The Marine Casualty Investigation Board (MCIB) has called on the Minister for Transport to consider a review and update of regulations on the use of liquefied petroleum gas (LPG) installations and systems on merchant vessels, fishing vessels, pleasure craft and other marine craft.
It is one of a series of recommendations in the MCIB’s report into the death of Det Garda Deirdre Finn in a fire on board a motor cruiser at Carrick-on-Shannon in early August 2023.
Det Garda Finn was serving as a detective in the Dún Laoghaire district of south Dublin and was also an official with the Garda Representative Association (GRA).
The MCIB recommendation to the Minister says the review and update of regulations must relate to the importance for “owners and operators of any vessel operating LPG systems onboard”.
The report says that the most likely cause of the fire on board the Freeman 33 river cruiser named DollFinn was that the pipe supplying LPG gas to the gas-fired refrigerator failed, thereby releasing LPG gas onto the after deck of the boat.
“On the morning of August 7th 2023, in all probability, LPG filled the after deck of the vessel DollFinn,” the report says.
“The calm conditions and high atmospheric pressure at that time ensured the LPG was not disturbed allowing it to build-up in volume until it reached a point that the pilot light for the refrigerator ignited the built-up LPG. The resulting fire generated a large and fatal level volume of carbon monoxide gas, which flooded into the sleeping quarters ahead of the fire,” it says.
“Evidence that the casualty was found lying on her back in a relaxed position would suggest that she was asleep when she inhaled carbon monoxide gas in high concentration and never knew or responded to the fire or the effects of the gas,” it says.
The vessel DollFinn was taking part in the 61st Shannon Boat Rally, organised by the Inland Waterways Association of Ireland between July 28th and August 6th, 2023.
The DollFinn was moored port side too at the northern most leg of the Emerald Star Marina in Carrick-on-Shannon.
The report notes the vessel had been surveyed while ashore, and was in “reasonable cosmetic condition” and some new safety equipment had been installed prior to relaunching.
The report says that one of the recommendations from the 2022 Condition Survey Report was that a carbon monoxide alarm should be fitted in the forward cabin/galley area.
“ An MCIB investigator inspected the remains of the vessel in January 2024 at a storage yard in Co Sligo. On inspection of the vessel, it was not possible to determine if this recommendation had been acted upon,”the report says
“ The MCIB investigator could find no evidence of a smoke or fire alarm onboard DollFinn, similarly there is no mention of any such alarms in the An Garda Siochána technical report,”the report says.
Carrick-onShannon Garda Station reported that at approximately 07.55 hrs they were alerted to a boat on fire at the Marina, Townparks, Carrick-on-Shannon, Co Leitrim.
The report says that several individuals from nearby boats attempted to get the blaze onboard DollFinn under control but without success.
It says that one Garda Siochána statement estimates that more than 20 portable fire extinguishers and a hose were used in the effort to fight the fire but “didn’t have any effect”.
One witness attempted to locate the casualty, and is quoted as stating that “I tried to break a window to gain access and I tried to open the hatch over the end of where her bed would be”.
“I eventually got the hatch open and as I did a huge amount of black smoke came out. I took a deep breath and took a dive down with my arms to try and feel around. I pulled out the duvet and tried to use that for some protection against the heat,”the witness told the MCIB.
“ I took a second deep breath and tried again. I couldn’t feel anything and at this stage the heat became over whelming. I had to get off the boat, my back was getting singed,”the witness said.
The MCIB says that the coroner’s autopsy report states that death was due to inhalation of combustion products including carbon monoxide, and “the determination of the cause of death is a matter for a coroner’s inquest”.
The report notes that as a privately owned and operated recreational vessel the only Irish legislation applicable to DollFinn is the Code of Practice for the Safe Operation of Recreational Craft.
“As the vessel is less than 13.7 m in length, the Merchant Shipping Fire Appliances rules do not apply. There are currently no statutory fire appliance requirements for recreational craft less than 13.7 m in length,”it says.
The MCIB makes a number of recommendations directed to the Minister for Transport, Waterways Ireland, Irish Marine Federation and the Inland Waterways Association of Ireland.
It says the minister should consider “amending the Code of Practice for the Safe Operation of Recreational Craft to include specific reference to fitting gas, carbon monoxide, smoke and/or heat detectors in all vessels with onboard liquefied petroleum gas systems”.
Waterways Ireland told MCIB that it is updating Shannon and canal bye-laws, which would grant it enforcement powers regarding the unsafe operation of vessels including the use of equipment such as gas installation systems.
“It is their intention to utilise the bye-laws legislation for that purpose. In the interim, Waterways Ireland will continue to promote safe on water behaviours under the current bye-laws,”the MCIB report says.
The full report is here
