R 151300Z MAR 04
FM CMC WASHINGTON DC(uc)
TO AL MARADMIN(uc)
MARADMIN
BT
UNCLASSIFIED
MARADMIN 114/04
MSGID/GENADMIN/CMC WASHINGTON DC//SD//
SUBJ/MC MANUAL P5102.1A OF 29 DEC 000, CH 3. MARINE CORPS GROUND
/MISHAP INVESTIGATION AND REPORTING MANUAL//
REF/A/DOC/MCO P5102.1A/YMD:20001229//
AMPN/REF A IS MARINE CORPS GROUND MISHAP INVESTIGATION AND
REPORTING MANUAL.//
POC/D.C. WEIGHTMAN/GS-14/SD-1/-/TEL:DSN 224-2423/TEL: COMM (703)
614-1077/1202//
RMKS/1. PURPOSE. THIS MARADMIN DIRECTS PEN CHANGES TO THE
SUBJECT MANUAL. THIS CHANGE IS APPLICABLE TO MARINE CORPS
ACTIVITIES ON PCN 1020726801 DISTRIBUTION.
2. BACKGROUND. MISHAP REPORTING IN COMBAT CONTINGENCIES VIA
MARTRAK WAS REPORTED IN OIF TO BE BURDENSOME. THIS CHANGE
PROVIDES A COMBAT ZONE REPORT (CZR) MESSAGE TEMPLATE WITH
DIRECTIONS TO ENHANCE MISHAP REPORTING TO HIGHER HEADQUARTERS
WITH WEBSITE AVAILABILITY TO ENTER MISHAPS INTO MARTRAK. THE
INFORMATION REQUIRED IN THE CZR ARE DATA FIELDS IN THE MARTRAK
THAT CAN BE USED TO OPEN A FILE, TRACK INFORMATION, AND CONDUCT
TREND ANALYSIS.
3. ACTION. CHANGE REF A AS FOL:
A. ADD TO CHAPTER 4, PARAGRAPH 4002.
6. COMBAT ZONE REPORTING
A. MISHAP REPORTING IN A COMBAT ZONE (CZ) IS EXTREMELY
IMPORTANT BECAUSE OF THE UNIQUENESS OF WARTIME OPERATIONS AND
THE DIFFICULTY IN CAPTURING USEFUL INFORMATION.
B. INITIAL NOTIFICATION OF AN INCIDENT, CASUALTY, OR
MATERIAL DAMAGE OF DOD OR NON-DOD PROPERTY FROM THE CZ SHALL BE
REPORTED BY PERSONAL CASUALTY REPORTS (PCR), OPERATIONAL REPORT
(OPREP-3) OR SITUATIONAL REPORT (SITREP) PER MCO P3040.4D,
MARINE CORPS CASUALTY PROCEDURES MANUAL AND MCO P5740.2F, OPREP-
3 SERIOUS INCIDENT REPORT. ADDITIONALLY, COMMANDS ARE TO ENSURE
COMNAVSAFECEN NORFOLK VA//00/02/10/30/40/60/90// IS AN INFO
ADDRESSEE ON THE PCR, OPREP-3 OR SITREP. COMNAVSAFECEN WILL
REVIEW AND EXTRACT PERTINENT INFORMATION FOR DATABASE ENTRY.
THIS PROVIDES THE MEANS TO TRACK RECORDABLE AND REPORTABLE
MISHAPS UNTIL FINAL DEPOSITION HAS BEEN DETERMINED.
C. THE CONTROLLING ACTIVITY SHALL REVIEW PCRS, OPREP-
3S, AND SITREPS TO DETERMINE WHETHER THE INCIDENT OR CASUALTY IS
THE RESULT OF DIRECT ENEMY ACTION (DEA) OR IS A MISHAP. IF THE
INCIDENT OR CASUALTY IS A CLASS A OR B MISHAP, THE CONTROLLING
ACTIVITY SHALL CONTACT THE APPROPRIATE SUBORDINATE COMMAND
TO ESTABLISH THE REQUIREMENT FOR A CZ REPORT. MISHAP UNIT
COMMANDERS MAY ESTABLISH A SAFETY INVESTIGATION BOARD (SIB) AT
THEIR DISCRETION USING A SAFETY INVESTIGATION (SIREP) REPORT.
THE MISHAP COMMANDS HAVE 30 DAYS TO SUBMIT A CZ REPORT OR A SIREP.
ALL CLASS A, B, AND C MISHAPS, AS DEFINED IN CHAPTER 2, THAT OCCUR
IN A CZ SHALL BE REPORTED MONTHLY IN MARTRAK UTILIZING FIELDS
CONTAINED IN THE CZ REPORT. COMMANDS SHALL USE FIGURE 6-8 FOR A
CZ REPORT OR FIGURE 6-5 FOR A SIREP REPORT.
D. FOR ALL INCIDENTS FALLING WITHIN THE DEFINITION OF FRIENDLY
FIRE, THE COMPONENT COMMANDER WILL CONVENE A LEGAL INVESTIGATION
TO DETERMINE THE FACTS OF THE INCIDENT AND GUIDE FURTHER ACTIONS
IAW DODI 6055.7, ACCIDENT INVESTIGATION, REPORTING, AND RECORD
KEEPING. COMMANDERS SHALL INCLUDE COMNAVSAFECEN ON DISTRIBUTION
OF THE LEGAL INVESTIGATION. COMPONENT COMMANDERS MAY CONVENE A
SIB AT THEIR DISCRETION.
E. DEFINITIONS:
(1). COMBAT ZONE: THE COMBAT ZONE IS AN AREA REQUIRED BY
FORCES TO CONDUCT LARGE-SCALE COMBAT OPERATIONS. IT NORMALLY
EXTENDS FORWARD FROM THE LAND FORCE REAR BOUNDARY. THIS DEFINITION
IS EXTRACTED FROM THE JOINT DOCTRINE ENCYCLOPEDIA.
(2). DIRECT ENEMY ACTION (DEA): IDENTIFIES A CASUALTY THAT
CAN BE DIRECTLY RELATED TO INVOLVEMENT OF ENEMY FORCES OR ACTION
AND WOULD NOT HAVE OCCURRED HAD THE ENEMY NOT COMMITTED A
DELIBERATE ACT.
B. ADD TO CHAPTER 6 FOLLOWING FIGURE 6-7, PAGE 40.
FIGURE 6-8 IS THE MESSAGE TEMPLATE FOR COMBAT ZONE REPORTING
MESSAGE.
FIGURE 6-8 COMBAT ZONE MISHAP REPORT MESSAGE FORMAT
FM (REPORTING ACTIVITY)
TO CMC WASHINGTON DC//SD//(USMC ONLY)
COMNAVSAFECEN NORFOLK VA//00/02/10/30/40/60/90//
INFO JOINT STAFF J3 READINESS DIV
(REPORTING ACTIVITY APPROPRIATE CHAIN OF COMMAND)
UNCLAS FOUO //N05102//
MSGID/GENADMIN/MSG ORIG/SER NO/MONTH//
REF/A/DOC/ (ENTRY EITHER OPNAVINST 5102.1D OR MCO P5102.1B AS
APPROPRIATE)
REF/B/MSG/ (REQUIRED FIELD)(REFERENCE ACTIVITY PCR, OPREP-3 OR
SITREP AND DTG)
NARR/REF A IS THE MARINE CORPS MISHAP AND SAFETY INVESTIGATION
REPORTING MANUAL.//
REF B IS THE ACTIVITY MESSAGE REPORT CONCERNING THE MISHAP//
SUBJ: COMBAT ZONE MISHAP REPORT - REPORT SYMBOL 5102-7C//
THIS REPORT IS FOR OFFICIAL USE ONLY. THIS IS A PRIVILEGED,
LIMITED USE CONTROLLED DISTRIBUTION, MISHAP REPORT.
UNAUTHORIZED DISCLOSURE OF THE INFORMATION IN THIS REPORT BY
MILITARY PERSONNEL IS A CRIMINAL OFFENSE PUNISHABLE UNDER
ARTICLE 92, UNIFORM CODE OF MILITARY JUSTICE. UNAUTHORIZED
DISCLOSURE OF THE INFORMATION IN THIS REPORT BY CIVILIAN
PERSONNEL WILL SUBJECT THEM TO DISCIPLINARY ACTION UNDER
CIVILIAN PERSONNEL INSTRUCTION 752.
RMKS/1. MISHAP SUMMARY: (SUMMARIZE THE MISHAP OPERATION,
EVOLUTION OR PROCEDURE IN 3 LINES OR LESS. EXAMPLE: A.
TRANSPORTING SUPPLIES WHEN VEHICLE ON HILL HAD NO BRAKES,
HITTING EMBANKMENT AND ROLLED OVER KILLING DRIVER. B. TANK
CROSSING BRIDGE WENT OVER THE EDGE AND LANDED UPSIDE DOWN IN
RIVER KILLING ALL INSIDE.) (DO NOT PLACE NAMES OF INDIVIDUALS
INVOLVED IN THE MISHAP OR CAUSAL FACTORS IN THIS SECTION.
2. MISHAP DATA: : (EXAMPLE: CLASS A MISHAP)
A. REPORTING ACTIVITY UIC/MCC/RUC:
B. UIC/MCC/RUC OF MISHAP OWNER:
C. MISHAP LOCATION:
D. PARENT COMMAND: (LIST THE OPCON COMMAND. BATTALION,
SQUADRON, MEF, MAGTF, FSSG, DIV, MAW, BASE, STATION, OR EQUIV
PARENT ACTIVITY OF THE ORGANIZATION OR UNIT HAVING THE MISHAP.)
E. TIME, DAY, AND DATE OF MISHAP: (EXAMPLE: 0134, TUESDAY,
24 MARCH 2003)
F. OPERATION/EVOLUTION/PROCEDURE: (DESCRIBE WHAT OPERATION,
EVOLUTION OR PROCEDURE WAS ONGOING AT TIME OF MISHAP.)
G. PERSONNEL INFORMATION:
(1) NAME OF INJURED PERSON (1): (LAST NAME, FIRST NAME,
MIDDLE INITIAL)
(A) AGE OR DATE OF BIRTH:
(B) PAY GRADE: EXAMPLE: (0-4, E-3, GS-12, WG-06, ETC.)
(C) DESIGNATOR/PRIMARY NEC/MOS (NEC/MOS AS RELATES TO
EVENT)/CIVILIAN JOB SERIES: (IF KNOWN. EXAMPLE: 1120, HM-8404,
9956,3502, GS-0018, ETC.)
(D) TASK (JOB) AT THE TIME OF THE MISHAP: (DESCRIBE
THE SPECIFIC JOB THIS INDIVIDUAL HAD IN RELATIONSHIP TO THE
OPERATION, EVOLUTION OR PROCEDURE.)
(E) INJURY CATEGORY: (SELECT ONE FATALITY, PERMANENT
TOTAL DISABILITY, PERMANENT PARTIAL DISABILITY, LOST TIME)
(F) INJURY: (DESCRIBE MOST SIGNIFICANT INJURY OR CAUSE
OF FATALITY. FOR INJURED PERSONNEL, PROVIDE THE APPROPRIATE
LOST TIME DATA BELOW, OTHERWISE, INDICATED N/A.)
1. LIGHT OR RESTRICTED DUTY START DATE AND TIME
(MMDDYYYY/LOCAL TIME): (EXAMPLE: 03102003/1625)
2. LIGHT OR RESTRICTED DUTY END DATE AND TIME
(MMDDYYYY/LOCAL TIME): (EXAMPLE: 03102003/1625)
3. LOST WORK DAY START DATE AND TIME
(MMDDYYYY/LOCAL TIME): (EXAMPLE: 03102003/1625)
4. LOST WORK DAY END DATE AND TIME (MMDDYYYY/LOCAL
TIME): (EXAMPLE: 03102003/1625)
5. HOSPITALIZATION START DATE AND TIME
(MMDDYYYY/LOCAL TIME): (EXAMPLE: 03102003/1625)
6. HOSPITALIZATION END DATE AND TIME
(MMDDYYYY/LOCAL): (EXAMPLE: 03102003/1625)
(G) IF PERMANENT LOSS TO COMMAND, PROVIDE TRANSFER
UIC/MCC/RUC:
(2) NAME OF INJURED PERSON (2): LIST ITEMS (1)(A) - (1)(G).
(3) NAME OF FATALITY (1): LIST ITEMS (1)(A) - (1)(F).
(4) NAME OF FATALITY (2): LIST ITEMS (1)(A) - (1)(F).
(5) NAME OF NON-INJURED PERSONNEL: (PROVIDE A LISTING OF
NON-INJURED PERSONNEL WHO WERE DIRECTLY INVOLVED IN THE
OPERATION, EVOLUTION OR PROCEDURE. INDICATE WHAT THEIR
RESPONSIBILITY WAS DURING THE MISHAP.)
E. PROPERTY DAMAGE AND COST: (LIST BELOW THE PROPERTY
INVOLVED IN THE MISHAP AND PROVIDE COST OR ESTIMATED COST.)
(1) DOD
(A) PROPERTY: (DESCRIBED EACH PIECE OF PROPERTY
DAMAGED AND LIST COST. DESCRIBE PROPERTY DAMAGE, ITEMIZED COST
AND INCLUDE HOURS TO REPAIR. IF PROPERTY WAS DESTROYED, SO
STATE.)
(B) PERSONAL PROTECTIVE EQUIPMENT: (LIST ANY PPE THAT
WAS REQUIRED, WHETHER OR NOT IT WAS USED, AND WHETHER OR NOT IT
WAS EFFECTIVE.)
(2) NON-DOD
(A) PROPERTY: (LIST EACH PIECE OF PROPERTY DAMAGE AND
ITEM COST. IF PROPERTY WAS DESTROYED, SO STATE.)
(B) PERSONAL PROTECTIVE EQUIPMENT: (LIST ANY PPE THAT
WAS REQUIRED, WHETHER OR NOT IT WAS USED, AND WHETHER OR NOT IT
WAS EFFECTIVE.)
F. ENVIRONMENT: (DESCRIBE WHETHER OR OTHER CONDITIONS THAT
MAY HAVE ATTRIBUTED TO MISHAP.)
3. CAUSAL FACTORS: (PROVIDE A BRIEF EXPLANATION OF WHAT CAUSED
THE MISHAP. IF MORE THAN ONE CAUSE IS IDENTIFIED, LIST IN ORDER
OF PRIORITY, 3A, 3B, 3C, ETC. EXAMPLE: INADEQUATE SUPERVISION,
ROUTINE RULE BENDING, COMMUNICATION BREAKDOWN, PHYSICAL FATIGUE,
MAINTENANCE PERSONNEL NOT TRAINED, MAINTENANCE OR OPERATOR
INDUCED FAILURE, MECHANICAL COMPONENT FAILURE, INAPPROPRIATE
ITEM USED, ETC.)
4. CORRECTIVE ACTION: (FOR EACH CAUSAL FACTOR, PROVIDE WHAT
CORRECTIVE ACTION IS BEING TAKEN AND BY WHOM, I.E., 3A (CAUSAL)
= 4A (ACTION/WHOM), 3B (CAUSAL) = 4B (ACTION/WHOM).)
5. COMMANDING OFFICER COMMENTS (OPTIONAL): (THE CO CAN PROVIDE
AMPLIFYING INFORMATION AS APPROPRIATE.)
4. POC FOR CHANGE: D.C. WEIGHTMAN, DSN 224-2423 OR COMM 703-614-1202,
EMAIL WEIGHTMANDC@HQMC.USMC.MIL.//