RAIB investigation - Hayes and Harlington, 25th July 2015

[whole diary]

[grahame]

https://www.gov.uk/government/news/passenger-accident-at-hayes-and-harlington-station

Investigation into a passenger trapped in train doors and dragged along the platform at Hayes and Harlington station, 25 July 2015

At approximately 13:10 hrs, the 11.37 hrs Oxford to London Paddington service departed from platform 4 with a passenger trapped by her hand in the last door of the three-coach train. The passenger was dragged for a distance of approximately 8 to 10 metres before falling to the ground; during the fall her hand became free. The passenger subsequently reported bruises to her hand and head to a member of staff at the station.

[grahame]

Noting an appeal for witnesses:

We would like to speak to anyone who witnessed the accident at Hayes and Harlington station.

[JayMac]

One for the RMT^▸ (National Union of Rail, Maritime & Transport Workers) belligerents currently in dispute with FGW^▸ (First Great Western)/GWR^▸ (Great Western Railway) to use in their arguments against driver controlled doors.

[ChrisB]

Unless the resultant report shows that the driver was shown everything on the CCTV^▸ (Closed Circuit Tele Vision) and ought not have moved off...

[Chris from Nailsea]

Hmm. 

As ever, gentlemen, we should please resist the temptation to speculate, however obliquely, about the possible cause(s) of this latest incident.

Time (and the Rail Accident Investigation Branch) will tell, in due course. 

[grahame]

The investigation is also looking at the follow up as well as the accident itself.

Our investigation will examine the sequence of events before, during and after the accident, in particular:
* the actions of the individuals involved
* the performance of the train and station equipment
* the investigation and reporting of the accident (the RAIB^▸ (Rail Accident Investigation Branch) was made aware of the accident during week commencing 24 August 2015)
It will also examine any relevant management issues.

Accident - 25th July.  RAIB aware - 24th August.

[ChrisB]

Can't find a thread for this - we must have missed it.

Very clear that DOO^▸ (Driver-Only Operation (that is, trains which operate without carrying a guard)) is as safe as two-person working/despatcher if worked correctly with correct equipment. In fact, they report more accidents of this type when two persons were involved in the despatch.

The RAIB^▸ (Rail Accident Investigation Branch) has reported

At around 13:10 hrs on 25 July 2015, a passenger was dragged along the platform at Hayes & Harlington station, London, when the 11:37 hrs First Great Western service from Oxford to London Paddington departed while her hand was trapped in a door. The passenger, who had arrived on the platform as the doors were about to close, had placed her hand between the closing door leaves.

The train driver did not identify that the passenger was trapped and the train moved off, dragging the passenger along the platform. After being dragged for about 19 metres, the passenger lost her footing and fell onto the platform. The passenger suffered head, hand and back injuries.

RAIB’s investigation found that the passenger had deliberately placed her hand in the closing door in the expectation that it would re-open as a consequence. RAIB has concluded that after closing the doors of the train, the driver either did not make a final check that it was safe to depart, or that the check was insufficiently detailed to allow him to identify the trapped passenger. The driver may have been misled into thinking that it was safe to depart because a door interlock light in his cab had illuminated, indicating that the doors were closed and locked and he was able to take power.

Our investigation identified that the train driver and other railway staff held the same misunderstanding: if someone had a hand trapped in a door it would not be possible for the door interlock light to illuminate and a driver to take power. This is not the case, and the door was found to be compliant with all applicable standards after the accident.

As a consequence of this investigation, RAIB has made two recommendations.

The first, addressed to RSSB^▸ (Rail Safety and Standards Board) to review, and if necessary extend, its research into the passenger/train interface to understand passenger behaviour and identify means for deterring members of the public from obstructing train doors.

The second recommendation is addressed to operators and owners of trains similar to the one involved in the accident at Hayes & Harlington, is intended to continue and expand upon a current review into the practicability of fitting sensitive door edge technology to this type of train.

RAIB has also identified three learning points. The first concerns improving awareness among train drivers of the limitations of train door interlocking technology and the importance of the final safety check when dispatching a train.

The second concerns the potential for drivers to be distracted by the use of mobile communication devices while driving.

The third is aimed at train operators to have the necessary processes in place to identify drivers who are showing signs of sub-standard performance or not engaging positively with measures agreed as part of a Competence Development Plan and the provision of briefing and guidance material for driver managers to enable them to identify behaviours and attitudes which are inconsistent with those expected of train drivers.

[Gordon the Blue Engine]

The full Report is an interesting read. 

Not easy to design a door safety system which protects against trapping and dragging incidents whilst still enabling a train to get away from busy stations without undue delay. 

I can recall incidents on the Tube when people have put hands in the doors in an attempt to get them re-opened, and the Driver refusing to re-open and the platform staff shouting at them to remove their hands.  The difficulty in pulling hands out of Turbo doors, as highlighted in the Hayes re-run, is a cause of concern.

Also, I'm surprised (along with, apparently, many GWR^▸ (Great Western Railway) staff) that Turbo door interlocks work with up to a 25mm gap between the doors. 

[IndustryInsider]

Not easy to design a door safety system which protects against trapping and dragging incidents whilst still enabling a train to get away from busy stations without undue delay. 

I'd go as far as to say it's impossible to design a door in such a way.  One of the biggest risks is getting scarves or coats caught in the doors.  Items that are wafer thin but can easily lead to the poor wearer from being dragged under the train when it departs.

Better equipment is needed - and fortunately it's coming in the shape of body side mounted cameras that feature on the 345s and 387s.

[Adelante_CCT]

Didn't they have problems when the 2009 Victoria line stock came out? Once the doors were 'shut' any attempt to pull something out that was stuck, (a coat, strap of a bag etc, whether it was from inside or the outside) resulted in the train being unable to move and the driver having to walk down the train resetting the doors manually or something, resulting in delays of 2-3 minutes which is catastrophic for the Victoria line.

IIRC^▸ (if I recall/remember/read correctly) the team at Seven Sisters devised a solution that made the train only sense when something was being pulled from outside the train, rather than from the inside meaning someone with the remains of a coat stuck whilst they were on the train wouldn't prevent the train from proceeding.


Edit:

Just found this on Wiki:

A new sensitive door edge, branded Intelligent Sensitive Edge, is being developed by the Victoria line engineers to overcome this problem...

[Chris from Nailsea]

Can't find a thread for this - we must have missed it.

No, we didn't. 

The original topic, posted by grahame, has now been merged here with this one. 

[Tim]

The problem is passenger education.  If people know that the doors are dangerous they will take more care.  Problem is that many people, not unreasonably given their experience of lift doors and PIR-triggered doors in shops, think that the doors will always open when blocked.  I do wonder if their is a difference in perception between swing plug doors and purely sliding ones.  Maybe the boffins need to do some phycology research produce a door which by its look, sound, speed of movement etc looks vicious and so is respected more that a gently sliding door.  Only half joking but would painting teeth on the door edge discourage people from putting their hands in?  That might be preferable to a purely engineering solution which could add complexity and delays due to false positives.

I know that the doors on the Munich S-Bahn are scary with their authoritative beeping and rapid whoosh as they close and I wonder if that acts as a discouragement to take a chance with them?

[Western Enterprise]

I've noticed that on the doors on some of the HEX trains that they have put serrated edges to sort of represent a saw blade. If the door was shutting you hopefully would have second thoughts about putting your hand in a saw!.
Not all have been fitted though, does look good from a distance though..

[Billhere]

I know that the doors on the Munich S-Bahn are scary with their authoritative beeping and rapid whoosh as they close and I wonder if that acts as a discouragement to take a chance with them?

If you want to know scary you should have tried the Paris subway in the 60's. Finger amputation stuff there when they closed, and a little handle dropped over as well to secure them (the doors not the fingers). You didn't put you hand in the door twice there !

None of your sissy bits of rubber, pure wood as I remember it.

[stuving]

Just thought I had better add this link about a passenger being dragged with their hand caught in DOO^▸ (Driver-Only Operation (that is, trains which operate without carrying a guard)) train.

http://www.msn.com/en-gb/news/uknews/driver-accused-of-dragging-train-passenger-along-platform-with-hand-stuck-in-door/ar-BBy6lTk?li=BBoPOOl&ocid=mailsignout

No second person on platform either guard or platform staff

I wasn't last year, it was 2015. Discussed in this thread. The technical background is in the RAIB^▸ (Rail Accident Investigation Branch) report.