# Presentation: 396670

## This presentation is for illustrative and general educational purposes only and is not intended to substitute for the official MSHA Investigation Report analysis nor is it intended to provide the sole foundation, if any, for any related enforcement actions. 

## GENERAL INFORMATION

- Operator:		Miller Bros Coal LLC
- Mine:		Risner Branch #1 Mine
- Accident Date:	May 23, 2006
- Classification: 	Powered Haulage
- Location: 		Dist. 7, Breathitt County, Kentucky
- Mine Type: 	Surface Mine
- Employment:	35
- Production:	2,000 Tons/Day

## ACCIDENT DESCRIPTION

- At 9:50 a.m. on Tuesday, May 23, 2006, a 23-year old miner with 10 months of mining experience was fatally injured at Miller Bros Coal LLC, Risner Branch # 1 Mine. The accident occurred when the victim, driving a Mack water truck, lost control while descending a steep mine access road.

- Hydraulic Oil Puddle

## ROOT CAUSE ANALYSIS

_*Causal Factor*_: Management failed to task train the victim. An existing procedure, the approved mine training plan, was not followed.
_*Corrective Action*_: Management shall adhere to the existing training program and provide proper training. Also, management will assure that trainers are aware of the requirements affecting miners to be trained.
_*Causal Factor*_: The service brakes were not properly maintained and the engine brake was inoperative. Management did not have an effective procedure to ensure that mobile equipment brakes were properly maintained.
_*Corrective Action*_: Management shall implement a written procedure to provide for regular examinations, maintenance, and repairs of braking systems for each machine. Defects found that affect safety shall be reported to the foreman and shall be corrected before the machine is placed in service.

## ROOT CAUSE ANALYSIS cont’d.

_*Causal Factor*_: Management did not have a policy in place to ensure that adequate pre-operational checks were performed. Nor did they have a procedure to ensure that equipment safety defects were corrected prior to equipment use.
_*Corrective Action*_: Management shall establish a procedure to assure that adequate pre-operational checks are conducted on mobile equipment and to assure that any safety defects identified are corrected prior to operation.

## ENFORCEMENT ACTIONS

**§104(a) Citation No. 7526389** citing 30 C.F.R. 48.27(a), was issued to Miller Bros Coal LLC.
- The fatal accident investigation has revealed that the victim had not received task training before being assigned to drive an RD888SX Mack water truck VIN 2M2P282C7LC001170. This condition contributed to the occurrence of this fatal accident.
**§104(a) Citation No 7526390 **citing 30 C.F.R. 77.1605(b), was issued to Miller Bros Coal LLC.
- The fatal accident investigation has revealed the brakes were inadequate on the RD888SX Mack water truck VIN 2M2P282C7LC001170. This condition contributed to the occurrence of this fatal accident.

## ENFORCEMENT ACTIONS cont’d.

**§104(d) (1) Citation No.7526391** citing 30 C.F.R. 77.1606(c), was issued to Miller Bros Coal LLC.
- The fatal accident investigation has revealed the engine brake was inoperative on the RD888SX Mack water truck VIN 2M2P282C7LC001170. The investigation also revealed the mine superintendent knew of this condition and yet assigned the victim to operate this truck. This condition contributed to the occurrence of this fatal accident.
**§104(a) Citation No. 7526392** citing 30 C.F.R. 77.1606(a), was issued to Miller Bros Coal LLC.
- The fatal accident investigation revealed that an inadequate pre-operational inspection was made on the RD888SX Mack water truck VIN 2M2P282C7LC001170 on May 23, 2006. The pre-operational inspection failed to reveal that the driver side steering axle brake linings did not contact the brake drum when the brakes were applied. This condition contributed to the occurrence of the fatal accident

## BEST PRACTICES
Maintain equipment braking systems in good repair and adjustment. 
Conduct pre-operational checks to identify any defects that may affect the safe operation of equipment. 
Know the truck's capabilities, operating ranges, load-limits and safety features. 
Observe all speed limits and traffic rules. 
Ensure all grades and haulage roads are appropriate for haulage equipment being used. 
Provide and maintain adequate berms. 
Never operate a truck or moving machine without using a seat belt. 
Never operate equipment without first receiving the proper task training.

- Maintain equipment braking systems in good repair and adjustment.
- Conduct pre-operational checks to identify any defects that may affect the safe operation of equipment.
- Know the truck's capabilities, operating ranges, load-limits and safety features.
- Observe all speed limits and traffic rules.
- Ensure all grades and haulage roads are appropriate for haulage equipment being used.
- Provide and maintain adequate berms.
- Never operate a truck or moving machine without using a seat belt.
- Never operate equipment without first receiving the proper task training.