201735 Unsafe act leads to fatality

 

While in port, the vessel’s crew needed to shift some heavy steel crankshaft webs and steel pipes from hold two to hold one in order to put the vessel on an even keel and specific draught for its next port. Before the work began, the Master briefed the vessel’s crew on the shifting manoeuvre, including the method, sequence, safety and roles of the crew during the task. He emphasised the importance of slinging each crankshaft web at equal distances either side of the mark indicating the centre of gravity of the unit.

The holds were illuminated by internal lighting and the deck and quayside were floodlit. The crankshaft webs were lifted using two 12m endless webbing slings. Each unit was landed on the quay, the slings transferred to the forward crane’s hook, and then the units were brought into the forward hold and lowered onto 15cm high pieces of wooden dunnage. 

After three hours, the ninth crankshaft web was being lowered into hold No 1, but it did not land square to the hold’s port side bulkhead as intended. The crane driver had slackened the slings but the chief officer (CO) informed him via his VHF radio that the crankshaft web needed to be repositioned. The CO climbed onto the top of the crankshaft web, held one of the slackened slings with his right hand and instructed the crane driver by radio and then by hand signals to heave up slowly. Meanwhile, another crew held the slings on the inboard side of the crankshaft web to prevent them from moving out of position. As the slings tensioned and the crankshaft web started to lift, the web and/or one of the slings suddenly jolted causing the CO to fall into the hole in the centre of the crankshaft web. The crane driver was alerted via VHF and he slackened the slings; the victim was quickly attended to. 

The victim received medical attention in a timely manner, but he nonetheless died as a result of numerous injuries.

Lessons learned:

• Standing on top of the crankshaft web was inherently unsafe and unnecessary.
   
• In the heat of the moment and with a ‘can-do’ attitude, the risks of standing on a load under tension were not recognised or intentionally flouted.
   
• When events start speeding up, step back and slow them down.