1. HSE LEARNING INCIDENT:
Floorman was standing on the rig floor cover plate slipping drilling lines. The plate moved causing him to fall into the bottom box beam. He broke his jaw bone. Pics Next Page
CAUSES:
Slip drill line procedure with old mast /sub-base design was used.
Rig management did not report the inadequate / incorrect procedure or the lifting of the floor plate observed to base management.
No MOC was raised to risk assess the change and put in appropriate mitigations to control and communicate the change.
The JSP / TRIC and TBT failed to have a plan, identify the associated hazards and risks and put in adequate barriers to manage removal of the floor plate.
The supervisor (NTP) was operating the utility winch, instead of supervising the job.
LEARNINGS:
Enforce Strict compliance to Management of Change (MoC) process.
Supervisor(s) are to supervise the job and stay away from getting manually involved.
Immediately update procedures after a change has been approved for implementation.
Refer to and Use the procedure / JSP / JHA during planning every job.
Identify all associated hazards, assess their risks and put in effective mitigations prior to starting any job .
Key Learning:
Struggling to do a job? STOP!!!! THINK and work a safe solution.
Broken Jaw
Use this Alert: Discuss in Tool Box Talks and HSE Meetings  Distribute to contractors  Post on HSE Notice Boards  Include in site HSE Induction
Contact: MSE511 for further information or visit the HSE Website Alert No 91 LTI # July, 2012

2. HSE LEARNING Broken Jaw
Use this Alert: Discuss in Tool Box Talks and HSE Meetings  Distribute to contractors  Post on HSE Notice Boards  Include in site HSE Induction
Contact: MSE511 for further information or visit the HSE Website Alert No 91 LTI # July, 2012