Finally …
On June 10, 1889, the coroner’s jury investigating the Grand Trunk accident of the previous April 28th heard the coroner’s charge, deliberated among themselves for seven hours and then came out with their decisions.
The Hamilton Spectator of the conclusion of the inquest follows :
“The final act in the railway disaster inquest was reached last night, when the jury, at the expiration of seven hours’ deliberation, agreed upon a verdict. Coroner Woolverton called the jury together at three o’clock yesterday afternoon, and read to them a voluminous charge, reviewing in the most exhaustive manner, the evidence which had been furnished by a cloud of witnesses during the many long evenings which had been devoted by the jury to an earnest endeavor to discover if the dreadful casualty had occurred through any negligence or preventable cause of whatever description. After some introductory remarks, the coroner takes up the story of the conflagration as follows :
On the morning of April 23 last, about twenty human beings went down to their death without a moment’s warning in the frightful railroad accident which you have been investigating. To the horrors of the wreck was added the greater horror of fire, which did its devouring work but too well, taking away all possibility of recognition of the unfortunate victims by their friends, except where a trinket of a bit of clothing still remained to afford a mark of identification. All the evidence goes to show that the great majority were probably killed outright, and thus mercifully saved the suffering of a second death by burning. In connection with this point, it will be your duty to consider whether this fire could have been prevented, extinguished when it was first discovered, and so have made the consuming of the bodies less complete, and thereby have facilitated their identification. As to the first point, its prevention, I do not remember one witness who stated that it could have been prevented or extinguished on its first discovery. They all state that it burst out from three to five minutes after the wreck occurred. Engineer Watson said in five minutes it was ten feet high. Baggageman Welch, whose clear-headedness and energy (himself being injured) so deservedly met with your commendation, stated that he saw the fire shooting up immediately after he extricated himself from the wreck, and very significantly said that it appeared as if it arose from powder or coal oil, and almost immediately the flames shot up five or five feet away. It seems to me that this rapidity of ignition can only be accounted for by the breaking of the lamps, the oil from which saturated the broken timber, which was broken, as some have remarked, into “match-wood.” I think it would be well for the jury to consider this point of lighting trains with such an inflammable substance as coal oil, and if some less flammable substance could not be substituted, as fire adds infinitely to the horror of these train disasters. Now, secondly, it is for you to consider whether the fire was put out at as early a period as possible, as the evidence goes to show that it was not extinguished till about noon, or a little after. You will have to consider several things in this connection. First, the lack of the appliances and the difficulty in getting water in sufficient quantities to have any appreciable effect upon such a fierce conflagration as this evidently was. Could the small number, or any number, of buckets, carrying water up a steep embankment of seventy or eighty feet, have extinguished the fire? If you think not, were there other means taken, or if taken, taken sufficiently early to put out the fire in such a time that would have made any appreciable difference as to the extent the bodies of the unfortunate beings were consumed? It is easy to be wise after it is all over, and judging from full information. It is only fair and just that you should take into consideration that it is given to few to have clear and decisive judgments in times of great excitement and mental shock. Chief Aitchison stated it would take at least an hour to get his engine to work upon the wreck. There is doubt expressed whether the engine could have got to the vicinity of the fire by the road. The chief said it would have been useless if taken out by train, as no water could have been procured, and the chemical engine would have been of no use in the open air. If word had been sent to the fire brigade on reception of the first news of the accident, the fire might have been extinguished at an earlier period. But there is no doubt the Grand Trunk railway authorities were deceived as to the extent of the calamity by Mr. Walker’s report. I have heard it stated that the Grand Trunk railway authorities did not wish the fire to be put out at too early a period, so that the bodies should be entirely consumed, thus covering up the number killed. But, gentlemen of the jury, this is too horrible to be believed. There is not the least particle of evidence to sustain it. I am certain that no one of you would sustain such a foul suspicion.
The coroner then proceeded to review the evidence relating to the make up of the train at London, and the time occupied in the various stages of the journey from that city to the point where destruction overtook it. This has all been published as it was given to the jury. The evidence relating to the speed at which the train was going varied so much that it was difficult to come to any decision on that point. The testimony of the officials and employees of the road in connection with the construction and arrangement of the track and switch at the point of the accident, and the position of the rails, ties and switch after the accident was all carefully reviewed. Particular stress was laid upon the information furnished through the reports of the experts engaged by the jury, and the charge concluded with an acknowledgment of the assistance rendered the coroner’s jury by the railway company and its evident desire to discover, if possible, what caused the accident.
At four o’clock the court room was cleared and the jury left to digest the mass of testimony. At ten o’clock the jury reported to the coroner the result of its lengthy deliberation, which is as follows :
The jury are of opinion that Frederick Gurney, R. J. Ederer and others who were passengers on the No. 52, east bound express, on Sunday, the 28th day of April, 1889, were killed by the accident which occurred to that train at the junction cut, near Hamilton, caused by the breaking of the flange of the left leading wheel of the engine truck, which break allowed the wheels to leave the track at the switch; and the jury are also of opinion that the speed at which the train was running had much to do with the cause and extent of the disaster which followed. Your jury are also of opinion that greater efforts could have been put forth to prevent the almost entire cremation of the unfortunate people who were buried in the wreck. Your jury would recommend, from all practical evidence adduced, that on a curve with a switch and a down grade a greater speed than twenty miles an hour is not consistent with safety; and further, that fifteen miles per hour would be much safer and desirable in the interests of the travelling public at such a point, and would likewise recommend that the government take such action as may be necessary to ensure a full and complete inspection by a competent person in all cases where there has been a loss of life through accident before anything whatsoever has been removed or touched than what may be necessary to rescue bodies from the wreck. Had this been followed the jury would have come to a verdict with much more ease and certainty.
W. A. Robinson handed in some supplementary testimony before the coroner read his charge, but it was principally amplification of points already dealt with in his previously published report.
Before adjourning the following resolution was moved by Mr. Littlehales, seconded by John Alexander : That the time, attention and skill bestowed in this inquiry by the coroner, Dr. Woolverton, justly entitles him to some extra remuneration, and this jury respectfully makes the suggestion to the government on his behalf.
A vote of thanks was tendered the chairman, John Hoodless.
The jury then dispersed, no doubt feeling a deep sense of relief at having at length arrived at the end of one of the longest inquiries of this nature ever held in Canada.
The Hamilton Spectator had the following editorial published after the coroner’s jury had made its final report:
“The jury which made inquiry into the railway accident near Hamilton on the 28th of April last has rendered its verdict. The investigation has been long continued. We believe all available testimony of importance has been brought out; and that the verdict is substantially in accordance with the evidence.
At the beginning, the question will be asked whether the calamity was due to any serious defect in the locomotive, the cars or the roadway. That question may with confidence be answered in the negative. The roadbed was in excellent condition, the locomotive and the cars fully equal to the best which money could buy.
The next question is, Was the train running at an unsafe rate of speed? The jurors say it was. The train was timed to leave London at 4:45 a.m., and to reach Hamilton at 6:55; seventy-five miles in 130 minutes – one mile in one minute and forty seconds – very nearly thirty-five miles an hour. Two stops were necessary – one, when approaching the crossing at Paris, the other when approaching the crossing at Harrisburg; while it is necessary to slack speed materially before passing the landslide at Dundas. An average speed of rather more than thirty-five miles an hour was necessary in order to cover the ground within the schedule time. The train was ten minutes late at London, lost one minute between London and Paris, and five minutes between Paris and Harrisburg, while from Harrisburg to Dundas it ran the time allowed by the time table, though not on time. This is thirteen miles in twenty-one minutes, one mile in one minute and thirty-six seconds, or rather more than thirty-seven miles an hour. The time allowed from Dundas to Hamilton is eleven minutes : at the rate of one mile in one minute and fifty seconds, or nearly thirty-three miles an hour. The instructions to engineers are not to make up lost time. There is some reason to fear that in this case these instructions were not faithfully followed. The train, as has been said, passed Dundas at seven o’clock. It ran nearly five miles before the accident occurred; then the conductor got out of the train, helped pull three passengers from the ruins, ran a quarter of a mile to the telegram office at the Toronto junction, and sent a dispatch to the city office, which dispatch was received at &:14. Let any person calculate for himself the time which would be consumed by the conductor in performing these various acts, deduct that time from fourteen minutes, and the remainder will be the time consumed by the train in running the distance from Dundas to the scene of the accident.
The immediate cause of the accident was the breaking of a part of the flange on one of the wheels of the bogey or track under the forward part of the locomotive. In some manner wholly unexplained, the forward truck axle became jammed and refused to revolve, the wheels slid along the rails till the flange broke, then that wheel mounted the rail, passed over it and slightly displaced it. The driving wheel following struck the end of the next rail about in the center, mounted it and ran off, dragging a portion of the train after it. The truck wheel which broke was sound and strong. The breakage was due to no defect of workmanship or weakness of material; and the actual original cause of the disaster will probably remain a mystery forever. What is certain is that the switch had no agency in the calamity. If it had, the point would have been bent or jammed; but there was no mark upon it.
Absolute proof not being in existence we are permitted to theorize a little: The train passed Dundas, on a down grade, at thirty-five miles an hour. The track was slippery, the train heavy and sixteen minutes late. Passing Dundas the track is straight for about a mile; then comes the sharp curve at the crossing of the Dundas and Waterloo road; then the track is again straight and nearly level. Let us suppose that the engineer found he had greater headway than he desired. He was approaching the Toronto junction, the Desjardins bridge, and the heavy grade running down to the Hamilton yard. He put on brakes, and at once the whole weight of the baggage, express and passenger cars became a force pressing upon the locomotive. When the locomotive reached the curve, it struck the incline of the rails towards the inside, and it swerved in that direction. The springs caused it to rebound, and at the moment the centrifugal force acting with the rolling of the machine threw the forward truck wheel with unusual force against the outer rail, broke the flange, disturbed the rail itself; and in an instant all the forward part of the train was a wreck.
Each accident of this nature is an admonition to make some endeavour to remove the causes of such calamities. We cannot ask the companies to lower the speed of trains. So long as rival lines maintain high rates of speed, this line must do the same or lose its through traffic. It would be a good thing for the public, and the companies would save money, if the maximum through rate were reduced to twenty-miles an hour: but unless all the companies agree, the thing cannot be done.
What can be done is to heat the cars with steam and light them with electricity. Then the frightful burnings which follow such accidents will be stopped. Now the lamps are broken and the oil scattered over the broken cars; the stoves are upset, and the coals scattered around; and a few seconds suffice to put the whole mass into a fierce conflagration. There is every reason to think that all those whose bodies were burned were killed by the crashing together of the cars. But in any case it is the duty of the railway companies to make every possible effort to prevent fires after accidents.”