GU-612 2012 Incident Notification and Investigation Guideline

Revision: 3.
0
Petroleum Development Oman LLC Effective: Nov -12
Petroleum Development Oman L.L.C.
Incident Notification and Investigation Guideline
Document ID GU-612
Document Type Guideline
Security Un-restricted
Discipline HSE
Owner MSE5
Issue Date 30/11/12
Version 3.0
Keywords: This document is the property of Petroleum Development Oman, LLC. Neither the whole nor any part of this
document may be disclosed to others or reproduced, stored in a retrieval system, or transmitted in any form by any
means (electronic, mechanical, reprographic recording or otherwise) without prior written consent of the owner.
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Revision: 3.0
i Document Authorisation
Authorised For Issue
Document Authorisation
Document Authority Document Custodian Document Controller
(CFDH)
Saeed Maamery Christopher Evans Christopher Evans
Ref. Ind::MSE5 Ref. Ind::MSE/54 Ref. Ind::MSE/54
Date: 30/11/2012 Date: 30/11/2012 Date: 30/11/2012

Revision: 3.0
ii Revision History
The following is a brief summary of the 4 most recent revisions to this document. Details of all revisions prior
to these are held on file by the issuing department.
Version No. Date Author Scope / Remarks

Version2.0 Aug-08 Nivedita Ram Updated in line with the Yellow Guide –
issue Dec 31, 2007. Inclusion of
MSE5
Incident Investigation Guidelines, ToR
for MDIRC, OSHA Guidelines. The
Guideline replaces the PR1418 Part II
and Part III
Version 1.0 Dec-03 Ohimai Aikhoje Updated in line with new SIEP
Standard for Health, Safety and
MSEM/4
Environmental Management Systems –
Incident reporting and Follow up EP
2005-0100-29.
Follows new EP global procedure for
Incident Reporting and Follow Up.
Version 1.0 July-03 Andrew Ure Update Procedure to bring it into line
with FIM Incident Management tool,
MSEM/4X
and with PDO re-organisation (Version
Not Issued)
Version 1.0 July-02 Chidozie Nzeukwu Supersedes HSE/97/01, Rev.3.
Ratification of reportable incidents by
MSEM/13
Area HSE Team Leader initially instead
of MSEM; update Environmental
Incident Notification Form; include
MDC review of contractor
disqualification for fatal incidents per
Commercial Procedures and
Guidelines; add MD Review of
Incidents meeting; clarify procedures
relating to non-accidental death; align
risk matrix with CP 122 HSE
Management System Manual. Inclusion
of information on PDO’s ‘incident
tracking tool’. Inclusion of Guidelines
on operation of IRCs.(Version Not
Issued)
iii Related Business Processes

Code Business Process (EPBM 4.0)
PR1418 Incident Investigation and reporting
iv Related Corporate Management Frame Work (CMF) Documents

Revision: 3.0
The related CMF Documents can be retrieved from the Corporate Business Control Documentation Register
CMF.

Revision: 3.0
TABLE OF CONTENTS
i Document Authorisation 3
ii Revision History 4
iii Related Business Processes 4
iv Related Corporate Management Frame Work (CMF) Documents 4
1. Introduction 7
1.1 Background 7
1.2 Purpose 7
1.3 Distribution/target audience & further copies 7
1.4 Structure of this document 7
1.5 Review & improvement 7
2. Incident investigation and reporting guideline 8
2.1 Scope 8
2.2 Description 9
2.2.1 Assessment of the actual incident severity 10
2.2.2 Tables defining severity levels in the RAM 11
2.2.3 Classifying process safety (AI-PS) tier events 15
2.2.4 Assessment of the initial potential risk rating 18
2.2.5 Guide to injury classification 21
2.2.6 Type of injury related to classifications 21
2.2.7 Incident ownership 23
2.2.8 Work relatedness of an incident 25
2.2.9 Determining the level of investigation and team composition 30
2.2.10 Incident InvestigationTerms of Reference (ToR) 32
2.2.11 Conducting a successful investigation 34
2.2.12 Incident reports 52
2.2.13 PDO Incident Review Committees (IRC) 55
2.3 Roles and Responsibilities 58
2.4 Related Business Control Documents 58
Appendices 59
Appendix A, Glossary of Definitions, Terms and Abbreviations 59
Appendix B, Forms and Reports 71

Revision: 3.0
2.2.14 Appendix 1: Template of Email from Operations to Senior PDO management 72

2.2.15 Appendix 2: Reporting Significant Incidents to SIEP and Stakeholders 73
2.2.16 Appendix 3: Initial Incident Notification form 74
2.2.17 Appendix 4: Statement of Fitness – After Restart: 75
2.2.18 Appendix 5: Template for low severity Incident Investigation Report 76
2.2.19 Appendix 6: General Medium Potential Incident Investigation Form 76
2.2.20 Appendix 7: Medium and High Potential Investigation Report content and format 93
2.2.21 Appendix 8: Medium/High Potential Road Traffic Incident Report & advice 95
2.2.22 Appendix 9: Non-accidental Death Reports (NAD) 104
2.2.23 Appendix 10: Template for Incident Review Presentation 107
2.2.24 Appendix 11: Example of a Lateral Learning 114
2.2.25 Appendix 12: Declaration of confirming close out of Redline actions 115
2.2.26 Appendix 13: Serious Incident Review template 117
2.2.27 Appendix 14: Level 3 SIR briefing note 119
2.2.28 Appendix 15: Determining environmental incident risk potential 120
2.2.29 Appendix 16: Completing the Statement of Fitness – Asset restart 126
2.2.30 Appendix 17: Using FIM to enter an incident – new input module 128
2.2.31 Appendix 18: Using FIM to enter an incident – old method 140
2.2.32 Appendix 19: Using Tripod Beta 150
2.2.33 Appendix 20: Investigation timetable – key events 151
2.2.34 Appendix 21: Examples of underlying causes relating to active causational failures 152
Appendix C, Related Business Control Documents and References 153

Revision: 3.0
1. Introduction
1.1 Background
The guideline provides information, definitions, templates, guidance and examples to help incident
investigations and is designed to be used in conjunction with the procedure for investigating
incidents, PR1418.
1.2 Purpose
The guideline follows the process flow within PR1418.
1.3 Distribution/target audience & further copies
The target audience is for HSE Teamleaders, HSE Managers/Advisers, Contract Holders, Contract
Site Reps, Contract Managers, Operational management and anyone who may be called upon to
report, notify, escalate or investigate an incident.
1.4 Structure of this document

The guidance in the document follows the incident reporting and investigation pathway providing
guidance on the assessment and classification of the incident, notification, investigation, reports and
presentations, learning from incidents through to the IRC and SIR process. The appendices contain
examples and templates and a comprehensive list of definitions for key terms used in incident
investigation
1.5 Review & improvement

This document shall be reviewed every 3 years and revised if necessary by MSE54, in line with any
changes in PR-1418.

Revision: 3.0
2. Incident investigation and reporting guideline

2.1 Scope
The guideline is relevant only to Health, Safety and Environment incident reporting and investigation, which
includes Process Safety (AI-PS) incidents.
2.2 Description
2.2.1 Assessment of the actual incident severity
Using the PDO Risk Assessment Matrix (RAM)
The PDO RAM shall be used to classify the actual severity of an incident:
The left hand column represents a rating of the severity of consequences (level 0 to 5) for harm or
damage to people (P), assets (A), the environment (E) or PDOs reputation (R). Each row provides a
different severity level for the incident’s actual consequences.
Find the most appropriate statement for the consequences of the incident in the rows 0 to 5 using the
descriptions in section 1.2.

Revision: 3.0
For determining the actual severity ratings, ignore the coloured box on right of the RAM.
Examples
A major injury to a person gives an actual severity of 3(P)

A major environment impact gives an actual severity of 4(E)
A slight damage to equipment gives an actual severity of 1(A)
A massive impact on PDOs reputation gives an actual severity of 5(R)
In cases where an incident has multiple effects, the most severe shall prevail in the classification.
Where the severities are equal the injury to personnel has priority over other effects.
For example
“A process vessel leaks and causes a flash fire, killing 3 people and resulting in damage and
deferrement costs of $15M.
The people consequence is classed as a 4 (P)
The asset consequence is classed as a 5 (A)
Hence the most significant risk for classification of the incident would be 5 (A), despite 3 fatalities
resulting from the incident.”
or,
“ A tanker rolls over and a driver suffers a broken arm as a result. The tanker is scrapped with a
resultant asset loss of $200K.
The people consequence is classed as a 3 (P)
The asset consequence is classed as a 3 (A)
As the classifications for the two categories are the same, the people consequence takes precedence
and the incident would be 3(P).”
A PDO doctor shall determine the ‘people’ injury severity involving any injury requiring anything other
than first aid treatment. This shall be provided within 48 hours of the incident and shall be done on a
purely medical basis and consideration of job type, the ruling and its rationale shall be recorded in
writing in the report from the PDO doctor.
The four tables in section 2.2.2 shall be used to determine the most appropriate definition for people,
assets, environment and reputational consequences.

Revision: 3.0
2.2.2 Tables defining severity levels in the RAM
2.2.2.1 People consequence

Use this table in determining the extent of personal injury
Severity
Definition
Level
Slight injury or health effect – Not affecting work performance or affecting normal daily life. Examples:
 First aid cases and medical treatment cases,
1
 Exposure to health hazards that give rise to noticeable discomfort, minor irritation, or transient effects
reversible after exposure stops.
Minor injury or health effect – For up to 5 days affects work performance, daily life such as restriction to
activities or to fully recover or reversible health effects. Examples:
2
 Restricted work day cases or lost work day cases resulting in up to 5 calendar days away from work,
 Illnesses such as skin irritation or food poisoning.
Major injury or health effect – For more than 5 days affecting work performance, absence from work or
affecting daily life activities or irreversible damage to health. Examples:
 Lost Work Day cases resulting in 6 or more calendar days away from work,
3
 Long term disabilities (previously called Permanent Partial Disabilities),
 Illnesses such as sensitisation, noise induced hearing loss, chronic back injury, repetitive strain
injury, or stress.
Permanent total disability or up to three fatalities – from injury or occupational illness. Examples:
4  Illnesses such as corrosive burns, asbestosis, silicosis, cancer and serious work related depression,
 Incident resulting in up to 3 fatalities.
More than three fatalities – resulting from injury or occupational illness. Examples:
 Multiple asbestosis cases traced to a single exposure situation,
5
 Cancer to a large exposed population,
 Major fire or explosion resulting in more than 3 fatalities.
2.2.22 Asset consequence

Use this table in determining the extent of asset damage including deferred oil
Severity
Definition
Level
Slight damage – Costs less than 10,000 US$. Example:

1
 No disruption to operation.
Minor damage – Costs between 10,000 and 100,000 US$. Example:

2
 Brief disruption to operation.
Moderate damage – Costs between 100,000 and 1 million US$. Example:

3
 Partial shutdown.
4 Major damage – Costs between 1 and 10 million US$. Example: Up to two weeks shutdown.

Revision: 3.0
Severity
Definition
Level
5 Massive damage – Costs in excess of 10 million US$. Example:Substantial or total loss of operation.
2.2.23

Revision: 3.0
Environmental consequence
Use this table in determining the extent of environmental damage which includes mixtures of effects, (e.g.
groundwater contamination), events with potential for environmental effect, (e.g. exceeding a limit) and
indicators of potential effects, (e.g., complaints).
Note that where there has been a quantitative solid or liquid release to soil or water to damage the
environment PDO utilises the Environmental Incident Severity Rating Index (EISRI) which is explained in
appendix 15 page 106.
Severity Level Definition
Slight effect
Slight environmental damage – contained within the premises. Example:
1
 Small spill in process area or tank farm area that readily evaporates.
 Halon and CFC release < 50 kg. Gas leak < 1,000 scm, EISRI < 50
Minor effect
Minor environmental damage, but no lasting effect.
Halon and CFC release 50 - 100 kg. Gas leak of 1,000 scm and greater. EISRI 50 - 4,999.
Examples:
 Small spill off-site that seeps into the ground,
2
 On-site groundwater contamination,
 Complaints from neighbours,
 Animal found dead in waste or water pit
 Single exceedance / of statutory or other prescribed limit,
Moderate effect
Limited environmental damage that will persist or require cleaning up. Halon and CFC release > 100 kg
EISRI 5,000 - 49,999.
Examples:
 Spill from a pipeline into soil / sand that requires removal and disposal of a large quantity of
3 soil/sand,
 Observed off-site effects or damage, e.g., fish kill or damaged vegetation.
 Off-site groundwater contamination.
 Complaints from community organisations (or more than 10 complaints from individuals).
Frequent exceedance of statutory and/or other prescribed limit, with potential long term effect.
Major effect
Severe environmental damage that will require extensive measures to restore beneficial uses of the
environment. EISRI 50,000 - 499,999 Examples:
Oil spill at a jetty during tanker (off) loading that ends up on local beaches, requiring clean-up
4 operations,
 Off-site groundwater contamination over an extensive area,
 Many complaints from community organisations or local authorities,
 Extended of statutory or other prescribed limits, with potential long term effects.

Revision: 3.0
Severity Level Definition
Massive effect
Persistent severe environmental damage that will lead to loss of commercial, recreational use, and/or
5 loss of natural resources over a wide area. EISRI > 500,000 Example:
 Crude oil spillage resulting in pollution of a large part of a river estuary and extensive clean-up
and remediation measures.
2.2.24

Revision: 3.0
Reputational consequence
Use this table in determining the extent of reputational impact
Severity Description
Level
Slight impact
1  Local public awareness but no discernible concern,
 No media coverage.
Minor impact
2  Local public concern,
 Local media coverage.
Moderate impact – Significant impact in region or country.

 Regional public concern,
3
 Local stakeholders, e.g., community, NGO, industry, and government are aware,
 Extensive attention in local media. Some regional or national media coverage.
Major impact – Likely to escalate and affect PDO reputation.

 National public concern
 Impact on local and national stakeholder relations. National government and NGO
4
involvement with potential for international NGO action.
 Extensive attention in national media. Some international coverage.
 Potential for regulatory action leading to restricted operations or impact on operating licences.
Massive impact – Severe impact on PDO reputation.

 International public concern,
 High level of concern amongst governments and action by international NGOs.
5
 International media attention,
 Significant potential for effect on national / international policies with impact on access to new
areas, grants of licences, and/or tax legislation.
2.23

Revision: 3.0
Classifying process safety (AI-PS) tier events
In addition to the RAM incident classification, PDO and the industry requires an additional classification of
process safety events classifying them into ‘Tiers’ depending on their severity.
A process safety event is an incident that occurs within the property limits of PDO owned or operated
hydrocarbon facilities (including gas plants, gathering and production stations, well pads, gathering systems,
injection systems, pipelines, etc) that resulted or could have potentially resulted in an unplanned or
uncontrolled release of:
 Combustible liquids (e.g. MEG, TEG, diesel, lube oil, hydraulic oil, etc.); or
 Flammable liquids (e.g. crude oil, methanol, IPA, etc.); or
 Flammable gas (e.g. natural gas, butane, pentane, etc.); or
 Toxic chemicals (e.g. H2S, SO2, mercury, etc.); or
 Non-toxic and non-flammable material (e.g. steam, nitrogen, compressed CO2 or compressed air)
that results in actual consequences.
The correct Tier should be identified using the table below in 2.2.3.1.
In FIM, the incident should first be classified as an “Incident with Consequences” and then in the
Environmental consequences section record the correct ‘Tier’ level.
The classifications for Tiers are shown below:
2.231 Tier 1 Process Safety Event (T-1 PSE)
A loss of primary containment with the greatest consequence as defined by API RP 754 below:
 employee or contractor (sub) lost work case injury or fatality;

 hospital admission and/or fatality of a third-party;
 officially declared public evacuation or public shelter-in-place;
 fire or explosion resulting in greater than or equal to $25,000 of direct cost to the Company (RAM 2+);
 a pressure relief device (PRD) discharge to atmosphere (whether directly or via a downstream
destructive device) resulting in a discharge quantity above the threshold quantities in the table below in
any one hour period and one or more of the following four consequences:
1. liquid carryover;
2. discharge to a potentially unsafe location;
3. an on-site shelter-in-place;
4. public protective measures (e.g. road closure);
 a release of material greater than the Tier 1 threshold quantities described in the following Table in any
one-hour period.

Revision: 3.0
NOTE Non-toxic and non-flammable materials (e.g., steam, hot water, nitrogen, compressed CO2 or
compressed air) have no threshold quantities and are only included in this definition as a result of their
potential to result in one of the other consequences.
Thres Material Hazard Classification Threshold Threshold
hold
Quantity Quantity
Relea
( Outdoor ( Indoor
s e
Categ Release ) Release )
ory
Tier 1 Tier 2 Tier 1 Tier 2
1 TIH Zone A Materials (not normally present in PDO operations, refer to SHOC 5 kg 0.5 kg 2.5 kg 0.2 kg
card)
2 Hydrogen Sulphide or other TIH Zone B Materials (refer to SHOC card) 25 kg 2.5 kg 12.5 kg 1.2 kg
3 Sulphur Dioxide or other TIH Zone C Materials (refer to SHOC card) 100 kg 10 kg 50 kg 5 kg
4 TIH Zone D Materials (refer to SHOC card) 200 kg 20 kg 100 kg 10 kg
5 Flammable Gases e.g., Natural Gas, Propane, Butane, etc. or liquids with 500 kg 50 kg 250 kg 25 kg
Initial Boiling Point ≤ 35 °C and Flash Point < 23 °C e.g. Natural Gas
Condensate) or Carbon Disulphide or Other Packing Group I Materials
excluding strong acids/bases (refer to SHOC card)
6 Liquids with Initial Boiling Point > 35 °C and Flash Point < 23 °C e.g., 1000 kg 100 kg 500 kg 50 kg
unstablised crude oil, methanol, IPA, etc. or other Packing Group II Materials
excluding moderate acids/bases (refer to SHOC card)
7 Liquids with Flash Point ≥ 23 °C and ≤ 60 °C or 2000 kg 200 kg 1000 kg 100 kg
Liquids with Flash Point > 60 °C released at a temperature at or above Flash
Point or strong acids/bases or Other Packing Group III Materials (refer to SHOC
card)
2.4.32 Tier 2 Process Safety Event (T-2 PSE)
A Tier 2 Process Safety Event is a Loss of Primary Containment incident with consequences lower than a T-1
PSE but greater than the T-2 PSE threshold in the above table.

Revision: 3.0
In general, a pin hole leak from equipment or piping containing pressurised hydrocarbon would be classed as
a T-2 PSE.
2.4.33 Tier 3 Process Safety Event (T-3 PSE)
A Tier 3 Process Safety Event is an incident resulting in a Loss of Primary Containment but below the Tier 2
threshold shown in the Table above.
Examples could include a seep or weep. These releases shall be reported at a facility level rather than in FIM.
A Tier 3 Process Safety Event can also be a Potential Incident where there has been no Loss of Primary
Containment but one of the barriers on the Bow Ties within the facility HSE Case has been challenged or
failed. Potential Incidents are also known as unsafe conditions or unsafe behaviours. Indicators at this level
provide an additional opportunity to identify and correct weaknesses within the barrier system.
Examples of Potential Incidents include:
1. Process deviation or excursion (e.g. HH level trip),

2. Discovery of a Safety Critical Equipment not meeting it’s Performance Standard upon testing (Note: this
should be raised as a corrective in SAP rather than recorded in FIM),
3. Physical damage to containment envelope not resulting in a loss of containment,
4. Discovery of incorrect equipment status (e.g., non-ex equipment installed in a hazardous area,
incorrectly made-up flanges, etc.)
5. Work taking place in a hydrocarbon area without an approved Permit (Life Saving Rule violation),
6. Discovery of uncontrolled overrides of Safety Critical Equipment (Life Saving Rule violation),
7. Hot work taking place without adequate gas testing (Life Saving Rule violation),
8. Confined space entry without approved Permit (Life Saving Rule violation),
9. Maintenance taking place without correct process isolations (Life Saving Rule violation),
10.Personnel working in a H2S area without the required PPE.
10.4.4

Revision: 3.0
Assessment of the initial potential risk rating
PDO looks at history to evaluate the potential future risk of any incident.
First ask the question “What is the worst scenario that could feasibly have gone wrong from this incident?”
Then review historical records to see if or when that last scenario actually happened and the consequences
that resulted from it.
Note that different but similar historical incidents may have led to several different outcomes and severities
affecting people (P), assets (A), the environment (E) or reputation (R).
The top row of the RAM (shown as columns A to E) represents the different degrees of likelihood of the
incident causing these potential consequences (based on how often those same consequences occurred in
the past).
The potential risk is recorded as a three digit potential risk rating:
1. Likelihood, (letter) 2. Severity (number), 3. Subject of the consequence (letter).
Example 1
A driver hit a sand-dune at high speed and suffered a major injury giving his actual severity as 3(P).
A review of records shows that PDO has suffered a death in 2 similar incidents 8 months and 11 months ago
with an actual rating of 4(P).
The potential for this person to have died then becomes D4 (P)
D = has happened more than once per year in the Company

4 = a singular fatality
P = consequences were to a person
Example 2
An engineer climbs on to the top of a storage tank is over come by H2S and dies. Two buddies in breathing
apparatus climb the tank to rescue the engineer but it is too late. The actual severity is 4(P).
A review of records shows that in PDO 3 years ago a person died in similar circumstances but the 3 man
rescue team were overcome as they did not have BA and also died with an actual rating of 4(P).
The potential for this incident is C4 (P) as four people were not involved here and so no more than 3 people
could have died even without BA.
C = has happened in the Company

4 = fatality, but less than 4
P = consequences were to a person
Example 3
A gas pipeline ruptures due to over pressure causing a moderate effect as it is spotted by a passing engineer
and the line is shut down. This gives an actual of 3(E). A review of records shows that this is the second
rupture on the same line in the same location in the last 9 months, the first caused major damage to the
environment as it was not spotted quickly. Its actual rating was 4(E)

Revision: 3.0
The potential for this incident becomes D4 (E) as it has proven it could have been worse as proven by history.
D = has happened at the location

4 = major damage
E = consequences were to the environment
Note that where there has been a quantitative solid or liquid release to soil or water to damage the
environment, PDO utilises the Environmental Incident Severity Rating Index (EISRI) which is explained in
appendix (15) page 106 to determine the potential environmental risk.
Boxes in the matrix represent different risk levels divided into light blue, blue, yellow and red areas.
1. Red – High potential incident

2. Yellow – Medium potential incident
3. Blue – Low potential incident
The four areas describe the level of control required to manage risk:
 Red: Identify and implement controls and recovery measures to reduce the risk to ALARP and provide
a documented demonstration of ALARP by a Bow-Tie or equivalent methodology.
 Yellow: Identify and implement controls and recovery measures to reduce risk to as Low As
Reasonably Practicable (ALARP).
 Dark Blue: Manage for continuous improvement through the effective implementation of the HSE
Management System.
 Light Blue: Manage for continuous improvement, although PDO may set lower priority for further Risk
reducton.
Risk = Severity of incident X Likelihood of the incident occurring.

Revision: 3.0
In order to determine the potential risk rating, the person assessing the incident must find the colour of the box
for the severity and likelihood you have agreed on. For the last examples
Example 1 was D4 (P) = Red

Example 2 was C4 (P) = Yellow
Example 3 was D4 (E) = Red
For clarity, use the explanations of terms in the RAM in the table below.
1.3.41 Definitions in the RAM to assess likelihood

Use the following definitions in the likelihood section of the RAM.
Industry Upstream Oil and Gas Industry
Company PDO and its contractors/subcontractors conducting PDO contracted work
Heard of By conducting a reasonable search in FIM, reviewing the website, industry literature, asking
HSE Advisers or operations
Has happened The previous incident must be similar in nature to the incident being investigated and have
similar primary causes but can be more severe in consequences and does not include the
incident being investigated.
Year Within the last twelve calendar months from the date of the incident being investigated, but
not including the date of the incident.
Location Depends on the type of operation
1 Exploration – same survey field, (e.g. Lekhwair seismic field)
2 Drilling – rig involved, not where the rig is drilling (e.g. rig 18)
3 Asset Integrity – the same facility, (e.g. pumping station, gas plant)
4 Pipeline – the same pipeline (e.g. header, MOL)
5 Road incident – same operational area, (e.g. Fahud, Nimr)
6 Camp incident – the same camp, not where the camp is situated.
63.5

Revision: 3.0
Guide to injury classification
The main injury classifications are:
63.5.1 First Aid Case

Any work related injury that involves neither lost workdays, restricted workdays or medical treatment but
which receives first aid treatment. (See appendix 1 page 50 for definitions)
63.5.2 Medical Treatment Case

Any work related injury that involves neither lost workdays or restricted workdays, but which receives medical
treatment.
63.5.3 Restricted Work Case

Any work related injury or illness that keeps the employee from performing one or more of the routine
functions associated with their job or a medical physician recommends that the employee not perform one or
more of their job's routine duties. A person must be signed back as “Fit to return to normal duty” by the PDO
doctor before being allowed to resume their normal work. This will be recorded on the Medical Services Injury
Form who will also send a copy to MSE52 when complete.
63.5.4 Lost Work Case

Any work related injury that renders the injured person temporarily unable to perform their normal work or
restricted work on any day after the day on which the injury occurred. Any day includes rest day, weekend
day, scheduled holiday, public holiday or subsequent day after ceasing employment. This excludes lost time
where the person is kept under precautionary observation and where such observation shows there is no
cause for concern. A person must be signed back as “Fit to return to duty” by the PDO doctor before being
allowed to resume work. This will be recorded on the Medical Services Injury Form who will also send a copy
to MSE52 when complete.
63.6 Type of injury related to classifications
63.6.1 Classifications of lost work cases for any type of work.

The PDO doctor will use the following reference list to determine if an injury should reasonably require time
from work irrelevant of whether the employee returns back to work without PDO doctor clearance. List
include:
 Fracture of any bone,

 Amputation
 Dislocation of the shoulder, hip, knee or spine;
 Chemical or hot metal burn to the eye or any penetrating injury to the eye;
 Injury resulting from an electric shock or electrical burn leading to unconsciousness, or requiring resuscitation or
admittance to hospital for more than 24 hours other than observation;

Revision: 3.0
 Any other injury leading to heat-induced illness or unconsciousness, or requiring resuscitation, or requiring
admittance to hospital for more than 24 hours other than observation;
 Unconsciousness caused by asphyxia or exposure to a harmful substance or biological agent;
 Acute illness requiring medical treatment, or loss of consciousness arising from absorption of any substance by
inhalation, ingestion or through the skin;
 Acute illness requiring medical treatment where there is reason to believe that this resulted from exposure to a
biological agent or its toxins or infected material.
63.62 Likely classifications of lost work cases for certain job types.
The following are additional injuries relating to specific job types which will render an injury a Lost Work Case.
 Professional Driver : Injury to eyes, head, arms, legs or neck which prohibits the person from driving.
 Manual work : Hairline fracture, amputated finger, thumb or toe, injury affecting vision
63.63 Likely classifications of restricted work cases for certain job types
The following are injuries which will normally allow a person in this job type to perform a restricted duty.
 Clerical, supervisory, manager – Hairline fracture, amputated finger or thumb.
63.7

Revision: 3.0
Incident ownership
63.7.1 Directorate and management team ownership

Ownership is first assigned to a PDO directorate and then delegated to the appropriate level within the
Directorate’s line. This relates to the PDO reporting line from Director – Manager – Team Leader, etc.
The Directorate employing the Team Leader who has direct authority, control or most influence over the
work/area/service provider involved in the incident owns the incident. In disputes between two Directors,
MSEM will adjudicate and decide. In his absence this falls to the Duty Director.
63.7.2 Owning transport related incidents

PDO employee – follow the line management of the PDO employee
PDO contractor – PDO contracted and managed journey - Contract Holder
PDO contractor – milk run – see below.
63.7.3 Owning an incident on a transport milk run

A milk run is defined as a delivery journey used to supply or service more than one site or contract,
(whether for PDO or not) and there is no single Contract Holder/manager accountable for the whole
journey. In such cases the journey shall be divided into discreet trips with each trip having a distinct start
and finish location.
Any PDO asset/team using a milk run arrangement for the delivery of a load shall be aware of the details
of the journey and from this determine which trips in the milk run he has ownership of.
A PDO asset/team takes ownership of any incident on a trip which concludes (or would have concluded) in
the vehicles arrival at their asset/contractors delivery location unless the start of this trip was from another
PDO asset/team location whereby the despatching asset/team retains ownership.
An example of the above rules is shown in the diagram below with the arrows showing the direction of trips
and the incident owners shown as asset holders.

Revision: 3.0
63.7.4

Revision: 3.0
Owning incidents on installations and worksites

If the incident, (excluding transport related incidents) occurs within the Team Leaders operation then
ownership rests within the reporting line of the Team Leader: e.g.
a) any interior operational facility, installation or operations asset such as:
- plants, pumping & compression stations,
- well sites,
- PDO & contractor interior offices, camps, workshops & recreational facilities,
- flow line or pipeline rights of way, etc.
b) any area of common use within the physically fenced coastal office and industrial area
63.7.5 Has ownership been transferred?

If the incident occurs within an area where holdership was transferred in a written agreement to an Asset
Custodian, then ownership of any incident transfers to the reporting line of the Asset Custodian.
This would normally apply to:

a) drilling and service rig locations and associated camp sites,
b) seismic operational areas and associated camp sites,
c) supply warehouse and storage areas
d) green-field construction sites
e) fenced off or access controlled areas of existing facilities where only construction or maintenance
activities are underway
f) interior contractors' facilities where only one PDO Contract Holder or Service Provider is
designated as accountable for those facilities
g) PDO School and Ras al Hamra Recreation Centre
h) defined areas within the Main Office complex.
63.7.6 Cases of dispute

If several reporting lines are involved in the incident and none of the above criteria have proven
definitive in determining incident ownership then it rests with the line in the following order:
1. Reporting line that suffers the most severe injury, damage or loss.
2. Reporting line responsible for supervising the activity most relevant to the causation of the incident.
In such an instance, the incident should be investigated and reported jointly with participants from each of
the involved lines and with the Incident Owner leading.
2.3.77 What management level should own an incident?
The Incident Owner is ultimately accountable to his Director and the Managing Director for the quality of the
investigation and report.

Revision: 3.0
Once the directorate owning the incident is determined, the authority level within that directorate should be
determined and should be based on the following:
High potential (Red) or actual severity 4 or 5 – Director

Medium potential (Yellow) or actual severity 3 – Manager
Low potential (Blue) or actual severity 0,1,2 – Team Leader
2.3.8 Work relatedness of an incident
There are nine possible classifications relating to the work relatedness of an incident.
2.3.8.1 PDO/PDO contractor incident

 work related reportable and recordable
 work related reportable but non recordable
 non work related
2.3.82 Third party incident

 work related reportable and recordable
 work related reportable but non recordable
 non work related
2.3.83 Non accidental death
Non accidental death is defined as the death of Company or contract employee due to suicide or non-work
related illness, occurring on company premises including company and contractor accommodation, or during
working hours on non-company premises.
 Suicide
 Death by natural causes not related to work exposure

Revision: 3.0
2.3.84 Non PDO incident
Note that when an incident is determined to be a non work related third party it is removed from the
statistics as it is deemed non PDO related.
The table below is used to determine the definitions in determining work relatedness and recordability.
2.3.85

Revision: 3.0
Definitions relevant to determining work relatedness
PDO incident Incident involves assets or persons which PDO has prevailing management control of
through ownership or management of plant/equipment or through an employment contract
of the injured person.
PDO Incident involves ownership or management of assets or an injured person employed by a
Contractor contractor (including subcontracting) formally working on a current PDO contract.
incident
Third party Incident involves PDO assets or PDO related operations which PDO or the PDO contractor
incident has prevailing management control of but where the injured person is not conducting work
on a PDO contract.
Reportable Requires an entry made in FIM if the incident relates in any way to a PDO or PDO
contractor operation
Recordable The incident is retained on the PDO statistics if the investigation identifies that a failure of
management controls as required by PDO standards, specifications or procedures led in
some way to causing or failing to prevent the incident.
Non The incident is removed from PDO statistics if the investigation identifies that no failure of
recordable management controls as required by PDO standards, specifications or procedures led in
any way to causing or failing to prevent the incident.
Work related i) The incident involves a PDO employee in the course of his or her employment or;
I. ii) involves operations of PDO, or involves property, products, plant, craft or
equipment owned or controlled by PDO or;
II. is related, in ways similar to i) or ii) above to a contractor's activities on behalf
of PDO or;
III. occurs at a place which can be considered to be under the prevailing influence
of PDO, or;
IV. is, or is likely to be, the subject of legal action or public accusations against
PDO.
Non work The incident does not involve a PDO or PDO contractor employee working on official or
related unofficial contract business or using PDO or PDO contract equipment for personal use.
Employment Means all work or activities performed in carrying out an assignment or request of PDO
or a PDO Contractor, including related activities not specifically covered but reasonably
expected by the assignment or request. 'Employment' also includes activities, even
outside of working hours, where PDO exerts prevailing influence. An incident which
occurs during an employee's specifically defined off-duty period would not be
considered as arising out of and in the course of employment.
Commuting Commuting incidents between an employee’s home and work site are not considered
work related unless transport is provided/organised by PDO or the PDO contractor.
Any incident which occurs during travel utilising transport provided or arranged directly
or indirectly by PDO is considered to be in the course of employment. This includes
national and international travel on public airlines for business purposes.
B u s in es s Incidents whilst travelling in the course of employment are considered to be Work
Travel Related. Exemptions include:
 Deviations from work-related travel for personal reasons which PDO is not
reasonably able to control.
 Leave travel is not considered to be in the course of employment.

Revision: 3.0
An incident shall be considered work related until such time as the investigation team have sufficient
justification to prove it is not.
All third party fatalities that are suspected to have resulted from work related activities, shall be notified to the
business and investigated. Two types of third party fatality are recognised:
 If the investigation reveals that failures of company or contractor management controls that should have
been in place contributed to the incident causation, the incident shall be recorded,
 If the investigation reveals that the incident was caused wholly by the action of the third party the incident
will not be recorded.
All work related third party fatalities resulting from assault, sabotage, and/or theft shall be included in the
statistics.
Any lessons that result from the investigations should be entered into FIM and tracked to closure.
IV.3.86

Revision: 3.0
Examples of work and non work related incidents

Code Incident Classification
Camp
C1 Employee is bitten by a snake in the camp in non working hours Non work
C2 Employee is bitten by a snake on duty in working hours Work
C3 Employee suffers food poisoning after eating food he has let spoil in his Non work
room
C4 Employee traps his finger in the door in a camp in non working hours Non work
C5 Employee slips on floor in shower block which is slippy and does not have Work
anti slip surface
C6 Employee trips over cables running over ground and which are not Work
adequately contained.
Travel
T1 Employee uses company vehicle without management permission for a Non work
private trip
T2 Employee travels from home to a medical organised by his company in a Work related
private vehicle when alternative transport has not been arranged.
T3 Employee travels back home in a private vehicle when he has a paid Third party Non work
bus/flight ticket from his employer
T4 Employee on a work journey decides to travel off road to chase a rabbit Non work
and rolls the vehicle
T5 Employee decides to leave for a work journey in the dark before the Work related
journey plan allows and has a crash in the dark
T6 Employee has a heart attack on a public commuting bus Third party Non work
T7 Vehicle demobilised from PDO work crashes on return journey Third party Non work
T8 Employee is travelling on a non PDO approved public bus service when Third party Non work
his company have arranged a ticket on a PDO approved bus
Work
W1 Contractors employee conducting non PDO work but in the contractors Work related
workshop/yard which should contractually be dedicated for PDO
operations.
W2 Employee is cooking food in a worksite without permission and burns Work related
himself
W3 Employee is jogging on the road outside the camp before work and is Non work
struck by a passing vehicle
W4 Oryx falls into unguarded and obsolete water pit from a rig Work related
W5 Employee chokes on food at a restaurant in non working hours whilst Non work
away on a business trip abroad
W6 Employee chokes on food in the camp mess Non work
W7 Employee falls down aircraft steps whilst boarding a plane on a business Work related
trip
W8 Employee trips and falls in a fenced pipe yard Work related

Revision: 3.0
The investigation team are responsible for proposing a classification regarding work relatedness and
recordability. The final confirmation of classification shall be the responsibility of MSEM or his delegate. In
case of a dispute the MDIRC will make the final decision.
IV.3.9

Revision: 3.0
Determining the level of investigation and team composition
The Incident Owner shall create his investigation team led by an investigation team leader based on the
expertise of his personnel.
IV.3.9.1 Investigation Team Leader
The membership of the investigation team is dependent on the incidents actual severity and its potential risk
rating.
The incident owner is encouraged to lead the investigation to demonstrate commitment, however it can be
delegated as per the table below:
Delegation is allowed based on a combination of the potential risk colour and the actual severity of the
incident.
Limit to Delegation Potential risk colour/Actual severity

Coordinator Blue / (0,1or 2)
Team Leader Yellow / (2 or 3) or Blue / 3
Manager (Director minus one) Blue / 4 or Yellow / 4 or Red /(3 or 4)
No Delegation Permitted (Director) Yellow /5 or Red /5
Investigation and reporting of a non-accidental death may be delegated to the Team Leader level provided
that there are no apparent unusual circumstances surrounding the death.
IV.3.9.2 Investigation team membership
IV.3.9.2.1 Contractor incident
The following membership is strongly suggested.
Potential risk classification Minimum investigation team

Low Contractor HSE Adviser, Contractor Operational
Manager, Contract Holder, PDO Area HSE
Adviser
Medium Contractor HSE Manager, Contract Manager,
PDO Manager, Team Leader, Contract Holder,
PDO Area HSE Adviser, Directorate HSE Team
Leader.
High Contractor CEO/MD, Contract Manager,
Department Manager, Contractor HSE Manager,
Directorate PDO Manager, Team Leader,
Contract Holder, Directorate HSE Team Leader,

Revision: 3.0
MSE54, Tripodian
IV.3.9.2.2 PDO operations incident
The following membership is strongly suggested.
Potential risk classification Minimum investigation team

Low Team Leader, Area HSE Adviser, Coordinator, ,
Medium PDO Manager, Team Leader; Directorate HSE
Team Leader, PDO HSE Adviser
High Directorate PDO Manager, Team Leader, PDO
Area HSE Adviser, Directorate HSE Team
Leader, MSE54, Tripodian
Additionally, if specific expertise is required to support the investigation, the Investigation Team Leader
should contact the relevant Corporate or Unit Functional Discipline Head to seek support and participating
experts.
For example, in transport and materials handling related incidents, advice should be sought from the
Corporate Functional Discipline Head for Transport – UWL or MSE/1 and for health related Incidents, advice
from MCOH should be requested. Other assistance is also available from outside of PDO through various
contractor organisations with experience in various types of incident investigation. MSE department can
assist in identifying suitable contractors if required.
IV.3.10

Revision: 3.0
Incident InvestigationTerms of Reference (ToR)

The following sets out the minimum that should be contained in the incident ToR
ToR title: Date of Incident; Contractor; Short term to identify incident

1. Incident summary - (Small paragraph to describe the incident)
2. Investigation protocols - Documents to be used to investigation e.g. PR 1418, GU612
3. Incident Owner - Name and reference indicator
4. Investigation Team members - Names, reference indicators, role in investigation
5. Special terms - Special conditions/requirements of the investigation (e.g. joint PDO/contractor)
6. Investigation deliverables: e.g: The team is responsible for investigating the incident primary and
root causes , completing the: Tripod;investigation report,MD/IRC presentation, and learning pack.
7. Investigation process - Step by step process to follow; for example:
a) RSST to provide the on-scene investigation and reconstruction.
b) Contract Holder to provide all relevant current and historic information on the management of HSE
in the contract, including HSE plan, audits, meetings, accident statistics, Life Saving Rule
infringement, contractor management, length of contract, competency requirements in the
contract and assurance of compliance.
c) Contract Manager to confirm:
i. relatives have all been informed and arrangements have been made for care
ii. report on escalation and recovery processes following the incident
iii. Report on how HSE is managed in the contract
iv. Report on how subcontractors (if relevant) are managed within the contract
v. Report on how journey management is conducted (if relevant)
vi. Report on competency on HSE in the contract
vii. Provision of the ROP investigation
viii. Arrangement for the witnesses to be interviewed by the investigation team
ix. Details and evidence of the contractual arrangements.
x. Details and evidence of management checks, audits and assurance
xi. Details of compliance to HSE plan and PDO specifications
xii. Details of competency and training records
xiii. Details of the inspection, maintenance, assurance of relevant equipment
xiv. Details of rotations, rest breaks, working rotations
xv. Details on training and tool box talks given to drivers
xvi. Other information as determined necessary
d) A site visit to take place and all witnesses interviewed.
e) Management system in relation to the incident to be tested in the field.
f) A Tripod shall be conducted identifying the failed barriers and immediate and underlying causes
which will be investigatedas agreed by the Team Leader.
8. Team Meetings:
The investigation team will regularly convene as directed by the investigation team leader and will
depend on progress made in the investigation.
9. Deliverables/deadlines
Date of issuing initial notification of the incident with learnings
Date of first Tripod Tree...........
Date draft investigation report, slide pack ready for initial IRC . Corrections/updates to be made.

Revision: 3.0
Date of directorate IRC panel......... Corrections/updates to be made.

Date of MDIRC will be held..........
The Investigation Team Leader will provide regular updates to the Incident Owner for the duration of the
investigation. Any significant critical learnings shall made known to the Incident Owner and passed to MSEM
for wider communication as soon as possible and shall not wait for the final report to be published.
9.3.11

Revision: 3.0
Conducting a successful investigation
9.3.11.1 Investigation timing
Investigations should take place as soon as possible after the incident. The quality of evidence can
deteriorate rapidly and delayed investigations are never as conclusive as those performed quickly. Important
evidence can be gained from observations made at the location, particularly if equipment remains
undisturbed after the incident. In the case of fatal incidents the scene must not be disturbed until permission
is obtained from local ROP officers.
9.3.11.2 The investigation process
9.3.11.2.1 General
In general the investigating team should consider the following points:

1. Confirmation/correction of the initial potential risk and actual severity of the incident
2. Establish facts and establish the sequence of events.
3. Where information is fact then state this and give supporting evidence.
4. If information is by supposition then state this.
5. Keep asking 'why' until no more fundamental reasons or causes can be found.
6. Try to establish not only the immediate causes, but also the underlying and root causes.
7. Never assume anything.
8. There is never any daft question in an investigation.
9. Do not be ruled by forms or templates – ask any question you think needs asking.
10. Do not fall into the trap of simply blaming the injured person as there are often many causes.
11. Medium and high potential incidents require a more in-depth investigation.
12. PDO require a Tripod beta analysis for all incidents of high potential &/or actual severity 4/5 or Tier1.
13. Fatalities will often be investigated by the ROP as well as by the Company.
14. The construction of a diagram showing the connections between the various events and conditions
leading up to the incident (an incident tree) is a useful tool in determining the underlying causes
and conditions leading to an incident.
14.3.11.22 Preserving physical evidence
In some incidents components or equipment may be damaged or have failed. In these cases, the equipment
should be stored in a secure place pending more detailed analysis.
14.3.11.23 Conducting special studies
Complex incidents can require specialists to determine causes of failure e.g. air crashes, crane failures and
explosions. The need for and use of specialists should be determined and organised quickly with requests
being made to the appropriate Corporate Functional Discipline Head(s). The investigation team should ask
whether the ROP or the relevant medical officer have conducted any tests to determine if alcohol or drugs
may have contributed to the incident.

Revision: 3.0
14.3.11.24 Rules of evidence
The investigation team leader must avoid presenting supposition as though it were fact. Whilst it may be
appropriate, sometimes even necessary, to evaluate the most likely cause(s) of an incident on the balance of
probability, it must be avoided where the implication is that somebody specific was responsible for the cause
of the incident. In such situations, the investigation must limit itself to the facts. This is especially important if
there is any possibility that criminal proceedings may result. Supposition or assumption should be clearly
stated as such and not confused with fact. Always remember that the main purpose of incident
investigation is not to assign blame to individuals.
14.3.11.25 Analysing the evidence
The purpose of the analysis stage is to identify critical sequences of events and to draw conclusions with
respect to immediate and underlying causes.
Data may be in the form of:
 Hard evidence such as written records, photographs of the undisturbed site, signs, procedures,
training records, tool box talk records.
 Witness statements.
 Reports from tests carried out since the incident, such as root cause analysis.
 Circumstantial evidence: the logical interpretation of facts that leads to a single, but unproven
conclusion.
14.3.11.26 Core stages in the investigation process
There are eleven core parts of an investigation:
1. Injured person (people)

2. Equipment
3. Environment
4. Third parties
5. Other parties
6. Witnesses
7. Activity taking place at the time
8. Activity taking place beforehand
9. Historical and management information
10. Causational pathway, underlying causes and wider learnings
11. Custodianship of evidence

Revision: 3.0
11.3.11.261

Revision: 3.0
The injured person (IP)
You have to find out as much as possible about the IP to be able to see the incident from his view. Get inside
his head at the time of the incident to better understand. When the IP is not immediately available for
interview it may result in you drawing your own conclusions prior to seeing him.
1. Name, age, service with the company ..................................................................................

..........................................................................................................................................................
2. Medical condition and medical results ..................................................................................
3. Experience in role doing at time of injury ...............................................................................
4. What was he employed to do? ..............................................................................................
.......................................................................................................................................................
5. What activity was he doing when injured? ............................................................................
6. Was he authorised to do the activity? ..................................................................................
7. Was he competent in conducting the activity? ......................................................................
8. Is there evidence of competency through training or instruction in the job?
...............................................................................................................................................................
9. How many hours had he worked that day? ...............................................................................
10. How many hours had he worked that week? .............................................................................
11. Had he reported feeling sick or poorly? .....................................................................................
12. Was he happy about doing the activity?
.....................................................................................................................................
13. How many hours had he driven?....................................................................................
14. How many hours did he have to go in the journey? ...................................................................
15. Had he complained of problems relating to the activity or equipment prior to the incident?
........................................................................................................................................
16. What motivators were there for the employee to potentially break rules? ..............................
........................................................................................................................................................
17. What is his character like? ........................................................................................
..........................................................................................................................................................
18. What is his previous incident record like? .......................................................................
................................................................................................................................................................
19. What is his training attitude like?
......................................................................................................
.........................................................................................................................................................
20. What is his attitude to rule breaking and diligence like? ............................................................
.........................................................................................................................................................
21. Had he just changed roles recently?
.................................................................................................
22. Has he been doing the same job for many years?
...........................................................................
23. What did he do before being employed by you? .......................................................................
..........................................................................................................................................................
24. Had he been inducted in health and safety and when? ..............................................................
25. What is the content and makeup of the training received? ........................................................
.........................................................................................................................................................
26. Can the company confirm through evidence the content of the training and instruction?
........................................................................................................................................
27. Can the company confirm through evidence the competency of the trainer or instructor?
.........................................................................................................................................
28. Did the employee confirm he understood through testing?
.............................................................................................................................................

Revision: 3.0
28.3.11.262

Revision: 3.0
The equipment:
The equipment is often initially ‘blamed’ for the incident and it is therefore essential to evaluate whether the
equipment played a causational part.
1. Record the serial numbers/number plates of all of the equipment involved in the incident to
avoid confusion
...............................................................................................................................................................
.......................................................................................................................................
2. Was the equipment the correct equipment for the task?
...............................................................................................................................................................
.......................................................................................................................................
3. Visually check and record the state of the equipment at the scene
...............................................................................................................................................................
.......................................................................................................................................
4. Record all defects found and judge whether or not they occurred as a result of the incident.
Test and inspect the equipment to ensure it was in a good state of repair. Do it with someone who
knows about the equipment as soon after the incident as possible
...............................................................................................................................................................
.......................................................................................................................................
5. Was the equipment being used in the correct manner?
...............................................................................................................................................................
.......................................................................................................................................
6. Review the servicing and maintenance records for the equipment.
...............................................................................................................................................................
.......................................................................................................................................
7. Review whether pre-shift checks had been conducted for the equipment, the results and any
follow up
...............................................................................................................................................................
.......................................................................................................................................
8. Identify the history of the equipment in relation to defects, complaints or previous incidents it
was involved in
...............................................................................................................................................................
.......................................................................................................................................
9. Check if a cause of the incident was due to equipment not being used when in fact it should
have been.
...............................................................................................................................................................
.......................................................................................................................................
10. If equipment was not used as required, check if it was available to the employee
...............................................................................................................................................................
......................................................................................................................................
11. If not available then check if employee raised it as an issue and if so what happened as a
result
...............................................................................................................................................................
.......................................................................................................................................
12. Was any PPE needed to use the equipment?............................................................................
13. Was the PPE being worn correctly?..............................................................................
14. Identify if the correct PPE had been issued
...............................................................................................................................................................
.......................................................................................................................................
15. What was the condition of the PPE?
...............................................................................................................................................................
.......................................................................................................................................

Revision: 3.0
28.15.11.263

Revision: 3.0
The environment
The environment can have a significant influence on an incident. There are two types of environment: Static
and Dynamic
 Static environment will change very little over time e.g. building layouts, road layouts, structures.
 Dynamic environmental conditions are quickly lost. It is essential to capture as much info on the
immediate environment as quickly as possible including the state of floors, road surfaces, spills, tyre
marks, lighting, weather, animals, personnel, status of controls, alarms etc
Static Environment
1. The workplace or road layout and widths
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
2. Signage, road or walkway markings, where and what
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
3. Distances, to-from junctions, between machinery
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
4. Ambient conditions; machinery noise etc
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
5. Topography of surrounding area
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
Dynamic Environment
6. Weather and lighting conditions at the time of the incident
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
7. Positions of related objects, bodies, debris
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
8. Positions of controls, status of equipments
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
9. Skid marks, spills, (or puddles),
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
10. Dust conditions
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
11. Ground conditions & the state of it
…………………………………………………………………………………………….……………………………
…………………………………………………………………………………….…………………………
28.11.11.264

Revision: 3.0
The third parties
Third parties are other people involved in the incident but who were not working in the PDO
operation/contract. They can be difficult to involve in investigations as they may be in hospital, have left the
scene, are upset, are uncooperative to avoid incriminating themselves or embellish the truth to make it more
exciting. You have no rights over 3rd party witness, they are ‘volunteering’ information and attempting to
formalize it may make them withdraw. Chat with them, ask questions, be interested but don’t make notes,
write it down later.
In dealing with third parties remember:

1. They may be in shock and so do not pressure them.
2. Liaise with the ROP as much as possible to ascertain what they have managed to discover.
3. Any information they give is to be treated as hear-say unless substantiated.
4. Remember the cultural differences which may be involved.
Ask them
1. What they saw? .................................................................................................
......................................................................................................................................................................
2. Were they looking in the direction of the incident before it happened?
.......................................................................................................................................................................
.................................................................................................................................................
3. What they heard?
.......................................................................................................................................................................
.................................................................................................................................................
4. What was the weather like?
...................................................................................................................................................
5. What was the lighting level like?
......................................................................................................................................................................
6. Who else was in the area? ............................................................................................................
..................................................................................................................................................................
7. Do they know the people involved in the incident? ..........................................................................
......................................................................................................................................................................
8. What they smelt? .............................................................................................................................
9. What they felt? ..........................................................................................................................
10. Where were they standing in relation to the incident?
..................................................................................................................................................
11. How far away were they?
.......................................................................................................................................................................
.................................................................................................................................................
12. What did they do after the incident?
.......................................................................................................................................................................
.................................................................................................................................................
13. Is there anything they can remember which might be important?
.......................................................................................................................................................................
.................................................................................................................................................
14. How do they think the incident happened?
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
......................................................................................................................................................................
14.11.11.265

Revision: 3.0
The other parties
Other witnesses are a good source of information and can allow you to build up a mental picture of what
occurred but be cautious as they may not be impartial to the people involved in the incident. They may
embellish what they have seen to make it more exciting and what they think they saw may not in reality be
true. They relay their perceptions to you. Collecting perceptions from a number of different witnesses allows
you to make an informed judgement of what happened. Distinguish facts from opinions. If using an
interpreter, ask short questions, wait for the answers. Don’t argue with them, if you are unclear, act confused
by their point, they may fill it in for you. Ask them :
1. What they saw?

.........................................................................................................................................................................
...........................................................................................................................................................
2. Were they looking in the direction of the incident before it happened?
.........................................................................................................................................................................
...........................................................................................................................................................
3. What they heard?
.........................................................................................................................................................................
...........................................................................................................................................................
4. What was the weather like?
.........................................................................................................................................................................
...........................................................................................................................................................
5. What was the lighting level like?
.........................................................................................................................................................................
...........................................................................................................................................................
6. Who else was in the area?
.........................................................................................................................................................................
...........................................................................................................................................................
7. Do they know the people involved in the incident?
.........................................................................................................................................................................
...........................................................................................................................................................
8. What they smelt?
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9. What they felt?
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10. Where were they standing in relation to the incident?
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11. How far away were they?
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12. What did they do after the incident?
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13. Is there anything they can remember which might be important?
.........................................................................................................................................................................
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13.11.11.266
Revision: 3.0
Witness statements
Witness statements can be vital in a successful investigation. Remember you are not interrogating the
witness; you are trying to solicit information which will help you to piece together the chain of events.
Interviews must be conducted in a timely and professional manner.
Try and collect statements in the following order:

a) Injured person (IP)
b) Witnesses
c) Line management
1. Identify the witnesses, make sure you have the correct names and contact details.
2. If the IP is unable to be interviewed gather as much evidence as possible from other witnesses and
write down whatever they remember.
3. Ensure you have privacy and any equipment/information you may need ready to use.
4. Allow a person to accompany the witness if he asks for this but do not allow them to answer questions
for the witness unless translating.
5. Put them at ease, ask how they are feeling etc, explain the purpose of the investigation, (incident
prevention) to them and introduce yourself, even if you know them.
6. Use a chart or sketch of the incident scene if necessary to help.
7. LISTEN to the witnesses, allow them to speak freely, be courteous and considerate. Let them put
forward their version of events.
8. Try not to stop the flow, if you are unsure or the witness goes off track try to bring them back gently by
asking them to explain a point in more detail.
9. Take notes and type the interview up as soon as possible afterwards. Provide a copy to the witness if
requested.
10. Word each question carefully and be sure the witness understands. Use a combination of open and
questions.
a. Open – to elicit information; ‘what did you see?’
b. Closed – to clarify a point; ‘did you see the truck?’
11. Be sure to distinguish facts from opinions
12. Be sincere and do not argue with the witness.
13. Use the interview to attempt to clarify any points you are unsure of.
14. Not all people will react the same to a particular stimulus; a witness close to the event may have a
completely different version to someone who saw it from a distance.
15. Stories may change with time and contact with other witnesses.
16. A traumatized witness may not be able to recall all the events.
17. Witnesses may omit entire sequences for various reasons such as failure to realize their relevance,
failure to observe, personal reasons, bias etc.
17.b.c).267

Revision: 3.0
The activity taking place at the time
The incident will always involve an activity taking place at the specific time of the incident. It is often very easy
to identify the activity which was taking place, it is more difficult to analyse the activity and identify whether or
not it was the correct activity or was being done correctly.
1. Was the activity part of the normal task conducted?

..................................................................................................................................................................
......................................................................................................................................................
2. Would the activity appear to have been done correctly?
..................................................................................................................................................................
......................................................................................................................................................
3. Is the activity difficult or complex?
..................................................................................................................................................................
......................................................................................................................................................
4. Is the activity itself risky or dangerous?
..................................................................................................................................................................
......................................................................................................................................................
5. Has the activity itself been documented and risk assessed?
..................................................................................................................................................................
......................................................................................................................................................
6. Is there evidence of shortcuts been taken?
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7. Is it an activity which is open to shortcuts?
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8. Is the activity commonly conducted or a rare event?
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9. Is the activity an everyday occurrence in the field by other persons?
..................................................................................................................................................................
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10. If so, can other persons comment on the shortcuts or problems in conducting the activity?
..................................................................................................................................................................
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11. Are there any particular circumstances which might have led to the activity been done differently
this time?
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12. Is the activity a relatively new activity or new equipment or has it taken place for many years?
..................................................................................................................................................................
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13. What are the controls which should be in place as a result of the risk assessment?
..................................................................................................................................................................
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14. Is there evidence that these controls were or were not in place?
..................................................................................................................................................................
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15. Are the controls which are in place adequate for the level of risk posed by the activity?
..................................................................................................................................................................
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16. What emergency action and escalation took place, medical treatment, 5555 calls etc …………
……………………………………………………………………………………………………………………

Revision: 3.0
17.16.c).268 The activity taking place beforehand
Sometimes the activity taking place before the incident is as crucial as the activity at the time of the incident.
The activities prior to the incident and even the day before can give an understanding of the frame of mind of
the IP, his potential motivations and what led him to do what he did (if relevant). The length of time analysed
before the incident will depend on the nature of the activity itself. Ask the IP or persons with him to talk
through the activities of the shift from the start, clarify timings with the interviewee. Ask them what they had
done on the previous shift and the time between shifts. Ask them to elaborate on anything which you feel
could be of relevance to the investigation. Cross reference what they have described, involve other people to
confirm that they have their facts correct. Question any discrepancy between their accounts and that which
you know to be fact or deviations from procedures, journey plans or other accounts. Do not make them feel
they are being cross examined, they will dry up.
1. What activities were taking place before the activity which involved the incident?
....................................................................................................................................................................
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2. How long had the previous activity been taking place?
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3. Was this activity normal practice?
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4. Did anything unusual happen during this activity?
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5. Was it common for him to conduct this activity?
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6. Was he trained in this activity?
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7. What affect did the previous activity have on him?
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8. Who was involved in this previous activity?
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9. Did the activity involved in the incident rely on the completion of the previous activity?
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10. Were there any time pressures to complete the activities?
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11. Who was responsible for managing the previous activity?
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17.16.c)11.69

Revision: 3.0
Historical and management information
Ask people if concerns regarding the risk had been raised historically. You may find that this is not the first
incident of this kind and reviewing the findings of the previous investigation can add value. Do not though
assume the causation is precisely the same. It may also be that discussions have been ongoing relating to a
potential problem. Review any minutes etc from these discussions. Check with management if issues
relevant to the incident have been raised before. Collect any evidence of such issues; follow the evidence
trail of the issues raised in relation to who was involved, how were they involved, what actions were taken (or
not), and identify if any lack of action could have been causational in this incident. If a procedure was not
followed try to establish why it was not followed: was it not known; not fit for purpose or was there some other
reason like ‘custom and practice’ where the official controls are ignored habitually.
Check
1. Departmental instructions,
2. Safety regulations,
3. Minutes of meetings
4. STOP cards
5. Previous similar incident investigation findings
6. Relevant emails, letters and memos
7. Complaints made or escalated
8. Relevant procedures or work instructions
9. Relevant standards or policies
10. Permit to work records
11. Job planning records
12. Site/location maps,
13. Organisational charts,
14. Roles and responsibilities documents,
15. Contingency or emergency response procedures
16. Training records
17. Medical records
18. Hazard management controls
19. Contract HSE plan,
20. Applicable Safety Case(s),
21. Hazard control or data sheets
22. Job safety plans.
23. ‘As built' drawings, instrument records, computer printouts, log books,
24. Transport documentation and time sheets
25. Results of previous audits
Important note

Revision: 3.0
Only raise issues in the report if they are directly linked to the causation of the particular incident you are
investigating. Do not increase the scope of the investigation to failures which are not relevant, they should be
dealt with separately.
25.16.c)11.610 The causational pathway, underlying causes and wider learnings
Investigations confined to reviewing the immediate causes will only identify local issues and the remedial
actions from the investigation will not prevent the same incident happening elsewhere.
Most immediate causes have underlying causes or latent management failings far removed from them. After
local issues have been identified the investigation should shift emphasis to following the causational pathway
which leads to the underlying causes and the reasons behind why the local issues came about.
To do this, for each hazard identified as contributing to the injury/damage identify the circumstances which
allowed the hazard to exist, then identify what controls should have or could have been in place to
control/protect against the hazard and then ask why those controls were not effective/in place. Finally ask
yourself what historically happened, (management decisions, budget cuts etc) which allowed these controls to
fail? This is called the causational pathway which leads to the underlying causes behind each incident.
Finally ask what needs to be done now to change the circumstances on both a local and wider scale to
prevent a reoccurrence of a similar incident with the same causational pathway elsewhere.
Note that an incident probably has several causational pathways so repeat the exercise until you have
identified all of the underlying causes. (See GU612 page 142 for simple examples)
The main underlying causes used by PDO are:
a. Incompatible goals
Failure to manage conflict between different goals, such as safety v production, formal v informal
rules, company directives v personal goals
b. Communication
Failure to effectively transmit information

c. Error enforcing conditions
Factors such as time pressure, changes in work patterns, physical working conditions (hot, cold,
noisy) etc that promote human error
d. Procedure
Unclear, unavailable, incorrect or otherwise ineffective work instructions

e. Training
Deficiencies in the system for providing the necessary knowledge or skills

f. Design
Deficiencies in the layout or design of facilities, plant or equipment

g. Maintenance management
Failures in the system for ensuring the technical integrity of facilities, plant, equipment and tools
h. Hardware
Failures due to inadequate quality or non availability of materials or equipment

i. Organisation

Revision: 3.0
Deficiencies in either the structure of a company or the way tasks, responsibilities and authorities are
assigned
j. Housekeeping
Deficiencies in conditions of tidiness and cleanliness of facilities and work spaces
j.16.c)11.611

Revision: 3.0
Custodianship of evidence
It is important to ensure that evidence can be relayed back to the incident.
1. All photos need to be date stamped.

2. Any notes or sketches which are made as part of the investigation should be kept in the investigation
file and marked as ‘working papers’.
3. Each page should be individually labeled or referenced. This is important as you may need this to
clarify a statement you have made in the investigation report.
4. Ensure it is clear how many pages each document contains, e.g. page 1 of 2, page 2 of 2.
5. Keep all of your relevant documents together and order them in an investigation file so that they can
be catalogued and create an index.
The investigation file should as a minimum contain:
a) Investigation report
b) IRC/MDIRC presentation
c) Tripod (where applicable)
d) Appendices
a) Training records
b) Photos and sketches
c) Lateral Learning
d) Employee records and details
e) Health records
f) Maintenance records
g) Audit records
h) Contract details and organogram
i) Management organogram
j) Inspection records
k) Witness statements
l) Pre-shift check records
m) Procedures
n) HEMP
o) Risk assessments
p) Guidance documents
q) Minutes of safety meetings
r) Previous incidents, learnings and remedial actions
s) Working papers
t) Previous complaints
t)16.12

Revision: 3.0
Incident reports
t)16.12.1 Report formats

The complexity of the incident report depends on the incident’s level of potential severity. The templates for all
of these requirements are highlighted in the next section 2.2.12.2
t)16.12.1.1 Low potential/minor incidents
These need only have the following completed:
a) Notification in FIM
b) Incident notification form
c) FIM investigation module
d) Low potential/minor investigation report
t)d)12.12 Medium potential incidents
The need the following completed:
d) Investigation report
e) IRC presentation
f) Lateral learning
t)f)12.13 High potential and non accidental deaths Incidents
The need the following completed:
d) High potential or NAD Investigation report
e) Tripod Beta report
f) MDIRC presentation

Revision: 3.0
g) Lateral learning
t)g)122 Templates
The templates for completing these incident reports are contained in the appendices:
Appendix 1 – Template of Email from Operations to Senior PDO management

Appendix 2 – Reporting of Significant Incidents to Stakeholders and Regional Management
Appendix 3 – Initial Incident Notification form
Appendix 4 – Statement of Fitness – After Restart
Appendix 5 – Low severity incident investigation report
Appendix 6 – Medium Potential Incident Investigation Record
Appendix 7 – Medium and High Potential Investigation Report content and format
Appendix 8 – Medium/High Potential Road Traffic Incident Report/advice
Appendix 9 – Non Accidental Death Reports
Appendix 10 – Template for Incident Review Presentation
Appendix 11 – Example of a Lateral Learning
Appendix 12 – Declaration of confirming close out of Redline actions
Appendix 13 – SIR presentation format
Appendix 14 – SIR Level 3 briefing form
t)g)123 Remedial actions
Remedial actions are the key reasons for investigating. These are learnings from the incident.
There should at least be actions both for each identifiable direct and underlying cause.
Actions should aim to reduce the risk to a minimum, practicable level or improve protective systems to limit the
consequences but noting that some risks cannot be totally eliminated due to practicalities and cost factors.
All actions should be SMART:
Specific; as an activity to be conducted and who should conduct them;

Measurable to the extent that it is clear when they have been implemented;
Achievable, to achieve the action point;
Relevant to resolving the identified cause (immediate or underlying);
Timed, with a realistic target date assigned.
Revision: 3.0
Statements such as the following expressions are not SMART.

'Drivers should take more care......
'Supervisors should ensure that
'The rules for..... should be followed.'
'More attention should be given to......
Actions should be restricted to addressing the causational pathway of the incident. They should address
failures in the controls or missing controls.
The top five actions from an investigation are called REDLINE actions. These are the key actions which will
most ensure that the incident does not happen again in PDO operations. These actions will be regularly
audited for close out completion.
All action descriptions should be such that it is clear to anyone who audits the success of the investigation as
to when and whether the action has been completed.
If the investigation identified areas for improvement not relating directly to the incident then these should be
included in the report under “Other findings” and communicated to the relevant person for action as part of the
follow up of the incident investigation.
Action parties shall be informed of the recommendations before they are formally included in the report. This is
to avoid the wrong action parties being identified for completing the action.
The action parties shall be involved in the wording of their relevant action points and target dates in the report.
This must take place before the IRC and MDIRC. In case of dispute between the action party and
investigation team then this shall be highlighted in the report and the review committee will make the final
decision.
All actions must be uploaded into FIM by the Investigation Leader unless it is reviewed by MDIRC where
actions are uploaded by MSE521. Actions are subject to audit by the investigation leader and the directors
HSE Team leader.
t)g).13

Revision: 3.0
PDO Incident Review Committees (IRC)
IRCs provide the opportunity for senior management to endorse the RAM rating and to quality check the
investigation protocol, scope, quality, findings, lateral learning and acceptability of actions and their deadlines
recommended. It also allows people involved in the incident and contractor management an audience with
PDO management and raises the profile of safety.
Victimisation is neither allowed nor intended and the reviews will therefore be carried out in an atmosphere
devoid of fear.
t)g).13.1 Directorate Incident Review Committees
t)g).13.1.1 IRC terms of reference
 Directorate IRCs shall review LTIs, NADs & Medium/High potential incidents.
 Directorate IRCs should be scheduled weekly in a fixed diary slot and shall always take place unless
there are no incidents to review. An incident should be review in the Directorate IRC within 20 days of
it having occurred.
 The investigation draft report and presentation shall be completed and issued to all IRC members prior
to the meeting.
 Each directorate manages its own IRC process however the following membership is recommended.
In case of absence a suitable replacement should attend:
 Director (chairman),
 Two senior management (one of which will be vice chairman)
 Directorate HSE Team Leader
 Contractor management (of IP) and Contract Holder
 Senior representative of the contractor community (optional)
 MSE department liaison point.
 Special invites to subject matter experts and the Injured Person/witnesses etc.
 The Director shall appoint a focal-point for each IRC to manage the IRC process and ensure the ‘Lateral
Learning slide’ is agreed and emailed to MSE51/MSE54 for final edit and cascade.
 The final presentation from the IRC shall be sent to MSE5/ MSE54 and MSE521 including minutes of the
IRC within 5 days of the IRC having taken place and if the incident is to proceed to MDIRC, a requested
MDIRC date shall be requested from MSE521by the directorate HSE Team Leader.
 The Investigation Team Leader shall upload the agreed actions into FIM
t)g).13.12 Lateral learnings
The lateral learnings from each incident shall form part of the IRC presentation.
Records should as a minimum include the following for each incident reviewed:
Page 1 – To be used as a poster and info for a Tool Box Talk
 Heading: PDO safety advice
 Sub heading left side top: What happened? (Brief description including consequences)

Revision: 3.0
 Sub heading left side bottom: Your learning from this incident: (A list of the key learnings for the people
exposed to the risk)
 Two photos; right side – (one to show what not to do, and one to show what to do).
 Bottom left side - Learning strap line (Simple and punchy)
Page 2 – To be used as a management tool for learning

 Heading: Management Learnings
 Sub heading: To ensure continual improvement all contract managers are to review their HSE HEMP
against the questions asked below.
 Sub heading: Confirm the following:
 List of the controls that had failed or were missing in the investigation in the form of closed questions
(Answer yes, or no to) for other contract management to ask themselves and audit.
An example of a lateral learning is contained in Appendix 11 page 100 and the template in on page (98/99)
PDO MSE will arrange translation and issue these lateral learnings on the web and to each Directorate HSE
Team Leader for cascade.
t)g).132 Managing Director Incident Review Panel (MDIRC)
t)g).132.1 MDIRC terms of reference
 MDIRCs shall review all incidents of 4/5 actual severity, high potential, NADs and Tier 1 and are
scheduled as close to 28 days from the incident, without exception. Investigations which have for any
reason not been concluded shall be presented as ‘work in progress’ justifying the reasons why the
investigation has not been concluded.
 The following membership is required and in case of absence a suitable delegate should attend:
 MD senior team - MD,TD, MSE5, OPAL representative,

 Directorate team - Director, Incident Owner, Investigation Leader, Line Manager, Contract Holder, HSE
Team Leader
 Contractor team - Contractor CEO, Contract Manager, Contract HSE Manager.
 Others - people invited by Incident Owner or Contractor MD as appropriate.
 MDIRCs shall be scheduled weekly in a fixed diary slot each Monday and take place unless there are no
incidents to review. The MDIRC will only review incidents that have:
 gone through the directorate IRC process,
 an investigation report and presentation completed and provided in the right format to
MSE521 by close of business on the Monday before,
 a Tripod analysis conducted where required,
 passed the MSE quality check for the presentation and investigation,
 a nominated secretary for taking minutes in the directorate team identified to MSE521.
 On the preceding Wednesday, MSE521 will issue the agenda and timing for the review. The relevant
Director, Line Manager, Incident Owner and Contract Holder (when applicable) will be advised.

Revision: 3.0
The format of the review remains a round table discussion, with a short presentation by the Incident Owner
or Contractor CEO. The presentation package shall be as per the templates provided. Incident reports are
not required to be submitted at this time, but should be completed within 4 days of the review and copied to
MSE/521 who will ensure the actions and report are input into FIM.
MSE5 will identify learnings with clear lateral learning value for company-wide communication and lessons
from the incident will be published on the HSE website and email sent to all Directors and HSE Team
Leaders for cascade within the organisation. The OPAL Representative will cascade the lessons amongst its
members via copy of the weekly highlights.
t)3

Revision: 3.0
Roles and Responsibilities
Roles and responsibilites are as defined in PR1418, the procedure for investigating and reporting of
HSE incidents.
t)4 Related Business Control Documents

PR1418 is the the procedure for investigating and reporting of HSE incidents.
SP1157 is the specification for HSE training, which includes incident investigation training

Revision: 3.0
Appendices
Appendix A, Glossary of Definitions, Terms and Abbreviations
Key Definitions (in alphabetical order)
Asset Damage
A direct loss of or damage to plant, equipment, tools or materials resulting from an incident.
Business
PDO business.
Business Travel - Employee

For a PDO employee, business travel is any travel undertaken for the purposes of work activities in which that
person is engaged in the interests of his or her employer, to the following extent:
 It includes the period from the time that person leaves their residence or their normal place of work
until they return or until the time they arrive at their destination and check into temporary
accommodation (‘home away from home’).
 It includes, on the return trip, the period from when the person checks out of their temporary
accommodation until they arrive at their residence or their normal place of work.
 It includes the whole spectrum of travel, from international travel through to simple acts like crossing a
public road on foot between two company buildings.
 It excludes a person’s normal commute to work.
 It includes travel to the airport for a business trip from the time an employee leaves home even if that
travel follows the same route as their normal commute. If the employee stops in the office first to work,
then the period of employee’s business travel starts from the office and not their home.
 It excludes that person’s commute from their home away from home to their temporary place of work
or a significant detour made for personal reasons.
 Any injury or illness occurring during the business trip is considered to be work related for recording,
investigation and learning purposes; but not all injuries and illnesses will be recordable for statistical
purposes.
Business Travel - Contractor

For a PDO contractor, business travel is any travel undertaken for the purposes of work activities in which the
contractor is engaged in supplying PDO with goods or services, to the following extent:
 It includes day-to-day travel undertaken by a PDO contractor in the course of carrying out PDO
work-related activities.
 It excludes day-to-day travel undertaken by the PDO contractor when that person is not engaged in
Revision: 3.0
PDO work related activities (such as their normal commute, or any travel undertaken in the interest of
their own employer).
 It includes contractor mobilization and demobilization when performed under contract with PDO
Causational pathway
The events and conditions that link between the underlying causes and the immediate causes.
Consequential Business Loss

The indirect loss associated with incidents resulting in asset damage, environmental impact or impact on
company reputation. It comprises elements such as loss of production (expressed as profit margin), process
unit downtime, product quality costs, cost of environmental cleanup, cost of recovery/disposal of waste and
cost of reprocessing off-grade material. The intention is to estimate the order of magnitude of the loss so that
the incident can be assessed on the RAM and the appropriate resources put into investigation. It should not be
necessary to conduct a detailed accounting of the full range of indirect costs. Consequential business loss
should be estimated on a 100% equity basis. When consequential business loss results from an incident with
impact on the environment or company reputation, the consequences should be assessed under both asset
damage and the environmental/reputation categories of the RAM and the highest rating used to determine the
extent of investigation and follow up.
Company
Company refers to Petroleum Development Oman LLC, (PDO), a PDO asset, a PDO business
facility/operation or a PDO affiliate. It excludes contractors or non PDO entities.
Contractor
All parties working for the company either as direct contractors or as subcontractors. It is a person or company
that conducts work under a contract for the organisation.
Delivery Team Leader

The Delivery Team Leader is as a minimum the most senior person on site and is responsible for the asset
and the Safety Case.
Environmental Impact
The negative impact on the environment resulting from an incident.
Exposure Hours
The total number of hours of employment including recorded overtime and training but excluding leave,
sickness and unrecorded overtime hours. Exposure hours should be calculated separately for company and
contractor personnel. Time off duty, even if this time is spent on company premises, is not included in the
calculation of exposure hours, but incidents during this time should be reported and investigated. When they
meet the work related definition, they should be included in the statistics as recordable incidents. In many
company sites the number of exposure hours can be calculated from computer controlled access or time
keeping records. In the absence of more accurate methods exposure hours can also be calculated from a
headcount and nominal working hours per person or time writing systems.

Revision: 3.0
In order to meet reporting schedules, exposure hours can be estimated on the basis of the previous data.
Corrections can be made at the end of the reporting period when more time is available.
Fatality
A death resulting from a work related injury or occupational illness, regardless of the time intervening between
the incident causing the injury or exposure or causing illness and the death.
FAR
The number of fatalities per hundred million exposure hours.
FIM
Fountain Incident Management (FIM) is the Group system for recording incident details, the investigation,
classification and action items. It can also issue notifications and reports. FIM should be used for all potentially
work related incidents including those occuring while in “home away from home status”.
Fires and Explosions

Normally taken to mean all fires that necessitated the use of a fire extinguisher or other extinguishing means,
e.g. snuffing steam, shut off fuel or switch off electricity supply. Fires with no visible flame, e.g. oil soaked
insulation, should also be included. All flammable explosions or overpressure explosions should be included,
irrespective of the extent of containment.
First Aid Treatment

An incident is classified as a First Aid if the treatment of the resultant injury or illness is limited to one or more
of the 14 specific treatments. These are:
1. Using a non-prescription medication at non-prescription strength;

2. Administering tetanus immunizations;
3. Cleaning, flushing or soaking wounds on the surface of the skin;
4. Using wound coverings such as bandages, Band-Aids, gauze pads, etc.; or using butterfly bandages
or Steri-Strip.
5. Using hot or cold therapy;
6. Using any non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc;
7. Using temporary immobilization devices while transporting an accident victim (e.g., splints, slings,
neck collars, back boards, etc.).
8. Drilling of a fingernail or toenail to relieve pressure, or draining fluid from a blister;
9. Using eye patches;
10. Removing foreign bodies from the eye using only irrigation or a cotton swab;
11. Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton
swabs or other simple means;

Revision: 3.0
12. Using finger guards;

13. Using massages; or
14. Drinking fluids for relief of heat stress.
15. Visit(s) to a health care provider limited to observation
First Aid Case (FAC)

Any work related injury that involves no lost workdays, restricted workdays or medical treatment but which
requires and receives first aid treatment.
High Potential Incident

An incident for which the combination of potential consequences and probability are assessed to be in the high
risk (red shaded) area of the RAM. They can be incidents that result in injuries, illnesses or damage to assets,
the environment or company reputation, or they can be near misses.
Incident
1) An incident is an unplanned and undesired event or chain of events that has, or could have, resulted in
injury or illness, damage to assets, the environment, company reputation, and/or consequential business loss.
2) The release or near release of a hazard, which exceeds a defined limit or threshold limit value.
These are unplanned events or a chain of events, which has caused or could have caused injury, illness,
damage and loss to assets, the environment, and/or company reputation..
Incidents do not include operations, maintenance, quality or reliability incidents which had no HSE
consequence or potential. Incidents do not include degradation or failure of plant or equipment resulting solely
from normal wear and tear.
Injury
Any injury such as a cut, fracture, sprain, amputation etc. that results from a single instantaneous exposure.
Loss of Consciousness
If an employee loses consciousness as the result of a work-related injury, the case must be recorded as at
least an MTC no matter what type of treatment was provided. The rationale behind this is that loss of
consciousness is generally associated with the more serious injuries.
Lost Time Injuries (LTI)

The sum of injuries resulting in fatalities, permanent total disabilities and lost workday cases, but excluding
restricted work cases and medical treatment cases. Note that if 20 people receive lost time injuries in one
incident it is 20 cases, not one.
Lost Time Injury Frequency (LTIF)

The number of lost time injuries per million exposure hours worked during the period.

Revision: 3.0
Lost Workday Case (LWC)

Any work related injury that renders the injured person temporarily unable to perform their normal work or
restricted work on any day after the day on which the injury occurred. Any day includes a rest day, weekend
day, scheduled holiday, public holiday or subsequent day after ceasing employment.
A single incident can give rise to several lost workday cases, depending on the number of people injured as a
result of that incident.
Lost Workdays (LWD)
The total number of calendar days on which the injured person was temporarily unable to work as a result of a
lost workday case. In the case of a fatality or permanent total disability no lost workdays are recorded.
Low potential incident

Incident which is classified as both light or dark ‘Blue’ in the RAM taking into account an historical review of
similar incidents in nature and causational pathways, looking at the actual consequences and profile of how
often they occurred and where.
May
The word 'may' is to be understood as indicating a 'possible course of action'.
Medical Treatment (MT)

An incident when the management and care of the patient to address the injury or illness is above and beyond
first aid and includes:
· Treatment of infection by antibiotics.
· Treatment of first, second or third degree burn(s)
· Application of sutures (stitches)
· Removal of foreign bodies embedded in eye
· Removal of foreign bodies from wound; if the procedure is complicated because of depth of
embedment, size, or location
· Use of prescription medications (except a single dose administered on the first visit for minor injury
or discomfort)
· Cutting away dead skin (surgical debridement)
The following may not involve any treatment but for purposes of severity classification, will be recorded as
medical treatment.
 Any loss of consciousness
 Significant injury or illness diagnosed by a physician or other licensed health care professional for
which no treatment is given or recommended at the time of diagnosis. E.g. punctured eardrums,
fractured ribs or toes, byssinosis.
 Needle stick injuries and cuts from sharp objects that are contaminated with another person’s blood or
other potentially infectious material.
 Occupational hearing loss.

Revision: 3.0
 Medical removal under a government standard (use the Shell Health Guidelines where no government
standard exists)
It does not include:
 The conduct of diagnostic procedures, such as x-rays and blood tests, including the administration of
prescription medications used solely for diagnostic purposes (e.g., eye drops to dilate pupils);
 Visits to a physician or other licensed health care professional solely for observation or counselling;
 Administration of tetanus shot(s) or booster(s). However, these shots are often given in conjunction
with more serious injuries; consequently, injuries requiring these shots may be recordable for other
reasons
 Diagnostic procedures, such as X-ray or laboratory analysis, unless they lead to further treatment.
Medical Treatment Case (MTC)

Any work related injury that involves neither lost workdays or restricted workdays, but which receives Medical
Treatment.
Medium Potential Incident

Incident which is classed as ‘Yellow’ in the Risk Assessment Matrix taking into account an historical review of
similar incidents in nature and causational pathways, looking at their actual consequences and profile of how
often they occur and where.
Near Miss
An incident that could have caused illness, injury or damage to assets, the environment or company
reputation, or consequential business loss, but did not. It is an unplanned event that did not result in injury,
illness, or damage to assets, the environment or Company reputation – but had the potential to do so if some
circumstance of the event were different. Only a fortunate break in the chain of events prevented an injury,
fatality or damage; in other words, a miss that was nonetheless very near.
Non Accidental Death

A Non Accidental Death is defined as death of Company or contract employee due to suicide or natural
causes, non-work related illness, occurring on company premises including company and contractor
accommodation, or during working hours on non-company premises.
Non Work Related Third Party Death

A reportable but non recordable fatality involving the death(s) of a third party but where the investigation
confirms no direct link to a Company work related activity. This is removed from the statistics when
classification is confirmed.
Occupational Illness
Any abnormal condition or disorder of an employee, other than one resulting from an occupational injury,
caused by exposure to health hazards associated with employment.

Revision: 3.0
An illness is work-related if the balance of probability is 50% or more that the case was caused by exposures
at work.
Occupational illnesses include acute and chronic illness or diseases that may be caused by inhalation,
absorption, ingestion or direct contact with the hazard, as well as exposure to physical and psychological
hazards.
OSHA occupational illness cases will be captured for benchmarking purposes in FIM (and other systems
where possible).
Occupational Stress
Stress involving work where stress is defined in terms of its physical and physiological effects on a person, and
can be a mental, physical or emotional strain. It can also be a tension or a situation or factor that can cause
stress. Occupational stress occurs when there is a discrepancy between the demands of the
environment/workplace and an individual’s ability to carry out and complete these demands. Often a stressor
can lead the body to have a physiological reaction which can strain a person physically as well as mentally.
One of the main causes of occupational stress is work overload. The OSHA definition of work relatedness
excludes a mental illness (unless it is post-traumatic stress syndrome where it can be tied to a specific
workplace incident, or are incidents where the employee voluntary provides an opinion from a physician or
other licensed health care professional stating the employee’s mental illness is work-related).
Permanent Total Disability (PTD)

Any work related injury that permanently incapacitates an employee and results in termination of employment.
Prescription Medication
1. All antibiotics, including those dispensed as prophylaxis where injury or illness has occurred to the subject
individual. Exceptions: Dermal applications of Bacitracin, Neosporin, Polysporin, Polymyxin, Iodine or similar
preparation.
2. Diphenhydramine (Benadryl) greater than 50 milligrams( mg.) in a single application.
3. All analgesic and nonsteroidal anti-inflammatory medication (NSAID) including:
 Ibuprofen (such as Advil) - Greater than 467 mg.
 Naproxen Sodium( such as Aleve) Greater than 220 mg.
 Ketoprofen (such as Orudis KT) - Greater than 25mg.
 Codeine analgesics (Cocodamol, Panadeine, etc.) – Greater than 16 mg. in a single dose.
Exceptions: acetylsalicylic acid (Aspirin) and acetaminophen (paracetamol) are not considered medical
treatment.
4. Dermally applied steroid applications. Exceptions: hydrocortisone preparations in strengths of <1%.
5. All vaccinations used for work-related exposure. Exceptions: Tetanus
6. All narcotic analgesics (except codeine as listed above)
7. All bronchodilators. Exceptions: Epinephrine aerosol 5.5 mg./ml or less
8. All muscle relaxants (e.g. benzodiazepines, methocarbamol and cyclobenzaprine).
9. All other medications (not listed above) that legally require a prescription for purchase or use in the state or
country where the injury or illness occurred.

Revision: 3.0
Note: Where there are apparent contradictions, advice should be sought from a PDO doctor.
Potential Incident
An unsafe practice or a hazardous situation that could result in an incident (incident has not occurred).
Process Safety Event

A process safety event is an incident that resulted in, or could potentially have resulted in an unplanned or
uncontrolled release of:
 Combustible liquids (e.g. MEG, TEG, diesel, lube oil, hydraulic oil, etc.);
 Flammable liquids (e.g. crude oil, methanol, IPA, etc.);
 Flammable gas (e.g. natural gas, butane, pentane, etc.); or
 Toxic chemicals (e.g. H2S, SO2, mercury, etc.); or
 Non-toxic and non-flammable materials (e.g. steam, nitrogen, compressed CO2 or compressed air)
that result in actual consequences.
From a process that occurs within the property limits of PDO owned or operated hydrocarbon facilities
including gas plants, gathering and production stations, well pads, gathering systems, injection systems,
pipelines, etc.
Recordable Incident
A proven work-related injury or illness is recordable in the statistics if it results in one or more of the following:
 Death
 Lost work case (days away from work )
 Restricted work or transfer to another job
 Medical treatment beyond first aid
 Loss of consciousness for any length of time
 A significant injury or illness (diagnosed by a physician or other licensed health care professional)
involving cancer, chronic irreversible disease, a fractured or cracked bone or a punctured eardrum.
All incidents resulting in damage or AI-PS proven to relate to PDO are also recordable.
The extensive OSHA documentation can also be used as guidance except where this document specifically
excludes its use, i.e., stress.
Reportable but Non Recordable Incident

An incident where Tripod investigation proves beyond reasonable doubt that no failure in (or missing)
management controls were involved in the causational pathway of the incident.

Revision: 3.0
Reputation Impact
The negative impact on company reputation resulting from an incident. The negative impact can be in the form
of adverse attention from media, politicians or action groups, or in public concern about company activities.
Restricted Work
Any work related injury or illness where the PDO doctor recommends the employee not perform one or more
of their job's routine duties as a direct result of injuries sustained.
Restricted Work Case (RWC)

Any work related injury which results in Restricted Work.
Restricted Workdays (RWD)

The total number of calendar days counting from the day of starting restricted work (not counting the day of
injury / illness) until the person returns to his normal work.
When restricted workdays follow a period of lost workdays, the restricted workdays are recorded in addition to
the lost workdays, but the injury is recorded as a lost workday case only.
Risk Assessment Matrix (RAM)

A tool that standardises qualitative risk assessment and facilitates the categorisation of risk from threats to
people, assets, environment and company reputation which characterises risks based on likelihood an
consequences.
Road Transport Incident

An incident involving a company or contractor vehicle in motion whether on or off the road, that has resulted in
injury or damage to assets, the environment or the company's reputation, irrespective of the cost of repair or
responsibility for the cause.
A vehicle is defined as a car, van, light vehicle, heavy goods vehicle, road tanker, bus or motorcycle any unit
under tow, e.g. trailers, rigs, caravans, mobile generators. It also includes plant or mobile cranes (if licensed to
travel on the roadways and with RAS) if the vehicle is driving on the roadway at the time of the incident.
This definition does not include:
 Incidents involving vehicles operating on aprons of public airfields;
 Damage as a result of normal wear and tear, e.g. minor paint scratches, stone chips, and mechanical
wear and tear;
 Incidents which occur when the vehicle was unattended,(except runaways) e.g. vandalism or other
damage whilst the vehicle was parked. These would be considered as incidents rather than transport
incidents.
 Incidents where the plant or crane is operating on a worksite.
Rollover

Revision: 3.0
Where a vehicle rotates such that it finishes resting on its side or otherwise rotates past 90 degrees.
Shall
The word 'shall' is to be understood to indicate a course of action with a required, mandatory status within
PDO;
Should
The word 'should' is to be understood as a preferred course of action which is 'strongly recommended';
Significant Incidents
Incidents with actual consequences that rate 4 or 5 on the RAM. (people, environment, damage or reputation).
STOP
STOP refers to the DuPont Safety Training Observation Program which is based on the principle that incidents
are caused by unsafe behaviour.
Third Parties
Persons or organisations that are not employed by or contracted to a company or contractor.
Total Sickness Absence

Absence from work on grounds of incapacity to work due to any sickness and injury, work related or not,
expressed as percentage of total workdays available. All other cases of absence such as pregnancy,
childbirth, leave, training and seminars, are not included in the definition of absence.
Total Recordable Cases (TRC)

The sum of injuries resulting in fatalities, permanent total disabilities, permanent partial disabilities, lost
workday cases, restricted work cases and medical treatment cases.
Total Recordable Case Frequency (TRCF)

The number of Total Recordable Cases per million exposure hours.
Total Recordable Occupational Illness (TROI)

The sum of all recordable occupational illnesses whether or not they have resulted in deaths, permanent total
disabilities, permanent partial disabilities, lost workday cases, restricted work cases and medical treatment
cases. Contractor occupational illness cases are to be reported when known, but are not to be included in the
TROIF.

Revision: 3.0
Total Recordable Occupational Illness Frequency (TROIF)

The number of occupational illnesses per million exposure hours.
Tripod Beta tool

Means the Tripod Beta Investigation and data analysis tool
Vehicle Kilometres Driven

The number of vehicle kilometres travelled during work related activities whilst being driven by a company or
contractor employee
Unsafe Act
Is an action by a person which could have led to an injury, damage or harm, but which did not result in any on
this occasion.
Unsafe Condition
Is a condition of a worksite which could have led to an injury, damage or harm, but which did not result in any
on this occasion.
Work Related
A work related incident results only from a work related activity i.e. an activity which has/should have
management controls in place.
The following activities should be considered as work related until proven otherwise:
 All work by PDO personnel on shift,

 All work by PDO contractor on PDO premises or on non-PDO premises for which it can reasonably be
concluded, based on risk assessment that PDO and contractor management controls are required.
“Contractor” includes all sub-contracted (etc) activities.
For PDO personnel, work includes overtime, attending courses, conferences, company organised events,
business travel, field visits or any other activity where the employee’s presence is expected by the employer.
 Participation in voluntary programs is not considered work related.
 Incidents off shift whilst away from home are not considered work related.
For contractor personnel, the same activities are included when they are executed under a contract on behalf
of PDO.
Where it is impossible or inappropriate for the Company to seek to apply management controls on a
contractor, exceptions may be justifiable. Examples may be found in areas where contractor services are not
dedicated to the company, for example:
 Manufacturing of components in a factory together with the manufacture of components for other
customers,

Revision: 3.0
 Construction at a contractor’s fabrication site shared by other customers,

 Delivery of goods or products to company locations by a contractor who is also employed to deliver
goods or products to other companies during the same journey,
 Customer collection of company products, where the vehicle and drivers are under the control of the
customer.
Work Related third party fatality

A reportable and recordable fatality involving the death of a third party due to a Company work related activity.

Revision: 3.0
Appendix B, Forms and Reports
Appendix 1 – Template of Email from Operations to Senior PDO management

Appendix 2 – Reporting of Significant Incidents to Stakeholders and Regional Management
Appendix 3 – Initial Incident Notification form
Appendix 4 – Statement of Fitness – After Restart
Appendix 5 – Low severity incident investigation report
Appendix 6 – Medium Potential Incident Investigation record
Guidance completing Medium Potential incident report
Listing of activities at time of incident
Listing and descriptions of incident types
Listing of possible immediate causes

Listing of possible underlying causes
Listing of possible facilities / plant / equipment
Listing of possible injuries or occupational illnesses

Appendix 7 – Medium and High Potential Investigation Report content and format
Appendix 8 – Medium/High Potential Road Traffic Incident Report
Guidance completing Medium/High road traffic incident report
Appendix 9 – Non Accidental Death Reports
Appendix 10 – Template for Incident Review Presentation
Appendix 11 – Example of a Lateral Learning
Appendix 12 – Declaration of confirming close out of Redline actions
Appendix 13 – SIR presentation
Appendix 14 – SIR Level 3 briefing note
Appendix 15 – Determining Environmental Incident Risk Potential
Appendix 16 – Guidance completing Statement of Fitness – After restart
Appendix 17 – Using FIM to enter an incident – new input module
Appendix 18 – Using FIM to enter an incident – old input method
Appendix 19 – Using Tripod Beta
Appendix 20 – Investigation timetable – key events
15.414

Revision: 3.0
Appendix 1: Template of Email from Operations to Senior PDO management
Title of email: Serious incident Email notification
Date/time of incident was: _____________________
Location of the incident: _____________________
Date/time incident was notified was: _____________________
Contractor/department involved: _____________________
Injured person: (Nationality) (age) (job title): _____________________
The activity taking place when incident occurred: _____________________
Description of the incident: _____________________
Initial assessment of loss or impact of the incident: _____________________
Extent of any injuries: _____________________
Treatment given: _____________________
Clinics and hospital taken to: _____________________
Initial view on days will be off work: _____________________
FIM number assigned: _____________________
15.415

Revision: 3.0
Appendix 2: Reporting Significant Incidents to SIEP and Stakeholders
i. Actual level 4/5 incident : E-mail Notification to stakeholders

“On…date of the incident… a (Age of deceased, Years old), a …position of the deceased…working for …
relation to the Business Unit (e.g., company, contractor, or third party), at …. place of work in PDO was
…activity undertaken during the incident…when …a short description of the incident. He received
describe injuries and medical treatment given but describe cause of death. Our thoughts and prayers are
with his family” FIM Entry No XXXX. (add a relevant picture to help explain the incident).
ii. LWC/Tier1 incident: Email notification to PDO operations

“On…date of the incident… name of deceased, (age of deceased, years old), a …position of the
deceased…working for … relation to the Business Unit (e.g., company, contractor, or third party), at ….
place of work in PDO, was …activity undertaken during the incident…when …a short description of the
incident. He received ….describe injuries and medical treatment given and is expected to be off work
for …. Days signed of absent. FIM Entry No XXXX.” (add a relevant picture to help explain the incident).
15.416

Revision: 3.0
Appendix 3: Initial Incident Notification form
15.417

Revision: 3.0
Appendix 4: Statement of Fitness – After Restart:

Confirmation of Statement of Fitness – after Restart Declaration
Complete this declaration following incidents involving:
 Uncontrolled shutdown of an asset
 Conditions outside the operational limits of an asset
 Environmental conditions beyond the original design parameters of an asset
Operating Unit:...............................................................................................................................
Facility:..............................................................................................................................................
Equipment:.....................................................................................................................................
FIM Incident #:............................................
By signing below I am confirming that the following criteria identified by PDO as the minimum criteria
necessary for the facility to reintroduce hydrocarbons have been met.
 The basic and immediate physical cause(s) of the incident have been clearly understood through
incident investigation and/or root cause process.
 Corrective actions required for restart have been completed, confirmed and address the incident
causes. This could include any or all of: repairs, alterations or modifications, required monitoring, temporary
equipment, mitigations.
 A review has been conducted assessing implications for similar equipment/barriers on the asset
 The Hazards and Effects Register has been reviewed as it applies to this incident.
 Statements of Fitness requirements have been met where applicable:
a. process safety risks have been identified and documented and are managed to ALARP;
b. employees or contractors executing HSE Critical Activities are competent and fit to work;
c. safety critical equipment meets its Technical Integrity requirements;
d. design and construction of asset modifications meet the design and engineering requirements;
e. the process safety basic requirements are met (Note 1).
f. procedures are in place to operate safety critical equipment within its operational limits.
g. modifications are complete and have been authorized as specified in the manual section management
of change;
 Initial incident report and other data and documentation are attached.
Delivery Team Leader

----------------------------------------, ----------------------------------------, ----------------------------------------,
Signature Name Date/time
Asset Owner
----------------------------------------, ----------------------------------------, ----------------------------------------,

Signature Name Date/time
Delivery Team Leader: the senior field based person: Asset Owner: person accountable for the asset

Revision: 3.0
g.418 Appendix 5: Template for low severity Incident Investigation Report

Revision: 3.0

Revision: 3.0
g.419 Appendix 6: General Medium Potential Incident Investigation Form
Reporting department: Date of incident: / /

Time of incident:
Incident location: Activity controlled: [ ] PDO

[ ] Contractor
Incident severity (0, 1, 2, 3, 4 or 5) : [ ] [ ] Third party
[ ] injury
[ ] occupational illness
[ ] environmental
[ ] asset damage
[ ] reputational
[ ] Potential risk rating
Activity at the time of the incident Broad description of the incident

(See App 6b for guidance) (See App 6c for guidance)
[ ] Using portable tools or equipment [ ] Slips/trips/falls (same level)

[ ] Welding / burning [ ] Fall from height
[ ] Manual lifting / handling [ ] Falling objects
[ ] Cleaning [ ] Fire or explosion
[ ] Operating plant / machinery [ ] Electrocution/electrical
[ ] Digging [ ] Struck by
[ ] Handling hazardous materials [ ] Struck against
[ ] Sampling [ ] Crushed by
[ ] Dismantling / assembling [ ] Trapped against
[ ] Draining / flushing [ ] Asphyxiation/chemical exposure
[ ] Drilling [ ] Assault
[ ] Disconnecting [ ] Loss of containment
[ ] Climbing / descending [ ] Pollution
[ ] Connections [ ] Theft or sabotage
[ ] Walking at same level [ ] Unsafe act or condition
[ ] Diving [ ] Other:
[ ] Working at height >2m
[ ] Piloting
[ ] Other:

Revision: 3.0
Parties involved
PDO Department/section: PDO Custodian :
Contractor - subcontractor: Contract Number:
Third party Name: Total number injured [ ]
How did the incident occur?

(Attach sketch / photographs / event tree as appropriate - more paper may be used if required).
Is the activity and associated hazard/controls addressed in the applicable safety case(s) [Y/N}? [ ]
If 'No', state measures proposed to rectify :
What actions were taken to determine if alcohol or drug use contributed to the incident?
Immediate action taken to prevent incident happening again
Details of the injured people (in liaison with medical team) (See App 6g for guidance)
Name:
Date of birth:
Employer:
Employee Number:
Job title:
Training attended:
Time on shift before the incident:
Days into rotation/days of rotation:
Previous incidents involving IP:
Date joined company?
Experience in current role?
Injury classification: (if RWC state alternate work assigned)
Nature of the injury or illness:
Part of the body injured:
Est. return to work date: / / (if LTI)

Revision: 3.0
Details of the non injured person involved in causation of the incident

Name:
Date of birth:
Employer:
Employee Number:
Job title:
Training attended:
Time on shift before the incident:
Days into rotation/days of rotation:
Previous incidents involving IP:
Date joined company?
Experience in current role?
Cost incurred as a result of this incident (US$) :

PROPERTY DAMAGE: PRODUCT LOSSES :
Environmental impact : (YES/NO) [ ]

Description of impact :
Details of equipment involved: ((See App 6f for guidance)
Type of facility : Equipment part :

Type of plant/equipment : Equipment tag No :
Phase of operation :
Details of leaking equipment

Item leaking [ ] Hazardous? (Y/N) [ ]
Duration of leak (min) [ ] Initial pressure (KPa) [ ]
Leak area (M2) [ ] How leak stopped? (AUTO / MANUAL)

Final pressure (KPa) [ ] Did detection system operate? (Y/N) [ ]
Name the reason for any detection failure :

Revision: 3.0
Fire or explosion
Duration (Minutes) [ ] How extinguished (Auto/manual) [ ]
Extinguishing medium [ ] Did detection operate? (Y/N) [ ]
Name the reason for any detection failure :

Revision: 3.0
Immediate cause Underlying cause

(See App 6d for guidance) (see App 6e for guidance)
[ ] Information error or omission [ ] Incompatible goals

[ ] Influence of intoxicating substances [ ] Error enforcing conditions
[ ] Failure to follow rules / procedures; [ ] Training
[ ] Inadequate equipment / tools [ ] Communication
specify :- [ ] Procedures
[ ] Misuse of equipment / tools [ ] Organisation
[ ] Procedure not documented [ ] Housekeeping
[ ] Work environment [ ] Maintenance management
[ ] Procedure considered impractical [ ] Hardware
[ ] Poor housekeeping [ ] Design
[ ] Procedure not communicated [ ] Defences
[ ] Access
[ ] Other
[ ] External factors, 3rd party, weather
[ ] Inadequate warning, safety devices
[ ] Other:
[ ] Failure to observe / use warning safety devices
[ ] Lack of due care and attention
[ ] Improper manual handling
[ ] Attack by animal
[ ] Inadequate PPE
[ ] Fatigue / stress
[ ] Failure to wear PPE
[ ] Lack of safety awareness
[ ] None of the above, specify:-
____________________________
Action taken to prevent recurrence

ITEM
Corrective action Action Targe Status
NO.
party t date

Revision: 3.0
Report writers name: Ref Ind.

SIGNED:
Report writer Supervisors name: Ref Ind.
SIGNED:
PDO Incident Owners name : Ref Ind.
SIGNED :
Date report completed : / /
Further recommendations
Date of incident : / /
Incident description:
Number Description of recommendation Action party Due by

Revision: 3.0
Signature of report writer :
g.419.1

Revision: 3.0
Appendix 6a: Guidance for the General Medium Potential Incident Report Form
The General Incident Report Form is used to report all types of Medium potential Incidents except Road
Traffic Incidents.
The form is to be signed by the Incident Owner for approval.
Heading Details required

Reporting department State the Ref indicator for the PDO reporting department.
Incident location State the general area followed by the specific locations e.g.
Yibal/GGP
Location controlled by Tick PDO if is predominantly controlled by the Company (e.g.
Production Station).
Tick Contractor if predominantly controlled by Contractor (e.g.
Construction Site)
Tick Third Party if neither applies.
Activity at time of incident Tick the box against the action which led directly to the incident
occurring. This is not necessarily the action of the injured parties (if
any). Refer to Appendix 6b for definition of activities.
Broad type of incident Tick the box against the general type of Incident. Refer to Appendix 6c
for definitions of broad incident types.
Parties involved Identify all parties involved that have or possibly have contributed to the
incident or have suffered from its consequences (injury/damage).
How the incident occurred Describe how the incident occurred. This will be based on results from
your investigation and must include:
- the reasons for carrying out the work
- events leading up to the incident
- the incident description and injury and/or damage incurred.
State whether the activity underway at the time of the incident and
its associated hazards / controls are adequately addressed in the
applicable Safety Case(s). Does the Safety Case need updating?
The Report form may not provide enough space for the full
description. In this case, state that you have provided additional
information (which may include photographs and drawings),and attach
the material securely to the report form.
Immediate action taken to State actions taken as an interim measure to prevent similar incidents
prevent recurrence happening on the site or to personnel carrying out similar activities.
Action parties must be listed against each preventative measure.

Revision: 3.0
Details of Injured Parties

This section is to be completed based on information from the PDO medical team. The injury
description is to be signed by the person who had provided the treatment. The following details are to
be provided for all injured parties.
Heading Details required

Name State full name
Date of birth State date of Birth or age if unknown
PDO Ref indicator State as applicable
Contractor State company name of contractor if applicable
Injury class Fatal, PTD, PPD, LWC, RWC, MTC, FAC, OCC. Refer to Appendix
6g for definitions.
Nature of injury State nature of injury. Only one entry is allowed. Refer to Appendix
6g for listing of injuries, and the rules in case of multiple injuries.
Part of body State part of body affected by main injury stated above.
Property damage State the approximate costs (RO) of property damage incurred.
Product losses, clean-up State the approximate cost of product losses including clean-up and
and restoration costs. restoration costs. Do not include cost of any deferred production.
Details of equipment See appendix 6f for guidance on equipment

damaged
Type of facility E.g. production stations, construction sites, etc.
Type of plant / equipment E.g. compressor, manifold, laboratory
Phase of operation E.g. construction, commissioning, maintenance, operation.
Equipment part E.g. : flange, hose, gauge
Equipment number State the equipment tag number
Details of leaking State the item of equipment from which the leak occurred e.g.
equipment/leaking item flange, valve, drain.
Duration of leak State duration in minutes.

Hazardous State yes/no depending on the pressure and nature of the fluids
released.
Leak area State the cross-sectional area of leak (and not of the area affected)
Initial/final pressure State pressure in vessel prior to and after the leak occurred.
Did detection operate State yes/no
Leak stopped by State automatically or manually.

Revision: 3.0
Fire/explosion
Duration State duration in minutes.
Extinguished by State: Automatically, or manually. (Manually includes hand held

extinguishers and fixed or portable systems which require manual
activation).
Extinguishing medium E.g. water, foam, CO2, BCF, powder
Did detection operate State yes/no
Reason for detection failure Briefly describe reason if applicable
Immediate cause The immediate causes relate mainly to the actions of individuals
directly involved in the Incident. Refer to Appendix 6d for description
of immediate causes.
Underlying causes The underlying causes can relate to managerial and organisational
weaknesses which allowed the Incident to happen. Tick the
appropriate boxes. Refer to Appendix 6e for underlying causes.
Action to prevent Corrective action items endorsed by the Incident Review Committee
recurrence must be listed. Each item must be identified by a number for ease of
follow-up. For each action item a PDO action party must be
nominated by the Committee. Both the current status and the target
completion dates must be recorded.
g.419.2

Revision: 3.0
Appendix 6b: Listing of activities at time of incident
Heading Description
Using portable An incident as a direct result of the use of hand tools or equipment including but not limited
tools and to the use of all powered/non-powered hand tools, e.g. screwdriver, wrench, shovel, grinder,
equipment chisel, hammer, punch, welding tools, saw, drill, blow torch, hatchet, pliers, scissors, etc.
Manual handling Incident as a direct result of manually moving or rotating an object in any plane or direction.
Operating plant / An incident as a direct result of operating a piece of equipment or machinery (excluding
machinery road traffic incidents which are reported separately), including but not limited to pumps,
compressors, mixers, well-heads, turbines, heat exchangers, boilers, draw-works, elevators,
laboratory equipment, cranes, vehicle mounted hydraulic hoists, earth moving plant etc.
Handling An incident as a direct result of hazardous materials whether in solid, liquid or gas form,
hazardous including but not limited to acids, alcohol's, arsenic compounds, pesticides, halogen
materials compounds, nitrous fumes, petroleum products or gas, explosives, chemicals, drugs,
medicines, radiation sources, etc. Check the Toxic Materials Manual for degrees of hazard.
Dismantling / An incident as a direct result of assembling/dismantling/demolishing of buildings, plants,

assembling process equipment, pumps, compressors, power generators, instruments, electrical
equipment, etc.
Scaffolding An incident as a direct result of the erection, dismantling or use of any type of scaffolding,
including the use of fixed and movable ladders.
Climb/descend An incident as a direct result of climbing on, or descending from something
Walking on same An incident as a direct result of any sort of walking (stopping, starting running, jumping) on
level any type of horizontal surface: floor, ramp, platform, walkway or street,
Driving / Piloting An incident as a direct result of operating mobile equipment such as a car, truck, forklift,
crane (whilst mobile) or piloting any sort of boat, plane or helicopter.
Working at high An incident as a direct result of working at a height (higher than 2m) level above the
level surrounding grade level or water surface on platforms, columns, vessels, buildings, cranes,
scaffolding, etc.
Welding / burning An incident as a direct result of any welding, burning or flame cutting operation.
Cleaning An incident as a direct result of any sort of internal or external cleaning operations of
moving or stationary equipment, vessels, tanks, buildings, trucks, barges, etc.
Digging An incident as a direct result of any kind of earth removal operations, be it onshore or
offshore, in shafts or tunnels, by hand or with machines or explosives.
Lifting / Crane An incident of which the major impact is caused by the direct consequence of lifting or
operations crane operations.
Sampling An incident as a result of a sampling activity of any kind of solid, liquid or gas flow, e.g. feed
stock flows, product flows, utilities system flows, etc.
Draining / flushing An incident as a direct result of a draining / flushing operation of any kind of equipment, e.g.
process vessels, tanks / tankers, pipes, bund-wall areas, sewer systems, etc.
Disconnecting An incident as a direct result of a part of system, e.g. disconnecting of instrument or

connections electrical cables or plugs, disconnecting of temporary or permanent pipes or hoses,
disconnecting of wire running tools from wellhead, etc.
Water transport An incident while transporting goods or people by sea
Diving An incident as a direct result of any operation where people are required to work fully
submerged in water, with or without aqualung, umbilical or submarine hoses, including all
surface operations, e.g. compression and decompression facilities.

Revision: 3.0
Other activity An incident not resulting from any of the above mentioned activities, excluding a road traffic
incident which is reported on a separate form. State the ‘Other’ activity.
g.419.3 Appendix 6c: Listing and descriptions of incident types
The broad incident types fall into several main categories which are not mutually exclusive. Only one entry per incident
can be entered, determined by which type of incident caused the major injury, environmental or financial impact.
Event Description
Slips, Trips and An incident of which the major impact is caused by a fall, trip or slip and where this impact
Falls same level remained limited to the direct consequences of the fall, trip or slip.
Fall from height An incident involving the fall of a person from more than 2m.
Falling objects An incident of which the major impact is caused by a falling object and this impact is limited to the
direct consequences of the falling object.
Fire /explosion An incident of which major impact is a direct result of a fire and/or explosion.
Electrocution/Elec An incident of which the major impact is caused by an electrical phenomenon, short circuit, static
trical electrical discharge, electrocution, etc., and where this impact is limited to the direct
consequences of the electrical phenomenon.
Struck by An incident where a person is struck by a moving or swinging object which is not falling from
height
Struck against An incident where a person struck a body part against a fixed or moving object
Crushed by An incident where a person is crushed under an object and gravity applies the weight
Trapped by An incident where a person is trapped between two objects in the horizontal plan
Asphyxiation/che- An incident where a person loses consciousness as a result of inhaling contaminated air or lack of
mical exposure air
Assault An incident of which the major impact is caused by the direct consequences of an assault on any
person or installation.
Loss of An incident of which the major impact is a direct result of loss of containment of a fluid, e.g. oil,
Containment gas, chemical, water, etc. The loss of containment can be due to a leak, rupture, blowout, a
malfunctioning valve, etc.
Pollution / An incident of which the major impact is pollution or any other damage to the environment, e.g.
environment water, soil, air or plant/animal life.
Theft and a non-HSE incident, which:

Sabotage
- was deliberately initiated for the purpose of secretly taking or damaging property belonging to
someone else with the intention of permanently depriving the owner of its use or possession, and
- where the most severe impact is the loss or damage of assets, including information assets.
Theft may involve visible intrusion (e.g. burglaries) or simply disappearance of an asset.
Unsafe acts / An incident without any injury, environmental or financial impact, which could, however, have
conditions developed into an incident with injury, environmental or financial impact because of unsafe acts or
conditions observed or violation of commonly accepted safe procedures.

Revision: 3.0
Other Any other incident which cannot be categorised within the above broad incidents type. Including
for example, an illness or adverse health effect caused by recurrent exposure to hazards. The
supervisor should state the "Other" Broad Incident type.
g.419.4

Revision: 3.0
Appendix 6d: Listing of possible immediate causes
Heading Description
Information error or Was an information error or omission occurring between parties directly or indirectly involved
omission with the activities leading to the incident a contributing factor?
Failure to follow Was failure to follow established rules and procedures a contributing factor, e.g. permit-to-work
rules/procedures system not followed, gas testing or vessel entry procedures not followed, etc.? There are several
reasons why there may be a failure to follow established procedures, listed below :-
Procedure not documented. Were there any documented rules or procedures which adequately
covered the task or activity being done when the Incident occurred?
Procedure considered impractical. Were the rules and procedures covering the task or activity in
place but generally not enforced because they were recognised or considered to be impractical /
inappropriate for the circumstances ?
Procedure not communicated. Were practical rules and procedures covering the task or activity
in place but they had not been successfully communicated to the people involved in the
Incident? A lack of communication may be due to the persons being unaware of the procedure
or being unable to understand it.
Other - any other reason not covered above why known rules and procedure were not followed.
Inadequate Were inadequate warning signs, lights, horns, whistles, etc., or malfunctioning warning signals a
warning/safety contributing factor. Or were safety devices, such as relief valves, blow down system, level,
devices pressure, gas or fire detectors, guards, screens or safety nets, by-passed, disconnected,
mal-adjusted, incorrectly replaced or not installed a contributory factor?
Failure to observe / Were available warning safety devices ignored, or were necessary warning signals not installed,
use warning safety placed or used?
devices
Improper manual Was improper handling e.g. incorrect lifting, carrying, gripping, applying of force a factor?
handling
Inadequate PPE Was inadequate quality of required personal protective equipment a contributory factor?
Failure to wear PPE Was the failure to wear or provide the required PPE equipment a contributory factor?
Intoxicating Were the effects, including side effects, of intoxicating liquids or illegal drugs a contributory
substances factor?
Inadequate Were the quality or quantity of the equipment or tools a contributory factor. e.g. non sparking
equipment/tools tools, uninsulated electrical tools, no flame or spark arresters, etc.? Did the equipment or tools
fail during operation?
Misuse of Was improper use of tools or equipment a contributory factor?

equipment/tools
Work Environment Was excessive noise, inadequate ventilation, inadequate illumination, inadequate traffic control,
inadequate building or workshop layout, inadequate furniture, etc. a contributing factor?
Housekeeping Was untidy worksite a contributing factor?
Access Was inadequate or congested access, aisle space, exits or clearance a contributory factor?
External factors Were uncontrollable outside influences factors, such as third party drivers, environmental
(3rd party, weather) conditions, sabotage, war, weather, floods, landslides, etc., a contributory factor?

Revision: 3.0
Other State any "Other" Immediate Cause as: Lack of due care and attention; Attack by animal;
Fatigue / Stress; or Lack of safety awareness. If none of these are applicable then specify
applicable immediate cause in words.
g.419.5

Revision: 3.0
Appendix 6e: Listing of possible underlying causes

The Underlying Causes used originate from the Tripod Beta options.
Heading Description
Incompatible goals A failure to manage a conflict between different goals, such
as safety versus production, formal versus informal rules,
company objectives and a persons own personal aims
including poor motivation to perform properly, being
distracted, reckless or uninterested?.
Error Enforcing Conditions Any conditions which promote human error. e.g. hard
physical working conditions, (hot, noisy, dusty, cramped work
area), work time pressures, changes in work patterns,
Training Deficiencies in the system for providing the necessary

knowledge and skills to make a person competent in their
role.
Communication A failure in transmitting or imparting information effectively

including checking that the information has been understood.
Procedures A failure to provide a person with clear, available, accessible,

understandable, correct, up to date, effective procedures,
permit to work, Job Hazard Analysis, Tric Card or Tool Box
Talk, rules or methods.
Organisation A deficiency in the way tasks, responsibilities or authorities

are assigned or a deficiency in the management structure.
This includes vetting a persons capability to conduct the
work, including physical (eyesight, fitness, health) and mental
(aptitude to conduct the task). It also includes inadequate or
lack of supervision. This also includes inadequate job
planning or preparation or inadequate manpower.
Housekeeping Problems and issues relating to the conditions of tidiness or

cleanliness of facilities or workplaces.
Maintenance management Issues relating to unsufficient or lack of preventative

maintenance and inspection systems for ensuring the
technical integrity of facilities, plan, equipment or tools which
results in the premature failure or malfunction of equipment
or structures?
Hardware Issues relating to unavailable or sub-standard quality

equipment or materials.
Design Issues relating to the layout or design of facilities, plant,

process line equipment or safety devices, or inadequate
construction, installation, or commissioning. This includes the
inadequate provision of warning signals or signage.
Defences Failures in systems which are designed to reduce the

consequences after an incident has occurred.

Revision: 3.0
g.419.6

Revision: 3.0
Appendix 6f: Listing of possible facilities / plant / equipment

Type of Facility Pump body Iron Sulphide oxidation Material/Product
Process/treatment plant Pump seal Others Additive
Production facilities Loading arm Bitumen
Utilities Safety relief valve Unit or Plant Chemical (general)
Product storage (tank farm) Small bore piping Control building Chlorine
Pipes (off-plot) Valve Offices Crude oil

Transport facilities Others Laboratories Fuel gas
Construction sites Living quarters/houses Fuel oil
Berths/jetties Phase of Operation Restaurant Gasoline
Movable field Construction or erection Warehouse/yard Natural gas
installations
Loading/unloading Dismantling Workshop/garages H2S
Buildings Maintenance or repair Steam/Hot water injection Hydrocarbons
Others Gas-freeing/cleaning of equipment Firewater system Kerosene
Starting up Flow line-gas \ oil LPG
Equipment Involved Shutting down Gas Compression Residue
Columns Upset conditions Gathering Station Steam
Compressors Normal operation Gas treatment Sulphur dioxide
Furnaces incl. boilers Others LPG facilities Water
Gas turbines Oil separation Others
Generators Source of Ignition Oil storage

Heat exchangers Auto or spontaneous ignition Offshore mooring Leaking Item
Pipework Hot surfaces or equipment Pipeline Gas \ Oil \ other Gasket
Pumps Welding brazing cutting Pumping \Booster Station Fitting
Reactors Flares Station \ metering Flange
Tanks Open flames Tanker- sea Vent
Vessels Smoking Tanker loading Valve
Others Lighting Well Head/ drilling Plug

facilities
Static electricity Wireline/workover unit Hose
Part of Equipment Friction-overheating/impact sparks Others Seal
Bellows Smouldering lagging or waste Pipe
Burners Gasoline/diesel engine or exhaust Drain
Filter Electrical equipment Nipple

Revision: 3.0
Flange/gasket Collision, vehicles etc. Pinhole
Hose Sabotage or vandalism Weld
Instrument element Chemical reaction Other
g.419.7

Revision: 3.0
Appendix 6g: Listing of injuries and occupational illnesses
1. The nature of injury classification identifies the injury in terms of its principal physical characteristics
2. When one injury is obviously more severe than any of others, select that injury. For example select an injury
involving permanent in preference to temporary injury.
3. When there are several injuries of different natures, such as cuts and sprains, no one is indicated as being more
serious than the others, classify as multiple injuries.
4. Damage of eyeglasses, hearing aids, dentures or artificial body parts is not considered an injury.
Injury Description
Open wounds e.g. cuts, lacerations, punctures, foreign objects (splinter).
Crushing/contusions/bruises Intact skin surface.
Bites and stings All bites and stings (insect, dog, human, reptile, etc.) except venomous reptile and
insect bites, see poisoning.
Superficial injuries e.g. scratches, abrasions.
Burns (heat/cold) The effect of contact with hot or cold substances. Include electric burns, but not
electric shock. Does not include chemical burns, effects of radiation, sunburn,
systematic disability such as heat stroke, friction burns, etc.
Burns (chemical) Tissue damage resulting from the corrosive action of chemicals, chemical
compounds, fumes etc. (e.g. acids, alkalis).
Heat/sun stroke or exhaustion All effects of exposure to environmental heat not including sunburn/radiation.
Radiation effects Sunburn and all forms of damage to tissue, bones or body fluids produced by
exposure to radiation (e.g. sun light, X-ray, gamma ray, etc.).
Asphyxia, strangulation Respiratory problems caused by oxygen deficiency or by airway obstruction. Does not
include drowning or the effects of toxic agents.
Fractures A break or rupture in a bone.
Cerebral concussion Transient loss of consciousness for a few seconds followed by a retrograde and
post-traumatic amnesia
Cerebral contusion Loss of consciousness longer than cerebral concussion often followed by a severe
residual neurologic deficit.
Dislocation Displacement of a bone end at a joint
Drowning Aspiration of fluids which results directly in asphyxia.
Sprains and strains A sprain is an injury with stretched or torn ligaments, soft tissue damage around the
joint. A strain is a muscle injury from over stretching.
Hernia/rupture Includes both inguinal and non-inguinal hernia, and all internal injuries.
Drowning In any depth of water
Loss of sight Loss of sight or impairment of sight.
Hearing loss or impairment Hearing loss / impairment as a separate, single injury not the sequel of another injury.

Revision: 3.0
Single exposure poisoning A systematic morbid condition resulting from the inhalation, ingestion, or skin
absorption of toxic substance affecting the functioning of either the metabolic,
nervous, circulatory, digestive, respiratory, excretory or the muscular-skeletal system.
Includes chemical, drug or metal poisoning, organic diseases, venomous reptile and
insect bites. Does not include effects from radiation, pneumoconiosis, corrosive
chemicals; skin irritations; septicaemia or infected wounds.
Other injury All injuries not elsewhere identified (state).
Multiple injuries Several injuries of different natures, such as cuts and sprains, no one of which is
indicated as being more serious than the others.
Electrical shock Shock from contact with an electrical source. Excludes electric burns.
Nature of Occupational Illness

Occupational illness exclude all illness caused by a single event or a number of events close together in the course of
employment. Only one entry is allowed.
Illness Description
Noise Induced Hearing Loss Hearing loss from long-term exposure to high noise levels.
Lung problems/diseases e.g. occupational asthma, dust disease (pneumoconiosis) such as silicosis or
asbestosis.
Skin disease e.g. contact dermatitis from repeated skin contact with solvents or allergic eczema
from repeated contact with epoxy resins.
Poisoning Systemic affects due to toxic mass e.g. anaemia from repeated benzene exposure.
Physical causes e.g. radiation, excluding effects from a single event, diseases from long-term
exposure to vibration. (Excludes Noise Induced Hearing Loss and toxic materials).
Infections/contagious e.g. tropical infections or contagious disease contracted during the course of
employment, animal disease, tuberculosis.
Cancer e.g. mesothelioma from asbestos exposure.
Stress Disorders due to stress at work
Repetitious injury Disorders associated with repeated minor trauma.
Other occupational illness Any illness not listed above - specify details
Classification of Occupational Illness

Infectious and Parasitic Diseases: malaria, food poisoning, infectious hepatitis, dysentery, lambliasis, legionnaire's
disease.
Skin Diseases and Disorders: contact dermatitis, allergic dermatitis, rash caused by primary irritants and sensitisers or
poisonous plants, oil acne, chrome ulcers, chemical burns or inflammations.
Respiratory Conditions due to Dust or Toxic Agents: silicosis, asbestosis, pneumoconiosis, pneumonitis, (allergic)
bronchitis, alveolitis, asthma, pharyngitis, rhinitis or acute congestion due to chemicals, dusts, gases, or fumes.
Poisoning (Systemic Effects of Toxic Materials): poisoning by lead, mercury, arsenic, cadmium, or other metals;
poisoning by carbon monoxide, hydrogen sulphide, or other gases; poisoning by solvents; poisoning by pesticides;
poisoning by other chemicals such as formaldehyde, plastics and resins.
Disorders due To Physical Agents (Other than Noise and Toxic Materials)Examples: heat-stroke, sunstroke, heat
exhaustion and other effects of heat stress; freezing, frostbite and other effects of exposure to low temperatures;
caisson disease; effects of ionising (alpha, beta and gamma rays, radium) and non-ionising (welding flash,
ultraviolet rays, microwaves, sunburn) radiation

Revision: 3.0
Disorders associated with Repeated Trauma: synovitis, tenosynovitis, and bursitis; Raynaud's phenomenon; other
disorders of the musculo-skeletal system and connective tissue associated with repeated trauma.
Cancers and Malignant Blood Diseases: mesothelioma; bladder cancer; leukaemia and other malignant diseases of
blood and blood forming organs
Disorders due to Mental Stress: tension headache, depression, neurosis, "stress", functional disorders of the
gastrointestinal tract
Noise Induced Hearing Loss: definition and criteria for reporting are given in the SHC Noise Guide 1991.
Other Illness and Disorders: Benign tumours; eye conditions due to dust and toxic agents; other (non-malignant)
diseases of blood and blood forming organs.
4.420

Revision: 3.0
Appendix 7: Medium and High Potential Investigation Report content and format
The contents of High and medium potential Incident reports should be based on the following template:
1. SUMMARY
2. INCIDENT DETAILS
2.1 Time, Date, Place
2.2 Persons involved in the Incident
2.3 Vehicles / equipment involved in the Incident
2.4 Events leading to the Incident
2.5 The Incident
2.6 Description of damage
2.7 Nature of injuries
2.8 Post Incident response
3. INCIDENT INVESTIGATION
3.1 Investigation Team membership and Terms of Reference
3.2 Findings from site conditions
3.3 Findings from vehicles / equipment (including maintenance)
3.4 Findings from work preparation / work task analysis
3.5 Findings from experience, competence & other details of persons involved
3.6 Sections to address any other issues specific to nature of incident
3.6i Supervision,procedures,PTW,Journey Management,contractor management
3.6ii Explicitly describe action taken determining if alcohol/drugs were involved
3.7 Emergency response to the incident
3.8 Tripod Beta Tree if required
4. SAFETY CASE GOVERNING OPERATION / ACTIVITY
4.1 Safety Case cross reference and comparison of controls
4.2 HEMP findings and controls – identification and implementation.
5. HSE MANAGEMENT
5.1 Organisation, roles and responsibilities
5.1.1 PDO
5.1.2 Contractor / Contract
5.2 HSE requirements for contract
5.3 HSE Plans (focus on issues which are implicated in causes of incident)
5.3.1 PDO
5.3.2 Contractor
5.4 Monitoring implementation of HSE Plans

Revision: 3.0
5.4.1 PDO monitoring if PDO is fulfilling responsibilities and obligations

5.4.2 PDO monitoring if Contractor is fulfilling responsibilities and obligations
5.4.3 Contractor monitoring if it is fulfilling responsibilities and obligations
(above sections include monitoring, auditing, inspections, reviews etc.).
5.5 HSE performance of contractor
(On contract in question and other contracts in general. Alternatively, address
PDO HSE performance if a PDO fatality)
6. CONCLUSIONS
6.1 Primary or immediate cause of the incident
6.2 Latent causational conditions (localised)
6.3 Latent causational management failings (underlying causes)
6.4 Other related/relevant findings
6.5 General conclusions and observations
7. RECOMMENDATIONS
7.1 Immediate actions
7.2 Follow-up actions
LIST OF ATTACHMENTS (including action close-out form template)
4.421

Revision: 3.0
Appendix 8: Medium/High Potential Road Traffic Incident Report & advice
Road traffic incident investigation form

Investigating Manager
PDO Directorate: Department
Contractor name: Contract No
Contract Holder:
Investigation start date: Time: am pm
Did a PDO/contractor manager attend incident scene: Yes No
Did RSST attend incident scene Yes No
Name of manager attending the scene:
Incident Details
Incident date: Time: am/pm Day:
PDO informed date: Time: am/pm
Description of incident: (continue on separate paper if required)
Draw a sketch of the incident on last page or on a separate page and attach.
Location Details
Town/Asset: Road Name/No:
Speed Limit:
Was adverse camber involved? Yes No
applicable)
Road Type : Graded Single blacktop Two lane black top 3 lane highway
Lay by Bus stop Car park Lorry park Yard Rig Pad
Gated entry Off Road Other (specify):
Road Configuration : Bend Crossroads Filter lane On ramp
Offset junction T Junction On – site Ped crossing Road narrows Chicane
Roadworks Roundabout Traffic lights Straight road Junction left Junction right
Power line crossing
Right of way Off ramp
Rig site
Pipe-line crossing Other (specify):
Road Conditions : Dry Wet Damp Spill on road

Rough
Flooded Greasy Muddy Potholes
terrain

Revision: 3.0
Other (specify):
Weather conditions : Dull Overcast Fine Sunny
Fog or mist Rain Strong winds Other (specify):
Lighting conditions : Dark No road lights Road lights on Lights off
Daylight Dawn Dusk Night Other (specify):
Brightness : Dazzling Good Fair Poor
Very poor Other (specify):
ROP License
ROP License Type: Light Heavy Plant Nationality:
ROP License Number: Full Provisional
Date ROP License obtained:
PDO Drivers Permit

Permit Type: Light Heavy Graded Bus Tanker
Permit Number: Issue date:

Date of last DDC06 assessment conducted:
Driver Experience
Experience on vehicle type: Total years
Driving:
Date of last competency assessment:

Date of last in house driver training:
Number previous accidents: Date of birth:
Shift start time: Shift end time:
Accident type: Fatal all parties injured 3rd party injured PDO driver injured
fire damage theft passenger/s injured

only
Pedestrian hit rollover 5th wheel failure Collision with an animal
Other (specify):
Driver
Employment status: Full Time Owner Driver No Driver
Business
Cash Driver Trainee Driver Contract Manager
Driver
Operations Mechanic Other (specify):
Driver Injuries: head eye ear nose
mouth neck shoulder chest arms

Revision: 3.0
wrist hand finger(s) back hip

leg knee ankle toe(s) internal
unclear Other (specify):
Description of injury : Bruise cut sprain
graze amputation dislocation unconscious fatality asphyxiation
unknown near miss Other (Specify)
Any relevant medical conditions
known:
Passengers
P1, Name: Company:
Telephone Emp Status
P2, Name: Company:
P3, Name: Company:
P4, Name: Company:
Injuries to passengers: Mark injury and passenger No.
Head Eye Ear Nose Mouth
Neck Shoulder Chest Arms Elbow
Wrist Hand Finger(s) Back Hip
Groin Leg Knee Ankle Toe(s)
Internal None seen Unclear
Other (specify):
Description of passenger injuries. Mark injury and passenger No.

Bruise Cut Sprain Fracture Graze
Amputation Dislocation Unconscious Fatality Asphyxiation
Unknown Near miss
Other (specify)
Journey Details
Purpose of Journey : Trunking Delivery to rig Delivery to yard
Rig move Camp move Back load Shunting Commuting
Personal Bussing Supply run Other (specify)
Journey start time: Planned end time:
Journey under control of journey manager: Yes No
If yes name of JM: Company:
JP Number: JM informed: Yes No
Was driver familiar with location: Yes No Was driver familiar with vehicle: Yes No
ROP details

Revision: 3.0
Was accident reported to ROP: Yes No Did ROP attend the scene: Yes No
Was driver breath tested: Yes No Passed: Yes No
ROP Officer Name:
ROP Officer Number: Incident Ref No:
ROP contact details:
Has a ROP investigation been Were any warnings of

Yes No Yes No
conducted? prosecution given?
If yes, please give details:
Was vehicle recovered? Yes No If yes to where:

PDO Contracted vehicle details
Type: Prime mover and trailer Prime mover only Rigid
Flatbed Lowboy Crane Canter Box truck Water tanker
Skid Tank Wire line Oil field Winch truck Landcruiser Pick up
Car Cycle Bus Seismic truck Fuel tanker Banana truck
Other (specify)
Make: Model: CC:
Registration Year: Colour:
Number:
Trailer Number: Year:
Veh. RAS Inspection Veh. Registration date:
date:
Tlr. RAS Inspection date: Tlr. Registration date:
RAS carried out by which company?
Description of load being carried:
Weight of the load being carried:
Manoeuvre being undertaken by PDO contracted vehicle :

Changing lane to left Changing lane to right Moving forward Reversing Moving off
Overtaking Proceeding normally Parked Unattended Slowing
Stopping Turning left Turning right U-turning Negotiating obstacle
Crossing carriageway Evasive action Out of control S - curve
Hill - incline Hill - decline Braking
Other (specify):
Which lights were on: Headlights low beam Headlights full beam Rotating
flashing

Revision: 3.0
None Sidelights Reversing Fog Hazards High intensity

Roof lights Interior Other (specify):
Any warnings given: Audible alarm Flashed lights No Reverse alarm
signals
Brake lights Indicating left Indicating right Hazard lights Revers Hand signals
e light
Other (specify):
Damage type None Slight Moderate Severe Write off
Unknown Other (specify):
PDO vehicle speed on approach: PDO vehicle speed on impact:
Description of damage (including load):
Location Details
Third Party Persons, Vehicles & Property

3rd Party involved Pedestrian Car Van Cyclist Motorbike
:
Building Fence No vehicle Parked trailer Parked PM Hitched trailer
Lamp post Road sign Barrier Cordon Pylon Pipeline
Other (specify):
3rd Party Vehicle / Pedestrian Details
Pedestrians injured? Yes No
3rd Party Approx age:
Name:
Address:

Revision: 3.0
Postcode: Telephone Number:
Insurers Details: Policy Number:

3rd Party Vehicle Details:
Type: Prime mover and trailer Prime mover only Rigid
Flatbed Lowboy Crane Canter Box truck water tanker
Skid Tank Road train Oil field Winch Landcruiser Pick up
truck
Refuse truck Repair vehicle Car transporter
Car Cycle Bus Other (specify)
Make: Model: CC:

Registration Year: Colour:
Number:
Trailer Number: Year:
Veh. RAS Inspection Veh. Registration date:
date:
Tlr. RAS Inspection date: Tlr. Registration date:
Description of load being carried:
Weight of the load being carried:
Manoeuvre being undertaken by 3rd Party vehicle :

Changing lane to left Changing lane to right Moving forward Reversing Moving off
Overtaking Proceeding normally Parked Unattended Slowing
Stopping Turning left Turning right U-turning Negotiating obstacle
Evasive action Out of control Crossing carriageway
Other (specify):
Which lights were on: Headlights low beam Headlights full Rotating flashing
beam
None Sidelights Reversing Fog Hazards High intensity
Roof lights Interior Other (specify):
Any warnings given: Audible alarm Flashed lights No Reverse
signals alarm
Brake lights Indicating Indicating right Hazard lights Reverse Hand signals
left light
Other (specify):
Damage type : None Slight Moderate Severe Write off
Unknown Other (specify):
3rd Party vehicle speed on 3rd party vehicle speed on
approach: impact:
Description of damage (including load):

Revision: 3.0
Witness Details (1)

Name:
Telephone Number:
Position relative to incident:
Witness Details (2) (continue on separate sheet for additional witnesses)

Name:
Telephone Number:
Position relative to incident:
Incident Type
Identify the incident type from the list below. (ring all applicable)
Forward Movement : Collision with - vehicle object pedestrian
misjudgment when - turning left turning right moving off entering
major road
changing lanes to left to right
Overtaking : misjudged overtaking vehicle misjudged moving vehicles on
offside
Misjudged parked vehicle on nearside Misjudged parked vehicle on offside
Misjudged between two lines of parked cars Misjudged moving vehicles on nearside
Height : Misjudged height forward
Reversing : Collision with - Vehicle Pedestrian
Bends : PDO vehicle PDO vehicle lost control
over centre line
Other vehicle Other vehicle lost control
over center
Miscellaneous : Animals on road Pedestrians on road opening door into
traffic
damaged whilst loading damaged whilst unloading failure to connect trailer properly
damage by load shifting failure to apply hand brake alleged vehicle fire
defect
damaged whilst parking Damaged whilst parked roll over
Other (specify):
Driver Behaviour:
Too fast Too slow Lane discipline Failure to comply with signals or signs
Primary Factors
Failure of PDO driver: Failed to stop (mandatory sign) Failed to give way
Failed to avoid pedestrian Failed to avoid vehicle in road Failed to avoid
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object in road
Failed to signal Gave misleading signal Failed to apply
handbrake
Failed to attach trailer correctly Poor lane discipline Failed to park safely
Failed to judge width correctly Lost control of vehicle Failed to secure
vehicle
Sudden braking Poor overtaking Failed to secure load
Swerved to avoid object/person/vehicle/animal in road
Other (specify):
Manoeuvres : sudden braking poor overtaking Poor turn
Swerved to avoid object in the road drove wrong way on one-way street
opened door carelessly Other (specify):
Failure of Pedestrian: Pedestrians on carriageway Crossed from behind
parked car
Ignored lights at crossing Dark clothing at night
Failure of 3rd party driver: Failed to stop (mandatory sign) Failed to give way
Failed to avoid pedestrian Failed to avoid vehicle in road Failed to avoid object in
road
Failed to signal Gave misleading signal Failed to apply handbrake
Failed to attach trailer correctly Poor lane discipline Failed to park safely
Failed to judge width correctly Lost control of vehicle Failed to secure vehicle
Sudden braking Poor overtaking Failed to secure load
Swerved to avoid object/person/vehicle/animal in road
Other (specify):
Contributory Factors, mark all applicable.
Personal details:
alcohol drugs fatigue illness eyesight sneezing
heart attack panic disability
physically distracted visually distracted distracted by phone
Distracted by passengers careless or reckless driving failure to judge speed
correctly
Failure to judge distance
Other (specify):
PDO Driver:
Excessive speed following too close inexperienced driver inexperienced with
vehicle
aggressive driving road rage
Other (specify):
3rd Party Driver:
Excessive speed following too close inexperienced inexperienced with
driver vehicle
aggressive driving road rage
Other (specify):
Vehicle defects :
Tyres at wrong pressure tyre deflated before impact tyres worn or poor
tread
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defective lights or signals defective brakes

Other (specify):
Local conditions:
Poor road surface poor street lighting inadequate signage Inappropriate signage
road works / slippery road earlier accident
Other (specify):
Obstruction:
Windows obscured glare from the sun glare from headlights fog or mist
animal out of control
Other (specify)
No fault:
Hit unavoidable by 3rd party.
Other (specify):
Without prejudice to yourself or the company, please state what you think caused the incident and
how it could have been avoided:
Remedial action
Identify the Remedial action to be taken :
Investigating Manager Signature Date
Drivers signature Date

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Further action to be taken

No action required retraining of driver Re-briefing of driver
re-briefing all drivers disciplinary action Safety alert
Other (specify):
Sketch of accident (use more sheets if required)

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4.422 Appendix 9: Non-accidental Death Reports (NAD)
In case of Non-Accidental Deaths (NADs), there is a requirement to identify whether the incident may be
work-related or involve a failure on the part of the company or contractor management controls that should
have been in place. This applies to non-accidental deaths in company premises and non-company premises
including company and contractor accommodation. It is mandatory for the Occupational Health Advisor,
MCOH or a delegate to be part of the investigation team.
Non-accidental deaths involving company or contractor employees shall be notified within 24 hours, and
investigated to:

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 Decide whether there is a causal relationship between work and the death, in which case the death
should be classified as a work related fatality and recorded in statistics,
 Identify work related causes or contributing factors that may provide the grounds for corrective action
and improvement,
 Assess maximum exposure rate (MER).
 Establish whether management systems were in place to ensure that the fitness of personnel was in line
with requirements for the job.
 Establish whether remedial actions were suitable and sufficient.
 Identify failures in management controls.
 Provide recommendations for improvement to avoid a reoccurence.
The investigation should be conducted in a way that respects medical confidentiality.
1. SUMMARY
2. EVENT DETAILS
2.1 Time, Date, Place of death
2.2 Details of the deceased
2.3 Nature of injuries/cause of death
2.4 Sequence of Events leading to the discovery of the deceased
2.5 Sequence of Events following the discovery of the deceased
2.6 Post Incident response
2.6.1 Assessment of Medical Emergency Response (including First Aid, Medical Treatment and
Medevac)
3. INVESTIGATION DETAILS
3.1 Investigation Team membership (including medical officer & OH Adviser)
3.2 Persons interviewed
3.3 Examination of relevant site / living conditions (vehicles, equipment, accommodation, etc.)
3.4 Examination of the work hazards
3.4.1 Are there any work related exposures e.g. contact with hazardous substances, poor working
environment etc. which could have contributed to the death?
3.5 Evaluation of pre-existing conditions / lifestyle factors
3.5.1 Are there any relevant lifestyle factors e.g. diet, tobacco, alcohol abuse, etc?
3.5.2 Were there any pre-existing medical conditions?
3.5.3 Has the individual been declared medically fit to carry out his/her normal duties in compliance with
Company Standards? Were medicals conducted satisfactorily?

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3.5.4 Had the individual exhibited any signs, or symptoms associated with the cause of death
before/during his/her recent work period?
3.5.5 Had the individual been recently referred to a doctor?
3.5.6 What emergency response took place and was it adequate?
4. HEALTH MANAGEMENT ASPECTS

4.1 Organisation, roles and responsibilities
4.1.1 PDO & Contractor
4.1.2 What is known of the health management within the direct working environment of the
deceased (health risk assessments, exposure monitoring, health controls and performance
indicators?)
4.2 Health requirements for contract
4.3 HSE Plans (PDO & Contractor) (focus only on issues which are relevant to the cause of death)
4.4 Monitoring and Implementation of HSE Plans
4.4.1 PDO monitoring if PDO is fulfilling responsibilities & obligations
4.4.2 PDO monitoring if Contractor is fulfilling responsibilities & obligations
4.4.3 Contractor monitoring if it is fulfilling responsibilities & obligations
* (above sections to include monitoring, auditing, inspections, reviews etc.).
5. CONCLUSIONS
5.1 Primary and Contributory cause(s) of the Death
5.2 General conclusions or observations
6. RECOMMENDATIONS
6.1 Immediate actions
6.2 Follow-up actions
LIST OF ATTACHMENTS
- information such as autopsy report, medical fitness certificate, etc. if available)
- including Action Close-Out form template
4.423

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Appendix 10: Template for Incident Review Presentation
For actual presentation template, click here.
The following outlines the template that must be followed for Incident Review Presentations. Deviation is not
allowed without Director and MSE5 written approval.
Slide 1

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Slide 2
Slide 3

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Slide 4
Slide 5

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Slide 6
Slide 7

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Slide 8
Slide 9

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Slide 10

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Slide 11
Slide 12

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4.424

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Appendix 11: Example of a Lateral Learning

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4.425 Appendix 12: Declaration of confirming close out of Redline actions
For actual presentation template, click here.
Slide 1 (copy from IRC presentation)

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Slide 2 (copy from IRC presentation)
Slide 3

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4.426

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Appendix 13: Serious Incident Review template
Slide 1
Slide 2

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Slide 3
Slide 4

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4.427 Appendix 14: Level 3 SIR briefing note
Level 3 – SIR briefing note from a Business Unit
Date & time of incident dd/mm/yyyy at 00:00hrs

Region, EP Company, asset team, EPM, PDO, ฀ Area (e.g Marmul) ฀ exact location (e.g
location swimming pool)
Proposed classification at time of Actual severity code (e.g. 5P); Potential risk rating
writing code ( e.g.C5P)
Incident description Immediate actions

Short description of incident happening Bulleted list of the immediate actions PDO
(All text in Times New Roman 10). Guide took to resolve the situation short term
length is 100 words
Underlying causes
Bulleted list of the underlying causes
identified in the investigation
Outcome
Short description of outcome of the event,
injuries sustained etc. Guide length is 50
words
Senior management actions to address

underlying causes
Main findings from investigation
Bulleted list of the main findings from the Bulleted list of the key remedial actions
investigation. Pick the key findings that what were introduced as a result of the
led to the causes, eliminate the peripheral investigation on a wider scale. Do not
issues include the local recommendations as this
is for the wider learning.

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Include a picture here if room and if it

adds value to the briefing note
Main causes
Bulleted list of the identified main causes
which led to the incident leading on from
the findings

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Petroleum Development Oman LLC Effective: Nov-12
4.428 Appendix 15: Determining environmental incident risk potential
To help give a quantitative assessment of the potential of a solid or liquid released to soil or water to damage
the environment.PDO utilises the Environmental Incident Severity Rating Index (EISRI) which is explained
below:
2.2.28.1Incidental releases of solids or liquids to soil or water

There are three factors which determine the potential for a particular environmental incident to impact the
environment:
Sensitivity, toxicity, quantity
A) Sensitivity Index (S) - the sensitivity of the environment it releases into which depends upon:
 Local topography, land use and land/soil quality.
 Proximity to:
 people either as local residents, workers in a work location or temporary accommodation, or travelling;
 "domestic" (i.e. herded or grazing) animals or agriculture;
 native (i.e. wild) fauna and flora, and their types;
 and ease of access to surface water and potable aquifers;
These factors have been rated and a Sensitivity Index (S) allocated and shown in the table below.
Description of Receiving Environment Sensitivity Index (S)
Flat topography (no vegetation, no population) 1

Sloping topography (no vegetation, no 5
population)
Proximity to aquifer for use other than drinking 10
water
Marine (sea) environment 100
Agricultural land, populated 100
Proximity to potable aquifer 100
Wadi 100
Within a Nature Reserve 100
Table 1
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B) Toxicity Index (T) – the more toxic the material released the worse for the environment. The materials
commonly used in PDO's operations have had their toxicity ranked using the chemicals SHOC card.
Toxicity Index of common hazards
Common Hazards Discharged in an Waste Management Chart Number Toxicity

Environmental Incident
(Part D of the Waste Management
Manual) Index
Acid spent A001 1,000

API sludge O003 1,000
Asbestos A004 1,000
Battery acid B004 1,000
Chemical waste C005 10,000
Clinical waste C006 1,000
Crude oil Refer to L001 1,000
Cuttings (oil base mud) C007 1,000
Cuttings (water base mud) C008 10
Degreasing solvents (halogens) D001 1,000
Dehydration water P007 10
Drilling fluid (oil based) O001 1,000
Drilling fluid (brine) B005 10
Engine oil (spent) L001 1,000
Ferric sulphide (pyrophoric dust) P008 10,000
Low Specific Activity Scale (or NORM)) N001 10,000
Lubricants (spent) L001 1,000
Paint P002 100
Paint thinner T002 100
Pigging wastes P004 100
Sewage (untreated) S001 100
Table 2
C) Quantity (Q) - the amount of material released expressed in cubic metres.

Note that all spills or leaks are reportable (within the general rules found in Section 11.1) no matter how small
the quantity is. The more spilled the worse for the environment.

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2.2.28.2 The Environmental Incident Severity Rating Index (EISRI)
The EISRI is calculated as follows:

EISRI = (S x T x Q)
1000
The calculated EISRI value is then entered into the table below to determine the actual environmental impact
and severity rating.
Calculated EISRI Environmental Severity Rating

Impact
0 No Effect 0
< 50 Slight Effect 1
50 - 4,999 Minor Effect 2
5,000 - 49,999 Localised Effect 3
50,000 - 499,999 Major Effect 4
> 500,000 Massive Effect 5
Table 3
The potential environmental risk depends on the potential severity and the probability of the incident
happening again. Potential severity is determined by recalculating the value of EISRI based on potential
scenarios and using the same tables. Once the potential severity has been determined, the probability of the
incident happening again must be assessed. Both are then entered into the RAM to determine the overall
potential HSE risk.
4.4281 Environmental incidents without toxicity, quantity or sensitivity data

Some environmental incidents cannot easily be classified according to quantity, toxicity and sensitivity and so
EISRI cannot be determined quantitatively.
Examples of these incidents include animals (camels, desert fox, rabbits, etc) falling into waste pits, releases
of natural gas, Halons or CFCs, presence of objectionable smells or high noise levels, and third party
environmental complaints, etc.
For these types of environmental Incidents, a qualitative approach for determining the environmental impact
must be used as defined in Environmental table on page 29.

Revision: 3.0
Examples of environmental incident risk assessment
A) Oil spill
Example 1:
Consider a spill of 1 m3 of oil from a flow line in flat, unpopulated terrain. As the Incident is a spill of liquid an
EISRI can be calculated. The Sensitivity Index (S) for flat unpopulated terrain is 1 and the Toxicity Index (T)
for oil is 1,000. The quantity (Q) of oil released is 1 m3.
Therefore the EISRI = S x T x Q/1000 = 1 x 1,000 x 1/1000 = 1 giving the actual consequence of the incident
as slight environmental impact with a severity rating of 1.
In calculating potential consequence of the incident consider whether the flow line runs through a wadi
anywhere along its length. In this case the Sensitivity Index would increase to 100 and the EISRI to 100. The
potential consequence of the incident becomes a minor environmental impact with a severity rating of 2.
The volume of oil spilled could have been larger, for example the leak could have started just before nightfall
and would not be noticed until the morning, increasing the volume to 100 m3. This could further increase the
EISRI to 10,000 and a localised environmental impact with a severity rating of 3.
If the probability of the incident happening again is determined to be 'D' the potential HSE risk in RAM is 3D
and the incident is classified as medium potential.
Example 2
Consider a 5 m3 crude oil leak into the sea while loading at the SBM. As the incident is a spill of liquid an
EISRI can be calculated. The Sensitivity Index (S) for the sea is 100, the Toxicity Index (T) for oil is 1,000
and we know the quantity (Q) of oil released is 5 m3.
Therefore the EISRI = S x T x Q/1000 = 100 x 1,000 x5/1000 = 500 giving the actual consequence of the
incident as a minor impact with a severity rating of 2.
In calculating potential consequence of the incident it is consider whether the volume of oil spilled could have
been larger. For example 50 m3 of oil could have been spilled before action was taken to stop the flow. This
would increase the EISRI to 5,000 and the potential consequences become localised environmental impact
with a severity rating of 3. If the probability of the incident happening again is determined to be 'D' the
potential HSE risk is 3D and the incident is classified as medium potential.
Alternatively, if the potential quantity spilled is 500 m3, the EISRI would increase to 50,000, the potential
consequence becomes major environmental impact with a severity rating of 4 and if the probability of the
incident happening again is determined to be 'D' the incident is classified as high potential.
B) Natural gas leak

Consider a 2 scm gas leak from a flow line. EISRI cannot be used as the incident does not involve a spill of
liquid or solid material. From the Environmental Severity table the actual consequence of the incident is a
slight environmental impact with a severity of 1 since the quantity of natural gas released is less than 1,000
scm.
In calculating the potential consequence of the incident consider whether the leak could have gone
undetected for longer resulting in a larger volume of gas, say 1,500 scm being released. In this case, the
potential consequence becomes minor with a severity rating of 2. If the probability of the Incident happening
again is determined to be 'D' the potential HSE risk in RAM is 2D and the incident is classified as medium
potential.
C) Halon release
Consider a release of 75 kg of Halon. EISRI cannot be used as the incident does not involve a spill of liquid
or solid material. From the Environmental Severity table the actual consequence of the incident is a minor

Revision: 3.0
environmental impact with a severity rating of 2 since the quantity of Halon released lies between 50 and 100
kg.
In calculating the potential consequence of the incident it is necessary to review an increase in the severity of
the incident. Usually if the fire fighting system is triggered, all the Halon contained in the system is released at
once and there is no potential for the amount released to be increased. In the unlikely event, for example, of
only half the total quantity of Halon being released, the quantity could increase to 150 kg. In this case the
potential consequence becomes localised environmental impact with a severity rating of 3. If the probability
of the Incident happening again is determined to be 'D' the potential HSE risk in RAM is 3D and the incident
is classified as medium potential.
D) Untreated sewage release

Consider a spill of 20 m3 of untreated sewage from a tanker on the road between a seismic camp and a
sewage treatment plant. As the Incident is a spill of liquid the EISRI can be used. The road is running
through flat, unpopulated terrain. The Sensitivity Index (S) for flat unpopulated terrain is 1, the Toxicity Index
(T) for untreated sewage is 100. The quantity (Q) of sewage released is 20 m3.
Therefore the EISRI = S x T x Q/1000 = 1 x 100 x20/1000 = 2 giving the actual consequence of the incident
as slight environmental impact with a severity rating of 1.
In calculating the potential consequences of the incident consider whether the road runs through a populated
area anywhere along its length which will increase the Sensitivity Index to 100 and the EISRI to 200. The
potential consequence of the incident becomes minor environmental impact with a severity rating of 2. If the
probability of the incident happening again is determined to be 'C' the potential HSE risk is 2C and the
incident is classified as low potential.
E) Dead wildlife in drilling waste pit

Consider a camel found dead in a drilling waste pit with complaints or claims received from the public. .
EISRI cannot be used as the incident does not involve a spill of liquid or solid material. From the
Environmental Severity table the actual consequence of the incident is a minor environmental impact with a
severity rating of 3.
It is difficult to predict a situation where the potential consequence is higher than the actual consequence and
they are therefore equal. If the probability of the incident happening again is determined to be 'C', the
potential HSE risk in RAM is 3C and the incident is classified as medium potential.
F) Persistent complaints from third parties

Consider a number of complaints being received from third parties owing to odours from a sewage treatment
plant. EISRI cannot be used as the incident does not involve a spill of liquid or solid material. From the
Environmental Severity table the actual consequence of the incident is a localised environmental impact with
a severity rating of 3.
they are therefore equal. If the probability of the incident happening again is determined to be 'E', the
potential HSE risk in RAM is 3E and the incident is classified as high potential.
G) Persistent cases of exceeding environmental permit requirements

Consider a sewage treatment plant where more than three consecutive weekly analytical results indicate that
the total coliform count is > 1600 (MPN/100ml). Since the permit requirement is 1,000 (MPN/100ml), this is a
regular case of exceeding the limits. EISRI cannot be used as the incident does not involve a spill of liquid or
solid material. From the Environmental Severity table the actual consequence of the incident is a localised
environmental impact with a severity rating of 3. An actual severity of 3 indicates that investigation may be
delegated to the level of Section Head.

Revision: 3.0
they are therefore equal. If the probability of the incident happening again is determined to be 'E, the
potential HSE risk in RAM is 3E and the incident is classified as high potential.
4.G).29

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Appendix 16: Completing the Statement of Fitness – Asset restart
The following provides guidance on the completion of the declaration found in Appendix 4.
1. Intent
The intent of this Statement of Fitness (SoF) is to ensure that when significant events occur, an appropriate
check-and-balance has been applied at a sufficient senior level to confirm that necessary controls are in
place to ensure a safe restart of the facility. The SoF aims to apply a formal process to aid the Operations
Manager in confirming those controls are indeed in place.
2. Requirements
These guidance notes clarify the requirements for restart following process upsets in producing assets. It
does not address the requirements for projects, including brown field modifications, which is covered by
SP-2062 or restarts following planned shutdowns, which is covered by PR-1721.
A Statement of Fitness (SoF) is required before restarting an asset for incidents meeting the criteria below:
 an incident involving uncontrolled shutdown, unintentional start up or,
 when the asset has been subjected to conditions outside the operational limits, or
 experienced environmental conditions beyond the original design parameters.
and
 which have been assessed as having an actual 4/5 RAM rating or,
 a potential risk assessed as red on the RAM (even if a near miss) or,
 a potential risk assessed in the 5A/B squares on the RAM (even if a near miss).
Notes:
1 Environmental conditions beyond the original design parameters mean the asset experienced
conditions beyond the original design parameters; e.g. earthquakes, hurricanes, etc.
2 Conditions outside the operational limits means “conditions outside engineering constraints”. The most
stringent constraint is often the Instrumented Protective Function (IPF) trip function or the relief valve
setting where the design does not include a trip function. See figure below.

Revision: 3.0
Figure 1 Note: Terminology used in ESP (Ensure Safe Production) and Alarm mgt DEP (DEP 32.80.10.14-Gen).
3. Delivery Team Leader (Senior person in the asset)
The Delivery Team Leader is as a minimum the most senior person on site. The Operations Manager as
the Asset Owner is the accountable party.
The Delivery Team Leader should after an incident as described in section 2:
1 deal with the immediate control of the incident and decide whether facilities or parts thereof should be
shutdown pending the outcomes of the investigation.
2 immediately report medium and high risk incidents to senior line/HSE management
3 conduct an initial scene of incident investigation and request appropriate support for the investigation.
4 immediately conduct an initial assessment of the incidents actual severity and potential risk.
5 register the initial notification for the incident in FIM within 24 hours.
6 issue a Level 1 notification to senior operational and HSE management within 24 hours for incidents with
rating an actual severity 4 or 5
7 ensure an appropriate mix of authority and experience of persons appointed to an investigation team
commensurate with the actual consequences and potential risk.
8 confirm after review the accuracy of the actual and potential risk of the incident and correct FIM within 3
days if required.
9 confirm the required corrective and/or preventative actions have been taken to eliminate the direct and
underlying causes of incidents, including near-misses, and reduce risks to ALARP.
10 complete and sign the statement of fitness declaration using the template in Appendix 4 if you decide to
restart, unless the incident involved an actual severity of 4/5 or a potential high risk where the Asset
Owner is the only signatory allowed to sign the statement of fitness.
11 confirm that records of investigations including investigation reports (in English) for incidents with an actual
severity ratings of 3, 4, or 5 or high potentials are available and to an acceptable level.
Senior management should after an incident as described in section 2:
1 arrange for the issuing of a PDO News List notification for AI-PSM Tier 1 incidents within 24 hours by
MSEM team.
2 ensure external parties (stakeholders, including authorities, e.g. regulatory authorities, shareholder have
been informed as required via the MSEM team.

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2G)30

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Appendix 17: Using FIM to enter an incident – new input module
Important definitions
a) Incident with consequences is where someone has been injured, a something has been broken or
damaged, a leak has occurred or a road incident has happened
b) Near miss is when an incident/something unplanned DID happen but no-one got injured, nothing got
broken and nothing was spilt to environment. e.g. something dropped by a crane but it didn’t hit
anybody.
c) Potential incident is an unsafe act or condition or dangerous practise that could result in an incident but
the incident DID NOT happen. e.g. a worker wearing a harness when working at height but not
attaching it to anything but he did not fall.
Slide 1

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Slide 2
Slide 3

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Slide 4
Slide 5

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Slide 6

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Slide 7
Slide 8

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Slide 9

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Slide 10
Slide 11

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Slide 12
Slide 13

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Slide 14
Slide 15

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Slide 16
Slide 17

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Slide 18
Slide 19

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Slide 20
Slide 21

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c)G)31 Appendix 18: Using FIM to enter an incident – old method
Important definitions
a) Incident with consequences is where someone has been injured, a something has been broken or
damaged, a leak has occurred or a road incident has happened
b) Near miss is when an incident/something unplanned DID happen but no-one got injured, nothing got
broken and nothing was spilt to environment. e.g. something dropped by a crane but it didn’t hit
anybody.
c) Potential incident is an unsafe act or condition or dangerous practise that could result in an incident but
the incident DID NOT happen. e.g. a worker wearing a harness when working at height but not
attaching it to anything but he did not fall.
A. Near Miss reporting

Slide 1

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Slide 2
Slide 3

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B. Incident with consequences

Slide 1
Slide 2

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Slide 3
Slide 4
Slide 5 – Entering people consequence

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Slide 6 – Entering asset consequence

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Slide 7 – Entering asset consequence
Slide 8 – Entering transport incident consequence

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Slides (9 -15) – Environmental incident consequence

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c)G)32

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Appendix 19: Using Tripod Beta
Tripod is software that can only be licensed to people who have attended and passed a Tripod Beta training
course.
It is a program that enables a person to identify the following:
1. Relevant timeline of key events that led to the Top event – which caused the harm
2. Identifies the key energies which led to the hazards in the events
3. Identifies the targets which the events acted upon
4. Identifies the barriers which
i. Were not in place but should have been
ii. Were not in place but had not been thought of
iii. Were in place but were not effective enough
iv. Were in place and were effective
5. Identifies the pre-conditions which led to the barriers failing – i.e. what was in the mind of the person
who chose to breach the barrier.
6. Identifies the underlying causes which led to the pre-conditions being allowed to have an influence and
leading to the barriers failing
Do not attempt to conduct a Tripod unless you have attended a Tripod course and have conducted a Tripod
within the last 24 months.
6.G)33

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Appendix 20: Investigation timetable – key events

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6.G)34

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Appendix 21: Examples of underlying causes relating to active causational failures
Incident Active causational failures

Latent causational conditions Latent causational
management failures
(underlying causes)
Vehicle rolls over and driver Driver failed to wear his SJM was not competent or PDO and self audits had
killed when thrown out of seatbelt. Vehicle rolled due compliant with PDO failed to identify and address
speeding vehicle whilst to high speed, poor specifications. failure by contractor to
driving tired at night visibility and fatigue. SJM comply with SP2000.
failed to prevent manager Seatbelt alarm had been
disconnected. Maintenance budgets had been
taking journey.
cut leading to poor standards.
IVMS data was not being
analysed. Contractor had lost qualified
mechanics due to poor salaries
Production meant that the part offered.
had to be delivered urgently.
Contractor had failed to invest
in IVMS management system
or resource making system
redundant and ineffective.
Loss of production outweighed
safety considerations in the
eyes of the management.
High pressure sour gas Flange leaked high pressure Gasket used was not to design Project quality management
injector well leaked on gas and engineers put at specification due to shortage system was not sufficient to
commissioning. risk standing downstream of material and desire by identify change to material
of leak without BA. contractor to avoid penalties. for gaskets or nitrogen.
Sensitive leak tests did not used Commissing system does not
the correct Nitrogen due to include requirement for a
shortage worksite dynamic risk
assessment and key rules to
No TBT was conducted to
assess risk for the follow.
commissioning.
The finger was trapped due

to using inadequate
Persons left index finger was Time pressures placed on Inadequate task planning &
equipment, , poor hazard
trapped between beam and employees in shutdown organisation: Lack of advanced
perception and poor
lifting aid using inadequate planning for S/D putting
co-ordination Toolbox talk did not address the pressure during short period-
equipment specific risks of the activity. where work could be done pre
– Shutdown.
Inadequate engineering design:
Use of non standard equipment
Temporary lifting equipment
that need more engineering
and approvals.
Inadequate verification of TRIC
effectiveness.

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Appendix C, Related Business Control Documents and References
None


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Revision: 3.

Petroleum Development Oman L.L.C.

Incident Notification and Investigation Guideline

Document Type Guideline

Issue Date 30/11/12

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Document Authority Document Custodian Document Controller

Date: 30/11/2012 Date: 30/11/2012 Date: 30/11/2012

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Version No. Date Author Scope / Remarks

iii Related Business Processes

iv Related Corporate Management Frame Work (CMF) Documents

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2.2.14 Appendix 1: Template of Email from Operations to Senior PDO management 72

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1.3 Distribution/target audience & further copies

1.4 Structure of this document

1.5 Review & improvement

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2. Incident investigation and reporting guideline

2.2.1 Assessment of the actual incident severity

Using the PDO Risk Assessment Matrix (RAM)

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A major injury to a person gives an actual severity of 3(P)

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2.2.2 Tables defining severity levels in the RAM

2.2.2.1 People consequence

2.2.22 Asset consequence

Slight damage – Costs less than 10,000 US$. Example:

Minor damage – Costs between 10,000 and 100,000 US$. Example:

Moderate damage – Costs between 100,000 and 1 million US$. Example:

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Severity Level Definition

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Moderate impact – Significant impact in region or country.

Major impact – Likely to escalate and affect PDO reputation.

Massive impact – Severe impact on PDO reputation.

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Classifying process safety (AI-PS) tier events

2.231 Tier 1 Process Safety Event (T-1 PSE)

 employee or contractor (sub) lost work case injury or fatality;

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Thres Material Hazard Classification Threshold Threshold

Categ Release ) Release )

4 TIH Zone D Materials (refer to SHOC card) 200 kg 20 kg 100 kg 10 kg

Condensate) or Carbon Disulphide or Other Packing Group I Materials

excluding strong acids/bases (refer to SHOC card)

excluding moderate acids/bases (refer to SHOC card)

7 Liquids with Flash Point ≥ 23 °C and ≤ 60 °C or 2000 kg 200 kg 1000 kg 100 kg

Liquids with Flash Point > 60 °C released at a temperature at or above Flash

2.4.32 Tier 2 Process Safety Event (T-2 PSE)

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2.4.33 Tier 3 Process Safety Event (T-3 PSE)

Examples of Potential Incidents include: