The Titanic Disaster: A Case Study in Root Cause Analysis
“CQD (come quick danger)…SOS (save our souls)…we have struck iceberg…sinking fast…Position 41.46 N. 50.14 W. CQD…SOS.”This was the desperate message repeated by Titanic’s Senior Marconi Wireless Operator to any ship that could hear it—many did—and come to their assistance in time. None could.Late on the night of April 14, 1912, in a remarkably perfect calm on the North Atlantic, the RMS Titanic collided with a massive iceberg and sank in less than three hours. As the story unfolded many questions demanded answers.
• How could the Titanic strike an iceberg in the perfectly calm conditions of the night?
• Was a missing key a key cause for not seeing the iceberg in time?
• Did a coal fire doom the Titanic?
• Did Captain Smith have all the ice warnings?
• After striking the iceberg, why did the unsinkable Titanic sink?
• Why were only 712 lives saved?
• What prevented the nearby liner, Californian, from helping?
Many books have been written that tell the whole or some facet of the story of the Titanic. The aim of this book is to tell the story in an engaging way, then present and use proven root cause analysis techniques to analyze the Titanic disaster.
The Perfect Calm: The Titanic Disaster: A Case Study in Root Cause Analysis by William Christiansen