@@Private-GtngxNMBKvYzXyPq lol yes I neglected to mention that fact in my original comment. I've learned so much from his videos - keep up the great work Sal!
As an airline pilot (Ret'd), I found this quite fascinating.. the parallels with aviation are quite marked. We long ago introduced what's known as the 'sterile cockpit concept', that's to say, No non-operational conversation in the cockpit below 10,000 feet. Below that altitude the crew need to be 100% focused on the task. The fact that the 3rd Mate was ineffective in more forcefully drawing the pilot's attention to a potentially developing hazardous situation, was a common factor until 20 yrs ago (and remains so in some cultures), now CRM .. Cockpit Resource Management training ensures that irrespective of seniority and experience the captain remains approachable and sympathetic to queries by the FO and in extreme cases, the FO can, and must take control of the aircraft. I take the point that on occasion it appears to take an inordinate amount of time before an accident report is filed. In the airline world the same criticism is often levied. We do have preliminary reports issued on many occasions but what we have to remember is that the report is not simply relating to what happened.. in many cases that's pretty obvious.. it's more to do with what 'didn't' happen. The investigation has to cover dozens, maybe hundreds of aspects that could have affected the outcome.. that takes time. What could be considered, 'The Cause Behind The Cause, Behind The Cause'. In a thorough investigation all interactions, actual or potential, mechanical and human have to be investigated.
Nice post. Your point is what I'm asking above. But different cultures. I'm of the mind ... and was trained to be more like an aircrew, but on those ships with small crews we were a bit like pirates.
Thank you, for including this information. You're correct, the 3rd Officer should have "Done Something" more to get the Pilot's attention out of his email and back on the Bridge where it belonged. I like your explanation of CRM. That kind of mindset is needed not only in an aircraft cockpit or flight deck but should be SOP among Bridge watchstanders, especially during "precision maneuvering" situations.
My understanding is that CRM has been expanded into other industries and while it used to mean Cockpit Resource Management it now means Crew Resource Management. In the electric generation and distribution industry, for example, it is understood to mean that all control room load dispatchers (also known as system operators) are required to take appropriate action to mitigate for any conditions that might imperil the transmission and distribution systems, without regard to rank. Therefore supervising system operators strive to maintain a control room environment where everyone is encouraged to speak up.
@@DanielinLaTuna Quite right.. I was using the original terminology..being an Old F@rt and retired.. CRM has been expanded to include 'Any' available resource, including ATC..As an instructor, I would discuss it extensively in the classroom and expand on it during simulator sessions.
There is a great video here on TH-cam of a sim session where the First Officer is being set up. He thinks it's a standard approach into some foreign airfield (I forget which one) .... and anyway the Captain, a somewhat senior guy, says "Oh I've been in here many, many times." The Captain kind of blows off the ....approach briefing. Anyway, that's the FO's first clue. "Complacency" Then the Captain is the pilot flying the approach and he seems behind the power curve. Not exactly a Top Gun day for him. (The FO's second clue) Then the approach begins falling apart and getting out of hand. (FO's third clue) Then they blow past the localizer and now the FO is looking over at the Captain visibly concerned. He mentions this to the Captain and the Captain sounding confused again goes, "No, I think we got this. I think we're OK. And again, blowing WAY past the centerline.....at which point FO says, "Captain I'm taking over. Ive got the airplane and we're doing a missed approach." The Captain acts confused and says, "Well, OK." He played his part very well. I probably have some of the quotes not exactly right but that's the gist of it. It's good to know they train to that level. To give them actual, experience in taking over to prevent an accident....rather than just discussing it in a classroom.
Commercial aviation has periods before landing and take off which are called sterile, which means the only appropriate topics of conversation even between the crew, are matters directly related to the operation of the aircraft.
@@tedmoss General aviation is safer now than it has ever been. Please have knowledge before you make libelous statements. Adjusted for hours flown, the general aviation accident rate was down 13% over the last five years. That being said, the NTSB is as negligent in it's overseeing of aviation as it is in the nautical instance. It needs to do better.
@@williampotter2098agree. It’s a bit lazy to slate general aviation, there are many reasons that the accident rate may be higher but every GA pilot I’ve ever flow with takes their responsibility seriously.
I think multiple hours of fully sterile cockpit would be really hard to enforce, but I agree that there needs to be more regs around distraction when transiting a channel like this.
Sal, your acting might not get you an Emmy. But it clearly put the report into a visual media for people. Totally worth it. Thank You. Keep the facts rolling. I rely on you for facts about the Port of LA and the Port of Long Beach. As well as the cargo industry.
I disagree. Not an Emmy. Emmy's are for TV. Sal needs to be nominated for Best Actor Oscar and Best Supporting Actor Oscar in a Comedy of Errors Drama across multi-media platforms. He should win both. A first for any actor.
Great report Sal, thanks. Attention to detail & situational awareness while on duty. This was hammered into me daily for 46 years of US Naval service as a ships force member, Fleet maintainer, USN sailor, MSC Mariner and NAVSEA systems lead engineer. Simply put, Pilot 1 negligently “lost the bubble” and performed his duties in a derelict manner. Too bad he won’t go to NJP. USCG Board of Inquiry can pull his license for cause.
@@kp6215 It was. The pilot is going through the administrative law process but Maryland yanked his ability to be a pilot. Pretty much everyone has more leeway in calling themselves a Maryland pilot than this guy after the order from Maryland.
Great vid Sal! Very good analysis. I'm curious why the USCG recommends that the ship operators have a cell phone policy but doesn't say boo about pilot's associations having one. A better trained bridge team might have been able to head off the problem earlier by using a graded assertiveness tool such as PACE (Probe, Alert, Challenge, Emergency). I've experienced this kind of Pilot distraction first-hand. It's important to remember this isn't charity. Ship operators pay Pilots a ton of money for their services. It is fair to expect their full attention. Keep up the fine work you do!
I for one enjoyed your introduction acting. As a US Navy Navigator, and a LtJg (pretty junior) More than once I made the call "Navigation does not concur" when someone senior to me started a maneuver that I thought dangerous. It takes a willingness to sound off which may well not have been something that was smiled on by that ship's deck department coming from the most junior deck officer. But, something like "pilot, I recommend turning to 180 at this time" might have gotten the pilots head removed from his rectum. The pilot having the conn, being the most knowledgeable person on the bridge, and the 3rd officer being the most junior deck officer on board may all have come into play in this case. Sal, thank you for the detailed report. David
Great intro there Sal; I'm actually surprised that the port had a policy of single pilot operations with vessels of this size. I know the Dutch have two pilots for these large container ships. Also as an ex Master I was quite used to eating my meals standing up on the bridge. 🙃
Sal, as a former USCG officer, I’m completely dumbfounded that such callous disregard for safety occurred while navigating a large vessel in a major US port. I think your comments are spot on, especially as to why the third officer did not assume command when he was obviously aware that the ship was in danger of grounding. While I agree that it’s highly unlikely that a junior officer would relieve a pilot, he still had responsibility for safe navigation of the vessel. At a bare minimum, he should have ordered engines astern to slow the vessel until such time as the course could be corrected. It seems there was too much emphasis by the pilot and others to “cover their six” and not enough initiatives taken to avoid a disaster. This also applies to the Coast Guard as well. In the old days, command didn’t have to review everything with legal before taking action. Now, nothing gets done until the lawyers have had their say. I blame a lot of that on the restructuring of the Coast Guard into DHS. The current political climate has the CG acting more as a second naval force vs their traditional role of ensuring maritime safety. Both the pilot and the ships master should lose their credentials for abdicating their responsibility, and I believe the third officer should face discipline for his failure to take action.
I think this is where the issue of culture and crew resource management comes in. If the third officer is Taiwanese or similar then their culture is not to challenge a person of higher rank.
Good reporting, really reflects society in general giving themselves permission to be distracted by cell phones and technology and not taking their jobs and responsibilities seriously. The consequences of not taking their responsibilities seriously are huge. I’m sorry I think that all of the parties involved were self absorbed and not taking their jobs seriously. What will be their consequences?
"I think that all of the parties involved were self absorbed and not taking their jobs seriously" I dispute that. The pilot and master, sure, but I don't think it's fair to blame the inexperienced junior officer for being inexperienced and junior and not effectively raising concerns. It sounds like a systemic problem that junior officers need to be trained to raise concerns, and senior officers need to be trained to receive those concerns (commercial aviation calls this Crew Resource Management) but it's not the third officer's fault that the system didn't give him that.
From the movie "Don't Look Up" to Don't talk on your phone when running around in a port with a huge vessel does not seem too unusual in this day and time. People in charge seem to be less and less professional for some reason. Keep reminding us of the expectations of these endeavors and what "professionalism" requires. Thank you for your commitment.
"I'm on the phone"... comedy gold. Loved the "dramatization" of the incident. Great factual report also. Pilot needs ticket pulled and retraining from scratch if he's not going to be let go. We've always heard that the Master has ultimate responsibility for vessel operations when a pilot is embarked. If the Master turned the con over to the pilot, does the 3rd Mate have any real say? Good that the Pilot didn't block the port with his shenanigans.
Sal, As always very informative and much appreciated. The issue with pilots and bridge team management has been in question throughout my professional career. I am still mystified that incidents of this type continue to happen. In my career I have been indirectly or directly involved in incidents involving tankers entering a channel prior to the pilot boarding, grounding a ship while in the process of going to anchor with a pilot on board, and an allision with a pilot on board. In all three the Master was on the bridge, per company policy. In the first instance the ship had entered a channel prior to picking up the pilot. The Master was on the bridge with a watch officer and an able-bodied seaman. The Master was signing crew members off the ship prior to arrival to help speed the process of the crew change after arrival. The Master took the watch from the mate and sent him to locate a crew member who needed to sign off. The ship passed three red buoys on the left before it grounded. Luckily it hit soft bottom. The bottom was rocky less than half the beam of the vessel to the right. The second involved the tanker being taken to anchor with the Pilot, Master and Mate on the bridge. One of the first things I was taught as a naval architect is that you can't drive a ship drawing 42' in 41' feet of water. 5,700 barrels and $14M later the spill was cleaned up. In the third case the ship departed the dock after discharge with a deck officer, Master, Pilot and AB on the bridge. There were reports of dense fog in the area. The Pilot was confident the fog would not impact the vessel. The ship approached a bridge in very restricted visibility. It sideswiped the bridge fendering cutting two holes, one 10'x100' and one 10'x200'. The company I worked for changed bridge team management practices. Pilots were brought to simulator training to make them an integral part of the bridge team. Training was designed to assure everyone on the bridge worked as one and communication was a key part of the process. As a naval architect in developing the design of new tankers we keyed on design improvements. We focused on bridge layout; totally enclosed, servo-controlled joy sticks so all move together, closed circuit TV showing the steering gears, identical displays in the engine room so the engineers can see both rudder demand and movement, and a raised table and bench so the Master and Pilot can sit and eat meals while watching what is happening. It is time that the USCG develops uniform requirements for vessel Pilots and bridge team management in pilot waters. Bob
Can I tell you that I saw that the report had been released and I purposely did not seek out to read anything about, let alone the report itself, because I was waiting for you video, and I have not been disappointed!!
Just to illustrate what should have happened; If I was the captain, I would never have left the helm. If I were the 3rd mate, I would have made sure the pilot was doing his job and taken over control immediately there was a derivation from proper procedure and called the captain. And if I was the pilot I would have paid attention to my job and not, not, been using the cell phone. My experience tells me that people don't conceive the massiveness of large objects, power systems, ships, planes, trucks, trains, etc. It seems hard to impress physics on people. The recent increase in the incidence of very bad road accidents is illustrative of the tendency to push the limits because of the false feeling of safety from improved equipment. This has been noted by others. I'm 79 years old so I have learned my lessons. I was an operations supervisor on the electrical grid and experienced these things myself. Some of us sat in Phoenix and wondered what Enron thought they were doing as we watched them crash.
Sal, Your acting is much better than most TV today. With all this information known so quickly there is no reason for some of it being released within a couple of days. A little info soon after the grounding possibly could have alerted other pilots around the world and made them more aware of their phone use. Great breakdown of the report. Thanks Phil Stevens
Your intro was a classic! With regard to missing a turn, I've done the same thing. Of course I was a student navigator in UNT (Air Force) and it was my first ride in the T45 simulator. I was still trying to get the work flow down and I was waaay behind the plane. There were no cell phones and I didn't have 15+ years experience. The complete lack of situational awareness says it all. CRM, or Cockpit Resource Management was developed to address situations like this in the cockpit, and perhaps a similar program should be developed for the bridge (if it has not already been done). I have a major safety briefing coming up for my CAP squadron, and this is going to be part of it.
@@potathooo Does Evergreen use it? Please don't take my comment the wrong way, the snark is targeted toward Evergreen and the harbor pilot. It sounds like the Third Mate was carefully trying to get the pilot back in focus without pissing him off. At least there were no injuries or fatalities from this accident.
@@robertjune1221 Honestly, I have no clue. The only thing I know is that the concept exists and is a common element in the training of maritime deck officers
At 16:53, the third officer announces his course and speed. This is the point where it could have all been avoided. The third officer making his announcement should have been taken as a "Check your course and speed!" by the pilot. It is my opinion as a retired Marine Investigator that the Third officer saw what was happening and in the only way he could, he announced his last received command to get the pilot to look up from his distraction. The amount of details in the observations taken by the third officer during the transit shows that they were paying attention to everything going on.
Besides the obvious, there would be no story here, what would ramifications of the ship's officer just ... well, taking control and doing the right things, slowing the ship, backing her even and putting her back in the channel be ? As a retired Marine Investigator you are the guy to ask.
Could that Third Officer, on noting that the Pilot was STILL off in his own little world have "taken the Conn" and tried to execute the starboard turn to 180? Or would "The Rules" have prevented that?
I believe in aviation speak a pilot can read back the instructions he has been given by air traffic control with the prefix "Confirm..." The ATC is expected to stop and reconsider those directions.
Culturally, it may be that the lower ranked 3rd officer couldn't directly challenge his superior. I believe that this was observed as an issue with the Koreans in aircraft and required substantial re-training (and probably personnel changes) to overcome.
@@travelertime4382 If the third officer had taken control, slowed the ship down and put her back in the channel, they'd be a hero among the people on the bridge at that time, and nobody else would know a thing. However, had the third officer taken control, slowed the ship down and run her aground on the opposite side of the channel, they'd be in a enormous amount of trouble. The pilot is on board because they are the expert in navigating those specific waters. The third officer is a third officer because they are inexperienced and do not yet have the decision-making expertise to take control in a situation like this. If the third officer was capable of doing all the things you're asking them to do, there'd be no need for a second officer, first officer or master. As we see from the fact that the third officer did subtly question the pilot's actions, they were capable of seeing that something was wrong, but they didn't necessarily know how to do it right, so couldn't necessarily take corrective action themselves. The issue is the cultural one, that the third officer didn't feel able to (or wasn't trained to) effectively raise their concerns, and the pilot wasn't keyed in to receiving concerns from the third officer.
“4.1.41. At 2101, Pilot I notified Sector Maryland National Capital Region that the EVER FORWARD was grounded via cell phone.” LOL. Sounds like a pretty accurate summary to me.
Good report , your opening made me smile , it was right to the point! Like many jobs out there ,there is a reason for procedures even tho it may seem mundane at times . Let’s just say I wouldn’t put someone like that on point….if you know what I mean…keep up the good work Sal , calm seas and fair winds my friend !
Railroading has a saying regarding all the rules and regulations put in place by the FRA (Federal Railway Administration) about the rules being the results of lessons written in blood. This Pilot and this Ship's Master should never be trusted on a Bridge again. I don't think I'd even trust them on a Bass Boat on a mill pond.
In the background, looks like you are building the LEGO model of the SS Titanic. My wife completed it a few months ago. The detail that is contained on the inside of the Titanic is amazing.
Sal, I Agree with your assertion that USCG took way to long to get preliminary information out. I wonder why you did not mention that the USCG did not take the pilots License or Pilot credentials away. Maryland did, but as a US professional Mariner the pilots actions were grossly deficient and the USCG should have taken is Pilot endorsements away as a minimum, and his License as full measure of this officers incompetence on a bridge. JMHO
Excellent follow up Professor Sal or Movie Star Sal. Maybe the pilot plug his controller (GPS?) into the ships Xbox and was streaming through his phone...lol On a serious note commercial truck drivers are forbidden to drive and text and all communications must be via headset. I heard about the pilot talking to his girlfriend but didn't believe it. Along with the absence of the pilot and captain off the bridge eating. As you put it why wasn't food brought to the bridge. Can you imagine the call to Evergreen HQ, "Hi, Ever Forward here just marking the Ever Given anniversary." Thanks again Sal for the update with your reliable sources. I couldn't believe what reading and thought you couldn't make this sh*t up...
For a Master to leave the bridge in confined waters - that to with a 3rd mate, just to go and have his meal is a bad idea. Either eat on the bridge or eat after the manouvering when the ship is at sea. I doubt he’ll ever make that mistake again! Thanks for sharing the report. I wish we could have had a report on the Suez incident as well. It would probably have been something equally ridiculous. This shipping company needs some serious reorganisation ! 😊
You mean you can no longer go for dinner and play with your phone while navigating a complex channel with high traffic present?! Does that even need a discussion?
I took the con from a pilot once. 2nd mate, about 3am North Sea. Captain was below. We were getting close to a fishing vessel crossing our bow. Too close for my comfort. I looked at the pilot, he was asleep in the captain's chair. I gave (whispered) a helm order to increase the overtaking distance. I told the AB on the wheel that the pilot was asleep and that I was giving the orders. He chuckled. The pilot woke up with a start, flew out of the chair, saw this mass of glaring white lights just off starboard bow. I told the pilot we should overtake him at a safe distance because I ordered a course change. The pilot ordered a course change of a few more degrees to what I ordered. I told the AB that the pilot was awake now. He chuckled again.
Maybe they should at least use Crew resource management (CRM) from the airlines in that anyone can speak up if there is something that is overlooked or someone/thing is in danger without fear of being punished. Even the AB "driving" the boat could have spoke up and said hey we aren't turning and the channel markers are coming up. He should have been able to raise the flag to get everyone's attention at that point too. Heck even the pilot should have asked the captain to stay on the bridge until his disembarkation. Its not just one thing that causes a disaster in the making. Good video and acting, better watch out or J.J. Abrams will cast you for one of the Ever Given or Ever Forward movie dramas! 😁🤠
Sal that lead in was funny as the dickens. You nailed it. Taking something that serious and making it funny while tying the truth around the Pilots neck in spectacular fashion.
Ignoring the cell phone aspect for the moment. I am amazed that the outbound course wasnt plugged into the auto nav system. Then small manual adjustments made as necessary. Manual helm all the way out? Interesting.
I could add volumes about ship pilots problems in the Baton Rouge to open waters but won’t. All I can say that there are a lot of incidents that occur because the lost of situationally awareness both on towboats and ships. Dependence’s on technology piloting has brought this problem about. Before electronic navigation and cellphones situationally awareness wasn’t that big of a problem. I worked through both the technology advanced world and without technology. I can say that I liked the non-technology world better. Good reporting Sal.
Sal, maybe I missed it, but does the local Baltimore area pilot association have a written policy on cell phone usage by a pilot while actively piloting a MV? PS - Will there be a follow on video on who bares the ultimate cost for this incident? P&I Club, pilot insurance carrier, … PS2 - Why is USCG recommending local authorities implement effective policies on usage of electronic gear while piloting? Doesn’t USCG have regulatory oversight to require US ports, pilot associations, MV operators operating in US waters to have effective policies regarding electronic gear? PS3 - Perhaps Tesla has another future line of business
Good report Sal, I have been a Professor, an Engineer , a Physicist, A carpenter, and a ditch digger. Expanding into acting is a great move, but practice make perfect. Or as one of my professors said perfect practice makes perfect this is both a commentary on your acting and the ship's performance in this video.
Marvin, I thought you was about to break into “I’ve been a puppet, a pauper, a pirate, a poet, a pawn and a king I've been up and down and over and out…” Apologies to Frank Sinatra
The pilot’s actions in this case are simply negligent and unjustifiable, but that’s only the first layer. The captain’s indifference to the potential difficulties they might encounter departing a foreign port at night via a long, narrow, and sinuous channel is pretty astounding, too. That’s the second layer. The interesting part to me is the third mate’s role. Legally speaking, who was ultimately responsible for the safe navigation of the vessel at that point, the third mate or the pilot? My hunch is that it was the mate, in which case, he/she is ultimately responsible for the mishap. The pilot is the primary tool, a resource for the crew to utilize to safely navigate the vessel into and out of unfamiliar ports, but the pilot is not the only tool for them to use. And when a primary navigational tool malfunctions, as the third mate, what do you do? You notify the captain immediately and take action to slow the vessel, make sure you have control, and then start figuring out where exactly you are. I know it’s not the culture on many ships for JO’s to speak up to seniors-I’m ex-Navy-but sometimes that’s what the job requires. The third mate should have respectfully called out the pilot on his inattentive behavior much sooner; if he saw that the pilot’s plot and his own disagreed he should have called that out immediately and resolved it; and if he couldn’t get a satisfactory response from the pilot himself he should have called the captain back to the bridge to address the problem. Heck, even the cadet could have influenced what was going on by saying the the mate, “Sir, I don’t understand what I’m seeing on my plot. At this course and speed, we’re going to leave the channel and go aground. Can you explain this to me?” My nurses do that all the time, and I’m grateful that they do because it keeps me out of trouble.
Love watching your videos, I actually found out about your channel when ocean gate sub went missing. I work in the transport industry as a truck driver my uncle is a commercial skipper running a small charter and I'm gonna do my deck hand certification someday but very much like the career I'm in with trucking it's good money and good people. Love your channel keep it up 😊
I’m guessing that preparing the report takes a long time because it will be used for litigation and disciplinary action. So the people preparing the report have to make sure every i is dotted and t crossed. And then send it to the lawyers to make sure there’s no comeback on them either. It’s always about the money.
@@kdubyaw3246 It can't be used in litigation because it is illegal to do so. The legal authority given to the organizations that compile these reports also explicitly rules that the reports are not admissible as evidence in a court of law.
Thank you for bringing this report to the public's attention. The delay in publishing this report smacks of interference by some group which would be adversely affected. I certainly hope that the pilot got a serious punishment.
that was great , I even enjoyed the acting ! thanks for clarifying who is in charge , it would appear in theory the pilot , captain and mate should all share the responsibility , also cellphones have no place in work environment in my opinion , they should be turned off , PERIOD
BY FAR the best acting performance on youtube since we got blessed by I just want to thank you for your dedication and kind of niche but awesome presentation of topics i else would never be intrested in (never went on a ship). Through you i learn so much about the global part that is the shipping/trading. Sry for my bad english (german). Wish you a verry enjoyable day and stay save and healthy
I'm sorry but this reminds me of Costa Concordia. Man do I wish people would focus on the right things at the right time. Then everything would be better and more people would be able to return safe to friends and family. And yeah goes for everyone, remember that next time you go driving for instance or walking, biking with music in your ears.
4:20 Wow that is impressive, Keel 4-8-20 to delivery on 9-28-20, less than 6 months? That's way quicker than a house build and it was at the height of the pandemic! 😮 My house took almost 13 months to build, and doesn't have 51,655.3 HP in it. Did they get off a year or so?
Your house was built by only a few people, and has to be done from the ground up. That is, people can't be working on the upstairs before the downstairs has been built. A ship is built by hundreds of people and different components that can then be assembled.
When I heard of the report I was looking forward to your perspective that I knew would be forthcoming. Thanks as usual for your great channel and service to the industry.
For what it’s worth - a system that lets one vessel’s mistake shut down 12% of the world’s trade is already broken. Failure is not an option. Failure is mandatory. What happens when (not if) things fail is what’s important.
Really love this. Sort of reminiscent of Mentour Pilot and his breakdowns of airplane incidents, especially with respect to the social structure on the bridge and how it can affect decision making.
Another great and interesting one Sal. With Aviation the NTSB seems very detailed and excellent in comms like you said. My question to you or to anyone is does the Coast Guard have a detailed instruction or protocol for doing these type of investigations. While not frequent they are common enough that a detailed instruction or procedure should be available. NTSB has teams with various disciplines. How many people would have been involved here from the CG. Again great job. Video was very clear and enlightening.
Huh 1700 (5pm) is in the middle of the C/O watch. 00-04 is 2/o, 04-08 C/O, 08-12, capt or 3/O, Then again it's quite common to have it shift during departure, depending on port work and rest, and expected duration of pilotage. The company I sail with has forbidden phones (or personal devices) on the bridge. I think even our flag state forbids it, same rules apply as in land vehicles, don't phone and drive, period. But it's extremly weird for the master to go off the bridge when under pilotage. In my experience most captains I sail with will enforce this rule towards pilots too. or report them to their office for not doing their job.
In railroading an incident like this would have resulted in a new rule within days. BTW the operating crew cannot use non-companyissue electronics while the equipment is in motion. We can call the dispatcher when stopped.
My son and his wife are “retired” Deck Officers, DIL was recruited years ago for a Pilot post. Their firm maintains the Pilot vessel. That Pilot should loose his license!! Not only the Pilot license but his Deck Officer license. I believe that the Columbia River Bar Pilots is a partnership. If that is true in this instance.. Oh my, the insurance hit!
One question I have is what does pilot behavior tend to look like on successful trips. Are they frequently taking calls to kill the long stretches? Are they dealing with emails about other issues? These are all things that are really only looked at during a failure but may be effectively standard procedure and the interesting thing would be the deviations. The PPU offering anything other than live views while underway seems like a safety issue.
@@wgowshipping My question is not "what should they do" but "if you compared cell phone records to the logs of all pilots over the course of the last year, would you find that they're frequently on the phone while piloting?"
Well for aship master it could have been worse, imagine getting a text, that your ship is on fire in port and no one want to manage the fire fighting effort...
Start your acting career with creative, entertaining, and compelling. NOW that you ARE entertaining, greater skills can be added to your talents. You did a great job.
It's amazing how the Swiss Cheese model is carrying over into the maritime world. It's usually not a singular event but a culmination of circumstances and factors compounded by bad decisions that usually results in these catastrophes.
For the M/V Golden Ray, also here the pilot made mistakes by cutting the turns in the channel early resulting in more tilting from the ship, also the pilot requested to keep the pilot doors open, for a pctc these are watertight doors
I wonder if the “sterile cockpit” rule of commercial aviation would be useful for situations like these. Also, modern crew resource management (CRM) would definitely have the 3rd speak up with timely concerns.
Sterile cockpit in an airliner lasts a few minutes on climb-out and maybe 20 minutes on approach. "Sterile Bridge" would have to be maintained for hours at a time, and I don't think that's feasible. And, honestly, with what was going on with that pilot, we don't need to be talking about "sterile" -- we're at the level where "wash your hands after going to the toilet" would be a major improvement in bridge "hygiene".
These large container ships are much larger than the US Navy Fleet carriers, much slower and much less maneuverable. Longer planning cycle to safely make the turns on time. Distractions must not be tolerated. Nuff said from a Calvery Scout instructor.
Thanks for a great explanation of the finds. I agree, the findings this this case revealed blaring faults early on a preliminary report and calls to action should’ve been provided. This reveals great potential for future catastrophes that domino in a short period due to inaction.
I liked your comedic rendition . I understood instantly , the message you were conveying. Very good ,now do you think the investigating agencies and Coast Guard might take note? Either way don't worry your Emmy is in the bag. Thanks for my morning chuckle . C&E*Ca.USA
When Hollywood calls (as I'm sure they will) please remember us ... the little people. 😁🤣😂 Great reporting as always Dr.Sal. It's great to get follow-up reports that the so called main stream media never bothers with.
Sal - you have tied a significant number of incidents together that could cause harm to the USA. With the recent electrical grid substation, pipeline, and other “social” events, there sure are a lot of coincidences. I learned a long time ago, “most coincidences are carefully planned”.
This was a terrific professional quality video. I know nothing about ships or shipping or their navigation but your explanations were understandable. While I am not a sailor, I do know aviation as it was my career for nearly 50 years. Yes, the NTSB is incompetent. It takes usually 2 years for a final report of accident and even then they rarely make recommendations. How many deaths have been caused by their dereliction? The NTSB needs a complete overhaul overseen by an outside agency.
Excellent reporting very well explained. You’re acting is passable and very clever. I think you should go to one of the college drama classes and collect up some of the kids and do a full scale reenactment of what we’re on on the bridge. Since apparently there was recordings of audio of what went on the bridge it would be just verbatim of what was said and done I think it be very clever
Sal you missed your calling. Hollywood is looking for you. What a great video. You made a terrible situation very entertaining sad to say that. Sal can we get an update on that piolet since I am see this video so late. I am so involved with your channell now because of the key bridge. What was the end result. Do they fine the piolet. To they fire him what about the captains n that was at dinner. Give me a part two. Lol. Sorry I’m so late to this party. I am so glad I found your channell. I was in media 20 yrs. I do not trust new or reporters. I get up ever signed morning and check for your videos to keep up with the key bridge. I also what the Chief everyday that you suggested. I Lov both of u. I need a part two of this video. Lol. Tfs.
Excellent, Sal! In aviation there is the “sterile cockpit rule”. At all times, from the start of taxi to reaching 10,000 ft (ca. 3 km), altitude, both crew members are at flight control positions. All actions only pertain to flight safety and control, and all communication is limited to safety of flight or communication to air traffic control. For maritime purposes how about that at all times during port movement operations the Master, pilot, and 1st mate are at the bridge, only preforming ship navigation duties, and limiting all communications to those pertaining to ship operation and safe navigation? This would pertain to both port arrival and departure,
Honest question here... Roughly how long is the period a plane is below 10,000ft in the sterile cockpit mode? A ship maneuvering in port can be anywhere from 2 hours to 10 hours plus.
Sal - don't sell yourself short on your acting abilities. You are highly entertaining!
Very amusing while also getting the point across quite well.
@@Private-GtngxNMBKvYzXyPq lol yes I neglected to mention that fact in my original comment. I've learned so much from his videos - keep up the great work Sal!
Drug test that professor !
As an airline pilot (Ret'd), I found this quite fascinating.. the parallels with aviation are quite marked. We long ago introduced what's known as the 'sterile cockpit concept', that's to say, No non-operational conversation in the cockpit below 10,000 feet. Below that altitude the crew need to be 100% focused on the task. The fact that the 3rd Mate was ineffective in more forcefully drawing the pilot's attention to a potentially developing hazardous situation, was a common factor until 20 yrs ago (and remains so in some cultures), now CRM .. Cockpit Resource Management training ensures that irrespective of seniority and experience the captain remains approachable and sympathetic to queries by the FO and in extreme cases, the FO can, and must take control of the aircraft.
I take the point that on occasion it appears to take an inordinate amount of time before an accident report is filed. In the airline world the same criticism is often levied. We do have preliminary reports issued on many occasions but what we have to remember is that the report is not simply relating to what happened.. in many cases that's pretty obvious.. it's more to do with what 'didn't' happen. The investigation has to cover dozens, maybe hundreds of aspects that could have affected the outcome.. that takes time. What could be considered, 'The Cause Behind The Cause, Behind The Cause'. In a thorough investigation all interactions, actual or potential, mechanical and human have to be investigated.
Nice post. Your point is what I'm asking above. But different cultures. I'm of the mind ... and was trained to be more like an aircrew, but on those ships with small crews we were a bit like pirates.
Thank you, for including this information. You're correct, the 3rd Officer should have "Done Something" more to get the Pilot's attention out of his email and back on the Bridge where it belonged. I like your explanation of CRM. That kind of mindset is needed not only in an aircraft cockpit or flight deck but should be SOP among Bridge watchstanders, especially during "precision maneuvering" situations.
My understanding is that CRM has been expanded into other industries and while it used to mean Cockpit Resource Management it now means Crew Resource Management.
In the electric generation and distribution industry, for example, it is understood to mean that all control room load dispatchers (also known as system operators) are required to take appropriate action to mitigate for any conditions that might imperil the transmission and distribution systems, without regard to rank. Therefore supervising system operators strive to maintain a control room environment where everyone is encouraged to speak up.
@@DanielinLaTuna
Quite right.. I was using the original terminology..being an Old F@rt and retired.. CRM has been expanded to include 'Any' available resource, including ATC..As an instructor, I would discuss it extensively in the classroom and expand on it during simulator sessions.
There is a great video here on TH-cam of a sim session where the First Officer is being set up. He thinks it's a standard approach into some foreign airfield (I forget which one) .... and anyway the Captain, a somewhat senior guy, says "Oh I've been in here many, many times." The Captain kind of blows off the ....approach briefing. Anyway, that's the FO's first clue. "Complacency" Then the Captain is the pilot flying the approach and he seems behind the power curve. Not exactly a Top Gun day for him. (The FO's second clue) Then the approach begins falling apart and getting out of hand. (FO's third clue) Then they blow past the localizer and now the FO is looking over at the Captain visibly concerned. He mentions this to the Captain and the Captain sounding confused again goes, "No, I think we got this. I think we're OK. And again, blowing WAY past the centerline.....at which point FO says, "Captain I'm taking over. Ive got the airplane and we're doing a missed approach." The Captain acts confused and says, "Well, OK." He played his part very well. I probably have some of the quotes not exactly right but that's the gist of it. It's good to know they train to that level. To give them actual, experience in taking over to prevent an accident....rather than just discussing it in a classroom.
Commercial aviation has periods before landing and take off which are called sterile, which means the only appropriate topics of conversation even between the crew, are matters directly related to the operation of the aircraft.
Aviation has set excellent examples for many critical situations, including hospitals!
@@veramae4098 Not so great examples recently in general aviation.
@@tedmoss General aviation is safer now than it has ever been. Please have knowledge before you make libelous statements. Adjusted for hours flown, the general aviation accident rate was down 13% over the last five years. That being said, the NTSB is as negligent in it's overseeing of aviation as it is in the nautical instance. It needs to do better.
@@williampotter2098agree. It’s a bit lazy to slate general aviation, there are many reasons that the accident rate may be higher but every GA pilot I’ve ever flow with takes their responsibility seriously.
I think multiple hours of fully sterile cockpit would be really hard to enforce, but I agree that there needs to be more regs around distraction when transiting a channel like this.
And the OSCAR goes to ……(Wait 9 months and we’ll tell you) yes the Oscar goes to Sal for .. Best Actor in a Container Shipping Drama !!!
I WANT TO THANK EVERYONE WHO MADE THIS POSSIBLE...
Sal, your acting might not get you an Emmy. But it clearly put the report into a visual media for people. Totally worth it. Thank You. Keep the facts rolling. I rely on you for facts about the Port of LA and the Port of Long Beach. As well as the cargo industry.
I disagree. Not an Emmy. Emmy's are for TV. Sal needs to be nominated for Best Actor Oscar and Best Supporting Actor Oscar in a Comedy of Errors Drama across multi-media platforms. He should win both. A first for any actor.
...and its by far, the best acting I've seen today.
Great report Sal, thanks. Attention to detail & situational awareness while on duty. This was hammered into me daily for 46 years of US Naval service as a ships force member, Fleet maintainer, USN sailor, MSC Mariner and NAVSEA systems lead engineer. Simply put, Pilot 1 negligently “lost the bubble” and performed his duties in a derelict manner. Too bad he won’t go to NJP. USCG Board of Inquiry can pull his license for cause.
His license should be pulled this is negligence
@@kp6215 It was. The pilot is going through the administrative law process but Maryland yanked his ability to be a pilot. Pretty much everyone has more leeway in calling themselves a Maryland pilot than this guy after the order from Maryland.
@@kp6215 Jailed, this could of been much worse. Imagine if the ship ruptured it's fuel tanks or he grounded an oil tanker...
Great vid Sal! Very good analysis. I'm curious why the USCG recommends that the ship operators have a cell phone policy but doesn't say boo about pilot's associations having one. A better trained bridge team might have been able to head off the problem earlier by using a graded assertiveness tool such as PACE (Probe, Alert, Challenge, Emergency). I've experienced this kind of Pilot distraction first-hand. It's important to remember this isn't charity. Ship operators pay Pilots a ton of money for their services. It is fair to expect their full attention. Keep up the fine work you do!
I for one enjoyed your introduction acting.
As a US Navy Navigator, and a LtJg (pretty junior) More than once I made the call "Navigation does not concur" when someone senior to me started a maneuver that I thought dangerous. It takes a willingness to sound off which may well not have been something that was smiled on by that ship's deck department coming from the most junior deck officer. But, something like "pilot, I recommend turning to 180 at this time" might have gotten the pilots head removed from his rectum. The pilot having the conn, being the most knowledgeable person on the bridge, and the 3rd officer being the most junior deck officer on board may all have come into play in this case.
Sal, thank you for the detailed report.
David
Communication is a fantastic tool ... when people use it.
Enlisted USN PO1 (SW) retired here. Thank you for your service Sir.
@@robertf3479 Mustang, EM1 and SWO. Thank You for your service as well.
I've already submitted this video to the academy. I fully expect your performance to be nominated.
Great intro there Sal; I'm actually surprised that the port had a policy of single pilot operations with vessels of this size. I know the Dutch have two pilots for these large container ships. Also as an ex Master I was quite used to eating my meals standing up on the bridge. 🙃
Sal ThankYou
Sal, as a former USCG officer, I’m completely dumbfounded that such callous disregard for safety occurred while navigating a large vessel in a major US port. I think your comments are spot on, especially as to why the third officer did not assume command when he was obviously aware that the ship was in danger of grounding.
While I agree that it’s highly unlikely that a junior officer would relieve a pilot, he still had responsibility for safe navigation of the vessel. At a bare minimum, he should have ordered engines astern to slow the vessel until such time as the course could be corrected.
It seems there was too much emphasis by the pilot and others to “cover their six” and not enough initiatives taken to avoid a disaster. This also applies to the Coast Guard as well. In the old days, command didn’t have to review everything with legal before taking action. Now, nothing gets done until the lawyers have had their say. I blame a lot of that on the restructuring of the Coast Guard into DHS. The current political climate has the CG acting more as a second naval force vs their traditional role of ensuring maritime safety.
Both the pilot and the ships master should lose their credentials for abdicating their responsibility, and I believe the third officer should face discipline for his failure to take action.
I think this is where the issue of culture and crew resource management comes in. If the third officer is Taiwanese or similar then their culture is not to challenge a person of higher rank.
Good reporting, really reflects society in general giving themselves permission to be distracted by cell phones and technology and not taking their jobs and responsibilities seriously. The consequences of not taking their responsibilities seriously are huge. I’m sorry I think that all of the parties involved were self absorbed and not taking their jobs seriously. What will be their consequences?
"I think that all of the parties involved were self absorbed and not taking their jobs seriously"
I dispute that. The pilot and master, sure, but I don't think it's fair to blame the inexperienced junior officer for being inexperienced and junior and not effectively raising concerns. It sounds like a systemic problem that junior officers need to be trained to raise concerns, and senior officers need to be trained to receive those concerns (commercial aviation calls this Crew Resource Management) but it's not the third officer's fault that the system didn't give him that.
From the movie "Don't Look Up" to Don't talk on your phone when running around in a port with a huge vessel does not seem too unusual in this day and time. People in charge seem to be less and less professional for some reason. Keep reminding us of the expectations of these endeavors and what "professionalism" requires. Thank you for your commitment.
"I'm on the phone"... comedy gold. Loved the "dramatization" of the incident. Great factual report also. Pilot needs ticket pulled and retraining from scratch if he's not going to be let go. We've always heard that the Master has ultimate responsibility for vessel operations when a pilot is embarked. If the Master turned the con over to the pilot, does the 3rd Mate have any real say? Good that the Pilot didn't block the port with his shenanigans.
Sal,
As always very informative and much appreciated. The issue with pilots and bridge team management has been in question throughout my professional career. I am still mystified that incidents of this type continue to happen.
In my career I have been indirectly or directly involved in incidents involving tankers entering a channel prior to the pilot boarding, grounding a ship while in the process of going to anchor with a pilot on board, and an allision with a pilot on board. In all three the Master was on the bridge, per company policy.
In the first instance the ship had entered a channel prior to picking up the pilot. The Master was on the bridge with a watch officer and an able-bodied seaman. The Master was signing crew members off the ship prior to arrival to help speed the process of the crew change after arrival. The Master took the watch from the mate and sent him to locate a crew member who needed to sign off. The ship passed three red buoys on the left before it grounded. Luckily it hit soft bottom. The bottom was rocky less than half the beam of the vessel to the right.
The second involved the tanker being taken to anchor with the Pilot, Master and Mate on the bridge. One of the first things I was taught as a naval architect is that you can't drive a ship drawing 42' in 41' feet of water. 5,700 barrels and $14M later the spill was cleaned up.
In the third case the ship departed the dock after discharge with a deck officer, Master, Pilot and AB on the bridge. There were reports of dense fog in the area. The Pilot was confident the fog would not impact the vessel. The ship approached a bridge in very restricted visibility. It sideswiped the bridge fendering cutting two holes, one 10'x100' and one 10'x200'.
The company I worked for changed bridge team management practices. Pilots were brought to simulator training to make them an integral part of the bridge team. Training was designed to assure everyone on the bridge worked as one and communication was a key part of the process.
As a naval architect in developing the design of new tankers we keyed on design improvements. We focused on bridge layout; totally enclosed, servo-controlled joy sticks so all move together, closed circuit TV showing the steering gears, identical displays in the engine room so the engineers can see both rudder demand and movement, and a raised table and bench so the Master and Pilot can sit and eat meals while watching what is happening.
It is time that the USCG develops uniform requirements for vessel Pilots and bridge team management in pilot waters.
Bob
Jason over at Fire Department Chronicles has a new competitor for top TH-cam Comedian! Well done Sal!
We both have the same hair style!
I love the skit Sal! This report just makes em shake my head in wonder.
U make shipping INTERESTING and UNDERSTANDABLE!! That is what a great teacher does!
Can I tell you that I saw that the report had been released and I purposely did not seek out to read anything about, let alone the report itself, because I was waiting for you video, and I have not been disappointed!!
Even with the bad acting?
@@wgowshipping Especially with the bad acting
Your corner movie production is far ahead of what Hollywood is currently coming up with by a Mile Sal! well done sir!
Sal I love your quirky ness!!!! Keep the skits coming!!!!!
Great intro! Complacency bites you in the tail.
Just to illustrate what should have happened; If I was the captain, I would never have left the helm. If I were the 3rd mate, I would have made sure the pilot was doing his job and taken over control immediately there was a derivation from proper procedure and called the captain. And if I was the pilot I would have paid attention to my job and not, not, been using the cell phone. My experience tells me that people don't conceive the massiveness of large objects, power systems, ships, planes, trucks, trains, etc. It seems hard to impress physics on people. The recent increase in the incidence of very bad road accidents is illustrative of the tendency to push the limits because of the false feeling of safety from improved equipment. This has been noted by others. I'm 79 years old so I have learned my lessons. I was an operations supervisor on the electrical grid and experienced these things myself. Some of us sat in Phoenix and wondered what Enron thought they were doing as we watched them crash.
Sal,
Your acting is much better than most TV today.
With all this information known so quickly there is no reason for some of it being released within a couple of days. A little info soon after the grounding possibly could have alerted other pilots around the world and made them more aware of their phone use. Great breakdown of the report.
Thanks Phil Stevens
Your intro was a classic! With regard to missing a turn, I've done the same thing. Of course I was a student navigator in UNT (Air Force) and it was my first ride in the T45 simulator. I was still trying to get the work flow down and I was waaay behind the plane. There were no cell phones and I didn't have 15+ years experience. The complete lack of situational awareness says it all. CRM, or Cockpit Resource Management was developed to address situations like this in the cockpit, and perhaps a similar program should be developed for the bridge (if it has not already been done). I have a major safety briefing coming up for my CAP squadron, and this is going to be part of it.
There absolutely is a maritime equivalent to CRM. They literally call it "Bridge Resource Management"
@@potathooo Does Evergreen use it? Please don't take my comment the wrong way, the snark is targeted toward Evergreen and the harbor pilot. It sounds like the Third Mate was carefully trying to get the pilot back in focus without pissing him off. At least there were no injuries or fatalities from this accident.
@@robertjune1221 Honestly, I have no clue. The only thing I know is that the concept exists and is a common element in the training of maritime deck officers
And if evergreen didn't train their staff on BRM before, I'm sure they really focus on it now lol
Thanks, Sal. I knew you would give us the report when it became available. Loved the intro, too!
Glad you liked it!
At 16:53, the third officer announces his course and speed. This is the point where it could have all been avoided. The third officer making his announcement should have been taken as a "Check your course and speed!" by the pilot. It is my opinion as a retired Marine Investigator that the Third officer saw what was happening and in the only way he could, he announced his last received command to get the pilot to look up from his distraction. The amount of details in the observations taken by the third officer during the transit shows that they were paying attention to everything going on.
Besides the obvious, there would be no story here, what would ramifications of the ship's officer just ... well, taking control and doing the right things, slowing the ship, backing her even and putting her back in the channel be ? As a retired Marine Investigator you are the guy to ask.
Could that Third Officer, on noting that the Pilot was STILL off in his own little world have "taken the Conn" and tried to execute the starboard turn to 180? Or would "The Rules" have prevented that?
I believe in aviation speak a pilot can read back the instructions he has been given by air traffic control with the prefix "Confirm..." The ATC is expected to stop and reconsider those directions.
Culturally, it may be that the lower ranked 3rd officer couldn't directly challenge his superior. I believe that this was observed as an issue with the Koreans in aircraft and required substantial re-training (and probably personnel changes) to overcome.
@@travelertime4382 If the third officer had taken control, slowed the ship down and put her back in the channel, they'd be a hero among the people on the bridge at that time, and nobody else would know a thing. However, had the third officer taken control, slowed the ship down and run her aground on the opposite side of the channel, they'd be in a enormous amount of trouble.
The pilot is on board because they are the expert in navigating those specific waters. The third officer is a third officer because they are inexperienced and do not yet have the decision-making expertise to take control in a situation like this. If the third officer was capable of doing all the things you're asking them to do, there'd be no need for a second officer, first officer or master. As we see from the fact that the third officer did subtly question the pilot's actions, they were capable of seeing that something was wrong, but they didn't necessarily know how to do it right, so couldn't necessarily take corrective action themselves. The issue is the cultural one, that the third officer didn't feel able to (or wasn't trained to) effectively raise their concerns, and the pilot wasn't keyed in to receiving concerns from the third officer.
“4.1.41. At 2101, Pilot I notified Sector Maryland National Capital Region that the EVER FORWARD was grounded via cell phone.” LOL. Sounds like a pretty accurate summary to me.
Good report , your opening made me smile , it was right to the point! Like many jobs out there ,there is a reason for procedures even tho it may seem mundane at times . Let’s just say I wouldn’t put someone like that on point….if you know what I mean…keep up the good work Sal , calm seas and fair winds my friend !
Railroading has a saying regarding all the rules and regulations put in place by the FRA (Federal Railway Administration) about the rules being the results of lessons written in blood.
This Pilot and this Ship's Master should never be trusted on a Bridge again. I don't think I'd even trust them on a Bass Boat on a mill pond.
In the background, looks like you are building the LEGO model of the SS Titanic. My wife completed it a few months ago. The detail that is contained on the inside of the Titanic is amazing.
Sal, I Agree with your assertion that USCG took way to long to get preliminary information out. I wonder why you did not mention that the USCG did not take the pilots License or Pilot credentials away. Maryland did, but as a US professional Mariner the pilots actions were grossly deficient and the USCG should have taken is Pilot endorsements away as a minimum, and his License as full measure of this officers incompetence on a bridge. JMHO
Excellent follow up Professor Sal or Movie Star Sal. Maybe the pilot plug his controller (GPS?) into the ships Xbox and was streaming through his phone...lol
On a serious note commercial truck drivers are forbidden to drive and text and all communications must be via headset. I heard about the pilot talking to his girlfriend but didn't believe it. Along with the absence of the pilot and captain off the bridge eating. As you put it why wasn't food brought to the bridge.
Can you imagine the call to Evergreen HQ, "Hi, Ever Forward here just marking the Ever Given anniversary."
Thanks again Sal for the update with your reliable sources. I couldn't believe what reading and thought you couldn't make this sh*t up...
For a Master to leave the bridge in confined waters - that to with a 3rd mate, just to go and have his meal is a bad idea. Either eat on the bridge or eat after the manouvering when the ship is at sea. I doubt he’ll ever make that mistake again! Thanks for sharing the report. I wish we could have had a report on the Suez incident as well. It would probably have been something equally ridiculous. This shipping company needs some serious reorganisation ! 😊
You mean you can no longer go for dinner and play with your phone while navigating a complex channel with high traffic present?!
Does that even need a discussion?
"and began drafting an email" lmao
Right?
Your 'skit' was fun...Thank you for all the coverage & information...🇺🇸 😎👍☕
I took the con from a pilot once. 2nd mate, about 3am North Sea. Captain was below. We were getting close to a fishing vessel crossing our bow. Too close for my comfort. I looked at the pilot, he was asleep in the captain's chair. I gave (whispered) a helm order to increase the overtaking distance. I told the AB on the wheel that the pilot was asleep and that I was giving the orders. He chuckled. The pilot woke up with a start, flew out of the chair, saw this mass of glaring white lights just off starboard bow. I told the pilot we should overtake him at a safe distance because I ordered a course change. The pilot ordered a course change of a few more degrees to what I ordered. I told the AB that the pilot was awake now. He chuckled again.
Maybe they should at least use Crew resource management (CRM) from the airlines in that anyone can speak up if there is something that is overlooked or someone/thing is in danger without fear of being punished. Even the AB "driving" the boat could have spoke up and said hey we aren't turning and the channel markers are coming up. He should have been able to raise the flag to get everyone's attention at that point too. Heck even the pilot should have asked the captain to stay on the bridge until his disembarkation. Its not just one thing that causes a disaster in the making. Good video and acting, better watch out or J.J. Abrams will cast you for one of the Ever Given or Ever Forward movie dramas! 😁🤠
Sal that lead in was funny as the dickens. You nailed it. Taking something that serious and making it funny while tying the truth around the Pilots neck in spectacular fashion.
Loving the debriefs and historical hermeneutics. Thanks!
Appreciate the support!
Ignoring the cell phone aspect for the moment. I am amazed that the outbound course wasnt plugged into the auto nav system. Then small manual adjustments made as necessary. Manual helm all the way out? Interesting.
The bridge should follow the "Sterile Bridge Environment" .... similar to that of the Airlines "Sterile Cockpit "
I could add volumes about ship pilots problems in the Baton Rouge to open waters but won’t. All I can say that there are a lot of incidents that occur because the lost of situationally awareness both on towboats and ships. Dependence’s on technology piloting has brought this problem about. Before electronic navigation and cellphones situationally awareness wasn’t that big of a problem. I worked through both the technology advanced world and without technology. I can say that I liked the non-technology world better. Good reporting Sal.
That was a scream!
Your best opening yet (cannot stop laughing - not just action, but the context... do more of them!)
I laughed - You encapsulated the report in your sketch! Hilarious. We have been waiting so long to hear what the story was!
Sal, maybe I missed it, but does the local Baltimore area pilot association have a written policy on cell phone usage by a pilot while actively piloting a MV?
PS - Will there be a follow on video on who bares the ultimate cost for this incident? P&I Club, pilot insurance carrier, …
PS2 - Why is USCG recommending local authorities implement effective policies on usage of electronic gear while piloting? Doesn’t USCG have regulatory oversight to require US ports, pilot associations, MV operators operating in US waters to have effective policies regarding electronic gear?
PS3 - Perhaps Tesla has another future line of business
There is no policy by the Maryland State Pilots Association.
I will keep everyone posted as more develops, especially regarding the insurance.
Good report Sal, I have been a Professor, an Engineer , a Physicist, A carpenter, and a ditch digger. Expanding into acting is a great move, but practice make perfect. Or as one of my professors said perfect practice makes perfect this is both a commentary on your acting and the ship's performance in this video.
Marvin, I thought you was about to break into “I’ve been a puppet, a pauper, a pirate, a poet, a pawn and a king
I've been up and down and over and out…”
Apologies to Frank Sinatra
The opening sketch was suitable for such an odd report. Set the tone so to speak, great show.
Love the acting in this. Emmy award winning.....
The pilot’s actions in this case are simply negligent and unjustifiable, but that’s only the first layer. The captain’s indifference to the potential difficulties they might encounter departing a foreign port at night via a long, narrow, and sinuous channel is pretty astounding, too. That’s the second layer. The interesting part to me is the third mate’s role. Legally speaking, who was ultimately responsible for the safe navigation of the vessel at that point, the third mate or the pilot? My hunch is that it was the mate, in which case, he/she is ultimately responsible for the mishap. The pilot is the primary tool, a resource for the crew to utilize to safely navigate the vessel into and out of unfamiliar ports, but the pilot is not the only tool for them to use. And when a primary navigational tool malfunctions, as the third mate, what do you do? You notify the captain immediately and take action to slow the vessel, make sure you have control, and then start figuring out where exactly you are. I know it’s not the culture on many ships for JO’s to speak up to seniors-I’m ex-Navy-but sometimes that’s what the job requires. The third mate should have respectfully called out the pilot on his inattentive behavior much sooner; if he saw that the pilot’s plot and his own disagreed he should have called that out immediately and resolved it; and if he couldn’t get a satisfactory response from the pilot himself he should have called the captain back to the bridge to address the problem. Heck, even the cadet could have influenced what was going on by saying the the mate, “Sir, I don’t understand what I’m seeing on my plot. At this course and speed, we’re going to leave the channel and go aground. Can you explain this to me?” My nurses do that all the time, and I’m grateful that they do because it keeps me out of trouble.
Love watching your videos, I actually found out about your channel when ocean gate sub went missing. I work in the transport industry as a truck driver my uncle is a commercial skipper running a small charter and I'm gonna do my deck hand certification someday but very much like the career I'm in with trucking it's good money and good people. Love your channel keep it up 😊
I’m guessing that preparing the report takes a long time because it will be used for litigation and disciplinary action. So the people preparing the report have to make sure every i is dotted and t crossed. And then send it to the lawyers to make sure there’s no comeback on them either. It’s always about the money.
And then who knows how many layers or managers and committees have to sign off on it.
A lot of back and forth goes on before advancing to the next level for approval before it hits final approval.
No, these kinds of reports explicitly cannot be used for litigation.
@@beeble2003 Tell us why it can't be used in any type of litigation Judge Wapner?
@@kdubyaw3246 It can't be used in litigation because it is illegal to do so. The legal authority given to the organizations that compile these reports also explicitly rules that the reports are not admissible as evidence in a court of law.
This opening is a classic. I never suspected you had acting chops.
Your intro was better than the Poseidon Adventure.
Thank you for bringing this report to the public's attention. The delay in publishing this report smacks of interference by some group which would be adversely affected. I certainly hope that the pilot got a serious punishment.
I dunno'... I think the acting was spot-on Sal!!
Another wonderful episode!!
that was great , I even enjoyed the acting ! thanks for clarifying who is in charge , it would appear in theory the pilot , captain and mate should all share the responsibility , also cellphones have no place in work environment in my opinion , they should be turned off , PERIOD
"""I am on the phone!!!!😤😤😤"'' 🤣😂Sal, the lines were great! A great way to start this video, and great content creation.
Thanks so much!!
BY FAR the best acting performance on youtube since we got blessed by
I just want to thank you for your dedication and kind of niche but awesome presentation of topics i else would never be intrested in (never went on a ship). Through you i learn so much about the global part that is the shipping/trading. Sry for my bad english (german). Wish you a verry enjoyable day and stay save and healthy
And there you have it. No calls or text while operating a motor vehicle!
I'm sorry but this reminds me of Costa Concordia. Man do I wish people would focus on the right things at the right time. Then everything would be better and more people would be able to return safe to friends and family. And yeah goes for everyone, remember that next time you go driving for instance or walking, biking with music in your ears.
Both cases of ‘thinking with the wrong head’
Hi Very run thru . The groundings at sea by you is perfect. I like the shirt
Glad you like it
Last time I heard, the only way to get in is by inheritance. The idea of a pilot getting lost for an hour on the phone...inconceivable.
Great video! Thank you for your effort.
4:20 Wow that is impressive, Keel 4-8-20 to delivery on 9-28-20, less than 6 months? That's way quicker than a house build and it was at the height of the pandemic! 😮 My house took almost 13 months to build, and doesn't have 51,655.3 HP in it. Did they get off a year or so?
Your house was built by only a few people, and has to be done from the ground up. That is, people can't be working on the upstairs before the downstairs has been built. A ship is built by hundreds of people and different components that can then be assembled.
When I heard of the report I was looking forward to your perspective that I knew would be forthcoming. Thanks as usual for your great channel and service to the industry.
It appears shipping could take a lesson from aircraft and implement a sterile bridge operation during operations in port and while in narrow channels.
What! They don't do that already?
How long are these sterile periods? I have transits that last longer than a Trans-Pacific flight.
For what it’s worth - a system that lets one vessel’s mistake shut down 12% of the world’s trade is already broken.
Failure is not an option. Failure is mandatory.
What happens when (not if) things fail is what’s important.
I was a master helmsman on a cruiser for four years. I've never seen a pilot take the con. I didn't even know that was a thing.
Really love this.
Sort of reminiscent of Mentour Pilot and his breakdowns of airplane incidents, especially with respect to the social structure on the bridge and how it can affect decision making.
Another great and interesting one Sal. With Aviation the NTSB seems very detailed and excellent in comms like you said. My question to you or to anyone is does the Coast Guard have a detailed instruction or protocol for doing these type of investigations. While not frequent they are common enough that a detailed instruction or procedure should be available. NTSB has teams with various disciplines. How many people would have been involved here from the CG. Again great job. Video was very clear and enlightening.
Caution here, bureaucracies are all the same.
Comes back to familiarity leads to contempt.
the doctrine of "last clear chance" would come into play when the third officer did not exercise his duty!
Huh 1700 (5pm) is in the middle of the C/O watch. 00-04 is 2/o, 04-08 C/O, 08-12, capt or 3/O,
Then again it's quite common to have it shift during departure, depending on port work and rest, and expected duration of pilotage.
The company I sail with has forbidden phones (or personal devices) on the bridge. I think even our flag state forbids it, same rules apply as in land vehicles, don't phone and drive, period.
But it's extremly weird for the master to go off the bridge when under pilotage.
In my experience most captains I sail with will enforce this rule towards pilots too. or report them to their office for not doing their job.
One of the best video's yet...
In railroading an incident like this would have resulted in a new rule within days. BTW the operating crew cannot use non-companyissue electronics while the equipment is in motion. We can call the dispatcher when stopped.
My son and his wife are “retired” Deck Officers, DIL was recruited years ago for a Pilot post. Their firm maintains the Pilot vessel.
That Pilot should loose his license!! Not only the Pilot license but his Deck Officer license.
I believe that the Columbia River Bar Pilots is a partnership. If that is true in this instance.. Oh my, the insurance hit!
That was The best entertainment I have seen in years quality
I had to watch it twice, it was so good.
Thanks Matt!
Thanks Ted!
One question I have is what does pilot behavior tend to look like on successful trips. Are they frequently taking calls to kill the long stretches? Are they dealing with emails about other issues? These are all things that are really only looked at during a failure but may be effectively standard procedure and the interesting thing would be the deviations.
The PPU offering anything other than live views while underway seems like a safety issue.
They should not be on the phone at all, unless it deals with the navigation of the ship.
@@wgowshipping My question is not "what should they do" but "if you compared cell phone records to the logs of all pilots over the course of the last year, would you find that they're frequently on the phone while piloting?"
Well for aship master it could have been worse,
imagine getting a text, that your ship is on fire in port and no one want to manage the fire fighting effort...
I tip my hat to you!
Start your acting career with creative, entertaining, and compelling. NOW that you ARE entertaining, greater skills can be added to your talents. You did a great job.
You just won my Maritime Oscar for best actor in an Ever Forward negligence video!
Loved the intro! Excellent job as always.
It's amazing how the Swiss Cheese model is carrying over into the maritime world. It's usually not a singular event but a culmination of circumstances and factors compounded by bad decisions that usually results in these catastrophes.
For the M/V Golden Ray, also here the pilot made mistakes by cutting the turns in the channel early resulting in more tilting from the ship, also the pilot requested to keep the pilot doors open, for a pctc these are watertight doors
Great job Sal. Support Jones Act!
I wonder if the “sterile cockpit” rule of commercial aviation would be useful for situations like these. Also, modern crew resource management (CRM) would definitely have the 3rd speak up with timely concerns.
Sterile cockpit in an airliner lasts a few minutes on climb-out and maybe 20 minutes on approach. "Sterile Bridge" would have to be maintained for hours at a time, and I don't think that's feasible. And, honestly, with what was going on with that pilot, we don't need to be talking about "sterile" -- we're at the level where "wash your hands after going to the toilet" would be a major improvement in bridge "hygiene".
These large container ships are much larger than the US Navy Fleet carriers, much slower and much less maneuverable. Longer planning cycle to safely make the turns on time. Distractions must not be tolerated. Nuff said from a Calvery Scout instructor.
Thanks for a great explanation of the finds. I agree, the findings this this case revealed blaring faults early on a preliminary report and calls to action should’ve been provided. This reveals great potential for future catastrophes that domino in a short period due to inaction.
I liked your comedic rendition . I understood instantly , the message you were conveying.
Very good ,now do you think the investigating agencies and Coast Guard might take note?
Either way don't worry your Emmy is in the bag.
Thanks for my morning chuckle .
C&E*Ca.USA
When Hollywood calls (as I'm sure they will) please remember us ... the little people. 😁🤣😂 Great reporting as always Dr.Sal. It's great to get follow-up reports that the so called main stream media never bothers with.
Thanks for the excellent breakdown of this report Sal. Your content just keeps getting better!
Truly an Oscar moment! I will be forwarding a copy of this tape to the academy ASAP!
Sal - you have tied a significant number of incidents together that could cause harm to the USA. With the recent electrical grid substation, pipeline, and other “social” events, there sure are a lot of coincidences. I learned a long time ago, “most coincidences are carefully planned”.
This was a terrific professional quality video. I know nothing about ships or shipping or their navigation but your explanations were understandable. While I am not a sailor, I do know aviation as it was my career for nearly 50 years. Yes, the NTSB is incompetent. It takes usually 2 years for a final report of accident and even then they rarely make recommendations. How many deaths have been caused by their
dereliction? The NTSB needs a complete overhaul overseen by an outside agency.
Professional? Did you skip the first 60 seconds? :)
Best intro ever!
Keep your reports coming.
Excellent reporting very well explained. You’re acting is passable and very clever. I think you should go to one of the college drama classes and collect up some of the kids and do a full scale reenactment of what we’re on on the bridge. Since apparently there was recordings of audio of what went on the bridge it would be just verbatim of what was said and done I think it be very clever
Sal you missed your calling. Hollywood is looking for you. What a great video. You made a terrible situation very entertaining sad to say that. Sal can we get an update on that piolet since I am see this video so late. I am so involved with your channell now because of the key bridge. What was the end result. Do they fine the piolet. To they fire him what about the captains n that was at dinner. Give me a part two. Lol. Sorry I’m so late to this party. I am so glad I found your channell. I was in media 20 yrs. I do not trust new or reporters. I get up ever signed morning and check for your videos to keep up with the key bridge. I also what the Chief everyday that you suggested. I Lov both of u. I need a part two of this video. Lol. Tfs.
Very funny intro😂 Love the content. Best wishes for continued success.
Thank you so much 😁
Excellent, Sal! In aviation there is the “sterile cockpit rule”. At all times, from the start of taxi to reaching 10,000 ft (ca. 3 km), altitude, both crew members are at flight control positions. All actions only pertain to flight safety and control, and all communication is limited to safety of flight or communication to air traffic control. For maritime purposes how about that at all times during port movement operations the Master, pilot, and 1st mate are at the bridge, only preforming ship navigation duties, and limiting all communications to those pertaining to ship operation and safe navigation? This would pertain to both port arrival and departure,
Honest question here... Roughly how long is the period a plane is below 10,000ft in the sterile cockpit mode? A ship maneuvering in port can be anywhere from 2 hours to 10 hours plus.