Inquiry finds North Sea helicopter crash could have been prevented
14 March 2014
A North Sea helicopter crash that claimed the lives of 14 oil workers and two crew might have been prevented, a fatal accident inquiry has found. The men died when a Bond Offshore Super Puma plunged into the sea off the Aberdeenshire coast on 1 April, 2009.
After a six-week inquiry, Sheriff Principal Derek Pyle said on March 13 that the aircraft’s operator had failed to follow maintenance procedures days before the crash. He said a “fundamental rule”, that maintenance must be done by the book, had been broken.
The sheriff said: "During the course of the inquiry there was much discussion about the circumstances which led Bond not to follow the clear terms of the maintenance.”
He found Bond had failed to follow the aircraft maintenance manual six days before the crash, after a fragment of metal was found in the gearbox. He concluded that on the balance of probabilities that spalling - the fracturing of metal - in the gearbox was the probable cause of the accident.
Bond failed to ensure communication with manufacturer Eurocopter were carried out according to procedure, with the result that “misunderstandings arose between the parties” and contributed to the failure to carry out the maintenance properly.
The sheriff said that while it was “certainly possible” the gearbox would have been replaced if Bond had carried out the maintenance, that had not been proved “on the balance of probabilities”.
He said: “The essential fact is that everyone in the company well knew that maintenance must be done by the book. On one occasion, that fundamental rule was broken. It resulted in the failure to detect a significant fault in the helicopter’s gearbox, which possibly – but only possibly – resulted in the crash.”
The inquiry heard a witness account of how the helicopter fell from the sky like a torpedo, followed separately by its detached rotor blades.
An earlier Air Accidents Investigation Branch (AAIB) report found the helicopter had suffered a “catastrophic failure” of its main rotor gearbox.
Jim McAuslan, general-secretary of pilots’ union Balpa, said: “The operator’s maintenance failures are the main lesson for the industry – maintenance must never be treated lightly. Sadly, this accident was preventable, but not survivable, and the pilots had no chance to save the lives of the passengers due to the mechanical failures.”
Bond Offshore said: “We have always accepted that we made mistakes through honest confusion over telephone calls and e-mails. Lessons needed to be learned, lessons have been learned and lessons continue to be learned. We are absolutely committed to continuing to drive safety improvements across the business.”
Manufacturer Airbus Helicopters, previously known as Eurocopter, said it would analyse the inquiry’s recommendations.
“The company took immediate action following the accident to understand the contributing factors and to enhance the safety of the fleet. Airbus Helicopters are confident that the actions implemented to date remove any risk of such a dramatic event recurring.”
The Crown Office has decided not to prosecute Bond. In a statement, it said: “For a criminal prosecution to have taken place, the Crown would have to prove its case beyond reasonable doubt. The sheriff principal makes clear a reasonable doubt remained over the technical cause of the crash.
“The evidence presented during the FAI has not altered the insufficiency of evidence, therefore the decision not to hold criminal proceedings remains the correct one.”
Families of the victims have been critical of the decision not to prosecute, and have joined trade unions in calling for a full public inquiry into offshore safety in the North Sea.
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