Another tragic case of not reading the manual

[miriam -at- silvershed -dot- co -dot- uk]

Just read this in the Guardian (a UK newspaper).

We discussed aeronautical instances of not using a manual a while ago -
this is a much more humble example of what goes wrong, isn't it.  And yet,
in its own way, equally tragic.

I wonder how far we can go as authors to make sure that this doesn't
happen - it seems like the manual could have been the most shining example
of technical authorship, and it still wouldn't have helped.

A laundry worker died of heat exhaustion after climbing into a giant
industrial washing machine to free some sheets and getting stuck, an
inquest heard yesterday.


Paul Clegg, 23, was caught inside for more than two hours because other
staff did not know there was an escape hatch on the 13-metre long machine.
It washed at up to 75C (167F), and had been running shortly before climbed
into it on March 21.


Coroner Sheriff Payne told the Bournemouth inquest that staff called the
fire brigade when it became clear their colleague was struggling to get
out. Fire commander Tim Spring arrived at 9.38am when Mr Clegg was still
conscious. "I asked on three or four occasions if there was an access
panel. They said there was not," he told the inquest.


The fire crew cut through the wall of the stainless steel machine to give
Mr Clegg oxygen, but by the time he was pulled out at 11.33am he had lost
consciousness, and was pronounced dead on arrival at hospital. A
postmortem examination gave the cause as hyperthermia.

David Lewis, engineer on duty at Sunlight Textile Services in Bournemouth,
told the inquest he had no qualifications and learned about the machine
"on the job". There was no written procedure for entering the machine, or
a set time to allow it to cool first. He confirmed he was one of those
unable to answer the fire commander, as he had not known there was an
escape hatch.

Questioned by Christopher Orchard, the solicitor representing Mr Clegg's
family, Mr Lewis said there was a manual, but he had not read it and had
never been asked to do so.

Laundry worker Jamie Woodford told the inquest he too had entered the
machine, and realised Mr Clegg was in trouble when he shouted:
"Get me out, I'm stuck."

Mr Woodford shouted to colleagues outside, and eventually made his way
back to raise the alarm. He knew nothing of an access panel close to where
Mr Clegg collapsed.

The laundry's chief engineer, Jim McGuirk, on a health and safety
committee which met monthly, told the inquest jurors, to gasps from Mr
Clegg's family, that he, too, did not know of any access panel.

The hearing continues today.