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UNITED STATES
DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION

District 7

Accident Investigation Report
(Underground Coal Mine)

Fatal Machinery Accident

No. 74 (ID: 15-18022)
Leeco, Inc.
Slemp, Perry County, Kentucky

January 21, 2000

by

Dennis J. Cotton
Mining Engineer

Originating Office - Mine Safety and Health Administration
Coal Mine Safety and Health
H.C. 66, Box 1699, Barbourville, Kentucky 40906
Joseph W. Pavlovich, District Manager



Overview


At approximately 10:45 a.m. on Friday, January 21, 2000, a fatal machinery accident occurred on the 001 working section of the Leeco, Inc., No. 74 mine near Slemp, Perry County, Kentucky. Eddie Harris, a 44 year old continuous mining machine operator with 25 years experience, suffered fatal injuries when he came in contact with the rotating cutter head at the front of the 12-12 CM Joy continuous mining machine. The working section was engaged in retreat mining and was in the process of removing belt (´┐Żbelting back') at the time of the accident. The victim's position, other materials found and examined at the front of the continuous mining machine and the corroborating statement of two of the mine employees, indicated that he was in the process of replacing worn or damaged bits to the cutter head.

The victim came in contact with the rotating cutter head of the continuous mining machine as a result of work being performed on the machine prior to the mine operator's ensuring that the machine was properly de-energized.

General Information


The No. 74 mine, located in Slemp, Perry County, Kentucky, is operated by Leeco, Inc., a subsidiary of James River Coal Company. The mine employees 74 persons underground and two persons on the surface. The mine is opened by three drift openings into the Hazard No. 4 seam which averages 48 inches in thickness. The mine produces coal two shifts per day on two working sections, five days per week. Maintenance and support work are performed on the third shift.

The mine produces an average of 1,800 tons of coal daily. Coal is transported from the face utilizing Long-Airdox continuous haulage system(s). The roof is supported during advance mining by Fletcher roof bolting machines equipped with automated temporary roof support (ATRS) systems. During retreat mining the roof is controlled utilizing timbers installed according to the approved roof control plan. Currently the mine consists of two working sections, main entries, panels, and two gob areas created by pillar extraction. The land is owned by Kentucky River Coal Corporation.

The principal officers of the operation are as follows:
Joseph G. Evans .......... President
Fred Shannon .......... Safety Director
James B. Crawford .......... Chief Executive Officer
James D. Dotson .......... Director
The last Mine Safety and Health Administration (MSHA) regular Safety and Health Inspection (AAA) was completed on December 30, 1999.

DESCRIPTION OF THE ACCIDENT


The first shift began at 6:30 a.m., as scheduled, on January 21, 2000. Don Hacker, Section Foreman, and his crew of eight (8) miners began work by traveling from the surface to the working section (MMU 001). The third shift had removed an in-line conveyor belt head drive during their shift and were completing the final work when the day shift crew arrived on the section.

The first shift crew began mining at 7:00 a.m. in the No. 4 pillar in the 51st crosscut. The section ´┐Żbelted back' once during the shift and continued retreat mining until 10:45 a.m., the time of the accident. Prior to the accident, the continuous mining machine had pushed the face conveyor belt structure (Lo-Lo) back in order to remove conveyor belt. Hacker, the Section Foreman, who had been in the face area supervising the pushing of the lo-lo belt structure, stated he left Eddie Harris, victim and Continuous Mining Machine Operator, and William G. Bumgardner, Certified Electrician, in front of the continuous mining machine to speak with Hershell Asher, Superintendent, on the mine phone. The mine phone was located four (4) crosscuts outby the location of the continuous mining machine. Two roof bolting machine operators, Terry France and Tinsley Maggard, stated during interviews that they were in the immediate area and in the process of installing the required timbers to continue retreat mining.

According to statements made in interviews, Harris had requested that Bumgardner de-energize the on-board circuit breaker of the machine. Bumgardner stated he was proceeding to the master station of the continuous mining machine to de-energize the machine when he heard the pump motor start up, followed by the engaging of the cutter motors. He turned and looked to the front of the machine and saw Harris in contact with the cutter head. He immediately switched the on-board circuit breaker to the "off" position, de-energizing the machine.

Hacker, the section foreman, was immediately summoned to the scene by Bumgardner and it was determined that Harris had received fatal injuries. Hacker and Bumgardner remained with the victim and the remaining crew members were withdrawn from the accident scene and mine management personnel were summoned to the site of the accident. Clyde Collins, General Superintendent, Fred Shannon, Safety Director, and Jeff Halcomb, General Mine Foreman arrived at the scene in response to the accident. Harris was placed onto a mantrip and taken to the surface. The victim was pronounced dead on the scene by Clayton Brown, Deputy Coroner of Perry Co., at 12:23 p.m.

INVESTIGATION OF THE ACCIDENT


At approximately 11:00 a.m. on January 21, 2000, approximately 15 minutes after the accident, Robert Rhea Supervisory Coal Mine Safety and Health Inspector of MSHA's Harlan, Kentucky Field Office, was notified by Hershell Asher, Superintendent, that a serious accident had occurred. An MSHA initial response team, comprised of Rhea, Donald A. Roby CMS&H Inspector, and Elmer Thomas CMS&H Inspector, was assembled and traveled to the mine, arriving at 12:00 noon. A 103-k Order was issued to ensure the safety of the miners until an investigation could be conducted. An Accident Investigation Team consisting of Dennis Cotton, Mining Engineer, Foster Brock CMS&H Specialist - Electrical and Jim Langley, Supervisory Coal Mine Safety and Health Inspector was dispatched to the mine to begin the investigation. Personnel from MSHA's Division of Safety and Technical Support Group assisted in the on-site investigation and the testing and evaluation of machine components.

Mine Safety and Health Administration (MSHA) and Kentucky Department of Mines and Minerals (KDMM) jointly conducted the investigation with the assistance of mine management and the miners. Initial interviews were conducted immediately of the nine (9) employees on the surface at the mine site who had been on the working section at the time of the accident. Formal interviews were conducted in conjunction with the KDMM on January 22, 2000.

During the investigation components of the continuous mining machine's radio remote control system were collected and taken for evaluation at MSHA's Approval and Certification Center in Triadelphia, West Virginia.

A list of those who were present and/or participated in the investigation is included as Appendix A.

DISCUSSION


Interviews were conducted with all persons known to be on the working section to determine the facts relating to the accident. According to statements the only mechanical problem experienced by the continuous mining machine on that shift was the on-board circuit breaker which had tripped on two (2) occasions for undetermined reasons. The circuit breaker had been reset and mining continued without other incidents.

Statements obtained from second shift personnel indicated that the continuous mining machine had a past history of unintentional startup of the cutter head, evidenced on two separate occasions: Bill Allen, Continuous Mining Machine Operator on the second shift, stated that two to three weeks prior to the accident the cutter head unintentionally started on the continuous mining machine. On one occurrence this reportedly occurred without starting the cutter head from the remote control station. Allen stated that he was making a "clean-up" run in a cut when the cutter head began running unexpectedly. He stated that the problem was determined to be caused by a faulty de-energization switch which was mounted on of the mobile bridge carriers. The faulty switch was replaced and the problem had not reoccurred. There were no maintenance records available to determine the exact date the repair work had been conducted.

Scott Maggard, Electrician on the second shift, stated that the cutter head had unintentionally rotated on another occasion while he was examining the cable for the de-energization switch, which extended from the front mobile bridge carrier to the continuous mining machine. Maggard stated that he had not known of a reoccurrence of the unintentional startup.

An in-depth investigation was conducted at MSHA's Approval and Certification Center in order to determine if the radio remote control system and all other related machine components were functioning properly (see Appendix E). Testing of the remote control system's Remote Control Multiplexer, Radio Transmitter, RF Receiver, and Demultiplexer Control Panel demonstrated that all functioned properly. (Note: Some damage to the Remote Control Multiplexer Unit was judged to have been sustained during the accident.)

Cross activation of the miner by other radio sources was ruled out because the 002 Section continuous miner was operating with a different remote control system (Forced Potato, Inc.) on a different frequency (450 MHz) approximately 6,200 feet away.

Functional testing of the continuous miner conducted underground demonstrated the machine to be functioning properly except for the "Pump" start function. However, a "jumper" wire was found installed between Terminals 9 and 10 of the Demultiplexer Control Panel. Also, the Demultiplexer Control Panel was not installed in the explosion proof enclosure specified on the approval drawings. The effect of the jumper was to bypass the safety interlocking requiring turning the "Pump-Traction" switch to the "Start" position to turn the pump on. The presence of the jumper wire does not bypass the safety feature requiring the two-handed operation of turning both the "Pump-Traction" switch and the "Cutter Motors" switch to their start positions to start the cutter head.

No unintentional start-up of the cutter head motors was experienced during any of the on-site testing of the continuous mining machine or during later testing of the machine components configured as found during the investigation. No explanation could be found for the two reported unintentional startup incidents prior to the accident. Previously reported malfunctioning of the radio remote control system was evaluated by investigators and no evidence was found that the malfunctioning of the radio remote control system or any related machine components, contributed to the fatality.

An evaluation of the cutter head bits in the cutter head was conducted to determine if any new bits were present prior to the accident. According to statements made in the interviews, the last time that worn bits were known to be replaced in the machine's head was at the last belt move. Since the last belt move, nine lifts of coal had been mined from the No. 3 pillar, right wall, and the No. 4 pillar.

A laboratory evaluation was conducted by the Engineering and Testing Division (E&TD), Approval and Certification Center (A&CC) of all the cutter head bits taken during the investigation. The purpose of the evaluation was to determine if the bits taken from the cutter head of the continuous mining machine involved in the accident had been used to cut coal or had been replaced immediately prior to the accident. The laboratory evaluation involved a microscopic examination of the cutter head bits.

Initially, nine (9) cutter head bits were taken for laboratory analysis. Five (5) of the bits were removed from the cutter head of the continuous mining machine involved in the accident. Three (3) of the bits were unused and were removed from a bucket of bits located near the continuous mining machine and were submitted as control samples. Another (1) bit, which appeared to be worn, was found and removed from the right rib in the No. 3 entry. Additional reference bits were removed at a later date with a known amount of usage from cutting coal.

The results of the microscopic examination of the bits taken from the cutter head revealed that two of the five bits exhibited scratched surfaces indicating that they had in fact, been used. However, no identifiable differences between the unused bits and three of the five bits removed from the cutter head following the accident were identified. An additional reference frame was required to confirm the analysis. A comparison of the bits removed from the cutter head after the accident and the reference bits used to make only one cut of coal was made by microscopic examination. The bits which were known to have mined one cut of coal exhibited a certain degree of wear. Based upon these findings, the evidence at the scene and the corroborating statements of two of the miners it is apparent that the cutter head bits had been or were being installed immediately prior to Bumgardner de-energizing the continuous mining machine.

Based upon interviews conducted with the employees on the 001 working section, there was conflicting testimony as to the activity of the victim at the time of the accident. Two witnesses, Terry France and Tinsley Maggard, stated that immediately prior to the accident Harris was kneeling in front of the cutter head of the continuous mining machine and appeared to be replacing worn cutter head bits. William G. Bumgardner (Electrician) stated that Harris was standing in front of the continuous mining machine and that he had been instructed by Harris to switch the on-board circuit breaker to the "off" position to de-energize the machine prior to replacing the worn cutter head bits.

PHYSICAL FACTORS INVOLVED


The following physical factors were determined to be relevant to the occurrence of the accident. 1. The accident occurred underground on the 001 MMU at the Leeco, Inc., No. 74 mine, MSHA I.D. No. 15-18022.

2. The 12CM12-10BX Joy Continuous Mining Machine (Serial No. JM3325), being operated on the 001 MMU, was operated by a molded plastic remote control station on a frequency of 318 MHz powered by a permissible cap lamp battery.

3. The "Pump-Traction" switch was found in the "Fast" position, and the "Cutter Motors" switch in the "Run" position after the accident.

4. The 12CM12-10BX CM Joy Continuous Mining Machine (Serial No. JM3325), being operated on the 001 MMU, was being operated with the following remote control system:
A. Matric Limited Remote Control Multiplexer, Model 205-376, P/N 601843-172, S/N 32203U002E, MSHA IA-460. A jumper wire was found between terminal 9 and 10 on the unit. The effect of the jumper was to bypass the pump start circuits which allowed startup of the pump with application of machine power. Additional testing of this unit was conducted by MSHA at the facilities of Joy Manufacturing Company (see Discussion).

B. Matric Limited Permissible Radio Transmitter, Model 500-256 (318MHz), P/N 601843-136, S/N 25604P015C, MSHA Approval 9B-170-1.

C. Matric Limited Cavity RF Receiver, Model 500-255 (318 MHz), P/N 601843-0135, S/N 25504N07B, MSHA IA-461-1.

D. Matric Limited Demultiplexer Control Panel, Model 500-200, P/N 601843-86 Rev. B, S/N 20011J21, MSHA IA-457.

E. Joy Manufacturing Co. Master Station Explosion Proof Enclosure, Assembly No. 571390-3430, Joy 1006564-2222, MSHA Certification No. X/P 3340-0, Control Panel Unit No. 500183-498.
5. A 14CM8 Joy Continuous Mining Machine was being operated on the 002 MMU using a Forced Potato, Inc. remote control system (MSHA Approval 9B204-0) on a frequency of 458 MHz powered by an internal power source. The 002 MMU was approximately 6,200 feet away from the 001 MMU at the time of the accident.

6. The victim was positioned in front of the 12CM12-10BX Joy Continuous Mining Machine (serial no. JM3325) 995VAC when the accident occurred.

7. The following items were discovered under the cutter head at the edge of the pan of the continuous mining machine after the accident: a methane detector case, a MSA W65 filter self rescuer, a pick hammer, and a piece of cloth.

8. Immediately to the right of the victim and the cutter head the following items were found lying on the mine floor: a package of clips for cutter head bits, a partial box of cutter head bits, a dust respirator, one knee pad, and the antenna for the radio transmitter. One discarded miner cutter head bit was found along the right coal rib which was fully exposed and on top of the gob on the mine floor. Other discarded cutter head miner bits were observed along the right rib which were in the gob on the mine floor.

CONCLUSION


The victim came in contact with the rotating cutter head of the continuous mining machine as a result of work being performed on the machine prior to the mine operator's ensuring that the machine was properly de-energized.

ENFORCEMENT ACTIONS


1. A 103 (k) Order, No. 7460034, was issued to ensure the safety of the miners until an investigation could be conducted.

2. A 104(a) Citation, No. 7507813, was issued for violation of Title 30, Part 75.1725(c), the operator failed to de-energize electrical equipment before work was done on such equipment. The continuous mining machine operator came into contact with the cutter head of the continuous mining machine as a result of performing work on the machine before the circuit breaker supplying electrical power to the machine was de-energized resulting in fatal injuries.


Related Fatal Alert Bulletin:
 FAB00C01




APPENDIX A

Listed Below Are Those Persons Who Participated and/or Were Present During the Investigation:

List of persons furnishing information and/or present during the investigation. Leeco, Inc. - Officials
Joseph G. Evans ............... President
Clyde Collins ............... General Superintendent
Hershell Asher ............... Superintendent
Fred Shannon ............... Safety Director
Kevin Bruner ............... Assistant Safety Director
Jeff Halcomb ............... General Mine Foreman
Willie Collins ............... Maintenance Chief
Don Hacker ............... Section Foreman (First Shift)
William G. Bumgardner ............... Electrician
Scott Maggard ............... Electrician
Marco Rajkovich ............... Attorney
Leeco, Inc. - Employees
Terry France ............... Roof Bolting Machine Operator
Tinsley Maggard ............... Roof Bolting Machine Operator
Lonnie Caldwell ............... Mobile Bridge Carrier Operator
Scott Loughran ............... Mobile Bridge Carrier Operator
Jeffery Asher ............... Scoop Operator
Alex B. Hensley ............... Conveyor Operator
Clifton Lewis, Jr. ............... Scoop Operator
Bill Allen ............... Continuous Miner Operator (Second Shift)
Kentucky Department of Mines and Minerals
Tracy Stumbo ............... Chief Accident Investigator
David A. Mullins ............... Accident Investigator
Johnny E. Greene ............... Accident Investigator
Randy Campbell ............... Electrical Inspector, Accident Investigator
Johnnie Walker ............... Electrical Inspector, Accident Investigator
David Johnson ............... Chief Electrical Inspector
Mine Safety and Health Administration
John M. Pyles ............... Assistant District Manager for Inspection Division, Barbourville, KY
Robert Rhea ............... Supervisory CMS&H Inspector
Jim Langley ............... Supervisory CMS&H Inspector
Dennis J. Cotton ............... Mining Engineer/Accident Investigator
Foster Brock, Jr. ............... CMS&H Inspector/Electrical Specialist
Donald A. Roby ............... CMS&H Inspector
Elmer Thomas ............... CMS&H Inspector
William Crocco ............... Mine Safety and Health Specialist Division of Safety
Jerry D. Dransite ............... Electrical Engineer, Electrical Safety Division Approval and Certification Center
Robert Boring ............... Electrical Engineer, Electrical Safety Division Approval and Certification Center
Chad Huntley ............... Electrical Engineer, Electrical Safety Division Approval and Certification Center
Michael P. Snider ............... Chief, Engineering Support Branch Approval and Certification Center
Richard J. Dunst ............... Chemical Engineer, Materials and Explosives Testing Branch Approval and Certification Center
Joseph Luckett ............... Attorney-Office of the Solicitor