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Board of Inquiry - Afghanistan 2002
Documents - Final Report

Proximate Cause
What caused the injuries and deaths?

All injuries and deaths that occurred at the Tarnak Farm Multi-Purpose Range on 17 April 2002 have been attributed to the blast and shrapnel effects created by the explosion of a

500-lb GBU-12 LGB, which impacted near the firing position of 3 Section, 3 Platoon, "A" Company at 21:26:01Z. 

Primary Evidence Reference Details
Significant Incident Report 004
Capt B. Hynes, Comd LO JTFSWA
Vol 8, Exhibit 4 Initial significant incident report passed via TITAN to NDCC, Comd OP APOLLO.
Statement of Maintenance
Capt                      USAF, CIB F-16 Advisor
Vol 13, Tab 57 Maintenance review package detailing the state of the F-16 aircraft involved (Tail # 87-0324) upon inspection following mission.

The GBU-12 LGB is designed primarily to produce a blast/fragmentation effect rather than an evenly distributed pattern of small pieces of shrapnel.  As a result of this, both the size and the distribution pattern of the shrapnel produced can be unpredictable.  For each person killed or injured in this incident, the extent of injury was determined by numerous variables including, but not limited to: proximity to the explosion; the individual's location within Wadi East or surrounding area; whether the individual was standing, kneeling or prone; the direction the individual was facing; and the degree of physical protection (both equipment and terrain) from shrapnel and concussive effects. 

In general, those members who were in closest proximity to the point of impact received the gravest of injuries; certainly, had the bomb impacted in even a slightly different location, many more casualties might have been incurred. 

The following table describes the effects of the blast on the personnel involved, in approximate order of severity:

Personnel

                                                                                           
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     
                                                                                                                                     

Primary Evidence Reference Details
Statement of Events -
17 Apr 02
Capt J. Jasper
Vol 8, Exhibit 6 Describes casualty sitreps - of note, Pri "4" used consistently to describe fatality. 
Statement of Events
Sgt W. Wilson (Med A)
Vol 8, Exhibit 15 Describes personal and medical team activities in the immediate aftermath of the blast.
Examination Reports -
19 Apr 02
US DMART Team
Vol 8, Exhibit 24 Details medico-legal examination process and findings, including death certificates.
NIS Investigative Synopsis
Capt J. MacEachern
Vol 9, Exhibit 36 Summarizes particulars of casualty reporting and identity determination process.
Coroner's Report, cases 2002 - 14, 15,16,17A,
Chief Coroner Ontario
Vol 13, Tab 50 Reports post-mortem examination results for deceased members.
Testimony - 01 May 02
WO W.A. Bolen
Vol 3, Page 439 Details immediate post-impact actions, including casualty assessment.
Testimony - 01 May 02
MCpl S. Clark
Vol 3, Page 504 Describes effects of the explosion.
Testimony - 01 May 02
Maj D. Vouriot
(3 PPCLI MO)
Vol 3, Page 452 Describes participation in medical treatment.


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