Real-life incident: Fatal consequences of delayed action

On a cargo ship at sea, two crew members, a fitter and a cadet, were tasked with welding work in a hold. As they gathered on deck near where the work was to be carried out, they both noticed a strong odor of heavy fuel oil (HFO) fumes coming from a nearby vent. While the fitter entered the hold to weld, the cadet remained on deck to pass hoses and equipment. During the work, which took approximately 15 to 20 minutes, he was approximately 3.5 m from the HFO vent.

When they stopped for lunch, the cadet told the mechanic that he was not feeling well and would rest instead of eating dinner. The next day, the cadet told a senior officer that he was not feeling well, probably because he had inhaled some fumes the previous day. The officer advised the cadet to rest and informed the captain of the cadet's condition later that afternoon.

Over the next few days, the cadet was able to go to the mess hall to eat, but had gastrointestinal problems. He also complained of a headache. The master reportedly encouraged the cadet to eat more food to gain energy and get some fresh air. Approximately six days after being exposed to HFO fumes, the cadet did not recover. The chief officer sought medical advice from the crewing manager, who consulted a doctor. He then recommended giving the cadet a light diet and informed the general director accordingly.

Approximately ten days after the cadet was exposed to HFO fumes, the ship was in rough seas and several crew members were seasick. Fearing that the cadet would be prone to falls in his weak condition, the captain advised him not to leave his cabin and instructed another crew member to bring the cadet's meals to his cabin. Two days later, the captain contacted the crew leader and informed him of the cadet's condition, which appeared to be deteriorating with dizziness, vomiting and diarrhea.

It was agreed to divert to a port to provide medical care to the cadet. Before the ship could reach port and approximately 13 days after his exposure to HFO fumes, the cadet was found dead in his bed. An autopsy revealed the cause of death to be asphyxiation due to aspiration of stomach contents.

Lessons learned

• Never be complacent when it comes to providing medical care to a suffering crew member. If symptoms persist for a long time or exceed the capabilities of the crew on board, seek radio medical advice directly from the Centro Internazionale Radio Medico (CIRM) or equivalent facility.
• Be aware of distorted judgments. In this case, the captain's sense of urgency may have been clouded by the thought that the new cadet was suffering from seasickness and/or adjustment to the ship rather than gas poisoning.