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guiriduro • yesterday at 3:11 PM • 1 reply • view on HN

They had an automated system, it had failed earlier in the day in that section causing trains to be signalled to stop. Then they had a manual go-slow human backup protocol which appears to also have not been observed - some drivers were given clearance to continue as normal. Swiss cheese of compounded failures, with tragic results.


Replies

sdoering • yesterday at 3:13 PM

And what are the systemic practices in place that led to people not following the official protocol?

Because if the system punished compliance and rewarded such behavior, you now have a systemic issue underlying the "people are lazy".

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