Preliminary summary of crew club post-accident reviews

Iowa State University commissioned two reviews following the tragic boating accident on March 28, 2021, at Little Wall Lake that resulted in the deaths of students, Derek Nanni and Yaakov Ben-David. An independent external review was conducted by the U.S. Council for Athletes Health (USCAH) with assistance from Mark Wilson, cofounder of All American Rowing Camp, a rowing expert identified with help from USRowing. Additionally, a separate internal review was conducted by a committee of university personnel with student activity and student organization expertise from the Office of University Counsel, the Office of Risk Management, the Student Activities Center and the Department of Public Safety Transportation Services.

University leaders appreciate the work of all involved in the review process and are working to implement the recommendations outlined in each review. The Iowa State community extends its condolences to the family, friends and loved ones of Yaakov Ben-David and Derek Nanni who lost their lives in the accident.

The following is an overview of the two reports, which will be released after appropriate student- privacy measures have been applied.

Significant Findings

While conducted independently, the two reviews identify similar concerns, findings and recommendations:

  • The reviews found that the university's implementation of health and safety policies for university sport clubs was deficient. This deficiency led to an inadequate level of health and safety oversight, training, and support for the Crew Club, as well as other higher risk sport clubs. The current operating and management structure of student organizations generally allows sport clubs, including those like the Crew Club, to operate largely autonomously without prescribed and consistent oversight by the university. While the individual clubs comprising the Sports Club Program present a wide spectrum of associated safety and risk issues, ranging from very low risk activities to higher risk activities, the same level of autonomy is extended to all. As a result, there has been an incomplete analysis of the relative risks and necessary safety considerations of each sport club and inadequate health and safety policies and practices in higher risk activities such as the Crew Club.
  • Both reviews concluded that the university failed to clearly define roles and responsibilities for effective oversight of sport clubs, especially for higher risk activities such as the Crew Club. This failure resulted in inadequate university health and safety oversight and supervision. Sport clubs are required to have a faculty/staff advisor and to coordinate their activities through Recreation Services. However, the faculty/staff advisor is not clearly empowered under current policy to provide administrative direction, make safety decisions, or otherwise adequately oversee club activities. Similarly, current policy does not provide for clear oversight by or accountability to Recreation Services for specific safety and risk management practices connected to club events and practice sessions. This lack of clarity in the administrative roles and administrative relationship with the Crew Club created an atmosphere where safety issues did not rise to an appropriate level of concern, coordination and oversight by university administration, Recreation Services and the club itself. Even where safety concerns were known by Crew Club student leadership and relayed to Recreation Services, neither the club leadership nor Recreation Services took adequate measures to address the safety concerns or suspend club activities until the safety concerns were addressed.
  • On the day of the accident, Crew Club leadership failed to follow critical health and safety procedures identified in the club’s constitution, its governing document. Despite being specifically required by the Crew Club’s safety procedures for all on-water events, the following health and safety standards were not applied on March 28:
    • Wind speeds were acknowledged to be outside of acceptable limits by Crew Club student leaders just prior to the on-water activity occurring, but the activity was not cancelled.
    • Crew Club student leadership failed to adequately respond to worsening weather conditions as the practice proceeded.
    • No safety launch boat was used, despite being required under the conditions.
    • No team member or coach was on shore or in a safety launch to relay changing conditions or respond to an emergency, despite being a requirement.
    • Two team members lacked sufficient on-water experience for the weather and water conditions present, violating the club’s constitutional requirement that does not permit members to row in conditions outside of their ability levels.
    • Team leadership did not ensure that proper safety equipment or communication devices were available in the case of an emergency.

Immediate University Actions

Each of the reviews provide specific recommendations regarding the Crew Club as well as the Sport Clubs program in general. Based on these recommendations, the university is taking the following immediate actions:

  • All Crew Club activities will be suspended for at least the 2021-2022 academic year. This suspension will allow for the implementation of all health and safety measures ultimately adopted by the university based on the recommendations of the reviews.
  • Appropriate offices, including University Risk Management, Recreation Services and the Student Activities Center, will develop a plan for reconstruction or reorganization of the sports club category of student organizations, taking into consideration all the recommendations of the reviews. The plan must at a minimum include the following:
    • A risk review of each sport club, assessing each as “high,” “moderate” or “low” risk.
    • The development of a plan to implement additional required safety training and a system of accountability for safety training specific to each club designated as “high” or “moderate” risk. The plan should include safety training for all team members, coaches and advisors.
    • A plan for implementing policy revisions and clarifications that clearly define the authority and roles of advisors and other administrators in Recreation Services and Risk Management regarding health and safety. This will include clear authority for advisors and other designated administrators to halt any activity for health and safety reasons.
    • The plan should analyze all other recommendations set forth in both reviews and provide recommendations regarding what other structural changes may be necessary to address the concerns identified in the reviews.
  • The university will prepare an after-action report detailing the specific changes that will be made in response to the recommendations of the review. The plan should be completed by January 31, 2022, with implementation completed by the end of spring semester 2022.