Marine safety investigations & reports

Independent investigation into the fast rescue boat incident on board the Isle of Man registered liquefied natural gas tanker British Sapphire off Darwin, Northern Territory on 16 May 2010

Investigation number:
275-MO-2010-004
Status: Completed
Investigation completed

Summary

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On 16 May 2010, the chief engineer of British Sapphire was being medically evacuated using the ship's fast rescue boat for the transfer. The fast rescue boat party consisted of the chief mate, second mate and fourth engineer. The chief engineer, second mate and fourth engineer were injured when, during the launch, the ship's fast rescue boat dropped 18 m and impacted the water below.

The investigation determined that, in the process of lowering the rescue boat, the wave compensator mechanism on the fast rescue boat's davit was activated early, before the rescue boat had reached the water. A fail safe interlock device should have prevented this by placing the wave compensator into standby mode, only becoming operational when the fast rescue boat was waterborne. However, the electrical installation of the interlock was incorrect and meant it could not work as designed, allowing the wave compensation unit to always operate and the fast rescue boat to make the uncontrolled descent to the sea.

The investigation identified safety issues relating to the commissioning, maintenance, testing, operating instructions and procedures for the fast rescue boat's wave compensator and its safety interlock system. Further safety issues were identified relating to the job hazard analysis for the use of the fast rescue boat, crew resource management principles and approved training courses for fast rescue boats.

The ATSB is satisfied that the safety action taken by BP Shipping and Davit International addresses these safety issues. The ATSB remains concerned about the adequacy of training in the use of wave compensation units on fast rescue boat davits and has released a safety advisory notice to national and international maritime training institutions about this safety issue.

Download Final Report
[Download  PDF: 1.7MB]
 
 
Alternate: [Download  DOC: 4.84MB]
 

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General details
Date: 16 May 2010   Investigation status: Completed  
Time: 0817 (UTC+9.5)    
Location   (show map): off Darwin   Investigation type: Occurrence Investigation  
State: Northern Territory    
Release date: 27 July 2011    
Report status: Final   Occurrence category: Serious Incident  
  Highest injury level: Serious  

Vessel details

Vessel details
Vessel British Sapphire  
Flag Isle of Man  
IMO 9333618  
Type of operation LNG Tanker  
Damage to vessel Nil  
Departure point Yung An, Taiwan  
Destination Dampier, WA  
Last update 14 November 2018