Dive Vessel Conception - NTSB Release Preliminary Report

The NTSB preliminary report.

https://www.ntsb.gov/investigations/AccidentReports/Reports/DCA19MM047-preliminary-report.pdf

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The LA Times reported that the last victim’s body was recovered. Also, all crew were sleeping.

Okay, guess they were able to raise the hull this morning.
This preliminary report does specify five crew asleep behind the wheelhouse, and one down below with the pax.

This is utter nonsense. Simply having a watch at all times LIKE YOU ARE SUPPOSED TO BY LAW AND COMMON SENSE most likely would have prevented this disaster and tragic loss of life. There is no excuse for this.

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Just a screenshot the play button does not work.

U.S. Coast Guard Convenes Marine Board of Investigation into Conception Boat Fire

Deputy Command for Operations, Vice Adm. Dan Abel, announced the convening of the MBI on Wednesday. A commandant-directed formal Marine Board of Investigation is the highest-level marine casualty investigation in the Coast Guard.

This was in the original thread Multiple Casualties During Dive Boat Fire Near Santa Cruz Island

As was this:

Just a little while ago the local news showed the conception being secured to the deck of the DB Salta Verde.
I’ll be surprised if they don’t end up on the navy side of port hueneme for the NTSB to continue their investigation.

https://www.msn.com/en-us/news/us/all-conception-crew-members-were-sleeping-when-boat-fire-broke-out-ntsb-says/ar-AAHcBbr

Where can that requirement be found?

https://www.law.cornell.edu/cfr/text/46/185.410

§ 185.410 Watchmen.
The owner, charterer, master, or managing operator of a vessel carrying overnight passengers shall have a suitable number of watchmen patrol throughout the vessel during the nighttime, whether or not the vessel is underway, to guard against, and give alarm in case of, a fire, man overboard, or other dangerous situation.

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This is how disinformation gains a foothold in the public deliberations and official investigations…

No witness of fire origination, known there was no watchman, and someone posits maybe it was the charging station or batteries… I hear they can explode. Someone offered some bit of speculation and any information is information when no scene exists to investigate forensically and investigators are proceeding with prudence and holding their cards until they have deliberated. Add to bias of media for clicks and stories about consumer safety (Is your toilet killing you? Join us on News 7 tonight!)

Since there is only such a small bit of info offered, why bother focusing on a wooden interior or veneers and finishes and the like (has anyone seen any results of samples of the other boats interior finishes or adornments? any stories they took samples?), the relative low bar of the electrical standard applicable to the boat. Boring. New thing, new hazards capture the imagination, even though the problems of lithium ion have been in place for years and the manufacturers of both batteries and chargers have been improving product safety, the original fear remains. It happened, so it can happen, forever…

Since it captures the imagination, of course the safety minded CG will lump it in with a series of ‘information’, ‘information’, I say again, information points in an ‘information bulletin’ not a Safety Alert or even a Concern—points worth reminding operators, not items found as a result of deliberative investigation, just throwing all of it out there, can’t hurt right, safety! Are you suggesting people shouldn’t consider these as a safety issue? Uh no, sure, go ahead, put it in there…

Press of course thinks, and then says ----CG issues a warning on chargers!

No warning on lack of fire watch - that would be a boring headline. Impugn product safety affecting countless consumers–that’ll get clicks.

Investigators can’t dismiss it, after all, the CG said something. Maybe ask a former NTSB investigator about it like they do in the article: “The intensity of the fire surprised people,” Peter Goelz, former managing director of the National Transportation Safety Board, told USA TODAY. “If it was being fed by lithium batteries, that might explain it.”

So someone who has seen public news stories makes a factual statement about whether lithium batteries ‘might’ be a fire hazard in a fire? OK.

Has this ever happened before, former NTSB?

“Goelz says he’s never heard of charging stations being linked to a boat fire – but he was not surprised by the bulletin. On commercial airplanes, crew members have gloves, tongs and flame-smothering bags at the ready, he noted.”

Yes, well, there’s a history to these batteries and their start was marked by incidents that called for prudent handling and prepared response, especially in the skies—but product safety has improved as incidents improved safety - does any safety agency even decide, OK safe enough, you can get rid of those bags now flight attendants? No, because hazards never disappear, ever. No one would ever declare batteries totally safe. The bulk of personal electronics use Lithium ion these days, the bulk! Market capture is an indicator of products having matured in a safety regime that has successfully tackled initial problems. But of course, you can never say ‘no hazard’. The past is always present.

“More than 30 divers spending a long weekend packed on a boat could have a lot of phones, cameras and laptops to charge, he said. One survivor even suggested the fire may have started in an area where electronics were charging.” I’ve also heard people like their personal electronics to be with the person, and not often left in public areas where people could access them. Especially phones so we can check twitter in the morning immediately!

But he says it correctly - “COULD”, “MAY” They ‘could’ have one of Elon Musk’s ‘Not a Flamethrowers’ too, I mean, can you prove they didn’t? Speaking of ‘would’, what about the wood? There was wood right?

“I’ve heard that a lot of attention is going there,” Goelz told USA TODAY. “Did they have a charging station of epic proportions? Were electronics stacked up? We don’t know yet.” A reminder of the headline - ‘CG issues warning on charging phone batteries’

Who have you heard it from? A responsible media? I don’t mean to bust on the former NTSB, he gave factual answers, shaded appropriately as conditional, speculative. It’s the media I’m bagging, and the CG a little bit by guilelessly enabling it.

The danger in this is that media induced speculation takes focus away from looking at the facts head on. And the investigators are pros, so they will have their guard up, but, the media will never stop bringing it up whenever they get an opportunity to talk to officials—after all, people are ‘hearing’ there’s a lot of attention there----so investigators will be placed in a bind - can’t rule out, can’t affirm, tie goes to “the ‘non-zero’ possibility ‘exists’ and cannot be discounted at this time”.

Horses, not zebras. If it’s a zebra, and they find evidence of a zebra, I’ll be one of the first to say, ‘wow, look at that zebra!’ But check for horses, first.

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Your projection was correct. They are in Port Hueneme now.

The navy side of PH is about as secure as one could hope for, considering.

Now that we have confirmation that the crew or more particularly the capt dropped the ball in response to the fire. Was it due to complacency, not knowing any better, being a victim of a lackadaisical culture…or combination of all the above? Hopefully the NTSB, uscg and all others involved have some luck going over the remains of the vessel.

What exactly can they find in regards to what sparked the fire considering whats left of the wreck and it was on the ocean bottom for a few days?

Here is the Conception COI

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From the COI: “A MEMBER OF THE VESSEL’S CREW SHALL BE DESIGNATED BY THE MASTER AS A ROVING PATROL AT ALL TIMES, WHETHER OR
NOT THE VESSEL IS UNDERWAY, WHEN THE PASSENGER’S BUNKS ARE OCCUPIED.”

Who spends the rest of their live incarcerated for this gross malfeasance (aka: manslaughter)? The CEO of Aquatics? The owner? The Master? or all of them?

Looks like the master.

If you think someone other than the captain is going to take the fall for this then you are nuts.

Even if he did everything right and assigned a watchman, and the watchman fell asleep he will still take the fall.

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There are two issues here. The first is whether the fire was ignited by thermal runaway of an Li-ion battery during charging. The second is whether lithium batteries were ignited by and accelerated a fire that started by some other cause.

In your analogy, the first is a zebra and the second is a horse. I agree that thermal runaway is low probability. I would, however, submit that acceleration of a ongoing fire is not. It is IMHO incorrect to confuse the two and thereby imply that the amount of lithium on board did not present a hazard. This was not a situation of 33 cell phones or even 33 laptops. This was a probably* a case of tens and maybe dozens of high capacity batteries for dive lights and video cameras, many in close proximity to each other at the charging station.

The USCG is aware of the hazards of lithium batteries in power supplies and cargo. If you doubt this, do a google search on “lithium” with the site limited to uscg.mil. I do not agree that the USCG was suddenly suckered by the media into considering the lithium hazard, but rather that they drew the logical conclusions from what they already knew.

Earl

*edit based on Jamesbrown comment. There were media reports from people who had been on previous trips that the charging station was crowded with batteries after a dive. FWIW.

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CRAP!!! I left “watchman” off the list. . .

Y’know, if the Master did “due diligence”, and assigned a watchman, and the watchman fell asleep, then IMHO the watchman should be the only fall guy, criminally. However, civilly, given the concept of “deep pockets”, wouldn’t the owner and operators be held accountable?

I’m thinking about “El Faro”, where the operating company was held somewhat accountable for the accident, although they were not in “direct control” of the vessel.

From the report:

  1. “At the time of the fire, five crewmembers were asleep in berths behind the wheelhouse, and one crewmember was asleep in the bunkroom”

  2. “A crewmember sleeping in the wheelhouse berths was awakened by a noise and got up to investigate”

  3. “He saw a fire at the aft end of the sun deck, rising up from the salon compartment below. The crewmember alerted the crew behind the wheelhouse.”

There is no mention of a watch having been assigned. I can’t find a diagram of the crew’s sleeping area but based on crew quarters on similar boats I’ve been on, the crew sleeps in open berthing. If that is the case, how could a crewmember assigned to do a roving patrol come back to his rack without getting detected?

The missing piece of the puzzle in that scenario is the crewmember sleeping in passenger berthing. If he was the assigned watchman, the captain has the unenviable choice of blaming a dead man or accept responsibility for not complying with the COI.

Could you please prove this is, in fact, what the situation was in the galley at the time of the incident?

Everyone is aware of lithium battery hazard and I reject your characterization of what I consider a horse or zebra. I’m just calling for clear eyed rational examination of evidence to conclusions, by pointing out how such can be derailed with speculations that gain a prominence due to unique features that draw selective media focus and how that can in turn create a self-sustaining and unproductive diversion.