+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| **Participants Manual**                                               |
|                                                                       |
| # SERIOUS ACCIDENT INVESTIGATION COURSE                               |
+-----------------------------------------------------------------------+
| **LESSON 6: Exchanging Information with Internal and External         |
| Entities**                                                            |
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| **INSTRUCTOR:**                                                       |
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| **Objectives:**                                                       |
|                                                                       |
| **After completing this lesson the participants will be able to:**    |
|                                                                       |
| -   **Identify key internal/external entities and the nature of their |
|     relationship to the investigation.**                              |
|                                                                       |
| -   **Exchange the appropriate information with identified key        |
|     internal/external entities.**                                     |
|                                                                       |
| -   **Understand the unique requirements of multi-agency              |
|     investigations.**                                                 |
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+--------------------------------------------+-------------------------+
| **Unit Title: Exchanging Information with  |                         |
| Internal and External Entities**           |                         |
+============================================+=========================+
| **Lesson 6:**                              | **Notes**               |
+--------------------------------------------+-------------------------+
| **MULTI-AGENCY INVESTIGATIONS**            |                         |
|                                            |                         |
| Many investigations involve cooperation    |                         |
| between Federal, State, County, and        |                         |
| Municipal Agencies. To fulfill each        |                         |
| agencies authorities and responsibilities  |                         |
| a multi-agency investigation is necessary. |                         |
|                                            |                         |
| The Team Leader should establish           |                         |
| cooperative relationships with the other   |                         |
| agencies involved in the investigation to  |                         |
| ensure that we meet our responsibilities.  |                         |
| This may involve negotiations, cooperative |                         |
| agreements, and coordination with the      |                         |
| agency DASHO or the agency official who    |                         |
| signed the delegation of authority.        |                         |
|                                            |                         |
| **ALL HAZARD/ALL RISK INCIDENTS**          |                         |
|                                            |                         |
| Agencies are becoming more involved in All |                         |
| Hazard/All Risk Incident Management        |                         |
| operations involving our employees,        |                         |
| equipment, and contract resources. When    |                         |
| accidents occur, this may necessitate the  |                         |
| need for multi-agency investigations where |                         |
| cooperation between the agencies is        |                         |
| paramount. Examples may include:           |                         |
|                                            |                         |
| -   Shuttle Recovery                       |                         |
|                                            |                         |
| -   FEMA Incidents, i.e. Katrina/Rita      |                         |
|                                            |                         |
| Also you need to understand that you will  |                         |
| be asked to provide information to groups  |                         |
| not directly related to the accident.      |                         |
|                                            |                         |
| This lesson is designed to give you an     |                         |
| idea of who these people are and what you  |                         |
| can expect from them and the importance of |                         |
| working with them during the course of the |                         |
| investigation.                             |                         |
|                                            |                         |
| **INTERNAL ENTITIES**                      |                         |
|                                            |                         |
| The first order of business for the Team   |                         |
| Leader is to identify who your internal    |                         |
| entities are and what their role is in the |                         |
| investigation.                             |                         |
|                                            |                         |
| **They may perceive their role differently |                         |
| than you do.**                             |                         |
|                                            |                         |
| A partial list of Internal Entities:       |                         |
|                                            |                         |
| -   SAIT members                           |                         |
|                                            |                         |
| -   Agency Administrator (AA)              |                         |
|                                            |                         |
| -   Agency Law Enforcement Officers        |                         |
|                                            |                         |
| -   Victims                                |                         |
|                                            |                         |
| -   Victims family members                 |                         |
|                                            |                         |
| -   Witnesses                              |                         |
|                                            |                         |
| -   Incident Commander                     |                         |
|                                            |                         |
| -   National-level contacts (e.g. National |                         |
|     Safety Office), Office of Fire &       |                         |
|     Aviation (BLM), Fire Director NIFC     |                         |
|     (NPS)                                  |                         |
|                                            |                         |
| -   DASHO                                  |                         |
|                                            |                         |
| Of **note** is the Agency Law Enforcement  |                         |
| Officer. They can be a great resource to   |                         |
| the team by securing the site, identifying |                         |
| witnesses, and helping coordinate with     |                         |
| local law enforcement and medical          |                         |
| personnel.                                 |                         |
|                                            |                         |
| **EXTERNAL ENTITIES**                      |                         |
|                                            |                         |
| In order to gather all the facts           |                         |
| surrounding an accident, it will be        |                         |
| necessary for you to go to people that     |                         |
| were not directly or indirectly involved   |                         |
| in the accident. Also, there will be       |                         |
| parties that will want information about   |                         |
| the accident that you will need to provide |                         |
| even though you may not want to. The best  |                         |
| example is the press.                      |                         |
|                                            |                         |
| **EXTERNAL ENTITIES**                      |                         |
|                                            |                         |
| (continued)                                |                         |
|                                            |                         |
| Consider the following when dealing with   |                         |
| internal/external parties:                 |                         |
|                                            |                         |
| -   Who is involved and what do they       |                         |
|     perceive their role to be?             |                         |
|                                            |                         |
| -   What expectations do they have?        |                         |
|                                            |                         |
| -   Are their political considerations?    |                         |
|                                            |                         |
| -   Are there hidden agendas?              |                         |
|                                            |                         |
| -   Will it impact the witness or the      |                         |
|     victim's family?                       |                         |
|                                            |                         |
| **OSHA**                                   |                         |
|                                            |                         |
| There are Federal and State OSHA offices.  |                         |
|                                            |                         |
| Federal OSHA offices have jurisdiction     |                         |
| over federal agencies and will have been   |                         |
| notified by the Agency or Region/State     |                         |
| Safety Office prior to your arrival.       |                         |
|                                            |                         |
| State OSHA offices do not have             |                         |
| jurisdiction over Federal employees or     |                         |
| agencies. State OSHA offices may get       |                         |
| involved if there are victims that are not |                         |
| Federal employee's e.g. State personnel,   |                         |
| contractors, volunteers, municipal         |                         |
| employee. They may also be involved if the |                         |
| accident is on State land.                 |                         |
|                                            |                         |
| Frequently OSHA will join your             |                         |
| investigation rather than conduct their    |                         |
| own, particularly in fire incidents.       |                         |
|                                            |                         |
| In all cases, cooperate with Federal OSHA  |                         |
| compliance officers. Make all              |                         |
| [factual]{.underline} information          |                         |
| available to them. See Handout 6-1 in your |                         |
| participant's manual.                      |                         |
|                                            |                         |
| Keep in mind that OSHA's mission is to     |                         |
| investigate the accident and when          |                         |
| appropriate issue the agency "Notices of   |                         |
| Violation". Your investigation findings    |                         |
| may be used as material to issue these     |                         |
| citations.                                 |                         |
|                                            |                         |
| **OSHA** (continued)                       |                         |
|                                            |                         |
| In the past they have released entire      |                         |
| witness statements of some employees       |                         |
| without any redactions. This is something  |                         |
| that we don't do. For this reason we       |                         |
| recommend that you do not include OSHA     |                         |
| Compliance Officers in witness interviews. |                         |
| OSHA has the right to request private      |                         |
| employee interviews.                       |                         |
|                                            |                         |
| It is a good idea to have the Accident     |                         |
| Investigation Advisor/Safety Manager       |                         |
| assigned to the team work with OSHA.       |                         |
|                                            |                         |
| **NIOSH**                                  |                         |
|                                            |                         |
| In 1998, Congress allocated funds to the   |                         |
| National Institute for Occupational Safety |                         |
| and Health (NIOSH) to address the          |                         |
| continuing national problem of             |                         |
| occupational fire fighter fatalities and   |                         |
| injuries.                                  |                         |
|                                            |                         |
| See Handout 6-2 in your participant's      |                         |
| manual.                                    |                         |
|                                            |                         |
| NIOSH has the authority to conduct         |                         |
| independent investigations of all on-duty  |                         |
| fire fighter fatalities.                   |                         |
|                                            |                         |
| We are required to notify them of the      |                         |
| accident. This is done by the Agency       |                         |
| Safety Manager.                            |                         |
|                                            |                         |
| They will request copies of the final      |                         |
| investigation report for their records and |                         |
| follow up with questions regarding the     |                         |
| accident to the agency to complete their   |                         |
| investigation.                             |                         |
|                                            |                         |
| **OIG**                                    |                         |
|                                            |                         |
| The Department of Agriculture Office of    |                         |
| Inspector General (OIG) has been           |                         |
| authorized by Congress to conduct          |                         |
| independent investigations of all fire     |                         |
| related entrapments or burnovers that      |                         |
| result in a fatality involving Forest      |                         |
| Service personnel. **Handout 6-3 Public    |                         |
| Law 107-203, Office of Inspector           |                         |
| General.**                                 |                         |
|                                            |                         |
| They are notified by the Agency Safety     |                         |
| Manager.                                   |                         |
|                                            |                         |
| **Other Potential External Entities :**    |                         |
|                                            |                         |
| Other potential external entities you may  |                         |
| have contact with during investigations    |                         |
| could include:                             |                         |
|                                            |                         |
| -   National Transportation Safety Board   |                         |
|     (NTSB)                                 |                         |
|                                            |                         |
| -   Federal Aviation Administration        |                         |
|                                            |                         |
| -   United States Coast Guard              |                         |
|                                            |                         |
| -   Department of Defense                  |                         |
|                                            |                         |
| **MEDIA**                                  |                         |
|                                            |                         |
| The level of media interest will depend    |                         |
| upon the severity of the serious accident. |                         |
| Coordinate all media interest with local   |                         |
| unit or assigned Public Affairs staff.     |                         |
| Identify one media contact and ensure that |                         |
| all team members refer any media questions |                         |
| to that individual.                        |                         |
|                                            |                         |
| If the incident has a lot of publicity,    |                         |
| you will probably have to give a statement |                         |
| to the press.                              |                         |
|                                            |                         |
| Manage the media, don't let them manage    |                         |
| you! Beyond the 72 hour report and any     |                         |
| Safety Alerts, little can be released      |                         |
| until the process is complete and the      |                         |
| report is submitted.                       |                         |
|                                            |                         |
| Keep in mind the media will have a         |                         |
| deadline to meet and will want information |                         |
| quickly. Some helpful tips in dealing with |                         |
| the media are:                             |                         |
|                                            |                         |
| -   Keep your information factual          |                         |
|                                            |                         |
| -   Don't speculate on causes or findings  |                         |
|                                            |                         |
| Sometimes it is helpful to have the entire |                         |
| team or certain members of the team        |                         |
| available at a press briefing. This can    |                         |
| preserve the appearance of objectivity and |                         |
| allow the team to answer questions         |                         |
| directly.                                  |                         |
|                                            |                         |
| **LAW ENFORCEMENT**                        |                         |
|                                            |                         |
| Federal, State, and/or Local law           |                         |
| enforcement may be involved in the initial |                         |
| investigation. Routinely, they will be the |                         |
| first on the scene and have pictures,      |                         |
| diagrams, and witness statements that are  |                         |
| important to your investigation.           |                         |
|                                            |                         |
| They may have taken statements during      |                         |
| their initial investigation. Don't rely    |                         |
| solely on these. Their approach to taking  |                         |
| statements is different than ours and they |                         |
| frequently won't ask the questions we need |                         |
| to have asked.                             |                         |
|                                            |                         |
| Remember the objective of the              |                         |
| investigation is accident prevention.      |                         |
|                                            |                         |
| Evidence gathered during accident          |                         |
| investigations may be utilized in other    |                         |
| official proceedings and must be processed |                         |
| correctly.                                 |                         |
|                                            |                         |
| If criminal activity is suspected notify   |                         |
| the appropriate law enforcement agency and |                         |
| the Agency DASHO. In such case, a joint    |                         |
| investigation will continue until a        |                         |
| determination has been made and the proper |                         |
| authorities determined.                    |                         |
|                                            |                         |
| **LOCAL AND STATE FIRE MARSHALS**          |                         |
|                                            |                         |
| Fire Marshals become involved when land or |                         |
| facilities under their jurisdiction are    |                         |
| involved in the accident.                  |                         |
|                                            |                         |
| Assess their involvement and need to be a  |                         |
| part of the accident investigation         |                         |
| process.                                   |                         |
|                                            |                         |
| **STATE DEPARTMENT OF LANDS/DIVISION OF    |                         |
| FORESTRY**                                 |                         |
|                                            |                         |
| Coordination with these organizations      |                         |
| usually occurs only when they have         |                         |
| resources that are involved in the         |                         |
| accident. This can happen during serious   |                         |
| fire accidents and would constitute a      |                         |
| multi-agency investigation.                |                         |
|                                            |                         |
| **NATIVE AMERICAN CREWS**                  |                         |
|                                            |                         |
| It's important to handle Serious Accident  |                         |
| Investigations involving Native American   |                         |
| crews with sensitivity and respect for     |                         |
| cultural differences.                      |                         |
|                                            |                         |
| When Native American crews are involved:   |                         |
|                                            |                         |
| -   Have the Interagency Resource          |                         |
|     Representative (IARR) attached to the  |                         |
|     crew act as a liaison between the team |                         |
|     and the tribe                          |                         |
|                                            |                         |
| -   If there is no IARR, contact tribal    |                         |
|     leaders through the BIA Agency         |                         |
|     Superintendent or the BLM Field Office |                         |
|     Manager, FS District Ranger, NPS Park  |                         |
|     Superintendent                         |                         |
|                                            |                         |
| **COUNTY,CITY, RURAL GOVERNMENTS**         |                         |
|                                            |                         |
| You will frequently be in contact with     |                         |
| these entities.                            |                         |
|                                            |                         |
| Local government officials can direct you  |                         |
| to key people and arrange for you to get   |                         |
| information that might not be otherwise    |                         |
| available.                                 |                         |
|                                            |                         |
| Local Politicians may be interested in the |                         |
| progress and direction of the              |                         |
| investigation. Ensure that adequate        |                         |
| briefings are scheduled with the local     |                         |
| unit so that the appropriate information   |                         |
| can be passed on.                          |                         |
|                                            |                         |
| Local authorities/citizens may have        |                         |
| valuable photographic evidence.            |                         |
|                                            |                         |
| Victims will usually be retrieved by the   |                         |
| local authorities.                         |                         |
|                                            |                         |
| The local Medical Examiner/Coroner will    |                         |
| likely provide the death certificate.      |                         |
|                                            |                         |
| **MEDICAL EXAMINERS/CORONERS**             |                         |
|                                            |                         |
| A Medical Examiner will be needed for the  |                         |
| autopsy. Handout 6-4 explains the          |                         |
| difference between a medical examiner and  |                         |
| a coroner. Sometimes they are the same     |                         |
| person, sometimes not. In smaller          |                         |
| jurisdictions, bodies may be sent to the   |                         |
| State M.E. for examination.                |                         |
|                                            |                         |
| SAI Teams need to coordinate with these    |                         |
| specialists to ensure they get copies of   |                         |
| death certificates and/or autopsy reports. |                         |
| Handout 6-5 is a Letter to the Medical     |                         |
| Examiner formally requesting copies of the |                         |
| official autopsy and toxicology reports.   |                         |
|                                            |                         |
| **FIREFIGHTER AUTOPSY PROTOCOL**           |                         |
|                                            |                         |
| This protocol was developed by the U.S.    |                         |
| Fire Administration for the purpose of     |                         |
| providing medical examiners and            |                         |
| pathologists with uniform recommended      |                         |
| procedures for investigating the causes    |                         |
| and contributing factors related to        |                         |
| firefighter deaths (Appendix G).           |                         |
|                                            |                         |
| While every attempt will be made to        |                         |
| provide this protocol to the medical       |                         |
| examiner at the same time the SAIT is      |                         |
| dispatched, you as a Team Leader should    |                         |
| follow up with the medical examiner to     |                         |
| ensure it was received and being utilized. |                         |
|                                            |                         |
| **Note:** Family members are entitled to   |                         |
| benefits under the U.S. Department of      |                         |
| Justice, Public Safety Officer Benefits    |                         |
| Program when "public safety officers found |                         |
| to have died as the direct and proximate   |                         |
| result of a personal injury sustained in   |                         |
| the line of duty" (28 CFR 32.1)            |                         |
|                                            |                         |
| To acquire these benefits, claimants are   |                         |
| required to demonstrate that the injury    |                         |
| resulting in death was a direct result of  |                         |
| activities performed in the line of duty.  |                         |
|                                            |                         |
| **Try to get the autopsy authorized as     |                         |
| soon as possible.**                        |                         |
|                                            |                         |
| **SOLICITOR**                              |                         |
|                                            |                         |
| **OFFICE OF GENERAL COUNSEL**              |                         |
|                                            |                         |
| The DOI Office of the Solicitor and the    |                         |
| USDA Office of General Counsel may be      |                         |
| useful as a sounding board for advice on   |                         |
| collecting evidence, releasing reports or  |                         |
| information, legalities of                 |                         |
| recommendations, etc.                      |                         |
|                                            |                         |
| **U.S. ATTORNEY'S OFFICE**                 |                         |
|                                            |                         |
| Mike Johns from the U.S. Attorney's Office |                         |
| will discuss with you his perspective on   |                         |
| the value of conducting a good accident    |                         |
| investigation and the importance of having |                         |
| a thorough and complete report. He makes a |                         |
| strong case for preparing a quality        |                         |
| report.                                    |                         |
+--------------------------------------------+-------------------------+