The short version
- An injury is a serious marine incident only if it needs treatment beyond first aid AND leaves the person unfit for routine duties.
- Alcohol testing must be conducted within 2 hours of the incident. The 8 hour figure is a ceiling on the duty, not a deadline.
- Drug specimen collection has 32 hours, and a missed test is documented on CG-2692 and CG-2692B.
- Blood may be drawn only by qualified medical personnel, and blood ships cooled inside 24 hours of carrier receipt.
- The subpart was amended on 30 June 2026, so older procedures need re-reading.
A clinical judgement starts a two hour federal clock
The most consequential medical decision on a US vessel is not a treatment. It is a classification, and the crew usually does not know they are making it.
46 CFR 4.03-2(a)(2), the medical limb of a serious marine incident
“An injury to a crewmember, passenger, or other person which requires professional medical treatment beyond first aid, and, in the case of a person employed on board a vessel in commercial service, floating OCS facility, or MODU, which renders the individual unfit to perform routine vessel duties.”[1]
Two limbs, joined by and. Treatment beyond first aid on its own is not enough. Unfit for routine duties on its own is not enough. Both together make the event a serious marine incident, and the SMI is what triggers mandatory chemical testing.
Half a conjunctive test is the most common way this rule is misread, and it is the same error that runs through the kit rules by class. That is the same conjunctive structure the reporting threshold turns on. The difference is what follows. Reporting has days. Testing has two hours.
The two clocks, and the one that almost always fails
46 CFR 4.06-3 sets two separate deadlines, and operators routinely plan for the long one and miss the short one.[2]
| Test | Deadline from the incident | Outer limit |
|---|---|---|
| Alcohol | Within 2 hours, unless precluded by safety concerns directly related to the incident[2] | Not required more than 8 hours after the SMI[2] |
| Drug, specimen collection | Within 32 hours, unless precluded by safety concerns[2] | As soon as the safety concerns are addressed |
| Either test missed | Document the reason on Forms CG-2692 and CG-2692B[2] | The documentation is the compliance, not an excuse |
The alcohol clock starts at the incident, not at the moment the marine employer decides it was an SMI. A crew that has just worked through a medevac decision or spent ninety minutes on damage control and then starts asking who should be tested has already lost most of the window.
The trap in the eight hour figure
46 CFR 4.06-3(a)(1)(iii) says alcohol testing is not required more than 8 hours after the SMI.[2] That is a ceiling on the duty, not a second deadline. The duty is 2 hours. The 8 hour line only limits how long a safety-delayed test remains compulsory.
The devices do not have to be aboard, and that is a decision
46 CFR 4.06-15 requires the marine employer to have enough alcohol testing devices readily accessible to test everyone directly involved, using devices on the NHTSA Conforming Products Lists.[3]
Then paragraph (a)(3) opens a door: the devices need not be carried on board if obtaining them and conducting the tests can be accomplished within 2 hours of the incident.[3]
That is a written risk decision, not a purchasing preference. A vessel operating four hours from the nearest collector cannot use that exemption, and planning by time to definitive care is the same arithmetic applied to a different question. Fleets working the Alaska grounds are the clearest case. For drug testing there is no such door: enough urine collection and shipping kits meeting 49 CFR part 40 must be readily accessible.[3]
Where qualified medical personnel become mandatory
46 CFR 4.06-20 splits the collection duty by specimen type, and one line puts a clinician inside the regulation.[4]
- Blood for alcohol testing must be taken only by qualified medical personnel.[4] Not the master, not a trained crew member.
- Saliva or breath must be taken only by personnel trained to operate the device in use.[4] Training is the qualification, and it has to exist before the incident.
- Urine for drug testing follows 46 CFR part 16 and 49 CFR part 40, which is a chain-of-custody regime, not a shipboard improvisation.[4]
Note what this is not. Post-incident specimens are evidence, not treatment, and nothing in the subpart licenses drawing on the ship’s medicine chest for the purpose. Where the chest holds anything scheduled, 21 CFR 1301.25 and its recordkeeping duty run on their own track.
Handling, too, is medical logistics. Blood specimens must be shipped cooled and by any means adequate to ensure delivery within 24 hours of receipt by the carrier.[5] Urine goes expeditiously but needs no cooling.[5] Getting that backwards destroys the specimen and the evidence.
The fatality procedure is written for the operator, not the coroner
When someone dies as a result of an SMI, 46 CFR 4.06-30 requires blood and urine specimens to be obtained from the remains, if practicable.[6] The obligations it places on the marine employer are specific and easy to fail at three in the morning.
| Duty | Who performs it | What goes wrong |
|---|---|---|
| Notify the local authority, coroner or medical examiner as soon as possible[6] | The marine employer | Waiting for the Coast Guard to make the call |
| Provide the collection and shipping kit and request assistance[6] | The marine employer | Assuming the coroner supplies the kit |
| If the authority or custodian declines, explain on Form CG-2692B[6] | The marine employer | Leaving the box blank |
The wider death on board procedure covers custody and repatriation, and the CDC report before a US port call can attach as well. This subpart adds a duty that runs in parallel and on a much shorter clock.
What the individual owes, and the eight hour drinking ban
46 CFR 4.06-5 places duties on the person, not only the company.[7] Anyone determined to be directly involved must provide a blood, breath, saliva or urine specimen when directed by the marine employer or a law enforcement officer.
Refusal must be noted on Forms CG-2692 and CG-2692B and in the vessel’s official log book where one is required, and the employer must remove that individual from duties affecting safe operation as soon as practical.[7] No one may be compelled to give a specimen, but refusal can lead to suspension and revocation proceedings, a civil penalty, or both.[7]
The provision most often missed: individuals subject to alcohol testing are prohibited from consuming alcohol for 8 hours after the SMI, or until testing is complete.[7] That has to be briefed before the incident, not explained afterwards.
Who is inside the net
The marine employer decides who was directly involved, and a law enforcement officer may add people to that list, at which point the employer must take all practical steps to test them too.[8] Testing personnel does not stop them working: the subpart expressly allows people who must be tested to keep performing duties in the aftermath where that is necessary to respond to safety concerns.[8]
The subpart reaches vessels in commercial service, floating OCS facilities and MODUs.[1] That takes in classes with otherwise thin medical rules, including MODUs, towing vessels, offshore supply vessels and commercial fishing vessels. A vessel with almost no medical equipment requirement still carries the full testing duty.
Ashore, the person who has to make this work is usually the same one carrying the DPA duty, and the paperwork lands in the crew medical record. Penalties run under 46 U.S.C. 2115.[9] The subpart was amended on 30 June 2026 by USCG-2013-1057, so any procedure written before that date should be re-read against the current text.[10]
Seven things to fix before the next incident
- Write the SMI test as two questions, not one. Beyond first aid AND unfit for routine duties.[1]
- Start the clock at the incident time on the same page where the crew records it.[2]
- Decide the device question in writing. Aboard, or provably reachable inside 2 hours.[3]
- Name the qualified medical personnel who can draw blood, per port or per region, before you need them.[4]
- Pre-stage kits and the cooled shipping route so blood reaches the laboratory inside 24 hours of carrier receipt.[5]
- Brief the 8 hour alcohol prohibition as a standing rule, not an after-the-fact instruction.[7]
- Print CG-2692 and CG-2692B into the response pack, because the documented reason for a missed test is itself the compliance.[2]
Discovery Health MD is led by Ann Jarris MD, MBA, FACEP, a board certified emergency physician. Deciding what counts as treatment beyond first aid, and doing it fast enough for a two hour clock, is a clinical call that belongs with a physician. Fleets that change flag keep this duty for as long as the vessel trades commercially in US waters. Our maritime medical consulting line writes that decision into the management system, and the programme setup and the audit walkthrough test whether it survives contact with a real casualty. Speak to the team.
Common questions
How long do you have to conduct alcohol testing after a serious marine incident?
Two hours from the incident. 46 CFR 4.06-3(a)(1)(i) requires alcohol testing of each individual directly involved to be conducted within 2 hours of when the SMI occurred, unless precluded by safety concerns directly related to the incident[2]. If safety concerns prevent it, testing must be completed as soon as those concerns are addressed, and alcohol testing is not required more than 8 hours after the occurrence. The 8 hour figure is a ceiling on the duty, not a second deadline.
What is the deadline for drug testing after a serious marine incident?
Thirty-two hours for the collection, not the result. 46 CFR 4.06-3(b)(1)(i) requires the collection of drug-test specimens from each individual directly involved to be conducted within 32 hours of the SMI, unless precluded by safety concerns directly related to the incident[2]. If the specimens were not collected, the marine employer must document the reason on Forms CG-2692 and CG-2692B.
What makes an injury a serious marine incident?
Two conditions have to be true at once. 46 CFR 4.03-2(a)(2) defines the medical limb as an injury requiring professional medical treatment beyond first aid AND, for a person employed on board, one which renders the individual unfit to perform routine vessel duties[1]. Treatment beyond first aid alone does not create an SMI, and neither does being unfit alone. The clinical judgement is what starts the two hour testing clock, which is why it should not be left to the person with the fewest medical qualifications aboard.
Do alcohol testing devices have to be carried on the vessel?
Not necessarily, and that is a decision to write down. 46 CFR 4.06-15(a)(3) states the devices need not be carried on board if obtaining them and conducting the required tests can be accomplished within 2 hours from the time of the incident[3]. A vessel that cannot reach a collector inside two hours cannot rely on that exemption. Drug testing has no equivalent door: enough urine collection and shipping kits meeting 49 CFR part 40 must be readily accessible.
Who is allowed to draw blood for post-incident testing?
Only qualified medical personnel. 46 CFR 4.06-20(a)(2) provides that collection of an individual’s blood must be taken only by qualified medical personnel, while saliva or breath may be collected by personnel trained to operate the alcohol-testing device in use[4]. Urine collection for drug testing follows 46 CFR part 16 and 49 CFR part 40. Identifying those medical personnel by port or region before an incident is part of a functioning programme.
What happens if someone dies in a serious marine incident?
Specimens must be sought from the remains, and the duty sits with the operator. 46 CFR 4.06-30 requires blood and urine specimens to be obtained from the remains if practicable, and requires the marine employer to notify the local authority such as the coroner or medical examiner as soon as possible, to provide the specimen collection and shipping kit, and to request assistance[6]. If the authority or the custodian of the remains declines, the marine employer must explain the circumstances on Form CG-2692B.
Can a crew member refuse a post-incident test?
No one can be compelled, but refusal has consequences. 46 CFR 4.06-5(d) states that no individual may be compelled to provide specimens, while refusal is a violation of the subpart that may subject the individual to suspension and revocation proceedings under 46 CFR part 5, a civil penalty, or both[7]. The refusal must be noted on Forms CG-2692 and CG-2692B and in the vessel’s official log book where one is required, and the employer must remove the person from duties directly affecting safe operation as soon as practical.
