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Thanks for your thoughts, I have been back to the site of the accident, here are some photos of the road markings, I am fairly convinced that i didn't hit the manhole unless I went flying 50m down the road to where I ended up, but could be wrong.
I do have the contact of a witness so may need her version of events.
Here are some photos of the road markings are they unnecessarily bumpy? I believe the maximum raised height is 5mm?
jazzythumper
@Oliver Schick
Sorry to hear about your injuries, jazzythumper. I haven't seen the markings in question, but if they're raised, that suggests they are simply painted, as bus lane markings generally are. Road markings are obviously renewed all the time, and one almost never hears about crashes being caused by them. It might be worth investigating whether perhaps one of the lines was raised too high, i.e. the paint was applied too thickly, so that it was the upstand that would have caused your fall. It was most definitely not any kind of slipperiness. It's a well-known problem that a large number of falls occur when people ride over slight upstands, e.g. at kerbs, that they don't expect and for which they don't have any evasive strategy. When I say 'slight', I mean that; it can be a matter of millimetres. This particularly affects older riders.
It may sound ridiculous to explore this, but notwithstanding how minor the particular feature of the markings may have been, you suffered some pretty serious injuries, and I believe there are regulations for the upstand of the paint in road markings. It's certainly unlucky, but that doesn't necessarily absolve the highway authority (in this case TfL) of responsibility, silly though it may sound to argue over millimetres.