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Reviewing the Charleston, South Caroline fire

By Andrew Pollack on 11/15/2007 at 09:25 AM EST

A tough evening last night. As part of our monthly officers meeting at the fire department, we listened to a good portion of the radio traffic from the tragic fire in Charleston, South Carolina last August. We also had some photographs and location markers to see where things happened. In that fire, nine good men died. Before I talk much about what seems to have gone so terribly wrong, I want to point out a few things.

1. It is much easier to criticize the incident after the fact, than to manage it as it happens.
2. Several different formal investigations are not complete.
3. The complete minute by minute analysis of the event is not yet available.


The point of going through this process is not to further humiliate those responsible, to cast more blame, or to pile on with calls for resignations or retribution. There is plenty of that going on, and it will continue.

The reason we do this is to figure out what we are doing now or would have done in that situation that could have had the same outcome. We want to know if there is a flaw in our procedures, something we're missing that could let this happen again. Out of this process has come nearly every advance in safety procedures in the history of firefighting. Even things like standardizing hose fittings can be traced back to an analysis of the famous Chicago Fire. In our department, we use a RIT (Rapid Intervention Team) approach and have practiced new large area search techniques as a direct outcome of incidents in Pittsburgh, PA and Worcester, MA.

So, all that said, let me talk a little about what we hear on this audio.

First of all, most of what we hear is very confused. Some of what we here is very distressing, and while I see the need to release this audio to the public, I don't think most people should really be listening to it just out of curiosity without understanding that good men died here and respect needs to be foremost in mind. We hear a couple of mayday calls, a last message to a wife, and a brief prayer. These are profound and private things, and if they are not very hard to listen to, you should not be listening.

The call came in as a "Possible Structure (fire)" at the "Super Sofa Store". The fire appears to have started in a dumpster or something like near the back of the main building. It looks like the ranking officer on scene was part of the initial attack or very close to it, and that a utility (booster) line was brought in initially. Shortly after that an inch and a half line (a typical small fire attack line) was requested. As the fire was spreading into the main building, there doesn't seem to be any evidence of recognition that this was not going to be quickly brought under control. As the fire escalates, additional engine companies are added to the call by special request one at a time. Water supply was never well established and there doesn't seem to have been a coordinated attack. From there, things went downhill rapidly. Within half an hour there were nine men dead.

Rather than offering specific criticisms of each aspect of the incident, which I'm not nearly as qualified to do as those who will do it formally, I want to list some things that at least in our department would have been different -- assuming we followed the procedures and policies we've trained on.

1. Initial Response -- This came in as a report of a fire at a sofa warehouse. Even if there was no "pre-plan" for that building, those two words "Sofa" and "Warehouse" are very scary when combined. Firefighters know that there was probably as much or more fuel load in that building as in the gas station next to it. Once a sofa starts to burn, putting it out isn't at all easy. We call it "solid form gasoline" for a reason. In any commercial building, the apparatus and crews sent here would have been at least twice, maybe three times the number.

2. Initial Size-up -- I never did hear a size up report on the radio, but arriving on scene to find a metal trussed warehouse of that size with any hint of smoke or fire would have triggered big-time alarm bells here. It is by definition just about the most dangerous possible setting. A high roof allows the smoke and heat to build up unnoticed for a long time before flashing over, while the metal trusses will fail at those high temperatures very quickly. You have only minutes in a building like that before the roof WILL come down. It is a building that was designed to burn down, not be saved.

3. Search -- The incident started just after 7pm. Was anyone in the building? I never heard any indication that it had been verified from outside or that a rapid initial search had been made. If the building was empty, we would have let it burn to the ground while we protected exposures given that there was not adequate water supply to put it out.

4. Attack -- At least 10 to 15 minutes into this fire, the crews in the back were still basically fighting as if it were a garbage fire. Nobody seemed to be clearly in charge. Interior crews started calling for more lines. There's a call for a two and half in line to be brought in through the front door. This would have meant (1) driving the fire toward the other attacking crews, (2) going well over 200 feet through a building to get to the fire, (3) opening the front door and adding fresh air to the fire.

5. Rescue -- There was one rescue made. A man called from his cell phone pleading for rescue. He said he was "in the back". Dispatch told him to stay low, that they were coming to get him. The man told dispatch he was banging on the wall with a hammer. A rescue crew (apparently from another town, there on mutual aid) cut through a wall and did get him out.

6. Ambulances & Medical Help -- The dispatcher called for an (as in one) ambulance as the rescue was taking place.

7. The first lost firefighter -- A firefighter is heard on the radio saying he'd got separated from the line (the hose line). In a building this size, that's very close to a death sentence. I learned from my Deputy Chief last night of a study done (in Phoenix I think) that showed every single time a firefighter is more than 150 feet into a building and separates from the line, it will lead to a fatality. As far as I can tell from the radio -- nobody heard him. There are phone calls to dispatch (from other firefighters or public listening to scanners) begging someone to go looking. This was confused with the other rescue. It doesn't sound like any action was taken.

8. The mayday call -- There is a mayday call, but it doesn't contain a location or air status. Nobody responds to it at first. After a bit (its hard to tell how long) someone (the chief?) tells everyone to get off the radio so they can hear.

9. Accountability -- I don't mean blame. I mean "who is doing what, where". We practice this constantly and I don't think I'll ever be comfortable that we're great at it. Its very very hard. In effect, a unit should always be together within visual or aural range of each other. The leader of each unit (company, team, group, whatever) should have a count of people and always be ready to respond to a call for "PAR" (personnel accountability report) with that number. PARs are taken periodically. We try hard to follow this practice. In this incident, once things go to hell, they start calling for people and you hear things like "Anyone from engine <x>" for three different companies -- no response.

10. Evacuation -- forgetting about what they were doing inside anyway, there was never an evacuation order.

11. RIT (Rapid Intervention Team) -- There doesn't seem to have been one.

12. Safety -- Even at a house fire, we establish an officer watching each side of the building. The idea is to stand back and watch the conditions change. In this case, it looks like even the person nominally in charge was directly involved in the initial attack and no command post seems to have gotten established.

What this all seems to point to, as was pointed out by another officer last night, is a reactive approach. The "command" (if there was one) was reacting to events as they happened. While many of the people on scene must have known that things were going wrong, there doesn't seem to be a command recognition of that fact and action taken until after about 20 minutes when the conditions rapidly changed and flashover or rollover ripped through the building killing several people. Personally, I suspect this will be found to have something to do with opening that front door -- but it was inevitable from the minute those sofas were on fire in that building.

Let me close by saying that this is all based on limited information. We don't know if the Chief of Department was directly involved early on. We don't know if the Battalion Chief who arrived first ignored procedures and training or if in fact the department simply didn't have procedures and policies in place and the training to back them up. We do know that most or all of these deaths should have been preventable. The final NIOSH report will be interesting and devastating reading.

If you want to learn more about the fire, or for some reason you feel the need to listen to the radio traffic, you can find it here:

http://www.charleston.net/news/2007/aug/11/anguish_courage/

If you do listen to it, I suggest you try comparing with the radio traffic from our department at recent events.

http://www.secondsignal.com/secondsignal/sshome.nsf/html/in-action.html

If you listen to the 2 Alarm Structure Fire from December 5th from that site, it makes an interesting comparison. Its a much smaller building, but the decisions made clearly illustrate the points I'm making above. You'll hear clear command traffic, accountability, RIT, resource control (water supply), and safety procedures being used. We are, of course, just a small town volunteer department and not a big city career one . That is what is so aggravating about listening to the incident in Charleston. We expect better from the leaders of a career department that what is displayed on that tape.


There are  - loading -  comments....

re: Reviewing the Charleston, South Caroline fireBy Ian Randall on 11/20/2007 at 01:11 AM EST
Andrew, I am a Notes Consultant from Australia and an ex-volunteer fire
fighter, so am interested in your Second Signal experiences.

I can't comment on the Charleston fire which sounds like a terrible incident,
but two weeks ago at a Health & Safety Conference that I attended in the middle
east (Doha in Qatar), Bob Woodward, the Senior Investigation Manager for the
Bouncefield Oil Depot Fire in London UK, which as I understand it, is the
largest fire in the world since World War Two made a presentation about this
incident.

Fortunately no one was killed in this incident because the explosion happened
at 6:00 on a Sunday morning, but over 20 people were injured and the smoke
cloud hung over London for weeks after the fire was finally extinguished (with
250,000 litres of foam), and was clearly visible from space and far away as
southern Spain.

The incident is still to be resolved in the courts, so Bob was formally
reserved in his public comments, but later during the evening drinks he opened
up and was more candid with me about what actually happened.

The problem started with the failure of a large fuel storage tanker to detect
that it had reached full capacity from the main inlet pipeline, so several
thousand gallons of aviation fuel overflowed the top of the tank and
u201Cwaterfalledu201D over the edge of the storage tank for about 15 minutes.

About half way down the tank the waterfall of aviation fuel struck a seam
protruding from the side of the tank, and the waterfall turned into a heavy
mist of air and aviation fuel. This fuel/air mist accumulated between the tank
and a lower metal wall that circled the storage tank.

The air temperature was just below zero and there was almost no wind at that
time of the morning.

The investigators still don't exactly know what the ignition source was, but
have identified two possible sources. But the closest possible ignition source
was at least 180 metres away from an electrical motor located in a pump station.

What this means is that the fuel/air mist must have stayed in an explosive
concentration for 180 metres, a distance that was previously considered
impossible.

The shock wave from the explosion destroyed everything for several hundred
metres in every direction, and the resulting fire spread to over 20 fuel tanks
in the Depot. Commercial Buildings positioned several hundred meters away
suffered heavily damaged by the explosion, and the Bouncefueld Oil Storage
Depot is still not operational some 2 years after the fire. Since this was the
main source of aviation fuel for both Heathrow and Gatwick Airports near
London, this is still a big deal.

This disaster will also have a huge impact on planning and zoning regulations
in Europe and around the world. It also highlights that misted fuel can travel
much, much further than previously considered possible, particularly when the
temperature is sub-zero and wind conditions are very light.

I wonder how many disaster plans will need to be revised with these conditions
in mind?

I am doing lost of work with LNG Processing Plants around the Gulf at the
moment, and this incident has certainly made me rethink what I consider to be a
safe distance.

Keep safe.
re: Reviewing the Charleston, South Caroline fireBy Ian Randall on 11/20/2007 at 07:46 PM EST
Sorry, need to make some correction of facts.

The estimated quantity of fuel spilled was between 300 and 400 Tonnes of
petroleum spirit.

40 minor injuries, none serious.

22 tanks engulfed in fire.

Facility had consent to store approx 196,000 Tonnes of fuel. Exact quantity of
actual fuel stored on site at the time of the incident is not known.

The fire is believed to have started in tank 912.

Calculations showed that tank was full at 0520 hours.

CCTV Evidence shows overflow of vapours from bund between 0540 & 0600 hours.

Tank fitted with independent high level alarm.

High overpressure.

Lack of confinement.

Explosion mechanism still being investigated, but could involve multiple
ignition sources.

High personal safety performance is no guarantee for good major accident hazard
control.

Some evidence of missed or deferred inspections.

The M1 Motorway (The main freeway connecting London to the north of England)
was closed for an extended period of time due to it's close proximity to the
site.

Many of the planning decisions made by Government in allowing other Commercial
buildings to encroach on the Depot site over the last 30 years had been made on
the assumption that a fire and explosion of this magnitute could never happen.
re: Reviewing the Charleston, South Caroline fireBy Charles Robinson on 12/26/2007 at 01:46 PM EST
Thanks for taking the time to offer an insider's perspective. I live in
Charleston and have seen the news reports, but it's hard to know what is normal
and where the real failures are without having some specific knowledge. Pretty
much everyone agrees that the tragedy was completely preventable had there
simply been better ground command. The lawsuits keep coming over a year
later. For anyone who comes across this post and is interested in learning
more, the Charleston Post and Courier newspaper has a special website dedicated
to the event: http://www.charleston.net/news/firefighters/


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