All this time later and few seem to be discussing the one unbelievably simple change that could have helped stopped this disaster form occurring: stop companies responsible for large operations and/or machinery from leaving a single employee to be operating them. Second employee catches mistakes and is there in case something happens to other employee. Some shareholder now has a slightly bigger boat because they were willing to endanger the lives of employees and the public. Just spent time on a ship on Lake Ontario where single engineers are on job by themselves during shifts, another disaster just waiting to happen. Another reason why corporations and business people shouldn't be allowed to make public policy.