Transport Malta has issued a safety investigation report into the fatality of a crew member onboard the Maltese registered general cargo FLORIANA at Tocopilla Anchorage, Chile on December 1st, 2014.
The Incident
On 01 December 2014, while Floriana was anchored at Tocopilla Bay, Chile, three crew members were engaged in the cleaning of the freefall lifeboat davits. The crew members were instructed to clean the davits in preparation for painting. Amongst the three crew members was the bosun. Prior to the commencement of the cleaning operations, the safety procedures were completed and the bosun was supplied with a safety harness fitted with a lifeline and a hook.
About 20 minutes into the job, the bosun fell down from the davits structure to the poop deck, hitting his head on the coaming around the deck winch. First aid was administered by the crew members and immediate arrangements were made to disembark the bosun, which was effectuated one hour later. Later that morning, the master was informed by the agent that the bosun had succumbed to his injuries in hospital at 1019.
The safety investigation identified that the immediate cause of the accident was the failure of the lifeboat lifebelt to which the bosun’s lifeline was attached after (in all probability), he slipped before falling to the poop deck. Taking into consideration the safety actions adopted by the Company, no recommendations were made to the ISM managers of the vessel.
Conclusions
Immediate Safety Factor
- The safety investigation identified that the immediate cause of the accident was the failure of the lifeboat’s lifebelt under the dynamic weight of the bosun.
Latent Conditions and other Safety Factors
- The lifeboat davits’ frame did not have steps, safety rails, or suitable strong parts to attach the fall preventer.
- Whatever the reason for the bosun to expose himself to the risk of falling, the task necessitated him to step onto the inclining davit structure where there was no suitably strong line to attach the hook of the safety harness.
- The strength of the lifeboat lifeline was not enough to take the dynamic impact of a falling person.
- It was not excluded that the strength of the lifeboat lifeline may have been weakened due to the exposure to the environment.
- It did not transpire that any of the crew members had either remarked about the bosun’s decision to walk on the davits’ launching rail or about the attachment of the fall preventer to the lifeboat’s lifebelt.
- An assessment to establish the risk of a fall hazard did not seem to have been thoroughly considered on the Form as there was no mentioning of this hazard and/or mitigation actions, which could have been put in place to prevent the fall.
- What seemed to be missing in the Risk Assessment Form was not only the ‘intrinsic hazards’ but also the possible ways/mechanisms by which the hazards could be realised.
Other Findings
- The fact that bosun wore a safety harness is suggestive that there were intentions to climb on the lifeboat davits, i.e. there was an understanding and acknowledgment that a fall hazard was realistic.
- An “Aloft Working Permit” was issued and signed by the bosun and chief mate, in accordance with SMS Form 112 SAF/AOP.
- The fact that a safety harness was provided and worn by the bosun, was indicative that there had been a clear intention to access areas where the risk of a fall was possible.
- The safety belt was found to be of a standard design and suitable for its purpose. No weakness in the safety belt were identified.
Learn more by reading the report
Source: Transport Malta
