Coast Guard Issues ‘Final Action Memo’ on El Faro Investigation

The El Faro is shown in this undated handout photo provided by Tote Maritime in Jacksonville, Florida, October 2, 2015. Photo: Tote Maritime

The U.S. Coast Guard on Thursday released its Final Action Memo on the loss of the El Faro and its 33 crewmembers during a hurricane near Crooked Island, Bahamas on October 1, 2015, essentially making official the Coast Guard’s findings from its investigation into the casualty. 

Commandant of the Coast Guard, Adm. Paul Zukunft, approved in the Memo the findings of fact, analysis, and conclusions detailed in the Marine Board of Investigation’s Report of Investigation, which was released in October exactly two years after the cargo ship sank. 

Following the Commandant’s review of the ROI and comments received from Parties in Interest and families of the crew, he concluded that the primary cause of the casualty was the decision to navigate El Faro too close to the path of Hurricane Joaquin.

The Memo also listed several contributing factors.

Contributing factors include: (1) an ineffective safety management system within the operating company, TOTE Services, Incorporated; (2) American Bureau of Shipping’s failures to uncover or otherwise resolve longstanding deficiencies that adversely affected the safety and seaworthiness of vessels on multiple occasions; and (3) failure of the Coast Guard to adequately oversee the third party in this case, and the investigation reveals that the Coast Guard has not sustained the proficiency and policy framework to do so in general.

“The loss of the El Faro and its crewmembers was tragic and preventable. The Coast Guard will take appropriate action on all that we have learned from this investigation,” said Zukunft. “I thank the members of the Marine Board of Investigation for their exhaustive work and independent recommendations. El Faro’s heartbreaking story points to the need for all maritime stakeholders to zealously recommit to both the safety of our mariners and to professionalism of the maritime industry.”

In addition to investigation findings, the Final Action Memo also outlines the final agency actions that will be taken in response to the Board’s recommendations. Rear Adm. John Nadeau, the assistant commandant for prevention policy, will lead the Commandant’s efforts in response to the recommendations.

“The tragic story of the El Faro points to the need for a strong and enduring commitment from all elements of the safety framework: vessel owner, Authorized Class Society, and the Coast Guard,” said Nadeau. “As the lead agency of the U.S. Flag Administration, the Coast Guard is ultimately responsible to monitor the performance of third party organizations entrusted with the safety of U.S. ships. The Coast Guard takes the implementation of the safety recommendations in the Commandant’s Final Action Memo very seriously and is committed to providing sustainable policy, oversight, and accountability both internally and externally.”

The U.S. Coast Guard’s Final Action Memo and its enclosures are available for download from the Coast Guard’s digital FOIA reading room.