Inquiries & Recommendations

Ngā ketuketutanga me ngā tūtohunga

On Wednesday 6 February 2002, at about 2152, the log carrier "Jody F Millennium" with a master and 18 crew on board, grounded in the Gisborne approach channel when it encountered large swells as it left the relative shelter of the breakwater while departing from the port. The ship was subsequently driven by the swell on to the shelving shoal area to the north of the channel, where it remained for 18 days before being re-floated. At the time of the grounding the ship was still within the pilotage area, but the pilot had disembarked a few minutes earlier.

[A preliminary investigation showed that the circumstances were not likely to have significant implications for transport safety. Consistent with section 13 of the TAIC Act the Commission discontinued the investigation and no report was published.]

On Tuesday 29 January 2002 at about 1119, express freight Train 530 collided with a stationary shunting locomotive in New Plymouth when the locomotive engineer fell asleep briefly while berthing. There were no injuries and the locomotives were only slightly damaged. The following safety issues were identified: • the restorative sleep habits of the locomotive engineer while working night shifts • the inability of the locomotive vigilance system to overcome short-term attention deficits in time to prevent this type of accident.

This report examines 3 separate track buckle occurrences on the South Island coal route during the summer of 2001/2002. Two of the track buckles resulted in derailments. Safety issues identified by these incidents included: • the need for staff training to ensure they recognise and respond to visible track defects • the need to protect continuous welded rail, formed at unknown neutral temperature • the need to control tamping and lining to ensure track is not realigned leaving increased compressive stress in the rails.

This report examines 3 separate track buckle occurrences on the South Island coal route during the summer of 2001/2002. Two of the track buckles resulted in derailments. Safety issues identified by these incidents included: • the need for staff training to ensure they recognise and respond to visible track defects • the need to protect continuous welded rail, formed at unknown neutral temperature • the need to control tamping and lining to ensure track is not realigned leaving increased compressive stress in the rails.

On Friday, 25 January 2002, at about 1430, Piper PA34-200T Seneca ZK-SFC was on approach to land at Gisborne Aerodrome when the nose undercarriage failed to extend. After several unsuccessful attempts to extend the nose undercarriage, the pilot diverted to Hastings Aerodrome where a full wheels-up landing was completed. The 2 crew members and one passenger on board were uninjured and the aircraft sustained minor damage.

This report examines 3 derailments due to washouts and slips (occurrences 02-101, 02-102 and 02-103) caused by inclement weather in the South Island during January 2002. No serious injuries were sustained but the opportunity existed in each case for more serious and potentially life threatening injuries to have occurred. Safety issues identified by these incidents included: • the lack of a formalised early warning river flow level notification process for the Rangitata River • the lack of staff available to respond to operating contingencies during the holiday period

On Saturday, 19 January 2002, at 0931, ZK-SEV, a Cessna 207, took off from Te Anau Aerodrome for Milford Sound Aerodrome. At about 1000 the aircraft collided with the side of a mountainous valley, approximately 4400 feet above sea level and 500 metres southeast of Gertrude Saddle, some 11 kilometres from Milford Sound. The pilot and 5 passengers on board died in the collision. The aircraft probably had not reached a suitable altitude to safely cross over Gertrude Saddle, and the pilot probably left his decision too late to turn back in the valley in order to gain more height.

This report examines 3 derailments due to washouts and slips (occurrences 02-101, 02-102 and 02-103) caused by inclement weather in the South Island during January 2002. No serious injuries were sustained but the opportunity existed in each case for more serious and potentially life threatening injuries to have occurred. Safety issues identified by these incidents included: • the lack of a formalised early warning river flow level notification process for the Rangitata River • the lack of staff available to respond to operating contingencies during the holiday period

This report examines 3 derailments due to washouts and slips (occurrences 02-101, 02-102 and 02-103) caused by inclement weather in the South Island during January 2002. No serious injuries were sustained but the opportunity existed in each case for more serious and potentially life threatening injuries to have occurred. Safety issues identified by these incidents included: • the lack of a formalised early warning river flow level notification process for the Rangitata River • the lack of staff available to respond to operating contingencies during the holiday period

This report examines 3 separate track buckle occurrences on the South Island coal route during the summer of 2001/2002. Two of the track buckles resulted in derailments. Safety issues identified by these incidents included: • the need for staff training to ensure they recognise and respond to visible track defects • the need to protect continuous welded rail, formed at unknown neutral temperature • the need to control tamping and lining to ensure track is not realigned leaving increased compressive stress in the rails.

On Monday 3 December 2001 at about 1430, Robinson R44 helicopter ZK-HTK was on a commercial transport flight from a remote campsite in the Urewera National Park to Ruatahuna, carrying two hunters whose recovery had been delayed by bad weather. While flying over the highest terrain en route, where the weather was probably worst, the helicopter collided with trees, fell to the ground and burned. One survivor was rescued 2 days later. The pilot's low experience probably contributed to his perseverance with the flight in conditions of low cloud and poor visibility.