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Amtrak 501 Derail in Washington State

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Posted by 243129 on Thursday, January 3, 2019 7:37 PM

Euclid

 

 
243129
 
Paul of Covington
Actually, I would say that when one realizes he has lost situational awareness...

 

A properly supervised ,vetted and trained engineer will know where he is at all times. When this engineer realized he was 'lost' he still took no action to slow down. That is criminal. It is also criminal in the way Amtrak supervised, vetted and trained him (and others).

 

 

 

Yes, he had to know he was lost.  He started out lost with the intenion of finding where he was by watching for key wayside marker points.  This process would cast doubt in most peoples' minds.  When you watch for markers to confirm your location, you might lose confidence by thinking you might have missed one.   That is the problem when you might find key markers such as mileposts, but do not really know the territory, which is 100% familiarity with every square foot of it.  I would not be surprised if this engineer was feeling doubt over the question of whether he had accidentally passed a key marker without seeing it.  If he was feeling doubt, he should have slowed down.  He must have felt the push of the Amtrak institution relying on him to make the schedule.   

 

Precisely!

Amtrak Operations are in dire need of oversight by a team of experienced railroaders.

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Posted by Euclid on Thursday, January 3, 2019 3:04 PM

243129
 
Paul of Covington
Actually, I would say that when one realizes he has lost situational awareness...

 

A properly supervised ,vetted and trained engineer will know where he is at all times. When this engineer realized he was 'lost' he still took no action to slow down. That is criminal. It is also criminal in the way Amtrak supervised, vetted and trained him (and others).

 

Yes, he had to know he was lost.  He started out lost with the intenion of finding where he was by watching for key wayside marker points.  This process would cast doubt in most peoples' minds.  When you watch for markers to confirm your location, you might lose confidence by thinking you might have missed one.   That is the problem when you might find key markers such as mileposts, but do not really know the territory, which is 100% familiarity with every square foot of it.  I would not be surprised if this engineer was feeling doubt over the question of whether he had accidentally passed a key marker without seeing it.  If he was feeling doubt, he should have slowed down.  He must have felt the push of the Amtrak institution relying on him to make the schedule.   

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Posted by 243129 on Thursday, January 3, 2019 2:02 PM

Paul of Covington
Actually, I would say that when one realizes he has lost situational awareness...

A properly supervised ,vetted and trained engineer will know where he is at all times. When this engineer realized he was 'lost' he still took no action to slow down. That is criminal. It is also criminal in the way Amtrak supervised, vetted and trained him (and others).

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Posted by Paul of Covington on Thursday, January 3, 2019 1:04 PM

243129
When one loses situational awareness the normal reaction is to slow down is it not?

   Actually, I would say that when one realizes he has lost situational awareness...

_____________ 

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Posted by Euclid on Thursday, January 3, 2019 10:47 AM

243129
 
Euclid
I agree that the engineer of 501 should have had the curve uppermost on his mind since properly reacting to it was deadly critical and completely dependent upon knowing when it will be encountered. It may indeed have been uppermost on his mind, but he intended to rely on a relatively weak process of reckoning to locate that deadly curve in a wide general area with which he was very unfamiliar.

 

When one loses situational awareness the normal reaction is to slow down is it not? He did not.

Who pronounced this person qualified? Someone who is minimally qualified themselves.

As I have said repeatedly the root cause(s) for this tragedy are poor vetting, poor training and poor supervision. Amtrak should be held accountable.

 

 

Yes, I agree that the root cause was hiring this engineer.  The engineer exhibited very poor judgement in choosing such a flimsy method of knowing when to brake for the curve when so much was at stake.  He lacked the common sense to see that.  Obviously Amtrak never vetted him for his poor sense of judgment, and lack of common sense.  The engineer should have chosen a different line of work. 

 

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Posted by 243129 on Wednesday, January 2, 2019 4:49 PM

Euclid
I agree that the engineer of 501 should have had the curve uppermost on his mind since properly reacting to it was deadly critical and completely dependent upon knowing when it will be encountered. It may indeed have been uppermost on his mind, but he intended to rely on a relatively weak process of reckoning to locate that deadly curve in a wide general area with which he was very unfamiliar.

When one loses situational awareness the normal reaction is to slow down is it not? He did not.

Who pronounced this person qualified? Someone who is minimally qualified themselves.

As I have said repeatedly the root cause(s) for this tragedy are poor vetting, poor training and poor supervision. Amtrak should be held accountable.

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Posted by Euclid on Tuesday, December 25, 2018 10:34 AM

Euclid
 
243129

charlie hebdo ,Euclid ,Overmod, BaltACD, you have all submitted insightful, sage, valid and informative information/observations but what is glaring to me is the significant speed reduction from 79mph to 30mph curve which if and was miscalculated could/did result in disaster. That in the relatively small portion of 'new' territory should have been foremost in the engineer's mind. The reason for it not being, in my opinion is, surprise!, poor vetting, poor training and poor supervision.

 

 

 

I recall some reporting on the reason why the curve was deemed to be necessary.  It sounded like straightening the curve was simply not possible, or maybe it is less possible to do after the highway had been built.  As I recall, straightening the curve now would require that the track would have to first curve way out to the right, and then start a final curve to the left in order to cross the highway. This would require buying a lot of land to the right side as the 501 approached the curve.  If they just started the curve earlier to reduce the curvature rate, then it results in a longer bridge to get over the highway.  The curve was also deemed to not be an issue when only running freight trains prior to the introduction of the new fast passenger trains.

 

I also recall in an interview with the engineer that he indicated that he and all of the other engineers were very much aware of the curve as almost an infamous and dreaded feature of the route.  Maybe this strong familiarity with the existance of the curve caused the engineer to let is guard down and underestimate how hard it might be to find it when running.

 

 

 

Actually, I had misinterpreted Joe's comment above to mean that the line should have not included the abrupt curve.  But I do not beleive that the curve was any part of the cause, and I now realize that Joe is not suggesting that either.  However, I will not be surprised if the NTSB suggests that the curve was part of the cause.  In any case, the curve is there and will probably stay. 

I agree that the engineer of 501 should have had the curve uppermost on his mind since properly reacting to it was deadly critical and completely dependent upon knowing when it will be encountered.  It may indeed have been uppermost on his mind, but he intended to rely on a relatively weak process of reckoning to locate that deadly curve in a wide general area with which he was very unfamiliar. 

 

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Posted by 243129 on Monday, December 24, 2018 9:10 AM

DELETED

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Posted by rdamon on Friday, December 21, 2018 3:56 PM

I believe that there was a earlier article that referenced a plan to continue the tracks down the north side of I5 and intersect the tracks there, but it required a lot of fill and land.

 

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Posted by blue streak 1 on Friday, December 21, 2018 1:09 PM

Euclid

 I recall some reporting on the reason why the curve was deemed to be necessary.  It sounded like straightening the curve was simply not possible, or maybe it is less possible to do after the highway had been built.  As I recall, straightening the curve now would require that the track would have to first curve way out to the right, and then start a final curve to the left in order to cross the highway. 

There would be another way to just eliminate the curve totally.  That would to build almost perpendicular horizontal supports across the I-5 and build the track across the highway at an acute angle.  Note the LAX metro did that as we saw a pictue posted by KP Harrier over a highway . elevation at that location would not be a problem just a matter of $$$

Would save a couple minutes as well !

If the proposed HSR line is ever built PDX- SEA along this alignment that option will be necessary to maintain high speed

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Posted by BaltACD on Friday, December 21, 2018 9:41 AM

Now that PTC has been reported as having been installed on the segment of track - are Amtrak-WSDOT conducting non-revenue training trips over the line?

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Posted by Euclid on Friday, December 21, 2018 8:30 AM

243129

charlie hebdo ,Euclid ,Overmod, BaltACD, you have all submitted insightful, sage, valid and informative information/observations but what is glaring to me is the significant speed reduction from 79mph to 30mph curve which if and was miscalculated could/did result in disaster. That in the relatively small portion of 'new' territory should have been foremost in the engineer's mind. The reason for it not being, in my opinion is, surprise!, poor vetting, poor training and poor supervision.

 

I recall some reporting on the reason why the curve was deemed to be necessary.  It sounded like straightening the curve was simply not possible, or maybe it is less possible to do after the highway had been built.  As I recall, straightening the curve now would require that the track would have to first curve way out to the right, and then start a final curve to the left in order to cross the highway. This would require buying a lot of land to the right side as the 501 approached the curve.  If they just started the curve earlier to reduce the curvature rate, then it results in a longer bridge to get over the highway.  The curve was also deemed to not be an issue when only running freight trains prior to the introduction of the new fast passenger trains.

I also recall in an interview with the engineer that he indicated that he and all of the other engineers were very much aware of the curve as almost an infamous and dreaded feature of the route.  Maybe this strong familiarity with the existance of the curve caused the engineer to let is guard down and underestimate how hard it might be to find it when running.

 

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Posted by rdamon on Thursday, December 20, 2018 9:58 PM

My guess is that that curve will be lit up like my neighbor's house when they decide to resume service.

 

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Posted by SD70Dude on Thursday, December 20, 2018 9:30 PM

cx500
zugmann
Wait, didn't your railroad use speed signals (Medium clear, approach slow etc)?

Those speed indications sometimes were due to insufficient braking distances at the next signal if a train approached it at full track speed.  It is a problem if the next signal is an approach and the following stop signal is one mile away, if traveling at track speed means the train will take 1.1 miles to stop.  Having speed signals allows the train to maintain full speed longer since it only has to slow down as it nears the approach signal.

I know of a couple locations with short blocks where the preceding signal will display "Clear to Medium*" or "Clear to Limited*" if the second signal is set at stop.  Officially that is an improper progression of signals as those locations have no Medium or Limited speed turnouts, but I understand the rationale. 

*The signal names changed in the CROR a number of years ago, well before I hired on.  For example what was once called "Approach" is now called "Clear to Stop" and "Approach Medium" became "Clear to Medium".  Only the names changed, the indications and meanings did not.

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Posted by SD70Dude on Thursday, December 20, 2018 9:17 PM

BaltACD
cx500
The operators became good at passing the red signal moments after it cleared.  There was a lunar below the red that presumably indicated it was controlling speed and the next block was in fact clear.  Did Saluda have something similar?

Back in the days when trains would 'ride the yellows' - expecting them to go green just before they passed them at track speed .... sometimes there were serious consequences when they rode the red in a similar manner - only to find the lead train stopped just past the red.

Unfortunately "riding the yellows" still happens, on CN I know of at least two stop signal violations this past fall alone that resulted from the practice.  On Edmonton's east side in 2011 there was a rear end collision in just such the manner you have described:

http://tsb.gc.ca/eng/rapports-reports/rail/2011/r11e0063/r11e0063.asp

Unfortunately there are many more. 

The Toronto subway motormen's practice CX500 described resulted in a fatal crash in 1995:

https://en.wikipedia.org/wiki/1995_Russell_Hill_subway_accident

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Posted by BaltACD on Thursday, December 20, 2018 9:03 PM

cx500
The operators became good at passing the red signal moments after it cleared.  There was a lunar below the red that presumably indicated it was controlling speed and the next block was in fact clear.  Did Saluda have something similar?

Back in the days when trains would 'ride the yellows' - expecting them to go green just before they passed them at track speed .... sometimes there were serious consequences when they rode the red in a similar manner - only to find the lead train stopped just past the red.

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Posted by cx500 on Thursday, December 20, 2018 8:03 PM

zugmann
Wait, didn't your railroad use speed signals (Medium clear, approach slow etc)?

Those speed indications sometimes were due to insufficient braking distances at the next signal if a train approached it at full track speed.  It is a problem if the next signal is an approach and the following stop signal is one mile away, if traveling at track speed means the train will take 1.1 miles to stop.  Having speed signals allows the train to maintain full speed longer since it only has to slow down as it nears the approach signal.

As to speed indications at control points, various routes may use different sizes of turnouts.  Without speed indications, trains would be limited to the speed of the most restrictive turnout within the interlocking, even if it was not part of its route that day.  Even on a simple single track line with passing sidings it is useful, since not all the power turnouts may have the same turnout number and the alternative is numerous notes in the ETT giving the speed at each; all too easy to miss one.

But I think you knew that already.Big Smile

I have seen signals used for speed control on curves but that was quite a different method, on the Toronto subway.  It did not use special indications.  Instead there was a timing circuit in the occupied block before the signal (and trip arm) at the end would clear.  The operators became good at passing the red signal moments after it cleared.  There was a lunar below the red that presumably indicated it was controlling speed and the next block was in fact clear.  Did Saluda have something similar?

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Posted by 243129 on Thursday, December 20, 2018 7:03 PM

charlie hebdo ,Euclid ,Overmod, BaltACD, you have all submitted insightful, sage, valid and informative information/observations but what is glaring to me is the significant speed reduction from 79mph to 30mph curve which if and was miscalculated could/did result in disaster. That in the relatively small portion of 'new' territory should have been foremost in the engineer's mind. The reason for it not being, in my opinion is, surprise!, poor vetting, poor training and poor supervision.

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Posted by BaltACD on Thursday, December 20, 2018 2:00 PM

zugmann
 
BaltACD

Railroad signalling has always been about protecting trains from other trains.  Using signalling for other purposes diminishes its real purpose. 

Wait, didn't your railroad use speed signals (Medium clear, approach slow etc)?

For specific SWITCH conditions at or approaching interlockings (Control Points).  No such signals were used to control speeds on curves.  On CPL's, the color identified the condition of the block ahead - the markers were additional information.

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Posted by zugmann on Thursday, December 20, 2018 12:16 PM

BaltACD

Railroad signalling has always been about protecting trains from other trains.  Using signalling for other purposes diminishes its real purpose.

 

Wait, didn't your railroad use speed signals (Medium clear, approach slow etc)?

  

The opinions expressed here represent my own and not those of

my employer, any other railroad, company, or person.

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Posted by BaltACD on Thursday, December 20, 2018 12:05 PM

Railroad signalling has always been about protecting trains from other trains.  Using signalling for other purposes diminishes its real purpose.

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Posted by Overmod on Thursday, December 20, 2018 10:27 AM

243129
blue streak 1

Still maintain that the signal before the curve should display approach and signal before that advanced approach!  Then a clear signal 2000 feet beyond the curve!

I am not familiar with the area so I will ask why? To slow the train?

The area in question involves what is basically a long 79mph tangent that abruptly terminates in a hard 30mph curve restriction.  The curve in question is already laid with the maximum easing of radius (which you can see in the aerial pictures) and presumably maximum safe superelevation that does not cause its own wear and stability problems.

I look at the approach to this 'feature' as being no different from a typical interlocking, with the only difference being that there is a fixed obstruction rather than a variable one like a raisable bridge or crossing at grade.  We have already commented on the fact that PTC penalty braking initiated at the current signal would have worked just about as well as what the engineer actually did.  Evidently, the "civil engineers" on the improvement project thought that speed reduction signs would take the place of illuminated lights to a crew running at high speed in virtual darkness.  They shouldn't, and I think one thing the accident proved is that they don't.  Why they thought a 79mph stretch should abruptly terminate in a 30mph curve is a greater mystery, although after the zero-train-length programming fiasco in NAJPTC little these 'postwar engineers' (to quote Steve Slaby) can do really surprises me.

I would be tempted to say that the 'approach' signal shouldn't be 2 miles back up the 79mph part of the track, but that it should be where a service-brake application to reach the 30mph restricted speed had been 'in being' for several continuous seconds, with the train speed reduced as it would 'need to be' to safely reach the home signal equivalent at the correct speed for the restriction.  Passing it at red would result in a PTC penalty service-brake application right down to a stop (not an 'emergency' brake application, but not forestallable either).

There is no point in a 'clear signal' beyond the curve, as it's less than 2 miles at mandatorily restricted speed to the actual station.  Leaving it 'clear' opens you right up to Brandon Bostian redux, whether or not your improved Amtrak training methodology teaches normally alert individuals the correct response to haptic location -- or how to behave when they are recognizably fatigued or otherwise impaired.

One not-improper result of post-Internet 'design methodology' is the idea that your processes fix emergent problems as they occur (and ought to revise SOPs and the like dynamically to keep them fixed, although that escapes the usual twentysomething junior engineers and designoids) instead of trying to exhaustively list all the possible failure modes and rigorously test combinations of them deterministically.  Doing this in training of locomotive engineers demonstrably failed in this situation.  If there have been changes in the mindset of any of the parties concerned, I haven't seen public or private evidence of them, and going back to a test-all-the-possibilities set of runs, even on a reasonable simulator, isn't going to be cost-effective even if I could trust them to do the thing right.

Part of the trouble here is that the best is the clear enemy of the better, complicated by the fact we won't know all the aspects of the achievable 'better' until we're well into actually trying to solve the problem ... perhaps not enough even then.  As a strictly metaphorical example, we might compare the Republican attempts to overturn "Obamacare" after 2016, where it was clear that "something" had to be done but no one would actually "do" enough unless they got to call some of the critical shots their way ... which was not going to happen.  Just as exhaustive-enough methodological changes aren't likely to happen in Amtrak's highly-politicized and sometimes decidedly 'nondiscursive' culture, but 'something has to be done'.

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Posted by Euclid on Thursday, December 20, 2018 8:42 AM

ROBIN LUETHE

You weren't asking me, and I am out of my field, but.....  ??

Should a train with that many heavy traffic grade crossings be going 80 MPH

Was the engineer known otherwise as smart and competent

Was he healthy or did he have underlying hidden health problems

 

His saying he missed seeing the sign is really not acceptable

 

And then: Smart competent people sometimes make deadly mistakes. Some, perhaps most airliner accidents are such.  

 

 

 

I do not believe that the engineer made a strong enough effort to make sure he would slow down for the curve.  He knew it was there, but was so unfamiliar with that rail line that he could not just recognize landmarks.  So, he picked key regulatory landmarks in the form of mile markers and signs.  I suppose he thought those official company landmarks would be plenty good to navigate to the curve. 

But, watching for the signs and markers while going 80 mph would be daunting. If he had known the territory, he would see a continuous stream of landmarks, and the mile markers would be anticipated exactly where they are known to fit into the stream of other landmarks.  However, not knowing the visual ques as he approached a mile marker required him to stare and wait for the anticipated mile marker to rush at him out of the dark.  If he missed it go by, he would be in grave danger of going too fast for the curve.  This is very “fail-unsafe.” 

Also, the engineer’s perception of the time interval between mileposts would be critical.  It should have been timed with a watch.  That way, he would know when he should encounter the next marker.  And if he did not encounter a marker when he should have, he would immediately have confirmation that he should slow down because he must have missed the marker.

Otherwise, if one were to lose track of the time interval, they might suddenly think it has been too long, and maybe they had passed it already.  Maybe they had missed it.  IF he had missed a marker, he would be heading right into disaster, and he should immediately get the speed down to the 30 mph limit. 

But, if he slows and it proves to have been unnecessary, it will be a public embarrassment in the mind of an engineer who is heavily invested in the showmanship of the first run of a new service.  In those circumstances, he would not have the option to slow down as a precaution against being lost.  Everybody witnessing this inaugural run would be watching the schedule.  Everything must go perfectly on the first run; and slowing down out of uncertainty of location would raise questions.  I think the pressure was enormous to keep a stiff upper lip and soldier on with the schedule. 

But this engineer put himself in this difficult situation.  He took a gigantic gamble that he could conquer the challenge of the curve with insufficient information.  I think he knew he was making that gamble.  And his passengers had not volunteered to be included in that dangerous gamble.  They had placed their faith in an engineer who would not gamble with their lives for frivolous reasons such as making sure the first run looked good to the public.

This incredibly reckless risk taking was a character flaw that should have disqualified this person for the job had he been properly vetted. 

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Posted by charlie hebdo on Thursday, December 20, 2018 7:33 AM

243129
Promotion from within gives the candidate 'a leg up' in experience and insight in to their work habits and cognitive skills as opposed to hiring someone 'off the street' so to speak.

I agree with that, with the addition that they must go through the same testing, etc. as someone "off the street."

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Posted by 243129 on Wednesday, December 19, 2018 4:58 PM

charlie hebdo
I think objective testing should be part of the process, focusing on sufficient cognitive abilities for the task, including attention and memory.

I agree.

charlie hebdo
I differ somewhat with your recommendation concerning promotion from within and the role of senior engineers. I think the latters' role should be primarily supervision and training of the new engineers.

Promotion from within gives the candidate 'a leg up' in experience and insight in to their work habits and cognitive skills as opposed to hiring someone 'off the street' so to speak.

The problem now with using senior engineers for supervision and training is that they are a product of Amtrak's inadequate training regimen. The unknowing teaching the unknowing.

 

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Posted by 243129 on Wednesday, December 19, 2018 3:41 PM

blue streak 1

Still maintain that the signal before the curve should display approach and signal before that advanced approach !  Then a clear signal 2000 feet beyond the curve !

 

I am not familiar with the area so I will ask why? To slow the train?

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Posted by blue streak 1 on Wednesday, December 19, 2018 3:38 PM

Still maintain that the signal before the curve should display approach and signal before that advanced approach !  Then a clear signal 2000 feet beyond the curve !

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Posted by 243129 on Wednesday, December 19, 2018 3:19 PM

ROBIN LUETHE
Should a train with that many heavy traffic grade crossings be going 80 MPH

Yes it is not uncommon. There is sufficient(should be)grade crossing protections in those areas. Unfortunately folks sometimes ignore them.

ROBIN LUETHE
Was the engineer known otherwise as smart and competent Was he healthy or did he have underlying hidden health problems

Evidently supervision deemed him qualified as he was allowed to go alone on the inaugural revenue trip. 

Hopefully his medical qualifications/records were current.

ROBIN LUETHE
His saying he missed seeing the sign is really not acceptable And then: Smart competent people sometimes make deadly mistakes. Some, perhaps most airliner accidents are such.

A 'qualified' engineer would not reply upon signage only.

Again I blame vetting, training and supervision as I have stated ad nauseam throughout this thread.

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Posted by ROBIN LUETHE on Wednesday, December 19, 2018 2:07 PM

You weren't asking me, and I am out of my field, but.....  ??

Should a train with that many heavy traffic grade crossings be going 80 MPH

Was the engineer known otherwise as smart and competent

Was he healthy or did he have underlying hidden health problems

 

His saying he missed seeing the sign is really not acceptable

 

And then: Smart competent people sometimes make deadly mistakes. Some, perhaps most airliner accidents are such.  

 

 

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Posted by charlie hebdo on Wednesday, December 19, 2018 10:04 AM

243129
What are your thoughts on what is wrong and how to correct it?

On vetting and  hiring.  I think the cognitive skill requirements of both new hires and potential internal engineer promotions needs to be tightened. I think objective testing should be part of the process, focusing on sufficient cognitive abilities for the task, including attention and memory. I differ somewhat with your recommendation concerning promotion from within and the role of senior engineers.  I think the latters' role should be primarily supervision and training of the new engineers.

As you can see, the difference is on emphasis.

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