The Marine Accident Investigation Branch (MAIB) has published its findings regarding the tragic death of Chief Engineer Roy Temme aboard M/Y Baton Rouge in Falmouth Harbour, Antigua, on February 23, 2024. The investigation concluded that Temme, a 47-year-old British national, lost his life as a result of electrocution while carrying out maintenance work.

According to the report, Temme was electrocuted while replacing a damper actuator in a ventilation overpressure duct compartment. Despite immediate resuscitation attempts, he could not be revived and was pronounced dead later that day.

The investigation identified a number of safety lapses that contributed to the fatal accident. These included the absence of isolation of the electric supply before starting the maintenance work, the lack of a permit to work (PTW) for electrical tasks, and a safety management system onboard that did not adhere to industry standards for enclosed spaces, leading to non-compliance with proper working and entry procedures.

Following the incident, Nigel Burgess Limited, the yacht’s manager, has taken corrective actions such as updating the PTW guidelines for electrical systems, revising the definition of enclosed spaces in safety management systems, and issuing fleet-wide guidance on revised definitions, PTWs, onboard risk controls, training, and drills.

The report's investigation determined that Temme’s electrocution occurred when he made contact with live 230VAC conductors while working on the ventilation damper electric circuit. However, the exact reason for this contact remains unknown. It was also noted that the PTW system failed to identify the hazards associated with the task, possibly because the crew did not recognize the area as an enclosed space. Additionally, no rescue plan was in place for extracting a person from the overpressure duct compartment.

As a result of the measures already implemented post-incident, MAIB did not make any further recommendations. Nigel Burgess Limited has made significant changes, including enhancing the PTW process for electrical work, emphasizing precautions against electrical shock, discouraging work on live electrical systems whenever possible, and updating safety manuals, risk assessments, and operational procedures to underscore the importance of enclosed space definitions.