‘Human error’ led to Balasore train tragedy, says report, pins fault on Signal & Telecommunication department

The Commissioner of Railway Safety says the triple-train collision on June 2 took place owing to lapses in the signalling-circuit alteration carried out at the Bahanaga Bazaar station, which resulted in wrong signal to Coromandel Express; report submitted to Railway Minister, Railway Board

July 03, 2023 10:46 pm | Updated July 04, 2023 08:06 pm IST - New Delhi/Chennai

A drone view shows derailed coaches after trains collided in Balasore district in Odisha on June 3, 2023.

A drone view shows derailed coaches after trains collided in Balasore district in Odisha on June 3, 2023. | Photo Credit: Reuters

Lapses at multiple levels in the Signal & Telecommunication (S&T) department led to the Balasore train accident on June 2, which left 291 dead and more than 900 injured, the Commission of Railway Safety said in its report submitted to the Railway Ministry last week.

Multiple sources in the Ministry told The Hindu that the primary responsibility had been pinned on the S&T department and that “human error” led to the triple-train collision in Odisha.

The Commissioner of Railway Safety, South Eastern Circle, A.M. Chowdhary, who conducted the inquiry into the circumstances that led to the accident, said in the report that the rear collision was due to “lapses in the signalling-circuit-alteration” carried out at the north signal goomty (of the Bahanaga Bazaar station). A goomty is a cabin that houses railway equipment.

The report pointed that the accident took place also due to lapses in the execution of the signalling work related to the replacement of electric lifting barrier at level crossing gate 94. On the ill-fated day of the accident that occurred at close to 6.40 p.m., the report said that the disconnection memo was issued at close to 4.20 p.m. for repair work to be carried out. On the same day, a reconnection memo was issued at 4.50 p.m. “After reconnection (which is ideally given after the work is complete) the S&T staff was still working on signal circuit,” the report said.

“These lapses resulted in wrong signalling to Train 12841 (Shalimar-Chennai Coromandel Express) where green signal was indicated for run though movement on UP mail line of the station, but crossover 17 A/B was set to UP loop line. This led to the train traversing on loop line, and eventual rear collision with the goods train,” it stated. There was also consequential derailment of train no. 12864 Yeshwantpur-Howrah Express in this course.

Sources said the 40-page report was submitted to Railway Minister Ashwini Vaishnaw’s office, Director-General Safety and the Railway Board. “The Railway Board has not yet accepted the report. If the report is accepted then multiple recommendations derived from the report will flow to different departments,” the sources added.

While the Railway Board studies the CRS report, the latest in line to be transferred is Rahul Agarwal, additional member (signal). “Even though Agarwal is in the top position, and is not involved in day-to-day functioning of signalling, the Ministry has viewed this accident with seriousness and has initiated multiple transfers,” a source said. Mr. Agarwal has been shifted to the Research Designs and Standards Organisation in the position of a special DG.

Speed: 126 km/h by Net Desk

Accident was avoidable

While it is still not clear whether the angle of “sabotage”, as earlier alleged by the Railway Ministry, was involved, sources said there was human error and total failure of the “fail-safe method”, leading to fault in signalling. Criminal negligence on the part of the supervisory staff, including the stationmaster on duty, is also being probed.

Referring to a similar incident in the past where there was a mismatch between the intended route set by signals and the actual route taken by a train on May 16, 2022 at the Bankranayabaz railway station under the Kharagpur Division of South Eastern Railway on account of wrong wiring and cable fault, the CRS said that had corrective measures been taken after the incident to address the issue of wrong wiring, the accident at the Bahanaga Bazaar railway station in Balasore would not have taken place.

Giving his recommendations post the inquiry to the Railway Ministry, Mr. Chowdhary said a drive should be launched to update the completion signalling wiring diagrams, other documents, and lettering of signalling circuits at site. Standard practices should be followed for carrying out signalling-modification work.

Before taking up modification of the signalling circuits, functional tests of the existing circuits, under alteration, should be done to ensure that the actual circuits are in accordance with the completed drawings. Any alteration to signalling circuits should be carried out with an approved circuit diagram, and in presence of an officer.

A separate team should be deployed for checking and testing of modified signalling circuits and functions before restoration/reconnection of the work. A competency certificate should be issued after a rigorous practical training for carrying out signalling modification work. Both execution, checking and testing of signalling-modification work should be done by staff in possession of the competency certificate, he said.

He said stationmasters should be made aware of possible faulty conditions of the electronic interlocking system that could be detected through indications on the panel.

Disaster response

Mr. Chowdhary said the initial disaster response of the railways should be faster. “Railway Board should review the system of disaster-response in the Zonal Railways, and also the co-ordination between the Zonal Railways and various Disaster-Response- Forces (National Disaster Response Force & State Disaster Response Force),” he said.

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