Inquiries & Recommendations

Ngā ketuketutanga me ngā tūtohunga

On Monday 11 December 1995 at about 0800 hours 20 LPA wagons loaded with roading aggregate rolled out of the loop at Raupunga onto the main line and ran down a 1 in 50 grade to Maungaturanga viaduct approximately 1.5 kilometres away. A painting gang working on the viaduct were forced to take urgent evasive action. The wagons came to rest a further 1 kilometre away on a 1 in 50 ascending grade and rolled back to the bridge. The causal factor of the main line runaway was unloading wagons on a crossing loop on a grade with no protection to stop runaway wagons entering the main line.

On Tuesday 8 August 1995 at about 1025 hours Y3 Shunt operated by New Zealand Rail Limited was shunting at Ravensbourne. Two shunters were riding on the footplate on the front of the locomotive. As the locomotive negotiated a turnout the left hand side of the footplate caught under the head of a rail on the adjacent road and the footplate buckled. The shunter on the left hand side was thrown off the footplate and trapped under it, suffering serious injuries. The causal factor was the relative heights of the rails on the converging tracks.

On Tuesday, 8 December 1998, at about 1635, the Tauranga Volunteer Coastguard rigid inflatable vessel "Rescue 1" was responding to a Mayday call from a vessel near Motiti Island when it suffered a failure of the outer covers that secured the buoyancy bladders to the hull. The two starboard bladders separated from the hull and the port forward bladder deflated. The vessel continued to Motiti Island and attended the rescue before returning to Tauranga. There were no injuries. Safety issues identified included:

At about 2145 on Monday, 19 January 1998, the general cargo vessel "T.A. Explorer" was outbound from Nelson under pilotage when the vessel failed to make the turn near the entrance to the harbour and ran aground on Haulashore Island. The vessel was re-floated after about 20 minutes and, as damage was minimal, continued its voyage to Timaru. The grounding occurred because the speed of the ship was too high for the tugs to assist in the manner intended by the pilot. Safety issues identified included: • incomplete assessment of new piloting techniques,

On Thursday, 10 September 1998, an on-track maintenance group had just finished packing up their two hi-rail vehicles for off-tracking when they noticed Train GR7, the EM80 track evaluation car, approaching from the north and approximately 2.7 km distant. The ganger managed to contact the locomotive engineer using the train control radio and the train was brought to a stop well clear of the hi-rail vehicles. The cause of the near collision was the drawing of a maintenance occupation on the train control diagram approximately 10 km south of its actual location.

At about 0900 hours on Friday, 25 October 1996, a gangway fell from a Steam Incorporated passenger excursion train being operated by Tranz Rail Limited between Paekakariki and Wairoa. The gangway fell clear of the track near Opapa. The carriage doors on either side were locked as a safety measure and the train continued its journey.

At approximately 2025 hours on Saturday, 9 December 1995, during a deer hunting sortie, the shooter, suspended on a strop beneath R22 helicopter ZK-HUH, fell onto a hard sand beach when the cargo hook opened unexpectedly. The shooter sustained severe internal injuries and died that evening. No definitive cause was established for the opening of the cargo hook. Civil Aviation Authority approval had not been sought for the carriage of a person on the strop, and special conditions to enhance the safety of a person so carried were not in place.

On Wednesday 12 November 1997, at about 1140 hours, the door at the west portal of the Otira Tunnel closed on the side of Train 801, the westbound TranzAlpine. The impact caused minor damage and there were no injuries. The door closed because of an unintended activation of the control system by Train 801. An optical sensor which could have prevented the closure was not functioning due to a loose electrical connection. Safety issues identified were a deficiency in the signalling design logic for the door control and the lack of a fail-safe optical sensor safety system.

On Sunday, 28 January 1996, at approximately 0550 hours, the fishing trawler "San Manukau", enroute from Auckland to North Cape, capsized 15 nautical miles north-north-west of Cape Karikari. One deck-hand was lost, presumed drowned. The vessel was towed into Doubtless Bay where it later sank during attempts to right it. The capsize was caused by the loss of stability due to back-flooding of the fish hold via the vessel's bilge pumping system.

The helicopter's main rotor was seen to separate from the aircraft while it was cruising at a low level. Both occupants were killed in the subsequent collision with the terrain.

Shortly after becoming airborne from Pauanui Beach Aerodrome, the aircraft's tailplane came off. The pilot abandoned the aircraft but became entangled in the parachute rigging lines and fell to the sea.