What happened
At about 1450 on 8 October 2010, the partially loaded Liberian
registered bulk carrier Grand Rodosi collided with the
Australian fishing vessel Apollo S in Port Lincoln, South
Australia. As a result of the collision, Apollo S, which
was unmanned, was crushed against the wharf and sank shortly
afterwards. Grand Rodosi sustained several relatively
small holes in its bow shell plating.
What the ATSB found
The ATSB investigation found that, despite the pilot ordering
astern movements, the ship's main engine did not run astern in the
5 minutes leading up to the collision. The chief engineer, who was
operating the main engine start/fuel lever in the engine room
control room, did not allow sufficient time for starting air to
stop the ahead running engine. Consequently, when fuel was
introduced into the engine, it continued to run ahead, despite the
astern telegraph orders.
The investigation also found that the chief engineer's mistake
was not identified by anyone on the ship's bridge or in the engine
room control room until after the collision; that the master/pilot
information exchange was less than optimal; and that bridge
resource management principles could have been better applied
during the passage to the berth.
What has been done as a result
Newlead Bulkers, the ship's managers, have amended their on
board procedures to ensure crew monitor the direction of main
engine turning after each engine order. They have also increased
awareness through their fleet about this type of incident
occurring.
Flinders Ports, the provider of pilotage services in Port
Lincoln, have revised their risk assessment for the manoeuvre being
undertaken during Grand Rodosi's berthing to include new
preventative, as well as restorative, measures to be followed.
Flinders Ports has also revised the port's pilotage passage plan to
include indicative courses to be followed, both while transiting
the channel and outside of it, and speed zones. This will enable
the crews of visiting ship to be better informed about the pilotage
passage their ship is about to undertake.
Safety message
It is of paramount importance that pilots and ships' crews
maintain awareness of main engine movements and check engine
tachometers following every movement to ensure that the engine is
operating in the desired direction. This is particularly important
when main engines are being operated in manual control.
In addition, pilots and the bridge teams should ensure that all
the necessary information is exchanged at the beginning of a
pilotage, including courses to be followed and speeds at critical
positions during the passage to or from the berth/anchorage, so
that all members involved in the pilotage have a shared mental
model and therefore, a good understand of the pilotage before it
begins.
