"Only a thorough, time-consuming investigation will uncover the facts, and the answers to questions like these as well as others that will undoubtedly arise. The NTSB and the FRA have investigators on the scene for this purpose. However, noted one observer: “The NTSB has all the information it needs to quickly determine exactly what happened: The train’s event recorder, forward- and inward-facing cameras in the locomotive cab, radio transmissions, dispatcher records, etc. So why will it take 12 to 18 months to issue an official finding and a final report? By now, anyone involved knows exactly what took place.”
Nothing bothers me more in this industry than the handing off of responsibility for investigating the causes of, identifying the risks to, determining the remedies for unsafe train operations except for the handing off of that responsibility and the delay to finding the remedies for unsafe train operations that such deferrals to a third-party, whether regulatory agency, or investigatory body inevitably causes.
Nothing. Not even close-call confidential reporting, which is but a "subset" of this impulse to deferral that seems to have possessed our industry.
Let's review: Over a year ago, a SUV entered an at-grade rail crossing in New York state and struck a Metro-North Commuter train, killing five passengers and the SUV driver. NTSB showed up, took charge of the investigation, swearing all others to silence and.....and that's where we are today.
Almost a year ago, the locomotive engineer on Amtrak #188 accelerated his train approaching the curve at Frankford Jct., spilling the train and killing eight people. NTSB showed up. NTSB took charge of the investigation, swearing all others to silence and......and that's where we are today.
Way back in the day, in 2013, the locomotive engineer on Metro-North #8808 accelerated his train approaching the curve at Spuyten Duyvil, killing four (note to self, spouse, children, grandchildren: avoid trains with multiple "8s" in the designation). NTSB showed up. NTSB took charge of the investigations, swearing all to silence-- an oath violated by the General Chairman of the locomotive engineer's collective bargaining unit, causing the GC to be removed from the investigating "team." And?
And perhaps motivated by the appearance of Two-Gun Schumenthal, the NTSB did reach a conclusion, and did make a determination, and did issue its report. But....
To my knowledge, Metro-North Railroad having once deferred to NTSB, hs not yet conducted an investigation, reached a conclusion, made a determination, issued a report on its own.
Everything MNR has done it has done in response to and accordance with NTSB recommedations, or FRA Emergency Orders, or FRA Open Letters, FRA demands, or the blowing hard of the Schumenthal.
To my knowledge, Amtrak has not conducted an investigation or issued a report in the matter of train #188, and the death of eight passengers.
Now 49CFR 240.307 requires that if and when a railroad determines that a locomotive engineer, due to violation of the provisions of section 240.117(e), no longer meets the requirements for locomotive engineers, the railroad must revoke the locomotive engineer's certificate of qualification and then...
...And then provide (b)(2) "an opportunity for a hearing before a presiding officer other than the investigating officer." (3)"Convene the hearing within the deadline prescribed by either paragraphs (c)(1) of this section or the applicable collective bargaining agreement as permitted under paragraph (d) of this section."
Why? In order to (4) "determine, on the record of the hearing, whether the person no longer meets the qualification requirement so this part stating explicitly the bases for the conclusion reached;"
And? And then (5) "When appropriate, impose the pertinent period of revocation provided for in 240.117 or 240.119" So?
So the railroad will (6)"Retain the record of the hearing for 3 years after the date the decision is rendered." Because?
Because 240.309 Railroad Oversight Responsibilities stipulates that "(a) No later than March 31 of each year, each Class I railroad (including the National Railroad Passenger Corporation and a railroad providing commuter service) and Class II railroad shall conduct a formal annual review and analysis concerning the administration of its program for responding to detected instances of poor safety conduct by certified locomotive engineers during the prior calendar year." So?
So that (c) Based on that review and analysis each railroad shall determine what action(s) it will take to improve the safety of train operations to reduce or eliminate future incidents of that nature."
The regulation contemplates, intends, specifies, that the railroads will conduct these investigations because the railroads have the responsibility to adapt, amend, undertake actions necessary to reduce or eliminate future incidents.
The regulation does not contemplate, intend, specify, that the NTSB will conduct the investigations, because the NTSB has no responsibility to undertake any actions to protect safe train operations.
The regulation does not contemplate, intend, specify, that FRA will undertake these investigations because those framing this regulation were smart enough to realize the limitations of FRA in attempting to oversee the specific details necessary for safe train operations in the various operating environments of the general railway system.
The regulation does not contemplate, intend, specify, deep dives, superficial skimmings, belly flops, open or closed letters of concern, advisories, wishes, hopes, wings and prayers-- any of that stuff, because none of that stuff can replace direct, rapid investigation of incidents by the operating officers of the railroad; rapid and thorough analysis of the immediate and secondary causes of unsafe train operations by those responsible for the safety of daily train operations; effective, thorough, unflinching determination of responsibility in order to mitigate the risks of irresponsible behaviors, whether those behaviors be active or passive, deliberate or unintentional.
Nature abhors a vacuum, at least in the world of Newtonian physics, and it's Newton's laws that govern railroading. NTSB through its "lead party" policy has created exactly such a vacuum on railroads.
Sworn to silence by NTSB until it completes its own investigation, FRA issues advisories, suggestions, directives emphasizing the importance of...emphasizing its already established guidelines which may very well need revision; may very well be ineffective in preventing future incidents.
FRA might, based on its determinations, want to revisit its interpretation of the 2008 RSIA that says the requirement for PTC to prevent unauthorized movement into the working limits established on a track allows for a train dispatcher to authorize train movement into a work zone, when in fact the fundamental principle, the vitality, for establishing working limits is that the train dispatcher cedes his or her power to authorize train movements in that section.
Railroads might, based on Amtrak's report on this tragedy, want to revisit their provisions for establishing working limits, for permitting foul time, for verifying the proper transfer of information regarding work zones when train dispatchers change shifts, or transfer assignments. And if railroads might want to do that, it might be better to know that now than 12 months from now.
We, that is to say the category of railroad operating officers, have a vested interest in discharging our responsibilities to the safety of the public, the employees, the entire industry.
We, that category of railroad operating officers, have an obligation to conduct our investigations without delay so that we, the category of railroad operating officers can share our conclusions across the entire industry as quickly as possible and thereby prevent an incident, an individual tragedy, from becoming the "same old-same old."
April 8, 2016
This space reserved