Apr 172014

NTSB Investigators Morgan Turrell and Christopher Babcock examine propulsion and steering controls on the bridge of Seastreak Wall Street.

By the time the captain of Seastreak Wall Street realised he’d lost control of the vessel it was too late to prevent the vessel colliding with a Manhattan pier at about 12 knots on the morning of January 9, 2013. Of the 331 people on board, 79 passengers and one crewmember were injured, four of them seriously, in the third significant ferry accident to occur in the New York Harbor area in the last 10 years.

The intended maneouvre was a common one among those commanding the Seastreak fleet: Reduce speed and transfer control from one bridge station to another better visibility less than a minute before reaching Pier 11/Wall Street on the East River. However, it left little opportunity to correct a loss of control at a critical moment.

The incident had been waiting to happen since July 2012 when a controllable pitch propulsion system was installed to replace the existing water-jet propulsion along with a poorly designed control panel and alert system, “The available visual and audible cues to indicate mode and control transfer status were ambiguous” says the NTSB. Continue reading »

NTSB Crits USCG Oversight

 Accident, Accident report, NTSB, US Coast Guard  Comments Off on NTSB Crits USCG Oversight
Jul 192011

NTSB says USCG has insufficient oversight of small boat ops

National Transportation Safety Board saya that the probable cause of a 2009 collision in San Diego Bay between a United States Coast Guard patrol boat and a recreational motorboat was due to the excessive speed of the Coast Guard boat in nighttime conditions in an area of high vessel density, and the Coast Guard’s ineffective oversight of its small boat operations nationally and at Coast Guard Station San Diego.

On December 20, 2009, at about 5:44 p.m. PST in San Diego Harbor, a 33-foot-long Special Purpose Craft-Law Enforcement, SPC-LE, Coast Guard vessel with five crewmembers aboard collided with a 24-foot-long Sea Ray recreational boat carrying 13 people. The collision occurred during an annual holiday boating event, the Parade of Lights. The Coast Guard boat, which was responding to a reported grounding which was considered a non-emergency, struck the Sea Ray from behind. As a result, an 8-year-old boy was killed and four other people were seriously injured. None of the crewmembers in the Coast Guard boat were injured.

The Coast Guard boat, when it struck the Sea Ray, was being operated at planing speed, which was at least 19 knots and possibly as high as 42 knots.

Continue reading »

NTSB To Discuss The Duck

 Accident, Accident report, collision, NTSB  Comments Off on NTSB To Discuss The Duck
Jun 202011

A Ride the Duck DUKW in Seattle, similar to the amphibious vessel which sank in the Delaware

The US National Transportation Safety Board, NTSB, will hold a public Board meeting to discuss the final report of the Board’s investigation into the collision of a barge, The Resource, that was being towed alongside a tugboat, the Caribbean Sea and a duck tour boat DUKW 34 on 7 July, 2010 in the Delaware River near Philadelphia. Two passengers on the DUKW 34 died in the accident.

The five member Board will vote to adopt the findings, probable cause, and safety recommendations from the final report. A synopsis of the report will appear on the website shortly after the conclusion of the Board meeting. The entire report will appear on the website several weeks later, says the NTSB.

A live and archived webcast of the proceedings will be available on the board’s website. Technical support details are available under “Board Meetings.”

See also:

NTSB To Release DUKW/Barge Collision Docs

Tug Did Not Respond To Distress Calls – Phil. Duck Report

Update On Philadelphia Duck Tragedy

Fishermen Prefer Death To Lifejackets

 fishing, lifejacket, Man Overboard, NTSB  Comments Off on Fishermen Prefer Death To Lifejackets
Oct 062010

Discovery Channel's Deadliest Catch. Seafarers prefer death to lifejackets.

Not so coincidental, perhaps, with the US National Transportation Safety Board’s upcoming forum on fishing vessel safety is a report from the Centers for Disease Control and Prevention, CDC, Commercial Fishing Deaths—United States, 2000-2009, published in the Journal of the American Medical Association. It may, at first sight, seem odd that a disease prevention agency should be involved in fishing accidents but, then, the refusal to wear a lifejacket is a disease, and an apparently incurable one, in the US as it is in the UK.

Continue reading »

USCG Don’t Phone Home

 NTSB, Safety Alerts, US Coast Guard  Comments Off on USCG Don’t Phone Home
Aug 112010

imageMobile phone or cellphones are not a good idea on the bridge as MAC, and others has observed before. Now following two accidents involving US Coast Guard personnel using cellular telephones while underway to engage in text-messaging activities or conversations that were unrelated to vessel operations or the mission at hand the US National Transportation Safety Board has issued two recommendations

The US Coast Guard recently issued its preliminary national policy concerning cell phone usage on their vessels while underway.  Therefore, the Safety Board made the following recommendation to the Coast Guard:

Continue reading »

Sleepy Man Joins NTSB

 maritime safety, NTSB  Comments Off on Sleepy Man Joins NTSB
Jul 062010

image Fatigue specialist Dr. Mark Rosekind, has joined the US National Transportation Safety Board as a member. Dr Rosekind is an internationally recognized fatigue expert who has conducted research and implemented programs in diverse settings, including all modes of transportation, healthcare, law enforcement, elite athlete and military groups.

Also new to the NTSB is flight safety expert Dr. Earl Weener, a licensed pilot who has dedicated his entire career to the field of aviation safety. He most recently has been a consultant and fellow for the Flight Safety Foundation, where he worked to reduce accidents through coordinated industry programs.

The appoints were a announced shortly before the NTSB presented its annual report to the US Congress.

NTSB Annual Report

NTSB Tired of Fatigue

 fatigue, news, NTSB  Comments Off on NTSB Tired of Fatigue
Mar 062010

image Hard on the heels of warning by the UK’s MCA that it will gun for shipowners who allow hours of rest requirements to be flouted the US National Transportation Safety Board chairman,  Deborah Hersma has called for greater efforts by the sleep research and healthcare community to educate policy makers of the dangers of fatigue in transportation.

Hersma told the annual conference of the National Sleep Foundation in Washington, DC, Hersman that fatigue has been a concern for the Board since the creation of the agency in 1967 and it has been an issue on the Board’s Most Wanted List of Transportation Safety Improvements since the list was established in 1990.

Continue reading »

Nov 252009

The US National Transportation Safety Board’s course Marine Accident Investigation, MS 101, scheduled for 7-11 December, 2009, at the NTSB Training Center in Ashburn, Virginia near Washington, DC, still has openings for interested  mid- to senior-level marine industry professionals.

The weeklong course covers the Safety Board’s processes and procedures during a major marine accident; reviews human factors, medical factors, and electronic data elements in a marine investigation; offers best practices for comprehensive and thorough interviewing techniques; and shares report preparation guidelines.

Continue reading »

Communication, Cosco Busan And Sex With A Duck

 allision, containership, maritime accidents, NTSB, Oakland, oil spill, pilotage  Comments Off on Communication, Cosco Busan And Sex With A Duck
May 092009

What, you might wonder, would bring together the NTSB, the IMO, the contact of  the Cosco Busan with the San Francisco-Oakland Bay Bridge and a senior loan officer at a bank in Spokane, Washington, having sexual relations with a Mallard duck?

The NTSB has just released the full report of the Cosco Busan incident and among the issues is that of communications, problems of which are involved in about one in five maritime incidents.

That’s why it is good practice to confirm that information has been understood and that its importance is appreciated.

On the Cosco Busan the voyage data recorder recorded the following conversation between the Pilot and the Master:

Pilot:  “What are these… ah… red [unintelligible]?”
The master responded, “This is on bridge.”

The pilot then said to the master, “I couldn’t figure out what the red light… red… red triangle was.”

The Pilot took this to mean that the red triangles marked the centre of the span when, in fact they indicated the buoys marking the bridge support which the ship later hit. The Master did not realise the importance of the question.

Later, as things unravelled:

Pilot: [unintelligible] you said this was the center of the bridge.
Master: Yes.
Pilot: No, this is the center. That’s the tower. This is the tower. That’s why we hit it. I thought that was the center.
Master: It’s a buoy. [unintelligible] the chart.
Pilot: Yeah, see. No, this is the tower. I asked you if that was [unintelligible]. . . .
Captain, you said it was the center.
Master: Cen… cen… cen… center.
Pilot: Yeah, that’s the bridge pier [expletive]. I thought it was the center.

Says the NTSB report “Shortly after this conversation, the master can be heard saying, in Mandarin, “He should have known—this is the center of the bridge, not the center of the channel.”

In many Asian cultures ‘yes’ does not necessarily mean an affirmative, oner can pick from a range of meanings that would not naturally occur to a Westerner.

(The curiosities and confusion of language are touched upon in Bob Couttie’s new, lighthearted book, Chew The Bones, which you can buy from Amazon and the proceed of which will help support MAC)

In a recommendation letter to US Coast Guard commander Thad Allen the NTSB wrote: “The Safety Board therefore recommends that the Coast Guard propose to the IMO that it include a segment on cultural and language differences and their possible influence on mariner performance in its bridge resource management curricula.”

It’s tempting to think that closely allied languages like English and American present less opportunity for confusion, but you would be wrong. Take this example from Snopes’ wonderful Urban Legend site:

“Armstrong proceeded to shag ducks…”

You can read the rest of the story here. While mallards are known to have a somewhat ‘out there’ sex life, sex acts between humans and 10 days old ducklings are further out than most would want to go.

Apparently ‘to shag’ in American means to catch baseballs, to us Brits it has a rather different connotation.

The lesson is clear: communication is transmitting information, receiving information and understanding information. It’s vital to double each each part of that process, that the communication is understood and verified.

Otherwise, you could end up being shagged by lawyers, and not like a duck.