Executive summary

At 2142 on 31 July 2008, the fully laden cape-sized bulk carrier Iron King departed from its berth in Port Hedland, Western Australia, with a harbour pilot on board.

Iron King made its way through the harbour and while the assisting tugs had been let go by 2217, just before the ship reached Hunt Point, they continued to escort it. Shortly afterwards, at 2219 and again at 2221¼, the ship's rudder failed to respond to port helm orders as the pilot attempted to steady the ship's heading on the Spoil Lead.

The master switched the steering control switch between the two follow-up control systems and informed the pilot that steering control had been restored. The ship was still turning to starboard, so the pilot ordered full ahead and hard-to-port in an attempt to keep the ship in the channel and thus avoid grounding. He also directed the tugs to make fast to the ship as soon as possible. However, the tugs were unable to provide much assistance and by 2225, the ship had collided with Beacon 44 and grounded.

The ship remained aground until the next high tide, when it was successfully refloated.

The investigation found that the steering gear failed to respond to the helm orders because a leaking actuator relief valve was limiting the steering system hydraulic pressure. It was also found that; it was normal practice for assisting tugs to be let go before departing ships reached Hunt Point; the pilot directed the tugs to make fast to the ship again, but they were unable to do so before it grounded; the master was not aware of the appropriate emergency steering system change-over procedure; and the pilot had not been provided with training in the implementation of a suite of 'risk analysed' responses to predictable emergency scenarios in a simulated environment.

A number of safety actions have already been taken by relevant parties to address these safety issues. In addition, the Australian Transport Safety Bureau has issued one Safety Advisory Notice.

Abstract

At about 1745 on 27 October 2008, during cargo discharge operations whilst alongside in Port Kembla, New South Wales, the chief mate of Great Majesty remotely opened two ballast valves adjacent to the number two water ballast pump (No. 2 WB P/P) to gravitate2 seawater into the number one water ballast tank (No. 1 WBTK).

About 10 minutes later, the engine room bilge alarm sounded and the duty motorman found seawater flooding into the space through the open casing of No. 2 WB P/P. Repair work had been started on No. 2 WB P/P but the suction line had not been blanked off.

The inflow of water was stopped after the alarm was raised. About 390 m3 of seawater had entered the engine room and a total of 22 electric motors located on the lower levels of the engine room were damaged by the water ingress.

The investigation found that the ballast operation procedure did not provide sufficient guidance to the crew. The investigation also found that the work permit system onboard had not been effectively implemented. Consequently, most maintenance and repair work being carried out by the ship's crew was without a work permit.

Abstract

On 18 November 2008, while the Maltese registered bulk carrier Saldanha was anchored off Newcastle, NSW, a ship's engineer was burned when the auxiliary boiler furnace 'flashed back' during a routine boiler oil firing unit burner exchange.

The ATSB investigation into the incident found that the ship's crew were not aware of all of the hazards associated with maintaining the boiler burner; were not aware of previous flashbacks involving similar burners; and were not aware of the appropriate first aid treatment required for burn injuries.

The investigation also found that the safety bulletin that had been previously issued by the manufacturer did not inform operators that the oil firing unit could be modified.

Executive summary

At 0710 on 15 July 2008, the Greek registered bulk carrier Atlantic Eagle sailed from Albany, Western Australia, partly loaded with a cargo of grain. At 0815, the ship was just outside port limits and its speed had been increased to 14 knots for the voyage to Fremantle, Western Australia.

During the next 10 minutes, the master made two significant course alterations and then set the ship on a heading of 235º, an allowance of five degrees to port of the ship's planned course. At 0835, he left the bridge, instructing the second mate to keep the ship on the set heading and clear of islands.

The second mate maintained the ship on a heading of 235º but did not monitor the ship's progress or establish its position. At 0856½, Atlantic Eagle grounded on Maude Reef, seriously damaging its hull, rudder and steering gear before moving clear of the reef. The grounding did not result in any pollution.

On 24 August, after completing temporary repairs, the ship was towed from Albany, bound for Jakarta, Indonesia, to discharge its cargo in preparation for undergoing permanent repairs in Vietnam.

The investigation found that Atlantic Eagle's safety management system procedures for navigation and record keeping had not been effectively implemented on board the ship. The report issues two recommendations to address these safety issues.

Executive summary

At about 1115 on 31 March 2008, a fire started in the engine room of the container ship MSC Lugano. The chief engineer operated the quick closing valves and the remote stops for the engine room fans and oil pumps. The crew closed the dampers for the engine room fans and the funnel vents and rigged fire hoses to boundary cool the engine room casing and funnel.

After about 50 minutes, the fire cut the electrical power supply to the emergency fire pump and water ceased to flow from the fire hoses. The master ordered the crew to close the engine room skylight and then muster. He then instructed the chief engineer to activate the ship's fixed fire extinguishing system.

At 1220, the master reported the fire to the Australian Rescue Coordination Centre (RCC).

By 1600, the crew had determined that the fire was extinguished. The engine room was ventilated, and the crew entered to assess the damage. They were able to re-start many of the engine room systems and restore electrical power, but they could not re-start the main engine. The ship was now about 90 miles south of Esperance, Western Australia and drifting towards the Archipelago of the Recherche.

The ship's owners entered into an agreement to tow the ship to Fremantle and, on 1 April, the tug Wambiri departed from Fremantle, Western Australia. Three other tugs, two based in Esperance and one that was in the vicinity towing a barge, were directed by the Australian Maritime Safety Authority (AMSA) to assist the ship until Wambiri arrived.

By 1245 on 5 April, Wambiri had rendezvoused with MSC Lugano and taken the ship in tow. The tow continued without incident and at 1506 on 13 April, the disabled ship berthed in Fremantle.

The report identifies a number of safety issues and advises of safety actions already taken and those recommended by the ATSB.

Executive summary

At 0541 on 9 May 2008, the Antigua and Barbuda registered container ship Francoise Gilot grounded while transiting the South Channel, Port Phillip, Victoria. The ship had sailed from Melbourne earlier that morning and was departing Port Phillip bound for Sydney.

The ship grounded between beacons 18 and 20 of the South Channel during a starboard turn around the Hovell Pile beacon at the entrance to the Channel. The ship was refloated at 0755 using its main engine following a water ballast transfer operation and it then returned to Melbourne where an underwater inspection of its hull revealed that it had not been damaged during the grounding.

The ATSB investigation found that the helmsman had put the helm to starboard instead of port during the turn around the Hovell Pile beacon and that he was probably affected by fatigue at the time. The investigation also found that neither the Port Phillip pilot nor the ship's master discussed the allocation of roles and responsibilities of the bridge team before the ship left the berth. Consequently, no one was actively monitoring the helmsman's actions when he was executing the pilot's orders and as a result, the helmsman's error was not detected until it was too late to avoid the grounding.

The report identifies a number of safety issues and the ATSB acknowledges the safety actions which have been taken by Reederei Alnwick Harmstorf and the Port Phillip Sea Pilots to address them. The ATSB makes two recommendations associated with two outstanding safety issues.

Executive summary

At about 1817 on 23 February 2008, the Marshall Islands registered passenger ship Van Gogh grounded briefly on the western shore of the Mersey River during a departure from Devonport, Tasmania. The ship was under the conduct of a harbour pilot who had taken over the conduct from the master about five minutes before, after the master had manoeuvred the ship off the berth.

As the ship left the berth, it began to be set towards the bulk carrier Goliath berthed ahead. Van Gogh was under the influence of the ebb tide and fresh water that was flowing from the Mersey River's catchment following heavy rain in the area in the previous 24 hours.

Van Gogh was difficult to manoeuvre at low speed because of its twin propellers and single rudder configuration. This, combined with the strong ebb tide and fresh water outflow in the river at the time of departure, resulted in there being insufficient water flow over its rudder to enable the pilot to manoeuvre the ship as he intended. In addition, the master did not inform the pilot that the crew would be using the ship's engines independently during turns in the river. This resulted in the pilot being concerned that his orders were being countermanded because he saw that the engine telegraph levers were not as he had ordered.

Following the grounding, the pilot successfully manoeuvred the ship back into the channel and the ship departed the port without further incident. There was no damage to the ship and no pollution resulted.

The report identifies a number of safety issues and acknowledges the safety actions which have been taken by Club Cruise International and the Tasmanian Ports Corporation to address them.

Executive summary

In September 2007, the crew of the Sierra Leone registered tanker Breakthrough joined the ship in China to prepare it for delivery to its new Nigerian owner. On 7 January 2008, the ship sailed from China.

On 20 January, the main engine began operating poorly after it was changed over from diesel to intermediate fuel oil because the fuel had not been effectively heated or purified. After drifting in the Indian Ocean for 21 days, the ship made its way to the Cocos (Keeling) Islands. At 1350 on 11 February, Breakthrough anchored off Direction Island in the Cocos Island group.

On 12 February, the weather deteriorated significantly, and the ship started to drag its anchor. The master ordered a second anchor let go and ran the main engine at dead slow ahead to ease the load on the anchor cables. The main engine could not provide sufficient thrust to prevent the anchors from dragging and, at 1545, Breakthrough's stern grounded, damaging the steering gear. On 13 February, the ship was successfully refloated and on 28 February, it was towed to Singapore for repairs.

The ATSB investigation found that the ship's owner did not implement an effective safety management system and did not provide sufficient support to the ship's master as required by the International Safety Management Code. The flag State's statutory certificates were issued by a management company solely with the purpose of allowing the ship to sail on an international voyage and did not appropriately represent the ship's ownership, operation or management. The ATSB also found that the ship's officers did not have adequate knowledge and experience to undertake the delivery voyage and did not effectively utilise their time before leaving China to familiarise themselves with the ship and its systems. The ATSB has issued one safety recommendation and three safety advisory notices.

Abstract

At 1230 on 9 February 2008, the Chinese registered bulk carrier Jin Hui berthed in Geelong, Australia. The ship's master had previously informed Australian authorities that there had been a fire in the ship's number three cargo hold. As a result, the emergency services were on standby when the ship arrived in Geelong.

When the number three cargo hold was opened, it was apparent that only two small areas of the cargo (palm kernel expeller) had been affected. These small areas of cargo were still smouldering, so they were sprayed with water and then discharged onto the wharf.

At 1530, the local fire authority declared the fire extinguished. The ship's normal cargo discharge was then allowed to begin.

Executive summary

At about 2102 on 21 January 2008, the Australian fishing vessel Allena collided with Northern Fortune, an Antigua and Barbuda registered container ship, off the Queensland coast. The fishing vessel's bow was badly damaged, but the crew were able to control the ingress of water and return the vessel to Bowen, Queensland, its home port.

The investigation determined that the lookout on board both Allena and Northern Fortune was ineffective and that neither vessel's watch keeper saw the other vessel in sufficient time to avoid the collision.

Additionally, the fishing vessel was not required to be fitted with an Automatic Information System (AIS) unit or a radar reflector and, consequently, it may have been difficult for the ship's third mate to detect the fishing vessel electronically.

After the collision, Northern Fortune's third mate did not stop to render assistance or ensure that the fishing vessel and its crew were safe because he claimed that he believed a collision had not occurred, only a close quarters passing.

The ATSB investigation report also found that the Queensland regulations for fishing vessel certificates of competency are ambiguous and are not consistent with current national standards. The regulations allowed Allen's skipper to operate the vessel up to 200 miles from the coast without appropriate training in navigation or the application of the collision regulations.

The ATSB has issued one recommendation and two safety advisory notices to address these safety issues.