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What happened?
A diver was working on a subsea isolation valve.
The diver was asked to operate an override switch on a remotely operated vehicle (ROV) with a hand-held torque wrench.
This was observed by another worker who intervened and stopped the job.
There was a possibility that the spring mechanism could unwind in an uncontrolled manner, causing the torque wrench to rotate and hit the diver.
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Why did it happen?
The warnings on the general assembly (GA) drawings stating that hand-held tools should not be used were confusing and missed.
The valves procedure did not include the dangers of using hand-held tools to operate the ROV override.
Engineers were not issued with the appropriate installation operations manual which included warnings not to use hand-held tools.
They assumed that a hand-held torque wrench could be used. Similar incidents had occurred within the organisation.
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What did they learn?
Any operation of an ROV override on a double actuated spring ¼ turn ball valve should not be operated with a manual hand-held torque tool unless there is clear confirmation from the valve manufacturer that it is safe to do so.
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Ask yourself or your crew
What could have been the outcome if the colleague had not intervened?
How would you intervene in this type of situation?
Does all the equipment you use have clear warning labels?
Have you ever made assumptions on which tools are safe to use? How did you know the assumptions were correct?
Do your procedures and guidance documents include all the dangers of using inappropriate tools?
What measures do we have in place to prevent this from happening here? How can we improve?
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
What happened?
A diver was working on a subsea isolation valve.
The diver was asked to operate an override switch on a remotely operated vehicle (ROV) with a hand-held torque wrench.
This was observed by another worker who intervened and stopped the job.
There was a possibility that the spring mechanism could unwind in an uncontrolled manner, causing the torque wrench to rotate and hit the diver.


Why did it happen?
The warnings on the general assembly (GA) drawings stating that hand-held tools should not be used were confusing and missed.
The valves procedure did not include the dangers of using hand-held tools to operate the ROV override.
Engineers were not issued with the appropriate installation operations manual which included warnings not to use hand-held tools.
They assumed that a hand-held torque wrench could be used. Similar incidents had occurred within the organisation.

What did they learn?
Any operation of an ROV override on a double actuated spring ¼ turn ball valve should not be operated with a manual hand-held torque tool unless there is clear confirmation from the valve manufacturer that it is safe to do so.

Ask yourself or your crew
What could have been the outcome if the colleague had not intervened?
How would you intervene in this type of situation?
Does all the equipment you use have clear warning labels?
Have you ever made assumptions on which tools are safe to use? How did you know the assumptions were correct?
Do your procedures and guidance documents include all the dangers of using inappropriate tools?
What measures do we have in place to prevent this from happening here? How can we improve?
A diver was asked to operate a remotely operated vehicle (ROV) override switch with a hand-held torque wrench. A fellow worker recognised that there was a possibility that the spring mechanism could unwind in an uncontrolled manner, causing the torque wrench to rotate and hit the diver. He intervened and stopped the job.