MARINE ACCIDENT

INVESTIGATION BRANCH

Summary of Investigations No 2/93

Marine Accident Investigation Branch

5/7 Brunswick Place
SOUTHAMPTON
Hants S O 12 A N

Telephone : 0703 232424

Accident Reporting Line 071 276 6004 (24 hours)

This summary contains facts which have been determined up to the time of issue. This
information is published to inform the shipping industry and the public of the general
circumstances of accidents and must necessarily be regarded as tentative and subject to
alteration or correction if additional evidence becomes available.

Extracts can be published without specific permission providing that the source is duly
acknowledged.

Crown copyright 1993

 INDEX
Page No.

Introduction

Collision with Jetty 1

Flooding of an Offshore Support Vessel 2

Hull Damage during Cargo Loading

Operations 3

Collision between a Gas Carrier and a Sail

Training Yacht 4

Hydraulic Cargo Hoist Failures on Ro-Ro Ferries 6

Engine Room Fire at Sea 7

Unsafe Hot Work in Port 8

Flooding and Recovery of 16 Metre Fishing Vessel 9

Flooding and Beaching of a Small Fishing Vessel 10

Loss of a Small Single Handed Fishing Vessel 11

Overloading of a Small Fishing Boat 12

Poor Maintenance Resulting in Flooding Incidents

on Two Fishing Vessels 13

Benefits of Survival Courses 15

Injury to Crew Member in Engine Compartment 16

Engine Compartment Fire at Sea 17

Flooding and Sinking of a Fishing Vessel 19

An example of the Benefits of Sea Survival Training 21

Sinking Fishing Vessel 22

Appendix A - Investigations Commenced in the Period 01/04/93 - 31/07/93

Appendix B - MAIB Priced Publications available from HMSO

 INTRODUCTION

No apologies are made for the fact that in this edition of the Summary of Investigations
no less than eleven of the eighteen summaries concern fishing vessels. Accidents to
fishing vessels and those on board account for well over fifty percent of the work of the
Branch so there is plenty of material from which to select the summaries.

Only one of the eleven incidents resulted in loss of life, but loss of property and earnings
and costs of repairs must have been considerable for the others.

A number of the incidents have common factors. There are many useful lessons to be
learnt from reading the accounts: perhaps the most striking, which should be driven
home loud and clear, is the need for the right equipment - and that it must be kept in
good order. No less than seven of the reports point out the need for a bilge alarm; and
in three of the seven an alarm was fitted but it did not function.

But it is not only bilge alarms which need to be well maintained. All equipment on
board, whether it be the main propulsion system, the fuel system, the fishing gear, life-
saving equipment, even galley equipment, needs to be maintained in first-class condition.
Equipment which is allowed to fall into disrepair or on which faults are not rectified
create hazards for all concerned which can have either disastrous or costly consequences.
This message of course applies not only to fishing vessels but to all vessels, irrespective
of type and size.

Chief Inspector of Marine Accident

August 1993
1. COLLISION WITH JETTY

Narrative

An 825 gross registered tonnage coastal tanker, registered in the UK, was fitted with
a rotary vane electro-hydraulic steering gear. The two hydraulic pump units installed
were each capable of being operated either singularly or in parallel. The hydraulic oil
output from the pumps is directed into the appropriate rotary vane port by solenoid
pilot valves. These valves are controlled from three locations; the wheelhouse steering
console, by a remote wandering lead and locally at the pump. Auto-pilot control of
the steering gear was also available.

The vessel, which was fully loaded with fuel oil products, left the oil terminal berth
in the early hours of the morning. The projected course was to cross the harbour and
then proceed seawards parallel to a disused jetty. At the time of departure the Master
and the Chief Engineer were in the wheelhouse with No 2 steering gear hydraulic
pump running - no steering gear test had been carried out prior to departure. During
the passage across the harbour, the Chief Engineer went below whilst the steering
gear hydraulic pumps were changed over from No 2 to No 1 unit. The vessel's speed
at this time was about 6 knots. When the Master applied port helm to maintain his
course parallel to the disused jetty, there was no immediate response. Increased port
helm was applied, but the vessel swung rapidly to starboard causing her to collide with
the jetty. Although damaged, the vessel was able to return to her original berth,
discharge cargo and proceed to the dry dock for repairs.

Observations

Examination of No 1steering gear, showed the solenoid pilot valve to be faulty, giving
rise to erratic operation and loss of control. This erratic operation is thought to have
been due to foreign bodies in the hydraulic fluid combined with wear within the valve
assembly.

Testing of the steering gear prior to departure would probably have identified the
problem and prevented the loss of steering control. Similarly, the use of both steering
gear hydraulic pumps during the passage in confined waters would have prevented this
incident.

Comment

Testing of steering gears prior to the commencement of a voyage is addressed in the

Merchant Shipping (Automatic Pilot and Testing of Steering Gear) Regulations 1981.
In the case of coastal vessels making frequent voyages, testing of the steering gear
before departure on each voyage should form part of the normal operational
procedures. The Regulations also require that in areas where navigation demands
special caution, the Master shall ensure that the ship shall have more than one
steering gear power unit in operation when such units are available and capable of
simultaneous operation.

1
2. FLOODING OF AN OFFSHORE SUPPORT VESSEL

Narrative

A 52 metre offshore safety standby vessel was operating with a crew of 12 in very
severe weather conditions. The wind strength was recorded as up to Force 12. A
section of the vessel’s starboard bulwark was carried away by the seas about mid
afternoon. During the early evening, with the weather still severe, a list of some 15
to starboard was noticed. Because of the weather conditions no inspection of the
weather deck could be carried out, but an internal inspection found flooding within
the survivor accommodation on the starboard side. The depth of flooding prevented
opening of the bilge valve in the space.

Assistance was requested from the Coastguard and other vessels in the area. The
majority of the crew were evacuated by helicopter.

The Master corrected the list by partial deballasting and by pumping out the flooded
space using a portable emergency pump. The vessel eventually reached port under her
own power.

Observations

External inspection, performed in port, established that an air vent to the survivor
accommodation had been carried away, thus opening this space to any seas breaking
over the deck. As this vent was in the same area as the damaged bulwark it was
concluded that the damage to the bulwark and air vent probably occurred at the same
time.

Comment

Although an inspection of the weather deck at the time of the bulwark damage was
impossible, any damage to the vessel’s structure should have been assessed as soon
and as far as was practicable. In this case ingress of water into the accommodation
spaces should have been very quickly and easily identified by the simplest of internal
inspections. This would have allowed the bilge valve for the space to be opened
before flooding became serious, so enabling the crew to control the situation from the
start of the incident.

2
3. HULL DAMAGE DURING CARGO LOADING OPERATIONS

Narrative

A single hold general cargo vessel of 1,326 gross registered tonnage loaded a cargo
of irregularly shaped scrap steel. On leaving the loading berth and making her way
outward, but before reaching the sea, the vessel developed a slight but increasing list
to starboard. Although the weather conditions were good the Master immediately
returned to a loading berth and concurrently took onboard soundings. It was very
quickly established that the main hold was flooding, but the ship's bilge system had
no difficulty in coping with the ingress of water and the vessel was able to be moved
to a repair berth.

Closer inspection revealed that the side shell plating of the vessel had been holed,
most probably due to impact by a sharp heavy piece of scrap during the loading
operation.

Observations

It was a standard practice of the Master for all cargo space bilge systems to be
inspected and tested after discharge and before loading any type of bulk cargo. The
value of this practice, which is set out in the IMO "Code of Safe Practice for Solid
Bulk Cargoes'' (BC Code), was clearly demonstrated in this case. Had it proven to be
impossible to pump out the bilges of the hold, the vessel could have been in serious
difficulties.

Comment

Another recommendation contained within the BC Code is that bilges should be

sounded on the completion of loading; an operation which was not performed in this
case.

3
4. COLLISION BETWEEN A GAS CARRIER AND A SAIL TRAINING YACHT

Narrative

A 1,367 gross registered tonnage gas carrier was steering a course of 250 (T) at a
speed of 9 knots in the western English Channel. A 10 metre sail training yacht, on
a cruise from a west of England port to the Channel Islands, was steering a course
of 122 (T) at a speed of about 6 knots. It was a fine summer night with a moderate
breeze from the south-west and good visibility.

From the gas carrier, a red light was sighted about three points on the starboard bow
and at close range. Course was altered to port. When the ship's head had reached
about course was altered back to starboard. Collision occurred when the
ship had almost regained her original heading, with the yacht crossing ahead.

From the yacht, the steaming lights of the gas carrier were seen about three points
on the port bow showing a green sidelight. After twenty minutes the lights appeared
to be two and a half points on the bow. It was thought that the ship would pass about
a mile ahead of the yacht. A little later the lights, which were now at close range,
became obscured from the cockpit by the sails and the dinghy on the cabin top. The
collision followed.

In the collision, the port bow of the ship struck the port quarter of the yacht. The
yacht was dismasted, extensively damaged and started to flood. Pyrotechnic distress
signals were used: these enabled the ship to locate the yacht and all seven of her crew
were taken on board, one having suffered a fractured thumb. They were later
transferred to an RNLI lifeboat and landed ashore. The gas carrier, which was
undamaged, subsequently resumed her voyage. The yacht, although later salvaged,
was a constructive total loss.

Observations

The radar on the gas carrier was only being used for navigational purposes on
a high range scale. For collision avoidance, the lookout being kept was a visual
one by the Officer of the Watch and the navigating watch rating.

The required minimum range of visibility of the navigation lights shown by the
sail training yacht was one mile.

There were seven people on board the sailing training yacht: the Skipper, who
held a Coastal Skipper Certificate, the Mate, the Bosun and four trainees.

Although the Skipper was aware of the approaching ship, he had gone below
and handed over the con to one of the inexperienced trainees with another
youngster, who was suffering from seasickness, detailed to keep a lookout. The
yacht took no action to avoid the collision.

4
Comment

1. The gas carrier was clearly the give-way vessel, but she failed to see the yacht
until the vessels were already close to one another. At that late stage the action
taken was grossly inappropriate and ineffective.

2. The yacht, although initially required to maintain course and speed, was
permitted under Rule 17 of the Collision Regulations to take action herself,
when it became apparent that the other vessel was not doing so. The Skipper
should have been on deck, hands should have been called to stand by to handle
the sails and efforts should have been made to draw attention, for example, by
using the signalling lamp both to call up the other ship and to illuminate the
sails.

3. When the situation had developed further and collision could not be avoided by
the action of the give-way vessel alone, the yacht was required, also by Rule 17,
to take such action as would best aid in avoiding the collision. This she could
have done by putting the helm hard over to starboard into the wind, allowing
the ship to pass to the south.

4. This collision could have had tragic consequences. It illustrates the vital
necessity of proper lookout by all available means and appropriate action in
ample time to avoid collision.

5
5. HYDRAULIC CARGO HOIST FAILURES ON RO-RO FERRIES

Narrative

Incidents involving the failure of hydraulic cargo hoists have been investigated. In
four cases the main actuating cylinders have failed allowing hydraulic cargo hoists to
fall uncontrollably to their lowest positions. In these cases the cause of failure has
been the sudden fracture of all the set screws holding down the stuffing box of the
hydraulic ram and bulk release of hydraulic fluid.

Observations

Investigations have shown that the failure in turn was due to over extension of the
cylinder ram travel resulting in metal to metal contact and fatigue of the set screws
because of:

1. Malfunction of electrical limit switches due to poor maintenance.

2. Absence of any mechanical stops designed and installed to limit the travel of the
hydraulic ram.

Comment

Against this background it is appropriate to draw attention to the Merchant Shipping

(Hatches and Lifting Plant) Regulations 1988 and its various provisions with regard
to the design, testing, service and maintenance of the cargo hoist plants of vessels and
the records to be kept on board for inspection. The relevant Regulations are
numbers 7 to 10, and further detailed guidance is provided in Chapter 17 of the
"Code of Safe Working Practices for Merchant Seamen" (1991 edition).

6
6. ENGINE ROOM FIRE AT SEA

Narrative

A 1,409 gross registered tonnage motor tanker was on passage in ballast when at 2030
hours the Chief Officer noted smoke issuing from the engine room skylights. The
fire alarm was sounded and the crew mustered to their emergency stations. At about
the same time, the Second Engineer left the engine room to report a severe fire on
the main engine exhaust manifold.

At 2033 hours the Chief Engineer shut down the engine room ventilation fans and
tripped the main engine fuel valves. Instructions were given to close all vents etc and
an unsuccessful attempt was made to put out the fire by directing a portable foam
extinguisher onto the fire from the engine room access. The main engine stopped
approximately 3 - 4 minutes after closure of the fuel valves. The Chief Officer and an
AB then entered the engine room wearing self contained breathing apparatus and
tackled the fire locally with portable foam extinguishers. The fire was extinguished at
2040 hours.

A Pan message was sent at 2042 hours, but after the smoke had cleared and an
inspection by the Chief Engineer and Chief Officer had been carried out, the Pan
message was cancelled at 2059 hours. The main engine exhaust cladding was removed
and No 3 unit cylinder head was found to have been blowing excessively. The fuel
pump for this unit was removed and at 2310 hours the vessel continued her voyage
to the UK at reduced revolutions.

Observations

1. No injuries to the crew or damage to the machinery have been reported.

2. This incident was probably brought about by hot exhaust gases leaking from No
3 cylinder head igniting dust, dirt and oily residues on the main engine exhaust
trunking.

3. The subsequent actions of the crew in fighting the fire were correct and may
well have prevented a more serious fire developing.

Comment

The watchkeeping and also the maintenance standards practised on this vessel must
be in question. A cylinder head leaking to the extent that it causes a fire, is both very
noisy and obvious to an efficient watchkeeping engineer. In the event that the leak
had been reported, then particular vigilance in that area of the engine room should
have been called for.

7
7. UNSAFE HOT WORK IN PORT

Narrative

A standby/diving support vessel was in port undergoing repair. Hot work was being
undertaken in a tank located adjacent to an accommodation space. The work
generated a gradual increase of heat in the divisional bulkhead linings which
eventually caught fire. The fire was subsequently extinguished by the shore fire
brigade.

Observations

1. There were no resultant injuries to personnel but fire damage extended

throughout the accommodation and into the wheelhouse.

2. Linings had previously been removed from the immediate area of the divisional
bulkhead in which hot work had been intended.

3. The fire water main on board was not readily available for use.

4. Although a fire watch patrol was in process, no person was assigned to

specifically oversee the progress of the hot work concerned.

5. The ship manager and the shore contractor did not have a clear agreement as
to who was responsible for fire watchkeeping.

Comment

1. Chapter 13 of the "Code of Safe Working Practices for Merchant Seamen" (1991
edition) and Merchant Shipping Notice No M.957 highlight the precautions
which should be taken prior to and during welding and flamecutting operations.

2. Merchant Shipping Notice No M. 1267 specifically addresses fire prevention and

fire fighting aboard ships in port and emphasises the need for ship and shore
staff to establish clearly defined instructions and practices.

8
8. FLOODING AND RECOVERY OF 16 METRE FISHING VESSEL

Narrative

A 16 metre fishing vessel, operating during the hours of darkness, had just shot her
gear and was engaged in a tow when all of the vessel’s lights failed. An immediate
inspection of the engine room was made where seawater to floor plate level was
found. Fortunately the cause of the flooding was quickly established as being a
fractured cooling water pipe for the fish hold cooling system. This system was quickly
and easily isolated to prevent further ingress of water. Although the main engine
continued to run, the main engine driven bilge pump was ineffective due to the
floodwater causing its belt drive to slip and fly off. Attempts to start the auxiliary
engine, which drove another bilge pump, failed due to floodwater damage of the main
battery set. Flooding was confined to the engine room by effective watertight
bulkheads.

A distress call to the Coastguard resulted in the vessel being supplied with a portable
pump by an RNLI lifeboat. This pump proved effective but as the main engine lub
oil was now contaminated with seawater, the vessel was towed to harbour.

Observations

1. A bilge high level alarm was fitted in the engine room but did not operate.

2. Although the vessel had a second power-driven bilge pump, driven by the
auxiliary engine, this pump was of no value due to the failure of the engine
starting system which was shared with the main engine.

3. The value of maintaining bulkheads in a watertight condition, in order to limit

the extent of any flooding, was clearly demonstrated in this case.

Comment

The vessel’s owners have decided to duplicate the bilge high level alarm.
Furthermore, they have decided to provide the auxiliary engine with its own dedicated
starting system. Although neither of these modifications are required to satisfy
regulations, they are both considered to be sensible and demonstrate how a
responsible owner can make prudent modifications, which are in excess of the
minimum requirements of the regulations, to enhance the safety of his vessel.

9
9. FLOODING AND BEACHING OF A SMALL FISHING VESSEL

Narrative

A 10 metre fishing vessel was on passage with three persons on board. The vessel had
two main engines and both engines started to slow down coincidentally with fumes
discharging from the engine casing vents. Inspection of the engine spaces revealed
serious flooding, although the cause could not be established. Use of three bilge
pumps controlled the water ingress until the Skipper beached the vessel. Subsequent
pumping out of the compartment revealed a fractured watercooled flexible exhaust
hose on one engine.

Observations

No bilge alarm was fitted to the machinery space. Early warning of flooding would
have probably led to identification of the cause and would have allowed the Skipper
to shut down the affected engine, thus preventing further ingress of water, and
avoiding the need to beach the vessel.

Comment

The owner has replaced both engine flexible exhaust pipes with new reinforced rubber
impregnated hoses. He has also fitted a high level bilge alarm to the machinery
compartment.

10
10. LOSS OF A SMALL SINGLE HANDED FISHING VESSEL

Narrative

A fishing vessel of 10 metres length was on passage off the UK coast on a short
delivery voyage. The vessel was being crewed by one person. During the early hours
of the morning the vessel’s electrical system failed causing the Skipper to inspect the
engine space. A substantial amount of water was found in this space and was
adjudged to be the cause of the electrical failure, but the depth of water prevented
proper investigation of the cause of flooding. The bilge pump was put into operation
and the Skipper changed course to head for a port of refuge. The pumping operation
appeared to be controlling the water level, but some four hours after the flooding was
discovered the vessel started to heel badly causing the Skipper to launch his liferaft
and abandon his boat which sank shortly afterwards. The Skipper released a smoke
canister which was seen by members of the public ashore and by a passing helicopter.

The Skipper was rescued by an RNLI lifeboat within two hours of him abandoning
his vessel.

Observations

1. No operational bilge alarm was fitted in order to give an early warning of water
ingress. Had the cause of the flooding been established earlier, simple
rectification may have been possible.

2. It should be noted that this Skipper had also instructed his wife to contact the
Coastguard in the event of him not making contact with her by a specified time;
this she did, coincidentally at the time her husband was being landed from the
lifeboat.

Comment

1. Although a fishing vessel of this size is not required to carry a liferaft, this
incident demonstrates the value of doing so. Further, having someone ashore
who is aware of a vessel’s planned movements, although not proving vital in this
case, is clearly a simple and prudent precaution.

2. An operational bilge alarm may well have allowed the flooding to be discovered
earlier, so allowing the cause to be rectified before the incident developed into
a full scale search and rescue operation.

11
11. OVERLOADING OF A SMALL FISHING BOAT

Narrative

A glass reinforced plastic fishing boat of about 5.5 metres length, operated by one
man, commenced laying creels in good weather conditions. As the day progressed the
weather deteriorated causing the fisherman to attempt to move his creels to a more
sheltered position. During this operation the lone fisherman drowned.

Observations

1. The body of the fisherman was recovered; he had not been wearing a lifejacket.

2. The boat has never been recovered but it is known that additions had been
made to it in the form of a large storage rack at the aft end. The capacity and
position of this rack was such that, if filled to capacity with creels, the reserve
stability and freeboard of the vessel is likely to have been seriously depleted.

Comment

1. Advice should be sought from a boat designer or Naval Architect before making
any modification to a boat which might reduce freeboard and/or stability.

2. When working alone fishermen should be particularly aware of the need to wear
a buoyancy garment.

12
12. POOR MAINTENANCE RESULTING IN FLOODING INCIDENTS ON
TWO FISHING VESSELS

Narrative

VESSEL A

The Skipper of a 10.6 metres angling boat with eight anglers on board, and 40 miles
out, alerted the Coastguard that the boat was taking on water fast. A helicopter and
lifeboat were launched to stand by it. The Skipper was alerted to the flooding when
the engine temperature alarm went off (the engine was stopped immediately) and he
entered the engine room to investigate the cause of the problem. He discovered a
high level of water in the bilge. The crew were unable to find the source of the leak
and the engine was re-started. It then became apparent that the water was being
ejected from a vent hole in the engine cooling water system. Apparently the plug to
the vent hole had been removed two days earlier during routine maintenance and
had not been adequately tightened down when it was re-fitted. The engine was
stopped again, the vent securely sealed, and the boat pumped dry. The rescue services
were stood down and the boat continued on its trip.

VESSEL B

The Skipper of an 8 metre creel boat with a crew of two on board alerted the
Coastguard that the boat was taking water but that the pumps were coping and they
were returning to port. The Skipper was alerted to a problem when he noticed that
the engine ignition light was flashing. On entering the engine room to investigate he
discovered 0.5 metre of water in the bilge, just up to the level of the alternator. The
cause of the flooding was not immediately apparent because of the spray generated
by the engine’s drive belts rotating in the bilge water. It was considered inadvisable
to stop the engine to investigate further, not only because it might have been
impossible to re-start it due to the high level of water but also because the engine
driven pump was necessary to cope with the flooding. The engine driven pump and
a small electrical driven pump were started and were adequate to reduce the water
level. It was subsequently discovered that the source of the flood water was the waste
engine cooling water injected into the engine exhaust which was leaking from a loose
pipe. Apparently, a length of the exhaust had been recently renewed and this pipe had
not been secured when it was replaced.

Observations

1. Both crews were only alerted to the flooding when it had reached such a level
as to interfere with the main engine and electrical systems.

2. It was fortunate that in neither case main engine power was lost, but there was
a very real possibility that it might have been which could have led to very
different conclusions to the incidents.

13
Comment

1. These incidents were entirely avoidable and resulted from a lack of attention to
detail when carrying out repairs and maintenance.

2. Neither incident would have developed to the point of endangering the vessels
and lives of the crews if the boats had been fitted with bilge alarms. These
would have alerted the crews to a potential flooding problem before it became
serious. Merchant Shipping Notice No M.1327 recommends the fitting of bilge
alarms to all fishing boats regardless of length. To quote the Skipper of vessel
B: "this whole affair would have been nipped in the bud with the installation of
a bilge alarm".

14
13. BENEFITS OF SURVIVAL COURSES

Narrative

A fishing vessel of approximately 9 metres length, operating with a crew of two,

started to behave in a very sluggish fashion whilst operating one mile from shore.
Investigation soon established that the vessel was seriously flooded. Unfortunately the
cause could not be found and the crew were very soon forced to abandon and take
to their liferaft. The men were picked up by another fishing vessel and their vessel
sank very soon afterwards.

Observations

1. No high level bilge alarm was fitted. The extent of flooding at the time of
discovery was too great to establish the source of the ingress or to effect a
remedy.

2. This vessel was equipped with an inflatable liferaft; an item which is not
mandatory for fishing vessel of this size, although it is a strong recommendation
of Merchant Shipping Notice No M.1467.

3. Both crew members had attended a safety training course in Sea Survival.

Comment

1. The lack of an effective bilge alarm is a common factor in many flooding

incidents involving small fishing vessels. Without the early warning afforded by
such systems, Skippers and crews often have little or no time to carry out repairs
before their vessels become unstable and have to be abandoned.

2. The survivors of this incident expressed gratitude for the knowledge they had
gained from their survival courses; claiming it "enabled us to do the right thing
without panic". It should be noted that all fishermen, serving on registered
fishing vessels, born after 1 March 1954 should have undertaken the Safety
Training courses as set out in Merchant Shipping Notice No M.1367.

15
14. INJURY TO CREW MEMBER IN ENGINE COMPARTMENT

Narrative

This 20 metre fishing vessel was alongside and had completed landing her catch. The
main engine was running but out of gear and with the clutch disengaged. A crew
member then went into the engine compartment in order to check the oil levels and
grease all moving parts. In order to gain easier access for greasing the stern tube, he
decided to turn the propeller shaft using a crow bar between the coupling bolts.
Having turned the shaft, the crew member left the crow bar in place whilst attending
to the greasing. Meanwhile, the Skipper was requested to move the vessel to an
adjacent berth. On engaging the gearbox, the crow bar turned with the shaft and
struck the neck of the crew member.

Observations

The owner of the vessel reported that the crew member had entered the engine
compartment without giving notice to anyone about his intentions. Although it was
normal practice to grease the stern tube on return to port, it should not be done when
the main engine is running. He has now issued instructions that no-one is to enter the
engine compartment without telling the person in charge.

Comment

1. Great care should be taken when working on or near running machinery.

Persons working on machinery which can be started remotely should place
notices saying "DO NOT START - MACHINERY UNDER MAINTENANCE".

2. The crow bar should have been removed from between the coupling bolts once
the shaft had been turned to the desired alignment. All tools should always be
removed from the immediate area of work when the task they were being used
for has been done.

3. Wherever possible someone should be advised before entering an unmanned

machinery space, particularly if it is intended to work on the machinery.

16
15. ENGINE COMPARTMENT FIRE AT SEA

Narrative

A 16.2 metre wooden hulled fishing vessel was on its way out of port towards the
fishing grounds. A fire was discovered in the engine room which developed very
swiftly. The Skipper slowed the engine down and called on the crew member to
investigate. On opening the engine room access, despite black oily smoke and the
crew member trying to tackle the fire with an extinguisher, the fire quickly spread to
the combined galley and wheelhouse. The Skipper managed to make a quick
"MayDay" call before being forced to leave the wheelhouse. The liferaft was launched
and both men climbed aboard after securing the painter to the handrail forward. As
neither had, nor could find, a knife to cut the painter and although attempts were
made to paddle away from the by now blazing vessel they continually drifted back
alongside. This problem was eventually solved when the painter burnt through. Both
men were rescued by other fishing vessels in the area with the vessel eventually being
towed back to port.

Observations

The cause of the fire was thought to be the failure ,of a flexible lubricating pipe
for the gearbox which resulted in oil being sprayed onto the hot turbo charger
casing of the main engine.

A fixed water spray was fitted in the engine room, with the hand operated pump
and controls on deck adjacent to the wheelhouse, but the speed of the
developing fire prevented its use.

The fuel tanks in the engine room had open ended plastic gauges but
fortunately the spring loaded gauge valves prevented any loss of contents.

A safety knife would have been included with the liferaft equipment but neither
of the men could locate it.

The difficulty in freeing the liferaft from the painter could have resulted in
injury or loss of life if the vessel had sunk or the fueltanks exploded.

Comment

1. This type of incident is identified in Merchant Shipping Notice No M.1456

where it is recommended that suitable screening arrangements should be
provided to deflect any fuel or leakage to a safe place.

2. The effect of vibration and the need for adequate securing arrangements for
pipework should also be borne in mind, particularly so in the case of unmanned
engine room spaces.

17
3. The use of the fixed water spray system may have assisted in preventing the
spread of the fire, but the siting of the operating mechanism on deck adjacent
to and above the engine room prevented its use. It is considered that such
systems should be sited away from the protected space, not just outside it.

18
16. FLOODING AND SINKING OF A FISHING VESSEL

Narrative

While manoeuvring to come alongside a jetty, a 40 year old single skin wooden fishing
vessel could not get astern power due to the morse control cable becoming fouled.
This loss of control resulted in the bows of the vessel becoming jammed between two
pillars of the jetty. There was no visible damage. The following morning the crew
checked the bilges, and finding only small quantities of water, the vessel left port to
go gill net fishing with a crew of three on board. She was on her fourth haul in the
early afternoon when a crew member noticed sea water in the engine room. The
mechanically driven bilge pump was engaged together with an electrically driven
pump. At that stage there was not too much concern among the crew but the Skipper
increased engine revs and headed towards port. The Coastguard was informed of the
flooding about 45 minutes after its discovery. At that stage the estimated depth of
water in the common bilge was 3 feet making it impossible to establish the cause of
the flooding.

The crew donned lifejackets, launched the liferaft and secured it to the vessel ready
for boarding. The vessel started going down by the head and it was decided that the
crew would board the liferaft, while the Skipper stayed with the vessel as long as
possible, finally boarding the liferaft shortly before the vessel sank in 56 metres of
water. The crew were rescued from the liferaft by another fishing vessel and safely
landed ashore.

The vessel’s EPIRB activated when she sank, and was later recovered by the crew of
the SAR helicopter.

Observations

1. Although this vessel was fitted with a bilge alarm, on this occasion it failed to
operate thus severely reducing the time available for the crew to take corrective
action.

2. The absence of watertight bulkheads in this vessel allowed widespread flooding

to take place before discovery, making the execution of any remedial action
difficu 1t.

Comment

1. After the contact with the jetty pillars, the vessel should have been closely
examined for structural damage. Subsequently, when proceeding to sea, a
constant watch should have been kept for possible flooding.

19
2. The Coastguard should have been informed of flooding as soon as it was
discovered, especially as this old wooden vessel did not have watertight
bulkheads to restrict the flooding. Early notification would have given the
Coastguard time to have a salvage pump flown out to the vessel, possibly
preventing her from foundering.

3. This case highlights the value of having effective operational lifesaving

equipment and crew members trained to use it.

20
17. AN EXAMPLE OF THE BENEFITS OF SEA SURVIVAL TRAINING

Narrative

A steel fishing vessel of 10 metres registered length was being operated single handed.
There was a moderate sea with a south-westerly Force 6 wind blowing when she
dropped into a trough of a wave and struck a large baulk of timber which broke one
of the wheelhouse windows. On looking below, the Skipper found the forward
compartment flooded. He then contacted the Coastguard on VHF Channel 16,
reported his position and that he was sinking. He then donned his survival dry suit,
secured all the hatches, launched the liferaft and entered it. A passing vessel spotted
red flares and recovered the Skipper from the liferaft and later transferred him a to
lifeboat. Together, the Skipper and the crew of the lifeboat managed to locate the
partially submerged fishingvessel and put a tow line on board. She was towed to a
safe area from which some time later she was salvaged. The Skipper was returned
ashore uninjured.

Observations

1. Correctly the Skipper first contacted the Coastguard on Channel 16, and told
them of the situation and his position. Using VHF enables the Coastguard to
use direction finding to check the senders position, but when a portable phone
is used this is not possible.

2. The Skipper very wisely carried and used a survival suit and a liferaft.

3. Closing the hatches must have helped keep the vessel afloat and in turn enabled
her to be salvaged.

Comment

The Skipper had attended a Sea Survival Course and put into practice what he had
learnt by providing and using the survival equipment.

21
18. SINKING FISHING VESSEL

Narrative

A wooden hulled fishing vessel of 16 metres length built in 1949 was trawling for
prawns 120 miles east of Dundee. A large unidentified object caught in her net at
about 1600 hours which was too heavy to haul on board. Attempts were made to
clear the net without success and it was cut away at 0800 hours on the next day. The
vessel then steamed for about two hours to a new fishing ground and began rigging
a replacement net. Whilst carrying out this operation, it was seen that the fore hold
and engine room were filling with water.

The two crew immediately took to a liferaft without issuing a radio distress call and
very shortly afterwards the vessel sank. A float-free EPIRB was fitted but this did not
come to the surface.

The crew were rescued by a helicopter which just happened to be over-flying the area
and saw the wreckage. Neither of the vessel’s crew suffered any injury and there was
negligible pollution.

The cause of the sinking is not known but it was most probably hull planking failure,
perhaps brought about by stress on the hull during the incident the previous
afternoon.

Observations

1. The vessel was fitted with a bilge alarm but this was not operational.

Comment

1. The bilge alarm should be regularly tested, preferably daily. Timely indication
that there is flooding is essential to allow remedial action to be taken or a call
for assistance broadcast. Merchant Shipping Notice No M. 1327 gives very good
advice for the prevention of flooding of a fishing vessel.

2. The reason for the failure of the EPIRB to surface has not been identified but
the following points should be noted in respect of the care and maintenance of
EPIRBs:

2.1 the EPIRB should be fitted and maintained as recommended by the

manufacturer,

2.2 the hydrostatic release unit requires renewing every two years and the
battery every four years. The use of a competent service agent is
recommended,

2.3 the tether lanyard should not be affixed to the vessel’s structure,

22
2.4 where an EPIRB has a switch that could turn the beacon off, this should
be checked to ensure that it is in the "active" position so that the beacon
will operate automatically when it floats free,

2.5 EPIRBs should be regularly inspected to ensure there is no build up of

salt/funnel deposits that may inhibit either the release mechanism or the
operation of the beacon in the water,

2.6 beacons should not be painted,

2.7 the EPIRB must be registered with the Department of Transport so that
vessel information can be rapidly passed to Search and Rescue
Authorities in the event of an emergency.

23
 APPENDIX A
INVESTIGATIONS COMMENCED IN THE PERIOD 01/04/93 - 31/07/93
DATE OF NAME OF TYPE OF FLAG SIZE TYPE OF
ACCIDENT VESSEL VESSEL ACCIDENT

07.02.93 ANDROMEDA II/ Fishing Vessel/ UK 26.35m Col 1i s ion

ROEYBUEN Fishing Vessel Norway 28m

04.03.93 JAMANDER Fishing Vessel UK 19.79m Grounding

26.03.93 DALMARNOCK Speci a l ised UK 2,266 g r t Machinery

Carrier

14.04.93 JOY NIELSON Fishing Vessel UK 16.31m Contact

17.04.93 CONDOR 8 Passenger UK 387 g r t Accident t o Person

18.04.93 NIL DESPERANDUM Fishing Vessel UK 8m Foundering

20.04.93 BERACHAH Fishing Vessel UK 19.05m Accident t o Person

24.04.93 NORTHERN VENTURE Fishing Vessel UK 23.35m Foundering

26.04.93 DAYSPRING II/ Fishing Vessel/ UK 21.31m Col 1i s ion

ANDROMEDA II Fishing Vessel UK 24.20m

27.04.93 RADIANT DAWN Fishing Vessel UK 18.32m Flooding

28.04.93 JOHANNA Workboat UK Foundering

28.04.93 ALEX WATT Fishing Vessel UK 14.91m Grounding

13.05.93 MAID OF THE Pleasure C r a f t UK 106 g r t Machinery

FORTH

16.05.93 GRAN PIEDRA Reefer Cuba 3,456 g r t Machinery

20.05.93 MERAK General Cargo Cyprus 1,326 g r t Flooding

26.05.93 CALVADOS Fishing Vessel UK 20.14m Fire

02.06.93 ORIENTAL BAY Container UK 50,235 g r t Accident t o Person

03.06.93 BRITISH TRENT/ O i l Tanker/ Bermuda 15,649 g r t Collision

WESTERN WINNER Bulk C a r r i e r Panama 15,953 g r t

10.06.93 BAZIAS 4 Ro-Ro Cargo Romania 2,831 g r t Fire

14.06.93 INA B Fishing Vessel UK 15.09m Fire

27.06.93 ST VINCENT/ Fishing Vessel/ UK 36.27m Collision

TROENVERVAS Fishing Vessel Norway 53m

30.06.93 LORD CHAD Fishing Vessel UK 14.10m Accident t o Person

02.07.93 MAID OF THE Pleasure C r a f t UK 106 g r t Machinery

FORTH

04.07.93 ROYAL PRINCESS Passenger Launch UK 115 g r t Contact

07.07.93 MERCHANT VICTOR/ Ro-Ro Cargo/ Bahamas 1.598 g r t Collision

LIBERTY Fishing Vessel UK 19.51m

12.07.93 SPARKLING STAR Fishing Vessel UK 16.49m Explo s i on

II

14.07.93 AMBER ROSE/ Fishing Vessel/ UK 21.69m Col l is i o n

OPOSSUM Naval C r a f t UK 2,030 g r t

15.07.93 JAMES CLARK ROSS Research Fal klands 5,732 g r t Hazardous Incident

21.07.93 AVON O i l Tanker Jamaica 43,622 g r t Grounding

28.07.93 SEACAT CALAIS Cargo/Passenger Australia 3,012 g r t Contact

29.07.93 CHERNOMORSKAYA Fishing Process USSR 12,487 g r t Fire

SLAVA