Catastrophic failures forensic analyses

Catastrophic failures forensic analyses are, most of the time, left in the hand of experiences engineers. At least, that’s the case for tailings dams failures and other catastrophes like major infrastructural accidents and for instance, aviation. Are we sure that is the best way? Normalization of deviance, management and decision-making are oftentimes ingredients of the catastrophic failure buildup, not only “engineering”. So, we dare to say, Independent Panels should include social scientists. They seem to be the most qualified to…

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Independent Forensic Team Report Oroville Dam Spillway Analysis

We just read the Appendix F From 2018 Independent Forensic Team Report Oroville Dam Spillway Analysis. So, we decided to discuss a few points from our risk perspective. It was a joy to read the statements the Independent Forensic Team made on “normalization of deviance” and the disproportionate influence some experts may exert on group deliberations. Indeed a Potential Failure Modes Analysis (PFMA) team generally includes various members bringing diverse perspectives into the process. Oftentimes one or two strongly opinionated persons,…

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Oroville Dam Spillway Incident Report

The Oroville Dam Spillway Incident Report became public in January 2018. The story it tells is remarkably similar to the one we assumed, based on publicly available information in the aftermath of the accident. As risk advisers and managers we discuss below the various statements in the Oroville Dam Spillway Incident Report. We aim at highlighting risk biases and potential management changes to avoid similar developments. Oroville Dam Spillway Incident Report Conclusions Commented The Independent Forensic Team Report made a number…

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10 commandments for resilient design

The 10 commandments for resilient design we propose below are based on risk management concepts. They are a complement to the resilient design principles delivered by the Resilient Design Institute. Definition of resilience Resilience definition is the ability to recover after an accident, the ability to withstand disruption and rebound quickly. In other words resilience is the capacity to bounce back after a disturbance or interruption. Resilient design is the result of an intentional effort geared toward enhancing buildings, landscapes, communities,…

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Failures do not happen overnight

Jim Rohn’s quote “Failure is not a single, cataclysmic event. You don’t fail overnight. Instead, failure is a few errors in judgment, repeated every day”. That quote struck a chord with the recent failure at Oroville dam, as indeed failures do not happen overnight. In Oroville dam “sudden” crisis we can quote various historic deviances Here is a tenative list of historic deviances: Oroville Dam annual inspections carried by State of California Division of Safety of Dam found water “seepage”…

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