Final report into PV Corsair grounding handed down, human error blamed

Almost 17 months after the dramatic late night grounding of a vessel that saw three people rescued by water police near Point Lonsdale, an investigation has found human error was to blame.

The final report into the October 2023 grounding of PV Corsair on the Point Lonsdale reef has been handed down.

Human error has been blamed for the grounding of a pilot boat on Point Lonsdale reef, an investigation into the October 2023 incident has found.

The report said the coxswain of the vessel, Corsair, misinterpreted the leading lights that marked the entrance to Port Phillip Heads and navigated to the west of the intended course.

The Australian Transport Safety Bureau published the findings on Thursday, having released an interim report more than 12 months ago.

Corsair, operated by Port Phillip Sea Pilots (PPSP), had collected the pilot of outbound container ship MV Rio Grande about two nautical miles southwest of the entrance.

It was returning to its Queenscliff base when it hit the reef, 500m from the Point Lonsdale coastline, travelling at about 24 knots.

The other launch crew member, a deckhand, was also not actively involved with the vessel’s navigation.

All three crew members aboard were rescued uninjured by Victoria Water Police at 1.30am on October 6, about two hours after the grounding occurred.

Corsair was wrecked during the night by the effect of the sea and the reef.

The Heads, or The Rip as it is also known, is a narrow waterway that connects Port Phillip to Bass Strait and which all ships visiting Melbourne and Geelong ports must pass.

The final report into the grounding of Corsair on Point Lonsdale reef has been handed down.

Chief investigator Mark Smallwood said the investigation found the Corsair coxswain had misinterpreted navigation aids on Shortland Bluff.

“The incidence of human error can be reduced through effective use of available resources including a vessel’s equipment and crew,” Mr Smallwood said.

“In this case, the coxswain relied on visual observations, and did not make effective use of available on-board navigational equipment.”

Corsair was destroyed during the night.

While not found to have contributed to the grounding, the report made a number of findings relevant to PPSP.

It noted that the pilot launch safety management system and procedures could be improved, while documentation supporting the training and assessment of launch coxswains was limited in detail and training records were incomplete.

Source: Office of the Chief Investigator.

In response, PPSP has developed additional guidance material for pilot launch operations and the effective use of launch equipment and crew resources.

This includes the review of risks associated with single person error and the updating of safety management systems.

The investigation was conducted by the Victoria’s Office of the Chief Investigator, on agreement with the Australian Transport Safety Bureau.

Originally published as Final report into PV Corsair grounding handed down, human error blamed