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Date: Thu, 2 Nov 2017 14:15:50 -0400


The USS Fitzgerald case seems to be mostly human error, but the USS John S
McCain case includes significant elements of poor ergonomics in the computers.

Extracts from the report:

At 0519, the Commanding Officer noticed the Helmsman (the watchstander
steering the ship) having difficulty maintaining course while also
adjusting the throttles for speed control. In response, he ordered the
watch team to divide the duties of steering and throttles, maintaining
course control with the Helmsman while shifting speed control to another
watchstander known as the Lee Helm station ... The CO had only ordered
speed control shifted. Because he did not know that steering had been
transferred to the Lee Helm, the Helmsman perceived a loss of steering.
... Additionally, when the Helmsman reported loss of steering, the
Commanding Officer slowed the ship to 10 knots and eventually to 5 knots,
but the Lee Helmsman reduced only the speed of the port shaft as the
throttles were not coupled together (ganged). The starboard shaft
continued at 20 knots for another 68 seconds before the Lee Helmsman
reduced its speed. The combination of the wrong rudder direction, and the
two shafts working opposite to one another in this fashion caused an
un-commanded turn to the left (port) into the heavily congested traffic
area in close proximity to three ships, including the ALNIC.

So, to gain operational flexibility it seems that the KISS principle (Keep
It Simple Stupid) has been egregiously ignored. There were 8 stations to which control could be transferred via pull-down menus and pop-ups. On top of that there are multiple operating modes that change the capabilities of those stations. A minimum of 24 crew would have to be trained on all the details.

[Remember the Einstein version of the KISS principle:
Everything should be made as simple as possible, *but no simpler*. PGN]

Few RISKS readers have commanded a ship at sea, but almost all have flown on an airliner. Imagine if 8 other stations on the plane or on the ground were able to take control away from the pilot such that the pilot doesn't even know if he is in control or not.

I am a technologist but also a blue water sailor. I am so KISS that I rejected a steering wheel in favor of an old fashioned tiller because complex steering can fail at sea.

I also have a grandson in the US Navy. Now, I'm very worried about his safety. There used to be "the Navy way" of doing things. That meant that any seaman with minimal training could perform critical tasks. Apparently, that no longer applies.

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