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NTSB Presentation Focuses on School Bus Fire Suppression Systems, Driver Health

The National Transportation Safety Board (NTSB) shared how recent school bus-related crashes and the lack of fire suppression systems and oversight of driver health contributed to recent fatal school bus crashes, representatives told attendees of an online National Association of State Directors of Pupil Transportation Services (NASDPTS) conference.

Sheryl Harley, a highway crash investigator with the NTSB, walked attendees of last week’s NASDPTS Federal Forums Plus conference through the purpose of the NTSB, which has studied various school bus-related crashes over the years. NTSB aims to determine the circumstances surrounding an incident and to make safety recommendations to hopefully mitigate future crashes.

For instance, she discussed the circumstances involving specific crashes over the last couple of years relating to school districts and pupil transportation. She discussed the Loxley, Alabama, motorcoach crash in March 2018, the Mesquite, Texas, school bus crash in October 2018 and the Bowlegs, Oklahoma, school bus crash in March 2019.

She said investigators determined that the Alabama driver suffered a medical event, which caused the driver to lose control of the motorcoach. The vehicle struck a bridge guardrail and fell 50 feet below the interstate. The driver was killed. Fifteen students on board were seriously injured, and 31 sustained minor injuries.

Harley said that while NTSB found that no pre-trip safety briefing was provided to the students, the driver’s pre-existing medical condition was the main cause of the crash. The driver was required to take medication yet did not disclose his condition to his employer.

In Mesquite, Texas on Oct. 3, 2018, a school bus was traveling southbound when the rear-tire of the school bus came loose, causing the 57-year-old school bus driver to lose control of the vehicle and veer off the road. The bus rolled then hit a power pole which caused a fire to ignite. One 12-year-old student on board was unable to evacuate due to her foot being trapped and was killed in the crash.

The NTSB found that had a fire suppression system been installed, emergency personnel would have had more time to free the student.

For the 2019 school bus crash in Oklahoma, Harley said NTSB once again found that a fire suppression system inside the school bus would have helped in the rescue efforts of the student that was otherwise killed.

On March 8, 2019, the school bus was occupied by a 30-year-old coach who was also the driver and six student softball team members. The girls were not seated properly within their seats, some standing and another sitting near the stairs of the bus, all gathering around the driver.

An SUV driver was serving back and forth between two lanes and as the school bus driver switched lanes to avoid a collision, the SUV driver served back, crashing into the school bus head-on. The SUV ignited into flames, engulfing both vehicles. The driver attempted to rescue all the student passengers, who were thrown about the bus, some ejected and one partially ejected due to standing during the collision. However, due to the smoke, the driver failed to notice one student, who was fatally killed.

The NTSB found several safety issues, including the students and driver violating state and school policies as well as the rapid development of fire and smoke which prevented rescue efforts by the driver.


Related: Fiery School Bus Crash in Texas Kills One Student
Related: Okla. School Bus Carrying Softball Team Hit Head-on, Three Dead


When studying a crash involving a driver who suffered a medical emergency, Harley noted that investigators seek to answer if it was an underlying health condition or the crash killed the driver first. She then announced an NTSB Medical Oversight Workshop coming in the spring.

The one-day training is designed to help improve driver health and ultimately driver safety, by covering topics on improved oversight, reporting safety issues, promoting safety, and promoting adequate care for drivers.

A spokesperson for the NTSB told School Transportation News that the event “will be a workshop where NTSB will bring a broad group of stakeholders together to discuss challenges and solutions related to the medical oversight of commercial vehicle drivers to promote traffic safety. The event will provide a forum for NTSB to hear from experts about potential ways to improve the medical oversight process.”

The NTSB is following health information to determine the format and date of the Medical Oversight Workshop for 2021. The event will be open to the public and more information on whether it will be conducted virtual or in-person, along with a date, will be provided in the future.

Meanwhile, Michele Beckjord, an NTSB survival factor investigator, discussed the process of how the agency conducts its investigations. She explained that the first step is to determine if the crash would provide any safety updates to the agency’s existing recommendations.

She said the NTSB Response Operations Center monitors crashes that occur nationwide. Once NTSB determines a crash meets the criteria for being investigated, including factors that the agency has yet to study, a team is dispatched to the scene. An onsite investigation could take anywhere from five to 14 days.

She said once on the ground, NTSB takes a multidisciplinary approach to the investigation and considers human performance, survival factors, vehicle factors, motor carrier operations, and technical support staff, when conducting the investigation.


Related: NTSB on Getting Back to School Safely
Related: Landsberg Named to New 3-Year Term as NTSB Vice Chairman
Related: NTSB Releases Full Final Report of Fatal Indiana School Bus Crash
Related: Requiring Lap/Shoulder Seatbelts Remains Among NTSB School Bus Safety Wishes


Members of the investigation team then submit and share any reports and information that they have regarding the crash. She said if a school district representative joins the team, they must understand that all the information shared is only between the group. The school district is ordered to not speak to the media. All outside communication must come from NTSB itself.

Beckjord explained that not everyone is allowed onto this “party process” team. Attorneys, insurance agency representatives, human resource personnel, union officials are barred from joining. She stressed that those on the team must bring specific technical expertise to the investigation process.

She said also that while onsite, the NTSB officials hold press briefings for the first few days. Team members would also be conducting interviews and would start pulling together vehicle, driver and passenger data.

In the weeks following the onsite investigation, the NTSB would release an initial investigation report and submit recommendations to involved parties for preventing future similar crashes.

Beckjord stressed that while there is usually one probable cause of a crash, several other contributing factors could also be present. She noted that many of the crashes investigated are preventable.

Editor’s Note: This article has been updated to include addtional information on the Medical Oversight Workshop hosted by the NTSB in the spring of 2021. 

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