Padstow RIB tragedy: final report released

Having experienced it in a rib, I would say its a bit more like a violent tank slapper in a car/ or more in tune with a motorbike accident where cornering hard and the bike slides a little, then grips and throws the ride off on a high sider.... nasty accidents. With a car you are strapped in, on a rib, like a bike, you are not. An phenomena that should be taught, but it all comes down to bloody kill cords, if only it had been worn this poor family wouldn't have had to suffer this tragedy..

All agreed, I was only referring to the lack of warning, ie. when you feel it start to go, it's usually too late to do anything about it.
 
Interesting to read that the husband and wife were generally careful and had taken the time to get qualifications but still got caught out by a couple of errors. The 'hooking' is something I'm aware of and wouldn't like to experiment with in my own boat. Probably something to learn about with professional training, though.

I've had discussions with swmbo about wearing the kill cord as soon as we leave our mooring. She's firmly of the opinion that it's not needed since we're in a six knot limit for four miles before we reach the sea. It took a while to persuade her to wear the crotch strap on her LJ, too.
 
Interesting to read that the husband and wife were generally careful and had taken the time to get qualifications but still got caught out by a couple of errors. The 'hooking' is something I'm aware of and wouldn't like to experiment with in my own boat. Probably something to learn about with professional training, though.

I've had discussions with swmbo about wearing the kill cord as soon as we leave our mooring. She's firmly of the opinion that it's not needed since we're in a six knot limit for four miles before we reach the sea. It took a while to persuade her to wear the crotch strap on her LJ, too.
when people get into ribs the whole atmosphere with everyone is electic all very excited most expect to get wet hit a few waves etc along the way thats what they are about but you shouldnt interfere with the helmsman grabbing the stering and increasing the throttles she was competent and qualifiied in my oppinion this was self inflicted by the husband if you was going along in your 40ft whatever and some one leaned over and threw the wheel over and applied throttle i am sure you would not be impressed
 
The way I see it (and we can discuss it till the cows come home) but a poor family has to live with a very tragic event.

No excuses, no if's, no but's...... Kill cords must be worn.
 
Exactly. Single cases make bad law. I was surprised they did not make more of the "real" cause, which was two people trying to drive the boat at the same time. Not difficult to imagine what might happen when full power is applied with full steering lock from almost standstill.

So true, look at Dunblane shooting / school massacre. Single case, knee jerk reaction and a whole industry and safety concious pleasant pass time for hundreds of people ruined. The guy that did that was LICENSED!

When everthee is a real tragic accident on the Roads, Air or Rail, there is never a single factor that caused it. Nearly always, something minor happens which causes a new set of circumstances making the original solvable problem escalate until there's a very sad tragic accident like this one.

Imho, there can be no blame on the Cobra rib, this is not a boat for a beginner or child. They are quick, usually with powerful engines and a newly qualified PB2 holder is not necessarily competent to drive it properly.

The report said that the mother had control and was making a careful gentle turn. Kill cord not an issue at this point, but her husband leaning over with out requesting control was just the start of it, he was either being flash or impatient with his wife I would suspect; but still not good practice.

There can only be one skipper on a boat or plane!

Bottom line here, and I think we're all in agreement that the accident was destined to happen but if only they had a Kill Cord attached the outcome would have been a fun story in the pub later that they would always remember instead of the frighteningly sad bitter ending that the family will never forget!:ambivalence:

My heart goes out to that family, so often people make mistakes but can be lucky enough to get away with it. This was a very hard tragic lesson that we should heed! :(
 
The other contributory factor was weight in the bows causing bad trim, it is possible that with that weight aft the hooking may not have happened or may not have been as drastic. Passengers forward of the helm at speed are not a good idea in most RIBs.
 
Loose weight

Now Im not advocating this but if the kill cord was attached to a lose weight on the dash board, if the boat hooks or any other jerking motion the weight would go flying pulling the kill cord out and stopping the boat .

The size and position of the weight would need to be chosen but that said if motion was enough to throw a child over , a 1 or 2 pound weight would go the same way.
 
I've not read through all comments but did pick up one interesting comment about kill cords not being fitted due to forgetting or being distracted as in the case of this accident. Got me thinking that rather than focus changes on what can be done to replace the kill cord a simple(ish) thing that could be done is to flash up an led/ display / audible alarm or whatever that can be seen and/or heard on turning the ignition with the sole purpose of reminding the user to fit the kill cord. Even simpler would be for outboard manufacturers to have to put a dirty great sign on the front of the engine "HAVE YOU FITTED YOUR KILL CORD?"
 
Now Im not advocating this but if the kill cord was attached to a lose weight on the dash board, if the boat hooks or any other jerking motion the weight would go flying pulling the kill cord out and stopping the boat .

Nice lateral thinking. It wouldn't need to be a loose weight, it could be designed into the kill switch mechanism.
 
I've not read through all comments but did pick up one interesting comment about kill cords not being fitted due to forgetting or being distracted as in the case of this accident. Got me thinking that rather than focus changes on what can be done to replace the kill cord a simple(ish) thing that could be done is to flash up an led/ display / audible alarm or whatever that can be seen and/or heard on turning the ignition with the sole purpose of reminding the user to fit the kill cord.

Just like the seat belt warning on your car.
 
What a tragic sequence of events. :(

I see two primary lessons here:-

The first, most obviously that the kill cord should always be used - they were intending to head at slow speed back to their berth and thus the wife at the helm didn't fit the kill cord. This may have been because she wasn't initially intending to drive the boat, but 'monitor' the helm whilst he worked at the stern. At some point however the decision was made to move the boat and at that point the kill cord needed to be fitted. No start up warning device etc or sticker on engine would have reminded her at that point. Something that needed to be done in order to select gear might have?

The second issue is that he should never have touched the controls whilst she was at the helm. I personally see no exception to that rule other than to perhaps cut the power in an emergency and even that is really a job for the skipper. The old saying of too many cooks is very apt here and he was clearly not in a suitable position to undertake the actions he did safely. Whether he underestimated the power (new boat) or hand slipped on throttle etc the events that followed were IMHO a direct result of this intervention. They had however by this time made the decision to go out for 'another run' - again a cue for fitting of kill cord. Much like driving a car when the habit of 'mirror, signal, manoeuvre' is instilled into drivers, whenever forward gear is selected and throttles are opened up, boat helm needs to think 'kill cord'.

The other factors may have been contributory, but in themselves I don't see as problems needing solutions. The children in the bow isn't uncommon in ribs and bowriders and at low speeds they are probably as safe there as anywhere - parents can see them much more easily. The children would have been quite safe without the hard turn under power - which appears not to have been planned... The design of the Cobra Rib probably wasn't undertaken with a holidaying family in mind, but for professionals who would usually be familiar with the handling characteristics of such vessels and would be less likely to open the throttles wide on full steering lock.
 
...The children in the bow isn't uncommon in ribs and bowriders and at low speeds they are probably as safe there as anywhere - parents can see them much more easily. The children would have been quite safe without the hard turn under power ...
Slow speed no problem, even though they are primarily locker lids that turn into a sunbathing platform rather than seats, but they affected the trim and their weight contributed to the hooking when the boat accelerated. I would never have passengers up in the bow of a RIB at speed - even the actual seats immediately in front of the console, which again are only locker lids, are often referred to as "suicide seats". All the actual seats for when the boat is cruising are behind the console and that is where passengers should sit - the boat is designed to carry the weight there, not in the bow.
 
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Slow speed no problem, even though they are primarily locker lids that turn into a sunbathing platform rather than seats, but they affected the trim and their weight contributed to the hooking when the boat accelerated. I would never have passengers up in the bow of a RIB at speed - even the actual seats immediately in front of the console, which again are only locker lids, are often referred to as "suicide seats". All the actual seats for when the boat is cruising are behind the console and that is where passengers should sit.

+ 1
 
We have compulsory skipper licensing here in Australia, its not worth the paper it written on, and people seem to think they are experts because they spent a day in a small boat and got their 'ticket'. If anything the average abilities out here are lower out here than I have seen in the UK and Med.

I wonder if something like RFID tag wrist bands would be an option, i.e. cheap and waterproof, you could have multiple ones so that several people can each keep one on whilst swapping about skiing etc, and a sensor by the wheel / throttle, when the band goes out of (short) range , say 6 inches, the throttle is cut.

I am sure by the time the manufacturers put their markup on their proprietary RFID system the bracelets would no longer be cheap to the point where you would buy several and not bother to swap them over, but it would also be a security system like keyless ignition, if someone else jumps on your boat they cant take it if they don't have a matched bracelet.

Ants

(PS Yamaha, et all, drop me a PM and I will let you know where to send your royalty cheques for using the idea :-) )
 
What a tragic sequence of events. :(

I see two primary lessons here:-

The first, most obviously that the kill cord should always be used - they were intending to head at slow speed back to their berth and thus the wife at the helm didn't fit the kill cord. This may have been because she wasn't initially intending to drive the boat, but 'monitor' the helm whilst he worked at the stern. At some point however the decision was made to move the boat and at that point the kill cord needed to be fitted. No start up warning device etc or sticker on engine would have reminded her at that point. Something that needed to be done in order to select gear might have?

The second issue is that he should never have touched the controls whilst she was at the helm. I personally see no exception to that rule other than to perhaps cut the power in an emergency and even that is really a job for the skipper. The old saying of too many cooks is very apt here and he was clearly not in a suitable position to undertake the actions he did safely. Whether he underestimated the power (new boat) or hand slipped on throttle etc the events that followed were IMHO a direct result of this intervention. They had however by this time made the decision to go out for 'another run' - again a cue for fitting of kill cord. Much like driving a car when the habit of 'mirror, signal, manoeuvre' is instilled into drivers, whenever forward gear is selected and throttles are opened up, boat helm needs to think 'kill cord'.

The other factors may have been contributory, but in themselves I don't see as problems needing solutions. The children in the bow isn't uncommon in ribs and bowriders and at low speeds they are probably as safe there as anywhere - parents can see them much more easily. The children would have been quite safe without the hard turn under power - which appears not to have been planned... The design of the Cobra Rib probably wasn't undertaken with a holidaying family in mind, but for professionals who would usually be familiar with the handling characteristics of such vessels and would be less likely to open the throttles wide on full steering lock.

Yes of course the kill cord should be used. However, the MAIB is indulging in wishful thinking when it recommends action to ensure that kill cord use becomes "second nature". That simply won't happen in a large number of cases. To describe an action as "second nature" is just another way of saying "habitual"; and actions don't become "habitual" until performed with sufficient frequency to be ... well errr habit forming. A pro skipper may develop kill cord use as second nature but for the average leisure user it won't happen.

The self-evident fact, in the Milly case, is that the kill cord safety system (as a 'system' not merely as a safety device) failed. An alternative or additional system may have provided (to use the aviation safety metaphor) that additional slice of cheese that stops the holes from lining up.

What is needed, in my opinion, is some fresh thinking from engine manufacturers and boat builders to develop additional, automatic safety device(s) that have the ultimate effect of disabling the engine if some test of <operator control present> is not satisfied. The kill cord is a robust and reliable (when used) device but it is a solution for the pre-electronic era. It simply must be possible to develop other system(s), at reasonable (or, in the context of new boat cost, even negligible) cost that can operate as an alternative or in addition to kill cords.

With respect, the comment "The design of the Cobra Rib probably wasn't undertaken with a holidaying family in mind, but for professionals who would usually be familiar with the handling characteristics of such vessels and would be less likely to open the throttles wide on full steering lock." is (if you think about it) simply ludicrous. If it was true, then Cobra would presumably be open to legal action for marketing their products to potential buyers who do not have and will not have the competence needed to operate them safely.
 
i would not consider a cobra rib a proffesional rib unlike ribcraft or redbay which come with jockey seats which is a much more secure way of being seated on a rib with grab handle in front of each seat, however cobra are good recreational ribs well built etc but at the end of the day if you turn on the taps of 250 hp at full throttle and full lock on the stearing without telling the helmsman or not warning the kids to hang on you are going to be in for a surprise. totaly self inflicted by the husband
 
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