MAIB recommends port authorities review pilot risks to prevent deaths

In its report, the MAIB identified key safety issues and made recommendations for improvements to prevent similar accidents from happening again.

“While superficially this was a simple accident, our investigation identified safety concerns across the training, equipment, medical standards and emergency response, and this report addresses all of these,” said MAIB chief inspector of marine accidents, Andrew Moll.

Investigators found the seafarer’s medical certificate issued to the pilot six months before the accident should not have declared him fully fit for duty, “given he suffered from several chronic health conditions that might have affected his fitness to perform his role,” said the MAIB.

“The pilot vessel’s man-overboard recovery platform had defects that probably rendered it incapable of lifting the pilot at the time of the accident and caused the pilot to be semi-immersed on the platform for over 40 minutes until evacuation, thereby reducing his chance of survival.”

The MAIB found Associated British Ports had not risk-assessed the physical capabilities required of its pilots to establish an occupational standard for the role.

“The port authority’s ‘stop-work’ procedure was unsuccessful in preventing the pilot from working on the day of the accident despite several interventions and concerns about his fitness being raised by his colleagues,” said the MAIB.

The government branch recommended the Maritime and Coastguard Agency issue guidance that non-SOLAS vessels carry an alternative means of recovery of an unconscious person from the water.

Associated British Ports was told to review its risk assessment and, where necessary, update its pilots’ personal protective equipment to improve survivability in cold water, and align the safety training given to pilots with industry guidance.

MAIB recommended port industry bodies issue guidance on setting occupational standards for marine pilots and provide suitable personal protective equipment to improve pilot survivability in cold water.

“While the MAIB has been encouraged by the actions of the port and industry bodies to address these safety issues, I strongly urge all harbour authorities with a pilotage service to learn the lessons of this accident and take action,” said Mr Moll.