Coast Guard Publishes Final Action Memo

U.S. Coast Guard
Wednesday, May 16, 2012

A damaged hoist cable and the inability to find equipment needed to repair the fraying cable are the two causal factors in the Coast Guard’s unsuccessful rescue of an injured crewmember off the sailing vessel Freefall during heavy weather Oct. 28, 2008, according to a Coast Guard final action memo released Wednesday.

The memo directs 12 actions including reviewing existing policies, checklists, and maintenance and gear stowage procedures related to aircraft search and rescue mission preparation; determining the feasibility of equipping the MH-60 Jayhawk helicopter with cable chaffing guards in critical areas when right external fuel tanks are installed;  and, evaluating the emergency rescue device for effectiveness in heavy weather hoisting operations.

The purpose of the investigation was to identify and better understand the factors that led to the unsuccessful rescue and what can be done to prevent future mishaps. “The crew of CG 6003 attempted to prosecute this search and rescue case in the most hazardous conditions,” wrote Vice Adm. Sally Brice O’Hara, Coast Guard vice commandant.  “The tragic loss of Freefall’s crewmember reminds us that we must continue to diligently commit and direct our efforts to perform operations as safely and effectively as possible.”

The 5th Coast Guard District command center received an emergency position indicating radio beacon signal from the sailing vessel Freefall the evening of Oct. 28, 2008.  Subsequent reports indicated the vessel had rolled, de-masted and begun to flood, but flooding had been stabilized.  The Freefall’s owner requested that he and his crew of two, which included a man who had been injured, be removed from the vessel.

The crew of the Coast Guard Jayhawk helicopter CG 6003 launched from Air Station Elizabeth City, N.C.  On scene weather conditions consisted of 40-knot winds with gusts up to 50-knots, 20- to 40-foot waves, and low visibility.
Based on the condition of the vessel and weather conditions, the pilot decided to deploy the rescue swimmer to begin hoisting the crew from the vessel.  Once aboard the Freefall, the rescue swimmer learned the injured male crewmember was ambulatory and decided to hoist the survivor from the water.

After multiple attempts to hoist the injured crewmember, a section of hoist cable was damaged, precluding further use without repair.  The flight mechanic cut the cable, intending to splice it, but was unable to locate the device necessary to make the repair.

CG 6003 used the last remaining hoist option, the Emergency Rescue Device.  While the Emergency Rescue Device was being rigged for use, CG 6003 deployed a life raft which the rescue swimmer recovered.  The rescue swimmer then placed the injured crewman into the the life raft.   The Emergency Rescue Device was lowered, the rescue swimmer attached it to his harness and maintained his grip on the crewmember, but the rescue swimmer was pulled violently through strong waves numerous times and was eventually separated from the injured crewmember.

The rescue swimmer, who was injured during the rescue attempt, was hoisted into CG 6003 without the Freefall crewmember.  Without any further means to rescue the injured Freefall crewmember, the CG-6003 returned to base.  A Coast Guard fixed-wing aircraft dropped a life raft for the injured crewmember, but he was never seen getting into it.

When recovered from the water approximately four hours later by an Air Station Cape Cod helicopter crew, the injured Freefall crewman was unresponsive.  He was later pronounced dead.

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