Mishap Reporting System

1. Mishap Reporting System

2. Authority COMDTINST M5100.47 Safety & Environmental Health Manual Aviation - Chapter 2 Vessels and Shore Facilities - Chapter 3

3. What is a Mishap? • Undesired event • Results in or has potential to: • Harm people • Damage property • Reduce production or mission capability

4. #1 Cause of Coast Guard Deaths #1 Cause of Off-Duty Mishaps FY05: 8 Fatalities , 2 total disabilities, 1 partial disability

5. Training Objective Given a functional MISHAP system, use the system to: • Prevent MISHAPs from occurring • Respond • Report • Investigate

6. Prevention • Develop Pre-MISHAP plan • Review MISHAPs • Recognize implications • Apply Operational Risk Management

7. Pre-MISHAP Plan Requirements: • Applies to all units • Revise Annually • Exercise Annually

8. RESPONDPre-Mishap Plan Shall Include: • Prior arrangements with other emergency services i.e.: Local Fire Department, other Government Agencies. • Notification Checklist. • Rescue, Recovery and Emergency Medical Care Guidelines for preservation of evidence. • List of local Religious personnel to assist with notifying Next of Kin

9. REPORTPre-Mishap Plan Shall Include: • Short descriptions of Mishap definitions • Notification Checklist. • Photographic Services (not News/Media) • Contact information for the Public Affairs Officer

10. INVESTIGATEPre-Mishap Plan Shall Include: • List of personnel on local Mishap Analysis Board • Photographic Services (not News/Media) • Ready Accessible Analysis Kit (Aviation).

11. Pre-Mishap Plan (cont) • A sample Pre-Mishap Plan can be found in the Admin section of the MLCPAC(kse) website http://cgweb.mlcpac.uscg.mil/mlcpackse/

12. Why Report Mishaps? • Inform • Document details for future use • Forward recommendations • Data for statistical analysis • Prevent future mishaps

13. Why Investigate Mishaps? • Determine facts • Analyze for causes • Recommend corrective action

14. MISHAP Reporting

15. Reportable Events Injury/Illness/Deaths • Coast Guard Active Duty member (on or off duty) • Active duty reserves (on or off duty) • Coast Guard civilian doing Coast Guard work • Auxiliarist under orders • Anyone unintentionally killed or injured by Coast Guard operation. MILOPS and LE are usually intentional uses of force. • Anyone killed or injured on Coast Guard property • Coast Guard dependents on Coast Guard owned or leased property • Coast Guard personnel’s occupational illness

16. Reportable Events • Damage to Coast Guard property • Coast Guard damage to property of others • Damage to auxiliary facility under orders • Trailer MISHAPs. Considered Government Motor Vehicle (GMV).

17. Non-Reportable Incidents • Intentional acts (suicide, homicide, mugging) • Intentional damage (sabotage, arson) • Unavoidable damage (e.g. damage from storms, range or forest fires, floods, or seismic events) • Normal wear & tear

18. Mishap Classification Classified by severity Class A B C D E

19. Class A Mishaps Reporting Requirements: Within 4 hours: • Immediate telephone report to CGHQ CC Center 202-267-2100 • Personnel Casualty Report MSG Within 12 hours: Preliminary MISREP MSG Report Within 72 hours: Progress/ Supplemental Message Report. Events: • Fatality • Permanent total disability • $1 million or more damage • Coast Guard resource missing, abandoned, damaged beyond economical repair. • Midair collisions

20. Class A Mishaps (Continued) Reporting Requirements: Within 4 hours: • Immediate telephone report to CGHQ CC Center 202-267-2100 • Personnel Casualty Report MSG Within 12 hours: Preliminary MISREP MSG Report Within 72 hours: Progress/ Supplemental Message Report. Events: A Coast Guard small boat has reportable property value of >$50K, and • (a) is missing or abandoned; • (b) Recovery is impossible or impractical; or • (c) Is beyond economical repair.

21. Class B Mishaps Events: • Permanent partial disability • Damage: $200K - $1M • 3 or more in-patient injuries • Boats: damage >$50K • Government Vehicles: damage anything over $20K. Reporting Requirements: Same as Class A

22. Class C Mishaps Reporting Requirements: Enter into E MISHAP within 14 days. • Events: • Lost time injury (any day beyond day of incident) • More than 30 days restricted duty • Damage between $20,000 & $200,000 • Accidental person overboard • Grounding, capsize, or rollover • Government Vehicles$5,000 to $20,000

23. Class D Reporting Requirements: Enter into E MISHAP within 21 days. Events: • Occupational injury or illness that requires more than simple first aid • Damage $1K - $20K • Accidental firearm discharge, electrical shock or fire that doesn’t meet higher classification requirements • Near midair collision • Near miss/near mid air collision/High Potential (HIPO) • Government Vehicles: $1K-4K (Lower threshold per Per ALCOAST 424/06)

24. Class E Mishaps • Aviation engine damage, regardless of the damage cost. • Foreign Object Debris damages confined to the engine or limited to internal components.

25. Scenarios • Trailering accident where CG trailer struck Non-CG trailer. Non-CG property cost $0.2K. • Trailering accident where POV struck trailer. $2.5K damage to POV. • CG 25718 runs aground on a sandy bottom with no property damage. • CG Boarding Officer falls overboard during boarding

26. MISHAP Process Responsibilities • CO • XO/Safety Officer • Unit Mishap Analysis Board(MAB) • Unit Safety Coordinator • First-line supervisor • Member

27. E-Mishap Reporting System • What is it? • Where is it? http://cgweb.lant.uscg.mil/Kdiv/kseMISREP/Default.asp

31. Summary Reasons to investigate & report Reportable incidents Mishap classification Mishap report preparation

32. Summary Reasons to investigate & report Reportable incidents Mishap classification Mishap report preparation

33. Summary Reasons to investigate & report Reportable incidents Mishap classification Mishap report preparation