Ross to act on re­port into Coast Guard death

Irish Examiner - - News - Eoin English

Trans­port Minister Shane Ross has pledged to im­ple­ment in full the rec­om­men­da­tions con­tained in a re­port into the death of a Coast Guard vol­un­teer off Clare which iden­ti­fied sys­temic “safety man­age­ment” is­sues in the Ir­ish Coast Guard.

Mr Ross was speak­ing yesterday fol­low­ing pub­li­ca­tion of the Ma­rine Ca­su­alty In­ves­ti­ga­tion Board’s (MCIB) re­port into the death of Caitri­ona Lu­cas, a 41-year-old mother of two from Lis­can­nor, Co Clare, dur­ing an ill­fated mis­sion off Doolin on Septem­ber 12, 2016.

While the Coast Guard has de­scribed the re­port as “flawed” and called for a full reap­praisal of its anal­y­sis, Mr Ross said he wel­comes the re­port which found that the res­cue boat Ms Lu­cas was thrown from was launched in con­di­tions be­yond its op­er­a­tional ca­pa­bil­ity; that there were crit­i­cal de­fi­cien­cies with its com­mu­ni­ca­tion and nav­i­ga­tion equip­ment; and that the Coast Guard does not have an ef­fec­tive safety man­age­ment sys­tem.

Ms Lu­cas, a vol­un­teer with the Doolin Coast Guard Unit, was one of three crew in a Delta RIB which was de­ployed from Kil­keetw ice that day as part of a search for a man, re­ported miss­ing three days ear­lier.

Their boat cap­sized in heavy seas as they searched a cove near Foohagh Point just af­ter 1pm dur­ing what was their sec­ond launch of the day.

All three lost their hel­mets and their per­sonal flota­tion de­vices were not in­flated.

The boat cox was washed in­shore and clung to rocks un­til winched off by res­cue he­li­copter R117. The sec­ond cox swam off­shore and was res­cued by a pri­vately owned boat.

Ms Lu­cas clung to the up­turned boat, as per her train­ing, for at least three min­utes. But she suf­fered a head in­jury and was sub­merged un­der the boat sev­eral times be­fore fi­nally be­ing washed away.

She was re­cov­ered by res­cue he­li­copter R 115 a short time later but was pro­nounced dead in hos­pi­tal. She had drowned.

The MCIB iden­ti­fied sev­eral is­sues with the fa­tal in­ci­dent it­self, in­clud­ing “man­age­ment is­sues” in the Kil­keeCoastGua rd unit, which had seen the de­par­ture of sev­eral coxes with lo­cal knowl­edge, and which ul­ti­mately re­quired the in­ter­ven­tion of Coast Guard head­quar­ters.

But it con­cluded that the Delta RIB cox did not hold the re­quired statu­tory oper­a­tor’s li­cence; that the RIB was not per­mit­ted to op­er­ate in surf; that its radar was not op­er­a­tional; that there was “wa­ter ingress into the GRP hull” dur­ing op­er­a­tions; that there was air leak­ing from the air sus­pen­sion in one of its seats; and that ad­di­tional faults were re­ported, in­clud­ing a bro­ken echo sounder, and a non-op­er­a­tional ‘fixed VHF trans­ceiver’.

The re­port also found that the so-called Triple Lock Sys­tem, a de­ci­sion-mak­ing process re­quired be­fore a boat is launched, was “not ad­e­quately ad­hered to” be­fore the RIB’s sec­ond launch that day.

In its con­clu­sions, the MCIB said the Ir­ish Na­tional Search and Res­cue Frame­work does not pro­vide ad­e­quate clar­ity as to when a search and res­cue op­er­a­tion be­comes a search and re­cov­ery op­er­a­tion, es­pe­cially in in­ci­dents where search and re­cov­ery op­er­a­tions take place close to cliffs and in surf con­di­tions.

It said while there were spe­cific is­sues linked to this tragedy, it is nec­es­sary to con­sider a wider con­text, in­clud­ing a sim­i­lar in­ci­dent in­volv­ing a Coast Guard RIB cap­siz­ing in a “surf zone” off Din­gle in 2014.

While there was no loss of life in this in­ci­dent, the MCIB said some of the 20 rec­om­men­da­tions linked to and pro­ce­dures have not been “fully im­ple­mented”.

Mr Ross said he has broad­ened the na­tional SAR Frame­work re­view, whose group un­der the in­de­pen­dent chair­man­ship of Sir Alan Massey, for­mer CEO of the Mar­itime and Coast guard Agency in the UK, met on Wed­nes­day, to en­com­pass the rel­e­vant rec­om­men­da­tions aris­ing from the MCIB re­port.

He said he has also in­structed the Coast Guard to ac­cel­er­ate its work in de­vel­op­ing an in­de­pen­dently ac­cred­ited ISO safety man­age­ment sys­tem that will be ro­bust and fit for pur­pose.

He said the work is al­ready un­der­way and sig­nif­i­cant ef­safety fort and in­vest­ment has taken place over the last two years.

But he said he will now re­quire the Coast Guard and the Ma­rine Sur­vey Of­fice to take the “nec­es­sary and prag­matic steps” to en­sure that any is­sues which could im­pact on ves­sel or crew safety are ad­dressed as a mat­ter of ur­gency.

Coast Guard vol­un­teer Caitri­ona Lu­cas from Lis­can­nor, Co Clare, who drowned dur­ing a mis­sion off Doolin on Septem­ber 12, 2016.

Pic­ture: Face­book

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