Challenging Our Thinking Regarding Lift Incidents

Roger Kahler and Nicholas Pierce

Wednesday 22nd September 2021

The purpose of this paper is firstly to present an understanding of the elevator fatality problem. Fatalities will then be presented in the context of the overall burden of personal damage. Damage to people can be classified as multiple fatality, single fatality, non-fatal permanent damage, temporary, and minor damage. The patterns or taxonomies associated with each class of damage are generally quite different from one another. The paper will suggest that the damage class of non-fatal permanent damage represents 80% of the cost of all damage (by any measure) and yet data with respect to elevators is seriously lacking on this class of damage. If we cannot describe the non-fatal permanent damage problem, we form hypotheses as to whether or not it is simply a subset of another level of damage. For example, a hypothesis could be “non-fatal permanent damage is a subset of fatalities. Therefore, manage fatalities and you will manage non-fatal permanent damage”. If the hypothesis is true, the overall size of the problem will alter. If the hypothesis is not true, we do not impact a critical class of damage. The proposition that will be put before the conference is that we cannot describe the size and nature of the problem associated with non-fatal permanent damage associated with elevators. Herein lies an opportunity, but the beginning point is the recognition of the gap. Additionally, the paper will present a model for thinking about the timeline of an elevator fatality event, suggesting there is still much more to do in the engineering space versus the procedural/training space. For example, Engineers need to be challenged to think about elevator equipment and the elevator shaft more strongly as an information detector, information processor, and decision maker. This will allow for controls to be found in the metastable and unstable time zones of an incident. Several elevator fatalities will be presented to illustrate.



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