Amtrak derailment

hokie71 posted:

Wonder how this happens at slow speed in the station?

http://www.nj.com/news/index.s...nother_at_ny_pe.html

Maybe it split a switch point.

Hmmm, I had to look that one up, my terminology is not too good!  Details i just read after googling seem to indicate causes might be poor maintenance or damage. 

They can't even get them out of the station !!

I agree with HOT WATER: switch issue likely.

Excrement occurs!  :-(

I'm with Hot Water, too.  That's the most likely reason, but not the only possible one.

So, if -- if -- Hot Water is correct, and it turns out to be splitting a switch , the investigation continues:

• Did Acela derail because a wheel split a switch?
  • if Yes
    • Was the switch point the culprit?
      • if Yes
        • Did switch point break prior to derailment
          • if Yes
            • When was switch point installed?
            • When was switch point last visually inspected?
            • When was last ultrasonic inspection?
            • When was last maintenance performed on this switch?
              • Describe what maintenance was performed.           - or -
          • if No
            • Was switch point connecting rod broken?
            • Was switch point connecting rod bent?
            • Was switch connecting rod improperly adjusted?
            • Were all switch connecting rod bolts intact and tight?
            • Did switch point show evidence from previously having been run through in  trailing position?
            • Was end of switch point battered or worn?
            • Was wheel already derailed before passing over switch point?
            • Did switch point move during passage of train?
              • if Yes
                • Was there a qeued intent from the Control Operator to realign switch after passage of Acela?
                • Was electrical lockout during occupancy tested?    - or -
      • if No
        • What was the measured track gauge each 10 feet, for 50 feet each side of the point of derailment?
        • Were there any missing or loose spikes or track bolts in the vicinity of the point of derailment?
        • Was there any evidence of foreign material having worked its way between the tie plates and the rail at the point of derailment?    - or -
      • if No
        • Was the wheel the culprit?
          • if Yes
            • Was wheel broken?
              • if Yes
                • Derailment direct cause identified.   (Further analysis of why the wheel broke will be required to identify root cause.  If not immediately evident, this analysis will be conducted off-site.)     - or -
              • if No, investigation continues
                • Was the culprit wheel flange measured using an AAR wheel gauge
                  • Provide measurement from wheel gauge
                • Was flange contour within standard?
                • Was there any evidence of sharp edge on flange?
                • Were there flat spots of any size on the wheel tread?
                • Were wheels properly gauged on axle?
                • When was culprit wheel installed on axle?
                • What was age of axle when culprit wheel was installed?
                • Was culprit wheel ever trued or re-profiled?
                  • if Yes
                    • How many times? furnish date(s), location(s), reason(s), amount of metal removed.
                    • What was diameter of wheel?
                    • Were all wheels on the truck of the same diameter? Furnish measurements.    -or-
      • if No switch or train defects found
        • What was the speed of Acela at point of derailment?
        • What was authorized speed at point of derailment?

Sometimes, you have to drill down pretty deeply to find the direct cause, and sometimes even further to identify the root cause of a derailment.  That's why it's risky to jump to any conclusion.  You have to start with an open mind, and not look for evidence to support what you already think caused the derailment.

Tinplate Art, you got it right the first time.  Your whimsical second explanation cannot ever be the cause.  Trying to sell that will get you fired.  The first derailment I investigated was a high value load that was set out on a worn-out back track with rotten ties, loose and missing spikes, and probably more that I have forgotten in the intervening 33 years.  The car dropped inside the outer rail of a curve and the crew shoved it 50 feet before they stopped.  I identified the cause as wide gauge.  The report went to the Superintendent via RRB mail in the baggage car of No.3, and the next morning, he called me.  The first thing he said was "Mister" and the way he said it left no doubt that he was furious.  I got the worst dressing-down of my life, even worse than any received during military basic training.  After that, I learned how to thoroughly investigate a derailment and determine both the direct, and root, cause.

Super story and wonderful decision tree. As an armchair layout railroader, I have overlooked switches. Quite an education here. Tom an all, two questions:

1. do railroads use trees like you present to investigate accidents

2. Not much in the list of possible causes that is not maintenance related. Seems possible implications for the quality of these efforts.

hokie71 posted:

1. do railroads use trees like you present to investigate accidents

2. Not much in the list of possible causes that is not maintenance related. Seems possible implications for the quality of these efforts.

Thank you for your kind comment.  I just wanted to show why we should not ever rush to judgment on the cause of an accident.

1.  No.  However, they do hold training classes and teach supervisors how to begin with a clear mind and investigate.  I would have made a different-looking decision tree for the Amtrak high-speed wreck in Philadelphia last year.  This one was for the low-speed derailment in Penn Station.

2.  In a low-speed passenger train derailment, when there is only a straight-through movement by the train that derailed, there is not much potential for human failure.  Other derailments might have more potential in that area.

Gotta say I'm impressed with the information and knowledge being shared on this forum. Been away from the hobby about 30 years. So much has changed and improvements in the "toys" has enhanced the pleasure of this pass time. Let alone the experience of Tom, Number 90. Giving such detailed steps and procedure of real train investigations.

Thank you fellas for keeping this hobby thriving.

NUMBER 90:

NEVER meant my facetious comment to be an excuse or "cause" for this incident - just pointing out the vagaries and/or vicissitudes of REALITY:  life and crap occurs! 

BNSF accident investigation tree....
1. Did the engineer die?
...... Yes.
............. It was the engineer's fault.
...... No.
............. It was the engineer's fault.

Does the NTSB and the TSB in Canada use such trees?