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Deepwater Horizon Oil Spill download - Coggle Diagram
Deepwater Horizon Oil Spill
Human Factors
Concrete was not allowed to set before a negative pressure test was undertaken
poor communication between workers
Due to poor work culture
latent failure :forbidden:
Active failure :forbidden:
Guidelines for undertaking a negative pressure test were not followed
Workers were not trained in the correct procedures
Latent Failure :forbidden:
Result of the negative pressure test were misinterpreted
Active Failure :forbidden:
Well was not monitored for an extended period of time on the day of explosion
Mud Loggers were told to stop monitoring well for an extended period of time
Active Failure :forbidden:
Patrick k. Smith (2013) discuses the lack of monitoring by Mud loggers
Management Factors
Communication
Management did not review the cement test to verify quality
management procedure issue- latent Failure :forbidden:
Time pressure, due to multiple set back
Latent Failure :forbidden:
management did not follow conventional ways of capping the well for temporary abandonment
Management did not adhere to safety standards set apon them
Active failure :forbidden:
Management ignored a 'lesson learned" document for a previous well incident
Active Failure :forbidden:
Safety budgets were cut in a bid to safe Bp money
Deterioration of public towards offshore rigging
Lack of creating a crisis communication plan
D.Wolf (2013) enforces how important a crisis comminciation plan is and the lack of one on Bp's behalf
Event sequence :red_flag:
Deepwater Horizon was set up in 2001 to drill for oil in the Macondo well.
The rig was owned by Transocean and leased to British Petroleum :
Well was drilled and capped with concrete
Hydrocarbons escaped the well and ignited creating a massive explosion and fire
11 people died and 17 were injured
Blow out preventer system did not stop oil from leaking into the ocean
49,000,000 barrels of oil spit into the gulf of mexico
Workplace factors
Electrical systems were not adequate to support fire systems in the event of a blow out
Latent Failure- Design flaw :forbidden:
Cement was used without looking getting an in-depth evaluation of the cement test
Phillip Broadwith (2010) highlights the importance of reviewing cement test and not overlooking details
An unapproved technique was used to determine cement placement
Cement bond log was not used
Latent Failure :forbidden:
Dangerous well conditions
precondition :forbidden:
Maintenance cycles
Poor procedures on maintenance cycles of critical components
poor communication of what maintenance had or had not been undertaken
System Parts
Oil rig
Hull
Power module
Electrical systems in parts of the rig were not adequate
Latent Failure :forbidden:
Dan little (2010) explains that engineers overestimated the reliability of critical components upon the oil rig
Process module
Drilling module
People
Rig manager
Driller derickhand
Floor hand
Lease hand
Management
Chron contributor (2020) breaks down the different roles on an offshore oil rig
Onshore customers
Onshore contractors
Safety components
Blow out preventer (BOP)
Blow out preventer batteries were not charged
poor maintenance
latent Failure :forbidden:
Gpo (2010) goes into detail as to why the batteries were flat on the BOP
Life boats
Fire Extinguishers
Safety alarms
Safety alarms had not been working for a number of week prior to incident
equipment design flaw :forbidden:
Management latent failure :forbidden:
Transocean's shut-in protocol did not address how to respond to a major blow out
Latent failure :forbidden:
