What Caused a Crash of Two Navy LCACs?

How Did 36 Sailors and Marines Get Injured?

Here’s a news report about the LCAC accident…

Thirty-six Marines and Sailors were injured when two landing craft (air cushioned) – LCACs – collided head-on at about 57 miles per hour. It was sheer luck that no one died. Of course, the two LCACs that were involved were heavily damaged.

What are some of the things that went wrong (Causal Factors)? From an article based on the Navy’s investigation, the following items were mentioned…

• Ignored warnings from crew members.
• Delays in operations resulting in late-night ops.
• Mechanical issues resulting in unplanned assignment of assets, with confusing communications about the change.
• Failure of the Craftmasters to identify the aspect of the other approaching LCAC and take appropriate action to avoid collision.
• Communication failures between the two LCACs about their intentions and actions to avoid collision.
• Failure of the Navigator to provide timely and accurate information about the distance and side of the LCAC that the other LCAC would pass on.
• Failure to maintain and require the use of seatbelts.

For a better look at how an LCAC works and where personnel are stationed, watch this video…

Potential Root Causes

The article’s headline said:

“Complacency led to Navy landing craft collision
that injured 36, investigation finds”

The article said that the Navy had forty-two recommendations to prevent future collisions (but didn’t list the recommendations).

The article also mentioned these potential root causes from the Navy’s report:

• Failure to follow the rules of the road.
• Breakdown in basic seamanship.
• Undermanning, budget shortfalls, and exhaustion (fatigue).
• Missing radio discipline.
• Broken windshield wipers.
• Improperly assigned roles that were unclear.
• Inadequate training (a recurring theme in Navy investigations).
• Manning shortfalls, gaps in operating doctrine, ineffective command and control, and improper assumption of risk.
• Inadequate standards of behaviour and operations.
• Complacency and an unprofessional attitude.
• Not implementing effective solutions to address root causes of past accidents and incidents.
• And of course, “cultural shortfalls,” including “culture of noncompliance and lack of discipline.”

The article reported that the Navy investigation called for:

“…a host of administrative and disciplinary actions, including administrative action for the commanding officers of the Wasp for failure to execute LCAC briefings by the book and the New York for failure to institute the correct watch bill. The leaders for the LCAC units were also faulted for failures of oversight and for re-tasking the landing craft in violation of policy. No senior officers appear to have lost their jobs over the disaster, though. The commanding officers of both amphibious assault ships transitioned out in standard passage of command ceremonies in January. The commander of Assault Craft Unit 4 retired in May.”

Plus:

“The navigators for LC70 and LC84 and a craftmaster with LC70 were recommended for discipline or administrative action due to dereliction of duty, and the crewmembers of both crafts were cited for not wearing seatbelts or helmets as required.”

The article quoted an unnamed source close to the investigation as saying:

“…with individual mishaps and investigations that take months to complete, it’s hard to keep attention on the problems. The end result is that people forget and move on; nobody connects the dots.”

I wish I could have seen the Navy’s actual accident investigation report, but it didn’t seem to be available online.

A separate report about the Navy’s accident rate in 2024 by The Maritime Executive quoted U.S. Navy Safety Command as saying:

“While less dangerous on average than driving, going to sea still involves risk. The accident rate afloat has been above average for the last three years: there were eight incidents in 2022, eight in 2023, and a decade-high 10 incidents in 2024. The year’s major accidents include the loss of two Navy SEALs at sea off Yemen in January; two other man-overboard incidents; an electrocution accident on a submarine in May; an LCAC collision; and four material casualties aboard MSC sealift vdessels, which – while serious – did not result in injury to crewmembers.”

As a Navy veteran and a TapRooT® User, I would like to see a detailed accident report with facts to use in drawing a detailed SnapCharT® Diagram about the LCAC collission, identifying actual causal factors, and then using the Root Cause Tree® Diagram to dig deeper into the actual root causes and generic causes. Then we could judge the adequacy of the corrective actions. Unfortunately, we probably won’t see such a detailed report and won’t be able to judge the Navy’s response.

After all, it would be nice to have confidence in the leadership of our naval forces (in their root cause analysis and corrective actions), to have confidence in their ability to protect our Sailors and Marines.