FOR OFFICIAL USE
(No. 7852.)
"SARVISTAN " (S.S.).
REPORT OF THE MARINE COURT OF INQUIRY APPOINTED TO INVESTIGATE
THE CIRCUMSTANCES ATTENDING THE ACCIDENT TO THE S.S. " SARVISTAN"
OF HONG KONG.
Chief Presidency Magistrate's Court,
Bombay,
30th August, 1927.
Pursuant to Government Resolution No. 783-1328, dated the 19th
August, 1927, Marine Department, Bombay, appointing Mr. H. P.
Dastur, Acting Chief Presidency Magistrate, Bombay, Captain Lionel
Arthur Beytagh, Master s.s. "Chakla," and Mr. Burns Crosbie Sharpe,
Assistant Mechanical Superintendent, Bombay Port Trust Workshops.
Mazagaon, to conduct an inquiry into the circumstances attending
the accident at Sea to s.s. "Sarvistan," the Court assembled on the
24th, 25th and 26th day of August, 1927, for the purpose
stated.
Mr. G. L. Walker, Solicitor to Government, appeared as
representative of Local Government.
Mr. F. J. Patel, Barrister-at-Law, appeared on behalf of the
Agents and Master of the s.s. "Sarvistau," with Mr. Pereira, of
Messrs. Pereira & Co., Solicitors. High Court.
Chief and Second Engineers appeared in person.
The parties were asked if copies of the questions raised and the
statement of the case have been furnished to them, and they
admitted they had received the same.
As it appeared that this investigation was likely to involve the
consideration of the question as to the cancellation or suspension
of a certificate or certificates, the Court, under Section 254 of
Act 21 of 1923, constituted as its Assessors Mr. Alston John Muir,
Superintending Engineer, B.I.S.N. Company, Limited, and Mr. George
Batton Shuttleworth Roberts, Chief Engineer, s.s. "Barala."
The parties had no objection to the above Assessors.
The s.s "Sarvistan," a steel twin screw steamer of about 7,714
tons gross, built at Bremerhaven in 1899 and named the "Frankfort,"
belongs to the Oriental Navigation Company, the Agents of which are
H. M. H. Nemazee & Co. She has two double ended boilers and two
single ended boilers, triple expansion and surface condensing. She
has four feed pumps, viz., two main and two auxiliary pumps. Her
Port of Registry is Hong Kong and a machinery certificate M.B.S.
has been assigned to the engines and boilers by the British
Corporation for the Survey and Registry of Shipping. She is a
pilgrim ship authorised to carry 1,605 pilgrims. She came from
Jeddah to Bombay to take pilgrims to Jeddah. She arrived here on
28th June and she sailed from Bombay on 2nd July.
Her Master, James Barker Struth, holds the Board of Trade
Master's Certificate No. 00826. The Chief Engineer, Herbert Lawton,
holds a Board of Trade First Class Engineer's Certificate No.
39817. The Second Engineer, Agenor George Emmanuel Raffin, holds a
First Class Engineer's Certificate No. 136 given by the Marine
Board of Examiners at Calcutta on 12th May, 1909.
On the previous voyage one Young was the Chief Engineer and
Lawton was the Second Engineer, Colonel was the Third while the
Fourth and Fifth Engineers were Chinese.
Young left on the 1st of July and Calonel and two Chinese
Engineers left on 30th June. Accordingly, Lawton. who was the
Second Engineer was made the Chief Engineer, and Raffin, DeSouza,
Wilde, and Samchet signed on as second, third, fourth and fifth
engineers respectively. That was on the 1st of July.
All the 4 feed pumps were inefficient and trouble started soon
after they left the harbour.
The first trouble experienced was with regard to the bilges.
That was soon put right. Owing to the inefficiency of the feed
pumps boiler water began to go down gradually. They had an extra
feed for 4&189; hours on the first day of her voyage and the
water showed half glass. On the 5th July the Auxiliary Weir Pump
broke down and on the 6th a test cock blew off and a hole was found
in the main feed valve discharge chest. On the 7th there was
trouble with the L. P. piston rod which got bent. They tried to run
compound but they could not do so. At 11.30 p.m. on that day it was
discovered that the piston rod was broken and the engine had to be
stopped. The control tank began to leak and the boilers were also
more or less leaking all the time. The water began to get
dangerously low and showed an inch or an inch and a-half in the
after glass and none in the forward. Only when she was on an even
keel or when the ship rolled it could be seen just above the
nuts.
On the 8th the port boiler had to be shut down. and on the 9th
the starboard engine gave trouble. Several tubes were expanded. But
the leakage from the boilers and float tank continued. She was
often out of control and some times she was drifting and the
combustion chamber tops got buckled through lack of water. Matters
grew worse on the 10th and all the fires of all the boilers had to
be drawn. On the 11th they started coming back to Bombay. She had
trouble with the boilers all the time. On the afternoon of the 14th
she was again out of control; on the 15th at 6-12 a.m. the
starboard engine was working but at 10-25 a.m. it stopped again.
The boilers leaked badly and at 5-45 p.m. the main steam pipe joint
blew out. At 10-50 p.m. all boilers and the dynamo were closed
down. From the 16th she remained out of control. At 7 p.m. the
Master wirelessed to the Port Officer for assistance. The R.M.S.
"Cornwallis" was despatched and she stood by her from the morning
of the 17th. She eventually came to Bombay on the 19th.
The ship was surveyed by Commander Horley, R.I.M., on the 26th
July and it was noticed that the L. P. piston rod of the port main
engine was broken off short at the large end of the taper for
piston. The rod was found badly flawed for about two-thirds of the
area. The combustion chamber crowns of all boilers showed distinct
signs of over-heating, the plates were buckled and the landings and
stays strained. A number of tubes appeared to be leaking and
several old cracks in the back ends, which were welded previously,
gave out, apparently due to the straining set up by over-heating.
He attributes the cause of the defects he noticed to over-heating
of the combustion chamber crowns due to a general shortage of
water.
The above facts do not appear to be in dispute. It is
quiteevident that the feed pumps were inefficient and the condition
of the boilers was defective when the vessel left Bombay though
they were not of such a nature as to prevent the vessel from
proceeding to sea. Neither the Master nor the Agents were informed
or aware of these defects.
It has to be observed that the vessel had been surveyed only in
February last and that she had just come from Jeddah and on that
voyage she did not experience any serious trouble. Exhibit No. 1 is
a report made by the then Chief Engineer Young to the Master. The
report shows that only petty repains were made to tubes and on one
or two occasions there were leaks in the centre boilers which,
however, were soon put right. The condition of the machinery and
boilers is described by Young as O.K. Even the letter. Exhibit E,
written by Young from Jeddah to the Master, but which the Master
says he received after Young left, says that the engine and boilers
were in good working condition and that he would see that
everything was O.K. before he left. Neither the Master nor the
Agents were informed by anyone of the defects in the feed pumps or
in the boilers and they would have no reason to believe that the
vessel was not in a fit condition to proceed on the voyage. The
trouble no doubt started on the very day they left. But the Captain
was never informed of it. The Chief Engineer does say that he used
to make verbal reports every day. He, however, failed to inform the
Captain of the exact nature of the trouble they were experiencing
below.
In his evidence the Chief Engineer says "When I became the Chief
Engineer I knew that the feed pumps were not in as good a condition
as they ought to be but I thought we could keep her getting along.
I did not think it necessary to report this either to the Captain
or to the Agents."
Even when the trouble became worse and there was shortage of
water he did not inform the Captain of it. Up to the 6th lie
himself did not seem to treat the matter seriously or realise the
gravity of the trouble. He says "The condition of the boilers was
that they were more or less leaking all this time. I then thought
that the boilers were all dirty and that was the main cause of the
leaks. It did not occur to me that there was shortage of of water."
The first time he suggested to the Captain to return to Bombay was
on the 8th. He says "I did not suggest to the Captain before the
8th that we should return to Bombay."
The Second Engineer says that on the 6th lie suggested to the
Captain that they should turn back. The Captain denies it. The
Captain struck us as a very honest witness, who has nothing to
conceal and answered all questions without hesitation. The
demeanour of the Second Engineer on the other hand was halting and
such as not to inspire any confidence. In our opinion he is an
absolutely unreliable witness and he is contradicted by himself and
by other witnesses in most material particulars. According to him
the trouble was not at all serious and he denies that the level of
the water was dangerously low. If that be so there would be no
occasion for him to suggest to the Captain that they should turn
back.
We hold that the Captain was first informed about the
seriousness of the trouble on the 8th and that by the Chief
Engineer. What he was told appears from the first telegram sent by
him to the Agents. In it the says "Port engine low pressure piston
rod severely bent, at present running that engine out of action.
Tubes in all boilens leaking very badly. One valve (meaning the
test cock) blew off boiler. Two bilge pipes one sanitary pipe
fractured owing to bad weather. Must go to Aden for repairs, very
serious."
He was not told anything about the shortage of water nor of the
buckling of the combustion chamber crown.
On the 9th he wirelessed: "Port L. P. piston rod broken off
piston head. At present dismantling engine to run compound. Boiler
tubes leaking very badly. We are 730 miles Bombay and 900 miles
Aden. Doing nothing against monsoon only drifting. Very advisable
to return Bombay. All of the engine room need repairs. What do you
advise."
On the 12th he wirelessed "Must return Bombay, port engine quite
useless. Can do nothing with ii., Steaming starboard engine. Chief
says boiler pumps require overhaul … making Bombay, will require
tug, ship unmanageable."
The Agents sent the tug "Rose," but it missed the ship.
Eventually as stated above the vessel arrived here on 19th doing
three and sometimes 1½ knots per hour.
We are of opinion that no blame of any kind attaches to the
Captain and that neither the Captain nor the Agents were informed
about the defective condition of the feed pumps or of the boilers
before the vessel proceeded to sea.
From what has been stated above it is evident that there was
shortage of water and that the level of the water gradually got
low, due to the defects in the pumps and in the boilers.
We agree with the assessors and hold that the defects in the
feed pumps and in the boilers were known to the Chief Engineer. He
joined the ship in March last at Singapore as Second Engineer. He
admits that the boilers and the feed pumps were not in first class
condition and ever since he joined they always had trouble with the
main tube, pumps and boiler tubes. And he further says "When I
became the Chief Engineer I knew that the feed pumps were not in as
good condition as they ought to be but I thought we would keep
getting her along. I did not think it necessary to report this to
the Captain or to the Agents." The result of these defects was that
on the very first day they had extra feed for 4½ hours due to a
leakage in the float tank and a burst of the feed pipes joint.
It is unnecessary for us to go into details as to the nature and
kind of trouble they had between the 4th and 11th of July. We have
already set it out above and it is admitted that the level of the
water was gradually getting dangerously low. The Chief Engineer, as
well as the Second Engineer were well aware of it.
The third Engineer, DeSouza, says that the water just showed in
the after glass and nothing in the forward glass. He blew the
forward glass but got no water. They had the ash pump working on
the boilers. He reported to the Chief Engineer that lie could not
keep the water level. He was afraid of the low level. He thought it
dangerous to go on in his watches. He would have drawn the fires if
he were the Chief. But neither the Chief nor the Second Engineer
did so.
The Fourth Engineer, too, says that they were able to keep water
one or one and a half inches in the after glass but nothing in the
forward glass. He says, "When the vessel was on even keel we were
able to show one or one and a half inches. It is correct to say
that after the 2nd day (of the voyage) the water was just showing.
It was not always showing."
In spite of this the Chief Engineer says he thought it was safe
to continue steaming. He says that he did not consider that the
water was dangerously low. He admits no water showed in the glass
at times. "After the 7th, leaks developed and we got from bad to
worse, sometimes we saw the water only when the ship rolled." And
yet lie did not inform the Captain about it. Damage to the
combustion chamber tops was reported to him on the 8th. "Our tops,"
lie says, "were all buckled up. The combustion chamber was slightly
distorted. The cause of distortion was perhaps due to shortage of
water owing to heating. At that time I had no idea what caused the
distortion. If there was no water in the glass one could not tell
what was wrong with the combustion chamber tops." it was only when
the matters got worse on the 10th that all the fires of all the
boilers were drawn. He admits that if he had drawn all the fires on
the 8th this damage (i.e., the buckling of the combustion
tops) would not have occurred. And he says they used 700 tons of
fresh water. He cannot say how much salt water was used.
The discipline too was not good. On the night of the 7th at
11.35. p.m. the port engine stopped. The telegraph was put to stop
at 11.35 but the Master did not know anything about it till he was
informed the next morning at 6 a.m. by the Chief Officer. When the
Chief Engineer was questioned by the First Officer whether he had
informed the Master he says he had not but he was going to report.
It was the third officer's watch and we think the third officer's
conduct was blameworthy. The Chief Engineer as well as the second
and third officers all failed in their duties in not informing the
Master.
As to the Second Engineer, we find on the evidence that he was
not in a fit condition when he joined the ship and that he was
incompetent.
He admits that he was not perfectly fit when he joined. He had
been suffering from a rheumatic knee but lie thought he was
justified in taking up the duty as he was on the way to recovery.
He knew that the job of the Second Engineer was a strenuous one and
that he was the most hard-worked man on the ship.
DeSouza says that the Second Engineer was not well acquainted
with the engine room and the connections. DeSouza used to relieve
him during his meal time and he found on two or three occasions the
wrong suction connections were being used and the pump drawing air.
On most occasions when he took over from the Second Engineer at
meal time he found water in the glass just about an inch. The Chief
Engineer says that he too found wrong suction valves opened. This
happened twice or thrice.
The Second Engineer admits that he did not take the density till
the 12th and that he found the water dangerously low and yet he did
not have the fires drawn. When questioned about it he says he could
not do so without the orders of the Chief Engineer, though the risk
of not doing so might be that the combustion chamber crowns would
have collapsed. If combustion chamber collapsed he knew that the
ship would have been blown up. He discovered the buckling of the
port boiler combustion chamber on the 8th and yet he gave no orders
to have the fires drawn. Though he admits it was his duty to get
first-hand information of the actual damage, he only went into the
back end of the centre boiler once, and that on the 11th. From the
6th to the 10th the trouble grew more and more serious, and it was
the worst on the 10th. He attributes his not going into the back
end of the boilers to his rheumatic knee. This is a lame excuse,
for he admits lie used to go up on deck and down the stokehold
every day. Only on the 7th and 8th he was put in bed by the Surgeon
of the ship, as he complained that his other knee was also
painful.
We therefore agree with the assessors and hold that the cause of
the damage was due to the wrongful act and culpable negligence and
default of the Chief and Second Engineers, and that it was
attendant with grave risk to life.
Taking into consideration the length of service put in by the
Chief Engineer we are of opinion that his Certificate of a First
Class Engineer should be suspended for a period of 12 months,
during which period we would recommend to Government that he should
be given a Second Class Engineer's Certificate.
As to the Second Engineer, we find him absolutely incompetent,
and we consider it to be a menace to the life of others to allow
him to hold a First Class Engineer's Certificate. We are therefore
of opinion that his Certificate as a First Class Engineer should be
permanently taken away and that he be given only a Certificate of a
Second Class Engineer.
Before we conclude we would recommend to Government the
advisability of having at least six Engineers and one boiler maker
on ships of the class of s.s. "Sarvistan," which are authorised to
carry more than a thousand pilgrims, so that the Engineers may work
in watches of two at a time.
H. P. DASTUR,
Acting Chief Presidency Magistrate,
Bombay.
A. A. BEYTAGH,
Master, s.s. "Chakla."
B. C. SHARPE,
Assistant Mechanical Superintendent,
Bombay Port Trust Workshops,
Bombay.
Questions.
1. What was the condition of the feed pumps and boilers of the
s.s. "Sarvistan" when the vessel left Bombay? Were they in a fit
condition to proceed to sea?
2. Was (a) any report upon the condition of the feed
plumps or boilers made by the Chief Engineer to the Master or Agent
before the vessel left Bombay and (b) if not should a
report have been made?
3. Was the level of the water in the boilers on the 4th, 5th.
6th, 7th, 8th, 9th, and 10th days of July respectively a safe
level?
4. If damage occurred, upon what date or dates?
5. What was the cause of such damage?
6. Was the damage due to wrongful act, negligence or want of
care on the part of the Agent or Master or Chief Engineer or Second
Engineer or all of these?
7. Was the damage material?
8. Was there any risk to life
Mr. Walker wishes to add the following questions as regards the
Master: -
9. Was it brought to the notice of the Master that the feed
pumps were inefficient and that it was dangerous to keep the fires
doing on the 6th of July or any subsequent date?
10. (a) Was it a wrongful act, default or lack of good
seamanship on his part not to return to Bombay when the L. P.
piston rod of the port engine broke on the 7th July, or
(b) When he was informed of the condition of the feed
pumps?
(c) Did such act or omission cause or conduce to the
damage?
In our opinion the condition of the feed pumps and boilers was
defective when the vessel left Bombay. We are of opinion that these
defects were not of such a nature as to prevent the vessel from
proceeding to sea.
(a) No.
(b) Yes. A report should have been made.
No.
We are of opinion that the damage to the boilers was caused from
4th to 10th July.
Shortage of water.
We are of opinion that it was due to the negligence and want of
due care on the part of Chief and Second Engineers.
Yes.
Yes.
No.
(a) No.
(b) When he was informed he did return.
(c) No.
With regard to the Chief Engineer: -
11. Was the Chief Engineer aware that the feed pumps were in a
defective condition prior to sailing from Bombay on 2nd July?
12. If so was it an act of neglect or default not to represent
the same to the Master or Agents, s.s. "Sarvistan"?
13. Did the Chief Engineer order or permit fires to be kept
under the boilers when the level of the water in the boilers was
known to be such as to render it imperative that the fires should
be drawn?
14. If so was this an act of neglect or default on the part of
the Chief Engineer?
15. Did such acts of neglect or default mentioned in the three
preceding questions cause or conduce to the damage?
As regard Second Engineer: -
16. (a) Was the Second Engineer physically capable of
performing his duties on joining the ship?
(b) Did he remain so throughout the voyage?
17. Did the Second Engineer properly perform his duties a.s
Second Engineer and on watch during the voyage?
18. Did the Second Engineer keep fires under the boilers on 6th.
7th, 9th and 10th July when the level of the water was such as to
render it imperative that the fires should be drawn?
19. Was this an act of neglect or default or was it incompetence
on his part?
20. Did such act, default or incompetence cause or conduce to
the damage?
Yes.
Yes.
Yes.
Yes.
Yes.
(a) No.
(b) Yes. Except on the 7th and 8th July.
No.
Yes. But only 6th, 9th and 10th July.
Incompetence and neglect.
Yes.
G. B. S. ROBERTS.
(Issued by the Board of Trade in London
on Friday, the 6th day of April, 1928.)
LONDON:
PRINTED AND PUBLISHED BY HIS MAJESTY'S STATIONERY OFFICE.
To be purchased directly from H.M. STATIONERY
OFFICE at the following addresses:
Adastral House, Kingsway, London, W.C.2; 120, George Street,
Edinburgh;
York Street, Manchester; 1, St. Andrew's Crescent, Cardiff;
15, Donegall Square West, Belfast;
or through any Bookseller.
1928
Price 6d. Net.
