INVESTIGATION

CASE 4
No Pool Attendant, No Rescue
Narrative
A passenger was noticed lying motionless at
the bottom of a swimming pool. He had been
under water in the unsupervised pool for 10
minutes before a fellow passenger saw him and
recovered him to the surface.
The alarm was raised and, following his
removal from the water, CPR was started
by fellow passengers until the ship’s medical
team arrived shortly afterwards. Despite
further attempts to resuscitate him, he was
pronounced deceased by the ship’s senior
doctor.
At the time of the accident, there were at least
four other passengers in the swimming pool.
The subsequent autopsy examination
determined the cause of death as drowning.
The Lessons
1. It is unknown whether or not the
passenger’s life could have been saved had
an emergency response been initiated
sooner. As there was no dedicated pool
attendant, his situation was not identified
until 10 minutes had passed.
2. Although patrolling personnel can provide
a degree of swimming pool supervision,
this accident demonstrates that, ideally,
constant supervision is required to
effectively identify and respond to a
passenger in immediate risk of drowning.
3. No formal documented risk assessment
for swimming pool use was in place at
the time of the accident. Although a risk
assessment might not have prevented the
accident, it would have identified relevant
hazards and control measures, including
those aimed at reducing the risk of a
passenger drowning.
4. The frequency of near drownings
in unsupervised swimming pools is
uncertain. It is therefore important that
this uncertainty is taken into account
when conducting risk assessments and
justifying any decision not to provide
constant supervision.
10
MAIB Safety Digest 1/2017