Master unaware of bow thruster’s problems due to lack of mitigating measures reveals TSB report

Master unaware of bow thruster’s problems due to lack of mitigating measures reveals TSB report
Master unaware of bow thruster’s problems due to lack of mitigating measures reveals TSB report

The Transportation Safety Board of Canada (TSB) has released its investigation report on a March 2019 berthing incident involving the roll-on/roll-off ferry Apollo in Matane, Quebec.

On 16 March 2019, the crew was preparing the Apollo for the return trip from Godbout to Matane. In response to a request by the master, the chief engineer went to the starboard bridge wing console to look into replacing the button that was used to activate control of the bow thruster at that console. The plan was to replace the existing button in the next few days with one that would illuminate to indicate the operational status of the bow thruster. This would allow the master to have a visual indication of the bow thruster’s status while performing docking manoeuvres. The modification had been requested following instances in which the master had not realized that the bow thruster’s main breaker had tripped while he was using the bow thruster to manoeuvre the vessel near shore infrastructure. The chief engineer opened the console panel in order to identify the electrical circuit for the bow thruster, moving some of the electrical wires in the process. Once he was finished, the chief engineer secured the console panel back in place.

During the entry of the Apollo into the port of Matane, the master pushed the button on the starboard bridge wing console to transfer bow thruster control from the bridge; however, the transfer did not initiate because of a broken electrical wire. The wire was in poor condition and likely broke just prior to the Apollo’s departure from Godbout when the console panel was opened as part of verifications to install a status indicator light for the bow thruster. Given the environmental noise from the wind and waves present at the time of the docking manoeuvres in Matane, as well as the darkness, the bow thruster’s operational status could not be confirmed based on the noise it normally produced or the presence of visible thrust in the water. There were also no indicators on the starboard bridge wing console to provide the master with this information. While it was possible for the bridge crew to verify the bow thruster’s operational status by checking the ammeter readings through the engine room crew, this was not done, and, as a result, the master was unaware that the bow thruster’s control had not transferred to the starboard bridge wing console.

Probable cause

– The master pushed the button on the starboard bridge wing console to transfer bow thruster control from the bridge; however, the transfer did not initiate because of a broken electrical wire.
– The noise from the wind and the waves, the darkness, and the absence of status indicators on the starboard bridge wing console prevented the master from noticing that the bow thruster was not responding to inputs.
– In response to the question from the chief engineer, the helmsman noted that the white and amber lights on the bridge console were illuminated and, without checking with the master, he misinterpreted that the bow thruster was being used. As a result, the master remained unaware that the bow thruster was not working.
– The combination of the high winds and the ineffective bow thruster controls during docking manoeuvres resulted in the vessel’s bow striking one of the mooring dolphins, breaching the vessel’s hull.
– Under pressure to restore the ferry service and considering the Apollo to be a temporary vessel for short-term use, the Société des traversiers du Québec put the vessel into service without adequately identifying hazards and assessing their associated risks. Although there were known risks associated with the use of the Apollo’s bow thruster, there were no formal mitigating measures put in place, which led to the master being unaware that the bow thruster was not operational while docking the vessel in high winds at Matane.

Download the full report: TSB Striking of Mooring Dolphin by Ferry Apollo 2022

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