Report from CYC on lost crew in Mac race.

[Johnb]

If he had been wearing a simple low tech life jacket that is inherently permanently buoyant then with the water at 70 degrees there would have been plenty of time for rescue.

Perhaps you'all could weigh in on why it is better to use inflatables which can never be as reliable or as robust as a regular life jacket. My experience from being in wrestling matches with capsized dinghies is that in the subsequent dragging yourself over the side etc the life jacket gets a lot of scraping and damage which a good one withstands - but an inflatable?

 

[Gunni]

Find a foam life jacket with 35lbs of buoyancy and integrated harness...and you will answer your own question. Inflatable PFDs are superior safety devices for keelboat sailors. But you have to maintain them.

 

[jssailem]

you have to maintain them

Magic point. Maintenance. Who thinks about that in the heat of race preparation?
Likely more folk will be going forward and at a more serious level, at least for a while. We are humans and we will tend to focus on the issues that are most serious. As we move further from the events that shock us we will become complacent and revert to the "what do I worry about today" issues.

PFD maintenance is not a big issue. How many of us have opened our PFD's and inflated them to see if they hold air (there is a manual inflation tube just like on the airplane life vests). Do they hold air for 24 hours?

Had a discussion with the Mustang folk last year. Asked about the warranties and the dates. Seemed a bit short. Their comment is that is what our lawyers have decided is the Best Practice. We will sell you a kit to update your PFD but it is up to you to keep current.

If you do a USCG safety check, the dates will be checked and even though the unit is "in the green" the life vest will not pass inspection if the date is beyond current. Just like old flairs.

I am thinking that the old dated PFD kits I have would be worth the test to experience what happens when you go in the water and the PFD inflates. I suspect it will be nothing like one suspects. At some point I expect that an aged PFD when inflated by the CO2 cartridge might just rip apart. Wouldn't that be the pits in an emergency...

 

[jssailem]

I think I need to have a designated "Swimmer" to jump in water and rescue an unconscious MOB

Who will that be Jim? What training will you expect of that individual?

 

[Parsons]

Perhaps you'all could weigh in on why it is better to use inflatables which can never be as reliable or as robust as a regular life jacket.

I'm with Gunni on this question. This particular drowning was highly unusual in that the COB was wearing a PFD that did not function. From CG statistics, most drownings from boats (not beach swimmers, etc.) are accidental water entry with no PFD. Statistically, the danger is not that the PFD is defective or damaged, but that it's still on-board the boat while the victim is drowning. Inflatable PFD's are more comfortable, so they're more likely to be worn. You'll note in the report that half the crew on this vessel (and probably every other racing boat in daylight out there) did not wear a PFD.

My take on this tragedy was that the root-cause was not boat design or maintenance, but pride and hubris. It strikes me that they were in challenging conditions for this boat (not survival, just tougher than normal), and there was little concern as evidenced by the casual COB drill and no requirement for safety equipment. They were all experienced sailors with multiple Mac's under their belts. Why did the COB not manually inflate the vest? Why did the crew not deploy the MOM / LifeSling or immediately declare a Mayday? I suggest perhaps they were rugged sailors who did not shift quickly (within the 4 minutes of this incident) from Race-mode to Survival-mode. Mentally, they were still pulling a hat from a calm harbor.

 

[JamesG161]

What training will you expect of that individual?

1) Swimmer that can grab the Unconscious MOB.
2) How to wear a PFD and use it.
3) Patient and does not panic.

It would be nice to have First Class Lifesaver, but really one that is not afraid to jump in and help grab the MOB.
It maybe me, if someone can manage the helm.
Jim....

 

[Scott T-Bird]

You know, from a forensic standpoint, this report is really lame. It is a regurgitation of the events, the recommendations are merely a regurgitation of safety procedures, and the appendices are a regurgitation of facts and responses. The "Race History" section is interesting but it only seems to be included to glorify the race and highlight the dangers that are assumed to exist. There is absolutely no critical evaluation or analysis. It is essentially a CYA formality to close the matter.

It is very strange that the report opens so many questions without any attempt at explanation or conclusion. It's obvious that the committee's effort was primarily to sweep the incident under the rug without hurting anyone any further. I'm not saying that anybody on any of the boats did anything blatantly wrong or unprofessionally. Obviously, the conditions were difficult, everybody involved made their best, responsible efforts, and it was a tragedy that I'm sure everybody is devastated over. I'm not even suggesting that these tragedies can always be avoided. I am saying that this report did not even scratch the surface regarding suitable explanations and recommendations. There must be hundreds of questions where there was not any attempt to answer.

 

[Jumpstart]

I have a lot of personal experience in the Chicago Mac race. I raced with a skipper who thought a real life test for the MOB was crucial. An experienced swimmer would jump off the stern announced in the pre start area. Most times the crew was not paying attention so it was a good test. Once, the guy jumped off in 15-18 knots without a life jacket. WE did the quick stop maneuver and could not get him on board after 3 passes under sail. This was with 13 experienced crew. Fortunately the guy was a strong swimmer but he was fading fast when another boat with an open transom picked him up. A pretty sobering experience and never again did the MOB tester go overboard without a life jacket. This was in waves that were 2-3 feet. In waves 6-8ft, a swimmer would have little chance to survive very long as the waves in that area are confused and steep. On my boat, in other than benign conditions, we would stop the boat by going head to wind,, turn the motor on, drop sails, put it in gear and go back.

 

[Davidasailor26]

One thing that struck me was the difficulty early on with getting the boat into a condition where they would be ready to make a recovery attempt. I'm sure that's much more complicated with a TP52 than, say, a 30' PHRF racer, but as I was reading it the chaos that was unfolding was tangible. I was thinking about the video that was recently posted here, from https://www.dailymail.co.uk/news/article-6709707/Crew-scramble-save-man-slips-yacht.html, and how different the communication seemed. In the successful COB recovery they had the sails down, boat turned around, May Day over VHF, and back to the COB in about 4 minutes. At that time the TP52 was trying to make recovery attempts, but still had sails flailing, no VHF calls, had miscommunications over whether the engine was running, etc. Maybe that's just a matter of boat size and complexity, but I think part of it is crew coordination and practice. I know the report listed years of sailing and Mac race experience for each crew member, but I'd be curious on how many races each of the crew had sailed together as a unit (if any).

One of the statements in the report was that "Normally the communication was very effective onboard, and everyone knew what to do. However, that management style worked fine until someone was in the water. Then people were out of place and people either didn’t respond or too many people responded to orders." I wonder if races like this one, where crews may be pulled in from many places, should require more thorough emergency preparedness briefings and exercises, to make sure that everyone knows their roles in an emergency situation.

 

[jon hansen]

i have done 9 mac races. was the captain for all. crew close friends and family.
i worked 18 seasons in the merchant marine on the great lakes. on the ships it is required by law that the crew have a fire and life boat drill every week. this included a safety lesson given by some officer. i've been to many many hundreds of safety meetings.
in the mac, it is required that all crew be wearing their PFD as it crosses the starting line. from my background, there were never any inflatables on aeolus. all type one offshore life jackets. one per crew plus two stored at the main mast on deck and another on the ready at the mizzen. i also maintained ten floating seat squares in the cockpit or on the cabin top. i want the crew comfortable as well as have a throwable device under their butt.
for day sailing and cruising i have all my seat squares out on top. i give all visitors a life jacket before we leave the dock. if a crew member gawfs at me, a saftey lecture will ensue.
plus remember i love bean bag chairs. pink and yellow. great MOB markers.

the glaring take away from my sensabilities is total lack of throwable devices on deck. what do you throw over? every thing, something will float!
twenty floating, colorful items to keep an eye on is way better than one body in the water.

also, they did run over the guy. never good.

 

[jssailem]

I wonder if races like this one, where crews may be pulled in from many places, should require more thorough emergency preparedness briefings and exercises, to make sure that everyone knows their roles in an emergency situation.

It seems that was a weakness in this situation.

 

[Rick486]

I have a bias regarding safety gear including things like inflatable PFD/harness, tethers, knives, PLB's, flashlights, handheld VHF, even a handheld GPS. I carry my own and keep it in good working order. This crew was using owner supplied gear. The suggestion that they could have put a man in the water to effect a rescue seems ill advised. I wouldn't ask any crew member to do that, or allow it. Not in L.Michigan. Once the MOB submerged the window of rescue closed. Unspeakably tragic.

Gunni makes a huge point. Keep your own gear in shape and always bring your own gear on another boat. We always bring our own safety equipment despite strange looks from other crew and skippers. Including tethers.

 

[jon hansen]

CYC runs the race as per offshore racing requirements. all safety standards and protocols are in place. if the crew fudges their requirements, shame on them

 

[Johnb]

Find a foam life jacket with 35lbs of buoyancy and integrated harness...and you will answer your own question. Inflatable PFDs are superior safety devices for keelboat sailors. But you have to maintain them.

OK, so an inflated inflatable is superior to a foam life jacket, but an un inflated one sure as hell is not. He did not need 35 pounds of buoyancy, just enough to keep him alive. What does an integrated harness do to keep you afloat?

This particular drowning was highly unusual in that the COB was wearing a PFD that did not function.
So, how could you drop that likelihood to zero?

 

[jssailem]

So, how could you drop that likelihood to zero?

Wear something that others might think is "Dorky" and uncomfortable...

 

[Jumpstart]

I can't believe nobody employed the MOM device. I have one. Incredibly easy to pull the quick pin and the MOM unit deploys automatically.

 

[Gunni]

He did not need 35 pounds of buoyancy

And you know this how? Go out in sweetwater with your foulies on, raging 6-8' seas, have a boat run over you twice and report out.

What does an integrated harness do to keep you afloat?

Nothing. An integrated harness is how your shipmates bring you back aboard.

This particular drowning was highly unusual in that the COB was wearing a PFD that did not function.
So, how could you drop that likelihood to zero?

You maintain your gear, you train your MOB drill, and you effectively execute a MOB. Surviving in 60deg freshwater for an hour is challenging even if you don't have chop breaking over your head.

 

[BigEasy]

Just a few observations after browsing through the CYC report and the current issue of Practical Sailor that addresses cold water survival.
1. The victim, John Santarelli was a current tri-athlete and an excellent swimmer. How many of us are in comparable
physical condition...not many. We hear it time and again, the importance of having a PFD on at the time of immersion
in order to survive a MOB incident, even in mild water temps. Both the CYC report and Practical Sailor mention
the effects of "cold water shock" and "instinctive drowning reflex" as contributing factors in drownings. Sudden
immersion causes physiological effects including massive increases in heart rate, blood pressure, hyperventilation, &
swallowing large amounts of sea water. It makes a sustained physical effort by the victim nearly impossible for more
than a few minutes, much sooner than the effects of hypothermia. To an untrained observer, the victim doesn't appear to
be drowning; however, they are. I doubt if any of us could have survived in a similar situation without assistance of
an operable PFD. The guy on board who was responsible for organizing the crew and ensuring that the mandatory
safety equipment was available was quoted " I'm not sure how to test an inflatable PFD with out setting them off"
The PFD was not available for inspection following the mishap because the medical examiner sent the PFD along with
the victim for cremation. The only component of the jacket was an exploded CO2 cartridge; therefore, it was impossible
to determine the reason for the vest not inflating.
2. I am not sure why, we as sailors, insist on attempting MOB recovery under sail, especially in conditions similar to
that experienced on the day of the incident. Perhaps it's pounded into our heads in intro sailing classes, ASA, &
US Sailing courses; however, stopping the boat and getting back to the MOB in the quickest and most controlled
manner increases the likely hood of recovering a victim. In 25-30 knot winds in 5-8 foot seas, getting close to a
MOB isn't good enough. The crew experienced a jib wrap and attempted 3 times to maneuver for a recovery over 15
minutes. Seems that it would have taken a crew of 13 experienced sailors only 2 minutes to drop the sails and secure
all lines to allow enable a controlled recovery under power....you're along side the victim within 3 to 5 minutes at worst. I
will reference a seminar that Captain Tom Tursi from the Maryland School of Sailing presented and posted on you tube.
He advocates an immediate stop and recovery technique under power as the most practical recovery method.
The guy has over 50 thousand miles under his keel in ocean racing & transits, so he's got lots of experience. You can check
out the seminar on you tube; "Crew Overboard Rescue Techniques." (Sorry, couldn't get the link to work). BTW, I plan to inflate my PFD's this weekend with compressed air, weigh the CO2 cylinders to make sure they are in spec, and check the indicator pins & bobbins, suggest y'all do the same before the season starts.

 

[Scott T-Bird]

Both the CYC report and Practical Sailor mention
the effects of "cold water shock" and "instinctive drowning reflex" as contributing factors in drownings. Sudden
immersion causes physiological effects including massive increases in heart rate, blood pressure, hyperventilation, &
swallowing large amounts of sea water. It makes a sustained physical effort by the victim nearly impossible for more
than a few minutes, much sooner than the effects of hypothermia. To an untrained observer, the victim doesn't appear to
be drowning; however, they are. I doubt if any of us could have survived in a similar situation without assistance of
an operable PFD.

It's true that these issues were mentioned in the report. The appendices included articles. However, the committee did not appear to link these factors to the cause of drowning. In fact, they didn't appear to offer any explanation. Contrarily, they mentioned the water was 70 degrees, which is not hypothermic during the time period at all, especially for someone as conditioned as Jon. Despite the wave height, I'm having a hard time reconciling the observations that he appeared calm and relaxed in the water almost until the point in time when he slipped under. I've played in the surf in Hawaii. I know from experience that it is relatively easy to relax and tread water for an hour in 8 to 10 foot waves (as long as you are in water deep enough to avoid the undertow), even with white water breaking over your head. The really strenuous activity comes about when you attempt to climb the shore break onto the beach. But, (and it is a really huge BUT) that is while wearing a swimsuit.

I was struck by the lack of explanations in the report. For instance, I'm guessing the clothes Jon was wearing may have caused a sudden change. It seemed as if buoyancy, even without a PFD, was relatively easy, until suddenly, perhaps it was not. One of the participants seemed to mention that perhaps he disrupted an air pocket in the clothing when he finally raised his arms to try for a line. For sure, the heavy clothing must have caused the fatigue rather quickly. I'm pretty much in agreement with @Parsons, that the shift in focus may have been rather late. The report was exceptional only for it's weakness in drawing conclusions.

 

[Scott T-Bird]

I thought it was remarkable that the accounts indicate that Jon appeared comfortable in the water for quite awhile during the first few attempts. Then, he appeared to quickly succumb to fatigue. The crew were calling out to him .. why didn't he call back when it appeared that he was calm and relatively at ease in the water? Why didn't he attempt the manual inflation? Could it be that he misjudged the situation himself? Perhaps he thought at first that buoyancy wasn't a problem. He was a strong swimmer, so it is relatively easy to be confident in the water even under the circumstance. There were boats all around him. I'm thinking that he misjudged the urgency until his clothes became saturated and the weight became over-fatiguing, all at once. Perhaps there is a lesson that the committee misses. I have to admit that I don't think I have ever been in the water in a circumstance with heavy, saturated clothing. I wouldn't know how long it takes before the clothes weigh me down to the point of incapacitation. Perhaps that was part of the misjudgment.

The other point that seemed to be missed was that the report mentioned that the boat-supplied PFD's were fitted with "manual AIS" (whatever that means). Was it not activated? Is it not functional underwater? Where was there any explanation about the potential for AIS to aid rescue?