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JANUARY 12, 2018. THE EXECUTIVE OFFICER THE LAW REFORM, ROAD and COMMUNITY SAFETY COMMITTEE PARLIAMENT HOUSE SPRING STREET, EAST MELBOURNE, VIC. 3002. [email protected] By Damien Codognotto OAM for the Independent Riders Group MAINTAINING STATE CONTROLLED ROADWAYS INTRODUCTION A. The Independent Riders Group (IRG) began when the Motorcycle Riders Association (MRA) closed in Victoria. The IRG retains much of the experience and expertise of the MRA in a less formal format. B. THE Law Reform, Road and Community Safety Committee invited written submissions from individuals and organisations on the effectiveness of VicRoads in maintaining/managing country roads in Victoria. C. It seems obvious to most rural road users that VicRoads is failing in its’ duty of care to people outside Melbourne. That said, replacing VicRoads with local councils in road maintenance duties presents a dilemma. LRRCSC - INQUIRY INTO VICROADS' MANAGEMENT OF COUNTRY ROADS SUBMISSION NO: 254 RECEIVED: 15 JAN 2018
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Page 1: LRRCSC - INQUIRY INTO VICROADS' MANAGEMENT OF COUNTRY ...€¦ · University of Sydney. ROADSIDE BARRIERS HH. According to the Macedon local paper, VicRoads will “roll out” around

JANUARY12,2018.

THEEXECUTIVEOFFICERTHELAWREFORM,ROADandCOMMUNITYSAFETYCOMMITTEEPARLIAMENTHOUSESPRINGSTREET,EASTMELBOURNE,VIC.3002.

[email protected]

ByDamienCodognottoOAMfortheIndependentRidersGroup

MAINTAININGSTATECONTROLLEDROADWAYS

INTRODUCTION

A. TheIndependentRidersGroup(IRG)beganwhentheMotorcycleRidersAssociation(MRA)closedinVictoria.TheIRGretainsmuchoftheexperienceandexpertiseof theMRAina lessformalformat.

B. THELawReform,RoadandCommunitySafetyCommitteeinvitedwrittensubmissionsfromindividuals and organisations on the effectiveness of VicRoads in maintaining/managingcountryroadsinVictoria.

C. ItseemsobvioustomostruralroadusersthatVicRoadsisfailinginits’dutyofcaretopeopleoutside Melbourne. That said, replacing VicRoads with local councils in road maintenancedutiespresentsadilemma.

LRRCSC - INQUIRY INTO VICROADS' MANAGEMENT OF COUNTRY ROADS SUBMISSION NO: 254

RECEIVED: 15 JAN 2018

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2.

CONTENTS

PAGE

1. INTRODUCTION.2. CONTENTS.3. VICROADSORCOUNCILS.4. CRASHDATAANDCONFLICTSOFINTEREST.5. ANIMALSTRIKESandROADSIDEBARRIERS.6. FRAUD.7. FRAUD.8. RURALROADSFACEBOOKPAGE&RECOMMENDATIONS.9. APENDIXA.DATACOLLECTION.10. APENDIXB.VICPOLONCRASHINVESTIGATORS.11. APENDIXC.RSPACLETTER.RIORDANMPONWRB.FACEBOOKDISCUSSION.12. APENDIXC.13. APENDIXC.14. APENDIXC.15. APENDIXC.16. APENDIXC.17. APENDIXC.18. APENDIXC.19. APENDIXC.20. APENDIXC.21. APENDIXD.TWODIEONBADROAD.22. APENDIXE.FRAUD.23. APENDIXE.FRAUD.24. APENDIXF.THEVICTORIANAUDITORGENERAL.25. APENDIXF.THEVICTORIANAUDITORGENERAL.26. APENDIXG.EXVICROADSCEOCOLINJORDANONABCRADIO.27. APENDIXG.LETTERTOTHEHERALDSUN.28. APENDIXH.LETTERTOTHEROYALAUSTRALASIANCOLLEGEOFSURGEONS.29. APENDIXI.RICHARDRIORDANMPONWRB.30. APENDIXI.RICHARDRIORDANMPONWRB.31. APENDIXJ.CFAFGEARSOVERSAFETYBARRIERSINTHEAGE.32. APENDIXK.THEBURRUMBEETFATALCRASH.

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3.VICROADSORCOUNCILS?D. The current situation is that VicRoads is too centralised with no real oversight. Countryproblems/complaintsgetreferredtoVicRoadsHQinMelbournetoooftencausinglongdelays,inappropriateresponsesandsometimesnoresponsesatall.E. VicRoads’ phones and online services are geared to corporate image and to discouragecomplaints and people seeking relevant information, not consumer service. Simple numbersthat used to be on VicRoadswebsite or in their library are no longer available to people ororganisationswithalegitimateinterest.F.ThechoiceistodecentraliseVicRoads’roadmaintenancedutiesandintroducerealoversightandaccountabilityinits’ruralregionsortomakecouncilsresponsibleforroadmaintenance.G.Adifficultchoice.H.DowekeepVicRoadsas is?Dowehope theelectedgovernmentof thedaywillbestrongenough to introduce the recommended checks/balances/changes and thetransparency/accountabilitysystemsordowestartawholenewsystemmakingmunicipalitiesresponsibleforroads?I.VictorianGovernments’haveapoorrecordimplementingrecommendationbyParliamentaryInquiries on road safety. Inquiry recommendations are subject to scrutiny then a “whole‐of‐government‐response”. The whole‐of‐government‐response is mostly written by thedepartmentsresistingchange.Theconflictofinterestisobvious.J. The 2012 Parliamentary Inquiry into Motorcycle Safety (PIMS) Recommendation 1, toestablishanindependentcrashdataauthority,wasmadebecausethecrashdataavailablehadtobe improved andverified.Therewas/isno completepicture.Bits of different informationwere/are held by different agencies. The latest spreadsheet does not even provide basicinformationon themakeandmodelof a crashedvehicle, engine sizeoreven if it is auteorluxurysedan,amotorcycleorscooter.Basicinformationismissing.Thisdatawouldbeeasytoincludebutrepeatedrequeststoincludeithavebedenied.K. This situation has been created by VicRoads/VicPol/TAC/Health/Justice. It is a systemicfailurethatdirectlyaffectsroadsafety,ruralroadbuilding,maintenanceandrepair.L. The whole‐of‐government‐response to PIMS recommendation 1 was: "the functionsidentified in the recommendationdonot require the creation ofanew office.The roadsafetypartneragencieswillcontinuetoshareandgatherdataand informationandwillcollaboratewith the Department of Health and Ambulance Victoria. Agencieswill alsowork to close gaps in current data collection, such as off‐roadmotorcycle crash data.Centralised data management processes will be investigated, and will include health,insurance, injury, road, registrationand licensingdata. It is expected that therewillbesubstantial costsassociatedwith establishing centralisedprocesses,but thesewouldbeminor compared with the costs associated with the establishing and operating a newoffice"M.Sixyearslatertherehasbeennoreal improvementindatasharingoravailabilityofcrashdata andParamedics and “front line”police are still not allowed todiscusswhat they see atworkwithanindependentagencyletalonethepublic.

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4.N.VicRoads/VicPol/TACdonotwantanindependentauthoritytoobtain,collate,interpretandmostofall,distributeroadcrashdata.Theywanttocontrolit.Becauseofthisselfishdesiretocontrolinformation,thefullpictureofroadtraumaonruralroadsmayneverberevealed.

O. Do we start again by making country road maintenance the responsibility of localgovernment?P. There seems little faith among IRGmembers or country road users that allcouncils willmanagecountryroadseffectively.And,thereisthemajorproblemofeffectiveoversightofsomanyCouncilsacrossthestate.

Q. VicRoads has no effective oversight. There is no real system to hold it accountable forvehicle/propertydamage,injuryordeathinthecaseofVicRoadsfailuretomaintainroadstoasafe standard, not use obsolete road furniture and/or to effect timely repairs. The VictorianOmbudsman can deal with minor issues but slow and frustrating. The Coroner should beeffective but is advised/assisted by VicPol and is often ignored. The current system mustchangeifwearetolowerthecountryroadtoll.R.Ascountryroadsaredeteriorating,countryroadinjuriesandsdeathsareincreasing.CRASHDATAANDCONFLICTSOFINTERESTS.All‐partycommitteesofMembersofParliamentholdinquiriesandmakerecommendationstoimprove the road safety effectiveness of VicRoads/VicPol/TAC. Then VicRoads/VicPol/TACwritethewhole‐of‐government‐response.Adangerousconflictofinterest.SeeAPENDIXA.T. Of 64 recommendations from the 2012 Inquiry perhaps 60 will never be seriouslyconsideredbecausetheyarenotinVicRoads/VicPol/TAC’sinterest.Recommendation1begins:“Thatan independentofficeofroadsafetydatabecreated,whichwillberesponsible forcollecting,collating,interpretingandpublishingalldatarelevanttoroadsafety……”U.Recommendation1iscriticaltoimprovingVicRoadsplanning/management/maintenanceofruralroads.But,VicRoadsandVicPolworktoocloselytogetherintheirdepartments’interestsforcrashdatatobeadequateorreliableorforthemtoagreetoanindependentauthority.V. Reliable crash data is a critical part of understanding country roads andwhere improvedplanning/management/maintenance needs to be targeted. You cannot effectively plan forinfrastructure projects, road maintenance programs or crash countermeasures withoutadequate,reliablecrashdata.W.VicPolinvestigatescrashesoncountryroads.Theinvestigationsarenotalwayscarriedoutbyscientificallytrainedcrashinvestigators.SeeAPENDIXB.DatapresentedtotheCoronerincourtisnotalwayscomplete.X. In the 2015 quadruple fatal crash at Pyalong there was at least one eyewitness but thestatementfromthatwitnesswasnotpartofVicPol’sevidencetotheCoroner.And,VicPoldidnot find the drugs, a victim’s wallet and the driver’s mobile phone. These were found byvictims’mothersandatowtruckoperator.Thecrashedcarwasnotkeptinasecurefacilitybutlayformonths,opentotheweather,inacommercialwrecker’syardinHeathcote.

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5.Y. The fact that VicRoads knew the barrier involved in the Pyalong crashwas obsolete anddangerouslyplaceddidnotfeatureintheCoroner’sfinding.Z. The Victorian Coroner has a team of supposedly independent experts to advise him/her.SomeoftheseareservingVicPolofficers.Anotherconflictofinterest.AA.ThePyalongcrashkilledfouryoungmen.ItseemedallVicPolcaredaboutwasgettingtheantidrugdrivingmessageonTV.Agoodmessagebuttheinvestigationwasnotadequate.BB. The further fromMelbourne the crash is, the less likely a quality, comprehensive crashinvestigation is. Insomeareas it takeshours foranuntrained,often inexperienced,officer togettoacrashsite.Oftenthesitehasbeencleanedupandevidencelost.ANIMALSTRIKESCC. VicRoads tell us that their data does not show that crashes involving vehicles hittinganimals are a serious problem. Animal strikes have not featured large in their data becauseoftenanimalstrikesarenotimmediatelyobviousorarenotlookedfor.Crashreportssaythingslike“lostcontrolofthevehicle”or“thedriverhaddrugsinhis/hersystem”.DD. Vehicle insurers keep figures on claims caused by animal strikes. In the whole‐of‐government‐responsetothe2012 inquirytheypromisedto include insurancedata inclosingthegapsincrashdata.Theyknowthegapsexist.FiveyearslaterVicroadsdenieditwasamajorissue.NoresearchevenafterCindyMcLeishMPaskedquestions. AnewspaperarticlenamedBendigoroadkillcapitalofAustraliabasedoninsuranceclaims.EE.Claimsfiguresshowanimalstrikesareamajorcauseofcrashesandahugecosttocountrypeople in terms of vehicle damage, business/tourism damage and quality of life damage.VicRoadshasignoredinsurers’figuresandrepeatedcallsfromtheIRGtodosomethingaboutanimalstrikesincountryVictoria.FF.Itissaidthatanimalsstrikesareincreasing.LukeO’SullivanMPbelievesit.Isittrue?OraretheremoreVicPol reports that crashes are indeed causedbywombats, kangaroos andotheranimals being caught on our roads because of recent publicity. And, what role do roadsidebarriersplayin“corralling”wildlifeintrafficlanes?Thereisnoreliabledata.GG. It seems VicRoads are not investigating/researching this longstanding, serious problem.TheRSPCAknowsofnoresearchprograms.SeeAPENDIXC.TheonlyresearchIRGknowsofinto road kill is being done by Bruce Englefield on Tasmanian Devils for his PhD with theUniversityofSydney.ROADSIDEBARRIERSHH.AccordingtotheMacedonlocalpaper,VicRoadswill“rollout”around1700kmsof wirerope barrier (WRB) in 2018. WRB is often duplicated unnecessarily fencing both sides ofcarriagewaysrightnexttothetrafficlanes.RichardRiordanMPbelievesthispracticeisadeathtraponcountryroads.IRGagrees.II.Between2015and2020VicRoadssaytheywillspend$4billiononWRBincountryVictoriawhilecountryroadsdeteriorateandcountrycasualtycrashesincrease.

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6.JJ.Dothenewkilometresofroadsidebarriersaffectthenumberofcrashescausedbywildlifeonourroads?Wehavebeentoldthatanimalsonroadsfencedonbothsides,whenstartled,willbolt fortheopenspace.Thatis,upordowntheroadratherthanoff it.At100kphthiscoulddemandlightningreflexestoavoidahit.KK.InNovember2015anexperiencedriderwasonpartoftheCalderHighwaywithnewwireropebarrier (WRB) close to the roadonhis left and right. It isdivided road.Conditionsandvisibilitywere good. Hewas experienced,wearing appropriate clothing and the bikewas ingood condition. He was a family man, a member of a Christian club and well liked in theBendigocommunity.LL.VicPolmediareportssaidhehitadeadkangaroo,crashedanddied.TherewasnomentionoftheWRB.VicPoldidnotsuggestspeed,drugsoralcoholwerefactors.WhetherornotVicPolshouldbeansweringquestionsbetterlefttoacourtinthemediaisanotherquestion.MM.Amotorcyclistcameonthecrashinaminuteorso.Hestoppedtohelp.Themanwasdeadwithanobviousbrokenleg.Hewasagainst/intheWRB.Thekangaroo,asmallgreywasdeadontheroad.Theriderstayedwiththevictimuntiltheparamedicsarrived.VicPoldidnottakeastatementfromthiswitness,justfromcardriverswhoreportedlydidnotseethecrashorgetclosetothevictim.NN. To experienced riders the media story does not ring true. Why did the rider hit thekangaroo?Itwasdrywithgoodvisibility.If itwasdead,whydidn’ttheriderridearoundtheanimal?WhydidtheriderendupwithabrokenlegintheWRB?OO.VicPolmightrecommendaninquestthatmayanswerthesequestionsinacoupleofyearstime.A seriousproblem is,most lovedonesof road crash victimshave few resources to getgoodlegaladviceandtheyareoftentooshatteredtogothroughacourtcaseevenyearsaftertheirloss.PP.Anotherquestionthatmustbeaskedis.HowdoesthemassivespendingonWRBaffectthecountryroadsmaintenance/repairbudget?FraudQQ.Therearethreeobviouswaysthatfundsformaintainingcountryroadscanbewastedorgoastray.

1. Inefficiency.2. MoneyisdivertedforotherpurposesliketheWRBrollout.3. Fraud.

RR. Inefficiency is amajorproblemwithVicRoadsand its’ sub‐contractors.There isno realoversight.SS. Damaged roads and road furniture often take months to repair. During that time thedamagedareaisahazardtolocals,workingdriversandvisitorstothearea.Badforroadsafety,bad for business and bad for quality of life. The whole of Victoria suffers from bad roadsbecauseVicRoads is not efficient.Many country roadusers feel thismaynot be apparent tobossesinVicRoadsHQinMelbourne.

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TT.OnMarch7,2015,amiddleagedcouplewentforarideononeofourfamoustouristroads.TheyhadtheexperienceandequipmentforasafetripontheGreatAlpineRoad.Theyweren’tspeedingorondrugsordrunk.Conditionsweregood.Theydied.UU. Two days before the fatal crash VicRoads conducted a hazard check. They found adangerouspotholebutdidNOTreportit.VV.Onedaybeforethefatalcrash,anotherriderhadaseriousinjurycrashinthesamespot.WW.Alarmbellsshouldhavebeenringing.Iftheywere,theywereignored.Motorcyclistsaredeemedtoputthemselvesatrisk.Theyareconsideredexpendable.XX.VicRoads/VicPolpreparedreportsfortheCoroner.Asfarasweknow,noonewaseverheldtoaccountforthisdoublefatal.Itdidnotneedtohappen.Efficientreportingandtimelyrepairswouldhavemeantthiscouplewouldhavereturnedsafelytotheirfamily.Theirfamilydidnotreceiveanysupportorcompensationweknowof.SeeAPENDIXD.YY.Thepotholetookanotherthreeweekstofixproperly.Byanyyardstickthiswasinefficientroadmaintenanceanditcostlives.ThisisjustacrashIRGfoundoutaboutthroughthemedia.ZZ.DivertingfundstosuitagendasisknowntohappenbutVicRoadsdonotliketotalkaboutit.Aforensicauditbyarecognised,independentcompanyisrequired.AAA.Fraudisfairlycommoninlargegovernmentdepartments.“DEFENCEinvestigatorshavemanagedtoreclaimlessthanathirdoflossesswindledfromourarmedforcesthroughfraudandcorruption.Just$1.1millionof$3.9millionstolenfromtheADFinthepastfiveyearsthroughcreditcardfraud,entitlementabuseanddishonestyhasbeenclawedback.….”“WELFARE cheats have pocketed millions of taxpayer dollars after the Department ofHumanServicesoverpaid$2.84billionthroughfraudorerrorlastyear..”SeeAPENDIXD.BBB. The Victorian Auditor General’s report said that VicRoads had no effective way ofmeasuring its’performancemaintainingruralroads.SeeAPENDIXF.VicRoadsperformancemaintainingruralroadsisdismal,measuringbitisimpossibleunderthecurrentsystem.CCC. A lot of ourmoney is being spent but the taxpayer is not kept informed. With tens ofbillionsofdollarsgoingintoroads,infrastructureandroadfurniture,thetemptationtomisuseourfundsisreal.Thewayourroadfundingisusedeffectsoursafety,economyandqualityoflife.There should be a forensic audit of VicRoads’ road funding looking closely at roadmaintenanceandroadbarriersovertime.DDD.WRBhasamuchshorterworking life thanotherbarriers. It ismoreeasilydamagedsorepaircostsaremuchhigher.ThereareseveralhiddencostswithWRB.VicRoadspromotionofWRB seems almost religious. Their zeal in installing WRB is extreme to the extent thatVicRoads/VicPolwillnotevenconsidersomefactsatcrashsites.EEE.ThecrashinvestigatorsblindspotwasapparentinthecaseofthePyalongquadruplefatalcrash.

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FFF.TimBullMPforGippslandhasaskedMinisterDonnellanmanytimes for informationonWRBinGippslandandforrealconsultation.

GGG.VicRoadsdoesnotconsultwithroadusersandtheirorganisations.Itcallspublicmeetingsthensendrepresentativestotellpeoplesomeofwhattheyhaveplanned.Awkwardquestionsaretakenawayforconsiderationthenusuallyconsignedtooblivion.HHH.VicRoads’failuretoproperlyconsultwiththeCountryFireAuthority(CFA)andtheStateEmergencyService(SES)inDecember2017resultedinaconfrontationinthemediaprovokedbyVicRoads.AftertellingallandsundryhowrighttheywereaboutWRBoncountryhighways,VicRoads now admits they got it wrong on the Calder and will retrofit the barriers soemergencyvehicles canget to firesandcrashesandsoon in safe, timely fashion.Howmuchmoneywillbedivertedfromcountryroadrepairstocoverthisblunder?III.TheCalderretrofitwillcosthundredsofmillionsofdollarsandinjuriesanddeathsbecauseVicRoads did not research adequately or consult properly. MP for Northern Victoria LukeO’Sullivan went to the Bendigo Advertiser with his concerns about animal strikes andemergencyserviceaccessinNovember2017.JJJ.VicRoadsDirectorBryanSherritt respondedclaimingtheWRBreducedhead‐onandrun‐off‐roadcrashesby85%!Basedonwhat?FiguresindependentexpertsarenotallowedtoseeandcrashdatathatthreeVictorianParliamentaryInquirieshavesaidisinadequate.KKK.The actingMinister forRoadsPhilipDalidakisMPwas onABC radio telling thepublic,presumably on VicRoads advice, that therewere breaks in highwayWRB every 500 to 700metreswhichisnottrue.Hesaid.“Ifthere’sanythingweneedtolearn,we’lldothat.”It’sabitlatenowactingMinisterDalidakis,VicRoadshasbeeninstallingWRBfortwentyyears.

LLL.FIXOURRURALROADSCOMMUNITYWEBSITEhttps://www.facebook.com/ruralroads/posts/929453180536631?comment_id=942779325870683&notif_id=1515825020552963&notif_t=feed_comment_replyMMM.RECOMMENDATIONS1. ThatVicRoadsspendingonrural roadmaintenanceandrepairsbesubject toa forensic

auditbyarecognisedindependentcompany.Theauditshouldincludecomparingthecostofthevariousroadbarriers,includinginstallation,workinglife,maintenanceandrepairsoveratleasttwentyyears.

2. That VicRoads “regions” be given more autonomy from VicRoads headquarters inMelbournebutwithmuchgreaterscrutinyandoversightbyanorganisationindependentofVicRoadsadministrators.

3. That Councils have an oversight/reporting role in their municipalites as part of thegeneralincreaseinchecksandbalancesensuringVicRoadsperformancecomesuptoanacceptablestandard.

4. ThatVicRoadsadministrationbemadetransparentinplanning,financesandcrashdata.5. That wire rope barrier installation stop immediately and that obsolete and dangerous

anchorpointsinVictoriaberemoved.6. That VicRoads consults road users and their organisations according to the dictionary

definitionofconsultation.7. That MEAP secrecy be lifted and membership opened to representatives

elected/appointed by their organisations then approved by theMinister of the day notVicRoads.

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9.APENDIXA.

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10.APENDIXB

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11.APENDIXC.

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21.APENDIXD.

Therewasnoneed for this couple todie. Inefficiency inhazard reporting and timelyroadrepairscosttwolivesandcauseduntoldgrieftotheirfamilyandlovedones.Howmanyothersimilarcasesare there thatdonotmake it to themedia?VicRoads/VicPolareunlikelytosay.

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22.APENDIXE.

MERCURYclippingsondefenceandwelfarefraudJanuary8&12,2018.$3.9and$2.8billionequals$6.7billion.VicRoadswillspend$4billiononwireropebarrierinfiveyears.

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APENDIXF.

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26.APENDIXG.

The Independent Riders' Group - IRG shared ABC Melbourne's post. Published by Cate Grace · 8 hrs · Steve Martin presenting Drive, Thursday, 11th January, 2018 From 1:04 Colin Jordan, Vic Roads 1993-2001, Ausroads Chairman, and RACV followed by Peter Todd, Acting Chief Executive, VicRoads, and various callers after that. http://www.abc.net.au/…/melbou…/programs/drive/drive/9305376

Colin Jordan's Letter to the Editor, "The Age", that morning . . .

JANUARY 11 2018 - 1:00AM Traffic snarls: Victoria's road system just isn't good enough

As a former chairman and chief executive of VicRoads, I write with dismay about the state of Victorian roads and the ominous warning signs that abound.

Several recent trips on major roads throughout Victoria showed that heavily potholed roads, reduced speed sections, weed and rubbish-strewn verges have become the norm for an organisation that apparently no longer has sufficient regard for the travelling public. Worse still, there are all too frequent signs of neglected structural failure of pavements. Lengths of wire-rope barriers hang loosely by the roadside unrepaired, clearly no longer capable of contributing to a safe road environment.

I cite two examples of many. The Western Highway has serious pavement failures in sections some of which are but a few years old. On the outer sections of the Monash Freeway commuters have been asked to put up with an astoundingly sub-standard running surface for months. Scratched, pitted and scarred from multiple line markings, how much more of a hazard could you create if you tried, and how easy it would be to provide a reasonable running surface. Failures like these on a statewide basis have safety and economic consequences for all of us.

It would be too easy attribute this serious decline to a lack of funds, this may be part of the issue, however we also need a substantial lift in customer care and the long-term professional capability of the stewards of our infrastructure resources.

Colin Jordan,

Glen Waverley

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27.

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28.APENDIXH.

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29.APENDIXI.

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30.

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32.APENDIXK.In the Burrumbeet fatal crash near Ballarat theWRB did not even slow the car andtrailer. It crashed into treesplanted some yearsbefore ignoringVicRoadsown safetyguidelines. Revised guidelines have been hung up in VicRoads legal department foryears.TheWRBdidnotwork.Theyoungpeopledied.TheVicRoadsregionalmanagerwasnotawareplantingguidelinesexisted.NoonewaseverheldtoaccountasfarastheIRGknows.Howmanymorecrasheslikethisdonotfindtheirwayintothemedia?