The National Transportation Safety Board found that a harbour pilot’s simple but critical error led to the tanker Platanos striking a refinery pier during an undocking manoeuvre in California. The pilot mistakenly reversed the positions of assist tugs on a reference card and issued incorrect commands, causing the vessel’s stern to swing toward the pier instead of away. The incident, which resulted in over $500,000 in damage but no injuries or pollution, highlights how routine operations can quickly escalate due to human error, particularly under conditions of limited visibility and fatigue.
