OAR 856-019-0010: Incident Investigation Procedures

(1) Upon receiving notice that an incident has occurred, the Board member who is a licensee for the pilotage ground where the incident occurred will commence a preliminary investigation as soon as practicable. If the incident involves that Board member, or if that Board member is not available to commence a timely preliminary investigation, then the Board Chair will appoint another Board member to commence the preliminary investigation, in which case the Board Chair will also seek a volunteer from among those who are or have been licensees for the pilotage ground where the incident occurred, to serve as an advisor to the Board member conducting the preliminary investigation. (2) The Board member conducting the preliminary investigation will, as soon as possible after receiving notice that an incident has occurred, gather sufficient information to form an opinion regarding whether the incident is likely to be a Category I or Category II incident, according to the following criteria: (a) Category I Incident: (A) Property damage exceeding $200,000; or (B) loss of life or serious personal injury (requiring hospitalization); or (C) allision with a bridge; or (D) release of more than 50 gallons of oil or other hazardous substance into the water; or (E) a pilot may have been acting under the influence of drugs or alcohol or there is evidence of gross negligence or willful misconduct; or (F) any factor that results in substantial, widespread public interest in the incident. (b) Category II Incident: Any incident reportable under Board regulations that does not satisfy any of the criteria in OAR 856-019-0010(2)(a). (3) As soon as possible after completing the preliminary investigation, the investigating Board member will contact the Board’s Chair to make a preliminary report and recommendation regarding classification of the incident as Category I or Category II. Based on the preliminary report, the investigating Board member’s recommendation, and such other factors as the Board Chair deems appropriate under the circumstances, the Board Chair will, in his or her discretion, determine whether to classify the incident as Category I or Category II. (4) Upon the Chair’s classification of an incident as Category I, an investigating team will be promptly appointed by the Chair. The investigating team will include: (a) The Chair or other public member of the Board, to serve as the team leader; and (b) a shipping industry or port representative member of the Board; and (c) the pilot member of the Board from the pilotage ground where the incident occurred, unless the incident involves that pilot, in which case the Chair will appoint another pilot member of the Board. If the pilot Board member appointed to the investigating team is not a licensee on the pilotage ground where the incident occurred, then the Board will request a volunteer from among those who are or have been licensees for the pilotage ground where the incident occurred, to serve as an advisor to the investigating team. (5) Upon the Chair’s classification of an incident as Category II, the Board member who conducted the preliminary investigation shall proceed with completion of the investigation. The Chair may, at any time during the course of the investigation, upon receipt of new information, elect to reclassify the incident as a Category I incident requiring the appointment of an investigating team. (6) The services of a qualified independent investigator, or an expert in a discipline that is relevant and necessary for determining the cause of an incident, should be obtained in the following circumstances: (a) In any Category I incident, upon request of the Chair, or of two or more members of the investigating team. (b) In any Category II incident, upon agreement of the Chair and the Board member conducting the investigation. (7) In order to qualify as an expert for purposes of OAR 856-019-0010(6), a person must have a postgraduate degree, professional training or substantial practical experience in a discipline or subject matter that the Board investigators determine is relevant and necessary for determining the cause of an incident. (8) The Board will keep and periodically update a list of qualified independent investigators who may be available to provide services. In order to qualify as an independent investigator for the Board, a person must: (a) Have had at least four years previous experience investigating maritime casualties; or (b) have served at least two years as pilot or master of vessels greater than 1600 GRT, and had formal training in investigations procedures or extensive actual experience investigating maritime casualties. (9) The role of an independent investigator is that of an advisor to the investigating team in a Category I incident, or to the investigating Board member in a Category II incident. An independent investigator is to serve as a fact gatherer at the direction of the Board investigators, delivering information to the Board members investigating the incident. Information gathered by an independent investigator may be used by the investigating Board members for their analysis and for use in their preparation of a written report with their recommendations to the Board as a whole. (10) When the investigation is complete, the investigating Board member or members will prepare a written report for consideration by the Board. The report shall describe the scope of the investigation, the information gathered, and include an assessment of the probable causes of the incident, and recommendations for any further Board action that should be considered. The written report shall also make a recommendation concerning the scope of distribution of the report.