The driver of an Ottawa bus that crashed into a Via Rail passenger train, killing five passengers and himself in 2013, was likely distracted by a video screen he was required to monitor on the job, the Transportation and Safety Board says.
A report released Wednesday also listed speed of the bus, the curve of the road ahead of the crossing, company practices and bus crashworthiness as contributing factors.
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There were 83 people on the OC Transpo bus when it crashed into passenger train No. 51 the morning of Sept. 18, 2013. Dozens of people were also injured in the collision at a level rail crossing near Fallowfield station in the south Ottawa suburb of Barrhaven.
Investigator Robert Johnston said the four-quadrant video monitor in the bus, which allows the driver to view the stairwell, upper deck, side doors and exterior of the bus, is a visual distraction.
Drivers of double-decker buses are required to monitor the upper deck to ensure no passengers are standing while the bus is moving.
The report detailed that bus driver Dave Woodard was also likely distracted by passengers on the lower deck discussing the seating availability on the upper deck just before the crash.
"I'd like to be clear that this accident goes far beyond the actions of any one individual. In fact, given the same circumstances, this accident could have happened to just about any driver," Johnston said.
The Transportation Safety Board of Canada made five recommendations, after reconstructing and analyzing the 2013 crash.
Four recommendations were directed to the Department of Transport.
- Develop comprehensive guidelines for the installation and use of in-vehicle video monitor displays, in consultation with the provinces, to reduce the risk of driver distraction.
- Develop and implement crashworthiness standards for passenger buses to reduce the risk of injury.
- Require passenger buses to be equipped with dedicated, crashworthy event data recorders.
- Provide specific guidance as to when grade separation should be considered.
The final recommendation was that the City of Ottawa should reconsider the need for grade separation at the Woodroffe Avenue, Transitway and Fallowfield Road level crossings.
Before the report was released, the city and Via Rail were given the opportunity to submit confidential comments for review by the TSB, which had the option to revise its report if necessary.
Minister of Transport Marc Garneau issued a statement Wednesday afternoon thanking the Transportation Safety Board for "tireless work investigating accidents like these in order to learn from them so that they do not happen again."
He said Transport Canada will review the recommendations along with provincial and territorial partners.
"I extend my heartfelt thoughts to the families and victims of this accident. While nothing can bring back the lives of those we lost, I do hope this report can provide some closure on the tragic events of that day."
Bus speeding at time of crash
Seconds before the crash, passengers on the upper and lower deck began shouting to warn the driver of the train up ahead, the report detailed.
The bus was travelling 67.6 km/h when the brakes were first applied, three seconds before impact, in an area where the posted limit was 60 km/h, according to the report. The stopping distance was increased because the driver did not initially apply the full force, the report said.
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The report said that if the bus had been travelling the speed limit, it should have been able to stop before the rail crossing.
The report also detailed that:
- No drugs or alcohol were found in Woodard's system, and he did not have a medical conditions that contributed the crash.
- The bus was in proper working order, and the TSB found no issues with the operation of the train or crossing signals or the condition of the track.