|2 US Head-on Collisions
Burlington Northern in Montana
as 2 freight trains thundered towards each other, misheard radio instructions sealed their fate
Ledger 1991 Naismith 1985
Photography by Richard C Logan
With Britain having just experienced one of its worst head on crashes for many years the details of two head on collisions from the USA are summarised below with photographs provided by Richard C Logan of Fargo, Nevada.
In the eastern foot hills of the Rocky Mountains is the town of Great Falls, Montana. About 70 miles to the north is the town of Shelby, also in Montana and between the two the Burlington Northern railroad wends it way between the hills on its route as a north/south feeder to the main east/west BN route.
The line is single and just south of Shelby there are two passing points at Naismith and Ledger. It is here that head on crashes occurred, one in 1985 and one, the more serious, in 1991.
Ledger, Montana 30 August, 1991
In the late afternoon, train 602 departed Shelby heading south. It comprised 3 BN locomotives GP38-2 2275, SD40-2's 8009 and 6909 and 20 loaded cars and 14 empties bound for Laurel, Montana. Westbound train 603 left Great Falls at 1:50pm and after calling at Conrad was re-consisted to comprise of 6 BN locomotives SD40-2's 6905 and 6901, GP38-2's 2287, 2283, 2274 and 2289 with 57 loaded cars and 28 empties.
At about 5:50pm the two trains collided head on near mile post 85.55 just north of Ledger, at a closing speed of 87mph. The destruction was extensive. As well as the collision damage fire broke out from fuel spilt from the ruptured fuel tanks adding to the damage. All nine locomotives were destroyed along with 22 freight cars with 9 seriously damaged. 3 train crew lost their lives and 5 were injured, 4 seriously.
How could this happen?
The line was operated with Track Warrants. The Warrants were issued for each single line section which gave the driver the instruction to occupy that section up to the next stipulated crossing point. From Shelby, there was a crossing point at Naismith at mile post 90 8 and one at Ledger at mile post 79 5. Warrants would be issued for train going south from Shelby to either Naismith or Ledger depending on the traffic in the opposite direction and where the dispatcher wished for the trains to meet.
Track Warrants were issued by radio from the dispatching centre direct to the drivers. The 25000 miles of BN tracks was controlled from seven dispatching centres. Montana Division was controlled by the Seattle Centre 500 miles away in Oregon. Seattle Centre has 8 dispatchers on shift one being the branch dispatcher for Montana Division. The "branch" dispatcher sat alone in an air conditioned room with a console containing six video screens. a printer, three keyboards and a 30 channel radio unit as well as three telephones. Typically, some 55 trains would be dispatched in a 24 hour period which would entail an issue of a Track warrant every 10 minutes.
The dispatcher was aided by a computerised track warrant system which enabled the issued track warrants to be logged and displayed. The dispatcher on duty at the time of the accident had problems with this system and was not at all conversant with its functionality. In addition the radio communication was indifferent with loss of quality and interference.
When train 603 reached Dutton, 22 miles south of Ledger, the conductor called the Dispatcher for permission to continue. The dispatcher entering the proposed authority limit into the computer and talking to the conductor at the same time said "Proceed from Dutton toooo ---------" and added "whaaa" as a suitable destination was searched for on the screen. At that point the radio button was accidentally released giving a hissing note. The voice tape recording of the transactions records the destination as "toooowhaesh" Nine seconds later the dispatcher said "Ledger". The track warrant was given the number TW8851.
The dispatcher's confirmation of Ledger was overheard by the driver of train 7825 waiting at Dutton. He did not hear any confirmation by the crew of 603 as at that moment 603 passed him and drowned out the radio. As 603 left Dutton the conductor said to the driver "Was that West Yard Shelby" to which the driver replied "sounded like West Yard Shelby to me". When the dispatcher asked for confirmation by repeating the track warrant the conductor reported the "to" location as West Yard Shelby.
Inexplicably, the dispatcher accepted this, underlining the "to" location on the computer system as confirmation of the track warrant. The word Ledger was underlined despite the response from the conductor as being Shelby.
The dispatcher was now convinced that train 603 had only been authorised to Ledger and this was confirmed on the computer screen by the underlined entry.
Now the conductor of train 602 called for permission to proceed. With train 603 authorised to Ledger there was nothing to stop 602 being authorised to the same location and this was done by means of track warrant TW8860.
With this, the accident was sealed. The driver of train 603 did not stop at Ledger but continued on and the two trains met 6 miles beyond the point at which the trains should have passed.
The conductor of train 602 riding in GP30-2 2275 was the first to see the approaching train 603. He called a warning to the driver and jumped. The driver put the train into emergency and paused to call a warning to the brakemen in the rear before he too jumped. Three survived.
In train 603, the driver saw the headlights of train 602, shouted a warning to the conductor and after putting his train into emergency he too jumped. Both the driver and conductor survived.
It was clear that the driver of train 603 interpreted the bad transmission as "west" something. This annotation usually applies to Yards and it was therefore understandable that both the driver and conductor should jump to this conclusion. The confirmation of Shelby was accepted by the dispatcher which further confirmed in the minds of the train crew that they were correct in their assumption. It is likely that neither conductor or driver heard the word "Ledger" issued after the 9 second pause. The day was hot and the cab windows open and neither was expecting a single word confirmation.
Working procedures had got sloppy. The combination of bad word intonation, the simultaneous entry of data into computers while holding a conversation with train crew which inserted gaps in the transmission, bad radio practice (later analysis identified 15 bad practices in the use of the radios at Seattle), failure to ask for clarification of the destination by the crew and finally a computer system that permits confirmation by matching two different words all added to the event.
Had any one of these been removed then Ledger would not have happened.
The cost to Burlington Northern - $19 million.
Naismith 25 April, 1985
In an earlier accident just 5 miles away two trains met in a head-on collision one comprising BN locomotives 2208/1815/1950 and the other locomotives 2231/1778/1705/8071. This would appear to be at slow speed. Nevertheless, 2208 overwhelmed 1815 as the picture shows and 1778 has broken its back. The cause is not currently known.
More photographs from Richard C. Logan - Amtrak derailment at Saco, Montana 1988
This file last updated: Sunday, 31-Oct-1999 12:52:46 EST