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Safety Recommendation Details

Safety Recommendation R-97-021
Details
Synopsis: About 5:38 p.m. on 2/16/96, eastbound Maryland Rail Commuter (MARC) train 286 collided with westbound National Railroad Passenger Corporation (Amtrak) train 29, the Capitol Limited, at milepost 8.55 on CSX main track near Silver Spring, Maryland. The MARC train was operating in the push mode in revenue service between Brunswick , Maryland, and Washington, DC.; it consisted of a locomotive and three commuter cars. The Amtrak train, operating in revenue service between Washington DC., and Chicago, Illinois, consisted of 2 locomotives and 15 cars.
Recommendation: TO THE FEDERAL RAILROAD ADMINISTRATION: Update 49 Code of Federal Regulations Part 228.17, train dispatcher's record of train movements, to include the same parameters for electronic recordkeeping of the dispatcher's record of train movements.
Original recommendation transmittal letter: PDF
Overall Status: Closed - Reconsidered
Mode: Railroad
Location: Silver Spring, MD, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA96MR004
Accident Reports: Collision and Derailment of Maryland Rail Commuter MARC Train 286 and National Railroad Passenger Corporation AMTRAK Train 29
Report #: RAR-97-02
Accident Date: 2/16/1996
Issue Date: 8/28/1997
Date Closed: 9/19/2001
Addressee(s) and Addressee Status: FRA (Closed - Reconsidered)
Keyword(s):

Safety Recommendation History
From: NTSB
To: FRA
Date: 9/19/2001
Response: The Safety Board has reviewed its position on this recommendation and now agrees with the FRA that the computer-generated train sheet problem identified by the Board in its investigation of the Silver Spring accident relates more to compliance and enforcement issues in Section 228.17, Title 49 CFR Part 228, "Train Dispatcher’s Record of Train Movements," and that computer-generated train sheets are covered by the regulation. Consequently, Safety Recommendation R-97-21 is classified "Closed--Reconsidered." The Safety Board encourages the FRA to determine if there is widespread problem with computerized train sheets not complying with 49 CFR Part 228.17.

From: FRA
To: NTSB
Date: 5/21/2001
Response: Letter Mail Controlled 05/25/2001 7:18:45 PM MC# 2010437: FRA continues to believe that the absence of: .MARC Train 286's train activity after its departure from Point of Rocks, Maryland, when it was required to make a reverse movement to crossover and go around a disabled freight train; the weather information, and the fact that the accident occurred, from the CSX's computer generated train sheet for MARC Train 286, relates to a compliance and enforcement matter, rather than a result of inadequacy of the regulation. Section 228.17, Title 49 CFR Part 228, "Train Dispatcher's Record of Train Movements," requires this information, whether train sheets are kept manually or electronically. While it is true that the regulation does not refer to electronic means of recordkeeping these data, the same application of Section 228.17 is required for both manually kept train sheets, and for electronic applications. FRA would be willing to meet with representatives of the Board to discuss fully the specific revisions to Section 228.17 that would aid the Board in future accident investigations. Until FRA is able to achieve the intent of the Board's recommendation, we request that Safety Recommendation R-97-21 be retained in "Open--Acceptable Action" status.

From: NTSB
To: FRA
Date: 9/30/1999
Response: THE SAFETY BOARD DISAGREES THAT ENSURING THE PROPER PREPARATION OF COMPUTER-BASED TRAIN SHEETS IS A COMPLIANCE PROBLEM THAT CAN BE SOLVED BY ENFORCEMENT. DURING THE SILVER SPRING INVESTIGATION, OUR INVESTIGATORS FOUND THAT THE CSXT'S ELECTRONICALLY PREPARED TRAIN SHEETS WERE OF LIMITED VALUE BECAUSE THEY LACKED INFORMATION REQUIRED BY REGULATION. THE BOARD AGREES THAT ELECTRONIC DATA RETRIEVAL AND RECORDING FROM ALL PERTINENT SYSTEMS CAN AND SHOULD BE USED TO ENHANCE SAFETY. COMPLETE SYSTEM DATA CAN BE PARTICULARLY USEFUL IN ACCIDENT INVESTIGATIONS. THE BOARD ALSO AGREES THAT THE FRA SHOULD CLEARLY IDENTIFY ITS OBJECTIVES AND DESIRED SAFETY RESULTS BEFORE REVISING 49 CFR PART 228.17. WE ARE PREPARED TO COOPERATE WITH THE FRA IN DEVELOPING SUCH OBJECTIVES. PENDING FURTHER ACTION, THE BOARD HAS CLASSIFIED R-97-21 "OPEN--ACCEPTABLE RESPONSE."

From: FRA
To: NTSB
Date: 2/25/1998
Response: FRA STATED THAT SECTION 228.17 STATES INFORMATION COLLECTION REQUIREMENTS THAT ARE EQUALLY APPLICABLE, WHETHER THE RECORD OF TRAIN MOVEMENTS IS MAINTAINED IN HARD COPY OR ELECTRONIC FORMAT. AT THE CSXT OPERATIONS CENTER IN JACKSONVILLE, SOME OF THIS DATA LOADS AUTOMATICALLY TO THE SHEET FROM OTHER COMPUTER SYSTEMS, WHILE OTHER-DATA MUST BE MANUALLY ENTERED BY THE DISPATCHER. DURING ROUTINE INSPECTIONS, FRA HAS WORKED TO ENSURE THAT THE COMPUTER-BASED TRAIN SHEET IS CAPABLE OF RECEIVING ALL PERTINENT FIELDS OF INFORMATION (AS IT HAS BEEN FOR SEVERAL YEARS) AND THAT DISPATCHERS ROUTINELY ENTER THAT INFORMATION (WHICH, UNFORTUNATELY, IS SOMETIMES NOT ACCOMPLISHED IN THE WAKE OF AN ACCIDENT DUE TO DISTRACTION OF THE DISPATCHER BY OTHER TASKS). IN ADDITION, FRA HAS ENCOURAGED THE RAILROAD TO PROVIDE FOR AUTOMATIC DATA TRANSFER OF WEATHER INFORMATION. FRA WILL CONTINUE TO WORK WITH THE RAILROAD AT JACKSONVILLE, AND WITH OTHER CARRIERS, TO PROMOTE SOUND RECORD KEEPING IN COMPLIANCE WITH 49 CFR PART 228. HOWEVER, FOR THE PRESENT THIS IS A COMPLIANCE ISSUE THAT MUST BE HANDLED WITH ALL OF THE DISPATCHER DESKS AT JACKSONVILLE WITH RESPECT TO EACH OF THE 1,400 TRAIN SHEETS GENERATED DAILY. WE ARE NOT AWARE OF ANY REGULATORY CHANGE THAT COULD SIMPLIFY THIS QUALITY CONTROL TASK, BUT WOULD CERTAINLY BE WILLING TO DISCUSS ANY SPECIFIC SUGGESTIONS. WITHOUT QUESTION, USE OF ELECTRONIC RECORD KEEPING SHOULD ENHANCE THE INFORMATION AVAILABLE FOR SAFETY PURPOSES, AND WE BELIEVE THAT IS VERY MUCH THE CASE PRESENTLY WHEN ALL PERTINENT SYSTEMS ARE UTILIZED. RETRIEVABLE DATA IN A CONTEMPORARY DISPATCHING CENTER IS NORMALLY FAR MORE EXTENSIVE AND HISTORICALLY RELIABLE THAN DATA DERIVED FROM A TRADITIONAL HAND-WRITTEN TRAIN SHEET. CENTRALIZED TRAFFIC CONTROL SYSTEM RECORDS (SIGNAL EVENT LOGS) PROVIDE DETAILED INFORMATION THAT CAN BE ANALYZED TO DETERMINE TRAIN MOVEMENTS. DISPATCHER VOICE TAPES AND COMPUTER-AIDED DISPATCHING SYSTEMS DOCUMENTS AUTHORITIES AND INFORMATION CONVEYED TO TRAIN CREWS. WEATHER INFORMATION IS SEPARATELY MAINTAINED IN ELECTRONIC OR HARD COPY FORMAT FOLLOWING ELECTRONIC DELIVERY FROM A COMMERCIAL SERVICE THAT PROVIDES VERY DETAILED DATA AND FORECASTS. THIS WEALTH OF INFORMATION IS AVAILABLE FOR ACCIDENT INVESTIGATION AND OTHER PURPOSES. FUTURE REVISIONS TO PART 228 COULD INCLUDE INPUTS TO THE "TRAIN SHEET" FROM SOURCES NOT PRESENTLY TAPPED. HOWEVER, IT WOULD BE IMPORTANT TO CLEARLY IDENTIFY OUR CORE OBJECTIVES AND THE SAFETY RESULTS THAT WE WOULD EXPECT TO ACHIEVE BEFORE PROCEEDING. WHETHER OR NOT TECHNICALLY ASSOCIATED WITH THE "TRAIN SHEET," THIS DATA IS USEFUL TODAY FOR A VARIETY OF PURPOSES.