# Presentation: 891525

## 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:		The Pittsburg & Midway Coal Mining Co.
- Mine:		North River #1 Underground Mine Accident Date:	June 1, 2005
- Classification: 	Powered Haulage
- Location: 		Dist. 11, Tuscaloosa County, AL
- Mine Type: 	Underground
- Employment:	360
- Production:	3.5 million tons/year

## ACCIDENT DESCRIPTION

- On Wednesday, June 1, 2005, a 42-year old electrician (victim) was assigned as section electrician.  After arriving at the section, he talked to the section foreman about repairs to the outby roof bolting machine.  He then walked to the power center and closed the circuit breakers to energize the section equipment.

- Hydraulic Oil Puddle

## ACCIDENT DESCRIPTION

- The electrician then went to start the feeder.  However, brattice cloth was wrapped around the pick breaker, which he attempted to remove. As he did so, the pick breaker was energized, pulling him into it. The section foreman found him in the feeder shortly after 11:10 p.m. and shut the pick breaker off using the emergency stop button.

- Hydraulic Oil Puddle

## CONCLUSION

- The victim was fatally injured as he was removing brattice cloth from the feeder pick breaker. The pick breaker, which was not blocked against motion, was started, pulling him into the rotating drum.  Management's written procedure, which prohibits work on machinery unless power is removed and the machinery is blocked against motion, was not followed.

- Hydraulic Oil Puddle

## ROOT CAUSE ANALYSIS

_*Causal Factor*_: Maintenance work was conducted on a piece of machinery that was not blocked against motion and while the power was not off. While management had written procedures that required power to be removed and machinery blocked against motion, these procedures were not followed. _*Corrective Action*_: The entire workforce has been retrained in the procedures for removing the power and blocking the machine against motion prior to maintenance or work being performed on the machinery. Management should periodically confirm that the procedures are being followed. Additionally, delayed startup and alarms have been installed on the section feeders.

## ENFORCEMENT ACTION

- A §104(a) Citation was issued to the Pittsburgh & Midway Coal Mining Company, North River #1 Underground Mine, for a violation of §75.1725(c). A fatal accident occurred on June 1, 2005. The results of the investigation revealed that power was not removed and the machine was not blocked against motion prior to maintenance or repair on the Oldenburg Stamler Feeder, serial number 13713, located on the West 2 section.

## BEST PRACTICES
Establish and use Lock-Out/Tag-Out procedures. 
Ensure that power is off and cannot be accidentally restored to machinery before any work is performed on such equipment. 
Ensure that machinery is blocked against motion before performing maintenance or repairs. 
Always identify safety hazards before beginning any work task, no matter how small or seemingly insignificant. 
Always position yourself in the safest possible position. 

- Establish and use Lock-Out/Tag-Out procedures.
- Ensure that power is off and cannot be accidentally restored to machinery before any work is performed on such equipment.
- Ensure that machinery is blocked against motion before performing maintenance or repairs.
- Always identify safety hazards before beginning any work task, no matter how small or seemingly insignificant.
- Always position yourself in the safest possible position.