The report into the Blackrock Island helicopter tragedy, which cost the lives of four people, may have brought closure to the grieving families. But it can hardly have brought much comfort.
The report catalogues a terrifying series of wilful blunders, of staggering incompetence and negligence, which resulted in the deaths of four blameless victims in an incident that was as needless as it was preventable.
It’s worth looking back on that tragic March night of 2017 and how it came about. The skipper of a fishing trawler, 140 miles out in the Atlantic from Eagle Island, contacted Malin Head Marine Rescue Centre in Donegal to seek advice because a 50-year-old crewman on board had suffered a serious thumb injury. Malin Head contacted the Coast Guard duty pilot in Sligo, tasking him to fly his R118 to the scene and airlift the injured man to hospital.
Malin Head then contacted helicopter R116 in Dublin to fly out and provide ‘top cover’, meaning back-up support, for R118, by then on its way to the accident vessel. The R116 travelled across the country, flying out over Blacksod Bay, and then turning to make the approach from the seaward side into Blacksod for refuelling.
As the pilot reduced her altitude to 200 feet for her approach, she was not to know, nor had she been warned, that Blackrock Island, 282 feet of sheer rock rising from the sea, stood between her and touchdown.
The resulting disaster saw the helicopter smashing into the rock and plunge to the bottom of the sea. Only two bodies were ever recovered.
To add another layer of poignancy, it was found that Captain Dara Fitzpatrick had actually managed to free herself from the craft, only to die by drowning.
Not surprisingly, the Air Accident Investigation report honed in on the neglect of basic safety requirements that sent the four to their deaths. There was the error that meant that Blackrock Island was not registered on the crew’s internal mapping system. The vital information they were entitled to rely on was simply missing, even though four years earlier, other pilots had complained of that very omission.
But a finding that has been given far less prominence was whether in fact the rescue mission was ever necessary, and whether, if proper procedure had been followed, either helicopter would have been in the sky that night.
By convention, search-and-rescue missions are implemented for those in imminent danger of death. The key clinical assessment is made by a HSE medical team in Cork, whose advice must first be sought before such a mission can be launched.
That did not happen on the night R116 was sent to its doom. According to the report, there was a ‘misunderstanding’ at Malin regarding the seriousness of the casualty on the trawler. The Sligo pilot was tasked to execute an airlift, even though the skipper had not requested it. It was only then that the HSE doctor in Cork was contacted, by which time the mission had already been activated, although the guidelines state that this can only happen after the clinical decision is made.
When, some minutes later, the Coast Guard in Dublin sought assurance from Malin, it was told that the doctor had indeed requested the evacuation, even though the report found that the doctor had merely ordered painkillers for the injured man.
And so, piece by piece, the awful tragedy played out.
Blameless and dedicated rescue personnel were sent to their deaths on a mission that turned out to be needless.
There must be many having sleepless nights since the Blackrock tragedy.