What steps led up to the error.

    October 7, 2022

Research the real-life story of Angels Flight Derailment that occurred in 2013. You are free to
research the 2001
incident, but for this report stick with the events that occurred in 2013. As
you are researching the story, think
about what went wrong and what errors might have
triggered the incident.
First Paragraph: Identify the cause(s) of error (there may be multiple errors that occurred that led to the
incident). Pick only 3 main errors and for each error you will conduct a step by step analysis that
will include each of the
1. Describe the error that occurred.
2. Type of error: Slip, Mistake, Lapse, or Violation.
3. At what level: Perception, Cognition, or Action.
4. What steps led up to the error.
Second Paragraph: Prevention; As a conclusion include what could have been done to prevent the errors you
identified. Be creative and original; aim for system-level solutions (e.g., design,
engineering controls, substitutions) and not only individual-dependent solutions (e.g., training,
discipline, procedures, rules, etc.).

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