Event
- Event ID
- 322
- Quality
- Description
A large hydrogen gas leak from a dewar resulted when bolts holding fitting the top of the tank was loosened. The fitting contained instruments. On loosening the third bolt, hydrogen gas excaped from the opening around seal. The Viton or neoprene 0-ring was blown out of its groove and was immediately frozen, making it impossible to reseal the fitting cover. The area was evacuated, dewar vented and gasket replaced. The ullage space was not purged with helium gas during the gasket replacement which may have been responsible for small leaks which developed during the transfer.
- Event Initiating system
- Classification of the physical effects
- Unignited Hydrogen Release
- Nature of the consequences
- leak no ignition
- Macro-region
- North America
- Country
- United States
- Date
- -
- Component involved
- flange (bolts)
- Failure mode
- erroneous release & ignition
- Initiating cause
- loss of tightness (wrong operation)
- Root CAUSE analysis
The INITIATING CAUSE was a release from a flange sealing.
The fitting which contained the instruments was mounted on a flange, which in turn, was secured to another flange. A set of long bolts and short bolts were used to retain the components. The bolt heads were identical and not labelled, therefore an error was made in loosening the wrong bolts. Leaks after gasket replacement probably due to condensation of moisture on related vent valve components.
The ROOT CAUSE was a human error facilitated by lack of clear guidelines/procedures.- Root causes
- Date entry in HIAD
- 30/10/2025
Facility
- Application
- Non-road vehicles
- Sub-application
- Aerospace
- Hydrogen supply chain stage
- All components affected
cryogenic tank
- Process temperature range [C]
- cryogenic temperature (below -50°C)
- Location type
- Unknown
- Location
- countryside or desert
- Operational condition
Emergency & Consequences
- Number of fatalities
- 0
- Number of injured persons
- 0
Lesson Learnt
- Lesson Learnt
H2TOOLS proposed improvement based on the need to clearly label bolts according to their function/role
Bolts could be identified by means of colour coding. Obviously, an explanation of the colour coding should be easily available at the working place.
In-depth data
- Release type
- gas
- Involved substances (% vol)
- H2 100%
- Release pressure [MPa]
- <1.0
- Probable IGNITION SOURCE
References
- Sources categories
- ORDIN
- Reference & weblink
Mishap no 32 in
P. L. Ordin, Review of hydrogen accidents and incidents in NASA operations, 1974, NASA TM X-71565
https://ntrs.nasa.gov/citations/19740020344Hankinson and Lowesmith, Qualitative Risk Assessment of Hydrogen Liquefaction, Storage and Transportation, FCH JU project IDEALHY, Deliverable 3.10 (2013)
confidential
(accessed October 2025)Lowesmith et al., Safety issues of the liquefaction, storage and transportation of liquid hydrogen: An analysis of incidents and HAZIDS, Int. J. Hydrogen energy (2014) https://doi.org/10.1016/j.ijhydene.2014.08.002
Also H2TOOLS uploded from Ordin
https://h2tools.org/lessons/technician-accidentally-removes-critical-bo…
(accessed December 2025)