On August 22, 2019, at 9:38 p.m. local time, northbound Sacramento Regional Transit District (SacRT) passenger train 9 collided head-on with a stopped southbound nonrevenue test train on the blue line near milepost 6.72 in Sacramento, California, at a speed of 32 mph. Train 9 had 1 operator and 27 passengers on board. The test train had one operator and two contractors on board. Thirteen people were transported to area hospitals with non-life-threatening injuries. Neither train derailed, and both trains experienced minimal structural damage. SacRT estimated damage to be $242,450.
We determined that the probable cause of the collision of two Sacramento Regional Transit District light rail trains was the Sacramento Regional Transit District’s weak administrative controls that allowed the transportation supervisor to authorize a high-speed test train to enter the mainline without knowing the location of passenger train 9 on the same track. Contributing to the collision was senior management’s failure to assess the transportation supervisor’s competency in the combined role as both a controller and dispatcher on the evening shift.
We made recommendations to SacRT to do the following: ensure employee performance is monitored and evaluated while on a performance improvement plan for the intended duration of the plan or until the employee has demonstrated competency in the position they occupy; conduct a risk assessment of mainline high-speed testing and revise testing schedules and communication requirements to ensure that necessary controls are in place; improve the train delay reporting process; and install a transmission-based train control system. We also recommended that the California Public Utilities Commission revise its instruction to SacRT and require SacRT to conduct a formal risk assessment of high-speed testing.
Further, we reiterated a recommendation to the Federal Transit Administration to require rail transit agencies to implement transmission-based train control systems that prevent train collisions.
