Rail transportation safety recommendation R00-01

Canadian National’s track and turnout inspection reporting and supervisory review procedures

The Transportation Safety Board of Canada recommends that a system-wide assessment of Canadian National's track and turnout inspection reporting and supervisory review procedures be conducted by either Transport Canada or the railway.

Rail transportation safety investigation report
Date the recommendation was issued
Date of the latest response
May 2004
Date of the latest assessment
May 2004
Rating of the latest response
Fully Satisfactory
File status
Closed

Summary of the occurrence

On 01 March 1998, at approximately 2359 eastern standard time, Canadian National westward freight train No. Q-107-11-28, travelling from Montreal to Toronto, derailed eight cars at Mile 127.54 of the Kingston Subdivision near Lyn, Ontario. Two of the derailed cars contained dangerous goods; however, no product was lost. The derailment occurred while the train was passing through a crossover. Derailed equipment fouled the two main tracks. 

The Board determined that the derailment occurred when a car wheel climbed over a defective switch point. This switch point became defective due to the separation or "chipping" of large sections of the running surface along the point of the switch. The application of existing maintenance and inspection practices did not prompt the required remedial action.

Rationale for the recommendation

In consideration of the facts of this occurrence the Board recommended that:

A system-wide assessment of Canadian National's track and turnout inspection reporting and supervisory review procedures be conducted by either Transport Canada or the railway.
TSB Recommendation R00-01

A response from the Minister has been received. The extent to which the recommendations have been addressed is assessed below.

Previous responses and assessments

September 2000: Board Assessment of Response to R00-01 (Satisfactory Intent)

The effectiveness of the Board's recommendation cannot be ascertained until the revised SPC 3500 is issued by CN. In consideration that TC has discussed the inspection of turnouts with CN to ensure understanding and appropriate action to guarantee safe turnout conditions and although CN is reviewing its SPC 3500 for universal applicability between CN and IC, there is no mention of a system wide assessment of the procedures from a quality assurance or safety perspective. Therefore, until the assessment is completed and the CN SPC 3500 is revised, the response to Recommendation R00-01 is assessed as having "Satisfactory Intent" only.

Latest response and assessment

May 2004: Additional Response from Transport Canada

CN and TC inspectors have completed a review and initiated changes to inspection and reporting and supervisory procedures. CN SPC 3500 has been revised to prescribe the following:

59. On point ends which are chipped or broken the thickness must not exceed 3/16” (5 mm).

May 2004: Board Reassessment of Response to R00-01 (Fully Satisfactory)

As CN and TC have addressed the safety deficiency the Board reassesses the response to Recommendation R00-01 as being "Fully Satisfactory".

File status

As CN and TC have addressed the safety deficiency the Board reassesses the response to Recommendation R00-01 as being "Fully Satisfactory".