Fire on Board the Liberian Passenger Ship Ecstasy, Miami, Florida ...

Conclusions 77 Marine Accident Report12. The procedures used by the Ecstasy’s shipboard personnel did not adequately accountfor passengers and crewmembers during the emergency.13. The lack of consistency between the information provided at the practice drill aboutthe provision of lifejackets and the procedures that crewmembers followed indistributing lifejackets during the actual emergency created unnecessary confusionamong some passengers on the Ecstasy.14. The lack of a means to call for help from the crew cabins delayed the rescue of twocrewmembers and contributed to the severity of their smoke inhalation injuries.15. The emergency response by shipboard and shoreside firefighters to the fire wastimely and appropriate, resulting in the fire being properly contained andextinguished.16. The failure to separate the power circuitry in the design arrangement of the auxiliaryvoltage supply to the high-speed breakers of the propulsion systems resulted ininadequate isolation of essential system components, which, in turn, resulted in theshutdown of both propulsion systems when a single distribution panel was damaged.17. To ensure the highest levels of safety and reliability, ship owners should require theuse of qualitative failure analysis techniques in the design and construction of theirvessels.Probable CauseThe National Transportation Safety Board determines that the probable cause offire aboard the Ecstasy was the unauthorized welding by crewmembers in the mainlaundry that ignited a large accumulation of lint in the ventilation system and the failure ofCarnival Cruise Lines to maintain the laundry exhaust ducts in a fire-safe condition.Contributing to the extensive fire damage on the ship was the lack of an automatic firesuppression system on the aft mooring deck and the lack of an automatic means ofmitigating the spread of smoke and fire through the ventilation ducts.