Meduri Naga Sai Diwakar -396317

Marine Accident Investigation Report

Meduri Naga Sai Diwakar,

396317.

Lecturer: Mohan Anantharaman,

Date of submission: 14th October 2016.

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Contents
Purpose of investigation ....................................................................................................................... 3
Introduction ....................................................................................................................................... 4
Vessel details .................................................................................................................................. 5
Factual information ............................................................................................................................... 5
Summary ............................................................................................................................................ 6
Information .................................................................................................................................... 7
Conclusions ……………………………………………………………………………………………………………………………………10

Voyage particulars ………………………………………………………………………………………………………………………..12

Marine casualty information ………………………………………………………………………………………………………….12

Aspects in marine accident investigation ………………………………………………………………………………………13

Purpose of marine accidents ……………………………………………………………………………………………………….14

Marine accident investigation authority ………………………………………………………………………………………15

Principles of Investigation …………………………………………………………………………………………………………….16

Marine investigation reports ……………………………………………………………………………………………………….17

References …………………………………………………………………………………………………………………………………..18

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In this report the panama bulker was grounded in Singapore waters which is of 72000

dead weight. A relevant case study was analysed in this report and reported to the executive

director of insurance company.

Maritime safety investigation: The safety of life at sea and protection of maritime

environment can be enhanced by the accurate reports identifying the casual factors and

appropriate remedial measures. Thus the intent of the maritime safety investigation team

is to analyse the root cause of the marine accident.

In this report of investigation, a case study of a grounded vessel is taken and the incident

is reported for further analysis.

Purpose of investigation: The objective of investigation is to enhance safety and to

reduce the safety related risks. An investigation report of investigation must include

factual material or sufficient weight to support the analysis and findings. A report

endeavours to balance the use of material that could imply adverse comment with the

need to properly explain what happened, and why it happened in a fair and unbiased

manner.

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Developing safety action: The investigation team rather than releasing the formal

recommendations they should proactively impose safety action. However, depending on

the level of risk associated with the safety issue and the extent of corrective action

undertaken by the relevant organisation; a recommendation should be issued either during

or at the end of investigation.

Terminology used in this report:

Occurrence: accident or incident

Safety factor: Event or condition that increases safety risk safety factor include the

occurrence events (engine failure, signal passed at danger, grounding).

Safety issue: A safety factor that can be reasonably be regarded as having a potential to

adversely affect the safety of future operations.

Introduction: the investigation team is responsible for the investigation of all types of the

marine accidents, both the vessels and to those on board. Generally, the investigation

team is professional staff and are appointed by the secretary of state under the provisions

of Merchant shipping act 1995.

Objective: The main objective in the investigating is an accident under the regulations is

the prevention of future accidents by establishing its causes and circumstances.

Procedures are generally governed mainly by the Merchant shipping act 1995 and by

regulations. The Merchant Shipping Accident reporting and investigation regulation 2012

SI No 1743, which replace the Merchant shipping (Accident reporting and Investigation)

regulation of 2005. Came into force on 31st July 2012, They define the accidents to which

they apply, set out of the purpose of the investigation and make provision for the ordering

and content of investigations.

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Definition of accident: An accident is defined as any marine casualty including very

serious marine casualties and serious marine casualties or any marine incident.

Penalties: The regulations lay down penalties breaches of the requirements. These

offences include a failure to report an accident or serious injury, not proving information

as required. Falsely claiming to have additional information or new evidence and a failure

to preserve evidence. In addition, penalties for obstructing an inspector or otherwise

impending his/her investigation are laid down in section 260 of Merchant shipping act

1995.

Vessel type name: Panamax Bulk carrier

IMO number: 8310217

Gross tonnage: 72000

Accident type: very serious marine casualty

Date & time: 18 February 2016

Location: Singapore

Summary:

At 0232 (UTC +1) on February 2016, while on passage the M.V Jai Velakalli Menakshi

ran aground at a full speed near Singapore. The vessel remained aground for almost 2

days and due to adverse weather conditions, was founded heavily onto the rocky

foreshore. This caused material damage to its hull and breaching of double bottom,

including some fuel tanks resulting in 25 tons of marine oil entering into the sea water.

After its salvage the ship is towed by the help of the tugs to the outer anchorage in

Singapore and thereafter to dry dock and there it was declared a constructive total loss.

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Outline of the accident investigation: Because the accident occurred in the high seas on a

ship registered in Lloyds registry shipping Singapore, accordingly to the IMO casualty

investigation code, has no obligations to investigate. The maritime safety investigation

branch Singapore interested state, investigated the accident.

Information:

At 0200 on February 17, 2016, the 72000 dead weight general cargo vessel arrived in

Singapore port to discharge its cargo of paper rolls, while in the port the second officer

prepared the passage plan for the vessel next port.

The navigational way points for the passage had been saved as an electronic file in the

vessels ECS data base from previous similar voyage as this file was loaded in the ECS.

The voyage:

Vessel departed from 1520 on February 17 2016, with a cargo of waste paper its draught

was 5.60m, the chief officer was the officer of watch till 1800 when he was relieved by

the second officer.

By the evening while off duty in his cabin the chief office made a telephone private call

which lead him to consume 0.5 litre of alcohol.

At 2150, master assisted the Officer on watch and monitored the vessel passage through

the way. He completed by 2300 and left to his cabin without no night orders and no look

out was posted.

At about 2350, before going on watch the chief officer informed the AB who was

scheduled to keep the 0000-0600 watch that he should remain in the deck office for his

watch as 1800-2400 duty AB had also done.

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At midnight the chief officer took over from the second officer. The chief officer then sat

in the chair located to starboard of the central manoeuvring station, from where he

monitored the ECS and the standard radar display. The vessel steering was in auto pilot

mode.

The control for the radar watch alarm set at the very low alarm volume every six minutes,

could also be reached from the bridge chair, and this was regularly reset throughout the

watch. No positions were plotted onto the vessel chair after midnight.

At 0100. The vessel course alteration due at that position was not made until 0105 just

after the radar watch alarm had sounded.

At that time the vessel was 0.4m from the planned route and outside 0.2nm cross track

limit set on the ECS, the alarm for which had been silenced.

At 0120 and 0145 course alterations were made to follow the passage plan.

At 0155 the radar watch alarm sounded and the vessel was altered from 300 degrees to

324 degrees. The wind was south-south-west gusting to 35 knots and the vessel made a

good course of 326 degrees as it approached the northern end.

The grounding:

At 0222 the vessel still heading 324 degrees, passed the wrong side of the new rocks

starboard level buoy, narrowly missing the rocks.

At 0231:22, shortly after the radar watch alarm had been reset, the steering mode was

changed from auto pilot to manual mode and the helmsman was placed hard –a – port.

The vessel was 0.1nm from the shore line and making a speed of 13.3 knots.

At 0232, the vessel grounded on the rocky shore line near the Straits of Malacca while

swinging to the port.

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Events following grounding:

At 0234, the master arrived on the bridge and put the propeller pitch to zero; he asked the

chief officer whether he was sleeping or drinking and if AB had been on the watch. He

also suggested that someone should go to the hold to check for the leakage. The

emergency checklist for grounding was not consulted.

At 0237, the master to stop the main engine and run the auxiliary engines informed the

main engine room chief engineer and the master asked the chief officer to check the local

tide times.

At 0240, the chief engineer reported that the double bottom sludge tank in the engine

room had been breached and filling with water.

At 0241, the master attempted to call the ship owner by that telephone and there was no

response.

At 0243, the master informed the coast guard at the Maritime rescue co-ordination centre

and gave its position.

At 0520, the vessel deck officer undertook breath alcohol test in accordance with the

owner’s alcohol and drugs policy. The chief officer breath alcohol reading was 2.71 mg/l,

the master and the second officer recorded zero.

Refloating and salvage:

Salvors were appointed and salvage tugs were sent into scene within 24 hours of the

accident. The salvors were undertaken a damage assessment of the vessel where it is

unexpectedly refloated at 2220 on 19th February 2016, The vessel was anchored and the

salvors carried out work to prevent further pollution to prepare the vessel to be towed to

dry dock in Singapore as directed by the Maritime and Coast guard agency. It was

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estimated 25 tonnes of Marine oil has been split as a result of the accident. The vessel

arrived in Singapore on 5th march following a hull survey and the vessel was declared a

constructive loss was subsequently scrapped.

Environment:

Wind: south-south-west force 6, moderate sea

Visibility: Good

Tides: 18 February 2016

Low water: 0007 0.9m

High water: 0611 4.7m

The wheel house was enclosed and its external door was closed at the time of accident.

Owner alcohol and drug policy:

The owner SMS stated that: During their entire service on board the company’s ships

employees are not allowed to consume or possess alcohol. All employees and contractors

have an obligation to present themselves for work in appropriate physical condition

without the presence of alcohol in their body. This means the company have a zero

alcohol tolerance alcohol policy in place.

Legislation: In UK, the railways and transport act 2003, sections 78,79 & 81 introduced

limits of alcohol for professional sea farers of 0.35 mg/l of alcohol in the breath.

Internationally the STCW convention required administration to establish limits of not

greater than 0.25mg/l alcohol in the breath for masters, officers and other seafarers while

performing designated safety security and marine environmental duties.

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Analysis:

Summary: the vessel grounded when the OOW lost situational awareness due to his

consumption of alcohol. While the chief office performance can largely be accounted for

by his alcohol consumptions. The investigation also uncovered poor navigational

practices and that defences/ control measures for the OOW becoming incapacitated were

being ignored.

Alcohol: the chief officer has consumed a very large amount of alcohol before going to

watch. However, investigation found that the owners zero alcohol policy on board was

often faulted by the crew members.

Conclusions:

1. The vessel grounded when the OOW lost situational awareness because of being

under the influence of alcohol.

2. The effective administration of the owner zero alcohol policy might have prevented

the development of a culture in which the chief officer considered it acceptable to

consume alcohol before his watch.

Actions taken:

Undertaken a concentrated inspection and audit of vessel resulting in

 Removal of bond store from the vessel,

 Verification of owner’s alcohol random testing regime,

 Issuing the instructions regarding the posting of lookouts,

 Revision of the management structure.

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Ship particulars:

Vessel name: Jai vekalli Menakshi

Flag: India

Classification society: Lloyds Registry

IMO number: 8310217

Type: General cargo

Registered owner: DFDS a/s

Manager: Samudra shipping

Year of built: 2000 India

Construction: Steel

Length overall: 129.03

Registered length: 122.64m

Gross tonnage: 7409

Minimum safe manning: 9

Authorised cargo: Forestry products

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Voyage particulars:

Port of departure: Singapore

Port of arrival: India

Type of voyage: International

Cargo information: Part loaded 50t of waste paper

Manning: 9

Marine casualty information:

Date and time: 18th February 2016 0232 (UTC+1)

Type of marine casualty or Very serious marine casualty

incident:

Location of incident: Singapore

Injuries: None

Damage/ environmental impact: Extreme double bottom damage

The vessel declared a constructive
total loss 25t marine gas spilled.

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What happened: Fatigue and intoxication by alcohol consumption by the chief officer is

the leading contributing factor.

What is learnt?

1. Fatigue is the ever-increasing problem, which played heavy role in this accident.

2. Crew and specially watch keeping personnel should be adequately rested and fit prior

to their watch.

3. Consumption of alcohol increase the effects of fatigue. All the crew should follow

company alcohol policy at all times.

4. All the watch keeping personnel should be well familiarized with and follow bridge

resource management procedures closely.

5. Bridge watch alarm systems should be regular checked.

Main aspects of marine accident investigation:

 International legal basis for marine accident investigation

 ‘International safety management code and accident investigation.

 Marine accident site risk assessment and hazard identification

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 Advance interviewing techniques

 Human factors and performance in marine accidents

 Preparing an effective accident report and develop justifiable safety

recommendations

 Occupational health and safety accidents.

Purpose of marine investigations: By the international maritime organisation, the

investigation conducted with the objective of preventing marine causalities and marine

accidents in the future. The code of marine casualties by the International Maritime

Organisation envisages that this aim will be achieved through:

 Applying consistent methodology and approach to enable and encourage a broad

ranging investigation, where necessary, in the interests of uncovering the casual

factors and other safety risks.

 Providing reports to the Organisation to enable a wide dissemination of information

to assist the International Marine Industry to address safety issues.

A marine investigation report should consist of:

 A summary outlining the basic factors of marine casualty or marine accident and

stating whether any deaths, injuries or pollution occurred as a result.

 The identifying of flag state owner’s operators the company as identified in the

safety management certificate, and the classification society.

 Where relevant details of the dimensions and engines of any ship involved, together

with a description of the crew, work routine and other matters, such as time ship.

 A narrative detailing the circumstances of marine casualty.

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 Analysis and comment on the casual factors including any mechanical human and

organisational factors.

 A discussion of the marine safety investigation findings, including the identification

of safety issues, and the marine safety investigation conclusions and

 Where appropriate recommendation with a view to preventing future marine

casualties and marine incidents.

Substantially interested state means a state:

 Which is the flag state of the ship involved in marine casualty or marine incident,

 Which is the coastal state involved in marine casualty or incident,

 Whose environment was severely or significantly damaged by the marine casualty,

 Where the consequences of the marine casualty, nationals of the state lost their lives

or received some injuries.

 For some reason establishes an interest that is considered significant by the marine

safety investigation state.

Marine accident investigation authority: When the marine casualty occurs on the high

seas or in an exclusive economic zone, the flag state of the ship or ships, involved, shall

notify other substantially interested state as soon as possible.

The notification should contain:

1. The name of the ship and flag state

2. IMO number

3. Nature of the marine casualty

4. Location of marine casualty

5. Time and date of marine casualty

6. Consequences of the marine casualty to individuals, property and the environment

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7. The identification of any ship involved.

Powers of investigation: All states shall ensure that their national laws provide investigator

carrying out a marine safety investigation with the ability to board a ship, interview the

master and crew and any other person involved, and acquire evidential material for the

purposes of the Marine Accident Investigation.

Principles of investigation: A marine investigation should be unbiased to ensure the free

flow of information to it. The investigator carrying out a marine investigation should have

functional independence from:

1. The parties involved in the marine casualty or marine incident,

2. Anyone who make a decision to take administrative or disciplinary action against on

the individual or organisation

3. Judicial proceedings

The investigator carrying out a marine safety investigation should be free of interference

from the parties with respect to:

 The gathering of all available information relevant to the marine casualties or

marine incident, including voyage data recordings and vessel traffic recordings.

 Analysis of evidence and the determination of casual factors

 Drawing the conclusions relevant to casual factors

 Distributing a draft report for comment and preparation of the final report and

 If appropriate, the making of safety recommendations.

Scope of marine investigation: Proper identification of casual factors requires timely and

methodical investigation going for beyond the immediate evidence and looking for

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underlying conditions, which may be remote from the site of the marine casualty or marine

incident, and which may cause other future marine causalities and marine accidents.

Marine investigations should therefore be seen as a means of identification not only

immediate casual factors but also failures that may be present in the whole chain of

responsibility.

Marine investigation reports: The marine investigation states shall submit the final

version of a marine investigation report to the organisation for every marine casualty

investigation conducted into a very serious marine casualty,

1. Where a marine investigation is conducted into a marine casualty or marine

incident, other than very serious marine casualty, and a marine investigation report

or produced which contains information which may prevent or lessen the

seriousness of marine casualties or marine incidents in the future, the final version

shall be submitted to the organization.

2. The maritime investigation report shall utilize all the information obtained a marine

casualty investigation, taking into account its scope, required to ensure that all the

relevant safety issues are included and understood so that safety action can be taken

as necessary.

3. The final marine investigation report shall be made available to the public and the

shipping industry by the marine safety investigating states or marine casualty

investigating stated shall undertake to assist the public and shipping industry with

details, necessary to access the report, where it is published by another state ir its

organization.

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References:

[1] Marine accident investigation branch Singapore – guidance notes MGN 458.

[2] Australian government transport safety bureau- investigation no:243

[3] Japan transport safety board – MA2011-10.

[4] Resolution MSC.255(84) International Maritime Organisation.

[5] European Maritime Safety Agency- Annual review of marine casualties and incidents.

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