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Marine transportation safety investigation M18C0018

The TSB has completed this investigation. The report was published on 6 August 2019.

Table of contents

On-board fatality

Bulk carrier Sage Amazon
Port-Daniel–Gascons, Quebec

View final report

The occurrence

On , the master of the bulk carrier Sage Amazon experienced a cardiac event while standing on an access ladder of No. 3 cargo hold. He fell from the ladder onto the main deck, receiving serious head injuries. At the time, the vessel was anchored 3 nautical miles off Port-Daniel–Gascons, Quebec. Medical aid, including CPR, was provided on the vessel, but was unsuccessful in reviving the master. He was later evacuated to the hospital in Chandler, Quebec, where a death certificate was issued.

Media materials

News release


Fitness for duty cited as key factor following fatal 2018 cardiac event aboard bulk carrier
Read the news release

Deployment notice


TSB deploys a team to Port-Daniel-Gascons, Quebec, following a fatal accident aboard the bulk carrier Sage Amazon
The Transportation Safety Board of Canada (TSB) is deploying a team of investigators to Port-Daniel-Gascons, Quebec, following a fatal accident aboard the bulk carrier Sage Amazon. The vessel is registered in Liberia. The TSB will gather information and assess the occurrence.

Investigation information

Map showing the location of the occurrence


Photo of François Dumont

François Dumont has been an investigator with the Transportation Safety Board of Canada since 2013. Before joining the TSB, Mr. Dumont sailed for twelve years in the merchant navy aboard bulk carriers, tankers, tugs, general cargo ships and icebreakers. He also was a Marine Safety Inspector with Transport Canada for three years. Mr. Dumont holds a diploma from the Institut Maritime du Québec in Marine Mechanical Engineering Techniques, a First Class Marine Engineer’s Certificate for motor vessels, and a Fourth Class Marine Engineer’s Certificate for steam vessels.


  Download high-resolution photos from the TSB Flickr page.

Class of investigation

This is a class 3 investigation. These investigations analyze a small number of safety issues, and may result in recommendations. Class 3 investigations are generally completed within 450 days. For more information, see the Policy on Occurrence Classification.

TSB investigation process

There are 3 phases to a TSB investigation

  1. Field phase: a team of investigators examines the occurrence site and wreckage, interviews witnesses and collects pertinent information.
  2. Examination and analysis phase: the TSB reviews pertinent records, tests components of the wreckage in the lab, determines the sequence of events and identifies safety deficiencies. When safety deficiencies are suspected or confirmed, the TSB advises the appropriate authority without waiting until publication of the final report.
  3. Report phase: a confidential draft report is approved by the Board and sent to persons and corporations who are directly concerned by the report. They then have the opportunity to dispute or correct information they believe to be incorrect. The Board considers all representations before approving the final report, which is subsequently released to the public.

For more information, see our Investigation process page.

The TSB is an independent agency that investigates air, marine, pipeline, and rail transportation occurrences. Its sole aim is the advancement of transportation safety. It is not the function of the Board to assign fault or determine civil or criminal liability.