NTSB Press Release

National Transportation Safety Board
Office of Public Affairs


September 1, 2009

Washington, DC - In a Special Investigation Repor adopted today, the National Transportation Safety Board concluded that pedal misapplication was a factor in five heavy vehicle accidents investigated by the Board between 2005 and 2008. Pedal misapplication occurs when a driver depresses the accelerator instead of, or in addition to, the brake pedal.

The report was prompted by the Board's investigation of a school bus accident that occurred in Liberty, Missouri, in May 2005. The NTSB subsequently investigated four additional accidents that shared common elements. In all five, the drivers either reported a loss of braking or were observed by vehicle occupants to be unsuccessfully attempting to stop the vehicles, though no evidence of braking system failure was found.

The Board noted that the purpose of the report was not only to review these recent investigations and the Board's previous work on pedal misapplications, but also to examine the potential benefits of a variety of possible technological solutions and to present safety recommendations designed to prevent or mitigate the consequences of pedal misapplication involving heavy vehicles.

As a result of this report, the Board called upon the National Highway Traffic Safety Administration (NHTSA) to require the installation of technology in heavy vehicles susceptible to pedal misapplication to prevent unintended acceleration when starting from a parked position. The Board also recommended that NHTSA both conduct an analysis of pedal configurations in heavy vehicles and study the effect of pedal design on the driving task. Upon completion of the analysis, the Board recommended that NHTSA publish pedal design guidelines for designers and manufacturers. Additional recommendations were made to the National Association of State Directors of Pupil Transportation Services and the National Association for Pupil Transportation to advise their members of the dangers of pedal misapplication and to consider driver refresher training and suggested mitigation strategies.

The NTSB also reiterated and reclassified two 1999 safety recommendations made to NHTSA requiring event data recorders on school buses and motorcoaches manufactured after January 1, 2003, and for NHTSA to work with other government agencies and industry to develop and implement standards for on-board recording of bus crash data.

A synopsis of the Special Investigation Report, including the findings, probable cause determinations for two accidents, and safety recommendations, can be found on the Board's website at www.ntsb.gov. The complete report will be available within several weeks.

NTSB Office of Public Affairs: (202) 314-6100



The National Transportation Safety Board (NTSB) is an independent federal agency charged with determining the probable cause
of transportation accidents, promoting transportation safety, and assisting victims of transportation accidents and their families.