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Passenger fatally injured on a train between Bath and Bristol, Saturday 01/12/18

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GodAtum

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RAIB update just published:

At around 22:04 hrs on 1 December 2018, a passenger travelling on a train from Bath to Bristol struck her head on a tree branch near to Twerton, about 1.5 miles (2.4 km) west of Bath Spa station. The train was travelling at about 85 mph (137 km/h) and the passenger sustained fatal injuries.

The train was the 20:30 Paddington to Exeter service formed of a GWR High Speed Train (HST). Witness evidence indicates that the passenger was standing at a door on the side facing away from the other track. The door was fitted with an opening droplight window, which is used to access the door handle fitted to the outside of the door. A yellow ‘Caution’ label above the door states ‘Do not lean out of window when train is moving’. The window was reported to have been opened and the passenger had her head out of the window.

Our investigation will encompass examination of the measures in place to control the risks from persons leaning out of train windows, including the threat from vegetation.

Our investigation is independent of any investigation by the railway industry, the British Transport Police or by the industry’s regulator, the Office of Rail and Road.

We will publish our findings, including any recommendations to improve safety, at the conclusion of our investigation. This report will be available on our website.

You can subscribe to automated emails notifying you when we publish our reports.

https://www.gov.uk/government/news/fatal-accident-twerton
 

Meerkat

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“Threat from vegetation”

Surely this tragic event helps get some reality into the tree cutting debate?
 

Deepgreen

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https://www.bbc.co.uk/news/uk-england-bristol-46420317


Oh dear - not a good news story. Is this the first passenger fatality on the UK rail network since the young man who was killed in similar circumstances near Wandsworth Road on a GatEx 442? I’m guessing a down HST was the train involved, probably the 2030 Padd-Exeter looking at the time of the incident (approx 2210 between Bath and Keynsham.)

Condolences to the family of the deceased, no doubt an investigation will establish the facts.
Wandsworth Common.
 

Taunton

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“Threat from vegetation”

Surely this tragic event helps get some reality into the tree cutting debate?
Great Western seems more afflicted by this than most. I was surprised going down the Cotswold Line last year at the extent of the bushes periodically brushing against the sides of the train, on both sides, on a single line with a formation that had once been double.

It's not just at window height, nor trees - softer vegetation seems more prevalent. Elsewhere, a large weed at New Cross Gate station by the Down Fast last year had been allowed to grow against the conductor rail to the extent that it was clouted by the collector shoes of every passing unit. I wonder if the NMT checks the structure gauge for vegetation, as well as the permanent way.

Neither of these would have been tolerated by the old Ganger at Taunton for a moment.
 
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Dr_Paul

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Great Western seems more afflicted by this than most. I was surprised going down the Cotswold Line last year at the extent of the bushes periodically brushing against the sides of the train, on both sides, on a single line with a formation that had once been double. It's not just at window height, nor trees - softer vegetation seems more prevalent. Elsewhere, a large weed at New Cross Gate station by the Down Fast last year had been allowed to grow against the conductor rail to the extent that it was clouted by the collector shoes of every passing unit. I wonder if the NMT checks the structure gauge for vegetation, as well as the permanent way. Neither of these would have been tolerated by the old Ganger at Taunton for a moment.

I noticed this a couple of years back between North Sheen and Mortlake on the Windsor line, there was a lot of bushy vegetation scratching along the side of the carriage. On one occasion I had a look at the paintwork when I alighted at Waterloo, and it was quite badly scratched. The vegetation has been now been trimmed back, but it was like this for several months.
 

edwin_m

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EMT has recently added some red stickers on and above their droplights to warn about the danger, probably in response to this incident. There are now four stickers on each door, three of which are about closing the window, plus two more central locking stickers just above.
 

Muzer

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EMT has recently added some red stickers on and above their droplights to warn about the danger, probably in response to this incident. There are now four stickers on each door, three of which are about closing the window, plus two more central locking stickers just above.
Plus many of their guards are making copious announcements about it and imploring people not to lean out when the train is moving, or even open the window until the doors have been unlocked!
 

edwin_m

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Plus many of their guards are making copious announcements about it and imploring people not to lean out when the train is moving, or even open the window until the doors have been unlocked!
That may explain the numerous but totally unintelligable announcements on my journey yesterday!
 

AndyPJG

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RAIB have published their report - https://assets.publishing.service.gov.uk/media/5da5d858e5274a392e9c9467/R142019_191016_Twerton.pdf

Summary
At about 22:04 hrs on Saturday 1 December 2018 a passenger was leaning out of the window of a moving train when her head came into contact with a lineside tree branch near Twerton, a suburb of Bath. The passenger suffered fatal injuries. The train, a Great Western Railway service from London Paddington to Exeter St David’s, was travelling at approximately 75 mph (120 km/h) at the time.

On the type of coach making up the train, opening windows are provided to allow passengers to reach through and operate the external door handles when the train is in a station. This is the only means by which passengers can open the train doors. However, other than warning signs, there is nothing to prevent passengers from opening and leaning out of such windows when trains are away from stations and moving. The accident occurred because the passenger did this when branches from a lineside tree were in close proximity to the train.

A possible underlying factor was that Great Western Railway’s risk assessment process had not historically identified the risk of passengers or staff being injured as a result of putting their heads out of windows on moving trains. Consequently, Great Western Railway had not provided adequate mitigation measures to protect against the risk.

Recommendations
The RAIB has made four recommendations and identified two learning points.

One recommendation is addressed to operators of mainline passenger trains, including charter operators, and seeks to minimise the likelihood of passengers leaning out of droplight windows when a train is away from stations. A second recommendation, is addressed to operators of heritage railways and seeks to improve their management of the risks associated with passengers leaning out vehicles.

The third recommendation is addressed to Great Western Railway and seeks to reduce the potential for hazards associated with its operations being overlooked.

The fourth recommendation is addressed to RSSB and seeks to ensure that its advice on emergency and safety signs reflects the level of risk associated with the hazard being mitigated.

The learning points reinforce the importance of undertaking regular tree inspections and the value of train operators having well briefed procedures for dealing with medical emergencies on board trains.
 

Taunton

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What a disappointing report from RAIB, once again in the Recommendations absolving Network Rail of any responsibility (so probably written by the same inspector who did the Athelney crossing accident).

Network Rail allow the lineside vegetation to grow, apparently for years, to the extent that it impinges on the structure gauge (the report states it had been foul of trains for at least 2 years), and yet the Recommendations are placed on the train operator, who is NOT responsible for clearing the structure gauge, and even on heritage railways, actually quite reasonably but they of course still have an integrated management where the PW keep the structure gauge clear, and know their more enthusiastic passengers do lean out.

The old ganger at Taunton long ago would never have allowed a tree to be foul of trains for more than a day, official standards and paperwork or not.

A couple of years ago I travelled down the Oxford-Worcester line (the same Network Rail Route management, notably) in an HST (not leaning out), and was quite dismayed to notice the way lineside vegetation had been allowed to impinge, right up against the side of the train on both sides, sometimes both at once. This was even on single line sections which had been reduced from double track. It was apparent that NR had just let the vegetation management go on that section. I think I wrote about it somewhere here at the time. It was before this accident.
 

Dr_Paul

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What a disappointing report from RAIB, once again in the Recommendations absolving Network Rail of any responsibility (so probably written by the same inspector who did the Athelney crossing accident). Network Rail allow the lineside vegetation to grow, apparently for years, to the extent that it impinges on the structure gauge (the report states it had been foul of trains for at least 2 years), and yet the Recommendations are placed on the train operator, who is NOT responsible for clearing the structure gauge, and even on heritage railways, actually quite reasonably but they of course still have an integrated management where the PW keep the structure gauge clear, and know their more enthusiastic passengers do lean out. The old ganger at Taunton long ago would never have allowed a tree to be foul of trains for more than a day, official standards and paperwork or not. A couple of years ago I travelled down the Oxford-Worcester line (the same Network Rail Route management, notably) in an HST (not leaning out), and was quite dismayed to notice the way lineside vegetation had been allowed to impinge, right up against the side of the train on both sides, sometimes both at once. This was even on single line sections which had been reduced from double track. It was apparent that NR had just let the vegetation management go on that section. I think I wrote about it somewhere here at the time. It was before this accident.

I commented above on how trackside undergrowth was scratching the sides of South-Western stock around North Sheen for quite a while before it was finally trimmed back. This also happened on the up line at Battersea Queenstown Road that goes around the side of the flyover. I've also noticed that in London trees that overhang the roadway and are a danger to buses are not trimmed back these days, but merely have a sign on them warning drivers of overhanging branches. London Transport used to have a Tree-Pruning Vehicle, an old STL with its roof removed, specifically for trimming offending branches. It's preserved these days: perhaps it needs to be brought back into service.
 

Islineclear3_1

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Network Rail allow the lineside vegetation to grow, apparently for years, to the extent that it impinges on the structure gauge (the report states it had been foul of trains for at least 2 years), and yet the Recommendations are placed on the train operator, who is NOT responsible for clearing the structure gauge.

Unbelievable! I can't believe that the responsibility for clearing the structual gauge should lie with the TOC. The TOC pays Network Rail for track access and that should mean being able to run trains free of any lineside obstruction. I am sure Network Rail would not wish for any agent from the TOC to be walking along its tracks with a hedge or tree trimmer...

Perhaps I should be responsible for maintaining the public road outside my house to prevent my car being damaged by running over a pot hole
 

Kingspanner

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I think the recommendations are trying to be reasonable in light of the available resources.
It is easier to modify a small number of vehicles to prevent heads being stuck out, than it it is to constantly ensure thousands of track miles are free from encroaching vegetation.
Indeed NRs policy (which is agreed with the regulator and freely available to TOCS) is about safety of trains not passengers putting their heads out.
A warning to us all really. I think of the droplights I hung out of as a youth armed with a Northumbrian Ranger ticket and shudder....
 

DarloRich

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What a disappointing report from RAIB, once again in the Recommendations absolving Network Rail of any responsibility (so probably written by the same inspector who did the Athelney crossing accident).

Network Rail allow the lineside vegetation to grow, apparently for years, to the extent that it impinges on the structure gauge (the report states it had been foul of trains for at least 2 years), and yet the Recommendations are placed on the train operator, who is NOT responsible for clearing the structure gauge, and even on heritage railways, actually quite reasonably but they of course still have an integrated management where the PW keep the structure gauge clear, and know their more enthusiastic passengers do lean out.

The old ganger at Taunton long ago would never have allowed a tree to be foul of trains for more than a day, official standards and paperwork or not.

A couple of years ago I travelled down the Oxford-Worcester line (the same Network Rail Route management, notably) in an HST (not leaning out), and was quite dismayed to notice the way lineside vegetation had been allowed to impinge, right up against the side of the train on both sides, sometimes both at once. This was even on single line sections which had been reduced from double track. It was apparent that NR had just let the vegetation management go on that section. I think I wrote about it somewhere here at the time. It was before this accident.

Firstly this is a terrible event which led to a pointless and, frankly, utterly avoidable loss of a life. No one comes out of this with any credit and silly points scoring isnt helpful.

The RAIB have, rightly in my view, focused on the ability of a person to lean out of the train rather than the terrible outcome of that initial failing. This is entirely consistent with their views in the recent Balham report and they clearly feel this is the primary cause of this matter. Perhaps they take such a view because they have not, yet, investigated a number of fatal interactions between train passengers and the green scenery. They have looked at a number of drop light related issues. The primary cause of this terrible event is being able to lean out of a train. That is driving their views and their focus on actions that can be taken to mitigate or prevent a repeat.

I must further point out that at no time does the report seek to hold the TOC liable for the state of line side vegetation. What the report does hold the TOC responsible for is for not having in place robust enough measures, to mitigate as far as practicable, the risk that someone could lean out of the train or even identifying that there was such a risk. In particular they note that the signage on the doors and windows was not adequate or "up to code". I draw your attention to paragraphs 42-49 & 78- 84 (& to a lesser extent 50 to 59)

For completeness could draw I the attention of the court to paragraphs 60 to 77, 88 to 90, 95c, 97, 98, 109, 110 & 114 (1) ALL of which deal with vegetation management. In particular 96c is important in this regard. I draw your attention to paragraph 109. You may feel that is "absolving Network Rail of any responsibility" but it is clear the RAIB have set out their workings to support their decision making and for the direction the report takes.

PS please can we stop referring to some mythical "old ganger in Taunton" and instead look at the real world of the 21st century. You are attempting to compare apples with Volkswagen and it is tiresome.
 

Comstock

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It's crazy that in 2019 we are still reliant on opening the window and sticking your hand out to open the door.

Presumably HSTs are so close to end of life it isn't considered worth the expense of coming up with something else.
 

Grumpy Git

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...........................

PS please can we stop referring to some mythical "old ganger in Taunton" and instead look at the real world of the 21st century. You are attempting to compare apples with Volkswagen and it is tiresome.

If I understand the points other posters are trying to make, they are referring to a time past, when people knew exactly what their job entailed and had both the skill and experience (and budget) to get on with it without needing an office full of "managers", method statements and risk assessments?
 

221129

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It's crazy that in 2019 we are still reliant on opening the window and sticking your hand out to open the door.

Presumably HSTs are so close to end of life it isn't considered worth the expense of coming up with something else.
I must be imagining all the modifications being done to the HST sets staying in service
 

pdeaves

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I think the RAIB report contains a false conclusion. The report states that the weather conditions did not have any effect on the incident. I suspect that if it was chucking it with rain there would never have been a head outside the window. (I readily accept that this is purely a minor observation and the other, controllable aspects are more important).
 

Taunton

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If I understand the points other posters are trying to make, they are referring to a time past, when people knew exactly what their job entailed and had both the skill and experience (and budget) to get on with it without needing an office full of "managers", method statements and risk assessments?
Thank you. And while management time is squandered on what you describe, the basics of keeping the track clear of obstructions are completely overlooked, or worse, removed from the work plan (as described in the report), presumably to come in within budget, while millions are spent on a Network Measurement Train that presumably comes past here regularly but never measures for obstructions.

The Old Ganger at Taunton, by the way, was not mythical; he was very real.
 

Comstock

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I must be imagining all the modifications being done to the HST sets staying in service

Well I did say "presumably" it wasn't considered worth upgrading the remaining HSTs. You almost certainly know more than me.

In fairness I should probably have ended the sentence with a question mark and not a full stop.
 

YorkshireBear

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Thank you. And while management time is squandered on what you describe, the basics of keeping the track clear of obstructions are completely overlooked, or worse, removed from the work plan (as described in the report), presumably to come in within budget, while millions are spent on a Network Measurement Train that presumably comes past here regularly but never measures for obstructions.

The Old Ganger at Taunton, by the way, was not mythical; he was very real.

So the measurement train which picks up track defects which could cause derailments etc is not worth the money? It is not even remotely a comparison.

Network rail should, if funded sufficiently, be able to manage lineside vegetation more effectively.

In the 21st century passengers really shouldn't be able to lean out of a passenger window at 125mph (not that this was the speed in this case) . Fortunately soon they won't be able to on the TOCs massively reducing the risk.

The outcomes from this investigation direct quite significantly towards the heritage sector. I am responsible for vegetation clearence on a heritage railway and will therefore be paying a lot of attention to the lessons learnt in this report, because realistically the whole sector isn't going to get rid of drop lights in the next few years.
 

Kingspanner

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The real old ganger at Taunton will have worked longer hours and earned far less in real terms than his equivalent today. Because we all insist on making a better living, labour has become relatively expensive, and as my electrician put it recently, anything is possible but it has to be paid for.
 

YorkshireBear

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The real old ganger at Taunton will have worked longer hours and earned far less in real terms than his equivalent today. Because we all insist on making a better living, labour has become relatively expensive, and as my electrician put it recently, anything is possible but it has to be paid for.

Can we stop this? I know gangers and people in maintenance who work ridiculous hours per week on contracts with no overtime pay. So lets not try and suggest modern maintenance don't work hard and that all the old ones were heroes who'd do anything for railway on no wage.
 

Taunton

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Let us concentrate on the matter at hand. This distressing and completely avoidable accident happened through failure to manage lineside vegetation over a long period. Something was going to hit it sooner or later. The photograph at paragraph 33 of the report shows not just that the tree was foul of someone leaning excessively out, but the lower part is actually brushing against the train, and that is after, as the report states, two feet of the tree was found to be freshly broken off.

Is there anywhere in the report that states what the structure clearance should be? I would have thought that would be a starting point for it.

Surely one of the most frequent users of droplights for looking forward and needing the appropriate clearance has always been the guard, as part of their duties.
 

Need2

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Let us concentrate on the matter at hand. This distressing and completely avoidable accident happened through failure to manage lineside vegetation over a long period. Something was going to hit it sooner or later.
That certainly played a part.
Does any blame fall on the 'sensible' adult who despite warning stickers decided to stick her head out of a window on a moving train?

I know whats coming.............
 

Llanigraham

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Can we stop this? I know gangers and people in maintenance who work ridiculous hours per week on contracts with no overtime pay. So lets not try and suggest modern maintenance don't work hard and that all the old ones were heroes who'd do anything for railway on no wage.

No-one has suggested such a thing, however what has been pointed out is that the regime and pay conditions of "the old ganger at Taunton" are in no way comparable to the situation now. And I can assure you that those employed by Network Rail to track walk and inspect are well paid and are paid overtime.
 

DarloRich

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If I understand the points other posters are trying to make, they are referring to a time past, when people knew exactly what their job entailed and had both the skill and experience (and budget) to get on with it without needing an office full of "managers", method statements and risk assessments?

Thank you. And while management time is squandered on what you describe, the basics of keeping the track clear of obstructions are completely overlooked, or worse, removed from the work plan (as described in the report), presumably to come in within budget, while millions are spent on a Network Measurement Train that presumably comes past here regularly but never measures for obstructions.

The Old Ganger at Taunton, by the way, was not mythical; he was very real.

This is silly. Please stop. Can we engage with the report and the points raised?

Let us concentrate on the matter at hand. This distressing and completely avoidable accident happened through failure to manage lineside vegetation over a long period. Something was going to hit it sooner or later. The photograph at paragraph 33 of the report shows not just that the tree was foul of someone leaning excessively out, but the lower part is actually brushing against the train, and that is after, as the report states, two feet of the tree was found to be freshly broken off.

Is there anywhere in the report that states what the structure clearance should be? I would have thought that would be a starting point for it.

Surely one of the most frequent users of droplights for looking forward and needing the appropriate clearance has always been the guard, as part of their duties.

It is clear you don't like the report published or the conclusions reached or the focus of the report and that you feel it is delivering the wrong message. However the published report does not support your position, no matter many how many times you state it.

If anything this report is a clear example of the "Swiss cheese" methodology so beloved of lecturers!

That certainly played a part.
Does any blame fall on the 'sensible' adult who despite warning stickers decided to stick her head out of a window on a moving train?

I know whats coming.............

It is good you know what is coming because it shows your view is wrong!
 
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nedchester

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That certainly played a part.
Does any blame fall on the 'sensible' adult who despite warning stickers decided to stick her head out of a window on a moving train?

I know whats coming.............

Tragic accident but 100% her fault. Sound callous but whatever happened to common sense and personal responsibility? And yes I have often stuck my head out of train windows.
 

Comstock

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That certainly played a part.
Does any blame fall on the 'sensible' adult who despite warning stickers decided to stick her head out of a window on a moving train?

She certainly takes plenty of blame in my book, but she obv paid the ultimate price for it.

Possibly she didn't realise how dangerous it was.....
 
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