Marine Accident Investigation Branch Safety Digest 1/2005 Case 16 Risk Assessment Could Have Prevented a Serious Accident Narrative The chief officer instructed that the main deck and lower hold were to be washed in accordance with the appropriate work order. The water was supplied from a connection that could only be accessed via an unprotected 1.2 metre wide platform adjacent to the main deck ramp and ship’s side. A personnel barrier was located at each end of the platform. When the ramp was in the ‘down’ position, there was a 5-metre drop from the platform (Figure 1). When the main deck wash down was completed, the three main deck ramps were lowered in preparation for washing the hold. An AB then went to the main deck platform, which was wet, to disconnect the hose and transfer it to the hold position (Figure 2). The normal process was to shut the valve, relieving the pressure at the hose end; this then allowed the hose to be disconnected. However, the AB was out of sight of the other ratings and it appears that the pressure was not relieved. While attempting to disconnect the hose, the isolating valve fractured and the AB fell backwards onto the ramp 5 metres below. He survived the fall, but suffered two broken wrists and a broken leg. It could have been far worse!
Figure 1: Ramp shown in the down position
Figure 2: Photograph of the main deck platform showing the hose connected to the water supply The Lessons |
