Tragic rescue prompts change
'The lack of experience with this sort of rescue
must be tempered by a sound regulatory oversight'
Miranda Scotland
Northern News Services
Published Monday, March 24, 2014
NUNAVUT
The Royal Canadian Air Force is determined to learn from a high-risk rescue of two Iglulik hunters which resulted in the death of a search-and-rescue technician.
Sgt. Janick Gilbert of Baie-Comeau, Que., died Oct. 27, 2011 during a search-and-rescue mission near Iglulik. As a result, the Royal Canadian Air Force is considering changes to its regulations, as well as equipment upgrades. - NNSL file photo |
The military is considering changes to its regulations, as well as equipment upgrades, following an investigation into the 2011 incident.
It has already implemented 12 measures to improve safety during future rescues.
"Appropriate regulations would serve to restrict operations when the risk is predetermined to be too high," states the flight safety investigation report. "They would override excessive self-reliance and would serve to temper the SAR motto 'that others may live' because the motto was not intended to promote a rescue in the face of unreasonable risks."
Iglulik hunters signalled for help on Oct. 26, 2011, after their boat became stranded in an ice-field in the Hecla Strait. The vessel later broke free into open water.
Rescue aircraft were sent from the south to locate the men and establish radio connection. The hunters told rescuers they were hungry, sea sick and thirsty before losing radio contact.
Fearing for the hunter's lives, Sgt. Janick Gilbert and two other technicians parachuted down to help from a Hercules aircraft.
The first SAR technician managed to reach the men but the two others struggled to find the target and eventually abandoned the effort to focus on their own safety.
On the night of the rescue weather conditions were rough. The technicians faced low visibility, winds gusting up to 47 knots and wave swells between 10 and 30 feet in height.
The hunters and two of the technicians were picked up by a helicopter after about four hours on the water.
The helicopter crew found Gilbert an hour later, face up, unresponsive with his life preserver inflated.
He was taken to the Iglulik health centre but couldn't be resuscitated.
The investigation determined Gilbert died from drowning. Although they aren't sure exactly what happened, investigators believe water may have leaked into Gilbert's flight suit, resulting in him becoming "non-functional and unable to re-enter his raft."
Investigators analyzed the situation in their report.
"On the night of the occurrence, an individual with dry undergarments in a sealed dry-suit immersed to the neck in sea water could have remained functional for up to 19 hrs while an individual with soaked undergarments, would have remained functional for only 1.7 hrs," the report notes.
Gilbert was told twice that his zipper was open and that his life raft survival kit strap was loose but he didn't fix the issue.
"The resulting communication failure may have occurred due to (Gilbert's) reflection on the challenges of the mission or an intercom discussion in progress - the exact reason remains unknown."
Other factors that may have contributed to the situation that led to Gilbert's death is a lack of adequate equipment, training and established regulations, and the inexperience of the crew, according to the report.
Gilbert had never performed a water rescue jump of this nature before, while his colleagues had only five months experience on the job and the aircraft captain was a junior.
"Therefore, Gilbert, using naturalistic decision making theory, without suitable experience, suitable regulatory guidance or a suitable checklist, could not recognize his own limitations, the risks to the other SAR techs and the unforeseen issues involved in conducting a rescue of this nature," the document states.
Some of the preventive measure the report recommends are equipping SAR personnel with a robust radio and devices to help them locate their co-workers and targets on the water.
It also mentions publishing instructions on jump procedures, enhancing training for SAR technicians, introducing a requirement to develop a realistic rescue plan before techs perform a water rescue and creating a water parachute rescue mission planning checklist, among other recommendations.
"Although R-323's crew ultimately rescued the men in distress, the mission's cost of one SAR tech life was extreme," stated Col. Steve Charpentier, director of flight safety for the Department of National Defence.
"On the sea, like in the air, the risks are high and the lack of experience with this sort of rescue must be tempered by a sound regulatory oversight that will ensure that the decisions and risks undertaken are appropriate and accepted at the proper level."
