Under the "international rules of the road" governing maneuver at sea, a ship crossing navigation paths with other vessels is obligated to give ships on its starboard, or right, side, the right of way. This entails maneuvering to stay clear of other ships and to avoid endangering them.
But when the guided-missile destroyer Fitzgerald approached the Philippines-flagged container ship ACX Crystal to its starboard side in the wee hours on June 17, no such precautions were taken, according to a new command investigation released Wednesday.
The investigation, which faulted leaders and watchstanders for a series of poor choices and failures to act that ultimately resulted in a deadly collision, raised questions about fatigue levels and knowledge gaps that could have contributed to the errors.
Moreover, investigators note, the ship had previously experienced a near-collision in mid-May, but hadn't taken steps to fix problems in operations.
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"Leadership made no effort to determine the root causes and take corrective actions to improve the ship's performance," they found.
The investigation did not detail the causes or the circumstances of that near-miss.
The June 17 collision took place about 56 nautical miles to the southwest of Yokosuka, Japan. The ship had recently passed Oshima Island in the Philippine Sea, a busier shipping lane with increased traffic from merchant vessels.
Around 1 a.m., as the Fitzgerald operated with the "darkened ship" procedures reserved for nighttime operations, it approached three merchant vessels traveling eastbound to the ship's starboard side.
"The closest point of approach of these vessels and the Fitzgerald was minimal, with each presenting a risk of collision," investigators wrote.
But the ship's crew appeared completely unaware of impending danger. From 1 a.m. to 1:30 a.m., when the Fitzgerald and the Crystal collided, the Fitzgerald remained on its course, cruising through the water at 20 knots. Neither vessel initiated bridge communications with the other or sounded a danger signal.
Investigators found, among other things, that watchstanders performing physical lookout duties were doing so only on the port, or left, side of the ship, despite the fact that there were three ships presenting a possible collision threat on the starboard side.
At 1:10 a.m., watchstanders tried to get a radar track on the Crystal, but were unsuccessful in doing so. Instead, the officer of the deck plotted out a radar track for a ship believed to be the Crystal, and determined it would pass 1,500 yards from the Fitzgerald on the starboard side.
In fact, the two ships were on a collision course, and both were maintaining a high rate of speed.
An official timeline shows indications of panic just before the ships collided. Three minutes before the collision, the officer of the deck ordered the Fitzgerald to change course, then immediately rescinded the order. Then, the officer of the deck ordered an increase to full speed and a rapid turn to the left. The order was not followed.
One minute before the crash, the boatswain's mate of the watch took the helm and started giving orders. By then, the disaster was inevitable.
Ultimately, seven sailors would die when their compartment, Berthing 2, was flooded.
Among those who sustained significant injuries was the ship's commanding officer, Cmdr. Bryce Benson, who had to be rescued as he dangled from the side of a ship after his stateroom was destroyed. He would ultimately be medically evacuated from the ship.
Those killed in the collision include:
- Gunner's Mate Seaman Dakota Kyle Rigsby, 19, from Palmyra, Virginia;
- Yeoman 3rd Class Shingo Alexander Douglass, 25, from San Diego;
- Sonar Technician 3rd Class Ngoc T Truong Huynh, 25, from Oakville;
- Gunner's Mate 1st Class Noe Hernandez, 26, from Weslaco, Texas;
- Fire Controlman 1st Class Carlos Victor Ganzon Sibayan, 23, from Chula Vista, California;
- Personnel Specialist 1st Class Xavier Alec Martin, 24, from Halethorpe, Maryland; and
- Chief Petty Officer Fire Controlman Gary Leo Rehm Jr., 37, from Elyria, Ohio.
All were posthumously promoted to those ranks.
In August, the Navy relieved Benson, Fitzgerald Executive Officer Cmdr. Sean Babbitt, and Master Chief Petty Officer Brice Baldwin, the senior enlisted sailor aboard the ship, in connection with the deadly crash.
Investigators found crew fatigue levels could have played a role in the errors that preceded the collision; the Fitzgerald had left port at Yokosuka the day before.
They also found that daily performance standards aboard the Fitzgerald had degraded "to an unacceptable level," and ship's leaders were unaware how bad things have gotten.
"The command leadership did not foster a culture of critical self-assessment," investigators found.
In the wake of the collision, the Navy has implemented a measure to ensure regularly scheduled sleep periods for sailors standing watch.
More measures may be announced Thursday, as Chief of Naval Operations Adm. John Richardson and the commander of U.S. Fleet Forces Command, Adm. Philip Davidson, release the results of a comprehensive review of Navy operations following the Fitzgerald collision and that of the destroyer USS John S. McCain two months later.