When it comes to safety, unless everybody’s on the same page
avoidable tragedies will happen.
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When the anchor-handling tug supply vessel Bourbon Dolphin capsized it came at enormous cost. Not just the loss of an almost new and expensive vessel, and a fine of more than $700,000 against Bourbon Offshore Norway, but, most importantly the loss of eight lives including that of a 14 year old schoolboy whose own life had yet to begin. It was a wake up call to the offshore industry that resonates even today.
It happened not because one man made an error but because an entire system failed to protect those onboard, because policies, procedures and practices that should have created a virtual safety net proved wanting, because not everybody was singing from the same songsheet.
The final Royal Commission report is more than 200 pages so we can’t cover it all in detail.
The process began from the time the building of Bourbon Dolphin began two years before. Like all anchor handling tug supply vessels she had a high superstructure forward with a long, wide flat deck behind. It’s a compromise design.
Towards the open stern she had two sets of towing pins, one either side of the centre line, through which anchor cable could be guided over a split roller at the stern.
Bourbon Dolphin was a new but conventional design, an A102. It was the first one to be built by Ulstein Verft. Changes were made as she was built that meant that her lightship weight, that’s the physical weight of the vessel alone, was 3,202 tonnes, some 392 tonnes heavier than originally designed, some of it accounted for by a heavier winch package installed on the third deck. There had been no control over additional weight put on the vessel.
The Royal Commission investigation the tragedy says that it did not get the “impression that the vessel’s stability characteristics had been subjected to any particular evaluation in the light of the changes implemented. It is clear that these characteristics would be affected and thus meant that the vessel’s stability could be more demanding to deal with during operations.”
Indeed, the instructions for masters in the stability book were standardised and, according to the commission report, provided no direct information about important matters related to the vessel’s stability in various operations. The commission says: “This is an unfortunate practice that the Norwegian Maritime Directorate ought to have pointed out during its approval of the stability book.”
Bourbon Dolphin’s progress
The book’s load conditions for anchor-handling did not follow the standard for set-up of conditions that the shipyard had used for other vessels. Use of winch power and the point of attack against the inner towing-pin is not compatible with the vessel’s maximum winch power and the use of the shark-jaw. The Commission noted that there are no concrete requirements for the content of such load conditions, but considered that the circumstances around this ought to a greater extent have been communicated in the stability book so as to make sure that the crew were aware of this and of the limitations it imposed.”
Surprising though it may seem, neither the IMO’s regulatory system nor Norwegian regulations have concrete requirements for the stability of anchor-handling vessels. The Commission has acquired information from British and Danish authorities confirming that they do not have separate stability requirements for anchor-handling vessels either.”
The Commission said that it “…cannot see that the industry has developed any standardised practice. This makes it difficult for the crew to master the vessel’s stability characteristics for anchorhandling.”
Simulation of the capsize
Captain Remoy had just a telephone call with the outgoing master and a 90 minute familiarisation during the handover to learn all there was to know about the handling of the Bourbon Dolphin. Critical information was not in the stability book. It might, of course, have helped if Captain Remoy had undergone appropriate simulator training. A Master’s Review and the Safety Committee had earlier made recommendations regarding the need for crew training. The company, however, closed these recommendations without undertaking any further analysis of the reason for the observation, and referred to the planned simulator training, which for its part had been delayed due to delays in the delivery of the simulator.
Possibly the final defence in the situation Bourbon Dolphin faced was the winch emergency release. Officers believed it was a quick release which, when activated, would immediately allow the anchor chain to run off the winch in an uncontrolled manner. Had that happened, its possible that Bourbon Dolphin might have recovered. In fact, the emergency release was intended to protect the winch, not the vessel. When activated it allowed the winch drum to revolve and accelerate according to the tension applied, a much slower process. By the time it was activated it was simply too late to save Bourbon Dolphin.
So, information about stability challenges was not passed through the system to Captain Remoy, nor were the officers aware that the emergency release did not do what they thought it did, She had a propulsion system that could cut out at a critical moment when she listed. There was shortfall of training and communications and the regulatory system failed to provide the safety net that might have avoided the disaster. They weren’t on the same page.
Communication problems arose during the rig move planning session when there was ambiguity about what the role of Bourbon Dolphin would be. Personnel from Trident believe they made it clear that she could be asked to operate as a primary anchor handling vessel while Frank Reirsen, then the master of the Bourbon Dolphin, believed he’d made it clear that she should only be used as an assist vessel and that he’d emphasised this to Captain Remoy. The day of the tragedy was very intense. The rig was fully manned but couldn’t get operational until the last two anchors were deployed and that process had already been severely delayed. It was the last day of this particular operation. Those are two situations that can become breeding grounds for accidents.
Nobody is going to deliberately short-cut safety when the heat is on to get job done but it can take the edge off safety awareness. And when the end of a project is in sight, it’s all too common to unconsciously let down your guard, and that’s when bad things happen. There is no evidence that happened in the case of the Bourbon Dolphin but it is a common enough situation and it doesn’t take many of those involved to let things slip inadvertently for an accident to happen.
Awareness and communication can save lives, or at least prevent them being put at risk. The struggle of Olympic Hercules when deploying Anchor 6 was a warning sign. Bourbon Dolphin had much the same angle of attack with regard to wind, waves and current as Olympic Hercules. That should have been a forewarning of what Captain Remoy was to face later an it might have been appropriate to review the operation and Bourbon Dolphin’s role in it, even though she was already underway.
The close call with Highland Valour was another warning sign that might have given those responsible on the rig pause for thought had they known about it. By then, the fate of Bourbon Dolphin was sealed and eight lives were lost. We can never bring them back.
The offshore industry has responded and new procedures and recommendations have been made swiftly, and you’ll find links to them on the Maritime Accident Casebook website. But perhaps if we remember Bourbon Dolphin, if we remember the life a 14 year old schoolboy, David Remoy, never got the chance to live, together we’ll remember that nearly everything we do is about safety.
This is Bob Couttie wishing you safe sailing.
Ulstein defends BOURBON DOLPHIN design
Official English version of the NMD’s report on safety measures for Anchor Handling vessels and Mobile Offshore Units.
Guidelines for the Safe Management of Offshore Supply and Anchor Handling Operations (North West European Area), a zipped file.
ANCHOR HANDLING MANUAL (available on MSF website) A recommendation following the Bourbon Dolphin is that all AHVs should have a vessel specific manual containing all information