HSE name Incident Investigation Main contractor LTI Date

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes HSE Investigation template and guidance Non Accidental Death (NAD) Confidential - Not to be shared outside of PDO/PDO contractors 1

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Process flow for investigations Notification Quality sign off IRC/MDIRC Kick off MSE 3 IRC Minutes Investigation Reporting draft PIM action close out Confidential - Not to be shared outside of PDO/PDO contractors 2

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Incident Investigation Terms of Reference (To. R) Info to be established during Kick Off meeting Remember guidance notes on bottom of slides Investigation protocols - Documents to be used to investigation PR 1418 Incident Owner - Name and reference indicator PIM No - XXXXXX Investigation Team Leader - Names, reference indicators, role in investigation Special terms - Special conditions/requirements of the investigation (e. g. joint PDO/contractor) Subject Matter Experts – as required to be discussed during Kick Off meeting Investigation deliverable - The team is responsible for investigating the incident and completing the following: Investigation report , MD/IRC presentation, and learning pack. Previous NAD - Previous incident, similar incident, including PIM No from company Immediate Cause – Bring to kick off meeting for agreement Critical Factors – 1. 2. Investigation Team Members- Names, reference indicators, role in investigation 1. Investigation Team lead Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 2. Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) 3. Name Reference Ind, Role, attend the scene (yes / no), HII (ICAM) trained (yes / no) If not HII (ICAM) trained the contractor is to provide Incident investigator, level of competency assurance from senior management. NAD investigations should always include a medical professional. Evidence repository must be provided electronically on data stick prior to MSE 3 IRC Confidential - Not to be shared outside of PDO/PDO contractors 3

HSE name Incident Investigation Main contractor – LTI# - Date ofguidance incidentnotes Timetable to be communicated during kick off meeting • Incident classification, Critical factors, SME requirements, Timelines for reports Rolling Days Action / Task 0 0 -1 1 10* 21 23* 30* 42 Notification received from MCOH Initial Notification Kickoff meeting 1 st Draft of report to MSE 3 representative Review 1 st draft return consolidated feedback 2 nd Draft of report to MSE 3 representative Review of 2 nd draft return consolidated feedback Final revision for MSE IRC MSE 3 IRC Final report QA / QC letter Director IRC MDIRC * Escalation process milestones for not keeping to the timeline: +3 days over due reminder 1 to Investigation Team Leader, HSE Team Leader and MSE 3 +5 days over due reminder 2 to Investigation team lead, HSE Team leader, MSE 3, MSEM and Director Confidential - Not to be shared outside of PDO/PDO contractors 4

Main contractor name – LTI# - Date of incident Non Accidental Death Name of Company Date of Incident 5

Name of –Company incident Main contractor name LTI# - Date and of incident date Incident details PDO directorate/dept : (e. g. OSD /OSO 4) Contractor name/number : (subcontractor-PDO)/CXXXXXX Incident owner : Name / Ref Ind of the Director PIM ID : Number assigned in PIM Location : Area / unit - (road/yard/station/rig/hoist/plant etc) Incident date & time Incident type : (d/m/yr) / (24 hour clock) – advise if estimated : Non Accidental Death (NAD) Actual severity rating : 4 P (as all NAD’s are already established) Immediate cause of Death : Short description of what caused the death Previous NAD : Include PIM number, short description of last (LTI/ NAD) of the contractor, this applicable to all contracts with PDO Key Mgmt Failure : Key Management system failure from conclusion slide including ICAM number Confidential - Not to be shared outside of PDO/PDO contractors 6

Name of –Company incident Main contractor name LTI# - Dateand of incident date Key Information about the deceased Name of deceased DOB and age Nationality Marital status and number of children. Including their age and sex Duration of service with the company: Job title Work schedule and date of last leave & leave cycle (Days off) HSE trainings and site induction Confidential - Not to be shared outside of PDO/PDO contractors 7

Name of –Company incident Main contractor name LTI# - Date and of incident date Summary Description of the incident: On ------- Confidential - Not to be shared outside of PDO/PDO contractors 8

Name of –Company incident Main contractor name LTI# - Date and of incident date Details of the Medical Emergency Response (MER) : Medical Emergency Response (MER) Yes/No Time to arrival Comments Was 5555 called? Was co-workers/bystanders involved initially? Was First Aider(s) involved initially? Was the Medic/nurse involved in MER? Was a doctor involved in MER? Was AED used and if so how long it took to start What was duration of resuscitation? (usually 30 minimum) Was the deceased medevac (details)? Other important comment(s) Confidential - Not to be shared outside of PDO/PDO contractors 9

Name of –Company incident Main contractor name LTI# - Date and of incident Past Medical history: Yes/No date Details Major surgery Chronic Medical condition(s) such as Diabetes, high BP, Cholesterol, others Allergies Any Regular medications Did the deceased attended the clinic or had any complaints within 2 weeks of his death during this work period? Medical examination: Yes/No Date done At PDO approved clinic Outcome -Fit /unfit/comments Was Pre-employment examination done? Was fitness to work examination done? Fit or unfit? Was periodic medical examination done? Fit or unfit? Was Framingham cardiac risk done? ……. . % Framingham score Was Cardiac stress test (TME) done? Confidential - Not to be shared outside of PDO/PDO contractors 10

Name of –Company incident Main contractor name LTI# - Date and of incident Life style and social characteristics date Yes/No Comments (E. g. quantity) Was the deceased an active person leading a healthy lifestyle? Was the deceased known to practice good dietary habits? Was the deceased known to do regular exercise activities? Was the deceased known to be a smoker /consume alcohol? Was the deceased known to have drug misuse or drug issues? Was the deceased notably obese? Weight …. ………kg. BMI ……………. Was the deceased a quite/loner type of personality? Was the deceased a friendly and always tend to mingle with other people? Was the deceased noted to have changed of behaviour in the past 1 or 2 months before his death? . Confidential - Not to be shared outside of PDO/PDO contractors 11

Name of –Company incident Main contractor name LTI# - Date and of incident Work Environment: Yes/No Comments date Any known work environmental factors which could have contributed to the death? Any known chemical exposure from working environment? Any known biological exposure from working environment? Any unusual work related stress/fatigue? Any other adverse work issue(s) worth noting. Accommodation: Was he staying alone or with roommate/s? Was ventilation / air conditioning adequate? Room lighting adequate? Water and sanitation adequate? Was food provision adequate? When clearing the deceased room, was any medicines or non-prescription drugs found? Confidential - Not to be shared outside of PDO/PDO contractors 12

Name of –Company incident Main contractor name LTI# - Date and of incident date Contractual Health Management (Find out about the health management in contracts within the direct working environment of the deceased) Yes/No Comments / Gaps Are all health risk assessments (HRA) carried out and completed? Are all work hazards exposure are being monitored and managed? Are health support and controls provided? (In compliance with SP-1230, 1232) E. g. Pre- employment, fitness to work, regular check up and general medical care and follow up. Are regular health awareness and education provided to all employees? Is MER plan available and regular drills conducted? Include dates and content of drills Are health activities included into the annual HSE plans and are they monitored by both contractors and PDO CH’s? Does your accommodation / camp comply with SP-1243? Confidential - Not to be shared outside of PDO/PDO contractors 13

Name of –Company incident Main contractor name LTI# - Date and of incident date Conclusions: Immediate Cause of Death Underlying Causes of Death Management system failure: MSF Ref No # ICAM Mgt System Failure Description Justification for Management System Failure cited 14

Name of –Company incident Main contractor name LTI# - Date and of incident date Key investigation findings: (List all the important findings) 1 2 3 4 15

Name of –Company incident Main contractor name LTI# - Dateand of incident date Immediate actions taken if any: No. Actions Date of action Status 1 2 3 *Immediate actions must be completed within 7 days of the incident Confidential - Not to be shared outside of PDO/PDO contractors 16

Name of –Company incident Main contractor name LTI# - Date and of incident date Remedial Action / Recommendations: No. 1 Recommendations(Actions) Target Date Action Party (Contractor) PIM Action Party (PDO) PIM action No. Status Open/ Closed Post action verifier for PIM 2 3 Confidential - Not to be shared outside of PDO/PDO contractors 17

PDO Second Alert Main contractor name – LTI# - Date of incident Date: Incident title: NAD What happened? Short description of what happened Your learning from this incident. . Photo explaining what was done wrong (This must solely relate to the people at risk of harm or people at risk of causing the harm) • Learning points for them from the investigation Photo explaining how it should be done right Strap line – should be the key (keep short and memorable ) 18

Name of –Company incident Main contractor name LTI# - Date and of incident date Management self audit - CHECK List to confirm 1 Do you report and investigate all occupational illnesses and NADs? 2 Are all your staff up to date with their periodic medical check and/or fitness to work? 3 4 5 6 7 8 9 10 11 12 13 Yes/No Are all PDO specific fitness to work medical examinations conducted by PDO approved clinics? and do your medical staff review the submitted reports to confirm conformance to PDO standards? Are all employees with chronic medical conditions such as diabetes, high Blood Pressure etc being followed up appropriately? Do you conduct regular health awareness to your staff? And specifically do you encourage your staff to seek medical help if feeling unwell? Do your medical staff get approved by PDO medical department prior to deployment to PDO sites? Does your medical staff attend regular continuous medical education and have valid MOH license and ACLS certification? Do you ensure calibration of Medical equipments including AED and carry out daily ambulance inspection ? Do you have Medical Emergency Response (MER) plan and do you conduct medical drills? Do you have a clear Alcohol and drugs policy? Does your medical service submit to PDO the monthly health performance report? Is health management within the direct working environment of the deceased meeting Company standards? Are health activities included into the annual HSE plans? Confidential - Not to be shared outside of PDO/PDO contractors 19

Name of Company and incident date Main contractor name – LTI# - Date of incident Sequence of events, during and post incident response – Timeline No. Date Time Description of event 1 2 3 4 5 6 7 8 20

Main contractor name – LTI# - Date of incident Investigation Team Members- Names, reference indicators, role in investigation Name 1 2 3 4 5 6 7 8 9 10 Ref. Ind Role Attended the scene Yes / No HII* trained Yes / No Date attended HII training Investigation Team Lead *HII – HSE Incident Investigation 21