UNITED STATES
DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION
District 2
ACCIDENT INVESTIGATION REPORT
(Underground Coal Mine)
Fatal Machinery Accident
Mine 84 (ID No. 36-00958)
Eighty Four Mining, Co.
Eighty Four, Washington County, Pennsylvania
March 28, 1997
by
Thomas G. Todd
Mining Engineer
David Lewtag
Coal Mine Safety and Health Inspector (Electrical)
Robert C. Boring
Electrical Engineer
Technical Support
Approval and Certification Center
Originating Office - Mine Safety and Health Administration
New Stanton District Office
RR1, Box 736, Hunker, Pennsylvania 15639
Joseph J. Garcia, District Manager
GENERAL INFORMATION
Mine 84, operated by Eighty Four Mining Co., is located near
Eighty Four, Washington County, Pennsylvania. The mine is opened
by eight shafts and one slope into the Pittsburgh coal seam which
averages 70 inches in thickness. Employment is provided for 471
persons underground and 51 persons on the surface. The mine
produces coal three shifts per day six days per week.
One longwall section and six continuous-mining machine sections
produce an average of 26,000 raw tons daily. Coal is transported
from the face areas to the section loading point by a chain
conveyor on the longwall section and by shuttle cars on the
continuous-mining sections. Coal is then discharged onto a
series of belt conveyors and transported to the surface
preparation plant.
The principal officers of the operation are as follows:
Thomas W. Garges, Jr...........................Chairman of the Board
Robert A. McGregor.............................President and Chief Executive Officer
Thomas H. Simpson...............................Superintendent
The last Mine Safety and Health (MSHA) regular Safety and Health
Inspection at this mine was completed March 27, 1997.
DESCRIPTION OF ACCIDENT
At approximately 6:30 a.m., on Friday, March 28, 1997, Bob Rasel,
chief electrician, received a report that the Joy 12CM12-11BX
continuous-mining machine in the North Mains section would not
tram. Rasel then instructed Joseph Kois, shift maintenance
foreman, to check on this problem between shifts. At approxi-
mately 8:00 a.m., Kois entered the mine with Lewis A. Radomile
and George F. Galensky, mechanics, to begin troubleshooting and
repair of the continuous-mining machine in the North Mains
Section, before the day shift crew arrived. The day shift
production crews normally enter the mine at 9:00 a.m. and the
midnight crews arrive on the surface at 8:00 a.m.
After arriving at the North Mains Section, Kois, Radomile and
Galensky proceeded to the continuous-mining machine which was
broken down in the last open crosscut between the 0 and 1
entries. The machine was positioned parallel to the south rib,
with the cutting head facing west in the crosscut and approxi-
mately 2-3 feet between the machine and the rib. Radomile took
the radio remote control from the continuous-mining machine and
with all three men standing to the right rear of the continuous-mining machine, attempted to tram it forward. The machine
trammed forward a few feet and then stopped. Radomile then
attempted to tram the machine in reverse. The continuous-mining
machine trammed backward a few feet and stopped.
Radomile and Kois then moved to the left (south) side of the
machine to view the diagnostic light panel located behind a lens
in the tram contactor enclosure. Kois stood to the left of the
tram contactor enclosure in a bent position, to view the input
and output lights. Radomile crouched down to the right of the
tram contactor enclosure holding the remote control in front of
him. Radomile used the remote control to send signals to the
machine so that he and Kois could observe the input and output
lights flash on the diagnostic panel. Suddenly, the continuous-mining machine pivoted, swinging the rear end to the left,
pinning both Radomile and Kois between the machine and the rib.
The radio remote control was pushed into Radomile's chest and
abdomen. Radomile called out "Get this machine off of me." Kois
immediately yelled for Galensky to "knock the power" on the
continuous-mining machine. Galensky opened the main circuit
breaker in the operator's compartment of the continuous-mining
machine and then went to get help from other workers in the North
Mains Section.
Joe Richie and Mike Reese, underground utility men, who were
truss bolting in the No. 3 entry of the North Mains Section,
heard Galensky shouting for help. The two men proceeded toward
the No. 1 entry when they saw Galensky and were told that
Radomile was pinned by the continuous-mining machine and to get a
scoop. Richie immediately ran to get the section scoop located
approximately five crosscuts outby the accident scene. Reese ran
to the accident scene with Galensky, saw Radomile and Kois and
called to Radomile, but received no response. Reese then moved a
shuttle car out of the adjacent crosscut so that the scoop could
be brought in by Richie and then went for the section first aid
equipment and emergency supplies.
On his way to get the scoop, Richie called the dispatcher on the
mine phone to inform him of the accident and requested help. The
dispatcher recorded the call at 9:02 a.m. Richie then proceeded
to the scoop where he encountered Ed Montanari, mason, and Dale
Dimarzio, beltman, and informed them of the situation. Richie
started back to the accident scene in the scoop with Montanari
and Dimarzio following. On the way, the men met Reese with the
emergency supplies, helped load the supplies onto the scoop and
then hurried to the accident scene.
Kois, who was pinned in a standing position, was able to free
himself and helped in the attempt to free Radomile. When Richie
arrived at the accident scene with the scoop, Galensky and Kois
were trying to tram the continuous-mining machine away from the
victim, using the tram levers located in the operator's
compartment. The machine would not move. Montanari then got on
top of the continuous-mining machine to try to resuscitate
Radomile. Richie positioned the scoop bucket under the
continuous-mining machine and unsuccessfully attempted to move
it. Richie, a former continuous-mining machine operator, then
got out of the scoop and tried to move the continuous-mining
machine by using the on-board controls with no success. Reese
got in the scoop and moved the continuous-mining machine on his
second attempt. Montanari was then able to free Radomile.
Montanari, Kois and Galensky placed Radomile on the stretcher and
Montanari began cardiopulmonary resuscitation (CPR) on Radomile.
The men placed the stretcher on top of the scoop and traveled out
of the section while continuing CPR.
When they arrived at the track, the victim was placed on a
mantrip and transported out of the mine. CPR continued to be
administered until the men arrived on the surface at approxi-
mately 9:23 a.m., at which time emergency care and transport was
taken over by Bentworth Ambulance Service. Radomile was
transported to Washington Hospital where he was pronounced dead
at 10:11 a.m.
INVESTIGATION OF ACCIDENT
MSHA was notified at approximately 9:20 a.m. on March 28, 1997,
that a serious accident had occurred. MSHA arrived at the mine
at about 11:00 a.m. A 103(k) Order was issued to ensure the
safety of the miners until an investigation could be conducted.
MSHA and the Pennsylvania Department of Environmental Protection
jointly conducted the investigation with the assistance of mine
management personnel, miners and representatives of the miners.
PHYSICAL FACTORS INVOLVED
The investigation revealed the following factors relevant to the
occurrence of the accident:
- The North Mains section, MMU 053, is comprised of five
entries with a single return air split on the left side.
The entry height in the last open crosscut, between 0 and 1
entries, was approximately 90 inches.
- The continuous-mining machine involved was a Joy 12CM12-11BX,
Serial No. JM7476, Approval No. 2G-3334A-02.
- At approximately 6:00 a.m., on the midnight shift, March 28,
1997, while tramming in the last open crosscut of the North
Mains section, between 0 and 1 entries, the continuous-mining
machine stopped tramming and could not be moved. The tramming
problem was an intermittent problem which had been occurring
for approximately two months. Records indicated the following
repairs were previously made in an attempt to correct the problem:
3/19/97 - Replaced Remote Control
3/19/97 - Tram Overload Stuck Open
3/22/97 - Changed Tram Overload
3/24/97 - Changed Left Tram Heater Strip
- There were no other operational deficiencies reported with
the Joy continuous-mining machine. When the continuous-mining machine was in operation, it was sensitive to all
control commands and no erratic movement was encountered.
- The exact location of the continuous-mining machine prior to
the accident could not be determined. However, based on
information received during this investigation, there was
approximately 2-3 feet between the continuous-mining machine
and the south rib before the accident occurred.
After the accident occurred and the continuous-mining
machine had been moved and Radomile freed, there was 1.35
feet between the continuous-mining machine and south rib.
- The remote control was pinned against Radomile's chest and
abdomen, which prevented the use of the remote control to
move the continuous-mining machine away from Radomile. The
remote control unit measured 13 inches long by 11 inches
wide by 9 inches high.
- According to company records, Radomile was employed as an
underground mechanic for approximately 21 years. Statements
made by management and labor indicated Radomile was
knowledgeable in the maintenance and operation of
underground equipment including remote control continuous-mining
machines.
- At the time of the accident, there were no other radio
remote controls on or near the North Mains Section;
therefore, no other remote controls could have initiated
movement of the continuous-mining machine.
- The two maintenance employees were in a close space while
using the remote control to operate the various machine
functions. This location was dictated by the location of
the diagnostic panel. The diagnostic panel observation was
a normal part of the troubleshooting procedure.
- An examination of the operator's compartment on the
continuous-mining machine showed that the canopy was
lowered; the seat was removed; the area was filled with
extraneous materials; the panic bar was inoperable and the
foot switch, necessary to operate the continuous-mining
machine using the on-board controls, was disconnected.
Discussions with management and labor indicated that the
continuous-mining machine was intended to be operated only
by radio remote control.
- In an effort to identify the cause of the tram problem, the
following electrical components were removed from the
continuous- mining machine for examination and testing.
Tests to assess the performance of the machine's radio remote
control components (remote control station, transmitter,
receiver, and demultiplexer units) were conducted at the MSHA
Approval and Certification Center. The remote controls
functioned as expected after each switch closure on the remote
control station. Also, additional checks of the remote control
unit showed that whenever RF communication between the
transmitter and receiver was interrupted by disconnecting the
transmitter battery supply or by separating the transmitter from
the receiver beyond the range of the transmitter, the demulti-
plexer assembly sensed the loss of signal and indicated the
shut-down of machine functions as expected.
Tests to verify the electrical operation of the tram drive firing
package and of the gate drive power bridge units for the left and
right tram circuits were conducted by Magnetek, Inc. and
witnessed by Dave Lewetag and Robert Boring. No operational
defects were found.
After extensive field and laboratory tests, the cause of the
continuous-mining machine intermittent tram problems could not be
determined. However, after the above components had been
replaced, there were no further reports of tramming problems.
CONCLUSION
The cause of this accident was the result of several factors.
The continuous-mining machine had developed operational problems
that caused the tramming mechanism to respond intermittently to
the tram control when it was activated. The location of the
machine when it finally quit tramming during the production shift
placed the diagnostic panel side of the machine near the coal
rib. Normal troubleshooting procedures to determine the cause of
the tramming malfunction required observation of the diagnostic
panel for the information displayed. This caused Kois and
Radomile to be in a tight, vulnerable position between the
machine and rib. While troubleshooting, the continuous-mining
machine suddenly pivoted towards Kois and Radomile pinning them
against the rib. The inability to have another means to tram the
continuous-mining machine, other than the remote which was caught
with the victim, may have been a factor in the severity of the
injury. However, if the on-board controls had been operational,
they may not have worked due to the nature of the tramming
problem.
ENFORCEMENT ACTIONS
- A 103(k) Order was issued to ensure the safety of the miners
until an investigation could be conducted.
- There were no violations observed that contributed to the
accident.
- During a subsequent spot inspection, two 104(a) citations
were issued.
Respectfully submitted by:
Thomas G. Todd
David Lewetag
Robert Boring
Approved by:
Joseph J. Garcia
District Manager--Coal Mine
Safety and Health, District 2
Related Fatal Alert Bulletin: FAB97C07
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