The engineer who drove the train that crashed into the Hoboken, New Jersey, terminal Thursday morning, killing one person and injuring more than 100, may have some serious health problems. William Blaine, a fellow engineer and witness to the accident, reported that he saw the driver slumped over the controls just before impact.

While he was said to be in critical condition earlier in the day, authorities have been able to talk with the engineer and say he is cooperating in the investigation.

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The train crashed at 8:45 a.m., slamming through the bumper and crashing through the station in New Jersey. One woman who was standing on the platform during the accident was killed. More than 50 people went to Jersey City Medical Center to be treated for their injuries, three of whom are in critical condition.

Hoboken University Medical Center is treating 22 people from the crash, mostly those with minor injuries such as lacerations and fractures. One hundred and eight people in all were injured.

But there were many more people who were on the train and in the station, and those individuals need to watch for signs of trauma in the days ahead as well, health authorities say.

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Portions of the Hoboken terminal collapsed on impact, but rescue teams have extricated all victims from the rubble. About 15,000 commuters frequent the terminal daily, many of whom had to skip work or find alternate routes. This crash is reminiscent of a similar accident five years ago, on May 8, 2011, when a train experienced a mechanical failure and flew through the bumper. Dozens were injured in that accident, too.

The U.S. Department of Transportation has tried to forestall crashes such as these by ordering all railroads to install new technology known as positive train control. This PTC technology automatically slows a train to prevent accidents, including derailing, train-to-train collisions, and misaligned track switches. The railroads have reported unexpected difficulties with this technology, so the installation deadline has been postponed to December 2018.

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In this case, however, the error seems more human than mechanical. “The train came in at a much too high rate of speed, and the question is: ‘Why is that?'” New Jersey Gov. Chris Christie said during a press conference Thursday afternoon.

New York Gov. Andrew Cuomo said investigators will determine whether the reason was an equipment failure, an incapacitated engineer, or something else. The train’s engineer, who was pulled from the mangled first car, is hospitalized and in critical condition.

Investigators from the National Transportation Safety Board are on the scene, looking at all possible causes, including whether the engineer was distracted or fatigued. The young woman who was standing on the platform and was killed on impact has been identified as Fabiola Bittar de Kroon, 34, of Hoboken.

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