Staffer’s Miscalculation Cited in Disney Tragedy

The Christmas Eve accident that killed a Disneyland tourist occurred because the worker who lashed the Columbia sailing ship to a dock as the ride ended did not realize the large boat was moving dangerously fast, an autopsy report said Wednesday.

In the first official account of the grisly tragedy, an Orange County deputy coroner said the mooring rope pulled taut, then ripped an eight-pound metal cleat out of the ship’s bow. The rope shattered the dock worker’s foot as it whipsawed around, then flung the cleat 15 feet into a crowd waiting to board the ship, fatally injuring a Washington state man and badly wounding his wife.

“The normal procedure when the ship is coming in too fast is to not secure the mooring line,” the report said. Instead, workers should let the ship “overshoot the dock, and then reverse” gently into its proper position.

In this case, however, the employee--earlier identified as Christine Carpenter--attached the mooring line to the cleat on the ship’s bow “not knowing the helmsman planned to overshoot the dock,” the report said.

Luan Phi Dawson, 33, of Duvall, Wash., died of a brain hemorrhage and skull fracture, the autopsy found. The flying cleat struck him in the face and neck, tearing away part of his jaw, the report said.

His wife, Lieu Thuy Vuong, 43, is expected to recover from her severe head injuries, including a partly paralyzed face. Carpenter also remained hospitalized Wednesday.

The autopsy report by Supervising Deputy Coroner Richard W. McAnally does not address whether Carpenter was properly trained or why the rope did not break, as it is designed to do in such circumstances. Investigators are examining the rope and other components that may have failed in the accident.

McAnally’s report does, however, raise questions about police access to the accident scene.

An Anaheim police detective sent to Disneyland was directed to a conference room, where he waited “for a considerable time” before being allowed to enter the park and examine the scene that bloodied the Frontierland dock, the report said.

“The scene had been cleaned up by Disneyland personnel and the evidence had already been moved before [the detective] was permitted access,” the report Police collected no evidence at the time, the report said, beinvestigating a crime and “Disneyland had insisted on retainingthe cleat, which was broken into two pieces, and two teeth foundfour days later by Disney’s legal department, the report said.

Anaheim Police Lt. John Haradan, however, downplayed the signaccess to the scene and evidence.

While acknowledging that he and two detectives met with Disneroom for about an hour before walking to the scene, he said thathis choice. Had investigators wanted to “rush out there,” they “We waited to get briefed so we’d know what to look for,” Hdetermined that Disneyland didn’t clean it up to destroy evidence of criminal conduct. They cleaned it up, in my opinion, as being the ranking person there, because it was unsightly.”

Disneyland spokesman Ray Gomez agreed. The scene was cleaned up “out of courtesy to our guests,” he said.

Haradan also said he was able to view the evidence after it had been taken from the scene.

In fact, authorities say, police became involved only after paramedics reported a possible fatality, and dropped their investigation after determining no crime had occurred. The state Occupational Safety and Health Administration is investigating the tragedy because a worker was hurt.

Carpenter, 30, was an assistant manager in the Frontierland area. Officials said she was filling in for an hourly staffer so the Columbia, one of the park’s tamest rides, could open on time.

Knowledgeable Disneyland workers told The Times that Carpenter had never received the formal one-day training session that Columbia trainers give to managers. Employees working the ride undergo a two-day training session.

They said the training would have included learning to avoid putting on the mooring line if the Columbia was approaching too fast. And she would have known to step behind a stack of boxes or the ride’s entry ramp as a safeguard in case the rope broke, they said.

“She sort of knew basic stuff just by being around, but the actual training just slipped through the cracks,” a worker said, speaking on condition of anonymity.

Matt Haynes, a trainer on the Columbia and a 10-year veteran at the park, said he never trained Carpenter. He said workers are warned in training not to attach the rope when the ship is coming in too quickly.

“It should have been said that if the boat is coming in too fast you shouldn’t throw the rope,” he said.

The cleat should never have been ripped out of the boat, he added, because the ropes are designed to give way instead, as a safety measure.

“What happened shouldn’t have happened,” Haynes said. “The ropes are supposed to break when there’s too much tension.”

Disneyland spokesman Gomez said he did not know whether Carpenter had been trained by the ride’s official trainers, but maintained that she was drilled “on all the procedures of docking the Columbia.” These procedures included letting the ship overshoot the dock if it is approaching too fast, he said.

Since October, “she had docked the Columbia about a dozen times prior to the accident, so she did have experience working the attraction,” Gomez said.

Workers said the number of hourly staffers assigned to some rides including the Columbia was cut this year and managers were told to spend more time on the front lines. The aim was not to replace hourly workers, but managers wound up pitching in to help run rides far more often than in the past, according to ride operators.