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June 22, 2022

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Croydon Tram Crash

Croydon tram crash: TfL admits to failings over fatal derailment

Transport for London (TfL) has indicated it will plead guilty to health and safety failings over the Croydon tram crash, which killed seven people, in November 2016.

Croydon Tram Crash

Sixty-nine passengers were on-board the tram, bound for Wimbledon via Croydon, when it over-turned and crashed near Sandilands tram stop in south London on 9 November 2016. Seven people were killed and more than 50 people injured.

During a hearing at Croydon Magistrates’ Court on 10 June, TfL indicated it will plead guilty to health and safety failings. Driver Alfred Dorris, 48, of Beckenham, also appeared and indicated a not guilty plea to an allegation of failing as an employee to take reasonable care of passengers.

The crash resulted in the deaths of Dane Chinnery, 19, Philip Logan, 52, Philip Seary, 57, Dorota Rynkiewicz, 35, and Robert Huxley, 63, all from New Addington, and Mark Smith, 35, and Donald Collett, 62, who were both from Croydon.

Nineteen of the 61 people hurt in the derailment suffered serious injuries.

Prosecutions against TfL, Mr Dorris and Tram Operations Limited (TOL) are being brought by regulator the Office of Rail and Road (ORR). TOL also indicated it will plead guilty to health and safety failings.

District Judge Nigel Dean released Mr Dorris on unconditional bail ahead of the next hearing at Croydon Crown Court on 8 July.

Following the hearing, TfL said its indication of a guilty plea would enable court proceedings to “come to a conclusion as promptly as possible”.

Andy Lord, TfL’s chief operating officer, said: “The Sandilands tragedy will never be forgotten and our thoughts remain with everyone affected.

“We have worked closely with the Rail Accident Investigation Branch (RAIB) and the ORR since November 2016 to introduce a new safety regime and implement all the recommendations from the organisations across the tram network.

“This has made the network safer for everyone and we continue to work tirelessly to ensure that such a tragedy could never occur again.”

Chief Inspector of Railways, Ian Prosser, explained the ORR had conducted an “extensive, detailed and thorough investigation” into the crash.

“The matter has now been sent to the Crown Court for a pre-trial hearing to case manage and list future hearings,” he said.

ORR opens prosecutions

In March 2022, Railway watchdog, the Office for Road and Rail (ORR), has opened prosecutions against the driver of the Croydon tram which crashed, killing seven people, in November 2016.

Transport for London (TfL) and the operator, Tram Operations Limited, are also facing action for breaches of health and safety law, along with the driver Alfred Dorris.

TfL is alleged by ORR to have failed to ensure the health and safety of passengers on the Croydon Tramlink network, so far as reasonably practicable.

Tram Operations Limited, which runs the tram service on TfL’s behalf, is also alleged to have failed to ensure the health and safety of passengers on the network, so far as reasonably practicable.

Driver Alfred Dorris has been accused of an alleged failure as an employee to take reasonable care of passengers whilst employed at work driving the tram.

ORR’s HM Chief Inspector of Railways Ian Prosser CBE said: “My thoughts are with the families of the seven people who lost their lives on 9 November 2016, the many more injured and everyone whose lives have been impacted as a result of this incident.

“Following a detailed and thorough investigation, we’ve taken the decision to prosecute Transport for London, Tram Operations Limited and driver Alfred Dorris for what we believe to be health and safety failings.

“We’ve made a fair, independent and objective assessment about what happened, and it is now for the court to consider if any health and safety law has been breached.”

The hearing is set to take place at Croydon Magistrates’ Court.

Inquest

In July 2021, the inquest into deaths concluded, with a jury ruling that the crash was an accident, with TfL paying compensation to the victims’ families, who have described a feeling of ‘being forgotten’ in the years since the crash.

The tram was travelling at nearly triple the speed limit when it derailed, and a Rail Accident Investigation Branch (RAIB) investigation said it was likely that the driver had ‘temporarily lost awareness’.

Mr Dorris is accused of “an alleged failure as an employee to take reasonable care of passengers whilst employed at work driving the tram”, the ORR said.

Simon French, Chief Inspector of the Rail Accident Investigation Branch, said Mr Dorris may have slipped into a period of “microsleep” before the derailment.

During the initial inquest, the foreman of the jury said: “The tram driver became disorientated, which caused loss of awareness in his surroundings, probably due to a lack of sleep.

“As a result of which, the driver failed to brake in time and drove his tram towards a tight curve at excessive speed.

“The tram left the rails and overturned on to its right side, as a result of which the deceased [were] ejected from the tram and killed.”

Prosecution

In November 2019, SHP reported that the driver, Alfred Dorris would be unlikely to face prosecution for manslaughter, due to a lack of evidence, according to the Crown Prosecution Service (CPS). Corporate manslaughter charges will also not be brought against Transport for London (TfL) or the operator Tram Operations Ltd. Prosecutors said the available evidence “does not support a prosecution.”

When it came off the tracks, before dawn and in heavy rain, the tram was travelling ‘significantly faster than allowed’, at almost four times the line’s speed limit. The official report into the crash concluded Mr Dorris, then aged 42, ‘probably dozed off’ moments before the tram left the tracks.

Some of the families of the victims were said to be devastated by the outcome of the report, and the time it took to complete.

Danielle Whetter, the granddaughter Philip Logan, one of the seven people killed, told the Croydon Guardian: “You can’t even put into words how we’re feeling, it’s horrible. We were expecting it because it has taken so long, but it’s a kick in the face.”

She criticised the British Transport Police for only released the information on the report to the families, an hour before publicly making it available to the media.

Croydon tram crash: Assessing the evidence

In order to prove manslaughter by gross negligence the prosecution need to establish that:

  • The defendant owed a duty of care to the person or persons who died;
  • By a negligent act or omission the defendant was in breach of the duty which he owed to the person or persons who died;
  • The negligent act or omission was a cause of death;
  • The negligence, which was a cause of death, amounts to gross negligence and is therefore a crime.

The CPS was satisfied that the first three elements of the offence could be established. Whilst driving a tram in public service with passengers on board, the driver either fell asleep or lost concentration to such a degree that he completely relinquished control of the driving task, with the result that the tram derailed. There was no evidence that the driver’s failure to drive the tram in a competent manner was the result of the sudden onset of a medical condition which rendered him incapable of carrying out his driving function or caused him to lose consciousness.

The fourth and final element of the offence is the need to prove that the conduct in question amounts to gross negligence, which the CPS concluded could not be proved in this case. In order for the conduct to be “gross”, the law requires it to be so reprehensible or bad in all the circumstances as to amount to a criminal act or omission, and not merely such as to give rise to civil liability for negligence. A conviction cannot be returned if the negligence is, or may have been, less than gross. Even serious mistakes are not to be equated with gross negligence. There must be something over and above negligence, even when there is a risk of death, in order for the conduct to be gross.4

Risk of overturning on curves ‘not properly understood’

At the time, the Rail Accident Investigation Branch (RAIB) found the risk of trams overturning on curves was ‘not properly understood‘ on the tramway and there were insufficient safety measures, according to its report into the Croydon tram crash.

Simon French, Chief Inspector of Rail Accidents, said: “The RAIB’s report into the accident at Sandilands will stand as the record of the events that led to the tram overturning and the terrible human consequences. Our careful analysis of the evidence, and identification of the causal and underlying factors, has enabled us to make a number of far-reaching recommendations. These will have a lasting impact on the way that the tramway industry manages its risk.

“Our careful analysis of the evidence, and identification of the causal and underlying factors, has enabled us to make a number of far-reaching recommendations. These will have a lasting impact on the way that the tramway industry manages its risk.”

French said there was recommended action in five main areas:

  • Modern technology to intervene when trams approach hazardous features too fast, or when drivers lose awareness of the driving task.
  • Tramways need to promote better awareness and management of the risk associated with tramway operations.
  • Work needs to be done to reduce the extent of injuries caused to passengers in serious tram accidents, and to make it easier for them to escape.
  • There need to be improvements to safety management systems, particularly encouraging a culture in which everyone feels able to report their own mistakes.
  • Finally, greater collaboration is needed across the tramway industry on matters relating to safety.

Recommendations

The RAIB made 15 recommendations intended to improve safety, including:

  • Technology, such as automatic braking and systems to monitor driver alertness;
  • Better understanding the risks associated with tramway operations, particularly when the tramway is not on a road, and the production of guidance on how these risks should be managed;
  • Improving the strength of doors and windows;
  • Improvements to safety management systems, particularly encouraging a culture in which everyone feels able to report their own mistakes;
  • Improvements to the tram operator’s safety management arrangements so as to encourage staff to report their own mistakes and other safety issues;
  • Reviewing how tramways are regulated;
  • A dedicated safety body for UK tramways.

Lost awareness

By far the most likely explanation of what happened in this case is that the driver fell asleep, or into a microsleep (a period of unintended, light sleep usually lasting for a few seconds) shortly before derailment. If this is what happened, it is clear that this was an unintended and involuntary act. There was no compelling evidence that the driver had done anything which he ought to have known could adversely affect his concentration or make him susceptible to falling asleep whilst driving the tram, nor was there evidence that he had culpably contributed to his negligent failure to drive the tram in a safe manner.

For these reasons the CPS has concluded that the offence of gross negligence manslaughter was not supported by the evidence.

The seven people killed in the crash were Dane Chinnery, 19, Philip Logan, 52, Philip Seary, 57, Dorota Rynkiewicz, 35, and Robert Huxley, 63, all from New Addington, and Mark Smith, 35 and Donald Collett, 62, both from Croydon. Family members of the victims sat in the public gallery to hear the verdict.

Jenny Hopkins, head of the CPS special crime and counter terrorism division, said investigators “fully recognise the impact this decision will have on families who have lost their loved ones.”

The CPS said there was no evidence for bringing corporate manslaughter charges as it found no defects in either the tram or the track which could have caused the derailment. According to the CPS, it is clear from the evidence that the sole cause of this tragic incident was the driver losing awareness and control of his driving task.

Legal perspective: Croydon tram disaster

Emma Evans and Claire Burrows at Brabners LLP share their legal observations following last week’s prosecutions following the Croydon tram disaster.

Croydon tram accident: Risk of overturning on curves “not properly understood”

The Rail Accident Investigation Branch (RAIB) found the risk of trams overturning on curves was “not properly understood” by the tramway and there were insufficient safety measures, according to its report into the Croydon tram crash last year.

Croydon tram crash: Union strike over safety device

Unions have claimed the health of tram drivers has been put at risk by a safety device installed to prevent future tram crashes.

Croydon tram crash: draft safety recommendations announced

Draft safety recommendations made ahead of final report.

Croydon tram crash driver “lost awareness”

The Rail Accident Investigation Branch (RAIB) has released its second interim report into a fatal accident involving a tram near Sandilands Junction, Croydon on 9 November 2016.

Croydon tram was going ‘three times over the speed limit’

A tram that derailed in Croydon last week killing seven people was going three and half times over the speed limit, investigators into the incident have said.

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Nigel Dupree
Nigel Dupree
2 years ago

Soooo, no one responsible in the “chain of causation” identifying “driver fatigue” as they primary cause of loss of life in this, so called, accidental loss of life where in the 21st Century work-stress fatigue exhibited in the exponential growth of presenteeism has become the norm for far too many in UK workplaces over the last couple of decades!

Nigel Harris
Nigel Harris
1 year ago

RAIB Report states 49 percent of drivers would brake at the second tunnel gap. So where do the other 51 percent brake, why this polarised braking strategy? Aside; remember this was autumn, leaves on the line.

I suspect a lack of supervision and understanding, on the part of competence/training management.

It’s not about speeding per se, braking points and rates of deceleration are more to the point.

Nigel Harris
Nigel Harris
1 year ago
Reply to  Nigel Harris

A braking point at the start of the tunnels would require around 5 percent g with respect to the falling gradient. The tram would arrive about 7 seconds later compered to the second tunnel gap.

Basic physics does not seem to be part of competence management rationale. The same is true for the railway. Just look at the RAIB Report regarding the Edinburgh Sleeper Incident. Some elementary calculation reveals all.