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Safety Recommendation Details

Safety Recommendation R-87-014
Details
Synopsis: ABOUT 8:36 A.M. ON MAY 7, 1986, BOSTON AND MAINE CORPORATION (B&M) TRAIN NO. 5324 STRUCK THE REAR OF CONRAIL TRAIN TV-14 STANDING ON CONSOLIDATED RAIL CORPORATION'S (CONRAIL) NO. 2 MAIN TRACK, AT BRIGHTON, MASSACHUSETTS. THE LOCOMOTIVE AND HEAD CARS OF TRAIN TV-14 HAD ENTERED CONRAIL'S BEACON PARK YARD AT BRIGHTON; THE LAST 10 CARS OF THE TRAIN WERE NOT IN THE YARD, BUT WERE EXTENDING THROUGH AN INTERCLOCKING PLANT AND ABOUT 6 OF THE CARS WERE STANDING ON THE NO. 2 MAIN TRACK IN A 2 DEGREE 8' CURVE TO THE RIGHT. OF THE 550 PASSENGERS 5 CREWMEMBERS ON THE COMMUTER TRAIN, 149 PASSENGERS AND 4 CREWMEMBERS WERE INJURED. THE CREWMEMBERS OF TRAIN TV-14 WERE INJURED. THE COMBINED EQUIPMENT DAMAGE WAS ESTIMATED TO BE $102,210.
Recommendation: THE NTSB RECOMMENDS THAT THE MASSACHUSETTS BAY TRANSPORTATION AUTHORITY: REQUIRE THAT ON-BOARD SPEED RECORDING INSTRUMENTS USED ON EQUIPMENT IN COMMUTER SERVICE BE MAINTAINED TO PERFORM THEIR INTENDED FUNCTION.
Original recommendation transmittal letter: PDF
Overall Status: Closed - Acceptable Action
Mode: Railroad
Location: BRIGHTON, MA, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA86MR002
Accident Reports: Rear-End Collision Between Boston and Main Corporation Commuter Train No. 5324 and Consolidated Rail Corporation Train TV-14
Report #: RAR-87-02
Accident Date: 5/7/1986
Issue Date: 5/19/1987
Date Closed: 6/20/1990
Addressee(s) and Addressee Status: Massachusetts Bay Transportation Authority (Closed - Acceptable Action)
Keyword(s):

Safety Recommendation History
From: NTSB
To: Massachusetts Bay Transportation Authority
Date: 6/20/1990
Response: Safety Recommendation R-87-14 states that the MBTA should require that on-board speed recording instruments used on equipment in commuter service be maintained to perform their intended function. The Safety Board has reviewed the forms attached to the MBTA letter of February 13, 1990, and reviewed the procedures described. Based on implementation of these actions, Safety Recommendation R-87-14 has been classified "Closed--Acceptable Action."

From: Massachusetts Bay Transportation Authority
To: NTSB
Date: 2/13/1990
Response: (SUMMARIZED) OUR PROCEDURES FOR MONITORING ON-BOARD SPEED RECORDING INSTRUMENTS IN ACCORDANCE WITH SAFETY RECOMMENDA TION R-87-014 REQUIRE THAT LOCOMOTIVE ENGINEERS REPORT SPEED INDICATOR CONDITIONS ON AMTRAK FORM MAP 100. IN ADDITION, A VERBAL REPORT IS MADE TO THEIR SUPERVISOR OF OPERATIONS OR TRANSPORTATION MANAGER WHO GENERATES A REPORT THAT IS RAPID FAXED TO THE REPAIR FACILITY MANAGER. THIS REPORT BACKS UP THE MAP 100 REPORT AND THE DAILY MAINTENANCE GENERAL FOREMAN IS REQUIRED TO IMPLEMENT CORRECTIVE ACTION. IN ADDITION, OUR COMMUTER RAIL MAINTENANCE FORM CRM-2 REQUIRES SPEED INDICATOR AND SPEED RECORDER CALIBRATION. THIS CALIBRATION DATA IS RECORDED AND SCHEDULED FOR EVERY 45 DAYS AS MBTA MAINTENANCE AND EVERY 92 DAYS AS PART OF FRA MANDATED MAINTENANCE. REPAIR USE A CERTIFIED VENDOR TO ENSURE ACCURACY.

From: NTSB
To: Massachusetts Bay Transportation Authority
Date: 1/4/1990
Response: Safety Recommendation R-87-14 states that the Massachusetts Bay Transportation Authority should require on-board speed recording instruments used on equipment in commuter service to be maintained to perform their intended function. While the Safety Board appreciates your response that you have instituted vigorous monitoring along with an insistence on proper operation of on-board speed monitoring equipment, we are concerned that without a formal requirement, the issue of maintenance may be overlooked. It has been the Safety Board's experience that monitoring without a specific requirement in place has been ineffective. We would appreciate a detailed description of the methods used to monitor the proper operation and maintenance of these devices. Pending further response, this safety recommendation will be classified as "Open--Acceptable Action."

From: Massachusetts Bay Transportation Authority
To: NTSB
Date: 6/2/1989
Response: The Massachusetts Bay Transportation Authority has no record of receiving your letter of November 25, 1987 or any follow up correspondence regarding R-87-14 and R-87-15. We also were unaware of a requirement to notify the Board of the implementation of the recommendations. Many changes have occurred since the referenced incident including a change of operators to Amtrak and the acquisition of considerable new equipment. Our response to recommendation R-87-14 has been to vigorously monitor, and insist on the proper operation of on board speed monitoring equipment. The recommendations of R-87-15 have been exceeded in our recent acquisitions of new coaches to include; seat hand holds, vertical, and overhead hand holds in the ends of cars, together with padded seat backs and non-slip flooring. We regret the classification that has been placed on the aforementioned recommendations and request you reconsider the "closed-unacceptable action" classification.

From: NTSB
To: Massachusetts Bay Transportation Authority
Date: 5/22/1989
Response: The National Transportation Safety Board is reviewing its safety recommendation files to identify those recommendations on which there has been no correspondence for an extended time. On May 19, 1987, the Safety Board issued Safety Recommendations R-87*14 and -15 to the Massachusetts Bay Transportation Authority. These safety recommendations address the maintenance of commuter train speed recording instruments and the use of equipment for commuter service that has interior features designed to prevent injury in an accident. The Safety Board again called your attention to these safety recommendations in a November 25, 1987, letter. Since there has been no response to Safety Recommendations R-87-14 or -15 or to our followup letter, we have classified these safety recommendations as "Closed--Unacceptable Action." If these safety recommenda ions have been implemented, the Safety I Board will be pleased to reconsider the status.

From: NTSB
To: Massachusetts Bay Transportation Authority
Date: 11/25/1987
Response: On May 19, 1987, the Safety Board issued Safety Recommendations R-87-14 and -15 to the Massachusetts Bay Transportation Authority (MBTA) as a result of the Board's investigation of the rear end collision of Boston & Maine Corporation commuter train No. 5324 with Consolidated Rail Corporation train TV-14, at Brighton, Massachusetts, on May 7, 1986. The National Transportation Safety Board is an independent Federal agency with the statutory responsibility ' . ..to promote transportation safety by conducting independent accident investigations and by formulating safety improvement recommendations" (Public Law 93-633). The Safety Board is vitally interested in any actions taken as a result of its Safety Recommendations. Our records show, however, that we have not received a response from the MBTA regarding the recommended actions. We would appreciate being informed as to what efforts are being made to implement these recommendations. The Safety 8oard's letter including these recommendations is enclosed for your information in this matter. Thank you for your cooperation. We look forward to hearing from you in the near future.