UNITED STATES CONSUMER

PRODUCT

SAFETY COMMISSION Petitioners: The Safety Institute Carol Pollack-Nelson,

Ph.D., Independent

Safety Consulting Cash, Krugler

& Fredericks,

LLC

F''' f\

=-y- ot£)

w PETITION

FOR RECALL

TO REPAIR/RETROFIT

AND RULEMltKING -----

,

, m_m___

**~v,**

1J Petitioners,

The Safety Institute,

Carol Pollack-Nelson,

and Cash, Krugler

& **Fr~geri~,** LLC (hereinafter "Petitioners"),

pursuant

to

16 C.F

.R.

§ 1051 Procedure

for PetS:tionia;g for Rulemaking,

request

that

the U.S. Consumer

Product

Safety Commission

inlfiate_o mandatory rulemaking

to set safety standards

for

the design

and installation

of residential elevators

to eliminate excessive

space between

the elevator

car door/gate

(interior

door) and hoistway

or swing

door (exterior

door). In many home elevators,

and similar versions

found

in older apartment

and commercial buildings,

the clearance

between

the two doors

is large enough

to allow children

as old

as 12 years

to

fit between

them. When

the elevator

is called

to another

floor,

the hoistway door automatically

locks,

and

the child's

body

is carried

along

with

the elevator

car until it meets

the obstruction

of the
sill, where

the child's

body usually

the head- is crushed. Industry

has been aware

of these dangers

for more

than

80 years,

but

has failed

to adopt an appropriate,

safe voluntary

standard

to address

this design

flaw.

At least

55 child deaths

have occurred

since

1967;

the most recent known

death occurred

in 2009.

Since 2010,

there

have been three serious permanent debilitating

injuries resulting

from
child entrapment. A mandatory

standard

is required because

the gap between

the doors

that

is permitted

by the voluntary

standard

has caused

deaths

and serious injuries.

Efforts

to work through

the voluntary standards

process,

as described

in this petition,

have

not adequately

addressed the defect

and therefore,

have

not reduced

the risk

of harm.

In fact,

35 years

ago,

the voluntary standards committee

actually changed

the dimensions

for residential

elevators from

a maximum

gap

of

4 inches between

the two doors,

to the less-safe

5-inch

gap. The petitioners

also request

that

the U.S. Consumer

Product

Safety Commission

order

a recall

(to repair)

of

all residential

elevators

that allow

a gap between

the hoistway

and swing

doors

of more

than

4 inches. Recalled defective

doors should

be retrofitted

with

a device

that would

either detect

the presence

of

a child

or small

adult

in the door

path

and prevent

the elevator

from operating

or physically

fill
the gap

to prevent children

and small adults from

becoming entrapped. Industry Knowledge

of Design Defect The elevator industry

has known

about

the entrapment

hazard

in swing

door elevators

foratleasteightdecades.In1931,OtisElevatorCompanyobtainedapatentforaninexpensive6-inchspaceguardtopreventchildentrapment.In1932,Otissentalettertoitscustomerswarningthemaboutthishazard.1In1943,thecompanyfollowedup;anOtisGeneralServiceManagersentaninter-officememoreiteratingthedangersofexcessivespacebetweenthehoistwaydoorsandthethreshold.Theelevatorcompanywasconcernedthatbuildingsmayhavechangedhandssincetheoriginalalertwentout,leavingthecurrentownersunawareofthethreat,orthattheoriginalownerignoredthewarningorinstalledaspaceshield,whichfillsthegapandmakesitimpossibleforachildtofitinthespace,butfailedtoremoveprojectinghardware.2In1955,thefirstResidenceElevatorCodeaddressedtheentrapmentissue.ASMEElevatorSafetyCodelimiteddistancebetweenthedoorstoamaximumof4inches.(Atthetime,therewerenoaccordiondoorsonelevatorsthiswasaflat-to-flatmeasurement.)3But,in1981,forunknownreasons,theASMEchangedtheruletowidenthegap,allowingamaximumof5inchesbetweenthedoors.ASMEstandardA17.1,Sec.5.3.1.7.2states:ClearanceBetweenHoistwayDoorsorGatesandLandingSillsandCarDoorsorGates.Theclearancebetweenthehoistwaydoorsorgatesandthehoistwayedgeofthelandingsillshallnotexceed75mm(3in).Thedistancebetweenthehoistwayfaceofthelandingdoororgateandthecardoororgateshallnotexceed125mm(5in.).4In1950,OtisGeneralServiceManageragainnoted"recentoccurrenceofaccidents"causedbyexcessivespacebetweenthehoistwayandelevatorcardoors,suggestingthatmanyelevatorsremainedunremedied.5A1963memonotedtheriseinliabilityclaimsagainstthecompanyandsuggestedasurveyofallOtiselevatorsunderaservicecontractwithsub-standardsafetyconditions-includingtheconditionoftoomuchspacebetweenthehoistwayandelevatordoors.6Intheearly1990s,theresidentialelevatorindustryintroducedaccordiondoorsforhomeelevators;thisonlyincreasedtheentrapmenthazard.Theaccordiondoor'sflexibilityanditspeaksandvalleyscreateexcessspace,aboveandbeyondthe5-inchgappermittedby1Subject:AutomaticElevatorSpaceconditionsBetweentheHoistwayDoorsandtheThreshold;H.R.Otto;OtisElevatorCompany;September30,1943.2Subject:AutomaticElevatorSpaceconditionsBetweentheHoistwayDoorsandtheThreshold;H.R.Otto;OtisElevatorCompany;September30,19433AmericanStandardSafetyCodeforElevators;PrivateResidentElevatorsandInclinedLifts;AmericanSocietyofMechanicalEngineers;June15,19554StandardA17.1,Sec.5.3.1.7.2;ASME5TerryGarmeySpeaksAboutTuckerSmithandtheCampaigntoRepair4,000GuardsonOTISElevators;SmithElliottSmith&Garmey;http://www.fairwaming.org/wpcontent/uploads/2013/12/TuckerSmithArticle.pdf6TerryGarmeySpeaksAboutTuckerSmithandtheCampaigntoRepair4,000GuardsonOTISElevators;SmithElliottSmith&Garmey:http://www.fairwaming.org/wpcontent/uploads/2013/12/TuckerSmithArticle.pdftheASMEStandard.Achildorsmalladultcanfitintothosevalleys,andwhenthehoistway(exterior)doorisclosedandtheelevatormoves,theycanbeseriouslyinjuredorkilled.Someelevatordesigners,installersandotherspurportedlyfollowingtheASMEA17.15-inchruledonottakeintoaccounttheextraspacecreatedbythevalleys,which,ineffect,canincreasethegapbyanadditionalthreeinchesormore.In2003,theOtisElevatorCompany,aspartofasettlementwiththefamilyofaneightyear-oldboywhodiedafterbecomingentrappedbetweenelevatordoors,launchedanationalsafetycampaign,equipping4,000elevatorswithspaceguards.OtisalsosentletterstoothermanufacturersurgingthemtocheckthesizeofthegapbetweenelevatordoorsandofferedfreespaceguardsforOtis-manufacturedelevators:7Overtheyears,anumberoftragicaccidentshaveoccurredonelevatorswithswing-typehoistwaydoors,includingthedeathsofnumerouschildren.Theseaccidentshavedemonstratedthesafety riskposedbyelevatorswithswingdoors.Ifthehoistwaydoorandcargatearebothclosed,thespacebetweenthemwouldbewideenoughtofitachildorsmalladult.Shouldtheelevatorbecalledupwhilethepersonisinthatspace,seriousinjuryordeathislikelytoresult.Thesetragediescanbeavoided.8Inaddition,Otis'DirectorofWorldwideStandards,LouBialy,highlightedthedangerposedbythisdefectinatradepublication,ElevatorWorld,entitledSpaceBetweenSwingDoorsCollapsibleGatesStillAHazard.9AsrecentlyasMarch2014,elevatorexpertsJamesFilipponeandJohnKoshakreiteratedthedangersofchildentrapmentinanotherElevatorWorldarticleentitledSolutionsNeededtoEnsureChildren'sSafety.SaferandFeasibleAlternativeDesignsSaferdesignoptionsreducethegapbetweenthehoistwayandcardoors.Suchdesignsrecognizetheergonomicfactorsthatcontributetothehazard.Forexample,astheCPSC'sownanthropometrydatashow,children'sheadsarelargerthantheirbodies,andthemostvulnerablechildren,ages2-3.5years,haveheadbreadthsoflessthanfiveinches.10TheCPSCandothershaveidentified4inchesasakeyelementofsafedesigninothercontexts,suchastheallowablespacebetweenstaircasespindles,specificallytopreventheadentrapment.11TheCPSC'sPublicPlaygroundSafetyHandbookrecommendsamoreconservativemaximumallowablegapof3.5inches,specificallytopreventachild's7LettertoNationalWheelovator;RaymondMoncini;OtisElevatorCompany;December8,20038LettertoNationalWheelovator;RaymondMoncini;OtisElevatorCompany;December8,20039SpaceBetweenSwingDoorsCollapsibleGatesStillAHazard;LouBialy;ElevatorWorld;May2003IOChangeinthePhysicalDimensionsofChildrenintheUnitedStates;U.S.ConsumerProductSafetyCommission;April27,1998IIErgonomicsandDesignReview;RaniLeuder;Helveyv.ThyssenKruppAccessCorporation;October22,2012head

from entering

the space

and becoming entrapped.

12 In addition,

history

shows

that

the design alternatives

are feasible.

From

1955,
when ASME's

first residential

elevator

code

was published,

until 1980, when

the dimension was changed,

the voluntary

industry standard

called

for

a maximum

gap

of

4 inches between

the two doors. Individual

states

have more stringent standards

than those

set

by ASME. Massachusetts' elevator

code,

for example,

restricts

any

gap between

the hoistway

doors

and

the

car doors

or gates

to

3 inches.

13 In the state

of Georgia,

an effort

to follow

suit

is underway. The amendment

to the International

Residential

Code proposed

by the State

Fire Marshal's

office,
which oversees
elevator

codes,

reads: Passenger elevators, limited-use/limited-application

elevators

or private residence elevators

shall
have hoistway

landing openings

that meet

the Georgia amended requirements

of ASME

Al7.1 Sections

5.3.1.1

and 5.3.1.7.2.

The clearance

between

the hoistway

doors

or gates

and

the hoistway

edge

of the landing

sill shall

not exceed

3/4 inch

(19 mm).

The distance between

the hoistway

face

of the landinf

door

or gate

and

the

car door

or gate shall

not exceed

3 inches

(75 mm).

1 This change

is scheduled

to be finalized

by the Georgia Department

of Public Affairs

in November

and

go into effect

in January

2015. A reduction

of the clearance

is feasible because

it does

not change

the manufacture

of the elevator

itself; rather

it guides

the installation

of the hoistway

door. Currently,

in residential

settings,

the exterior

door

is typically

set flush

to the wall,

like

any other

door in

a home.

This setting typically

creates

the excessive

gap. Installers

can exacerbate

the gap

by misinterpreting

the

5" Rule

in the voluntary

standard

as measuring

the distance between

the closest

points between

the doors, rather

than

the furthest

point.

In fact, manufacturers'

designs

often instruct installers

to measure between

the hoistway

door and

the peak

of an accordion

car door, rather

than

to the valley.

Those

who

do not take into account

the extra space beyond

the peak

of the accordion

door

can create

up

to

8 inches

of refuge

space, which permits

entry

by

a child. Voluntary Standards

Have

Not Prevented

Risk

of Harm In

83 years,

the industry

not only

has failed

to address

the entrapment

hazard,

it actually increased

the potential

for injury

and death

by re-writing

the voluntary

standard

to allow a wider

gap between

the hoistway

and exterior

door. 12 Public Playground

Safety Handbook;

U.S. Consumer

Product

Safety Commission;

undated 13 5.3.1.7.2 Clearance

Between Hoistway

Doors

or Gates

and Landing

Sills

and
Car 'Doors

or, Gates;

5.3.1. 7 Protection

of Hoistway Openings.;

524 CMR Board

of Elevator Regulations;

PDF

Pg. 214; September 28,2012 14 Georgia

State Amendments

to the Residential

Elevator

Codes

for One

and Two-Family

Dwellings; August 13,2014ThevoluntaryASMEstandardhasfailedtosafeguardchildrenfrominjuriesanddeaths.AccordingtoCPSC'sownfigures,therewereanestimated1600injuriesassociatedwithresidentialelevatorsinjustatwo-yearperiod.ThemostrecentfiguresfromCPSC'sNEISSsystemshowthatanestimated1,600injuriesassociatedwithresidentialelevatorsandliftswereseeninemergencydepartmentsfrom2011through2012.CPSConlyhasjurisdictionoverelevatorscustomarilyusedbyconsumersinaresidentialsetting.Someofthoseinjuriesincludedchildrenbecomingentrappedinthegapofresidentialelevators,tragicallyleadingtofatalitiesandseriousinjuries.Theagencyhasanactiveandongoingcomplianceinvestigationregardingthesafetyofresidentialelevatorsandtheentrapmenthazardtheycanpresent.WhileCPSCinvestigatestheroleandresponsibilitiesofmanufacturersandinstallerswhenitcomestothesafetyofresidentialelevators,ownersofresidentialelevatorsshouldtakestepstoensurechildrendonothaveunsupervisedaccesstoin-homeelevators.15Inaddition,theentrapmenthazardhasledtoanumberofchilddeaths.Intheearly1990s,theOtisElevatorcompanyrevealedtotheplaintiffsinaNewJerseycasethedeathsorsevereinjuriesto34childrenfrom1983-1993inthesouthernNewYorkandNewJerseyareaalone16andanadditional16deathsfrom1947to1963.17Morerecently,thepetitionersareawareoffivemoredeathsandtwocatastrophicinjuriesinwhichchildrenwereentrappedandcrushedinresidentialelevators.18TheASMEVoluntaryStandardsProcessHasBeenaFailureTheASMEstandards-settingprocesshasnotproducedasubstantivechangetothevoluntaryresidentialelevatorstandardinnineyearsofcommitteemeetings,despitemembersrepeatedlybringinguptheexcessivegapissue.In2005,theA-17committeebegandiscussingrevisionstothe"Clearance"sectionofthestandard.SeveralmembersoftheA-17CommitteelobbiedtochangetheClearancedimensionsofthestandardbacktotheoriginaldimensions.MinutesofthecommitteemeetingsbetweenSeptember2006andJune2007showthatsomecommitteemembersexpressedconcernaboutthehazardousgappermittedbythestandard.However,thegrouprejectedanyproposalsforrevisingthestandardtorequiretighterclearancesandmorepreciselydescribedmeasuringpointstoensurethathomeelevatorswouldcomply.1915EmailtoTheSafetyRecordBlog;ScottWolfson;USConsumerProductSafetyCommission;August27,201316TheElevatorDesignHazardThat'sBeenKillingChildrenforDecades;TheSafetyRecordBlog;JulyII,201317ElevatorSafetyFlawsPersist,DespiteHistoryofTragicAccidents;ShawnHubler;FairWarning;December8,201318AppendixA;ElevatorEntrapmentDeathsandInjuries19A17ResidenceElevatorCommittee;Minutes;September19,2006-June18,2007Forexample,CalvinRogier,chiefofthestateofMichigan'sElevatorSafetyDivision,suggestedthatthelanguagebemodifiedtoonlyallowfora4-inchclearance,becausewhenaccordiondoorsareused,theclearancefromthefaceofthehoistwaydoortothefurthestpartoftheaccordiondoorresultedinaclearanceof5.5-inches.Atonesuchmeeting,hesaid"Theclearancesbetweenthecarandthehoistwaydoormustbereducedtoprovideanacceptablelevelofsafetyforthefamiliesusingthisdevice.Accidentsdealingwiththisareahavebeendeadly."20Anothercommitteemember,RichardGregory,anelevatorconsultant,describedanincidentthatoccurredinMichiganinwhicha 10-year-oldboywhohadslippedbetweenthehoistwaydoorandtheaccordiondoorwasfatallycrushedwhentheliftwascalledtoafloorbelow.Itwouldbeeasytoreduceclearancesinelevatorswithwidegapswithproductsreadilyavailableonthemarket,hesaidinanemailtothe committeechairman?1"It'seasy,itsaveslives.Soitshouldbedone,"Gregorywrote.22Despiterepeatedattemptstopersuadethemajorityofmembersthattheexcessivegapwasaserioussafetyproblemthatresultedinachild'sdeath,thecommitteedecidedthatthestatusquoshouldremain:"Thecommitteefeelsassuredthatthemeasurementcriteriapresentedwillprovideforsafety.Inaddition,the5-inchdimensionhasbeeninthestandardformanyyears."2Notonlyhasthesubcommitteefailedtorevisethestandardinordertoadequatelyaddressthishazard,theyrecentlyconsideredmakingtheClearancessectionofthestandardevenmorelenient.Atthefirstquarterlymeetingof2013,thecommitteewaspoisedtocodifythelatestrevisions,whichincludedmeasuringinstructionsthatwouldhavealloweddesignerstoconsidertheshortestpointwhenmeasuringtheclearance,insteadofthefarthestpoint.Fortunately,amemberofthelargerstandardscommitteemadeanimpassionedandsuccessfulpleatorejectthechange.Morerecently,thecommitteeshelvedaproposaltoreducethegapbetweenthedoorsonexistingelevatorstoa4-inchmaximum,whileitawaitstheresultsofaninternalhazardanalysis.AlthoughtheA17committeehadbeenlookingatthisissuesince2005,theyjustvotedtoperformahazardanalysislastyear.Thecommitteealsoweighedaproposaltoclarifytheruleandmakeexplicitthatthe5-inchmaximumdimension/constraintmustbemeasuredbetweenthefarthestpointsbetweenthedoors-nottheclosest.EveniftheCommitteeimmediatelyapprovedboth,anyrulechangeiseffectivelydelayedforanotherthreeyears,whenthenexteditionoftheElevatorSafetyCodeispublished.20Al7ResidenceElevatorCommittee;Minutes;September19,2006-June18,2007;CarlRogier;PDFPg.10;ResponsestoLetterBallott#05-1123Comments;November28,200521AccordionDoorAccident;email;RichardGregorytoAIVershell;June27,200622AccordionDoorAccident;email;RichardGregorytoAIVershell;June27,200623Al7ResidenceElevatorCommittee;Minutes;September19,2006-June18,2007;CarlRogier;PDFPg.10;ResponsestoLetterBallott#05-1123Comments;November28,2005Wehavenoreasontobelievethatwillhappen.NineyearshaveelapsedsincetheASMEcommitteefirstconsideredmodifyingrequirementsforclearances.Todate,thestandardstillhasnotbeenrevisedtoeffectivelyaddressthehazard.Clearly,industryhasdemonstrateditsunwillingnesstocorrecttheproblemonitsownandthereisinsufficientindustrybuy-insupportingthechange.Forexample,whenonemembersuggestedamendingtheruletoreflectthatthemeasurementsshouldbetakenfromthefarthestpoints,itwasrejected:"TheCommitteefeelsassuredthatthemeasurementcriteriapresentedwillprovideforadequatesafety."24Inanotherinstance,asmallgroupwithinthecommitteevotedagainsttheproposedrule,withonememberarguing:"Thoseclearancesbetweenthecarandhoistwaydoorsmustbereducedtoprovideanacceptablelevelofsafetyforthefamiliesusingthisdevice.Accidentsdealingwiththisareahavebeendeadlyforthoseinvolved."25Evenwhenconfrontedwiththehistoryofchilddeaths,theresponsewas:"Thecommitteefeelsassuredthatthemeasurementcriteriapresentedwillprovideforadequatesafety.Inaddition,the5"inchdimensionhasbeeninthestandardformanyyears."26Moreimportantly,evenifASMEA17amendsthe rule,itsadoptionisnotautomatic.Anyjurisdiction(whethercity,countyorstate)mayadoptanyversionoftheA17ElevatorSafetyCode.Manyjurisdictionsaredecadesbehind.Forexample,somestatestodayusethe2004orolderversions,eventhoughtherehavebeenmanysubsequentversions.Otherjurisdictions,suchasSouthCarolina,donothaveanycodeforresidentialelevatorsanddonotrequirepermittingorinspectionsforsinglefamilyresidentialelevators.Childrenrepresentavulnerablepopulationwhoneedtheprotectionofastrongmandatorystandardwhenthevoluntarystandardsprocesshasrepeatedlyfailedtoofferreasonableandfeasibleprotectionsagainstpotentiallygrievousinjury.TheASME'sstandard-settingprocess,unfathomabledelaysandrationaleforrejectingproposedchangesisatoddswiththepurposeofdevelopingasafetystandard.Industry'sinactionisevenmoreegregiousgiventhatmethodsforaddressingthehazardaretechnologicallyandeconomicallyfeasibleandhavebeenformanyyears.Further,toconcludethatastandardshouldnotbechangedsimplybecauseithasexistedformanyyearsisnottheresultofacrediblestandards-writingprocess.Ironically,theelevatorindustryhaslaunchedthehomeSAFE(SafetyAwarenessforElevators)Campaign,toincreasehomeelevatorsafetyawareness.ThecampaignissponsoredbyAssociationofMembersoftheAccessibilityEquipmentIndustry(AEMA),NationalAssociationofElevatorContractors(NAEC),NationalAssociationofElevatorSafetyAuthoritiesInternational(NAESA)andThyssenKruppAccess.TheHomeSAFECampaignrecommendsthathomeownersmakesurethegapbetweentheaccordionandswingdoorsbenomorethan4inches,evenastheASMEcommitteerefusedtocodifythisadviceintoitsownstandards:24TN05-803ResidenceElevatorCommittee;Attachment8C;Pg.525TN05-803ResidenceElevatorCommittee;Attachment8C;Pg.626TN05-803ResidenceElevatorCommittee;Attachment8C;Pg.6Measure

the gap between

the elevator

door

and

the hoistway

door

to verifY it

is not wide enough

for

a child

to become entrapped.

ASME

Codes require

the space

be

no more

than

5 inches;

but

for additional

safety precautions, homeSAFE recommends

the space between

the hoistway door

and

cab gate

is no more

than

4 inches. Features

such

as space guards or special hoistway

doors

can help reduce

the space between

the elevator door

and

the hoistway

door. Other safety devices

such

as li9ht curtains also may help detect someone

in the space between

doors.

2 Petition Request The Petitioners

hereby formally

submit

this Petition

for Rulemaking

under

the authority and process

set forth

in

16 CFR

§ 1051 Procedure

for Petitioning

for Rulemaking

and request

the Commission

to promulgate

a mandatory

standard

that constrains

the space between residential

elevator hoistway

doors

and

car doors/gates

to

4 inches

when measured

from

the inside

of the hoistway

door

to the farthest

point

on the

car door/gate (i.e.,

the valley

for

an accordion

door). Under

Sec.

9 [15 U.S.C.§

2058] Procedure

for Consumer

Product

Safety Rules,

the Commission

must meet certain criteria

to commence

a rulemaking:

identifY

the product and

the risk

of injury associated

with

that product,

ensure

a rule

is

in the public interest, and consider

the adequacy

of any already existing voluntary

standard

in eliminating

or adequately

reducing

an unreasonable

risk. The petitioners

believe

that

the record clearly establishes

the hazard

the entrapment

risk posed

by excessive

space between

the inner

and outer elevator

doors;

the significant

risk of injury

and fatality;

and

the failure

of the voluntary

standard

to mitigate

or eliminate

the hazard despite

the feasibility

of

a technical

fix. To ensure

the safety

of existing elevators,

the Petitioners

also request

that

the Commission

commence

a recall

to repair, requiring

all manufacturers

to retrofit existing elevators

to prevent children

and small adults

from becoming entrapped.

Several technologies

exist

to eliminate

this hazard.

For example,

light curtains

use light beams and sensors

to detect

a presence between

the doors

and interrupt

the operation

of the elevator

if something

or someone

is

in this space.

This would prevent

the scenario

of the elevator

car being called

to another

floor while

a child

is entrapped

between

the

car door/gate

and

the hoistway

door.
Door baffles

(or space guards)

are another potential solution.

These after-market

space blockers

fill

the excess clearance

space, removing

the opportunity

for children

or small adults

to

fit themselves

in the space between

the

car and hoistway

doors. The Petitioners appreciate

the Commission's consideration

of this request.

We

are available

to discuss

this petition

at your convenience. 27Respectfullysubmitted,TheSafetyInstituteBy:JamieSchaefer-WilsonExecutiveDirector340AnawanStreetRehoboth,MA02769646-644-6320IndependentSafetyConsultingBy:CarolPollack-Nelson,Ph.D.13713ValleyDriveRockville,MD20850301-340-2912CashKrugler&Fredericks,LLCBy:AndrewCash,DavidKrugler5447RoswellRd,Atlanta,GA30342404-659-1710InterestofPetitionersThispetitionisbroughtbythreeorganizationsonbehalfofallchildrenandtheirfamiliesaffectedbyresidentialelevators:TheSafetyInstituteisa501(c)3non-profitorganizationwhosefocusisoninjurypreventionandproductsafety.TheSafetyInstituteexaminesareasofinjurypreventionandproductsafetyacrossabroadspectrum.TheInstitutebasesitsplansandprioritiesonissuesthatrequiregreaterstudyandemphasis,aswellasthosewhichmaybeunderservedbyotherorganizationsandadvocates.TheInstitutegivesspecialattentiontothose areasofemergingimportancetoinjuryandproductsafety,includingtheeffectsofnewandchangingtechnologies.IndependentSafetyConsulting(ISC),throughitsprincipal,CarolPollack-Nelson,provideshumanfactorsconsultingspecializinginconsumerproductsafety,byevaluatingproductdesigns,warningsandinstructionsinordertoidentifyhazardsandreduceriskstoconsumers.Ms.Pollack-NelsonwasaHumanFactorsPsychologistattheCPSCfrom1988through1993.Cash,Krugler&Fredericks,LLCisalawfirmrepresentingvictimsandtheirfamiliesincasesinvolvingcatastrophicinjuryanddeath.Thefirmpursuesthispetitiononbehalfofthefamilieswithwhomtheyhaveworkedwhosechildrenhavesufferedbraininjuries,paralysisandotherdisabilitiesduetoresidentialelevatorhazards.AppendixAElevatorEntrapmentDeathsandInjuriesAccordingtoCPSCstatistics,therewereanestimated1,600injuriesassociatedwithresidentialelevatorsinatwo-yearperiod.Thefollowingincidentsareasmallsampleoftheinjuriesanddeaths:1958:Three-year-oldgirldied,caughtbetweentheinnergrillandouterdoorSanFrancisco,California•••Thethree-year-oldgirlranaheadtopressthebuttonfortheautomaticelevatorasherbabysitterpreparedtoleave;Theelevatorarrivedatthefourth-floorandtheoutsidedooropened.Thegirlwascaughtbetweentheinnergrillandouterdoor,whichclosedbehindher;Somebodypressedthebuttononanotherfloorandtheyounggirlwascrushedtodeath.11961:Seven-year-oldboydied,crushedwhenhebecamewedgedbetweentheelevatordoorandthegateRedBank,NewJersey••Theseven-year-oldboywhomayhavebeenplayingorhidingfromaplaymatewhentheincidentoccurred,becamewedgedbetweentheelevatordoorandthegate;Theboy'sbodywasfoundwedgedinthespacebetweenthedoorandthegateoftheelevator,whichwasstuckbetweenthethirdandfourthfloorsoftheapartmentbuilding.21962:Three-year-oldgirldied,caughtbetweenthewallandthemovingelevatorBrooklyn,NewYork••Three-year-oldgirlwascrushedtodeathbetweenthewallandthemovingelevator;Policesaidthevictimsomehowmanagedtogettheinnerdooropenandtookholdthefourth-floorouterdoorastheself-serviceelevatordescendedinaBrooklynapartment.3•41CharlestonDailyMail,Thursday,May8,1958,Page1;http://newspaperarchive.com/us/westvirginia/charleston/charleston-daily-mail/1958/05-08/2RedBankRegister,TuesdaySeptember5,196;http://209.212.22.88/data/rbr/1960-1969/196111961.09.05.pdf(Page2)3ManitowocHeraldTimes,Thursday,May24,1962,Page17;http://newspaperarchive.com/us/wisconsin/manitowoc/manitowoc-herald-times/1962/05-24/page-174ToledoBlade,May23,1962;http://news.google.com/newspapers?nid=l350&dat=19620523&id=RbxOAAAAIBAJ&sjid=MgEEAAAAIBAJ&pg=6627,5118121976: Seven-year-old

boy died, trapped between

the outer

door

and

the wall

of the elevator

shaft Newark,

New Jersey • The seven-year-old

boy became trapped

in the building's

elevator between

its outer

door

and

the wall

of the elevator

shaft; • The elevator

was activated

and

the boy

was dragged

up

to the third floor; • Another

child

who

was racing

up

a nearby stairway

to beat

the elevator

opened

it, saw

the victim wedged

within

it, and

ran

to seek help; • Rescue workers
worked

for four

and one-half

hours

to free

the child;

he died while

still trapped.

5 1977: Ten-year-old

girl; crushed

in

an elevator between

the hoist

way door

and

the gate Yonkers,

New York • Ten-year-old

girl was crushed

in

an elevator between

the hoistway

door

and

the gate.

6 1980: Seven-year-old

boy sustained

broken

leg, bruising

and scarring Newark,

New Jersey • The seven-year-old

boy

was getting

out

of the elevator

at

a basement

landing when

he found himself trapped

as the

car gate closed behind

him

and

the hoistway door

was

not open; • Someone

else called

the car,

and

it ascended

with

the young

boy stuck between the
car gate

and hoistway

door.

7 1986: 12-year

old boy died, trapped between elevator

door

and swing

gate Newark,

New Jersey • The 12-year-old

boy became wedged between

the swing

hatch

door

and

the elevator

car gate; • The elevator received

an
up call

and traveled

away

from

the basement

landing, crushing

the child between

the wall immediately

above

the basement

door header and

the

2nd landing

sill and leading

edge

of platform

with

toe guard.

8 5 Portee

v. Jaffee

I Leagle.com; http://leagle.com/decision/1980

17284NJ88 1169.xml!PORTEE%20v.%20JAFFEE 6 The Herald Statesman,

August

20, 1978;

- http:/ /fultonhistory .com/newspaper%20

1 0/Y onkers%20NY%20Herald%20Statesman/Y

onkers%20NY%20 Herald%20Statesman%20 1978%20Grayscale/Yonkers%20NY%20Herald%20Statesman%20

1978%20Gra yscale%20-%206052.

pdf 7 Liberty Mutual, accident

report, December

9, 1980 8 Otis Elevator company,

accident

report,

April

14, 19871997: Four-year

old girl died, caught between

floors

in

a residential

elevator Chicago,

Illinois • Four-year-old

girl was caught between

the floors

of

an elevator

in

a residential building; • Her mother

had gotten

off before

her and

the other children
pressed

the call button.

9 2001:

Eight year-old

boy died, entrapped

between

swing

door

of residential

elevator Bethel,

Maine • The 8-year-old

boy pushed

the call button

and opened

the swinging

door;

the door closed behind

the boy; before

he could

open

the collapsible

gate

a maid

on the second

floor pushed

the call button, interlocking

the outer

door

and trapping

the child

in the gap between

the outer swing

door

and collapsible

gate; • The young

boy

was nearly decapitated

and died

in front

of his family; • The distance between

the outer swing

door

and collapsible

gate

was seven inches. • Otis settled

and sent notices

to the elevator industry

about

the hazard.

10

• 11 2002:

Two sisters,

ages

six and seven

died, heads crushed

in residential

elevator Monmouth

County,

New Jersey • Two

girls were lying down

in the elevator

with their heads partly across

the threshold

as the

car rose; • The safety feature

was disabled allowing

it to descend

while

the girls' heads

stuck out past

the gate; • They

died when

their heads

were wedged

against

part

of the shaft.

12 9 CPWR Deaths

and Injuries Involving Elevators

and Escalators, September

2013; http://www .cpwr.com/sites/default/files/publications/elevator

_escalator_ BLSapproved

_ 2.pdf (Page

23) 10 Space Between

Swing
Doors Collapsible

Gates

Still

A Hazard;

Lou Bialy; Elevator

World;

May
2003 11 Terry Garmey

Speaks

About Tucker

Smith

and

the Campaign

to Repair

4,000 Guards

on OTIS Elevators;

Smith Elliott

Smith

& Garmey; http://www.fairwarning.org/wpcontent/uploads/20 13112/TuckerSmithArticle.pdf 12 Asbury

Park Press, August

2, 2002; http://house.michigan.gov/sessiondocs/20

13- 20 14/testimony/Committee238-9-24-20

13 .pdf2003: Ten-year-old

boy died, entrapped

and crushed

in swing

door

of residential elevator equipped

with

an accordion

door Mass

City, Michigan • The ten-year-old

boy

got caught between

the hoistway

door

and

the accordion door; • The elevator

started

going
down crushing

the boy who
then suffocated; • The distance

to the peak

of the accordion

door

was approximately

5", but valleys were much deeper; • The family's

expert notified

ASME

A17 Residence

Elevator Committee

of this incident

in 2006

. 13 2004: Five-year-old

boy died, crushed between elevator

door

and hoistway

door Dallas,

Texas • The five-year-old

boy entered

the elevator

with

his two-year-old

brother

in their family's multistory condominium; • The accordion-style

gate

was

not closed, allowing

the boy's

body

to be extended outside

the door

as the elevator

started moving

up; •

As
the elevator ascended,

his head

was crushed

by the second

floor landing.

14

• 15 2006: Eleven-year-old

girl died, entrapped

between

the elevator

and shaft walls Carolina

Beach,

North Carolina • The 11-year-old

girl was thought

to have entered

and exited

the elevator

with another

child; • The owner

of the residence

went

to use

the elevator

and was unable

to open

the door; • The

fire department

was notified

and upon responding

and opening

the downstairs elevator

found

the

girl pinned

in the elevator

shaft between

the elevator

and shaft walls.

16 13 ASME

Al7 Residence

elevator committee

2006 meeting minutes 14 The Dallas Morning

News, Sunday

June

20, 2004,

Page

3B; http:l/newspaperarchive.com/us/texas/harlingenlvalley-morning-star/2004/06-20/page-3 15 The Dallas Morning

News, Saturday

June

19, 2004,

Page

2B; 16 Caroline

Beach Police Department,

North Carolina, Incident/Investigation

report

July

23, 20062009:Nine-year-oldboydied,pinnedinanelevatorshaftbetweenthewallandthedoorSturgis,Kentucky•Anine-year-oldboyattendinghisgrandmother'sweddingceremonydiedwhenhebecamepinnedinachurchelevatorshaft;•Hewanderedoffbyhimselfandwasridingtheelevatorinthechurchsanctuarybetweenthefirstandsecondfloors;•Hebecamepinnedbetweentheelevatorandthewall;therewerenowitnesses.172010:Three-year-oldboysufferedcatastrophicbraininjury,entrappedbetweenhoistwaydoorandaccordiondoorCummings,Georgia•Thethree-year-oldboywasentrappedbetweenthehoistway(exterior)doorandelevatoraccordiondoor;•Afterchildclosedthehoistwaydoor,thedoorautomaticallylockedbywayofaninterlock;•Whenmotherhitthecallbuttonfromthe3rdfloor,thechildwastrappedinthisspace;theelevatorrosetowardthethirdfloorandthenstoppedandre-leveled;•Thechildwascrushedbytheelevatorwhenitre-leveleddowntothesecondfloor;•Thedistancebetweenthehoistwaydoortoaccordiondoorvariedbynearly3";4.875"totipoftheaccordiondoorI7.5"tovalleyoftheaccordiondoor;•Injuriesarecatastrophicandpermanent.Childdiagnosedwithananoxicbraininjuryduetodeprivationofoxygenforanextendedperiodoftime;hecannotcommunicatewiththeoutsideworldormoveinanymeaningfulway;•ThisincidentwasreportedtotheCPSConDecember7,2012.1817EvansvilleCourier&Press,June13,2009;http://www.courierpress.com/news/local-news/child-crushedsturgis-ky-church-elevator18JacobHelvey,ElevatorIncidentreportdate,December7,2012;http://www.saferproducts.gov!Viewlncident/1289132November

2013: Ten-year

old boy suffered catastrophic

brain injury

and quadriplegia,

entrapped

and pinned

under elevator

car Murrells

Inlet, South Carolina • Ten-year-old

boy suffered

a catastrophic

brain injury

when

he became
trapped

in an Elmira residential

elevator manufactured

by Cambridge
Elevating,

Inc.

out

of Cambridge,

Canada; •

As
the elevator

began

to rise with

the

car gate open,

the child peered

over

the edge

of the

car platform

and down

into

the elevator

shaft; •

As
the

car continued

to rise,

the child's

head came

into contact

with

the doorframe,

pinning

his head under

the elevator

car; • The

car continued

to rise

up

to the third floor, where

the child

was found laying face down

on the floor

of the elevator

car with

his head

and neck trapped

under the

car platform; • The jaws

of life were eventually

required

to rescue

the child

from

the elevator; •

In addition

to multiple fractures,

he suffered catastrophic

brain injury.

19 19 Jordan Nelson Elevator Incident

report

date September

5, 20

14; http://www.saferproducts.gov/Viewlncident/1427183