Hong Kong provides lessons learned from a fatal accident that took place on board a Hong Kong registered bulk carrier when the vessel was shifting astern through its warp lines and winches for aligning the position of the port terminal’s ship loader with the cargo hold.
The incident
A Hong Kong registered bulk carrier berthed at a terminal for loading iron ore in bulk. In order to align the position of the port terminal’s ship loader with the cargo hold of the vessel, the vessel was shifted approximately 90 meters astern through its warp lines and winches without external assistance.
In the process, one roller suddenly came off its axis due to the great energy of the stress and axial force generated from the winch and the mooring warp line.
The detached roller hit an ordinary seaman (OS) on the ship bow centre mooring platform. Although emergency first aid was applied to the OS by the shipboard emergency medical team and the shore medical service, the OS was unfortunately confirmed dead on the same day.
Probable cause
The investigation revealed that the contributory factors of the accident were as follows:
- The maintenance of the roller performed on board did not comply with the procedures provided in the maintenance manuals and shipboard safety management system (SMS);
- The inadequate design of the security locking system of the roller and maintenance errors, resulting in the great energy of the stress and axial force generated by the winch and the mooring warp line hurled to the axis of the roller, causing its detachment;
- Failure to follow the requirements of the shipboard SMS to effectively monitor the maintenance of critical equipment on board.
Lessons learned
In order to avoid similar accidents during operation in the future, operators should ensure the following:
- To ensure that the shipboard operations, especially of critical equipment, are performed in accordance with the established procedures of the shipboard SMS;
- To enhance the shipboard safe operation training, such as work related to the maintenance and monitoring the maintenance, specifically the critical equipment;
- The mooring warp line rollers should be installed in such a way that the equipment can withstand the axial forces to which it will be subjected.
