On June 10, Minister presented the report to Cabinet. In his Facebook, Dr Wee highlighted "the Investigation Committee’s 23 recommendations to achieve these systemic improvements expeditiously". He enlisted the improvements recommended for short term of three months, medium term of 3 to 6 months, and long term of 6 months or longer. .
The real matter sought by the public is the cause and he touched on it near the end of his posting. An extract reproducd below:
FACTORS LEADING TO INCIDENTIn the report, the Cabinet has been informed of the sequence of events that led to the collision. Due to a combination of technical faults, communication between the hostler/driver and the operations control centre (OCC) in safely manning the empty ‘timed-out’ Train 40 and release of Train 81 were compromised prior to the incident.Train 40 experienced technical difficulties and the Vehicle On-Board Communication (VOBC) system was halted on one of two of its VOBC systems at 6.26pm on 24 May 2021. The standby VOBC, as the standard redundant safety system of the LRT trains, then kicked in. In line with proper safety procedure, Train 40 was then vacated of passengers and remotely brought to the Lembah Subang depot via Automated Train Operation (ATO) mode for the necessary maintenance.However, at 8.13pm, the second VOBC on Train 40 halted and lost communication (time-out) with the OCC while en route to Lembah Subang depot. As a failsafe system, when a train experiences time-out, it will come to a complete stop. Train 40 stopped between KLCC and Kampung Baru LRT stations.
During this time-out, the OCC was unable to detect and remotely control Train 40. A hostler was then called to manually reset both VOBCs and drive Train 40 to the ‘re-enter’ point near Dang Wangi LRT station (after Kampung Baru station), in an attempt to return operation of Train 40 to ATO mode.During the process of resetting both VOBCs and driving the Train 40 manually to the re-enter point, both the hostler and OCC’s train controller had overlooked and missed critical procedures during this process. This inadvertently resulted in Train 40 being manually moved towards KLCC station instead of south-bound towards the designated re-entry point at Dang Wangi station.At the same time, Train 81, with passengers on board and on the same track, was held back at KLCC LRT station and a protective Manual Route Reservation (MRR) was implemented while Train 40’s situation was being resolved. However, the MRR was lifted and Train 81 was prematurely made to depart KLCC station towards Kampung Baru station without the proper verification that Train 40 had been safely reset and re-entered into ATO mode. This led to the collision between Train 40 and Train 81.
The public and media picked on the statement in the conclusion:
To reiterate, the findings of the Investigation Committee’s report aim to introduce systemic changes that will prevent similar future incidents and to repair confidence in the public transport services. It is not to apportion blame nor liability on any party.
The knives are out to find the culprit and lawyers are sharpening it. Naturally the "not to apportion" is not words they would take positively.
Singapore media highlighted "train driver, control centre overlooked critical procedures before LRT crash". Dr Wee was quoted in The Star saying, "Train 81 should not be released from KLCC while there is another train in the tunnel".
Dr Wee clarified in another FB status to explain the action to be made on the perpatrator or errand ones is not the responsibility of the Investigation Committee, but an Adjudicating Committee. And, he reiterated the term of reference of the Investigation Committee.
There will be damages claims from affected passengers. There was a systemic error and the party liable for the error will need be identified and actions taken. Otherwise, it will weaken Prasarana legal standing. The need for an Adjudicating Committee to established will arise.
To reiterate again, the accident did not cost any life. Apart from a single or two serious medical cases, all passengers lived and those limping out of the hospital could recover. That would be something to thank God for.
It is not the first rail accident in Malaysia but it is uniquely first for Putra LRT. Even the Japanese Shinkasen had an accident in 2017. The efficient Japanese have the own history of rail accidents. It is not an excuse, but more important than the adjudication is the immediate remedial action to avoid a repeat of such occurance.
Till the Putra LRT Adjudicating Committee is established, over and out.