A series of failures allowed a fire to spread through a trawler which killed three men who were asleep onboard.
Sheriff Marysia Lewis ruled last week that a fire which broke out on the Banff-registered Vision II was due to a faulty fan heater.
The trawler was berthed at Fraserburgh harbour when the fire started late at night on July 3,1 2008.
Ramilito Calipayan and Benjamin Potot, both 33 and from the Philippines, died while they were sleeping in the vessel’s galley.
Latvian Rimans Venckus (50), had tried to escape but was overcome by smoke and collapsed in the wheelhouse.
A fatal accident inquiry into the fire was held in Peterhead in May this year. It found that a defective base unit fan heater had over heated causing the blaze.
In a written determination by Sheriff Lewis it stated that a number of precautions could have prevented the deaths.
The fan heater, which was installed when the Vision II was built, should have been housed within a suitable plywood box.
It was found that the heater should not have been covered up and items that were combustible should not have been close to it.
Sheriff Lewis added that the self-closing mechanism on the fire door separating the galley from the passageway should not have been disabled and that the door should not have been kept permanently open which allowed the fire to spread to other parts of the vessel.
There was also a problem with the fire detection system on board the boat due to the system being switched off at the time of the incident.
“On July 28, with repair work about to commence, the engine and auxiliary machinery were shut down. Rimants Venckus connected the vessel to shore power. In doing so, he turned off all of the 24v breakers and isolated the fire alarm detection panel.” stated Sheriff Lewis.
She also found that the fire detection system should have been wired in such a way to prevent it from being turned off, adding it should have been connected to a secondary power source if the main power failed or was turned off. Extra fire alarms should also have been fitted to the vessel in the galley, passageway and the cabin space.
It was found that the crew members were not provided with adequate training and regular inspections and maintenance of emergency exits were not undertaken.
Sheriff Lewis recommended that base unit fan heaters should no longer be fitted in fishing vessels.
“In event of a base unit fan heater currently fitted in a fishing vessel, ceasing to operate due to a component failure, the entire base unit fan heater should be removed and thereafter replaced with a panel heater.
“Where a base unit fan heater has already been installed in a fishing vessel, it should be housed in a suitable marine plywood casing, to comply, insofar as possible with the installation and operating instructions for that type of heater.”
The inquiry also heard of a misunderstanding on who was responsible for inspecting the heaters.
The Maritime and Coastguard Agency (MCA) and the Sea Fish Industry Authority (SFIA) were confused on who was responsible for such safety checks and neither organisation inspected the heater due to the confusion.
Following the fire the Vision II was repaired and new safety measures put in place including seven CCTV cameras, alarms fitted in the cabin, galley and passageway as well as the galley door no longer being tied back and all crew taking the UK basic safety awareness programme.
The vessel previously know as the Amethyst was bought by Alexander Jack the day before the fire. He was contacted on a family holiday when the fire happened.
The alarm was raised shortly after 1am on August 1 when a harbour security guard saw smoke coming from the main deck and beneath the wheelhouse of the vessel. When he opened the galley door he was engulfed in smoke. After trying the wheelhouse door he was again engulfed in smoke and called the emergency services.
Ambulance and fire services were both at the scene. Fire-fighters using breathing apparatus and thermal imaging cameras went on board and found the three dead crewmen.
MCA has said since the accident that it has been involved in reviewing and promoting safety issues.
This includes producing a guidance note showing the minimum standards acceptable for vessels not normally equipped for on board sleeping.