Millions Impacted by Data Breach At Target

By Kim Smiley

Are you one of the millions of customers affected by the recent data breach at Target?  Because I am.  I for one am curious about how data for approximately 40 million credit and debit cards was compromised at one of the United States’ largest retailers.

The investigation is ongoing and many details about the data breach haven’t been released, but an initial Cause Map can be built to begin analyzing this incident.  The latest information released is that the Justice  Department is  performing an investigation into this incident.  An initial Cause Map can capture the information that is available now and can easily be expanded to include more detail in the future.  A box with a question mark can be used to indicate that more information is needed on the Cause Map. (Click on “Download PDF” to view an Outline and high level Cause Map.)

One of the causes that I think is worth discussing is that retailers in the United States are being specifically targeted for this type of attack in recent years.  The vast majority of credit and debit cards in use in the United States are magnetic strip cards, while Europe has been transitioning to newer credit card technology that uses chips.   Magnetic strip credit cards are a more desirable target for criminals because the technology to create fake magnetic strip cards is readily available.  The data on magnetic strip cards also stays the same while chips use unique codes for each transaction.  Cards with chips also require a pin when used, adding an additional layer of protection.

So why does the United States still use magnetic strip cards?  One of the main complicating factors is money.  Transitioning to cards that use chips requires a significant investment of money by both banks and retailers.  It is estimated that the cost to transition to the higher tech cards will be $8 billion so the money required is considerable. Both parties are nervous about being the first to commit to the process.

Rising credit card fraud rates in the United States have been increasing the pressure to move to newer credit card technology.  Credit card fraud rates in the U.S. have doubled in the 10 years since Europe began using chip cards.  As long as the United States remains the softest target, the rates are likely to increase.

On a positive note, the transition to the newer chip cards should be gaining traction in the next few years.  Credit card companies have typically footed the bill for credit card fraud, but many card companies have stated that merchants or banks that have not transitioned to chip cards will be held accountable for fraudulent purchases that the higher tech cards would have prevented by the end of 2015.

The frustrating thing is that there are limited ways individual consumers can protect themselves short of switching to cash.  You can be smart about where you swipe your cards, for example avoiding unmanned ATM kiosks, but a major retailer like Target didn’t seem suspicious.  As somebody who has had multiple instances of credit card fraud in the last few years, I look forward to a safer credit card in the future.

300,000 Unable to Use Water after Chemical Spill in West Virginia

By Kim Smiley

Hundreds of thousands of West Virginians were unable to use their water for days after it was contaminated by a chemical spill on January 9, 2014. About 7,500 gallons of 4-methyl-cyclohexane-methanol, known as MCHM, leaked out of a storage tank and into the Elk River.   At the time of the spill, little information was known about MCHM, but officials ordered residents not to use the use the water because the chemical can cause vomiting, nausea, and skin, eye and throat irritation.  The ban on water usage obviously meant that residents should not drink the water, but they were also told not to cook, bathe, wash clothes or brush their teeth with it.

The investigation into this incident is still ongoing, but some information is available.  An initial Cause Map, or visual root cause analysis, can be built now and it can easily be expanded in the future.  A Cause Map is used to illustrate the cause-and-effect relationships between the many causes that contribute to any incident.  In this example, it is known that the MCHM leaked into the river because it was being stored in a tank near the river and the tank failed.  MCHM was being stored in a tank because it is used in coal processing and it was profitable for the company to sell it.

The cause of the tank failure hasn’t been officially determined, but the company who owned the facility has stated that an object punctured the tank after the ground under the tank froze.  (Suspected causes can be included on the Cause Map with a question mark to indicate that more evidence is needed to confirm their validity.)

The tank in question was older, built about 70 years ago.  There were no regulations that required the tank to be inspected while it was being used to store MCHM because the chemical is not currently legally considered a hazardous material.  The tank is also an atmospheric tank so it is exempt from current federal safety inspections because it is not under pressure, cooled or heated.

Many are asking questions about why a tank full of a chemical that can make people sick that was so close to the water supply had so little regulation and no required inspections.  The debate that has been sparked by this accident will force a close review of current regulations governing these types of facilities.

It’s also alarming how little was known about this chemical prior to this accident.  It’s still not well understood exactly how dangerous MCHM is.  Experts have stated that the long term impacts should be minimal, but it would be awfully reassuring to the people living in the area if there was more information about the chemical available.

Companies need to have a clear understanding of the risks involved in their operations if they hope to reduce the risk to the lowest reasonable level and develop effective emergency response plans to deal with any issues that do arise.  As the old saying goes – failure to plan is planning to fail.  Just ask the company involved.  Freedom Industries filed bankruptcy papers on January 17, 2013 as a direct result of this accident.

Improper Fireplace Installation Results in Firefighter’s Death

By Mark Galley and Angela Griffith

While battling a fire in a mansion in Hollywood Hills, California on February 16, 2011, a firefighter was killed (and 5 others seriously injured) when the roof collapsed.  As a result of the firefighter’s death, the owner/ architect of the home was convicted of involuntary manslaughter.  He is scheduled to serve 6 months and then will be deported.

The fire wasn’t arson, but the owner/ architect was considered responsible due to the installation of an outdoor-only fireplace on the top floor of his home.  Because of the legal issues surrounding this case, it’s important to carefully determine and clearly present all of the causes that led to the fire and the firefighter’s death.

We can capture information related to this issue within a Cause Map, or visual root cause analysis.  A Cause Map begins with the impacted goals, allowing a clear accounting of the effects from the issue.  The firefighter’s death is an impact to the safety goal, as are the injuries to the other firefighters.  Impacts to the safety goal are the primary focus of any investigation, but we will capture the other impacted goals as well.  In this case, the regulatory goal was impacted due to the non-compliant fireplace, the non-compliance being missed during inspection, and the prison sentence for the architect/owner.  Additionally the loss of the home and the time and effort put into firefighting and the subsequent trial impact the property and labor/time goals.

Once the impacts to the goals are determined, asking “why” questions begins to develop the cause-and-effect relationships that resulted in those impacts.  A Cause Map can start simple – in this example, the safety goal was impacted due to the death of a firefighter.  Why? Because the ceiling collapsed.  Why? Because the house was on fire.  Why? Because heat ignited flammable building materials.

Though this analysis is accurate, it’s certainly not complete.  More detail can be added to the Cause Map until the issue is adequately understood and all causes are included in the analysis.  Detail can be added by asking more “why” questions – the heat ignited flammable building materials because an outdoor-only fireplace was improperly used inside the house.  Causes can also be added by considering causes that both had to occur in order for the effect to happen.  The firefighter was killed when the ceiling collapsed AND the firefighter was beneath the ceiling, fighting the fire.  Had the ceiling collapsed but the firefighters not been inside, the firefighter would not have been killed by the ceiling collapse.

Detail can also be added between causes to provide more clarify.  In this case, the ceiling collapse was not directly caused by high heat.  Instead, the high heat activated and melted the sprinkler system, resulting in a buildup of water that caused the ceiling collapse.  The other goals that were impacted should also be added to the Cause Map, which may result in more causes.  In this case, the improperly installed fireplace was missed by the building inspector, which is an impact to the regulatory goal.  The reason it was missed was debated during the trial, but changes to the inspection process may result that would make this type of incident less likely, ideally reducing the risk to firefighters and home owners.

An incident analysis should have enough detail to lead to solutions that will reduce the risk of recurrence of the impacted goals.  As I mentioned previously, solutions from the perspective of the building inspectors may be to look specifically for issues on fireplaces that could lead to these types of fires.  Ideally, a way to determine if a sprinkler system was malfunctioning and leading to water collection could be developed that could reduce the risk to firefighters.  For homeowners, this incident should stand as a reminder that outdoor-only heat sources such as fireplaces are outdoor-only for a reason.

Freight Train Carrying Crude Oil Explodes After Colliding With Another

By Kim Smiley

On Monday, December 30, 2013, a 106-car freight train carrying crude oil derailed in North Dakota and violently exploded after colliding with another derailed train that was on the tracks.  No injuries were reported, but the accident did cause an impressive plume of hazardous smoke and major damage to two freight trains.

The investigation into the accident is ongoing and it’s still unknown what caused the first train to derail. Investigators have stated that it appears that there was nothing wrong with the railroad track or with the signals.  It is known that a westbound freight train carrying grain derailed about 2:20 pm.  A portion of this train jumped onto the track in front of the eastbound train.  There wasn’t enough time for the mile long train loaded with crude oil to stop and it smashed into the grain train, causing the eastbound oil train to derail.  (To see a Cause Map of this accident, click on “Download PDF” above.)

Train cars carrying crude oil were damaged and oil leaked out during the accident.  The train accident created near ideal conditions for an explosion: sparks and a large quantity of flammable fluid.   The fire burned for more than 24 hours, resulting in a voluntary evacuation of nearby Casselton, North Dakota due to concerns over air quality.  The track was closed for several days while the initial investigation was performed and the track was cleaned up.

The accident has raised several important issues.  The safety of the train cars used to transport oil has been questioned.  Starting in 2009, tank train cars have been built to tougher safety standards, but most tank cars in use are older designs that haven’t been retrofitted to meet the more stringent standards.  This accident, and others that have involved the older design tank cars in recent year, have experts asking hard questions about their safety and whether they should still be in use.

The age of the train cars is particularly concerning since the amount of oil being transported by rail has significantly expanded in result years.  Around 9,500 carloads of oil were reportedly transported in 2008 and nearly 300,000 carloads were moved during the first three quarters of 2013.  The oil industry in North Dakota has rapidly expanded in recent years as new technology makes oil extraction in the area profitable.   North Dakota is now second only to Texas in oil production since the development of the Bakken shale formation.  Pretty much the only way to transport the crude oil extracted in North Dakota is via rail.  There isn’t a pipeline infrastructure or other alternative available.

And most of the time, transporting oil via freight train is a safe evolution.  The Association of American Railroads has reported that 99.99 percent of all hazardous materials shipped by rail reach the destination safely.  But it’s that 0.01 percent that can get you in trouble.  As a nation, we have to decide if where we are at is good enough or if it’s worth the money to require all tank cars used to transport oil to be retrofitted to meet the newest safety standards, a proposition that isn’t cheap.