35 Miles from Shore (30 page)

The Coast Guard cutter
Point Whitehorn
had remained in the search area overnight as well. The small boat had taken a beating in the rough seas. Most of the crew became sick.
⁴
They continued searching for survivors for the better part of the day. No bodies or survivors were found, though the
Whitehorn
did recover a number of items from the scene, including the rescue basket that had been cut from Bill Shields's helicopter; the four life rafts that had been dropped; as well as life jackets, seat parts, and other miscellaneous debris. A picture of some of the recovered items was published in the
Virgin Island Daily News
on Wednesday.

The search for survivors covered a wide area and involved numerous aircraft, helicopters, and ships. Low ceilings and poor visibility, however, hampered their efforts. If there were survivors still in the water, they would have seen the search aircraft flying overhead. But their prolonged submersion in the cool waters would have left them immobile, assuming they were still conscious. A person able to signal rescuers has a much better chance of being seen than an individual floating motionless in a rough sea. Despite the odds of finding anyone alive, the Coast Guard decided to continue the search at first light Monday morning.
*

D
ICK
B
AKER WAS AT HOME IN
O
XON
H
ILL,
Maryland when he first learned of the ditching of ALM 980. Dick was an investigator with the National Transportation Safety Board (NTSB). He received the initial call about the accident around 6:00
P.M
. and was told to wait for further instructions. He had no way of knowing it then, but at the very time he was learning of the accident there were passengers and crew still in the water waiting to be rescued.

Dick was one of only four men at the time to hold the title of Investigator in Charge (IIC). The IIC is the senior investigator coordinating the investigative functions for the NTSB. This includes organizing the parties to the investigation, assigning individuals to investigative groups, dealing with the press, conducting daily briefings, writing preliminary reports, and providing updates to managers at headquarters.

Dick was informed later that evening that he was to head the investigation into ALM 980. He was told to fly to St. Croix to determine how many people were going to be needed for the investigation.
Normally, the IIC would round up the people on his on-call list and head to the scene of an accident immediately upon notification. If no commercial airline flights are available, the NTSB can utilize FAA aircraft to fly to the site of an accident. Dick decided to take the earliest commercial flight, which was a morning departure on American Airlines to San Juan, Puerto Rico.

Dick arrived in San Juan early Sunday afternoon. His first stop was the San Juan Air Route Traffic Control Center. Dick knew the accident involved a DC-9 and that it had ditched in the Caribbean due to fuel exhaustion. He was aware of the failed landing attempts in St. Maarten. He also knew that the aircraft belonged to Overseas National Airways, an airline that he had not heard of prior to the accident. That was the extent of the information Dick had received.

Accident investigators are taught to not speculate about the cause of an accident before all the facts are known. At the same time, it is human nature to speculate. On the surface, this accident looked like an open and shut case. The crew tried to land at an airport in marginal weather and after multiple landing attempts ran out of fuel trying to divert to their alternate. Dick Baker, however, had been investigating aviation accidents for a long time. He knew that there was seldom a single factor involved in an accident. Part of his knowledge came from personal experience. Dick had been involved in an aircraft accident himself. Ironically, the accident involved fuel exhaustion.

Dick Baker was a former naval aviator, having spent fifteen years on active duty and five years in the Navy reserve. He had flown a variety of aircraft for the Navy, including the turbine-powered F9F Panther, which he flew during the Korean War. The last few years of his military service, Dick flew helicopters. He also flew helicopters
part time for a civilian company with the hope of getting a job when his military career ended. It was during this transition period when he was flying for both the Navy and for the civilian company when he had his accident.

Dick was flying over a densely wooded area of North Carolina in a civilian Bell helicopter when the engine suddenly quit. Dick and his lone passenger received only minor injuries, but the helicopter was severely damaged. At that time, the Civil Aeronautics Board conducted all investigations concerning civilian aircraft. Dick was eager to find out the cause of the engine failure and volunteered to assist the investigators. The first thing he and the investigators discovered was that the engine had quit due to fuel exhaustion. He had been flying the helicopter with an inoperative fuel gauge. Fuel records and flight time records, however, indicated that there should have been adequate fuel for the flight. Dick and the investigators combed over the wreckage searching for clues. Upon closer inspection, they discovered fuel stains running overboard from the fuel tank. They searched for the origin of the stains and discovered a loose fitting between the fuel tank and the engine, which allowed the fuel to leak out. Determining the cause of his own accident piqued Dick's interest in the process of accident investigations.

When he left the Navy in 1958, Dick was offered a job with the Bureau of Aviation Safety, a division of the CAB. He remained with the CAB as an investigator of both civil and commercial aviation accidents until 1967, at which time the NTSB was formed for the purpose of accident investigations.

At close to six feet tall and with a crew cut, Dick Baker wasn't that far removed from the naval aviator he once was. He was forty-nine but still looked and dressed much like he had two decades earlier, when Buddy Holly tunes ruled the airwaves and hair that touched the collar was considered long.
¹

One of Dick's first tasks when he arrived in San Juan was to determine which investigative groups were going to be needed. The NTSB uses a group methodology to conduct accident investigations. Each investigative group examines the accident from a specific viewpoint. Examples of the types of investigative groups include weather, human factors, Air Traffic Control (ATC), maintenance, operations, etc. The groups are comprised of individuals from various interested parties, including representatives of the airline, the aircraft manufacturer, the FAA and ALPA. The information derived from these separate groups forms the basis for the Board's overall conclusions.

It wasn't immediately apparent from the information that Dick had received what groups would be needed. For example, since there was no wreckage, did they really need a structures group? Dick decided that there was no need for a structures group, though one of the investigators was given the task of examining aircraft parts that had been recovered from the water. One group that should have been formed but was not was the maintenance records group. The oversight wouldn't be discovered until weeks later, giving ONA ample time to correct any deficiencies in the paperwork concerning the fuel totalizer and the work done on the fuel probes.

With the investigative groups identified, Dick called Washington to notify his go-team. The go-team was the name given to the individual investigators who would later head up the separate investigative groups. Team members began arriving in San Juan on Sunday evening. Dick and the rest of his team flew to St. Croix on Monday afternoon and set up operations at the airport. They also began the process of assigning individuals to the various investigative groups. The delay in getting the investigation teams in place hampered the investigation to a degree. By Monday, many of the surviving passengers had already left the island or were planning to leave the next day. Interviews with survivors were limited to the passengers on hand at
the hospital or those still at the St. Croix airport. The investigators did manage to get written statements from a number of eyewitnesses who were on the ground at St. Maarten during the failed landing attempts. Those statements would later challenge the weather reports given to the crew by the controller at St. Maarten.

Ed Veronelli learned early Monday morning that he was to fly to St. Croix with Steedman. He hadn't even had time to go home and pack. He had to buy a suit jacket and some shirts on a stopover in San Juan. Accompanying Steedman and Ed on the flight on Monday morning were Steve Lang, a lawyer for an outside firm that represented ONA, and Assistant Vice President of Legal Bob Wagenfeld.

That evening after arriving in St. Croix, they had dinner with Balsey, Harry, and Hugh. They ate near the beach at a table as far from the crowds as they could find.
²
Condolences were expressed, but little was said about the accident. Steedman, in the presence of the two lawyers, was especially guarded in his comments. The pastel-colored shirts and tennis shoes worn by the three ONA crewmembers stood in stark contrast to the business attire worn by Steedman and the lawyers and only added to the awkwardness of the meeting.

On Tuesday, additional ONA managers arrived in St. Croix, including Ed Starkloff, Milt Marshall, and Ed Leiser, the Superintendent of Maintenance. That morning they met with the NTSB investigators and were assigned to different investigative groups. Ed Veronelli was assigned to the human factors group. The primary focus of the human factors group is crash survival analysis. One of Ed's tasks was to interview survivors at the hospital in Christianstead. This was Ed's first experience with an accident investigation, and he found the job unsettling. One passenger they interviewed was Gloria Caldwell, the woman who had lost her husband
and two little girls. When Gloria learned that Ed was with ONA, she asked him to leave the room and refused to answer any questions until he did. From that point on, Ed identified himself only if asked.

Ed listened carefully as passengers described seats being ripped from the floor and seatbelts failing. He heard complaints about passengers not having adequate warning prior to impact. He heard about difficulties with finding, opening, and donning life vests. Several passengers reported that the life vests were inadequate for the conditions that existed, claiming that the vests rode too high around their necks, restricting their breathing and funneling water into their faces. Some stated that the life vests failed to keep their heads above the water.
*

The Coast Guard had recovered a number of life vests both from the water and from the Coast Guard helicopters used in the rescues. The vests were in fairly good shape. Some were still partially inflated. The lights on some of the vests were still working.
^†
Dick Baker and several other NTSB investigators took a half dozen of the life vests to do some preliminary testing in a pool back at the hotel. They first wanted to see if the vests would right an unconscious person in the water. They discovered that they could only right themselves by using their arms and legs. Once they were righted, however, they didn't have any problems with the vests riding up their chests like many of the passengers had stated. But there were some major differences between their test conditions and the conditions that existed the day of the ditching. First, they were in a hotel pool in a controlled environment, and they had more than five minutes to properly don the vests. Secondly, they performed their tests wearing swimming trunks.
Had they been fully clothed, in salt water, and in rough seas, they might have reached some very different conclusions.
³

Each morning the members of the various investigative groups met at the airport to discuss their findings from the previous day and to map out what needed to be done next. Dick Baker was to oversee the meetings. The progress meetings were an opportunity for the individual investigative groups to share information and additional leads.

By the end of his first day with the human factors group, Ed Veronelli had heard enough sad stories that he asked to be reassigned to one of the other investigation groups. He was subsequently reassigned to the ATC group. He left for San Juan on Wednesday to listen to the ATC tapes containing the communications between San Juan Center and ALM 980.

Part of Dick Baker's job was to do a cost benefit analysis on certain aspects of every investigation. When it came time to make a decision on whether to attempt a retrieval of the cockpit voice recorder (CVR) and the flight data recorder (FDR), Dick determined that the data that might be retrieved was not worth the cost of retrieval. The plane had ditched in waters that were five thousand feet deep.

The flight data recorder on the DC-9 was rudimentary compared to the digital flight data recorders found on today's commercial aircraft. The actual recording was done by a stylus that engraved traces of the recorded parameters on a continuously moving metal foil. The only flight parameters recorded were airspeed, altitude, heading, and g-loads. The engine and fuel readouts were not recorded. Still, it would have been useful to have the data to compare with the recollections of the crew with regard to the approaches at St. Maarten and the subsequent diversion. The FDR records the last twenty-five hours of flight and thus would have recorded the entire
flight. The cockpit voice recorder would have been even more valuable, having captured the last thirty minutes of conversation inside the cockpit. This would have covered all three landing attempts and the ditching. Whether there was even technology available that would have made retrieval possible was never discussed, though Ed Starkloff was approached by a representative of a salvage company who offered to retrieve the aircraft for one million dollars. Starkloff politely turned him down.
*

T
HE STORY OF THE DITCHING WAS FRONT-PAGE NEWS
for the major papers in the Caribbean and several papers in the U.S., including the
New York Times
. Early news reports of the accident, however, were fraught with errors. Several papers gave erroneous numbers for passengers who were listed as either missing or dead. The
San Juan Star
on May 3 reported 37 rescued, 26 missing, and one dead.
*
Some papers reported that the flight had originated in St. Maarten. A passenger list provided by KLM contained several errors that were never corrected. The errors included the names of passengers who were not aboard the flight and numerous misspellings. Loretta Gremelsbacker was not listed on any passenger list. Gene Gremelsbacker's sister, Ellen, who was supposed to have been on the flight but had canceled at the last minute, was listed on the passenger list as Elly Gremelsbacker. Rick Arnold was listed as Reginald Arnold. A number of papers reported that two
infants on the flight were missing. The reports were referring to Jennifer and Kristin Caldwell, whom most passengers remembered as being between the ages of four and five.