DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION
REPORT OF INVESTIGATION
SURFACE COAL MINE
Fatal Falling Materials Accident
August 21, 2001
Winfield South Strip Mine
TXU Mining Company
Mt. Pleasant, Titus County, Texas
ID No. 41-03658
Accident Investigators
Lester Coleman
Coal Mine Safety and Health Inspector
Michael Shumway
Coal Mine Safety and Health Inspector
David Weaver
Mine Safety and Health Specialist (Training)
Originating Office
Mine Safety and Health Administration
District 9
P.O. Box 25367
Denver, Colorado 80225-0367
Allyn C. Davis, Acting District Manager
RELEASE DATE: 11/01/2001
OVERVIEW
On Tuesday, August 21, 2001, at 11:30 a.m., Robert M. Batey, age 49, fuel mechanic, was struck by dirt material, which fell from the inside of a dragline bucket, and was fatally injured. The bucket was set on the ground in an inverted position during drag rope maintenance procedures. Batey and Dennis Starek, fuel mechanic, were sitting on the bucket arch in the shade of the inverted bucket eating lunch when the accident occurred. The chunk of dirt that fell was approximately 24 inches long, 18 inches wide, and 6 inches thick. It fell approximately 18.5 feet from the back rim of the bucket down to the bucket arch. Starek was not injured in the accident. Starek and Richard Neal, fuel mechanic, began first aid and CPR, and emergency medical assistance was summoned. Emergency medical personnel arrived and transported Batey to the Titus Regional Medical Center, where he was pronounced dead at 12:45 p.m.
The cause of the accident was the failure to sufficiently clean and remove materials from inside the dragline bucket prior to standing it on end in an inverted position. The two fuel mechanics inadvertently placing themselves in a hazardous position to eat lunch was a contributing factor to the accident.
GENERAL INFORMATION
The Winfield South Strip Mine is a surface lignite mine located approximately two miles south of Interstate Highway 30 on Titus County Road SW-5 near Winfield, Titus County, Texas. Mine operations began in 1974. The mine is owned and operated by TXU Mining Company.
Six seams of lignite are mined in the Calvert Bluff Member of the Wilcox formation. The seams are designated as 4R, 4C, 4D, 5C, 6B and 6C. Seam thicknesses range from 3.3 to 8.6 feet. Partings between the seams vary from a few inches to 22 feet. The mine has 2 active open pits. Overburden is removed by 2 electric powered draglines and a bucket wheel excavator with a cross-pit spreader. A Bucyrus Erie Model 2570 dragline with a 121 cubic yard bucket is used in the H-area of the mine. A Bucyrus Erie Model 1350 dragline with a 65 cubic yard bucket and a bucket wheel excavator with a cross-pit spreader are used in the G-area. The bucket wheel excavator removes overburden and transfers it to the cross-pit spreader which coveys the material to the spoil pile. The bucket wheel excavator and cross-pit spreader have a design capacity to move 20 million cubic yards of overburden per year.
Lignite is loaded into haul trucks with hydraulic excavators and front-end loaders. It is transported to a railroad loading station where it is crushed to a six- to nine-inch size or smaller. It is loaded onto rail cars for delivery to the Monticello Steam Electric Station located approximately ten miles south of the mine.
The mine operates three different work shifts. The stripping operation works two 12-hour shifts per day, seven days per week. Loading crews work two 12-hour shifts and two 8-hour shifts per week. The maintenance day crews work five 8-hour shifts per week.
The last Mine Safety and Health Administration (MSHA) Regular Safety and Health (AAA) inspection was completed on July 12, 2001. The Non-fatal Days Lost (NFDL) incidence rate for the mine for the first half of 2001 was 4.77. This compares to a National rate for surface mines of 2.00. Daily production is 11,000 tons.
The principal mine officials at the time of the accident were:
Lonnie Smith .......... Monticello Manager of Mines Phillip Jordan .......... Winfield South Mine Manager Thomas Dodds .......... Winfield South Operations Supt. Daniel Grissom .......... Winfield South Maintenance Mgr. Larry Schultz .......... Winfield South Senior Safety Rep.
DESCRIPTION OF THE ACCIDENT
On Tuesday, August 21, 2001, the day shift maintenance crew, supervised by Michael Wilbanks, started the shift at 7:00 a.m. Wilbanks held a short tailgate safety talk and assigned the crew to change the drag ropes on the Bucyrus Erie Model 1350 dragline, located in the G-pit area.
The previous graveyard shift had positioned the dragline for the drag rope change. Wilbanks examined the area and was not satisfied with the setup. He decided to move the dragline to an area that was wider and more level, and he assigned this task to Clarence Brooks, dragline operator. Brooks moved the dragline to the new area, inverted the dragline bucket on the ground, and positioned the dragline for repairs. Wilbanks then looked the job site over in general, but did not do an examination of the individual work sites.
Wilbanks motioned to Robert Batey, victim, Richard Neal, and Dennis Starek, all fuel mechanics who were waiting on a nearby hill, to come to the site and start the repair work. This was at approximately 7:30 a.m. Wilbanks left and returned to the dragline twice in the next two hours. While at the site, he talked with his crew to see how the job was going. He left the site between 11:15 and 11:20 a.m. for his lunch break. The dump rope change was completed at approximately 11:15 a.m.
Since it was almost lunch time, it was decided to break for lunch while another crew completed x-rays on the pendant lines. Neal went to a truck, which was parked close by, to eat his lunch. Batey and Starek sat on the bucket arch in the shade of the dragline bucket. Neal then decided to join Batey and Starek and went to their area and sat on a chain facing them. At approximately 11:30 a.m., Neal observed a chunk of dirt fall from the bucket directly above Batey. The dirt struck Batey in the head, neck, and upper shoulder region, pushed him to the ground, and rendered him unconscious.
Neal and Starek started first aid and CPR, and emergency medical assistance was summoned. Others arrived to assist and direct emergency personnel quickly to the accident site. Emergency medical personnel arrived and took over CPR and administered emergency medical treatment. Batey was transported by ambulance to the Titus Regional Medical Center where he was pronounced dead at 12:45 p.m.
INVESTIGATION OF THE ACCIDENT
Allen Head, MSHA field office supervisor at McAlester, Oklahoma, was notified of the accident at 1:30 p.m., August 21, 2001. Head was in Longview, Texas, at the time. Head and Calvert Browning, MSHA inspector assigned to the Longview, Texas, MSHA office, traveled to the mine to conduct a preliminary investigation. A Section 103(k) order was issued to assure the safety of all persons at the mine until an investigation could be conducted.
Lester Coleman, Coal Mine Safety and Health Inspector from Castle Dale, Utah, was assigned as the Lead Investigator. Other investigators were Michael Shumway, Coal Mine Safety and Health Inspector from Price, Utah, and David Weaver, Mine Safety and Health Specialist (Training) with Educational Field Services from Rolla, Missouri.
The MSHA accident investigation team arrived at the mine at approximately 4:00 p.m., August 22, 2001. Interviews were conducted with witnesses and the accident site was examined. The investigative work at the mine concluded on August 23, 2001.
DISCUSSION
1. The drag rope change out procedure that was being performed the day of the accident was done approximately every 14 to 21 days. The drag ropes are turned around at about 2,000,000 cubic yards of overburden moved and are changed out at about 4,000,000 cubic yards. Four or five sets of drag ropes are used during an average year. Batey and his co-workers had turned/changed the drag ropes numerous times.
2. The mine operator had detailed written procedures for the drag rope change out operation. A written Job Safety Analysis (JSA) for the drag rope change was also available. Regarding bucket positioning, the written procedures state, "Operator positions bucket directly under boom point with room to work on each side of bucket. Operator then pulls slack out of drag ropes and drag chains." The JSA states, "Have operator set up bucket under boom point. Leave hoist rigging suspended with no tension on dump ropes." The procedures do not address removal of dirt and material from the bucket before positioning it. The drag rope change out procedures did not require anyone to be positioned under the inverted bucket or to be exposed to material falling from inside the bucket.
3. The dragline bucket, as positioned during repairs, was sitting vertically with the front of the bucket resting on the ground and the back of the bucket in the air directly above the front. The bucket was routinely set in this inverted position whenever the drag ropes were turned or changed out.
4. Observations indicated that the bucket did not have a complete covering of Teflon on the inside. A Teflon coating is applied to the inside of the bucket during scheduled maintenance at the bucket shop. A portion of the coating had been damaged during normal wear and use and was no longer present in the area from where the dirt fell. Damage to the Teflon coating is not repaired in the field but is done when the bucket goes to the shop for scheduled maintenance.
5. Statements indicated that hard material, such as what fell during the accident, had not fallen from the bucket during previous maintenance procedures. Dripping mud had fallen from the bucket, but not hard chunks of material.
6. Wilbanks moved the dragline from where the graveyard shift had left it to provide a wider, more level, and a safer and more stable area for the repair work.
7. Batey and Starek sat on the bucket arch during their lunch break. Observations of the accident site indicated that their position was in the shade of the inverted bucket.
8. The material that hit Batey fell from the back of the bucket, which was directly above the bucket arch. The bucket arch, which is at the front of the bucket, was resting on the ground. The material fell approximately 18.5 feet from the back of the bucket to the bucket arch.
9. The material that hit Batey was estimated to be approximately 24 inches long, 18 inches wide, and 6 inches thick. It is roughly comparable to an 80-pound bag of cement. The material consisted of a sandy clay.
10. Training records for the victim, co-workers, and supervisor were examined and found to be in compliance with all required 30 CFR Part 48 training requirements. Batey had received Annual Refresher training on February 19, 2001.
11. During previous maintenance work, employees examined the bucket for loose and questionable material and if found, the bucket was bounced against the ground to loosen and remove the material. The mine operator has implemented a new procedure using chipping hammers and other tools to remove all materials from the bucket prior to inverting it for maintenance work. This procedure also requires an examination of the work area by a certified person.
CONCLUSION
The cause of the accident was the failure to sufficiently clean and remove materials from inside the dragline bucket prior to standing it on end in an inverted position. The two fuel mechanics inadvertently placing themselves in a hazardous position to eat lunch was a contributing factor to the accident.
ENFORCEMENT ACTION
A Section 103(k) Order, No. 7600478, dated August 21, 2001, was issued to the operator to ensure the safety of all persons until an investigation could be completed and the dragline deemed safe.
Related Fatal Alert Bulletin:
FAB01C14
APPENDIX A
List of persons participating in the investigation:
TXU MINING COMPANY OFFICIALS
Phillip Jordan ............... Mine Manager
Don Lowry ............... Administrative Supervisor
Larry Schultz ............... Senior Safety Representative
Glenn Hood ............... Corporate Safety Representative
Daniel Grissom ............... Maintenance Superintendent
Michael Wilbanks ............... Maintenance Foreman
TXU MINING COMPANY EMPLOYEES
Richard Neal ............... Fuel Mechanic
Dennis Starek ............... Fuel Mechanic
Kenneth Jones ............... Mechanic
Roy Smith ............... Mechanic
Jerry Black ............... Mechanic
Marshall Hensley ............... Mechanic
Bobby Conner ............... Electrician
Clarence Brooks ............... Dragline Operator
LOCAL I.B.E.W. REPRESENTATIVE
Steve Austin ............... Miners Representative
MINE SAFETY AND HEALTH ADMINISTRATION
Lester Coleman ............... Coal Mine Safety and Health Inspector
Michael Shumway ............... Coal Mine Safety and Health Inspector
David Weaver ............... Mine Safety and Health Specialist
(Training), Educational Field Services
Allen L. Head ............... Supervisory Coal Mine Safety and Health Inspector
Calvert Browning ............... Coal Mine Safety and Health Inspector
APPENDIX B
List of persons interviewed:
TXU MINING COMPANY OFFICIALS
Phillip Jordan ............... Mine Manager
Don Lowry ............... Administrative Supervisor
Larry Schultz ............... Senior Safety Representative
Glenn Hood ............... Corporate Safety Representative
Daniel Grissom ............... Maintenance Superintendent
Michael Wilbanks ............... Maintenance Foreman
TXU MINING COMPANY EMPLOYEES
Richard Neal ............... Fuel Mechanic
Dennis Starek ............... Fuel Mechanic
Kenneth Jones ............... Mechanic
Roy Smith ............... Mechanic
Jerry Black ............... Mechanic
Marshall Hensley ............... Mechanic
Bobby Conner ............... Electrician
Clarence Brooks ............... Dragline Operator