Conception Dive Boat NTSB Report

[Larmo]

Includes statements of the entire crew. https://dms.ntsb.gov/pubdms/search/...1021dbc87-F11970CF-5056-942C-92BCB46F37C925B2

As predicted they were all sound asleep. Also seems like there was a history of electrical issues in the galley, according to crewman, Ryan.

And as predicted it’s rumored quite strongly that one or more indictments for criminally negligent homicide are imminent.

According to the report there were a number of safety breakdowns that were common practice in that fleet and were known to the owner who was also a licensed <100 ton mariner. That makes the vessel unseaworthy legally and it assigns privity to the owners which will preclude the Federal Court limitation of liability action from proceeding.

His business is gone. He will likely face criminal charges and he will live with the knowledge that his conduct contributed to the deaths of over 30 people in his care. If that isn’t a lesson for all, idk what else it would take.

 

[One_Leg]

Hell of a way to go.

RIP, fellow divers.

 

[Xue]

At least it may put every boat operation on alert to safety.

 

[1steveT]

Geeez, what a nightmare.

 

[Mtnfshr]

as predicted it’s rumored quite strongly

Like Joe Friday often said, "Just the facts."

Such a sad and avoidable event. Or at least with a better outcome for all aboard.

 

[MYNomad]

How come we have never seen the conclusion of the investigation into Attessa IV - Prowler collision? Or perhaps I missed it. But that one is likely to be more instructive for the rest of us, so I would love to learn whatever can be learned from that.

 

[Laukia]

Questions..........from a layman's perspective>>

Why isn't the interview with the Conceptions' captain included with all the NTSB reports/documents?

The 52 pages of the interview with the owner is incredibly damning in my opinion. His lawyer was present, but evidently never was instructed to not answer or clarify his answers. Evidently there was no company safety policy protocol written down anywhere or followed other than to rely on the captain and crew instructions. Likewise the owner said the crew could/would possibly do electrical upgrades or repairs and he (the owner) did not know for certain the number of electrical receptacles on the vessel or when (or if) they had been changed out. The logs for the vessel's mechanical/engine maintenance were kept on the vessel (lost in the fire) with no back up records on file onshore. This guy is in deep, deep shit.

 

[rexor_rn]

Includes statements of the entire crew. https://dms.ntsb.gov/pubdms/search/...1021dbc87-F11970CF-5056-942C-92BCB46F37C925B2

As predicted they were all sound asleep. Also seems like there was a history of electrical issues in the galley, according to crewman, Ryan.

And as predicted it’s rumored quite strongly that one or more indictments for criminally negligent homicide are imminent.

According to the report there were a number of safety breakdowns that were common practice in that fleet and were known to the owner who was also a licensed <100 ton mariner. That makes the vessel unseaworthy legally and it assigns privity to the owners which will preclude the Federal Court limitation of liability action from proceeding.

His business is gone. He will likely face criminal charges and he will live with the knowledge that his conduct contributed to the deaths of over 30 people in his care. If that isn’t a lesson for all, idk what else it would take.

Hopefully Justice will be given to the innocent victims and the boat owner should be held criminally liable to the maximum penalty the law allows.

Eventhough all his assets and properties will be garnish but this are still not enough to compensate to the lives lost of those innocent victims.

Kudos NTSB! Painful lesson for the greediness of putting profits above safety in any business.

 

[Larmo]

How come we have never seen the conclusion of the investigation into Attessa IV - Prowler collision? Or perhaps I missed it. But that one is likely to be more instructive for the rest of us, so I would love to learn whatever can be learned from that.

The criminal investigation would have expedited this report. The Prowler report still isn’t available.

 

[Phil]

Questions..........from a layman's perspective>>

Why isn't the interview with the Conceptions' captain included with all the NTSB reports/documents?

The 52 pages of the interview with the owner is incredibly damning in my opinion. His lawyer was present, but evidently never was instructed to not answer or clarify his answers. Evidently there was no company safety policy protocol written down anywhere or followed other than to rely on the captain and crew instructions. Likewise the owner said the crew could/would possibly do electrical upgrades or repairs and he (the owner) did not know for certain the number of electrical receptacles on the vessel or when (or if) they had been changed out. The logs for the vessel's mechanical/engine maintenance were kept on the vessel (lost in the fire) with no back up records on file onshore. This guy is in deep, deep shit.

I've been reading through the report and noticed a few mentions that NTSB investigators were not permitted to interview the Captain by the US Attorney. Here's a quote from Document 91 (6- Survival Factors -Group Chair's Factual Report) "... Although the captain of the Conception, voluntarily made himself available for interview on two occasions, the office of the US Attorney prohibited NTSB investigators from interviewing him..."

 

[Fins in the Bin]

Thanks for providing this Larmo,
I've missed your posts.
A lot of good reading here and very informative. Second captains first night on the vessel, wow what an experience to add to an already apprehensive first day on the job.

 

[Fins in the Bin]

I agree that what we all guessed about the lack of "Roving patrols" is the main difference maker but I never found the history of electrical issues or Ryan's testimony, which part of the report was that in?

I feel bad for all parties involved including the ownership group to have to carry this around with them the rest of their lives. I wonder if it was to many of those sleep apnea machines plugged into a socket? It very well could have been that old plug with loose prongs on the phone charger too that just slowly smoldered and built up next to an open window.

 

[Larmo]

I agree that what we all guessed about the lack of "Roving patrols" is the main difference maker but I never found the history of electrical issues or Ryan's testimony, which part of the report was that in?

I feel bad for all parties involved including the ownership group to have to carry this around with them the rest of their lives. I wonder if it was to many of those sleep apnea machines plugged into a socket? It very well could have been that old plug with loose prongs on the phone charger too that just slowly smoldered and built up next to an open window.

Ryan is the first Galley Crewman. His statement is logged with the others.

Could also have been the wet gear on the charging table. it’s incredible they allowed that to go on.

 

[Fins in the Bin]

Questions..........from a layman's perspective>>

Why isn't the interview with the Conceptions' captain included with all the NTSB reports/documents?

The 52 pages of the interview with the owner is incredibly damning in my opinion. His lawyer was present, but evidently never was instructed to not answer or clarify his answers. Evidently there was no company safety policy protocol written down anywhere or followed other than to rely on the captain and crew instructions. Likewise the owner said the crew could/would possibly do electrical upgrades or repairs and he (the owner) did not know for certain the number of electrical receptacles on the vessel or when (or if) they had been changed out. The logs for the vessel's mechanical/engine maintenance were kept on the vessel (lost in the fire) with no back up records on file onshore. This guy is in deep, deep shit.

I saw a few items answered wrong but he seamed like he ran the boat for the first 20 years and had a great captain he relied on for specific answers for daily operations, what were the damning parts you saw here Laukia?

 

[http404]

Interview with 2nd Captian:

 

[Laukia]

I think the most damning thing about this operation was the decision of the owner to file the preemptive case to prevent the families from attempting to receive compensation for their loss. If I remember it correctly the bodies hadn't even been identified. The 150 year old law they relied on was a tool for the continued flow of international commerce and huge insurance companies like Lloyd's of London and the like.........not this case of personal liability. Needlessly cold blooded insult added to unfathomable misery left behind.

The interview of the owner repeatedly passed off the responsibility to the captain, who was in fact in this case his employee......no? Yet he was not at all familiar to the details of the fire drills ("the log was kept on the boat")

In terms of liability in the context of 33 lives lost I don't see how the owner squares this:

Pg10, lines 21-25
21 Q. Okay. All right. Do they, for all your crews, do they
22 regularly drill in emergencies?
23 A. Yes.
24 Q. Does that emergency drill include fire?
25 A. Yes.

Pg 11,
1 Q. Okay. Do you have, do they keep logs of those emergency
2 drills?
3 A. That's up to the captain. But I believe they might have had
4 a log on board.
5 Q. Okay. It was on board at the time?
6 A. Yeah. It's all on board.
7 Q. Okay. All right. Speaking -- I'd like to turn a little bit
8 to company policies and procedures. Do you have a company safety
9 policy? Anything written as far as safety?
10 A. On board the vessel?
11 Q. On board for the vessel or company wide.
12 A. I would have to look. Most of that stuff is on board the
13 boat.
14 Q. Okay. And similar question with operating procedures. Are
15 there company wide operating procedures?
16 A. No.
17 Q. This would be things like watch standing procedures, anything
18 like that.
19 A. No, not company. It's, again, the captains are qualified
20 captains and how that's conducted is up to them.
21 Q. Okay. All right. Are there any company wide policies as far
22 as work, rest schedule, in other words amount of rest that crew
23 members get?
24 A. Again, that's all run by the captain. It's not like, a
25 standard time because of, you know, they may be moving the boat

 

[Vigilant32]

No S.O.P. For his fleet. What an asshat operator. It’s up to the Captain you say, let’s throw my employee(s) under the liability bus.

I don’t hire an electrician we just cobble that important fire prevention stuff together adhoc with no audit or repair trail.

This clown and his crew & passengers were living on borrowed time for god knows how many voyages.

 

[sickcat]

I agree that what we all guessed about the lack of "Roving patrols" is the main difference maker but I never found the history of electrical issues or Ryan's testimony, which part of the report was that in?

I feel bad for all parties involved including the ownership group to have to carry this around with them the rest of their lives. I wonder if it was to many of those sleep apnea machines plugged into a socket? It very well could have been that old plug with loose prongs on the phone charger too that just slowly smoldered and built up next to an open window.

Early in the investigation the USCG released a notification which covered a number of basic safety concerns which included unsupervised lithium battery charging and use of extension cords/power strips. While an old plug may have been part of it (I have not read the whole report yet) it seems that they suspected a runaway lithium battery charging. It you have never seen that type of failure it can be quite violent even with a reasonably small battery. Also if you have a bunch of batteries charging close together a single battery failure generates plenty of heat to send the others down the same path.

 

[sickcat]

I think the most damning thing about this operation was the decision of the owner to file the preemptive case to prevent the families from attempting to receive compensation for their loss. If I remember it correctly the bodies hadn't even been identified. The 150 year old law they relied on was a tool for the continued flow of international commerce and huge insurance companies like Lloyd's of London and the like.........not this case of personal liability. Needlessly cold blooded insult added to unfathomable misery left behind.

The interview of the owner repeatedly passed off the responsibility to the captain, who was in fact in this case his employee......no? Yet he was not at all familiar to the details of the fire drills ("the log was kept on the boat")

In terms of liability in the context of 33 lives lost I don't see how the owner squares this:

Pg10, lines 21-25
21 Q. Okay. All right. Do they, for all your crews, do they
22 regularly drill in emergencies?
23 A. Yes.
24 Q. Does that emergency drill include fire?
25 A. Yes.

Pg 11,
1 Q. Okay. Do you have, do they keep logs of those emergency
2 drills?
3 A. That's up to the captain. But I believe they might have had
4 a log on board.
5 Q. Okay. It was on board at the time?
6 A. Yeah. It's all on board.
7 Q. Okay. All right. Speaking -- I'd like to turn a little bit
8 to company policies and procedures. Do you have a company safety
9 policy? Anything written as far as safety?
10 A. On board the vessel?
11 Q. On board for the vessel or company wide.
12 A. I would have to look. Most of that stuff is on board the
13 boat.
14 Q. Okay. And similar question with operating procedures. Are
15 there company wide operating procedures?
16 A. No.
17 Q. This would be things like watch standing procedures, anything
18 like that.
19 A. No, not company. It's, again, the captains are qualified
20 captains and how that's conducted is up to them.
21 Q. Okay. All right. Are there any company wide policies as far
22 as work, rest schedule, in other words amount of rest that crew
23 members get?
24 A. Again, that's all run by the captain. It's not like, a
25 standard time because of, you know, they may be moving the boat

While I don't disagree with you entirely the above part of the interview seems exactly what I would expect from any boat/landing relationship. I bet if you ask the same questions of any non-operating owner and the vessels captain you would get the same answers.

IMO many of the operations that I have seen here in CA operate at a lower standard than the Conception did. They just got caught.

 

[makairaa]

I think the most damning thing about this operation was the decision of the owner to file the preemptive case to prevent the families from attempting to receive compensation for their loss. If I remember it correctly the bodies hadn't even been identified. The 150 year old law they relied on was a tool for the continued flow of international commerce and huge insurance companies like Lloyd's of London and the like.........not this case of personal liability. Needlessly cold blooded insult added to unfathomable misery left behind.

The interview of the owner repeatedly passed off the responsibility to the captain, who was in fact in this case his employee......no? Yet he was not at all familiar to the details of the fire drills ("the log was kept on the boat")

In terms of liability in the context of 33 lives lost I don't see how the owner squares this:

Pg10, lines 21-25
21 Q. Okay. All right. Do they, for all your crews, do they
22 regularly drill in emergencies?
23 A. Yes.
24 Q. Does that emergency drill include fire?
25 A. Yes.

Pg 11,
1 Q. Okay. Do you have, do they keep logs of those emergency
2 drills?
3 A. That's up to the captain. But I believe they might have had
4 a log on board.
5 Q. Okay. It was on board at the time?
6 A. Yeah. It's all on board.
7 Q. Okay. All right. Speaking -- I'd like to turn a little bit
8 to company policies and procedures. Do you have a company safety
9 policy? Anything written as far as safety?
10 A. On board the vessel?
11 Q. On board for the vessel or company wide.
12 A. I would have to look. Most of that stuff is on board the
13 boat.
14 Q. Okay. And similar question with operating procedures. Are
15 there company wide operating procedures?
16 A. No.
17 Q. This would be things like watch standing procedures, anything
18 like that.
19 A. No, not company. It's, again, the captains are qualified
20 captains and how that's conducted is up to them.
21 Q. Okay. All right. Are there any company wide policies as far
22 as work, rest schedule, in other words amount of rest that crew
23 members get?
24 A. Again, that's all run by the captain. It's not like, a
25 standard time because of, you know, they may be moving the boat

I agree with 99% of what you said. His preemptive lawsuit was unfortunately not needless from his perspective. If I understand the law right its the difference of tens of millions of dollars vs thousands of dollars. Now should he have waited for at least a month so it did not immediately prove he was a slimy POS? Definitely. I hope the judge denies him and he gets what is coming to him.

 

[Phil]

I have read through about 2/3rds of the report documents - some really chilling details. Not my place to second guess or assign blame - that's what the legal process is for, but there were many things which could have been done to prevent the tragic loss of so many lives. Any organization (or business) which has been in place for a long time and basically done the same thing over and over again across many years can easily fall into the "...we've always don't it that way..." trap. The lack of a roving watch at night when everyone else is sleeping is nearly beyond belief.

For the loved ones and friends of those who died on the Conception it might be of little comfort, but for many more who take dive trips or fish multi-day or long range trips on the SoCal fleet hopefully this incident and this report will lead to some critical thinking and make all of us safer. I've been on a good number of long range trips and considered myself "safe" because the boats I've sailed were Coast Guard inspected annually, adhered to the SOLAS standards, and had good long-serving crew members. I am still confident the boats are safe, but I will think a little differently in a few weeks when my next trip leaves the pier.

Thanks for posting the report link and feedback from everyone.

 

[Larmo]

FBI evidence response team Conceptuon wreckage photo.

NTSB Board meeting is today to consider and approve the findings.

 

[2454 big mike]

FBI evidence response team Conceptuon wreckage photo. View attachment 1214163

NTSB Board meeting is today to consider and approve the findings.

Holy crap

 

[dalurker]

Cell Charging Possible ~ Maritime Executive
and

NTSB Calls for Major Safety Improvements to Small Passenger Vessels

www.ntsb.gov

 

[PacificBlue]

It is time for the Passenger/Charter Vessel Industry in SoCal to become professional across the board, it will cost passengers more to enjoy the water activities in the future but safety will finally become job #1.

More crew, more safety improvements/measures, more cost, but everyone comes home, no one left behind. And they are going to have to rethink all those “grandfathered” situations in regards to compliance to past regulations.