A vessel was on standby when a fire alarm was activated from the laundry room. The steward was nearby and took immediate action by switching off the relevant circuit breaker. All crew members proceeded immediately to the muster station. The fire-fighting team subsequently conducted an assessment and found a dryer machine had overheated, due to prolonged use and being overloaded with clothing.
What went wrong? What were the causes?
- Immediate cause: Around ten days earlier, the crew had carried out repairs on the dryer and replaced its thermostat with a spare thermostat from oven, as a temporary measure;
- This allowed the dryer machine to continue to operate when overheated;
- The failure and subsequent repair of the dryer with the inappropriate part had not been reported to the company, though this was required by company procedures;
- Replacement of components should follow original specifications; any changes from the original, if approved, should have followed a management of change process. In this particular case, the change of specifications would not have been approved and the incident would not have occurred.
This was a potentially very serious incident which could easily have been prevented. Procedures were not followed; the failure and repair were not reported to management. The repair using an inappropriate part introduced a huge further risk to the safety of the vessel and its crew, and should never have been permitted.
Members may wish to refer to the following incidents:
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