An Osprey crash that killed three Marines during an exercise in Australia last year narrowly avoided a mid-air collision caused by pilot error – a military report on Friday revealed further revelations about the tragedy.

The tragic crash on August 27, 2023, which killed pilots Captain Eleanor V. LeBeau (29) and Major Tobin J. Lewis (37) and crew chief Cpl. Spencer R. Collart, occurred amid a “culture of disregard for flight safety” that squadron leadership continued to tolerate, the report said.

While LeBeau and Lewis, the plane’s commander, died in the crash, 21-year-old Collart died after “heroically returning to the plane’s burning cockpit to rescue the trapped pilots,” military investigators said.

Twenty other soldiers who were in the rear of the plane survived.

The accident occurred as two Ospreys, which can fly as airplanes or helicopters, were making a low-level final approach to landing during the multinational training exercise.

As one helicopter followed the other, the lead aircraft reduced power without telling the following one. The second Osprey did not notice how quickly the gap between the two was closing and responded by making a steep turn to avoid a collision with the lead helicopter.

The pilot entered two more steep slopes, where he encountered a tailwind of 20 knots and eventually went into a spin, leading to the crash, according to the report.

In those fateful minutes, the aircraft commander should have brought the situation under control earlier, the report continued.

The fatal accident exposed serious safety deficiencies at the Hawaii-based squadron, which could lead to court-martial charges against a senior squadron member and possible administrative action against the squadron’s former commander, Lt. Col. Joe Whitefield, who the report accuses of “perpetuating a culture of disregard for flight safety procedures.”

An unnamed senior maintenance officer was charged with violating the Uniform Code of Military Justice for neglect of duty and falsely preparing and signing a form detailing the weight and load of the aircraft after the crash.

According to investigators, there were several problems before the planes took off, including two minor accidents, including a near-collision caused by weight and loading problems three weeks earlier.

Those problems should have been warning signs, but they did not prompt Whitefield to request a pause in work to investigate larger safety issues, the report said. By failing to take action, Whitefield “directly contributed to the failure to comply with required flight safety and weight and power procedures on August 27,” investigators found.

Lewis, the aircraft commander, served as flight instructor to the pilot of the lead Osprey and also as aircraft commander of his own Osprey. However, he did not review the mission planning documents describing the flight or other details related to the exercise before the flight, the report said.

Both Ospreys had 2,000 pounds more fuel than planned and there were only estimates of how much each soldier weighed in the back. The weight of the aircraft can play a critical role in its operational safety.

In addition, the Osprey that crashed was inadequately maintained, meaning it should not have taken off. However, the investigation found that these problems were not responsible for the crash.

The deaths of the three Marines “continue to impact the entire Marine force,” the 1st Marine Expeditionary Force said in a statement on Friday.

The crash last August is one of four fatal accidents involving the Osprey in the last two years.

With post wires