An allision between chemical/oil products tanker Ali Ka (IMO 9451226) in October 2022 and a fuel jetty at Canvey Island, Essex, in the Thames Estuary was likely the result of control being lost because the pilot’s plan missed key information, was compromised by incoherencies in documentation, no tug was used, and the pilot was highly likely to have been severely fatigued, an investigation by MAIB has found
On October 25th 2022 the Ali Ka departed the Oikos fuel storage facility, Canvey Island, Essex in the early hours. While manoeuvring off the berth under pilotage, control of the ship was lost and it made contact with another fuel jetty at the site.
Ali Ka’s starboard aft quarter was damaged in the accident, but there were no injuries. The resulting damage to the westernmost dolphin, and a walkway, at Oikos Jetty 2 caused the jetty to be taken out of commission for two months. It then returned to service at reduced capacity. It took eleven months for the Oikos facility to return to pre-accident capacities.
The Oikos fuel storage facility was part of the national infrastructure for the import and distribution of distillate fuel in the UK. It was regulated by the Health and Safety Executive under the Control of Major Accident Hazards Regulations 2015 (COMAH).
The investigation concluded that it was highly likely that the pilot was fatigued, was unfamiliar with the berth, and had elected to sail without the support of a tug. It also found that:
- The Port of London Authority documentation on tug use had not been comprehensively updated to include a mandatory tug requirement for the Oikos berth, which was subject to the Control of Major Accident Hazard Regulations 2015.
- Ali Ka’s bridge team roles and responsibilities had not been allocated to best support the pilot during the manoeuvre.
- The pre-departure master/pilot exchange was ineffective and unsuccessful, and challenges to decision-making did not result in changes to the departure plan.
- Parts of the Port of London Authority’s marine safety management system lacked clarity and the management of pilot fatigue did not identify and control the risk of fatigue.
- The Port of London Authority had identified lessons from previous incidents but these had not resulted in fully updated procedures and opportunities for capitalising on learning had therefore been lost.
MAIB noted that the Port of London Authority had taken numerous actions as a result of this accident, including revisions to its safety management system, the withdrawal of out of date guidance, and the introduction of qualitative reviews of pilotage plans.
Recommendations have been made to the Port of London Authority to conduct risk assessments of high-risk berths (in conjunction with Oikos for its berths); review the risk and management of pilot fatigue; implement stop procedures; and highlight, to pilots, the practices contained in the International Chamber of Shipping Bridge Procedures Guide.
Ali Ka’s operator, Trans Ka Tankers, has been recommended to revise its fleetwide training in Bridge Resource Management and review the use of aids to navigation during pilotage.
The International Chamber of Shipping has been recommended to update its Bridge Procedures Guide with regard to the assignment of roles and responsibilities during the master/pilot exchange.
Safety Issues
MAIB said that “in the accident investigated in the first part of this report, the pilot had operated at times of day that resulted in sleep loss, but would have been unlikely to have triggered the two night policy because the two acts of pilotage prior to the accident had on base times of 05:15 and 07:00. In the absence of a definition of ‘night’ it is unlikely that a 07:00 base time would have been considered a night act. Given this, the only protection from the pilot operating whilst fatigued was the pilot identifying this in themselves and reporting being fatigued, therefore not undertaking the act of pilotage. This did not occur, but we do not know why.”
The 129.5m oil/chemical tanker Ali Ka had a registered owner as North Star Tankers Ltd.
The managers were Trans Ka Tankers.
The vessel had a gt of 7,324. It had 18 crew on board, with the ship carrying a load of hydrogenated vegetable oil.
The vessel is now known as the Baltic and is flagged in Denmark.
https://www.gov.uk/maib-reports/contact-with-oikos-jetty-2-by-chemical-tanker-ali-ka
https://assets.publishing.service.gov.uk/media/668d306c7541f54efe51bc3a/2024-6-AliKa-Report.pdf