Marine Accident Investigation Branch Safety Digest 2/2005 Case 1

Don't Just Watch it Happen

Narrative
While on passage, two deckhands were instructed by the master to prepare the vessel’s steel uprights for the next deck cargo, but not to fit them. The weather conditions were good with a force 3 wind and slight sea, but overnight rain had left the hatch covers wet.

The uprights were rusty, and the two deckhands decided, on their own initiative, to make sure they still fitted into the slots on the hatch coaming. This proved difficult, and caused one of the deckhands to slip and fall overboard.

The master, who was on watch, witnessed the accident and immediately altered course. He then released the man overboard smoke float, sounded the general alarm and transmitted a PAN alert on the radio. The rescue boat was launched, and the deckhand was safely retrieved on board within 15 minutes.

The Lessons
1. The master had specifically instructed the deckhands not to fit the steel uprights. However, they chose to ignore his instruction; something the master was aware of yet chose to do nothing about.

An instruction is of no value unless it is implemented. In this case, a risk of someone falling over the side had been identified. The control measure was not to fit the steel uprights. The control measure was overridden, and an accident ensued.

2. The master’s reaction, and that of the crew, immediately following the fall overboard was swift and effective in enabling the deckhand to be recovered from the water quickly, and demonstrated the benefit of regular drills.

3. The consequences of this accident could have been far worse if, for example, the deckhand had struck his head while falling overboard, or if the master had been looking elsewhere at the time. Such tasks should be avoided, if possible. However, where there remains an unacceptable risk of someone falling overboard, suitable control measures should be employed, such as the use of safety lines or working lifejackets.