Transport Malta’s Marine Safety Investigation Unit has issued an investigation report into fatal injuries to a crew member, during cargo operations in the port of Bata, Equatorial Guinea on 21st July 2023.
The incident
On 21 July 2023, Port Gdynia was moored alongside in the port of Bata, Equatorial Guinea. Cargo loading operations were in progress when the electrotechnical officer (ETO) was found lying on deck, with a severe head injury. The crew members observed that the injured ETO did not show any signs of life and their attempts to revive him were unsuccessful. He was eventually transferred to a hospital, where his death was confirmed. There were no witnesses to the occurrence, but the safety investigation considered it likely that the ETO may have tripped over an obstruction on deck and fallen, subsequently suffering a fatal head injury. The MSIU has issued one recommendation to the Company, aimed at ensuring that the crew members always use the safety helmets’ chin straps.
Analysis
Aim
The purpose of a marine safety investigation is to determine the circumstances and safety factors of the accident as a basis for making recommendations, and to prevent further marine casualties or incidents from occurring in the future.
Cooperation
During this safety investigation, MSIU received assistance and cooperation from the Państwowa Komisja Badania Wypadków Morskich (PKBWM), Poland. Cause of death Since an autopsy was not carried out, the cause of death was not determined. However, the death certificate attributed the cause of death to a fall and considering the severity of the head wound, the safety investigation considered it likely that the ETO may have suffered a fatal injury after falling on deck. Probable cause of the fatal injury The ETO’s head injury suggested that it had been caused by a strike against a hard object / fitting. Since there were no indications which would suggest that the ETO had checked or was checking any reefer container in the vicinity, the MSIU considered it highly unlikely that the ETO had fallen from a height.
As mentioned earlier in this safety investigation report, the cross deck where the ETO was found, was narrow with various obstructions along it. Of the measured 1.9 m, about 1.0 m of the cross deck was taken up by the fixed deck fittings (container sockets and pad eyes), leaving just about 0.9 m of space for a person to pass through. However, around the time of the occurrence, this 0.9 m of space was also not free of obstructions, with loose cargo securing gear lying around and reefer container cables running across it. It was therefore likely that the ETO may have tripped over an obstruction (either some cargo securing gear, reefer cable, or a fixed deck fitting) and fallen, face-first on the deck, with his forehead directly striking either the deck, or another fixed deck fitting. Although he was not known to have been suffering from any illnesses prior to the occurrence, bearing in mind the age of the ETO, the safety investigation was also unable to completely rule out the possibility of the ETO collapsing on deck due to a natural cause and then suffering the fatal injury.
Probable cause of the ETO tripping
While noting that the numerous obstructions on the cross deck presented tripping hazards, the safety investigation also considered that since the ETO had been on board for more than two months, he would have passed through that cross deck on several occasions and would have been aware of the tripping hazards present there.
Conclusions
- The death certificate attributed the cause of the ETO’s death to a slippery and abrupt fall [sic.] on the deck. An autopsy was not carried out.
- The head injury suggested that it had been caused by a hard strike against a blunt metal object / fitting. The safety investigation considered it likely that the ETO may have suffered a fatal injury when his forehead directly struck either the deck or another fixed deck fitting, after he fell on deck.
- In view of the ETO’s age and in the absence of an autopsy examination, the safety investigation was unable to completely rule out the possibility of the ETO collapsing on deck due to a natural cause, after which he suffered the fatal injury.
- It was possible that the ETO may have been distracted while passing through the narrow cross deck and consequently, he may have not noticed an obstruction in his path and probably tripped over it.
- The safety investigation did not exclude the possibility that the ETO’s vision may have either been slightly blurry due to dry eyes, or he may have applied his eye drops while passing through the cross deck, which may have resulted in the momentary blurring of his vision while his eyes settled.
- The safety investigation hypothesized that the ETO had intended to proceed towards the forward part of the vessel, to check some other electrical equipment. Since cargo operations were in progress from the port side, the only option he may have seen was to pass through the cross deck to the starboard side.
- The safety investigation considered it possible that the ETO had intended to proceed to the starboard side and since the accommodation’s starboard side door was locked, he used the cross deck.
- The wound seen on the ETO’s forehead suggested that his safety helmet was not on. Probably, if the ETO had tripped over an obstruction, the safety helmet may have slipped off his head, especially since a chin strap was not fitted to the helmet.
- Information relayed to the safety investigation suggested lack of preparedness in the port, at that time, to deal with medical emergencies. However, the safety investigation was unable to verify the extent of such preparedness.
Recommendations
Polskie Linie Oceaniczne S.A. is recommended to:
09/2024_R1 ensure that all safety helmets on board its fleet are fitted with chin straps and that the crew members always use the chin straps.
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Source: Transport Malta
