Thursday 24 March 2016

SMRT accident on 22 March 2016: 2 maintenance staff killed on tracks near Pasir Ris station

Safety lapse in track accident, says SMRT
Trains should have been stopped from going into sector where track work was being done
By Adrian Lim and Seow Bei Yi, The Straits Times, 24 Mar 2016

A day after two of its trainees were hit and killed by an oncoming train just outside Pasir Ris station, SMRT has disclosed that a key safety procedure was not followed.

The rail operator revealed yesterday that a group of 15 technicians, including the victims, failed to notify a station signal unit that they were stepping back onto the track.

That meant a train travelling at 60kmh on an automatic mode was not diverted to an alternate platform or told to stop. The driver applied emergency brakes when he saw staff on the track, but it was too late.

"We take responsibility and apologise for the tragic accident," SMRT added in its statement released yesterday evening. This came just hours after Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, were buried at the Muslim cemetery in Lim Chu Kang.

SMRT said it has established a team to evaluate all workplace safety procedures and instituted mandatory work-team level safety reviews.

Tuesday's incident, which saw the station closed for three hours, left many puzzled on how the men could have been hit. SMRT had said initially that procedures were followed. The men, who were investigating a possible fault with a point machine used for trains to change tracks, were walking single-file on a 0.5m-wide access walkway alongside the track, and facing the direction of oncoming trains as they were supposed to. But after "carrying out investigations round the clock", SMRT yesterday revealed more on what had happened.

The 15 technical staff, including four trainees, were given permission at 10.54am to go onto the tracks. Mr Nasrulhudin and Mr Muhammad Asyraf were second and third in line, following an engineer leading the group towards the point machine.

"Before the team is allowed to step back on to the track, the following procedure must be carried out: The team must coordinate with the signal unit at the station for oncoming trains to be brought to a stop and to ensure that no trains enter the affected sector," SMRT said.

"Our records do not show that this procedure took place."

One of the men who was on the track on Tuesday, 24-year-old trainee Muhammad Hatin Kamil, told The Straits Times that the group was in the midst of crossing over the third rail to get to the tracks and point machine. The third rail provides power to the trains.

"We didn't realise that there was a train coming towards us... After I put my foot over the rail, my senior technical officer behind shouted: 'Train is coming! Train is coming!' "

He escaped onto the walkway, but saw Mr Nasrulhudin crushed under the train and Mr Muhammad Asyraf flung about 5m away.

SMRT said it is not uncommon for staff to be sent to the tracks while trains are running - authorisations are given two to three times a day.

What you need to know about interim safety measures ordered on SMRT by LTA and the Singapore Ministry of Manpower.
Posted by Channel NewsAsia on Wednesday, March 30, 2016

SMRT ordered to ensure on-track work safety
LTA, MOM spell out procedures, which take immediate effect, after two killed in accident
By Christopher Tan, Senior Transport Correspondent, 31 Mar 2016

Eight days after an MRT train killed two SMRT employees on a track near Pasir Ris station, the Government issued the rail operator a slew of measures to enhance safety for on-track work.

In a joint press statement sent out at 8pm last night, the Ministry of Manpower (MOM) and Land Transport Authority (LTA) said that, with effect from today, SMRT has to ensure that no trains are driven in automatic mode for sections of the track where workers are on an adjacent track walkway.

"Trains on such sections of the track should be operated manually, and at low speeds," the statement said, without specifying a speed limit. The train that ran over two workers was on auto mode.

It also said the section of a track where works are taking place should be isolated - that is, no train is allowed to approach it. "Measures for isolation must be continuously in place until staff have left the work area and trackside."

MOM and LTA said there should be "robust authentication procedures" between workers on the tracks and the Operations Control Centre. And watchmen should be deployed to alert workmen of oncoming trains.

[News Update] Following the track incident near Pasir Ris MRT station on 22 March 2016 that led to the demise of two...
Posted by Singapore Ministry of Manpower on Wednesday, March 30, 2016

In response yesterday, SMRT said it already has existing safety procedures for when staff go to the track during train service hours. It had admitted to a lapse last week as the team on the track failed to notify a station signal unit that they were going back onto the track.

Observers familiar with MRT operations said most of the recommendations are indeed already in place, except the one calling for the work section to be isolated.

Transport expert Gopinath Menon, an adjunct professor at Nanyang Technological University, said it is similar to work on highways, where the affected area is isolated by truck-mounted attenuators, traffic cones and diversion signs.

He said that on a railway, such measures would invariably affect passenger service. Unless it is an emergency, "it is better to confine work to late at night when trains are not running", he added.

Meanwhile, SMRT said its probe into the cause of the fatal accident will be completed by next week. "Findings will be reviewed by a panel comprising independent safety experts and the members of SMRT Board Risk Committee," it said, adding that a report will then be handed over to the police and MOM "for their statutory investigations".

SMRT would not say if it has offered compensation to the families of the two dead employees.

Asked if it would call for an inquiry, MOM said it was "too early" to comment.

SMRT track accident at Pasir Ris: Trainee barely escaped as best friend was killed
24-year-old worker recalls how two colleagues died in accident
By Seow Bei Yi, The Straits Times, 24 Mar 2016

They had been "best buddies".

But the friendship between two SMRT maintenance staff came to a tragic end on Tuesday when Mr Muhammad Hatin Kamil saw Mr Nasrulhudin Najumudin killed by a train as they went to inspect the track near Pasir Ris MRT station.

It was the first time 24-year-old Mr Hatin and 26-year-old Mr Nasrulhudin were on the tracks during the day. The trainees joined the train operator only in January.

They were part of a 15-strong team sent to investigate a possible fault after high voltage was detected from a point machine there, said Mr Hatin.

They walked in single file, with Mr Nasrulhudin and Mr Muhammad Asyraf Ahmad Buhari, 24, second and third in line respectively behind a supervisor. Mr Hatin was the fifth person.

To reach the point machine, Mr Hatin told The Straits Times, the group had to cross the third rail supplying power to trains - which was still live - to get on the track.

"We didn't realise that there was a train coming towards us from this second track, going to our track, the first track," he said. "After I put my foot over the rail my senior technical officer behind shouted: 'Train is coming! Train is coming!'"

"Our environment up there is different - you wouldn't be able to hear the train coming," said Mr Muhammad Hatin Kamil,...
Posted by The Straits Times on Wednesday, March 23, 2016

Mr Hatin saw the train nearing and his friend running towards the sidewalk. Mr Hatin quickly put his foot back on the walkway and hugged the railing.

When he took a second to check on Mr Nasrulhudin, he saw the trainee crushed by the train. But Mr Nasrulhudin was not the only casualty. Mr Hatin said: "Aysraf's body flew over behind me, like 5m away."

The supervisor walking in front of them avoided the train by jumping onto the walkway and squatting.

"This happened right in front of my eyes," said Mr Hatin. "I couldn't think. I went back to the platform, I couldn't do anything."

No one knew a train was coming, he recalled. "Our environment up there is different - you wouldn't be able to hear the train coming," he explained, adding that their supervisor had not said anything in the moments before the accident.

"The person in charge knows the system because they are more senior than us. Our job was to observe.

"It's very harsh. I don't know who is at fault."

SMRT revealed yesterday that the 15 men were split into two groups - six in front near the point machine and nine at a distance behind. It is unclear how exactly the supervisor in front managed to escape and why the two deceased did not.

Mr Hatin and Mr Nasrulhudin had known each other since their first days on the job as SMRT maintenance staff in January.

"He was my best buddy. He was my everything... my work buddy," said Mr Hatin.

"He was always with me; we ate breakfast at 4am together."

The pair had been on the tracks at night previously, and also worked together on shifts. But Mr Asyraf and the fourth trainee in the group had never been on the tracks before and Tuesday was their first time.

Mr Hatin and other SMRT staff arrived at Mr Nasrulhudin's home in Tampines Street 12 yesterday morning to pay their respects.

When he saw his friend's body, Mr Hatin broke down.

"It is with deep sadness that two SMRT staff, Nasrulhudin Bin Najumudin and Muhammad Asyraf Bin Ahmad Buhari, passed...
Posted by SMRT on Tuesday, March 22, 2016

SMRT orders safety review after train kills two trainee technical staff
By Adrian Lim and Seow Bei Yi, The Straits Times, 23 Mar 2016

A review of safety measures has been ordered by rail operator SMRT after a train pulling into Pasir Ris Station at 60kmh ran into two trainee technical staff, killing both of them yesterday morning.

The Manpower Ministry (MOM) and police are also conducting their own investigations into the deaths of Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, both of whom had joined SMRT just two months ago.

It remains a puzzle why the pair were hit about 150m from the station, when 13 other staff who were walking single-file with them on a 0.5m-wide access walkway were unhurt. The two, who were getting on- the-job training, were second and third in the line, behind a supervisor.

SMRT said excursions onto the track level are a regular occurrence, happening a few times a month.

The crew in the incident had been authorised to walk to a point machine, which switches tracks for trains and was located about 200m away from the station.

The 11.10am incident forced the temporary shutdown of Pasir Ris MRT station, on the East-West Line, and train services to and from Tanah Merah were suspended for three hours, affecting up to 15,000 commuters. The 35 passengers who had been on the train had to walk on the tracks to the station.

"We are deeply saddened by the deaths of our two staff. Our first priority is their families and are doing all we can at...
Posted by SMRT on Tuesday, March 22, 2016

SMRT chief executive Desmond Kuek said: "Exactly how it is that they (the two men) were hit by an oncoming train when there was a clear line of sight, and when there was a supervisor ahead of them, is the subject of the investigation."

No CCTV cameras are located on the part of the track where the accident took place, but SMRT said it is interviewing the other staff members who were out with the two men. Asked why the two junior staff were allowed near the tracks, SMRT Trains managing director Lee Ling Wee said: "After proper training and safety brief, it is all right for them to access the track."

Mr Nasrulhudin and Mr Asyraf were pronounced dead on the scene by paramedics. Their bodies were removed from the tracks at about 1.25pm, and colleagues could be seen in tears. Mr Asyraf's parents are in Saudi Arabia on a pilgrimage, while Mr Nasrulhudin's father is believed to be also working for SMRT.

Offering his condolences to the two families, Prime Minister Lee Hsien Loong posted on Facebook: "Whether it turns out to be an unforeseeable mishap, an individual lapse or a system problem, we must do our best to ensure this does not happen again."

Saddened to learn about the deaths of two SMRT trainees today. My deepest condolences to their families. We understand...
Posted by Lee Hsien Loong on Tuesday, March 22, 2016

"I was riding, so I parked my bike on the side of the road and broke down," Sulaiman Mustafa, a childhood friend of SMRT maintenance trainee Muhammad Asyraf Ahmad Buhari.
Posted by The Straits Times on Tuesday, March 22, 2016

“We are gathering the details to understand how the accident happened and how the safety procedures could be further...
Posted by Land Transport Authority – We Keep Your World Moving on Tuesday, March 22, 2016

'Normal practice' to send crew to check track faults: SMRT
Walkway was 50cm away from line; operator investigating whether the two killed had got onto track or were too close
By Adrian Lim, The Straits Times, 23 Mar 2016

Sending maintenance crew to the track level to investigate faults - even as trains services are running - is a normal practice, SMRT said in the wake of yesterday's accident.

SMRT Trains managing director Lee Ling Wee said staff walk near the tracks to check on faults a "few times a month".

At Pasir Ris MRT station, the walkway which the two men were on was more than 50cm away from the line.

The operator was last night still investigating whether the men had got onto the track or were too close to the oncoming train.

Mr Lee said permission must be granted by SMRT's operations control centre before staff are allowed to access the 50cm-wide walkway.

However, they should not be on the tracks themselves when trains are running.

In yesterday's incident, 15 technical staff, including the two who died, were sent to investigate an alarm triggered by a sensor on a "point machine". They would have been required to ask permission for the power to the tracks to be cut before they could check the device.

Point machines are deployed at crossings to direct trains when tracks split into two.

They are typically used to switch tracks for trains at crossing points.

Mr Lee said: "The accident happened before they actually reached the site where they were supposed to do the investigation."

The 15 staff had walked about 150m from the Pasir Ris MRT station platform, beside the eastbound tracks, when the accident happened at about 11.10am.

The two men killed - Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24 - had joined SMRT in January and were doing their on-the-job training.

The oncoming train which hit them was pulling into the Pasir Ris MRT station at about 60kmh.

Mr Lee said: "The rules are that they are supposed to walk against the direction of the train."

He added that that was what they were doing.

Train captains are usually given alerts on activities taking place on the tracks. and SMRT said it would look into how the men could have been hit, when there was a "line of sight".

The train which hit the men was being driven automatically, but a captain was on board.

Asked why such junior staff were allowed near the tracks, Mr Lee said both trainees and permanent staff are trained on safety issues beforehand.

Additionally, SMRT chief executive Desmond Kuek said going onto the track level is a "routine" and "controlled" practice.

Mr Kuek said: "When we detect a fault and we need to troubleshoot it, the first course of action is to go down onto the site to determine what is the cause.

"The only way to do so, to get access to the track while service is on, is to walk on the side with supervision and control from the ops control centre, with all the safety and permissions granted. This is a controlled and supervised activity."

Meanwhile, SMRT said it is reviewing all safety protocols relating to staff track access, and it will improve upon them when necessary.

It is currently investigating the case with the police and the Ministry of Manpower.

In October 2010, a 48-year-old technician was at a designated walkway on the Bukit Panjang LRT, checking the power rail between Phoenix and Bukit Panjang stations, when an oncoming train hit him. He suffered head injuries and needed a leg amputation, and died about two weeks later.

#FBLIVE: SMRT Press conference on Pasir Ris train incident, which killed two staff members. video was broadcast live on Facebook earlier)
Posted by Channel NewsAsia on Tuesday, March 22, 2016

Death of 2 trainees: SMRT must assure all that safety comes first
By Royston Sim, Assistant News Editor, The Straits Times, 24 Mar 2016

Many questions remain about the tragic accident that left two new SMRT employees dead after they were struck by a train near Pasir Ris MRT station.

While the duo had just joined the public transport operator in January, SMRT Trains managing director Lee Ling Wee said they were trained and given a safety brief before they were allowed onto the track.

They were among a group of 15 staff walking in a single file along a 0.5m-wide walkway to investigate a possible fault 200m away from the station.

Facing the media for a brief session that lasted all of 13 minutes, SMRT chief executive Desmond Kuek said the walkway is safe for staff, and that a supervisor was in front of the two deceased.

How exactly the duo were hit by a train travelling towards the station on auto mode at about 60kmh remains unclear.

Mr Kuek could only say that the operator is still trying to establish from witnesses "exactly how they got on to the track or got close enough to the oncoming train".

He added that there was no closed-circuit television cameras along that stretch.

SMRT accident: The investigation will be focusing on how new employees Nasrulhudin Najumudin and Muhammad Asyraf Ahmad Buhari were hit by an oncoming train.
Posted by The Straits Times on Tuesday, March 22, 2016

Accessing the track to investigate and fix faults is commonplace, said SMRT. And its operation control centre had given the staff permission to do so yesterday.

But there may still have been safety lapses. For one thing, should the train have been travelling in auto mode and at a speed of 60kmh with workers along the track?

The Straits Times understands that, as part of safety protocol, trains should be driven manually whenever there are staff working on the track.

A staff member stationed at the headwall of the station that the train is departing from - Tampines in this case - is also supposed to alert train drivers that there are men on the track, and to switch to manual.

Train drivers are meant to keep a lookout, and slow down when approaching a work party.

Was there a station staff member at Tampines who gave the alert, and did the driver know about the 15 men on the track?

If he did know, why was the train not driven in manual mode at a slower speed?

When asked if train drivers were aware of people on the track, Mr Kuek said this is among the facts SMRT is trying to establish.

In response to a query about whether trains should be in manual mode when staff are on the track and why it was on auto in this case, SMRT said these matters are also under investigation and that it could not comment further.

Many will be dismayed by yesterday's developments and might well wonder about the wisdom of allowing trains to hurtle past workers walking barely 0.5m away from the tracks, at 60kmh. The top speed of an MRT train is about 80kmh.

The speed of the passing train would be unsettling at the least, and lethal to any worker who, for whatever reason, falls onto the track or finds himself in its path.

At that speed, trains could not possibly stop in time.

The walkway that the 15 men were on has a width of about 0.5m, and is another about 0.5m away from the track.

There are no barriers, at least along the stretch of track near Pasir Ris MRT station, to act as a physical barrier separating the workers from trains.

Rightly, the operator is now reviewing all its safety protocols, and perhaps the design of such maintenance walkways is one of the things that need relooking.

In a note to staff after the two deaths yesterday, SMRT reminded them that "all safety procedures should be followed closely as they are there for our well-being and protection".

It is critical that it takes a hard look at its procedures and makes substantial improvements promptly, given that maintenance teams are sent onto the tracks while trains are running, several times each month to deal with faults.

As Prime Minister Lee Hsien Loong said in a Facebook post yesterday: "We understand that faults and malfunctions do happen in our train system, and generally take them in our stride. But it is different when two young men lose their lives in a workplace accident... Whether it turns out to be an unforeseeable mishap, an individual lapse or a system problem, we must do our best to ensure this does not happen again."

The deaths of the two young men were heartbreaking and seemingly avoidable. They also come on the back of an increase in the number of workplace deaths last year. According to statistics from the Workplace Safety and Health Institute, 66 workers were killed at their workplaces last year, up from 60 in 2014. At least 10 have died in such accidents in the first two months of this year.

Thankfully, no passengers on the train were seriously injured in the incident, and there were hardly any complaints about delays after word of the tragic deaths spread.

SMRT needs to get to the bottom of the incident, put things right, and inform the public just how it has done so, to assure all passengers and staff that they are safe.

There must have been more than one safety lapse that led to the deaths of two SMRT maintenance staff on Tuesday. Working...
Posted by The Straits Times on Thursday, March 24, 2016

SMRT track accident points to more than one safety lapse
By Christopher Tan, Senior Transport Correspondent, The Straits Times, 25 Mar 2016

SMRT Corp's latest statement on the tragic accident that claimed two young lives points to a safety lapse on the part of the maintenance crew.

It said the crew must coordinate with the station for oncoming trains to be halted before any track crossing takes place, and that there was no record of this procedure having taken place on the fateful day.

Was this why Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, were hit and killed on Tuesday morning by a train that was travelling at 60kmh in auto-drive mode?

It would be most unfortunate - and downright scary - if our rail safety protocol allowed a single lapse to result in a fatal outcome.

Railway tracks are hazardous places to be on foot - with intersecting metal rails, loose gravel, sleepers, bolts, brackets, fasteners and cables to trip over - even when trains are not moving.

But when trains are plying, they can be as dangerous as a loaded weapon. So any safety protocol governing the deployment of work crew during service hours would have to include a number of fail-safes - so that if there is a lapse (or even two), tragedies can be avoided.

SMRT is not shedding more light on the incident beyond what it has said in its latest statement.

It would, however, not be unreasonable to say that there were several safety lapses - and not just the one that SMRT pointed to in its statement. Because the alternative - to assume the safety protocol was not multi-layered - would simply be unthinkable in a place like Singapore.

According to experts, trains approaching a worksite would have to be driven in manual mode, and moving at a crawling speed.

This makes perfect sense because a train, unlike a road vehicle, cannot steer away to avoid collision. And a fully laden six-car train weighs close to 300 tonnes, and would require well over 100m (about the full length of a football field) to stop if it was moving at 60kmh in dry weather.

If it was moving at a crawling speed, the stopping distance would have been drastically shaved.

It is also imperative for a driver to be in control at all times when workers are on the tracks.

A driver in control would have a clear line of sight, so he can apply the brakes when necessary. Train systems are not designed to look out for people or obstacles - except for another moving train. So, allowing a train to move in auto mode and at 60kmh near a work zone is ill-advised.

A driver at the helm is also supposed to sound the horn as soon as he spots workers from afar. That is because MRT trains, being driven by electric motors, can be relatively quiet on an open track near road traffic.

Mr Muhammad Hatin Kamil, 24, who was with his two unfortunate colleagues when they were mowed down, said: "Our environment up there is different - you wouldn't be able to hear the train coming."

Another layer of safety that is commonly employed pertains to lookouts stationed at least 50m from the work party. This would give workers ample time to get off the tracks and get back into the safe walkway area when a train approaches.

Similarly, a flag-waving signalman must be at the station headwall to warn train drivers of workers ahead.

All these steps would have been on top of a system that requires work teams to seek permission before going onto the tracks. If so, SMRT's operations control centre (OCC) would have been aware of a work team near Pasir Ris station on Tuesday morning.

Which means train drivers moving along that stretch should already have been forewarned. So, even if there were no lookouts or signalmen, drivers would already have been on alert.

Another thing, track-switching when men are on site is a bad idea as it introduces unpredictability into an area where predictability is crucial.

The OCC could also have chosen to remove speed codes along that selected stretch, thereby forcing drivers to drive in what is known as restricted manual mode. In this mode, speed is automatically capped at 18kmh.

That is what is meant by having fail-safes.

The fact that at least one man in that work team on that tragic day had to jump out of the way of the train suggests that he did not expect it to come towards him, or to come towards him at such a high speed.

That may well point to safety lapses other than the one SMRT alluded to.

By the same token, if all the safety measures had been observed religiously, the two deaths might well have been prevented.

The two who died were part of a 15-man team, so we shudder to think how far worse the tragedy could have been if more men were not on the viaduct's walkway when that train hurtled by.

Looking ahead, we can only hope that rail operators and regulators learn from this incident and therefore be in a better position to ensure there is no repeat of it.

We can meanwhile take comfort in the fact that Tuesday's incident was only the second rail accident that resulted in staff sustaining fatal injuries on the tracks in Singapore's 29-year rapid transit history.

Let us hope the relatively clean slate has been the result of strict adherence to a robust safety protocol, and not sheer luck.

* SMRT names external experts to review probe

Report will be given to MOM, police for their investigations before findings made public
By Christopher Tan, Senior Transport Correspondent, The Straits Times, 9 Apr 2016

Transport operator SMRT has completed its internal investigations into the cause of a track accident which claimed the lives of two of its young employees last month.

But the Temasek-owned company would not reveal its findings. It said the Ministry of Manpower (MOM) and police would have to complete their investigations before anything can be made public.

The Straits Times understands that the tragic incident is likely to have been caused by multiple lapses in safety protocol.

SMRT said yesterday that it has appointed experts from Keppel and Transport for London - the equivalent of Singapore's Land Transport Authority - as well as a former executive of Hong Kong's MTR to review its findings. The review will be carried out with SMRT board members. After that, a report will be handed over to MOM and the police for their statutory investigations, an SMRT spokesman said.

Singaporeans Nasrulhudin Najumudin, 26, and Muhammad Asyraf Ahmad Buhari, 24, were hit by a train near Pasir Ris station when they were on the track to investigate a technical fault on the morning of March 22.

The two men, who had just joined SMRT in January, were part of a team of 15 dispatched to look into a reported alarm from a monitoring device.

They were killed by a train travelling at 60kmh in automatic mode. The driver, understood to be an SMRT veteran, applied the emergency brakes but could not stop in time.

The accident was the second one in six years that led to the death of SMRT staff. In 2010, technician Chia Teck Heng, 48, was hit by a train while attending to a fault on the Bukit Panjang LRT. He had injuries to his head and legs, and died 12 days later without emerging from a coma.

Rail operators have had mixed safety records when it comes to staff fatalities. According to MTR's latest sustainability reports, the Hong Kong company had zero fatality from 2009 to 2014. Likewise, London Underground has had zero workforce fatality for over a decade, according to the UK Office of Rail Regulation. But in New York, nine city subway workers have been killed since 2000, according to the New York City Transit.

** Safety lapses cause of fatal accident: SMRT
Findings on incident that killed 2 staff submitted to the authorities
By Christopher Tan, Senior Transport Correspondent, The Straits Times, 26 Apr 2016

Rail operator SMRT Corp has admitted that a failure to follow safety measures before allowing a work team onto train tracks had "directly" caused an accident which killed two of its employees last month.

The lapses included allowing a train to ply in automatic mode while workers were on site, not deploying watchmen to look out for approaching trains, and failing to provide early warning to the work team.

SMRT released the findings of its investigations in a statement yesterday, 34 days after workers Nasrulhudin Najumudin, 26, and Muhammad Asyraf Ahmad Buhari, 24, were hit by a train near Pasir Ris MRT station when they were on the track to investigate a technical fault on the morning of March 22.

The Straits Times understands a number of personnel had failed to observe safety protocol that day, but SMRT said no one has been singled out for disciplinary action yet.

The transport operator said the findings were part of an internal investigation which was reviewed by its board of directors as well as an external panel of three experts.

The panel said though existing mechanisms were adequate, track access management controls, communication protocols and track vigilance must be improved.

"Before a work team is allowed onto the track, protection measures must be applied," SMRT said.

This includes "code setting the speed limit on the affected track sector to 0 kmh so that no train can enter on automated mode".

This procedure was not followed on the day of the accident, when six signalling workers and nine track workers were on a maintenance walkway near Pasir Ris station to check on a possible fault in a component. As they approached the device, the signalling team, led by a supervisor, stepped onto the track "before protection measures were implemented", SMRT said.

"The supervisor narrowly avoided being hit by the oncoming train, but Nasrulhudin and Muhammad Asyraf, who were second and third in line, were unable to react in time."

The two young men were just two months into the job.

SMRT did not say why the work crew did not seem to notice the train till the very last moment, why the train driver did not see the men earlier, or why the train changed tracks at the site. It said its investigation report has been submitted to the police, Manpower Ministry and Land Transport Authority to help with their investigations.

The police said they are investigating the "unnatural deaths" of the two men, and had started interviewing a number of SMRT employees.

Transport Minister Khaw Boon Wan has said there will be a coroner's inquiry "in due course", and that if SMRT staff were found not to have followed safety procedures, they would be taken to task.

National Safety Council of Singapore deputy president Fong Kim Choy said: "For critical jobs, a permit to work has to be granted. And the manager or managers granting that permit will have to ensure that all safety measures are in place before the work can be carried out."

Meanwhile, Mr Nasrifudin, 33, Mr Nasrulhudin's eldest brother, said: "Since SMRT has acknowledged the mistakes and given us full support from day one until now, we don't think we will be taking further action at the moment."

Additional reporting by Seow Bei Yi

SMRT sacks train driver in fatal track accident

By Christopher Tan, Senior Transport Correspondent, The Straits Times, 14 Sep 2016

Transport operator SMRT Corp has fired the train driver who was involved in a fatal track accident that killed two of his colleagues in March.

The Straits Times understands that Mr Rahmat Mohd, 49, was dismissed yesterday after an internal disciplinary inquiry.

Mr Rahmat, who was reassigned to a non-driving job after the accident, said he felt "sad" about the company's decision. "I've no plans at the moment," he added.

Sources said an operations control centre staff member had also left earlier on account of the incident.

SMRT spokesman Patrick Nathan said the company does not comment on staff disciplinary measures.

National Transport Workers' Union executive secretary Melvin Yong said: "NTWU understands that SMRT has taken action to dismiss two workers related to the incident on March 22. NTWU has previously written to SMRT to withhold any actions against the affected workers until completion of official investigations so as to not prejudice the outcome of the official investigations. We will now review the situation, study the grounds for SMRT dismissal, and work with the affected staff on the next steps."

Two SMRT maintenance workers were killed while they were on an East-West Line track near Pasir Ris station on the morning of March 22. Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, were hit by an oncoming train while they were undergoing on-the-job training.

The two men were part of a group of 15 sent to investigate a possible fault with a track equipment.

SMRT said in April - after an internal probe into the tragedy - that failure to follow safety measures had led to the accident.

Lapses included allowing a train to ply in automatic mode while workers were on site, not deploying watchmen to look out for approaching trains, and failing to provide early warning to the work team.

The Ministry of Manpower had also called on the operator to tighten its safety procedures a week after the fatal incident. A coroner's inquiry into the accident is expected to convene early next year.


Fatal track accident: More SMRT staff disciplined

By Christopher Tan, Senior Transport Correspondent, The Straits Times, 16 Sep 2016

More SMRT employees, including "senior management", were disciplined for their role in the track accident on March 22 that killed two trainees.

In an internal mail message to staff on Wednesday, SMRT Trains managing director Lee Ling Wee said two employees had been dismissed and several others disciplined.

"Besides the two dismissals, verbal and written warning letters were issued to staff across several grades," Mr Lee wrote.

He also alluded to pay cuts and, possibly, demotions.

"Individual performance grades were recalibrated downwards across various levels of the Trains team, including senior management," he said.

Mr Lee's communication came swiftly after The Straits Times reported on Wednesday that two SMRT employees had been sacked over the fatal accident, including the driver of the train that hit the two trainees.

On the morning of March 22, Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, were among 15 men on the track near the Pasir Ris station when they were hit by an oncoming train.

The Straits Times understands that the driver might not have seen the workmen on the track and, if he had seen them, did not sound the horn as required. According to sources, the train had switched tracks moments before hitting the workers. Train drivers have no control over track switching.

A second employee, said to be part of the work team on the track that day, was also dismissed.

The Straits Times understands that a senior controller of the network's Operations Control Centre also left following the accident.

In his mail message to staff, Mr Lee said: "Our disciplinary process is fair. We do not single out any staff or department to bear the responsibility when things go wrong."

He said there had been previous dismissals for safety breaches.

"We did this in an all-out effort to never again repeat safety lapses," he wrote.

Since the tragedy - the second fatal track incident in six years involving employees - SMRT has set up a Track Access Management Office "to control access to railway tracks".

Mr Lee also said any staff member, regardless of rank, can "call a time-out if they feel safety is compromised".

SMRT said in April that failure to follow safety measures had led to the accident.

There were several lapses, including allowing a train to ply in automatic mode while workers were on site, not deploying watchmen to look out for approaching trains, and failing to provide early warning to the work team.


Fatal track accident: 2 sacked SMRT workers to submit appeals

By Pearl Lee, The Straits Times, 17 Sep 2016

The two workers sacked by transport operator SMRT Corp over a fatal track accident in March will submit appeals next week.

SMRT has given them until next week to appeal, and the National Transport Workers' Union is helping them to do so, said labour chief Chan Chun Sing yesterday.

The union will discuss the next steps after the appeals are filed, he told reporters on the sidelines of a dialogue with human resource professionals.

Earlier this week, SMRT fired Mr Rahmat Mohd, 49, who drove the train that struck and killed two SMRT trainees undergoing on-the- job training on the tracks near Pasir Ris station on March 22.

Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24, were part of a group of 15 sent to investigate a possible fault with a track equipment.

The other employee who was dismissed is believed to be part of the work team on the track that day.

SMRT, which conducted an internal probe into the tragedy, said the accident occurred as safety measures, such as deploying watchmen to look out for approaching trains, were not followed. Besides firing the two workers, SMRT sent verbal and written warnings to other staff.

In an internal e-mail message on Wednesday, SMRT Trains managing director Lee Ling Wee said: "Individual performance grades were recalibrated downwards across various levels of the Trains team, including senior management."

Mr Chan said the union will continue to engage with SMRT to "see how we can best manage this issue".

*** SMRT Trains director of control operations fined $55,000 over fatal track accident

By Elena Chong, Court Correspondent, The Straits Times, 30 Sep 2017

The director of control operations at rail operator SMRT Trains was fined $55,000 yesterday over the death of two trainees, who were hit by a passenger train on March 22 last year. Teo Wee Kiat, 41, admitted to failing to take necessary measures to ensure the safety of SMRT's employees, such as making sure that they complied with the approved operating procedures when accessing the train track during traffic hours.

He also failed to ensure the procedures passed safety audits, were documented and disseminated.

The trainees, Mr Nasrulhudin Najumudin, 25, and Mr Muhammad Asyraf Ahmad Buhari, 24, were part of a 15-member team sent to check an apparent fault relating to switching equipment when a train hit them near Pasir Ris MRT station.

It was SMRT's worst fatal rail accident and the operator was given a record fine of $400,000 in February over the same breach.

Deputy Public Prosecutor Anandan Bala said SMRT employees had received permission from the Operations Control Centre (OCC) to enter the train tracks during traffic hours, without first sticking to certain safety procedures stipulated.

Investigations showed such practices had been allowed to perpetuate for some time before the accident.

While heading the OCC, Teo knew that it had been permitting employees to conduct track access in contravention of "Unit 3C OP", a set of documented operating procedures to govern track access during traffic hours , said the DPP.

He urged District Judge Chay Yuen Fatt to impose a fine of at least $60,000, taking into account Teo's personal culpability, and the potential and actual harm caused.

The Ministry of Manpower said yesterday that SMRT employees had not been complying with "Unit 3C OP" from as early as 2002, and the frequency of them using such unapproved methods of track access had increased from 2007.

In mitigation, Teo's lawyer Adam Maniam from Drew & Napier said his client voluntarily took steps to fix the problems that had led to the incident before he was charged.

He said Teo set up a dedicated unit to coordinate and control track access for works during non-traffic hours, and took over control of the maintenance operations centre.

The maximum penalty for the offence under the Workplace Safety and Health Act is a $200,000 fine and two years' jail.

**** Engineer who led SMRT trainees onto tracks in 2016 fatal rail accident jailed for 4 weeks
His failure to effect 'last line of defence' safety protocol was most direct cause of two trainees' deaths, says judge
By Tan Tam Mei, The Straits Times, 13 Mar 2018

Two SMRT trainees died because of a failure to impose safety protocols that would have prevented trains from entering the work site where a track inspection was being carried out.

But former SMRT engineer Lim Say Heng's failure to effect a "last line of defence", known as the 0/0 Automatic Train Protection speed code, was the most direct cause of death, said District Judge Chay Yuen Fatt.

For his role in the March 2016 rail accident, Lim, 48, was sentenced to four weeks in jail yesterday after he pleaded guilty to causing death by negligence.

The accident, the train operator's worst in history, resulted in the deaths of Mr Nasrulhudin Najumudin, 26, and Mr Muhammad Asyraf Ahmad Buhari, 24.

Judge Chay said: "There is no denying that (Lim) did not impose or give the instruction for the protocol."

The prosecution had asked for a sentence of at least four weeks in jail, and said that a fine, even a large one, would be insufficient, given that it was "fully" within Lim's "powers to ensure a safe inspection".

Judge Chay agreed that a jail term should be imposed.

In his submissions, Deputy Public Prosecutor Anandan Bala said the consequences of Lim's failure to ensure that the particular safety code was imposed set in motion a chain of events that resulted in the fatal accident.

When imposed on a track circuit, the code would have ensured that a train come to a stop before approaching the area.

The court heard that on March 22, 2016, a fault was detected along the track between Pasir Ris station and Tampines station on the East-West MRT line at around 6.30am. The team of 15, led by Lim, was deployed at around 11am.

The safety protocol was not implemented and, instead of boarding a designated train that would take them to the work site, they walked on a walkway parallel to the track.

This was among the failures of different parties to comply with an approved set of safety operating procedures known as "Unit 3C OP" that governs track access during traffic hours.

Lim managed to avoid the oncoming train, but the two trainees behind him were unable to react in time and were hit by the train.

He was sacked six months after the incident, and now works as a technician.

During mitigation, defence counsel Lee May Ling said Lim was not solely responsible for the implementation of the safety protocols.

"Within SMRT, there was an environment where the documented safety protocols were not, and could not be, adhered to," she said. The defence sought a $10,000 fine.

In October last year, former director of control operations Teo Wee Kiat, 41, was fined $55,000 for failing to take necessary measures to ensure the safety of SMRT employees.

The rail operator was given a record fine of $400,000 in February last year over the same breach.

The families of the two trainees declined comment when contacted by The Straits Times.

Safety procedures not followed
The Straits Times, 13 Mar 2018

Investigations into SMRT's fatal rail accident of March 2016 showed that various parties involved in track access that day did not comply with proper safety procedures.

Proper procedure: A request to impose the safety code that would prevent trains from entering the track must be submitted for track access. Approval for track access and the specifics, such as time, duration and safety arrangements, must be granted by the operations command centre.

What was done: No form was submitted.

Proper procedure: The person in charge must liaise with the duty station manager on the exact time to impose the safety code.

What was done: The parties had agreed that the safety code would be imposed "at a later time" when the inspection team reached the work site, but no exact timing was given.

Proper procedure: A designated train picks up the work party at the station platform to head to the work site.

What was done: The joint inspection team walked to the work site.

Proper procedure: The safety code must be imposed before the work party boards the designated train and leaves the station platform.

What was done: The safety code was not imposed before the team left the platform.

Proper procedure: There must be a message displayed at the prior station to warn train drivers that there are people working on the track ahead. The message should be a standard printed sign.

What was done: A handwritten message was displayed at Tampines station. But it did not indicate there were people working on the track ahead.

#####  SMRT to face $1.9 million in fines for deaths of two trainees and flooding incident
LTA to penalise operator for fatal track accident in 2016 and last October's MRT tunnel flooding
By Zhaki Abdullah, The Straits Times, 21 Jul 2018

Train operator SMRT faces fines totalling $1.9 million for two incidents: An accident in March 2016 which resulted in the death of two SMRT trainees, and the flooding incident in October 2017 which disrupted train services for about 231,000 passengers.

In a statement yesterday, the Land Transport Authority (LTA) said that in the 2016 case, investigations found that the SMRT work team had not complied with operating procedures for track access during train service hours.

"These lapses were further compounded by inadequate supervision of MRT operations at the time of the accident," it said, adding that the operator had failed to take the necessary measures to ensure the safety and health of employees.

On March 22, 2016, two SMRT trainees were hit by a train while on the railway tracks investigating a possible signalling fault between Tampines and Pasir Ris stations.

SMRT will be fined $400,000 for this incident. The Manpower Ministry also fined the rail operator the same amount in February last year over the incident.

In the case of last October's flooding incident, LTA's investigations found SMRT fully responsible, as the flooding would have been prevented if the Bishan storm water sump pit and its pumping system had been maintained properly.

The authority said it intended to issue a fine of $1.5 million to SMRT for the incident under the Rapid Transit Systems Act. It considered "all facts and the severity of the incidents" in assessing the penalty amount for each of the two incidents.

"LTA will also consider any other mitigating facts which the operator may raise as part of the due process for the imposition of the financial penalties," it said, adding that the fines collected will go to the Public Transport Fund to help needy families with transport fares.

LTA added that last November's collision between two trains at Joo Koon station was due to a problem with the signalling system, and was not caused by SMRT's actions. In response to queries, LTA said it reserved the right to seek compensation for the incident from supplier Thales after the upgrading of the signalling system on the East-West and North-South lines is completed.

This is not the first time the operator has been fined by the regulator. In 2015, it was fined a record $5.4 million for a breakdown that crippled the North-South and East-West lines in the evening peak period.

Mr Yee Chia Hsing, who sits on the Government Parliamentary Committee for Transport, said: "Such incidents should never have happened, and we owe it to our rail maintenance crew (to make sure) that they are able to do their job without compromising their safety." The Chua Chu Kang GRC MP added that he hoped "whatever lessons SMRT needed to learn have been learnt".

In a statement, SMRT chairman Seah Moon Ming apologised, and said the firm is "committed to doing all we can to prevent future incidents from happening".

He noted that the rail operator has implemented various measures to strengthen its systems and processes since the two incidents.

"SMRT has also been working closely with LTA to improve the reliability, maintainability and safety of our MRT network, as well as to enhance network resilience and robustness," he said, adding that trains have been running more smoothly in recent months.

Mr Seah said SMRT is fully committed to providing "safe, secure and reliable" services to commuters.

Additional reporting by Christopher Tan

Financial Penalties Imposed on SMRT for Two Rail Incidents -20 Jul 2018

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