Executive summary
On Wednesday 21 October 1998, at approximately 0840 hours, Train 700, the northbound Coastal Pacific express passenger, collided with No. 2 shunt standing in the loop at Rangiora. Train 700 was unintentionally routed onto the loop as it approached Rangiora on the main line. A passenger and crew member sustained minor injuries in the collision.
Factors contributing to the collision were: the excess tonnage being hauled by the shunt, the limitations of the automatic points operation logic designed into this type of Track Warrant Station and the failure of the LE of Train 700 to register and respond to the points indication displayed which gave warning of a loop setting ahead which he did not expect.
Safety issues identified included:
• the suitability of procedures for controlling tonnage
• the desirability of the locomotive engineers of passenger trains being required to determine stopping needs at certain localities in Track Warrant areas
• the visibility of the purple loop light on points indicators
• the reliance on compliance with regulations as the only defence against foreseeable human error without sufficient additional defences to minimise risk exposure.
Five safety recommendations were made to the operator.
Related Recommendations
Install halogen bulbs in all purple loop points indicator lights at Track Warrant Stations.
Carry out a comparative risk analysis on the operations of indicator loops compared to loops equipped with arrival/starting signals in Track Warrant areas to assess the risk exposure at indicator loops and take action to bring the risk exposure within acceptable limits where necessary.
Ensure that all Circuit Marker Posts marking the track circuit approaching the Facing Points Indicators in Track Warrant areas are maintained in position.
Review the desirability of requiring the LEs of passenger trains to assess stopping requirements at stations, on a location by location basis, to ensure that there is no potential conflict with safe train operation, and take appropriate steps where such conflict exists.
Implement procedures to ensure tonnage limitations are not exceeded on shunting services.