How the incident happened
During their work onboard a vessel, the two service engineers were installing a new electronics board. They both conducted their work safely and all the documentation needed, as permit to work (PTW) and job safety analysis (JSA) were done.
Then, one of the engineers went back to the monkey island to take some missing tools, without wearing any personal protective equipment (PPE). As IMCA notes, the engineer didn't wear any fall protection and hadn't make sure that the lock out/tag out and PTW were still in place. When he reached the monkey island, he couldn’t find the missing tool, and so he went to check on the mast itself.
At the same time, the Captain along with the second service engineer put the radar into operation for the final test. As a result, the radar antenna began spinning and hit the service engineer. The engineer lost balance and fell down from the mast to deck and then landed on the roof of a fiberglass lifeboat.
The engineer suffered multiple fractures. IMCA comments that he was 'fortunate not to have been killed'.
After the incident, the engineer was transferred to hospital for surgery.
Causes of the incident
- Poor communication and coordination;
- Poor management of subcontractors on the part of the vessel crew;
- Weak safety culture in subcontractor;
- Insufficient job preparation and completion of checklists.
Following this event, IMCA discusses what are the lessons learned:
- Better communication required: the vessel Master and second service engineer were not informed that the service engineer went back up onto the monkey island;
- Job preparation: more attention should be given to detail in preparation and to identification and mitigation of risks;
- Subcontractor management: better management and control of subcontractor required. Subcontractors should be more thoroughly monitored, especially when working in a dangerous area;
- Subcontractor selection: better selection should be made to focus on HSE aspects and to encourage subcontractors to improve their safety culture.
- Lessons learned: Ensure that incinerator flame failure devices are tested
- Lessons learned: Keep batteries in good condition to avoid overheating