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Accidents Happen 22 June 2013AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG.

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Presentation on theme: "Accidents Happen 22 June 2013AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG."— Presentation transcript:

1 Accidents Happen 22 June 2013AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG

2 Mishap Investigation Col William W. Pond, MD, SFS, MC Indiana State Air Surgeon 18 June 2010AANGFS RSV ProgramMinneapolis, MN Col William W. Pond, MD, SFS, INANG

3 AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

4

5 Thanks and a tip o the hat to the following: Leah W Brockway, Col, USAFR, MC, FS 446 ASTS, McChord AFB, WA Maj Leslie Picht, Pilot, 92 ARW Safety Center Lt Col Rick Gist, USAFR, MC, SFS Aircraft Mishap Investigation Handbook Col (ret) Rob Allen, USAF, MC, CFS Col Hadley Reed, USAF, MC, SFS

6 Identifying data has been removed; sanitized presentation information is for educational and demonstrative purposes. INFORMATION IN THIS BRIEFING IS FOR SAFETY PURPOSES ONLY. THE BRIEFING CONTAINS PRIVILEGED, LIMITED-USE SAFETY INFORMATION. UNAUTHORIZED USE OR DISCLOSURE CAN SUBJECT YOU TO CRIMINAL PROSECUTION, TERMINATION OF EMPLOYMENT, CIVIL LIABILITY, OR OTHER ADVERSE ACTIONS. RESTRICTIONS IN AFI 91-204 APPLY.

7 Items to cover Mishap Classes Mishap Classes Early actions Early actions ISB, SIB, AIB Boards ISB, SIB, AIB Boards Purpose Purpose SIB Composition SIB Composition SIB Witness Interviews SIB Witness Interviews Safety Privilege Safety Privilege Site Safety Site Safety Dos & Donts Dos & Donts Media Media AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

8 Source Information Air Force Safety Center Surgeon DSN 246- 0830 Air Force Safety Center Surgeon DSN 246- 0830 Life Sciences Equipment Lab, Brooks AFB Life Sciences Equipment Lab, Brooks AFB DSN 240-4722 AFI 91-204 Safety Investigations and Reports AFI 91-204 Safety Investigations and Reports AFJI 91-206 Participation in a Military or Civilian Accident Safety Investigation AFJI 91-206 Participation in a Military or Civilian Accident Safety Investigation AFPAM 91-211 USAF Guide to Safety Investigation AFPAM 91-211 USAF Guide to Safety Investigation 18 June 2010AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

9 4 th Edition, Feb 2006 AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

10 Do not hesitate to ask for assistance LtCol Lisa Snyder LtCol Lisa Snyder Col William Pond, 260-602-5167 Col William Pond, 260-602-5167 Chain of Command Chain of Command Wing Safety Wing Safety Air Force Safety Center (AFSC) Air Force Safety Center (AFSC) –DSN 246-0830, 246-0880 –http://afsafety.af.mil/ http://afsafety.af.mil/ AFSC Life Sciences Branch AFSC Life Sciences Branch –Flight Surgeon DSN 246-0871 –Life Support DSN 246-0853 –Aerospace Physiology DSN 246-0880 –Aviation Psychology DSN 246-3763 Air Force Institute of Pathology (AFIP) Air Force Institute of Pathology (AFIP)

11 Types of Mishaps Class A Class A Class B Class B Class C Class C Class E Class E Class J Class J

12 Class A Mishap Greater than $1 M in damages to airframe Greater than $1 M in damages to airframe Fatality or permanent total disability of crew or passengers Fatality or permanent total disability of crew or passengers Destroyed aircraft Destroyed aircraft

13 Class B Mishap Greater than $200k in damage Greater than $200k in damage Permanent partial injury to crew or passengers Permanent partial injury to crew or passengers Hospitalization of three or more people Hospitalization of three or more people 18 June 2010AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

14 Class C Mishap Greater than $10 K damage Greater than $10 K damage Lost work day or days Lost work day or days

15 Class E Mishap Events that dont meet A, B, or C criteria Events that dont meet A, B, or C criteria Trending for safety/mishap prevention Trending for safety/mishap prevention Physiologic incidents Physiologic incidents

16 Class J Mishap Engine mishaps Engine mishaps Foreign Object Damage, BASH Foreign Object Damage, BASH 18 June 2010AANGFS RSV2009 Snowbird, UT Col William W. Pond, MD, SFS, MC, INANG

17 Type of Mishap Related to Intention to Damage 1. Aircraft Flight Mishap- damage to aircraft with intent for or during flight operations 2. Aircraft Flight Related Mishap- damage to property or people from aircraft with intent for or during flight, no reportable aircraft damage 3. Aircraft Ground Operations Mishap- damage to aircraft without intent for flight 18 June 2010AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

18 Priorities after the Mishap Safety: Do not be a victim at scene Safety: Do not be a victim at scene Clearance from on-scene commander/Fire Chief Clearance from on-scene commander/Fire Chief Treat Survivors Treat Survivors Preserve Life & Function Preserve Life & Function Run Care of Survivors Checklist Run Care of Survivors Checklist If necessary, run Care of Fatalities Checklist If necessary, run Care of Fatalities Checklist Be attentive to psychological needs of team Be attentive to psychological needs of team Refer media to PA, no comment Refer media to PA, no comment

19 Site Access Readiness factor Readiness factor Maps Maps Know your local jurisdiction issues beforehand Know your local jurisdiction issues beforehand Appropriate authorities secure mishap site Appropriate authorities secure mishap site Work with other authorities/request access Work with other authorities/request access

20 Mishap Site Etiquette and Safety Stay Clear Of The Mishap Scene Until Its Declared Safe By The On-scene Commander Stay Clear Of The Mishap Scene Until Its Declared Safe By The On-scene Commander Walk Cautiously – Tripping & Evidence Preservation Walk Cautiously – Tripping & Evidence Preservation Beware of Beware of –Hazardous Materials – Carbon Fibers, Etc. –Unexploded Ordinance – Squibs, Flares, Etc. –Pressurized Containers – O2 Bottles, Etc. –Wild Animals, Serpents And Insects –Biological Hazards – Blood, Etc. –Sharp Objects

21 Purpose of Investigation Find underlying cause/explanation Find underlying cause/explanation Future mishap prevention Future mishap prevention Improve risk management/ORM Improve risk management/ORM Improve safety process Improve safety process Preservation of combat resources Preservation of combat resources

22 Safety Investigations NOT To Fix Blame, but Fix the Cause NOT To Fix Blame, but Fix the Cause NOT Merely to Gather Evidence, but to analyze NOT Merely to Gather Evidence, but to analyze NOT Used for Disciplinary Purposes NOT Used for Disciplinary Purposes

23 Safety Mishap Investigation Boards Interim Safety Board (ISB) Interim Safety Board (ISB) –Preserve evidence until permanent safety board arrives –Gather pertinent data that may be lost over time –Accomplish initial actions for permanent board Wing Mishap Response Plan (MRP) Wing Mishap Response Plan (MRP) –Lists ISB member duties –Checklists available for all base agencies Safety Investigation Board (SIB) - AFI 91-204 Safety Investigation Board (SIB) - AFI 91-204 –Mishap prevention –Determine cause(s) –Recommend corrective actions –Privileged report, partially

24 Accident Mishap Investigation Board Accident Investigation Board (AIB) - AFI 51-503 Accident Investigation Board (AIB) - AFI 51-503 –Claims & litigation –Disciplinary action –Adverse administrative actions –Publicly releasable report

25 Board Composition Full Board- Class A, full compliment of members Full Board- Class A, full compliment of members Tailored Board- only the required board members (determined by convening authority) Tailored Board- only the required board members (determined by convening authority) Single investigator- when formal board not required Single investigator- when formal board not required

26 Board Member Selection ISB Chosen By WG/CC ISB Chosen By WG/CC SIB Appointed by MAJCOM/CC SIB Appointed by MAJCOM/CC –Safety Office Researches Availability Annotates Adverse Impact To Individual And / Or Wing Annotates Adverse Impact To Individual And / Or Wing Seeks Members With Desire To Be Chosen Seeks Members With Desire To Be Chosen Always A Short Notice Suspense Always A Short Notice Suspense –Wing CC Approves Local List Submitted To MAJCOM –MAJCOM/CC Appoints

27 Members Board President (Rated Colonel or O-7 for Fatality) Board President (Rated Colonel or O-7 for Fatality) Investigating Officer Investigating Officer Maintenance Member Maintenance Member Medical Officer Medical Officer Pilot Member Pilot Member AFSC Representative AFSC Representative Recorder Recorder Technical Assistance Members As Required Technical Assistance Members As Required

28 Flight Surgeon Role Medical expert for board members Medical expert for board members Liaison to Mortuary Affairs/AFIP Liaison to Mortuary Affairs/AFIP Team leader for all Life Sciences Team leader for all Life Sciences Advisor for: Advisor for: –Search & Rescue Team (SAR) –Human factors –Human survivability –Aircrew medical qualification –Lifestyle –Crew rest analysis Family liaison Family liaison

29 Flight Surgeon Liaison Flight surgeon job Flight surgeon job Local coroner/ME Local coroner/ME Local emergency medical care Local emergency medical care Local FS/interim board Local FS/interim board Pathology Pathology AFIP consultant for investigation, photography, and autopsy AFIP consultant for investigation, photography, and autopsy

30 22 June 2013AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG

31 Procedural Legal Considerations Establish jurisdiction (JAG duty) Establish jurisdiction (JAG duty) Location of death Location of death Location of pronouncement Location of pronouncement

32 Jurisdictional Issues for Fatalities Local Mortuary Affairs Officer Local Mortuary Affairs Officer Local Laws- coroner may have to give permission before remains are moved Local Laws- coroner may have to give permission before remains are moved Fed Jurisdiction- Office of Armed Forces Medical Examiner (OAFME) must be notified Fed Jurisdiction- Office of Armed Forces Medical Examiner (OAFME) must be notified International issues- JAG to contact appropriate liaison International issues- JAG to contact appropriate liaison

33 AFIP/OAFME Over 700 cases per year Over 700 cases per year –Suicides –Homicides –Other Aircraft Accident investigations Aircraft Accident investigations –10-15 cases per year on site –10-15 cases in consultation Consultants to NTSB Consultants to NTSB

34 AFIP/OAFME Autopsy Autopsy Forensic identification Forensic identification Dental evaluation Dental evaluation DNA analysis DNA analysis Photography Photography Examination of flight/life support gear Examination of flight/life support gear Evaluates medical history/evidence Evaluates medical history/evidence Determines circumstances of death Determines circumstances of death

35 Site Documentation Document everything in situ Document everything in situ Do not disturb remains or wreckage Do not disturb remains or wreckage Document photographically, temporally, and in writing Document photographically, temporally, and in writing Document scene and remains Document scene and remains

36 Accident scene Accident scene Mark & photograph all remains in situ Mark & photograph all remains in situ Crew spaces Crew spaces Equipment Equipment Impact points Impact points –May be distant from main debris field –Avoid area disturbance until search complete

37 Photography Digital/film Digital/film Aerial Aerial Scene Scene Remains Remains Static displays Static displays Video Video

38 Marking Locations Grids (squares, circles) Grids (squares, circles) GPS GPS Sifting/gravel operations Sifting/gravel operations Water recovery Water recovery

39 Identification Obtain accurate flight manifest/SSNs Obtain accurate flight manifest/SSNs –Allows DNA cards to be pulled quickly Identifies all flight crew & passengers Identifies all flight crew & passengers Flight surgeon- survivability assessment Flight surgeon- survivability assessment Closure for family Closure for family AANGFS Col William W. Pond, MD, SFS, MC, INANG

40 Identification Presumptive- identifies individual to sub-group (initial) Presumptive- identifies individual to sub-group (initial) Positive- legal identification based on forensics Positive- legal identification based on forensics

41 Presumptive Identification Flight manifest Flight manifest Visual (tattoos) Visual (tattoos) Anthropomorphic Anthropomorphic Personnel data Personnel data Medical history Medical history Personal effects Personal effects

42 Positive Identification Dental Dental Fingerprints Fingerprints Palm prints Palm prints Foot prints Foot prints DNA DNA Radiographic ID Radiographic ID

43 How long does it take to identify positively Dental 1-2 hrs Dental 1-2 hrs Fingerprints 24-48 hrs Fingerprints 24-48 hrs DNA 48 hrs DNA 48 hrs

44 Records Gather all Names/SSNs Gather all Names/SSNs Obtain status & nationality Obtain status & nationality Sequester all records early Sequester all records early –Medical –Dental –Behavioral health –Civilian Do not permit changes after the fact Do not permit changes after the fact Sequester all medical/dental imaging evidence Sequester all medical/dental imaging evidence

45 Sequester Records Physical-remains Physical-remains All equipment All equipment All examinations and studies- unaltered All examinations and studies- unaltered –Medical records (military & civilian) –Dental records –Behavioral health records –Radiology films & data Photographs/video- at scene & autopsy Photographs/video- at scene & autopsy Witness information & statements Witness information & statements –Privileged –Non-privileged

46 Postmortem Examination X-ray X-ray All parts/pieces of all bodies must be x-rayed All parts/pieces of all bodies must be x-rayed Intact bodies need specified series of films Intact bodies need specified series of films Survivors need x-rays in some cases Survivors need x-rays in some cases –ejection Autopsy Autopsy Toxicology Toxicology Lab Lab Ancillary studies Ancillary studies

47 X-rays Full body clothed Full body clothed Hands/feet/head/neck Hands/feet/head/neck Permanent evidence of injuries Permanent evidence of injuries Demonstrates fractures/morphology Demonstrates fractures/morphology –mechanism of injury

48 Autopsy Involve AFIP early Involve AFIP early Crew members involved, preferably all victims Crew members involved, preferably all victims Photography of remains as recovered Photography of remains as recovered Documentation of all injuries Documentation of all injuries External examination of injuries External examination of injuries Internal examination- chest, abdomen, cranial vault Internal examination- chest, abdomen, cranial vault Dissection of soft tissue injuries Dissection of soft tissue injuries Laminectomy if needed Laminectomy if needed Documenting all injuries & natural disease Documenting all injuries & natural disease

49 Interim Safety Board Flight Surgeon Timeline 8 hour message 8 hour message 24-48 hrs 24-48 hrs –72 hr & 14 day histories on all involved –Review of records & images –Notifications –Collect lab specimens & results –Preservation/shipment of items to AFIP –Interview witnesses Begin data entry into AFSAS Begin data entry into AFSAS Transfer all information/evidence to SIB FS Transfer all information/evidence to SIB FS Remain available for questions Remain available for questions

50 Safety Board Flight Surgeon 4-6 wks 4-6 wks Continue data accumulation Continue data accumulation Consultations Consultations Team support Team support Data entry into AFSAS Data entry into AFSAS Tab Y Tab Y

51 SIB Witness Interviews Promise Of Confidentiality Available (Aircraft, Space, Missile, Nuclear Only) Promise Of Confidentiality Available (Aircraft, Space, Missile, Nuclear Only) Not Under Oath Not Under Oath No Article 31 Rights No Article 31 Rights Note Any Medications Note Any Medications

52 Safety Privilege Encourage frank & open communication with witnesses/contractors Encourage frank & open communication with witnesses/contractors Allow commander to quickly obtain accurate mishap information Allow commander to quickly obtain accurate mishap information Helps ensure appropriate corrective action Helps ensure appropriate corrective action Ultimately, enhances national security Ultimately, enhances national security

53 Dos and Donts Do talk to witnesses as soon as possible Do talk to witnesses as soon as possible Do ensure part locations are marked Do ensure part locations are marked Do preserve the evidence Do preserve the evidence Dont rely on memory – take notes or use recorder Dont rely on memory – take notes or use recorder Dont put two fractured parts together Dont put two fractured parts together Dont dismantle parts without reassemble marks Dont dismantle parts without reassemble marks Dont release wreckage until its no longer needed Dont release wreckage until its no longer needed Dont jump to conclusions as to mishap cause Dont jump to conclusions as to mishap cause Dont discuss the mishap outside the board Dont discuss the mishap outside the board

54 Media Relations Refer all questions to Public Affairs Refer all questions to Public Affairs –Only the board president is authorized to release info Use extreme courtesy Use extreme courtesy Dont speculate on mishap cause Dont speculate on mishap cause Politely ask civilians & media not to photograph fatalities or classified items Politely ask civilians & media not to photograph fatalities or classified items –Contact security forces if necessary Refer potential claimants to JA Refer potential claimants to JA Avoid media; let AIB do its job Avoid media; let AIB do its job

55 Flight Surgeon Role Assist with all life science & human factors issues Assist with all life science & human factors issues Interview or history-taking expert on board Interview or history-taking expert on board Assist Line board members in understanding human issues/factors involved in mishap Assist Line board members in understanding human issues/factors involved in mishap Assist survivors, direct/indirect Assist survivors, direct/indirect –Victims –Families –SAR –Board Process improvement role Process improvement role

56

57 August 7, 2009AANGFS RSV2009 Snowbird, UT Col William W. Pond, MD, SFS, MC, INANG

58 Help the other members to understand the human factors component

59

60 Ponds Pearls As soon as selected for the AIB, make telephone contact with Board President and exchange contact informationthe AIB President is a sharp, knowledgeable senior pilot whose assistance is invaluable. As soon as selected for the AIB, make telephone contact with Board President and exchange contact informationthe AIB President is a sharp, knowledgeable senior pilot whose assistance is invaluable. Prior to arriving, read AFI 91-204, AFI 51-503, AFPAM 91-211 and the Aircraft Mishap Investigation Manual published by the Society of United States Air Force Flight Surgeons Prior to arriving, read AFI 91-204, AFI 51-503, AFPAM 91-211 and the Aircraft Mishap Investigation Manual published by the Society of United States Air Force Flight Surgeons For and AIB, read the SIB report in its entirety and make notes to summarize findings along with tab and page number. This will save time when trying to recall the information. For and AIB, read the SIB report in its entirety and make notes to summarize findings along with tab and page number. This will save time when trying to recall the information. When writing, include the document citation and location at the time of compositionthis will save a lot of time trying to find it later. When writing, include the document citation and location at the time of compositionthis will save a lot of time trying to find it later.

61 Ponds Pearls -- 2 Read all interviews and data from the SIB and review HUD tapes as soon as practicable. Read all interviews and data from the SIB and review HUD tapes as soon as practicable. For the first several days, be a sponge soaking up information and making notes, but not conclusions. For the first several days, be a sponge soaking up information and making notes, but not conclusions. Formulate possible scenarios, and let the data guide the formulation of hypotheses. Formulate possible scenarios, and let the data guide the formulation of hypotheses. Remember, medical members are expert at the scientific method and analytical thought process which they use in daily practicethis thought process is key to the AIB process. Remember, medical members are expert at the scientific method and analytical thought process which they use in daily practicethis thought process is key to the AIB process. Realize that some key data may never be available due to the nature of the mishapa 300 knot impact and flaming JP8 are very effective at destroying evidence. Realize that some key data may never be available due to the nature of the mishapa 300 knot impact and flaming JP8 are very effective at destroying evidence.

62 Ponds Pearls -- 3 Review news clippings and tapes early. Review news clippings and tapes early. Hope that Safety Privilege was granted by SIB only to those needing it; otherwise it may be necessary to again ask the wife and others the same questions. Hope that Safety Privilege was granted by SIB only to those needing it; otherwise it may be necessary to again ask the wife and others the same questions. Limit testimony to facts and observations and avoid speculations. Limit testimony to facts and observations and avoid speculations. Place date/time on footer of documents such as timelines that may be updated frequently, so that the prior versions are not confused with the most current one. Place date/time on footer of documents such as timelines that may be updated frequently, so that the prior versions are not confused with the most current one. Take videos of flight simulator scenarios. Take videos of flight simulator scenarios.

63 Ponds Pearls -- 4 Fly path of mishap and get video. Fly path of mishap and get video. Personally listen to the tapes while reviewing the transcript. (E.g. the tape said, Give me an oral airway and BVM, but the transcribed version said, Give me an oral airway and beam me up.) Personally listen to the tapes while reviewing the transcript. (E.g. the tape said, Give me an oral airway and BVM, but the transcribed version said, Give me an oral airway and beam me up.) Formulate a timeline to incorporate the data from all sources and to coordinate several time measures such as Zulu, HUD and ACMI. Formulate a timeline to incorporate the data from all sources and to coordinate several time measures such as Zulu, HUD and ACMI. Utilize DoD Human Factors guide that lists all 140+ human factors with explanations to examine each person and action. This will assure completeness and uniformity with other investigations. Utilize DoD Human Factors guide that lists all 140+ human factors with explanations to examine each person and action. This will assure completeness and uniformity with other investigations. Enlist the assistance of an aerospace physiologist or Guard physician specialists. Enlist the assistance of an aerospace physiologist or Guard physician specialists.

64 Ponds Pearls -- 5 Murder Board is the process whereby board members read and critique the report as it is displayed on the screen. This is valuable because it gives a thorough insight into others information and thought processes. Comments from the group on the individuals section are important because sometimes the author gets so involved in his/her own section that he/she assumes that certain items are known or clear. Murder Board is the process whereby board members read and critique the report as it is displayed on the screen. This is valuable because it gives a thorough insight into others information and thought processes. Comments from the group on the individuals section are important because sometimes the author gets so involved in his/her own section that he/she assumes that certain items are known or clear. The AIB document is released to the public, so one must be sensitive to the feelings of the next of kin and privacy. The graphic details of the autopsy reports are not public, so the Flight Surgeon should compose a summary of the medical findings for Tab X with details only to the extent necessary to support the conclusions and answer the questions of the family. The AIB document is released to the public, so one must be sensitive to the feelings of the next of kin and privacy. The graphic details of the autopsy reports are not public, so the Flight Surgeon should compose a summary of the medical findings for Tab X with details only to the extent necessary to support the conclusions and answer the questions of the family. Get 2 monitor screens and functional scanner. Get 2 monitor screens and functional scanner. Remember that medical records are protected medical information and cannot be released. Remember that medical records are protected medical information and cannot be released.

65 Ponds Pearls -- 6 Make sure the orders include a rental car. Make sure the orders include a rental car. Assure that orders allow travel time before the convening of Board. Assure that orders allow travel time before the convening of Board. Flight surgeon is eligible for incentive pays if service is greater than 30 days, continuous, not aggregate. Flight surgeon is eligible for incentive pays if service is greater than 30 days, continuous, not aggregate. Guard days and funding must flow, a complex process that may require expediting. Guard days and funding must flow, a complex process that may require expediting. Get good computer support and email access early. Get good computer support and email access early. Do not plan on free time Do not plan on free time –14 hours per day, –6 ½ days per week

66 Ponds Pearls -- 7 To enhance possibility of selection for a Board, To enhance possibility of selection for a Board, –Be prepared to give an immediate answered, yes or noI will check means no. –Have all training issues completed. –Document all items in mobility folder; have it checked by Unit Deployment Manager. –Arrange windows of availability with associates for coverage. –Assemble SIB Information and keep it packed or on disk. Bring personal camera and get CDs to transfer to military computer. Bring personal camera and get CDs to transfer to military computer.

67 Oh yes, Learn to use Table of Contents on MS Word. Learn to use Table of Contents on MS Word. Back up early and frequently. Back up early and frequently. Bring personal laptop. Bring personal laptop. Bring Flying Forms. Bring Flying Forms. Bring Aerospace Physiology reference book or write me. Bring Aerospace Physiology reference book or write me. Cell phone and international data plan for PDA. Cell phone and international data plan for PDA. Scan documents early and file by person and type. Scan documents early and file by person and type. Have Adobe distiller on computer. Have Adobe distiller on computer. AANGFS RSV2009 Snowbird, UT Col William W. Pond, MD, SFS, MC, INANG

68 Oh, I just remembered Assist the Board President in preparing thank you letters on your behalf by supplying addresses and template Assist the Board President in preparing thank you letters on your behalf by supplying addresses and template AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG

69 Dont expect luxury accommodations 18 June 2010AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

70 Realize that the process is all consuming; you will think about it before you sleep and when you awaken, when you eat, shower and walkbut it is that conscientiousness and attention to detail that assures you have left no stone unturned and no question unanswered. We owe that level of dedication to our comrades, their families and the Air Force. 18 June 2010AANGFS RSV2010 Minneapolis, MN Col William W. Pond, MD, SFS, MC, INANG

71 Do expect to make a true impact on the future 22 June 2013AANGFS RSV2013 ANGRC, Joint Base Andrews Col William W. Pond, MD, SFS, MC, INANG


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