Joystick confusion caused tanker to run aground, TSB saysOct 2, 2015 02:32 PM
The crew’s lack of familiarity with their ship’s steering system and inability to regain control when the autopilot override and alarm were activated led to the grounding of a chemical tanker in the St. Lawrence River last year, investigators said.
The 530-foot, 12,619-gross-ton tanker Halit Bey got stuck April 22, 2014, along the south side of the river at Grondines, Quebec. The ship had arrived from the Netherlands and was proceeding upstream in the St. Lawrence River laden with 18,500 metric tons of liquid fertilizer. The vessel’s owner is VBG Shipping and Trading Co. in Turkey.
After picking up pilots at Quebec City, Halit Bey proceeded up-bound in the St. Lawrence River and, at 0354, reduced speed to allow two other vessels to overtake it. The personnel on the bridge included a helmsman, officer of the watch (OOW), the chief engineer, deck cadet, two pilots and a pilot apprentice. After the two vessels had passed, the pilot who was conning Halit Bey ordered the engine telegraph to full ahead.
With the pilots and navigational crew present, the autopilot override alarm sounded and the helmsman reported that the helm was not responding, Canada’s Transportation Safety Board (TSB) wrote in an investigative report. Despite all attempts by the pilots, ship’s officers and master, the control panel failed to respond to attempts to regain control using the non-follow-up (NFU) mode on the controls. The ship ran aground at approximately 0415.
Halit Bey remained hard aground for 10 hours. The ship was finally refloated using two tugs and its own propulsion. Escorted by the tugs, Halit Bey proceeded, with the steering in follow-up mode, to its assigned berth in Trois-Rivières, where it discharged cargo. It departed at 0115 on April 24 for Valleyfield. The next day, an underwater survey concluded that the vessel had not sustained damage.
In its findings, the TSB determined that steering control from the steering wheel was likely disabled when the unprotected NFU joystick was inadvertently moved, which activated the autopilot override and alarm.
“An incompatibility between the steering gear control panels meant that even when the vessel was not operating in autopilot mode, touching the non-follow-up joystick still activated the autopilot override and associated alarm, which disabled all of the steering controls except for the NFU joystick itself,” the TSB noted.
The TSB said “the bridge crew was not adequately familiarized with the characteristics of the Halit Bey’s steering control system and did not know how to regain steering control after the autopilot override alarm activated.”
The investigators noted that if crewmembers are not familiarized with all aspects of the operation of safety critical equipment, such as a vessel’s steering control system, there is a risk that they will not have the knowledge required to operate the system proficiently or regain control in the event that it is lost. There are potential design issues too.
“If critical bridge systems, such as steering gear control systems, are not designed and arranged to be straightforward and intuitive with safeguards to minimize human error, there is a risk that an operator will not be able to respond quickly and effectively in the event of an emergency,” the report said.
On May 29, 2014, the TSB forwarded Marine Safety Advisory letter 05/14 to the vessel owners to identify the issues with the configuration of the steering gear controls and the familiarization of the navigation crewmembers with the steering gear system aboard Halit Bey.
Following the grounding, complete emergency changeover procedures were posted on the bridge of Halit Bey and sister vessel Nilufer Sultan, taking into account the particularity of the steering control that could be disabled if the autopilot override mode is activated. The company issued a fleet-wide navigation safety circular.
VBG Shipping and Trading did not respond to requests for comment.