UK MAIB has issued an investigation report into an incident where a beam trawler deckhand was fatally injured when the port trawl beam fell and struck him.
The incident:
On 6 February 2021 at 0630, a deckhand/cook on the beam trawler Cornishman was fatally injured when a heavy steel trawl beam fell and trapped him while a second deckhand suffered minor injuries. The crew was repairing the port trawl gear about 44 nautical miles south-south-west of the Isles of Scilly.
The skipper alerted the coastguard, and rescue teams were dispatched, but the injured deckhand was declared deceased at the scene. The investigation revealed the quick-release chain supporting the beam fractured due to wear, corrosion and cracks.
Despite a previous similar incident, the company’s safety and inspection regimes failed to identify the design flaw or chain deterioration. The chain was made of low ductile steel with high hardness, unsuitable for corrosive marine conditions, leading to embrittlement and sudden failure.
Investigation
Safety issues directly contributing to the accident that have been addressed or resulted in recommendations
- The deckhand died when struck by the port trawl beam falling on him as he repaired the trawl chain mat after a chain link from the quick-release gear fractured.
- The risk assessments for the repair were not followed, and the stated risk mitigations were ineffective, putting the crew at risk while working under a suspended load.
- At the time of the accident, safety management on board Cornishman was not fully effective; implementing the FSM Code and a comprehensive safety management system could improve crew safety.
- The design of the chain over fixed pin quick-release gear caused side loading, bending of chain links, and heavy pin wear, making failure more likely.
- Grade 8 chains were unsuitable for corrosive environments, and their use in the quick-release gear increased the risk of material degradation and failure.
- The Grade 8 chain did not meet the minimum breaking strain standard but was not a direct cause of failure.
- The chain’s high hardness, low ductility, and weak break strength indicated an unsuccessful tempering process.
- Hydrogen embrittlement from operating the hard chain in saltwater caused cracks, and bending stress over the fixed pin caused chain link fractures.
- Using an alternative quick-release system instead of a chain over fixed pin would likely reduce failure risk and beam drops.
- The chain’s corrosive environment made loading and fatigue life hard to assess, requiring regular inspection and maintenance to avoid failure.
- Maintenance and inspection did not detect faults or degradation in the quick-release gear, leaving it prone to failure.
- Cornishman’s competent person lacked sufficient knowledge for effective quick-release gear inspection, allowing defective chains to remain in service.
- This and other accidents suggest ineffective training for lifting equipment competent persons and unclear industry guidance on inspection competencies.
Safety issues not directly contributing to the accident that have been addressed or resulted in recommendations
- A lack of some safety-related training likely affected the crew’s ability to assess and implement onboard risk assessments.
- Additional guidance on the inspection aide-mémoire and training for MCA surveyors regarding LOLER-related equipment acceptance would likely be beneficial.
Actions taken
MAIB actions
The MAIB has issued a safety bulletin urging owners and operators of beam and scallop trawlers to inspect their vessels’ quick-release arrangements and make necessary changes to ensure crew safety.
Additionally, it has released a safety flyer to the fishing industry highlighting the impact of side loading on chain links over fixed pins and recommending safety improvements to reduce sudden failure risks.
Actions taken by other organisations
The Maritime and Coastguard Agency has undertaken a focused inspection campaign of scallop dredgers and beam trawlers to assess the condition of quick-release gear.
W. Stevenson & Sons Limited has:
- Employed an external specialist marine consultant to advise on the measures required to ensure compliance with the lifting regulations.
- Replaced the existing quick-release arrangement on its fleet of vessels with a Van Damme system that does not involve using chains over fixed pins.
- Introduced vessel-specific lifting plans across its fleet to clarify the requirements for lifting equipment inspections and thorough examinations.
