Now the report from Norwegian "accident investigation board" have come out. the report is long as a year, but I'll try to make it short. I could write a book out of this report, But short version, there is a lot of psychology in to the picture of this, specially on the frigate.
The short version is that there are no one factor that are at fault, but it is multiple factors that applies to this accident. There is 5 main things that went wrong:
1. The crew of the frigate didn't realize what they saw, was a tankship
- Around 15 minutes before the accident, was the crew change on the bridge.
- During the crew exchange, both the outgoing and incoming duty officer, saw that there was a luminous object at the Sture terminal in Øygarden.
- They thought what they saw was part of the Sture terminal, or something else that had nothing to say to the voyage.
- They did not realize that it was a 250 meter long tanker, which was getting ready to depart from the quay and straight towards them, loaded with oil.
2. The frigate sailed without AIS
- AIS deactivated when traveling in congested water, but Helge ingstad is also equipped with Kongsberg warship-AIS (it's a encrypted AIS) this one would send out an alarm if something is getting close, it was also deactivated.
3. The traffic center forgot to plot the frigate
- Just over an hour and a half before the collision, the warship sailed into the operating area of the Fedje Navigation Center.
- They called Fedje as they are supposed to do, and said they were coming in from the north.
- What the traffic operators at Fedje was supposed to do, was to plot the vessel name and other information about the ship on the radar so that they could follow it even if it did not send an AIS signal.
- Thus, the traffic operator could not respond to "Sola TS" when he asked which vessel was coming at them at full speed.
4. The tanker deck light made it impossible to see the lanterns
- As the "Sola TS" departed from the quay, powerful floodlights lit up the entire giant deck. The ship was going out into open water, and the crew needed light to clear their "equipment" and make the deck clear for travel.
- The powerful floodlights made it difficult for incoming vessels to see the lanterns, the safest way to recognize a vessel.
- When the pilot tried to signal to the oncoming frigate that there was danger going on with a so-called aldis lamp, no one on the bridge saw it, for the same reason.
5. The bridge crew on the frigate had too little experience
- The officer on duty of the warship had had nine months of training before being cleared as a commander... seven months before the accident.
- Among the six people he brought with him on the bridge was a training officer under training and five enlisted.
- According to the AIBN, the lack of experience among the crew on the bridge helped them not to change their understanding of the situation:
They had decided that the luminous object, which was in fact "Sola TS", was not something they needed to take into account .
- in addition there is also talk about fatigue among the crew after the big NATO exercise that was held in Norway just then.
video that have been posted, based on surveillance video footage from TS Sola + crew explanation
https://www.bt.no/nyheter/lokalt/i/OpX1 ... wsource=cl
But the main culprit is:
misconception of the situation of the bridge crew on HNoMS Helge Ingstad
It's a bit psychology in this: when you have decided on something "is", it's hard to realize something that "is", "isn't"!
- To understand the accident, you do not get beyond the concept of situational understanding and "confirmation bias" - that is, the first opinion confirms itself as a fact, says department head Dag S. Liseth of the State Accident Investigation Board
Thus the frigate continued to travel at 17 knots and had focus on 3 smaller ships heading north, plotting a course, keeping them to port at safe distance. At the same time "Sola TS" due to it size decide to go a more direct rout out than normal procedure... that is to cross the "traffic sone" and first then turn on to the correct course. But at the same time a tank ship as big as Sola TS, doesn't really want to cross a fjord due to it size and difficulty at move/turn and get up at speed.
side note: The Helmsman on Helge Ingstad did saw and realize that those lights was Sola TS. but as a helmsman he has his own task. He believed that the lockout had informed the duty officer on the bridge. He clearly believed the crew and officers had full control of the situation.... this was 13 minutes before the accidents. He didn't realize that the bridge crew and officer believed that Sola TS wasn't moving. At the same time the two officer on the bridge at the moment was standing at the radar screen, discussing if what they saw was a ship or just the terminal...
The Navy says that they have come to the same conclusion as the Transport investigation board. And they are changing many of there routine and how they train up crews and officers. They says, this will change the Navy.