Autopsy of an Amphib

A deep dive into the Bonhomme Richard Fire Report.

A fine ship...

USS BONHOMME RICHARD (LHD-6) in better days.

There may have been other articles written in response to the official redacted report – but I haven’t looked for them – the official report is enough for me <warning – 50+ mb file>.  I will confess that at the time, it was easy for me to dismiss the entire incident as a disgruntled sailor committing arson (it would not be the first time and it won’t be the last) – although that is looking less and less likely.  Similarly, the [easy to swallow] claims that additional “woke” training and COVID mitigation processes diverted attention and resources from important damage control basics – while attractive on the surface – do not appear to hold any real validity upon an examination of the facts of the case.

Apparently this full report was publicly released around the same time as the Major Fires Review report (a significantly smaller file) – but for whatever reason, the links I followed at the time only lead to the Major Fires report – which summarized findings from 15 prior incidents over the 12 years preceding the Bonhomme Richard (BHR) fire.  Both reports are well worth the read, but I will be focusing on the BHR file for this article – it does have a lot of pictures for the crayon-eaters out there.

If nothing else, the thoroughness and rapidity with which this report was both compiled and publicly released is a good sign that the Navy is serious about addressing the underlying factors – however embarrassing they are shown to be – and trust me – it’s bad.  It should also be noted that although NCIS and the ATF (boo!) took over the initial [criminal] investigation once arson was suspected, this report (among other recent findings) avoids theorizing on the absolute specifics of the fire’s origin (although there are still significant obvious faults) while focusing on the bigger picture.

BLUF (Bottom Line Up Front) – the CO, the XO and the ship’s crew done fucked up big time.  A lot of other people fucked up to a lesser extent, but this was completely avoidable and in no measurable way exacerbated by COVID protocols or woke training.

Strangely no McCain's were involved....

Some point in time on 12 July 2020.

A little more background – as I briefly mentioned in my previous SWO-Life articles – during my two afloat tours, I spent over 12 months in dry-docks (public and private) in addition to many more months of routine maintenance pier-side.  During those long periods, it is very easy to get complacent about certain types of things, or…in my case, particularly going into the dry dock a month after you check aboard your first ship – remain ignorant about some of the basics – for longer than should really be the case.  That said – during my time in OCS earlier in spring 2010, we did have both a course in firefighting training (complete with full ensemble and hose manning) and flooding training aboard USS Buttercup.  It should be noted that only in times of absolute emergency will an officer likely be directly assigned to a flooding party or firefighting party, but as it is for rifle qualification in the army/marines – every sailor is a firefighter.  (I had a second session of shore-based firefighting training at a commercial ship firefighting facility in Seattle in 2011 or 2012 – which kept me qualified through the date I left my second ship in 2014).

The report also emphasizes the fact that fighting a fire at sea is something we continually train for and that we are far, far better equipped to do than pierside during a maintenance availability.

To be perfectly honest, now as I look again at this 434 page report…it’s hard to know where to start in terms of summarizing the key points.  It’s more than worth the full read if you have the time – it’s not very dry and there are plenty of glossaries and references, but let me try and pull out a few of the multitude of findings to go over in more detail.  Some of the criticism is positively withering and it makes you feel good to see things called out so clearly and concisely almost as bluntly as I would like to do in a similar situation – I seriously think that the top cover on this one let the writers get away with a lot more than we might otherwise expect to see).

Top. Men.

Definitely overqualified to manage a project like this.  Recipe for success.

The CO, XO and the rest of the chain of command had no awareness of the shape of their crew or the condition of the ship as they progressed through an extended maintenance period.

When it comes down to it, this may be the most damning element of the situation.  The CO always bears ultimate responsibility for his ship – the only exceptions being for weirdly specific navigation issues such as traversing the Panama Canal or the entrance/exit from a dry dock – which require absolute precision from 3rd party operators coming onboard the ship (see the segment on “pilotage“).  As a big deck amphibious ship, BHR spent a lot longer in its maintenance availability than either of the ships I served on (albeit significantly less than would be involved in a Carrier refueling) – and as is normally the case, some work got delayed and the availability was extended as additional issues were found that needed to be addressed – although from what I’ve seen, in this case they completed the dry-docking period on schedule and it was only the remaining pier-side maintenance that was extended.  The CO and his command team had no visibility of the situation on their ship.  They were not involved in routine qualification measures – such as “boarding” officers to stand Command Duty Officer (CDO) watches.

The CDO role (in port) is second only to the Officer of the Deck (Underway).  They are effectively in command of the ship when the ship is in port and the CO is not aboard.  They are responsible for managing the routine operations of the ship and potentially – in a wartime or other emergency – even getting the ship underway without the CO present.  Neither the CO or XO were involved in holding boards to qualify their officers (nor were they aware of the disposition of their crew) – in fact the officer standing CDO the day of the fire was standing it for the first time after receiving his qualification (and he actually gets called out for exemplary decisions *under the circumstances*).  There were other, more senior officers also qualified and assigned to the same duty section – but for whatever reason, members of the duty section were permitted to leave the ship during their duty day (and of course missing personnel contributes to significant issues when you’re trying to gain accountability during a fire).  In my own experiences, this was frequently permitted – but only for the purposes of going to buy food or other brief appointments – certainly never overnight.  Similarly, the duty section turned over without verifying that enough personnel were present, much less the members of the Inport Emergency Team – and there was zero senior oversight of the watchbills themselves – a more experienced CDO (at least on the ships I served on) would not have assumed the watch from the off-going CDO until the standard was met and would have notified the XO/CO of the situation.

I see nozink!

Fire hazard? What fire hazard?

I’ll grant you that a Wasp Class LHD is significantly larger (with a larger crew) than any ship I’ve been directly assigned to before – and I haven’t spent any significant amount of time on a similarly sized ship until my inspections this past summer – but I am still used to a command structure that wanted to stay on top of issues (and informed) – particularly when preparing to come out of a maintenance availability – and ALWAYS when it involved massive safety issues.  By sweating the small stuff (appropriately), you don’t have to sweat the big stuff (generally speaking).

You're doing it wrong

If only that were firefighting foam….you really don’t want to watch the aluminum superstructure melt and flow through the deck of the ship.

Similarly, the report highlights a large number of significant material faults that were either ignored or misunderstood.  To go back to the standards of Navy maintenance availability – it is routine to have a meeting at least once a day between ships representatives, navy civilians and contractors to go over the current status of outstanding jobs – particularly high visibility issues such as damage control equipment, electrical systems, engineering gear, etc – to provide updates and coordinate which spaces on the ship will need to be accessed while conducting this work, etc.  It is not normal for the CO or XO to attend the daily meetings (although my XOs often did) – they will normally have at least one weekly higher level meeting that they attend – but from all indications – this was not happening.  Key material issues on the ship during the time leading up to the fire – and exacerbating the firefighting efforts – that I do not believe a reasonable Commanding Officer would have permitted – include the following:

–  A firemain (firefighting water system) that was not remotely fully functional – but which nobody apparently knew the official status of – and none of the fireplugs – particularly in the critical area – were actually functional (or had the necessary operating equipment present).

–  An AFFF (Aqueous Film Forming Foam) firefighting system that was not properly functioning and which the operators were not aware would not operate remotely as designed.

–  No functioning internal communication system between key watch stations including damage control central/engineering/damage control repair lockers/the quarterdeck/etc. – personal cell phones should NEVER be a primary means of communication on a ship for OPSEC reasons – there are multitudes of areas (esp on a ship like this) where there is no reception).

–  No backup generator available in case of a loss of ship or shore power.

–  Damage control repair lockers without power and/or communications.

–  Improper stowage of flammable materials and associated equipment in locations they should not have been, authorized without any apparent oversight or awareness of the relevant departments.

Just gotta slap a little paint on it and it'll look good as new

All about scale.

Similarly, during maintenance periods – as in other in-port periods – it is routine for the duty section to conduct Anti-Terrorism Force Protection (ATFP) and Damage Control drills *daily* after the end of the normal duty day.  I’m not gonna lie though – these suck donkey balls – and all the more when you’re in a maintenance availability.  It’s really easy to get rote and overly familiar and play these by ear – you can’t access a lot of spaces you would normally deal with – especially if you were underway – and due to all the hoses and cables, etc running through the ship for contractor services, you can’t even simulate properly setting fire/smoke/flooding boundaries – which makes the whole thing often feel even more surreal on a daily basis.  That the BHR crew was slacking on these is even more evident by the fact that they formally failed all of the officially mandated *special* availability fire drills that had more oversight and visibility with the shipyard and port facilities (behind schedule to boot) – but there is no evidence that the chain of command took these failures for action.

Not a great pattern

Mandated oversight fire drills and dates performed (or not as the case may be)

There’s always a lot of crew turnover during maintenance availability, but folks coming from basic training should have already had at least the basics in firefighting training – even during COVID (and by all reports they had).  More importantly, new sailors arriving at the ship were not always receiving the training specific to their situation – to include proper operation of quick release fixtures on air hoses/power lines/etc running through the ship and setting boundaries.  It’s not that sailors were arriving at the ship completely unprepared to fight a fire – it’s that the organization they checked into was not operating with an appropriate safety-oriented mindset given the ongoing nature of the maintenance availability.

Worst space in the ship for a BBQ.

If the markings aren’t clear enough – all those orange spaces – across 3 decks – are technically a single open space – accessible not by narrow hatches with simple doors, but wide ramps made to drive an M1A up and down them to access the flight deck or well deck.

In the end, the fire started in one of the worst possible locations on the ship in terms of setting fire/smoke boundaries and isolating – but it was still manageable IF the sailors assigned to the watchbill were on the ship, firefighting equipment was fully operable and working communications were present (or a few variations of that combination).

As it is, we lost multi-billion dollar warship – thankfully with only a few injuries and no deaths (by the grace of God) – due to a perfect storm of completely avoidable factors.

Harder than it looks.

Pic makes it look easy, but these Navy pilots were only certified for daytime dropping water on land fires (for CA) – they wound up doing hundreds of precision night drops over the course of the fire in a very smoky, congested airspace – big brass ones.


If you have the time – I *highly* recommend reading the report in full.