Inquiries & Recommendations

Ngā ketuketutanga me ngā tūtohunga

A train controller starting his morning shift on 23 September 2008 unknowingly planned to direct a freight train along a line that was occupied by another freight train, which was standing awaiting routing through an area where a signalling fault was under repair. He was not aware the second train was stationary on the line. A potential low-speed, head-on collision was avoided when the first train was subsequently routed along the adjacent line after the signal failure had been partially corrected.

The pilot carried out two flights in her own hang glider before making a short flight, essentially an aborted auto-tow launch, in the accident glider. She had no difficulty gliding into the field from a height of some 40 or 50 feet. The second launch started normally but as the glider approached the usual top of climb point its nose up attitude increased by about 15, the tow rope parted, and the glider pitched up to a near vertical position.

On 8 December 1993 a shunting locomotive collided with a car on the Stanley Road level crossing, Gisborne, fatally injuring the motorist. The safety issue identified in the investigation was the risk to railway shunting staff of riding on the footplates of locomotives while crossing over public roads. A recommendation that event recorders should be fitted to shunting locomotives which travel on main lines or over public level crossings is also made.

On 14 April 2014 the general cargo vessel Da Dan Xia was berthed at the port of Wellington, New Zealand, preparing to load a cargo of logs. The crew were conducting a launch-and-retrieval drill for the vessel's freefall lifeboat, using the "alternative" launching and retrieval davit.

On Saturday 20 November 2005 at about 1400, the restricted limit passenger vessel Milford Sovereign, with a Master, 10 crew and 238 passengers on board, was on a cruise of Milford Sound when it was struck by a gust of wind that heeled the ship and turned it from its intended course. The Master was unable to return the ship to its original course, so decided to continue the turn initiated by the wind and took the ship through 180 onto the reciprocal of its original course and returned the ship to the inner Sound.

On Saturday 8 October 2005 at about 1312, the container ship "Spirit of Resolution" collided stern first with the Old Mangere Bridge as the ship departed Onehunga when control of the unberthing manoeuvre was lost during high winds. There were no injuries. The ship, old road bridge and wharf all sustained damage during the incident. Safety issues identified included: - bridge resource management - contingency planning for emergency situations on board - ambiguities in the pilotage exemption requirements and training for Manukau Harbour.

[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.]

New Zealand has completed its support for this inquiry. For further information please contact TSB Please note: TAIC will not be producing a report for this inquiry.

On 1 November 2008, a Robinson Helicopter Company R22 helicopter registered ZK-HXR, which was being flown from Haast to Wanaka with the pilot only on board, did not arrive at the Wanaka aerodrome for an intended refuel. Efforts to locate the helicopter began promptly and items from the helicopter were soon found floating in Lake Wanaka, about 22 kilometres north-west of the aerodrome. Most of the fuselage of ZK-HXR, along with the deceased pilot, was retrieved from the lake bed 4 days after the accident, but some key components were not recovered.

A landing accident and subsequent collapse of the nose undercarriage occurred to Cessna 206 ZK-DOV, at Tangahoe private airstrip.

The aircraft was flying into the wind at about 250 feet above ground level and had made several turns when it was observed to bank very steeply to the left. It entered a steep spiral dive and shortly afterwards struck the ground. The instructor on board received fatal injuries on impact. A student pilot who occupied the left seat died at Christchurch Hospital later in the day from injuries sustained in the accident.

On Wednesday 12 March 2003, at 1547, flight SQ286, a Boeing 747-412 registered 9V-SMT, started its take off at Auckland International Airport for a direct 9 hour flight to Singapore. On board were 369 passengers, 17 cabin crew and 3 pilots.