Hoboken Terminal is one of the busiest transportation hubs in the New York metropolitan area, a Beaux-Arts landmark where NJ Transit trains, PATH trains, ferries, and buses converge every morning to funnel commuters toward Manhattan. NJ Transit is the third-busiest commuter railroad in the United States, and its last fatal incident before the 2016 crash had been the 1996 Secaucus train collision, two decades earlier. But the agency had already drawn federal attention: the Federal Railroad Administration had been auditing NJ Transit since June 2016 after an increase in safety violations led to citations. Train 1614 was a Pascack Valley Line local making all stops, with cab car 6036 leading and locomotive 4214 pushing from the rear. The train did not have positive train control, an automatic braking system designed to intervene when an engineer fails to stop.

The impact killed Fabiola Bittar de Kroon, a 34-year-old Brazilian-born woman who was standing on the platform. Portions of the station roof collapsed, the train shed buckled, and water sprayed from ruptured lines. Jersey City Medical Center treated sixty-six people; the Hoboken University Medical Center treated twenty-three. Most injuries were among passengers on the crashed train. Hudson-Bergen Light Rail service through the station was suspended, and delays rippled across the regional rail network into the following week. One of the two event recorders recovered from the wreckage was unusable. The second, retrieved in early October, provided data that would prove critical. In a surreal footnote, FEMA acknowledged that a test of the Emergency Alert System using placeholder text from Dr. Seuss's Green Eggs and Ham had coincidentally been relayed by a Utica, New York, television station in a broadcast that seemed to foreshadow the crash. The agency confirmed it was pure coincidence.

In November 2016, Gallagher's attorney disclosed that his client suffered from severe sleep apnea, undiagnosed until after the crash. NJ Transit operated a sleep apnea screening program, yet a physical examination in July 2016 had cleared Gallagher for duty. The NTSB's final report, released February 6, 2018, determined that fatigue from undiagnosed obstructive sleep apnea caused the engineer's failure to stop the train. Contributing factors included NJ Transit's failure to follow its own internal screening guidance to identify at-risk workers and refer them for testing. The agency had also failed to recognize end-of-track collisions as a hazard, despite at least two similar incidents at the same station: a 1985 crash that injured fifty-four people and a 2011 PATH train overrun that hurt thirty-two. The Federal Railroad Administration was faulted for not requiring railroads to screen safety-critical workers for sleep disorders.

NJ Transit imposed immediate changes: engineers were required to have a second crew member present when pulling into Hoboken, and the approach speed limit was halved from ten miles per hour to five. Tracks 10 through 17 reopened on October 10, but full service was not restored until October 17. Tracks 5 and 6, where the crash occurred, remained closed for months. The pedestrian concourse did not reopen until May 14, 2017. Track 6 returned to service in June 2017 and Track 5 around September 2018. Permanent repairs to the concourse roof and structural supports stretched into 2019 before the agency declared the work complete. The crash joined a grim pattern of sleep-related rail disasters that included the December 2013 Spuyten Duyvil derailment in the Bronx and a January 2017 Long Island Railroad crash at Atlantic Terminal, both attributed to sleep apnea.

Obstructive sleep apnea affects an estimated twenty-two million Americans, many of them undiagnosed. The condition causes breathing to stop repeatedly during sleep, fragmenting rest and producing the kind of chronic fatigue that can cause micro-sleep episodes at any time, including behind the controls of a commuter train traveling at twice the posted speed. The NTSB noted that positive train control could not be relied upon to prevent end-of-terminal collisions and called for other technologies to intervene. But the deeper lesson was about human factors: a system that depends on a single person remaining alert for every approach into a dead-end terminal needs more than a speed limit sign and a bumper block. It needs screening, accountability, and the institutional will to act on what the data already shows.