DEPARTMENT OF LABOR
MINE SAFETY AND HEALTH ADMINISTRATION
Coal Mine Safety and Health
Report of Investigation
Underground Coal Mine
Fatal Fall of Rib Accident
August 19, 2002
Cardinal Mine
Warrior Coal LLC
Madisonville, Hopkins County, Kentucky
ID No. 15-17216
Gunther-Nash Inc. ID B08
Slope Sinking Project
Accident Investigators
Edward R. Nichols
Coal Mine Safety and Health Inspector
Curtis W. Haile
Coal Mine Safety and Health Inspector
Originating Office
Mine Safety and Health Administration
District 10
100 YMCA Drive
Madisonville, Kentucky 42431-9019
Carl E. Boone II, District Manager
Release Date: September 27, 2002
OVERVIEW
On Monday August 19, 2002, at approximately 9:00 p.m., a rib roll occurred in the developing underground belt slope of Warrior Coal LLC's Cardinal mine. The fall of rock from a rib roll caused fatal injuries to a 29-year-old supply man who had approximately eight weeks total mining experience. The victim was gathering tools and placing them in the material-hoisting car to be taken outside when he was struck by a rock measuring 8.5 feet by 3 feet by 2 feet.
General Information
The Cardinal mine, I.D., 15-17216 is located three and one tenth miles southwest of Manitou, Kentucky off U.S. Highway 41. This underground coal mine began operating as Cardinal #2 under the ownership of Robert Bros. Coal Co. Inc. on March 9, 1993. On February 16, 2001 the Legal Identity was changed to reflect that Warrior Coal, LLC was the official operator and the mine name was changed to Cardinal.
The Cardinal underground mine currently employs 136 persons. Coal is extracted on two mechanized mining units by the room and pillar method during two 9-hour production shifts daily and one maintenance shift. Continuous mining machines extract coal from the Kentucky No. 9 coal seam on the No. 1 unit, MMU 001-0. Continuous mining machines are also used to extract coal on the No. 2 Unit, MMU 002-0, which operates in the Kentucky No. 11 coal seam. Shuttle cars are used to transport coal from the working face to a conveyor belt that transfers it to the surface overland belt for conveyance to a surface preparation facility. The processed coal is shipped by rail to Louisville Gas and Electric (LG&E) and the Paradise TVA power generating facilities located in western Kentucky.
The principal officers at the Cardinal Mine at the time of the accident were:
William C. Adelman .............. General ManagerGunther Nash Inc. (MSHA I.D. B08), an independent contractor from St. Louis, Missouri was contracted by Warrior Coal, LLC to sink an airshaft and a belt slope into the underground workings of the Cardinal mine. The airshaft was completed on July 3, 2002. Gunther Nash is currently developing the slope into the Kentucky No. 9 coal seam on a 16-degree grade starting from the surface elevation of 463 feet to the bottom elevation of 74 feet. The slope dimensions during the excavation before the installation of the tunnel liner is 19 feet wide and 12 feet in height. The finished slope will be 15 feet wide and 8.5 feet in height with the finished tunnel liner installed. The excavating is being done by the drill, shoot, and muck method. A Gardner Denver Drill 93 mounted on a rail mounted drill jumbo is being used to drill the face. EMICO Models 632 or 634, air operated mucking machines, load the rock from the face into steel rail mounted muck cars. The muck cars are hoisted to the surface by a Vulcan hoist to a rollover dump structure.
Paul Love .............. Safety Director
Tom Kessinger .............. Mine Foreman
The slope is ventilated by a two stage direct driven axial flow Spendrup 71x2-45-3600-CR fan driven by two 50 horsepower motors. The slope is supported by 48" rock lock bolts installed on four-foot centers in the roof and on the ribs as required. Test holes 12" deeper than the roofbolts being installed are drilled every 30 feet. The slope at the time of the accident had advanced from the surface approximately 1545 feet. The total length of the slope is proposed to be 1726.94 feet from the surface to the bottom of the coal seam. The location where the accident occurred was approximately 1473 feet from the surface.
Forty persons were employed at the slope sinking operation. Six persons, in addition to the hoist operator, were working during the second shift when the accident occurred.
The names of the independent contractor officials are as follows:
Albert J. Dudzik ............... Vice President of OperationsThe last Regular Safety and Health Inspection (AAA) was completed at the Cardinal Mine by the Mine Safety and Health Administration (MSHA) on June 28, 2002. A Safety and Health (shaft, slope, and major construction sites) Inspection was conducted (BAE) August 13, 2002.
Terry Adams ............... Project Superintendent
Albert Gonz ............... Project Manager
Description of the Accident
On August 19, 2002, between 3:30 p.m. and 4:00 p.m., Foreman Matt Merrifield conducted a pre-shift inspection of the slope and reported no hazardous conditions were observed. The second shift crew consisting of Dwight Camplin, Greg Kirtley, Phillip Clark, and Barron Kennedy, under the supervision of Foreman Thomas Behnke, entered the slope at their regularly scheduled starting time of 4:00 p.m. Mickey Travis, (victim) who works the majority of his shift on the surface, was responsible for loading tools and supplies for the face crew. The roof of the slope in the face area had been supported during the previous day shift. The second shift loaded out two car loads of rock from the face of the slope approximately 1545 feet inby the portal and pumped water to the surface that had accumulated at the face. Additional sections of track rail were installed prior to marking locations on the face for the drill hole placements.
The Gardner Denver drill was hoisted down the slope and used to drill 45 holes in the developing face. Around 8:15 p.m., Mickey Travis first entered the slope to transport explosives and blasting caps near the face of the slope on two separate hoisting cycles. After the face was drilled, Travis and Kirtley traveled alongside the drill as it was being hoisted back to the surface. Behnke, Camplin, Kennedy, and Clark began cleaning out the drilled holes in the face and loading them with explosives.
Kirtley and Travis re-entered the slope and were lowered down to the face area around 8:45 p.m. Kirtley began assisting the others loading explosives in the face while Travis started gathering the hand tools and other supplies that were to be transported to the surface prior to blasting the face. The crew working at the face could hear Travis, who was working approximately 72 feet up the slope, throwing objects into the muck car. The area Travis was working had been mined through approximately five days earlier. Shortly after 9:00 p.m., the face crew heard the sound of a rock falling in the area where Travis was working. Clark yelled out to Travis but got no response. When he and the others saw the reflective tape on Travis's safety harness near the base of the fallen rock, they began running up the slope to aid Travis.
Clark and Foreman Behnke arrived at the scene first and saw the upper portion of Travis's body pinned beneath the rock. Behnke immediately telephoned the hoist operator on the surface to request the ambulance service. Kennedy pushed the upper half of the rock, which apparently had separated on impact, toward the center of the slope during the rescue attempt. The rock measured 8.5 feet in length by 3 feet in height and 2 feet wide.
Behnke, Clark, Kirtley, with the help of fellow workers Kennedy and Camplin used pry bars and boards to lift the rock high enough to the remove the victim. Foreman Behnke performed CPR on Travis until he was loaded in the stretcher and transported to the surface inside the rail- mounted muck car.
The Regional Medical Ambulance Center in Madisonville, Kentucky received the dispatch call at 9:11 p.m., and arrived at the construction site at 9:21 p.m. The ambulance left the mine site at 9:26 p.m., transporting Travis to the Regional Medical Center where he was treated for injuries. Mickey Travis was pronounced dead at 1:45 a.m., on August 20, 2002.
Investigation of the Accident
Albert Gonz, project manager, notified MSHA of the accident on August 19, 2002, at 9:40 p.m. MSHA Supervisor James Hackney along with accident investigators Eddie Nichols, Curtis Haile, and Roof Control Specialist Terry Cullen, arrived at the mine at 11:20 p.m. A 103(K) order was issued to ensure the safety of all persons and an investigation of the underground accident immediately began.
Preliminary interviews were conducted with miners who were working in the vicinity where the accident occurred prior to the investigating team entering the underground slope. Photographs were taken and sketches were made of the accident scene. Additional photographs and sketches were made on August 21, when the investigators revisited the accident site with Technical Support Specialist John Cook and International Representative of the United Mine Workers of America Butch Oldham.
On August 21, interviews were conducted with Foreman Thomas Behnke, and hourly workers Dwight Camplin, Craig Kirtley, Phillip Clark, and Barron Kennedy at the MSHA District 10 Office in Madisonville, Kentucky.
The on-site portion of the investigation was completed and the 103(K) order was terminated on September 5, 2002.
Training
James Hackworth, MSHA Educational Field Services Specialist, reviewed Travis's training records and all the required training was found to be complete.
Discussion
During the investigation the following physical factors were determined to be relevant to the occurrence of the accident:
1. The victim was gathering tools in a bucket approximately 72 feet outby the face of the developing slope when the accident occurred. He was working in the area where the pager phone communication system to the mine surface was located.
2. The roof of the slope where the accident occurred was supported approximately 5 days earlier with 4 foot and 6 foot long fully grouted roof-bolts with 6" by 16" steel plates. Roof-bolts were installed beginning at 8 feet from the floor on the left side facing down the slope on 2-foot centers across the roof to within 10 feet of the floor.
3. As indicated by the drawing of the Geological Slope Profile, beginning at 1300 feet and extending to face at 1545 feet, the slope intersected several different coal streaks and changes in strata. These changes in strata were also visible to persons working and traveling inside the slope.
4. Strata material from the area where the accident occurred was susceptible to moisture degradation. Water in the slope and on the rib surfaces may have weakened the strata and contributed to the rib failure. Vertical stress from approximately 400 feet of overburden may also have been a contributor.
5. Pre-Shift and On-Shift examinations of this area failed to detect any visible hazardous conditions of the roof and ribs.
Root Cause Analysis
The root cause was management's failure to adequately control the ribs as required by the Approved Slope Sinking Plan.
The drawing of the Geological Slope Profile indicated the slope would intersect several coal streaks and changes of strata between the 1300 foot depth interval and the 1545 foot depth interval. These changes in strata were also visible to persons working inside the slope.
The accident could been have prevented by management recognizing the hazards associated with the changes in strata through the transitional area and adequately supporting the rib by adding wire mesh securely attached to the roof bolts or steel arches with lagging as additional support.
Conclusion
It is the consensus of the investigation team that the accident occurred because of inadequately supported rock that fell from the rib of the slope approximately 72 feet outby the developing face.
Enforcement Actions
(1) A 103(K) order No. 4069131 was issued to Gunther Nash Inc. to ensure the safety of the miners until the investigation could be completed.
(2) A 104(A) citation No. 4069133 was issued to Gunther Nash Inc., I.D., B-08, for a violation of 30 CFR, Section 77.1900 stating "The roof and Rib control portion of the Slope Sinking Plan was not being complied with in that the ribs were not adequately controlled where required. On August 19, 2002, an 8.5 foot by 3 foot by 2 foot rock fell from the left rib of the slope fatally injuring a Gunther Nash Inc. employee.
Related Fatal Alert Bulletin:
FAB02C20
Appendix B
Appendix C
APPENDIX A
The following persons provided information and /or were present during the Investigation:
Gunther Nash Inc. Mining Officials
Albert J Dudzik .............. Vice President of OperationsGunther Nash Inc. Mining Employees
Terry Adams .............. Project Superintendent
Albert Gonz .............. Project Manager
Thomas Behnke .............. Shift Foreman
Craig Kirtley .............. Miner DrillerMine Safety and Health Administration
Phillip Clark .............. Miner Driller
Barron Kennedy .............. Miner Driller
Dwight Camplin .............. Miner Driller
James Hackney .............. Supervisory Coal Mine Safety and Health Inspector
Eddie Nichols .............. Inspector/ Accident Investigator
Curtis Haile .............. Special Investigator/ Accident Investigator
Terry Cullen .............. Roof Control Specialist
John Cook .............. Mining Engineer, MSHA Office of Technical Support
James Hackworth .............. MSHA Educational Field Services Specialist