IOSH Offshore ConferenceDiscovery centre Dundee19 October 2017

Danny Harwood MSc CMIOSHPrincipal Inspector of Marine Accidents

www.maib.gov.uk

Who are MAIB?

’

Secretary of State for

Transport

MAIB was established 1989

Herald of Free Enterprise (1987)

Public Inquiry recommendation: Separate accident investigation from regulation

MAIB Organigram

Deputy Chief Inspector

Chief

Inspector

Red Team Green Team Blue TeamWhite Team

• Investigation support staff

• Electronic data recovery

• Publications

• IT support

• Technical editing

• Health & safety manager

• Based in Southampton

• About 35 staff

MAIB Inspectors

• Typically ex-seafarers• Specialisations:

• Navigation• Engineering• Fishing• Naval Architects

• DfT accredited accident investigators

AIMS OF THE MAIB

• Improve the safety of life at sea

• To satisfy the general public and the maritime community that marine accidents are properly investigated

• To fulfil the requirements of IMO Resolutions: A849(20), MSC 255(84), SOLAS Chapter 1, reg 21 and EU directive (2009/18/EC)

What do the MAIB investigate?

• UK flag vessels anywhere in the world

• Any vessel in UK waters (12 mile limit)

• Merchant vessels of all sizes

• Fishing vessels

• Leisure craft (commercial and private)

Types of accident

• Casualty to vessels• Sinking• Capsize• Collision• Fire/explosion• Pollution

•Occupational accidents• Falls from height• Confined spaces• Entrapment in machinery• Mooring deck operations

Recent cases I have led or managed

FV Karen

Failure of HMPE

mooring line on

board LNG carrier

Zarga resulting in

serious injury to

one crewman

Recent cases I have led or managed

FV Karen

Collision between

unnamed RN

nuclear submarine

and fishing vessel

Karen

Recent cases I have led or managed

FV Karen

Loss of Cyprus

registered cement

carrier Cemfjord

and its 8-man crew

January 2015

Recent cases I have led or managed

FV Karen

Sinking of Wacker

Quacker 1 and fire on

board Cleopatra

The investigation process

• What?

• Where?

• When?

• How?

• Why?

• What can be done to prevent it happening again?

Starts with the receipt of a report

• Vessel owner

• Vessel master

• Harbour Authority

• Police

• Member of the public

• Maritime and Coastguard Agency

Categorise the accident

• Very serious

• Serious

• Less serious

• Marine incident

• Outside regulations

Pre-deployment preparations & information gathering

• Inform vessel owners, operators and master of MAIB intentions

• Establish status of vessels involved

• Preserve of evidence

• Compile initial list of contacts

• Travel and accommodation

Arrival at the accident site

• Introductions

• Liaise with all interested parties

• Establish primacy

• Agree an investigation plan

• Risk assessment

Police

MCA

P&IFire

Service

Flag state

Class

HSE

Insurers

CG

Legaladvisors

Owner’s

RYAMOD

DEFRA

SOSREP

Trading standards

Salvors

CouncilOfficials

Media/press

Foreign Flag States

Foreign CoastalStates

HarbourAuthorities

BorderControl

Accident site safety management

Accident site safety management

Accident site safety management

Evidence gathering

• Witness evidence

• Electronic evidence

• Physical evidence

• CCTV, video recordings, photographs

• Mobile phone records

• Documentary

• Priority given to perishable evidence

Witness interviews

• Set the right atmosphere• Location• Rapport• Refreshments

• Explain role of MAIB

• Explain the process• Information provided is

confidential • Right to have a friend• Interview will be recorded• Note taking

Electronic evidence

• Voyage data recorders

• Radar

• Electronic chart plotters

• Automatic Identification Systems

• Global Positioning System

• Machinery data loggers

• Fire detection systems

VDR Save

VDR recoveryCapsule

Hard drive

Electronic evidence

Branch review

•Brief Chief Inspector

• Peer review

• Challenge the evidence

•Decision on type of report

•Need for a safety bulletin?

• Follow-up work?

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

• Underwater surveys

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

• Underwater surveys

• Wreck recovery

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

• Underwater surveys

• Wreck recovery

• Trials and reconstructions

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

• Underwater surveys

• Wreck recovery

• Trials and reconstructions

• Non-destructive and destructive testing

Investigation follow-up work

• Company visits

• Additional or follow-up interviews

• Passenger questionnaires

• Underwater surveys

• Wreck recovery

• Trials and reconstructions

• Non-destructive and destructive testing

• Paint sample analysis

Recommendations meeting

• Review of MAIB investigation findings

• Chaired by the Chief Inspector

• Findings presented by the lead inspector

• Attended by invited stake holders and industry experts

• The aim is to assist in the identification of achievable, proportionate and smart recommendations

MAIB report writing process

• Inspector’s draft report

• Team draft report

• Technical editor review

•Deputy Chief Inspector & Chief Inspector review

• Consultation period

Other MAIB publications

• Safety bulletins

• Interim reports

• Safety flyers

• Safety digests

• Safety studies

Top tips (Interviews)

• Plan your interviews

• Interview all witnesses

• Conduct interviews as soon as practicable

• Listen carefully to witnessesIf a witness said that something happened, it does not mean that something actually happenedIf something a witness said happened, did not happen, it does not mean that that witness was lying

• Treat all witnesses with respect and closely monitor their wellbeing

IOSH Offshore ConferenceDiscovery centre Dundee19 October 2017

Danny Harwood MSc CMIOSHPrincipal Inspector of Marine Accidents

www.maib.gov.uk