2008 — Sep 12, Metrolink 111 and Union Pacific Train Collision, Chatsworth, CA — 25

 

— 26  Wikipedia. “List of Rail Accidents (2000-2009).”[1]

— 25  NTSB. Collision of Metrolink Train 111 With Union Pacific Train LOF65-12… 2010, p. ii.

— 25  NTSB. Public Hearing…Collision of Metrolink Train 111 with Union Pacific… 3-3-2009.

— 25  NTSB. Survival Factors Group Chairman’s Factual Report. 1-30-2009, p. 2.

— 25  NTSB. Track & Engineering Group Factual Report (DCA-08-MR-009), p. 2.

— 25  NTSB. “Update:  NTSB’s Investigation of the Metrolink, Union Pacific…” Oct 1, 2008.

— 25  Shackelford, et al. “Fatalities of the 2008 Los Angeles Train Crash.” ADJM, 6/1, 2011.

 

Narrative Information

 

County of LA: “On September 12, 2008, at 4:23 p.m., Los Angeles City Fire Department (LAFD) and County Fire Department (LACoFD), Los Angeles City Police Department (LAPD), Los Angeles Sheriff Department (LASD), local trauma centers and hospitals, private ambulance providers, DMH, Coroner, and other supporting agencies responded to a major Mass Casualty Incident (MCI) involving a Metrolink commuter train and a Union Pacific freight train.

 

“The Metrolink commuter train, #111, consisting of a 250,000 pound locomotive pulling three (3) bi-level coaches, departed Union Station in downtown Los Angeles at 3:35 p.m. heading westbound to Moorpark in Ventura County. The westbound commuter train, with 222 passengers aboard, departed the Chatsworth Station and traveled 1.25 miles when it collided head on with an eastbound Union Pacific freight train traveling on the same track at approximated 40 miles per hour. The freight train was led by two (2) locomotives weighing more then 500,000 pounds each. This collision resulted in the worst multi-casualty train incident in California in 50 years….

 

“The train collision occurred just east of Topanga Canyon Boulevard and about a quarter of a mile south of the 118 Freeway, within the City of Los Angeles and near the Ventura County line (Attachment I). The initial 9-1-1 calls into LAFD dispatch described a train accident. At 4:30 p.m. LAFD responded to the private home from which the first 9-1-1 call had originated. Upon arrival into the area, LAFD personnel observed the train collision and, due to the complexity of the situation and extent of the observed damage, immediately summoned additional resources.

 

“LAFD observed the derailed trains with the Metrolink locomotive telescoped back into the compartment of the first passenger car. The Metrolink locomotive and three (3) of the attached cars were affected by the collision. A fire ignited by the collision added to the complexity of the scene and was quickly extinguished by LAFD. Following the Incident Command System protocol, LAFD was designated the Incident Command Agenda (ICA) and established command and control of the scene.” (County of LA. Chatsworth Train Derailment – LA County Operational Area After Action Report. 4-13-2009, p. 2.)

 

NTSB Update: “The following is an update of the NTSB’s investigation of the September 12, 2008 accident in Chatsworth, California involving a Metrolink commuter train and a Union Pacific freight train. As a result of the head-on collision, there were 25 fatalities and numerous injuries.

 

“Information regarding the Metrolink engineer’s cell phone activity on the day of the accident was obtained from his service provider under subpoena from the NTSB.  As part of the ongoing investigation, this information is being used to determine the timing of cell phone activity, which includes text messaging to and from the engineer’s cell number, in relation to the engineer’s duty hours and train operations. Although the precise timing and correlation of these events is still underway at the Safety Board’s Recorder Laboratory, preliminary information is being released regarding the approximate cell phone activity during the engineer’s duty hours on the day of the accident.

 

“On the day of the accident, the Metrolink engineer was on duty for two periods of time.  The engineer was responsible for the operation of a train from 6:44 am until 8:53 am. During this period of time, the engineer’s cell phone received 21 text messages and sent 24 text messages.

 

“He was then off duty until 2:00 pm.  The engineer was responsible for the operation of Metrolink train 111 from 3:03 pm until the time of the accident. During this time period, the engineer’s cell phone received 7 text messages and sent 5 text messages.  According to the time on the cell phone provider’s records, the last text message received by the engineer’s phone before the accident was at 4:21:03 pm, and the last text message sent from the engineer’s cell phone was 4:22:01 pm.

 

“A preliminary estimate for the time of the accident, according to the Union Pacific train’s onboard recorders, is 4:22:23 pm.  The Safety Board’s Recorder Laboratory is continuing to correlate times recorded for use of the Metrolink engineer’s cell phone, train recorder data, and signal system data to a common time base.” (NTSB. “Update: NTSB’s Investigation of the Metrolink, Union Pacific…” Oct 1, 2008.)

 

NTSB Public Hearing Executive Summary: “About 4:22 p.m., Pacific daylight time, on Friday, September 12, 2008, westbound Southern California Regional Rail Authority Metrolink train 111, consisting of one locomotive and three passenger cars, collided head-on with eastbound Union Pacific Railroad freight train LOF65–12 near Chatsworth, California. The Metrolink train derailed its locomotive and lead passenger car; the UP train derailed its 2 locomotives and 10 of its 17 cars. The force of the collision caused the locomotive of train 111 to telescope into the lead passenger coach by about 52 feet. The accident resulted in 25 fatalities, including the engineer of train 111. Emergency response agencies reported transporting 102 injured passengers to local hospitals. Damages were estimated to be in excess of $12 million.

 

“The National Transportation Safety Board determines that the probable cause of the September 12, 2008, collision of a Metrolink commuter train and a Union Pacific freight train was the failure of the Metrolink engineer to observe and appropriately respond to the red signal aspect at Control Point Topanga because he was engaged in prohibited use of a wireless device, specifically text messaging, that distracted him from his duties. Contributing to the accident was the lack of a positive train control system that would have stopped the Metrolink train short of the red signal and thus prevented the collision.

 

“The safety issues identified during this accident investigation are as follows:

 

Inadequate capability, because of the privacy offered by a locomotive operating

compartment, for management to monitor crewmember adherence to operating rules such

as those regarding the use of wireless devices or the presence of unauthorized persons in

the operating compartment.

 

Lack of a positive train control system on the Metrolink rail system.

 

“As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Railroad Administration.” (NTSB. Public Hearing: Railroad Accident Report Collision of Metrolink Train 111 with Union Pacific Freight Train LOF65-12 Chatsworth, California, September 12, 2008. Washington, DC: NTSB, 3-3-2009.

 

Shackelford: “This is a review of the medical examiner records of the 25 fatalities in the train crash. The Injury Severity (ISS) Score, body area with severe injuries (Abbreviated Injury Scale [AIS] > 4), specific organ injuries, and causes of death were recorded. The immediate cause of death was determined to be the most severe or most rapidly fatal injury in the opinion of the reviewers. Results: A total of 25 fatalities occurred, including 24 victims who were pronounced dead at the accident scene and one who died 4 days later in the hospital. One victim did not undergo full autopsy. All of the decedents were located in the locomotive or in the passenger car immediately behind the locomotive. Overall, 15/24 decedents (63 percent) sustained unsurvivable injuries to at least one body region rendering an ISS of 75. The chest was the most severely injured body area (AIS > 4; 18/24, 75 percent), followed by the head (13/24, 54 percent), the extremities (11/24, 46 percent), and the abdomen (7/24, 29 percent). Spinal fractures were recorded in 17/24 (71 percent), and the cervical spine was the most commonly injured site. Thoracic aortic rupture was found in eight cases (33 percent) and cardiac ruptures in five cases (21 percent). Conclusions: The Metrolink train crash in 2008 in Chatsworth, Los Angeles, was the worst train crash in the history of California with 25 fatalities….”[2] (Shackelford, et al. “Fatalities of the 2008 Los Angeles Train Crash.” ADJM, 6/1, 2011.)

 

Wikipedia: “September 12, 2008 – 2008 Chatsworth train collision, California, United States: A northbound Metrolink (Southern California) double-deck commuter train runs a red light and collides head-on with a Union Pacific Railroad freight train pulled by three engines at about 60 mph and derails; the 220-ton derailed Metrolink engine is knocked 30 feet backwards into a 119-ton passenger car, crushing it in half. At least 26 people are killed[3] and about 135 are injured.” (Wikipedia. “List of Rail Accidents (2000-2009).”)

 

Sources

 

County of Los Angeles. Chatsworth Train Derailment – Los Angeles County Operational Area After Action Report. Los Angeles, CA:  County of LA Chief Executive Office, April 13, 2009. 20 pages. Accessed at: http://file.lacounty.gov/bos/supdocs/41082.pdf

 

National Transportation Safety Board. Public Hearing: Railroad Accident Report Collision of Metrolink Train 111 with Union Pacific Freight Train LOF65-12 Chatsworth, California, September 12, 2008. Washington, DC: NTSB, 3-3-2009. Accessed 6-19-2015 at: http://www.ntsb.gov/news/events/Pages/2009_Chatsworth_CA_IHG.aspx

 

National Transportation Safety Board. Railroad Accident Report. Collision of Metrolink Train 111 With Union Pacific Train LOF65-12, Chatsworth, California, September 12, 2008 (NTSB/RAR-10/01, Notation 8175). Washington, DC: NTSB, adopted 1-21-2010, 83 pages. Accessed 10-4-2016 at: http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1001.pdf

 

National Transportation Safety Board. Survival Factors Group Chairman’s Factual Report. Washington, DC: NTSB, Office of Railroad, Pipeline and Hazardous Materials Investigations, Human Performance and Survival Factors Division, 1-30-2009, 25 pages.

 

National Transportation Safety Board. Track & Engineering Group Factual Report: Head-on Collision of Metrolink Commuter Train No. 111 and UP Freight Train No. LOF65-12, Chatsworth, CA, September 12, 2008 (DCA-08-MR-009). Washington, DC: NTSB, no date, 18 pages.

 

National Transportation Safety Board. “Update: NTSB’s Investigation of the Metrolink, Union Pacific Accident in California.”  Washington, DC: NTSB Advisory, October 1, 2008. Accessed at: http://www.ntsb.gov/Pressrel/2008/081001.html

 

Shackelford, Stacy MD; Lawrence Nguyen, MD; Thomas Noguchi, MD; Lakshmanan Sathyavagiswaran, MD; Kenji Inaba, MD; Demetrios Demetriades, PhD, MD. “Fatalities of the 2008 Los Angeles Train Crash: Autopsy Findings;” pp. 127-131 in American Journal of Disaster Medicine, Vol. 6, No. 1, Jan/Feb 2011. Accessed 5-18-2011 at:  http://pnpcsw.pnpco.com/cadmus/testvol.asp?year=2011&journal=ajdm

 

Wikipedia. “List of Rail Accidents (2000-2009).” Accessed 1-9-2010 at:  http://en.wikipedia.org/wiki/List_of_rail_accidents_(2000%E2%80%932009

 

 

 

[1] Inaccurate. Deaths were twenty-five.

[2] There have been several train accidents in California history with greater than 25 fatalities – see Deadliest Disasters by State document.

[3] Incorrect – twenty-five killed.