commitment efforts, and for the empathy that they have shown to Adam’s family throughout the coronial process.

11.2 I also thank Detective Senior Sergeant Holmes, and his Critical Incident Investigation Team, for their thoroughness in conducting a critical incident investigation in a professional and independent manner, and for compiling the initial comprehensive brief of evidence.

11.3 The findings that I make under section 81(1) of the Act are: Identity The person who died was Adam Moore.

Date of death Adam died on 25 January 2024.

Place of death Adam died at Mount Pritchard NSW 2170.

Cause of death The cause of Adam’s death was multiple injuries.

Manner of death Adam was riding a motorcycle on a residential street when he was unable to negotiate a left hand turn and collided with a parked vehicle. Shortly prior to the collision Adam had proceeded through a red traffic signal and was being followed by a New South Wales Police Force officer in a marked vehicle intending to perform a traffic stop.

12. Epilogue 12.1 On behalf of the Coroners Court of New South Wales and the Assisting Team, I offer my deepest sympathies, and most sincere and respectful condolences, to Adam’s partner, Tawnni; Adam’s mother, Patricia; and Adam’s wider family, loved ones and many friends for their most painful and tragic loss.

12.2 I close this inquest.

Magistrate Derek Lee Deputy State Coroner 28 November 2025 Coroners Court of New South Wales

Inquest into the death of Adam Moore File Number: 2024/32036 Appendix A Non-publication orders Order 1: Pursuant to s 74 of the Coroners Act 2009 (NSW), the Court orders that there shall be no publication of: a) the following information contained within version 9.2 of the New South Wales Police Force (NSWPF) Safe Driving Policy (Tab 52 of the brief of evidence): Page number (red text): Page 16 Paragraphs 5-1-4 to 5-1-8 up to and including the end of the 1st full paragraph after the last dot point Page 17 Paragraph 5-4-2 from the 1st word on line 3 to the 3rd word on line 4 Page 17 Paragraph 5-4-4 Page 18 Paragraph 7-1-5 Page 19 Paragraph 7-2-4 Page 20 Bullet points 6, 9, 10 and 15 of 7-5-1 Page 22 Paragraph 7-6-3 Page 23 Paragraphs 7-6-8 and 7-6-9 b) The following information contained in the Expert Statement of Inspector Dearne Jeffree (Tab 34 of the brief of evidence): i. Page 2, paragraph 1: From the 1st word of line 3 to the end of the paragraph.

(collectively “sensitive information”).

c) the sensitive information where it appears in the brief of evidence and any documents, submissions and other evidence relied upon or tendered in this inquest.

Order 2: Pursuant to s 65 of the Coroners Act 2009 (NSW), and the Court’s implied or incidental powers, the Commissioner of Police is to be notified and given an opportunity to be heard should any person seek to vary these orders or to access the sensitive information on the Coroner’s file.

Magistrate Derek Lee Deputy State Coroner 28 November 2025 Coroners Court of New South Wales