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LOGBOEK - JOURNAL DE BORD |
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Cosco Busan decision calls for change in navigation training
The disastrous potential consequences of failures in competence when
The US District Court has ordered the shipmanagement company involved in the Cosco Busan accident in 2007 to change its navigation training practices, and hit it with a $10 million fine. Fleet Management Ltd was ordered to pay the $10 million for its role in causing the oil discharge and a subsequent coverup after the ship struck the San Francisco Bay Bridge in November 2007, according to the US Justice Department. In addition, it was also ordered to implement a comprehensive compliance plan that would include heightened training and voyage planning for ships engaged in trade in the United States.
“The US Coast Guard is pleased to see an increased emphasis on crew training," said Rear Admiral Joseph Castillo, commander of the 11th Coast Guard District. "The safety of mariners, the health of our economy, and the protection of our environment all require the safest possible operation of merchant ships sailing in our ports, waterways and coastal areas, and proper training is key to safe operations." The case did bring to light a number of disturbing moves to conceal the activity of those onboard involved in navigating the Cosco Busan. The Department of Justice statements on the issue showed, in particular, that a false berth-toberth passage plan for the day of the crash was created after the incident, at the direction of superintendents and with the knowledge of the ship’s master. Additionally, a ship officer falsified the ship’s official navigational chart to show fixes that were not actually recorded during the voyage. Other records, including false passage planning checklists, were also created after the fact. Navigation technology The details of this accident offer a reminder of the serious consequences of human error when dealing with navigational technology onboard ship. According to the official NTSB (National Transportation Safety Board) investigation into the incident, the Cosco Busan was equipped with a three-node (navigation station, planning station, and conning station) voyage management system (VMS), which integrated the vessel’s major navigation components to display data gathered from a variety of sources in a single place. This system was particularly important in areas of low visibility, and was heavily relied upon by the pilot and crew of the ship as it left San Francisco on a foggy November morning. The VMS consisted of two ARPA radars (X- and S-band), an electronic chart system, and a conning information display, as well as an AIS (automatic identification system). The radar displays could also be superimposed onto the electronic chart along with AIS data. The vessel’s voyage plan could be superimposed onto the radar screen if entered into the VMS. Radar tests conducted before and after the accident indicated that the equipment was all functioning correctly, however VDR evidence retrieved after the incident showed the crew to be patently unfamiliar with the operational details of the systems.
A representative of the radar manufacturer noted at a public hearing that the VDR recordings showed that crewmembers had increased the gain on the antenna to a level “really higher than it should be.” He added: “While this [high gain setting] never impacts the [radar’s] ability to give a good picture, it does . . . give much more return on the display. What you’ d see is things get a little larger, a little more clutter because the gain is up so high.” While this error in the use of the radar was not identified as a direct cause of the accident, it does indicate the potential problems that might arise when gaps exist between the capabilities of the technology onboard and the capabilities of the users. Electronic chart confusion More serious than the lack of radar expertise among the crew, in the context of this accident, was the confusion of the pilot and the ship’s master over the symbology used by the electronic chart system. The electronic chart system in use on the Cosco Busan was not a full ECDIS system, as it was operating with unofficial chart data, though the hardware itself was capable of performing as an ECDIS. However, NTSB does note in its report that the symbols upon which the pilot relied for navigation were “similar, if not identical” to the type of symbols approved in the International Hydrographic Organization’ s (IHO’s) Presentation Library for ECDIS. Despite this the report says that in post-accident interviews the pilot stated that: “even though he typically saw as many as 10 different ECDIS systems during a work week, he had ‘never seen a red triangle on any piece of navigation information, electronic, paper or otherwise’ .” “The red triangles to which the pilot referred were the conical buoys on either side of the Bay Bridge Delta tower.” The report continues with details of discussions of these symbols that took place between the master and pilot, recorded by the VDR. It says: “the pilot asked the master about the ‘red triangles’ - as he referred to them - on the electronic chart display of the vessel’s transit area. When asked about the meaning of the red triangles, the master said, ‘this is on bridge’.” “This was far from a precise response and, based on subsequent events, the pilot apparently interpreted this as ‘centre of the bridge’ or, more significantly, ‘centre of the span’.” This confusion and uncertainty in the use of the navigation equipment aboard the Cosco Busan had disastrous consequences, as the containership struck the base of the bridge’s Delta tower and leaked approximately 53,500 gallons of fuel oil into San Francisco Bay. The $10 million fine imposed by the US District Court is only a small fraction of the estimated $70 million spent on the environmental cleanup of the area, but it is hoped, at least, that the spotlight on the facts of the incident will remind ship operators of the importance of cultivating onboard expertise in the use of navigation technology. DS
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