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Safety Recommendation Details

Safety Recommendation M-17-043
Details
Synopsis: On Thursday, October 1, 2015, the SS El Faro, a 40-year-old cargo ship owned by TOTE Maritime Puerto Rico and operated by TOTE Services, Inc., was on a regular route from Jacksonville, Florida, to San Juan, Puerto Rico, when it foundered and sank in the Atlantic Ocean about 40 nautical miles northeast of Acklins and Crooked Island, Bahamas. The ship had sailed directly into the path of Hurricane Joaquin, carrying a crew of 33, including 5 Polish contract repair workers. All those aboard perished in the sinking. As part of its accident investigation, the National Transportation Safety Board (NTSB) led a joint effort with the US Navy, Woods Hole Oceanographic Institution, and the National Science Foundation to locate the ship’s wreckage and retrieve its voyage data recorder (VDR). The VDR was pulled from 15,250 feet below the ocean surface in August 2016 during the third undersea mission and yielded more than 26 hours of parametric data and audio files. The NTSB’s accident investigation identified the following safety issues: captain’s actions, use of noncurrent weather information, late decision to muster the crew, ineffective bridge resource management, inadequate company oversight, company’s safety management system, flooding in cargo holds, loss of propulsion, downflooding through ventilation closures, need for damage control plan, and lack of appropriate survival craft. The NTSB made safety recommendations to the US Coast Guard; the Federal Communications Commission; the National Oceanic and Atmospheric Administration; the International Association of Classification Societies; the American Bureau of Shipping; Furuno Electric Company, Ltd.; and TOTE Services, Inc.
Recommendation: TO THE UNITED STATES COAST GUARD: Require that open lifeboats on all US-inspected vessels be replaced with enclosed lifeboats that meet current regulatory standards and freefall lifeboats, where practicable.
Original recommendation transmittal letter: PDF
Overall Status: Open - Await Response
Mode: Marine
Location: 36 NM Northeast Crooked Island Bahamas, AO, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: DCA16MM001
Accident Reports: Tropical Cyclone Information for Mariners Sinking of US Cargo Vessel SS El Faro Atlantic Ocean, Northeast of Acklins and Crooked Island, BahamasSinking of the US Cargo Vessel El Faro: Illustrated Digest
Report #: MAR-17-01
Accident Date: 10/1/2015
Issue Date: 2/7/2018
Date Closed:
Addressee(s) and Addressee Status: USCG (Open - Await Response)
Keyword(s):

Safety Recommendation History
From: NTSB
To: USCG
Date: 4/30/2019
Response: We note that you agree that open lifeboats should be phased out of operation, and that you support legislation or proposals from vessel owners and operators to accomplish this. We further note that, in 1989, you published a notice of proposed rulemaking (NPRM) proposing a requirement that all oceangoing vessels be retrofitted with enclosed lifeboats by July 1, 2001. However, because the cost-benefit analysis required by the Office of Management and Budget (OMB) for new regulations did not show a positive cost benefit, the proposed requirement was removed from the interim and final rules. Because you are not able to issue the recommended requirement, you have initiated a CIC to ensure that open lifeboats remain in serviceable condition. We understand that you consider your actions in response to this recommendation to be complete, and you have requested that it be closed. We are aware that all new federal regulations are reviewed by OMB and that a positive cost benefit must be shown before the regulation can be issued. We issue safety recommendations based solely on safety concerns, and we do not perform cost-benefit analyses of our recommendations. Our El Faro accident report pointed out that modern enclosed lifeboats enhance survivability compared with the open lifeboats on board El Faro, and that it was possible that some of that vessel’s crew would have survived if modern enclosed lifeboats were available. Further, the NPRM discussed above was issued 30 years ago. Before we close this recommendation, please review and update the benefits associated with the recommended requirement to learn if events in the last 30 years now support the proposed action. We also ask that you describe your program to support and encourage vessel owners and operators to voluntarily retrofit their vessels with modern enclosed lifeboats. Pending the results of an updated benefit analysis and a description of your program that encourages voluntary retrofits, Safety Recommendation M-17-43 is classified OPEN--AWAIT RESPONSE.

From: USCG
To: NTSB
Date: 7/17/2018
Response: -From Karl L. Schultz, Admiral, U.S. Coast Guard, Commandant: I concur with the intent of this recommendation. The Coast Guard agrees that open lifeboats should be phased out of operation and supports proposals from vessel owners and operators or legislation to accomplish this. In 1989, the Coast Guard proposed retrofitting all oceangoing vessels with enclosed lifeboats by July 1, 2001 (54 FR 16236). However, due to cost-benefit and competiveness concerns, as well as insufficient support the proposed requirement was removed in the Interim and subsequent Final Rules (61 FR 25276 and 63 FR 52817, respectively). For existing vessels fitted with open lifeboats, the Coast Guard has initiated a Concentrated Inspection Campaign (CIC) to ensure that the lifeboats remain in serviceable condition. A final report of the CIC will be made public via the Coast Guard Maritime Commons blog. I consider the Coast Guard's action on this recommendation complete and request that it be closed.

From: NTSB
To: USCG
Date: 2/7/2018
Response: On December 12, 2017, the NTSB adopted its report Sinking of US Cargo Vessel SS El Faro, Atlantic Ocean, Northeast of Acklins and Crooked Island, Bahamas, October 1, 2015, NTSB/MAR-17/01. The details of this accident investigation and the resulting safety recommendations may be found in the attached report, which can also be accessed at http://www.ntsb.gov. Among the safety recommendations are 29 issued to the US Coast Guard, which can be found on pages 248–251 of the report. The NTSB is vitally interested in these recommendations because they are designed to prevent accidents and save lives. We would appreciate a response within 90 days, detailing the actions you have taken or intend to take to implement these recommendations. When replying, please refer to the safety recommendations by number. We encourage you to submit your response to correspondence@ntsb.gov. If it exceeds 20 megabytes, including attachments, please e-mail us at the same address for instructions. Please do not submit both an electronic copy and a hard copy of the same response.