Mass Casualty Incident Occurs when Duck Boat Sinks in Rural Missouri — Local Fire Protection Districts Lead Response and Recovery
On July 19, 2018, a duck boat capsized and sank in Table Rock Lake, killing 17 of the passengers onboard. The duck boat was battling high-velocity winds and crashing waves during a particularly bad thunderstorm around 7:00 p.m. the night of the incident. The duck boat, a modified version of the World War II-era DUKW amphibious vehicle that operates on land and water, was at capacity with 31 people onboard. None of the passengers were wearing life jackets or personal floatation devices (PFDs) when the vessel sank. This tragic event required a complex joint response from multiple agencies in the area.
Mike Moore, the Deputy Chief and Training Officer for Southern Stone County Fire Protection District (SSCFPD), was in a meeting at the district headquarters when he received the dispatch call that a duck boat had sunk off the shore where a popular riverboat cruise, the Branson Belle, was docked. The Southern Stone County Fire District (SSCFPD) is geographically wide and long, covering 280 square miles of land in the southern parts of Stone County, Missouri. Table Rock Lake is mostly located in Stone County and is widely referred to as part of Branson, Missouri. Branson, however, spans across 2 counties: Stone and Taney Counties. The location at which the duck boat sank borders the Western Taney County Fire Protection District's jurisdiction. A small peninsula near Table Rock Dam is within SSCFPD's jurisdiction, which means that when the Branson Belle is in dock, it is considered to also be within SSCFPD's response area. Once it leaves port, however, it is within the jurisdiction of the Western Taney County Fire Protection District. Responders followed the same jurisdictional borders established for the Branson Belle during the mass casualty response; this geographical distinction meant that both Southern Stone County and Western Taney County Fire Protection Districts responded to the duck boat incident in coordinated joint action.
While en route to the incident, Moore and his colleagues tried to gather all the information they could. The duty officer that day preemptively declared the situation a mass casualty event, given available details and the state of the weather. Moore recalled crossing over Table Rock Dam and watching the waves crash onto a rockface near the Army Corp of Engineers' Dewey Short Visitor Center. He had never seen anything like the wave height and intensity that was coming off the lake that evening.
When SSCFPD arrived on scene, the Branson Belle was in dock, with passengers aboard, after having delayed a scheduled excursion due to weather and wind conditions. Moore served as the Operations Section Chief (OSC) and was the first person to arrive at the Branson Belle. As he parked next to its berth, he was struck to see multiple PFDs floating in the cove around the riverboat. At first, he thought there were a lot of people in the water — however, once he got closer, Moore realized that there were no people in the life jackets.
When he arrived on scene, there were already 3 cardiopulmonary resuscitations (CPR) in process onboard the Branson Belle. Civilians had jumped in the water to attempt to rescue the duck boat passengers. It is lucky, noted Moore, that more people were not lost due to the wave and wind conditions. A diver from a nearby marina was also in the water, diving off a platform pontoon boat, to look for wreckage and survivors. Response boats had issues maneuvering around that platform, and all these factors made it difficult for responders to tell who exactly was in the water.
Regardless, first responders continued to pull survivors and deceased individuals out of the water. Of the 31 passengers aboard the duck boat, 17 perished. Moore described the first 30-60 seconds after he arrived on scene as “mass pandemonium,” in which SSCFPD had difficulty accurately assessing the scene. For the entire first hour of response, SSCFPD could not account for everyone with certainty.
The Western Taney County Fire Protection District also responded to the scene and took joint responsibility for response and recovery efforts alongside SSCFPD, since they were used to working together. A Western Taney County battalion chief and Moore relayed what was happening on scene back to the command post. Some survivors swam to the berthing of the Branson Belle and responders helped them out of the water.
The district's two Marine Division fire boats responded in the water during the storm. SSCFPD's marine division was assisted by Western Taney County's fire boat on the water. They worked with Mercy Emergency Medical Services (EMS) and the Taney County Ambulance District (TCAD) paramedics to triage and tend to the wounded.
The rescue efforts shifted to recovery once responders realized the extent of the fatalities, recalled Moore. After SSCFPD completed the initial response and recovery, the sheriff of Stone County became the Incident Commander and began an investigation into the accident. The National Transportation Safety Board (NTSB) also conducted an independent investigation.
SSCFPD responders were faced with multiple storm-related and human health emergencies in the middle of a highly unusual and tragic boating accident. Moore said that everyone “did a fantastic job” of mitigating casualties where possible. SSCFPD's initial response and recovery lasted from around 7:00 p.m., when Moore received the dispatch call, to nearly 2:00 a.m. At the close of his initial involvement, Moore left the duck boat accident site to assist with a structure fire that was ongoing through the early morning hours.
SSCFPD operates in a rank structure, including the Chief for the district, 3 Deputy Chiefs, and 2 Battalion Chiefs. Once a particular company or chief officer is assigned to an incident, the dispatcher is responsible for “broadening the net” to increase response capacity. This means assigning battalion units to respond to incidents wherever capacity is needed most, which is what occurred during the duck boat incident response.
SSCFPD also uses the Incident Command System (ICS) and the Fire Accountability System in their operations approach. The Fire Accountability System includes tools such as an accountability tracking board, through which individual responders are assigned roles and functions during a response, and personnel accountability tracking tags, to attach to the board while activities are in queue or in progress and to remove from the board once the task is complete. Within the accountability structure, the Incident Commander (IC) assigns a Personnel Accountability Officer, who ensures that all responders are accounted for during an emergency response.
During response activities, SSCFPD follows a standard operating procedure (SOP) guideline that covers mass casualty incidents. While the SOP did not cover duck boat accidents specifically, “a good guideline is able to cover a multitude of different types of situations,” said Moore. Responders within the district are trained for these events, both in their initial training and as part of ongoing training.
Because of their training, SSCFPD had a working understanding of triage. At the time of the duck boat incident in 2018, SSCFPD was using the Simple Triage and Rapid Treatment (START) method. Following the incident, SSCFPD evaluated what in their SOP needed to change; most of the changes focused on emergency medicine and triage. SSCFPD has evolved since the duck boat accident, Moore noted, and in 2022 they operate along the Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT) triage methodology.
Response and Recovery
Building upon their existing territorial understanding, first responders at the scene of the duck boat accident agreed that SSCFPD would handle anything to do with recovery on land. This included placing casualties; administering first aid; beginning triage; and staging units, personnel, and medical supplies. Western Taney County Fire Protection District would handle everything on the water. This decision was natural, said Moore, as it simplified a highly complex event by establishing clear boundaries and allowing responders to maintain the span of control. Otherwise, both entities would have been attempting to handle both roles, which could overwhelm and undermine response capacity.
Moore was responsible for helping locate additional response capacity and coordinate the response at the scene of the accident. He also called upon mutual-aid response partners to assist SSCFPD in responding to other emergencies while their capabilities were overwhelmed. Branson Fire and Rescue as well as Western Taney County Fire District units provided firefighting capacity for structure fires that night. Moore also directed where responders in boats needed to go, so that they could recover survivors and victims from the incident. One of SSCFPD's fire boats was used to help secure the area on the water and keep onlookers at a distance. Mercy Health Systems and Mercy EMS provided and set up mobile morgues at the scene of the duck boat accident.
Initially, responders were unsure of the position of the duck boat in the water. It was difficult to find its resting place, so underwater responders were brought in. The duck boat was later determined to have been only 75-100 feet out from the dock when it sank 40 feet under. It then rolled down a sloped shelf to the lake bottom, resting at an 80-foot depth. Missouri State Highway Patrol divers were able to follow the tire tracks left by the duck boat as it rolled into the deeper water.
Responders on the scene at the duck boat accident felt the tragedy of the night. There was nothing that responders could do to change the outcome of what had already occurred, explained Moore. In remembering this incident, Moore said that the responders were “thrown into it with optimism.” While everyone can think of a “worst-case scenario,” the responders on scene tried to be as optimistic as possible about the outcome. Moore said he always tries to find a positive spin during a disaster; however, he quickly realized how tragic the duck boat accident's impact would be for his community.
Each responder dealt with the tragedy differently. For some, post-traumatic stress disorder (PTSD) affects them every year around the anniversary of the duck boat accident. Other were able to process and normalize their grief and trauma following the incident. The responders at SSCFPD, Moore noted, were resilient. As part of the post-incident analysis, SSCFPD held a Critical Incident Stress Debriefing (CISD), a facilitator-led group process that allows responders to process a traumatic event and reflect on their thoughts and emotions with others who have been through the same experience. Multiple agencies held a joint CISD for responders in the community as well.
The community surrounding Table Rock Lake provided support and appreciation for the first responders who responded to or assisted with the duck boat accident. Churches held gatherings and prayers, and hundreds of people gathered in Branson, Missouri, to hold a vigil for the victims of the accident, according to a 2018 ABC News report, Vigil Held for Victims of Missouri Duck Boat Tragedy: 'This Is Branson, This Is Who We Are'. The community, said Moore, was collectively hurting for the families who lost loved ones that night.
In April 2022, SSCFPD conducted a mass casualty incident training drill that featured a school bus crash in the rural district. Students from the drama club and the media club at the local high school were placed in a school district bus that had been turned on its side — responders treated the drill as if it were a real mass casualty incident. This event, according to Moore, was eye-opening and was a valuable tool in SSCFPD's continuous training process. Having SSCFPD units show up and mitigate the training exercise allowed the district to evaluate its capabilities and compare them to new triage ideas and methodologies to determine if they would be useful to the district. Exercises and drills such as this have allowed SSCFPD to make improvements in how they respond to mass casualty incidents so that responders will be more confident if a situation like the duck boat accident happens again.
Multiple organizations — including Western Taney County Fire Protection District, TCAD, Mercy EMS, Branson Fire and Rescue, and the Missouri State Highway Patrol — responded to the duck boat incident, and many helped maintain response capacity in other areas of the district during the storm, through mutual-aid agreements and cooperation. SSCFPD did not train with other entities for mass casualty response, so relying on their SOP and maintaining a “sandbox mentality” of mutual respect as agencies helped the responders do what they could to help the situation. Moore noted that just because he was “wearing a white helmet as deputy chief” did not mean that he was in charge at the partner agencies. Working within another agency's boundaries means that responders must adapt to different dynamics than they are used to.
The success of SSCFPD's response to the duck boat accident was borne of everyday activities and routines. To SSCFPD, the duck boat incident was as if someone put a week's worth of what the responders do on a daily basis into a small timeframe. They are experienced with handling individuals who are injured, recovering the bodies of deceased individuals, responding to individuals who have been in accidents, performing CPR, doing water rescues and recoveries, and dealing with tragic events. Part of SSCFPD's success with this incident can be attributed to the well-trained and prepared responders.
SSCFPD is guided by their core values: Safety, Professionalism, Integrity, Respect, Innovation, and Teamwork (SPIRIT). These values, said Moore, do not indicate whether a firefighter is good at “throwing ladders” or hooking up hoses. Rather, they indicate if a responder is a responsible person with good character. The SPIRIT core values define the organization's commitment to serving the public in an upstanding way.
In the middle of the response and recovery operation, the Branson Belle disembarked passengers, which added to the number of people on the dock and pier. The number of people on the pier and in the immediate area created challenges. It became more difficult to discern who had been on the Branson Belle and who had been on the duck boat. A response liaison worked with the company that owned the duck boat to compile records of who was listed on the duck boat's manifest that evening to mitigate this issue. However, the chaos created challenges for the responders tasked with this responsibility and made it difficult to determine and account for who was at the scene.
Additionally, nurses and emergency medical technicians (EMTs) who had been onboard the Branson Belle as passengers came to the scene of the accident to offer medical assistance and help with response efforts. Moore noted that if SSCFPD and other responders had needed the help, they would have accepted those medical professionals. Unfortunately, by that time responders on-scene were in recovery mode, rather than rescue mode, and there was little need for additional personnel.
Sometimes, the survivors of a traumatic incident do not immediately realize that they are victims of a disaster. They know that they have been involved in “something that is horribly tragic,” said Moore, but oftentimes shock sets in first, before they become aware of all that has happened. Just because survivors appear uninjured does not mean that they do not need attention. In the course of triage, responders moved past the walking wounded to attend to those with severe injuries — this is required of triage, as those who need immediate, life-saving care must be prioritized. However, the walking wounded often experience shock and distress. Moore lamented the lack of attention that these individuals received within the immediate response and recovery process. “I don't know if we failed them,” he said, but it is dangerous for responders to deviate from the triage structure. Survivors often find it difficult to process the trauma of what happened and sometimes need medical or psychiatric care.
Within the same timeframe of the initial SSCFPD dispatch call to the duck boat accident, a structure fire was reported elsewhere in the district's jurisdiction and required immediate attention. Throughout the course of the night, SSCFPD also responded to medical calls; the district, noted Moore, was stretched thin during the initial duck boat response. SSCFPD had engine companies that were divided into 3 battalions — responders from different battalions had to be diverted to areas outside of their response radius to account for those responding to the incident on Table Rock Lake.
SSCFPD's South Battalion has a southernmost boundary at the Arkansas border and covers land just up to south of Kimberling City, Missouri. The Southern Battalion Units were delegated to routine emergency responses as far as Indian Point, Missouri — over 12 miles from Kimberling City. This, said Moore, was significant, as the Southern Battalion had never responded to structure fires on Indian Point and were not necessarily familiar with where the fire hydrants were located in the area. This resulted in a learning curve for units responding in areas outside of their regular radius.
The emergency response agencies in this rural area of Missouri do not respond to mass casualty events very often. The mutual-aid agencies who responded to the duck boat accident had not practiced for such a full-scale disaster. It was awkward, said Moore, “like dancing with a person for the first time.” However, despite the awkwardness of coordinating such a large-scale, multi-agency response, it was not a detriment to the ultimate mission.
SSCFPD uses very high frequency (VHF) radios, while other organizations use ultrahigh frequency (UHF) radios or have adopted the Missouri Statewide Wireless Interoperable Network (MOSWIN) radios. These are all different bands of communication, so responders were limited by who they could communicate with, depending on what radio individuals from different organizations had. SSCFPD, for example, could not use their VHF radios to contact anyone with a MOSWIN radio. Many districts and departments, Moore noted, are limited in their ability to upgrade their radio capacity due to financial constraints and the high price of upgrading to a digital system like MOSWIN.
News agencies from across the country were covering the duck boat accident. SSCFPD's Public Information Officer (PIO) was trying to field media inquiries with his contacts during the incident, which became overwhelming due to national interest. Some reporters obtained Moore's personal cell phone number and were contacting him for information while he was managing the incident. Moore said, at that time, SSCFPD “didn't know what [they] didn't know” — he was not ready for that kind of media attention and the persistence of the journalists was a factor for which he had not previously accounted.
Following the incident, Moore recounted how difficult it was to see the victims' names, faces, and families on national television. During the response and recovery process, the grief is separated from the job. However, seeing the pictures of the victims and learning personal details about their lives brought the sadness of the accident back in full force. In addition, national attention following the incident produced confusion regarding the duck boat accident, response, and recovery details. National speculation was a component of the aftermath that on-scene responders had a difficult time processing.
Securing the Scene
During the initial response and recovery activities on Table Rock Lake, Moore noticed someone he did not recognize wearing a Southern Stone County Fire t-shirt and walking around the ambulances and fire engines. Moore introduced himself and asked for the individual's name, as he thought this was a volunteer whom he had not met yet. After the encounter, Moore asked a colleague about the individual and was informed they were a former volunteer with SSCFPD from several years ago. The person had come to the scene wearing an official t-shirt in the hopes that they could assist in the response.
While this encounter was innocuous, it was an important reminder about securing the scene and maintaining on-scene awareness. The incident site must be well-secured to ensure the safety and privacy of the accident victims as well as to establish a liability-free scene in which first responders can work efficiently.
Reporters called Moore's cellphone during the incident and tried to get him to confirm the number of deceased individuals. However, at this time, the PIO had not released any information regarding the number of fatalities. In fact, Moore recalled, responders were not even sure that there were 31 people onboard the duck boat yet. A few minutes after receiving that phone call, Moore heard response teams on the water communicating through their radios on tactical frequency. Information, such as how many deceased individuals they had recovered from the water, where their bodies were located, and how many survivors were moved to the Branson Belle, was shared through official communication channels. Someone was listening to the responders' tactical frequency to get fatality numbers and was sharing them with reporters.
This realization made SSCFPD more aware of procedures for communicating sensitive information. Anyone who was close enough to the responders and knew their tactical frequency could listen to everything that was being said operationally. Sensitive information, such as the unofficial death toll of an accident, is not something that responders at SSCFPD wanted to go out over the radio channel, even on the tactical frequency. SSCFPD has learned that they need to use care with radio communications.
Moore emphasized the importance of transparency to the mission of the first responders at SSCFPD. Any communication SSCFPD is having must be communicated cautiously, whether it is over primary, secondary, or tactical frequencies. The public listening in is not a threat if information is being handled responsibly. Moore values having full transparency with the public. Everyone has a camera or a smartphone, he said, and it is within their rights to record what SSCFPD is doing. According to Moore, it should not matter as a responder who is recording, videoing, or listening if “you are doing what you're supposed to be doing, what the public is expecting you to do.”
While SSCFPD did hold a CISD as part of their post-incident analysis, it did not happen until 1-2 weeks after the duck boat accident. Moore regrets that they did not hold it sooner after the incident. According to the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) Critical Incident Stress Guide, a CISD should happen within 24-72 hours of a traumatic event. The district faced challenges finding a time to hold the CISD, since SSCFPD is a combination district involving both career and volunteer firefighters, the latter of which had jobs to schedule around. The Fire Chaplain reached out to responders individually and provided a “more personal touch” for those struggling with trauma from the incident.
For first responders and community emergency managers responding to a mass casualty event in a rural area, Moore suggests:
Be FlexibleUnderstand that “the call you get isn't going to be the call you got.” Responders may think that they have a good idea of the situation that awaits based on the dispatch information, but they must be flexible enough to change and adapt upon arrival. Dispatch information is not always clear or concise, said Moore. Additionally, upon initial arrival, what you see may not be the reality of the situation, he noted, referencing the PFDs in the water by the Branson Belle. Adaptability is a must for anyone responding to these types of mass casualty events.
Maintain ComposureThe first 30 seconds to 3 minutes on the scene of a disaster can feel like pandemonium as responders try to assess the situation. Adrenaline is high in these situations, Moore noted. Responders must be able to maintain their composure, especially when everyone else is panicked. Responders must be able to run an incident, rather than allowing the incident to run them.
FailureThere are great contingency plans for almost any type of disaster; however, they do not apply to every event. Moore warned that there will always be something that a responder may not have considered. The best advice, he said, is to know that you are going to fail — and when you fail, “own it and keep working.” It is not a question of if but rather when a responder will make a mistake or wrong decision, he said. Making decisions in a mass casualty situation is very stressful, so responders must understand that a decision may not always be perfect.
Mike Moore, Deputy Chief and Training Officer
Southern Stone County Fire Protection District
Opinions expressed are those of the interviewee(s) and do not necessarily reflect the views of the Rural Health Information Hub.