WASHINGTON - A bus driver's mistaken use of an exit ramp when he intended to stay on an Atlanta freeway's high-occupancy-vehicle lane caused a crash that killed him, his wife, and five Bluffton University baseball players 16 months ago, the National Transportation Safety Board concluded yesterday.
The report that the safety board adopted yesterday also faulted the Georgia Department of Transportation for inadequate and, in some cases, confusing signs and lane markings on southbound I-75 at the Northside Drive interchange as contributing to the crash.
The NTSB reiterated previous recommendations for enhanced safety systems on motor coaches that it said would have reduced the crash's severity.
The safety board recommended that the Georgia transportation agency immediately make sign and marking changes beyond those it performed shortly after the crash on March 2, 2007.
The accident killed Jerome and Jean Niemeyer, along with ballplayers David Betts, Tyler Williams, Scott Harmon, Cody Holp, and Zach Arend. All except Mr. Arend were killed instantly.
Twenty-eight other players and team staff members were injured, seven seriously.
The board also advised the Federal Highway Administration to pursue changes in sign and marking standards for such ramps on a nationwide basis, and urged the National Highway Transportation Safety Administration to follow through on bus-safety measures that the NTSB first proposed in 1999. Those measures include:
• requiring seat belts for all passengers.
• installing windows glazed with a special shatter-resistant coating to reduce the risk of passenger ejections in crashes.
•strengthening roofs for crush resistance during rollovers.
•installing electronic data recorders to measure vehicles' operating systems and also to record impact forces during crashes.
John Betts, the father of crash victim David Betts, said the NTSB findings included no surprises but provided reinforcement to the growing call for enhanced passenger-safety appliances on motor coaches.
Mr. Betts expressed doubt, though, that the National Highway Traffic Safety Administration will adopt bus-safety regulations in a timely manner, and said his hope rests with bus-safety legislation in the U.S. Senate.
The NTSB, he said, made "the same recommendations they made since 1999. The issue is how you get from hither to yon."
"[Yesterday's] report underscores the need for stronger safety regulations to protect bus passengers," said U.S. Sen. Sherrod Brown (D., Ohio), co-sponsor of the Senate motor coach safety bill introduced after the Atlanta crash.
"Bluffton University students and families affected by this tragic accident have turned their understandable grief into action," Mr. Brown said after yesterday's NTSB meeting.
Eric Fulcomer, vice president for student life and enrollment management at Bluffton University, called the safety board's report "comprehensive" and predicted lives will be saved if regulatory agencies adopt its recommendations.
"It's frustrating that some of their recommendations had to be reiterated. Some of these things could be implemented tomorrow," Mr. Fulcomer said.
Mark V. Rosenker, the safety board's chairman, pledged to personally contact Nicole Mason, administrator of the National Highway Traffic Safety Administration, to promote the NTSB recommendations, and called on relatives of crash victims to support that cause.
"It is also our [the safety board's] job to advocate for the recommendations we have made," he said, and the survivors and relatives can be "great partners" in that effort.
"We need to take this tragedy and learn so that other families don't have to endure the pain that you are going through," Robert L. Sumwalt, the safety board's vice chairman, said while addressing victims' relatives in the audience at the NTSB hearing room in Washington. Mr. Sumwalt also cited the legislation Mr. Brown and U.S. Sen. Kay Bailey Hutchison (R., Texas) have sponsored as a positive step.
The NHTSA declined to comment on remarks made about its regulatory performance during the meeting.
At about 5:38 a.m. on March 2, 2007, the chartered bus taking the Bluffton baseball team to a tournament in Sarasota, Fla., exited southbound I-75 at Northside Drive at an estimated 65 mph, careened through a street intersection at the ramp's top, struck a barrier wall on the far side, then flipped over the barrier and tumbled 19 feet back onto the freeway.
Four passengers were ejected onto Northside Drive before the bus flipped over the barrier wall, six more were ejected onto the freeway when it landed, and two were partially ejected and pinned under the wreckage, Kristin Poland, the safety board's biochemical analysis group chairman reported.
Since the safety board last recommended safety belts, coated window glass, and other passenger-protection measures in 1999, she said, the agency has investigated 33 bus crashes in the United States that have involved 123 deaths, 1,031 injuries, and 255 passenger ejections.
Other countries, notably Australia and members of the European Union, have required at least lap belts - if not lap-shoulder belts - for many years.
While the baseball team had been on the bus overnight, Mr. Niemeyer had relieved a previous driver in Adairsville, Ga., at about 4:30 a.m.
The bus traveled about 54 miles with Mr. Niemeyer at the wheel before the crash.
NTSB investigators said yesterday they believe Mr. Niemeyer may have become fixated on the yellow stripe along the freeway's left shoulder as he drove toward Atlanta and mistakenly followed it onto the exit ramp at Northside Drive.
David Rayburn, chairman of the investigative team's highway factors group, said it was also possible Mr. Niemeyer, who had made the Florida trip for Bluffton University twice before, mistook the Northside ramp for a point about a mile farther south where the high-occupancy-vehicle (HOV) lane itself separates from the I-75 mainline to merge with the HOV lane on I-85, where those two freeways intersect.
Design and placement of "guidance" signs leading up to the Northside exit was the subject of extended discussion both in the report and among the board members. Rather than having white letters on a green background, as is normal for informational signs, the HOV lane's signs had black letters on a white background, just like speed-limit signs.
Furthermore, signs designating the exit ramp and the through lane at Northside were not located on the same mast.
Mr. Rosenker said he found that separation "particularly troubling" because a driver not carefully reading the signs could mistakenly believe the arrow pointing to the Northside exit was actually guiding him or her along the HOV lane's route.
Mr. Rayburn said the Georgia Department of Transportation had posted the two signs separate from each other when the HOV lane was created in 1996 because of metal failure with signposts that would have been necessary to support two signs over the roadway.
The sign arrangement was considered acceptable at the time and approved by the Federal Highway Administration, he said.
Since then, Mr. Rayburn continued, stronger signposts have been developed that do not have the same metal problem.
Among the safety board's recommendations to GDOT is a specific request that all exit-ramp arrow signs have a companion sign identifying the mainline route.
Mr. Rayburn also reported that along with reviewing nine crashes involving motorists who took the Northside exit at high speed after 1996, investigators received numerous comments from people in the area who reported taking that exit by mistake but discovering their error before they crashed. All nine of the motorists involved in the wrecks were either from distant parts of Georgia or from out of state, he said.
Gena Abraham, commissioner of the Georgia Department of Transportation, issued a statement reporting that her agency already is considering changes in its sign standards as a result of the crash and Federal Highway Administration recommendations.
"We heard quite clearly the recommendations of the National Transportation Safety Board. We do understand. We are going to consider every option put before us by the NTSB and the Federal Highway Administration," Ms. Abraham said.
No HOV lanes like the ones on I-75 in Georgia exist in Ohio or Michigan.
While Mr. Niemeyer's commercial driver's license was valid at the time of the crash, the accompanying medical certificate had expired on March 1, 2007 - the day before, said Deborah Bruce, the NTSB's project manager for the inquiry. But while staff also noted that Mr. Niemeyer exhibited several risk factors for sleep apnea, a disorder that compromises one's quality of sleep, the agency drew no conclusion that Mr. Niemeyer was unfit to drive in any other sense than the certification violation.
They also said that Mr. Niemeyer appeared to have had adequate time for at least seven hours' sleep before going on duty that morning, had not worked for 12 days before driving down to Adairsville the day before, and had only been driving the bus for an hour - all indications that he was unlikely to have fallen asleep at the wheel.
After the crash, Ohio officials determined that Executive Coach Luxury Travel, the Ottawa, Ohio-based charter bus operator, had been delinquent in overseeing its drivers' certifications, said Bruce Magladry, director of the NTSB's Office of Highway Safety.
Matt Butler, a spokesman for the Public Utilities Commission of Ohio, said later yesterday that Executive Coach is no longer registered with the state and its insurance coverage was canceled in October. He could not immediately confirm the results of a compliance review his agency performed after the crash.
- David Patch
Contact David Patch at:
or 419-724-6094.38.89037 -77.03196