In their statements on the day Cannon died, Sealab officials were insistent that whatever may have gone wrong, Cannon’s equipment had functioned normally. They said the cause of death was an apparent heart attack, but that must have been a best guess, since an autopsy had yet to be performed. But within a few days the Mark IX rig had become a smoking gun. One of the three rigs found hanging outside the PTC had a canister with no Baralyme, the sandy carbon dioxide absorbent. Without it, a diver wearing the Mark IX wouldn’t get far before he had trouble breathing. But the empty canister theory raised as many questions as it answered. Complicating matters was a chicken-and-egg quality to the findings of the autopsy, performed within a day of Cannon’s death with Dr. Bond observing.
Dr. Francis Luibel, the pathologist with the San Diego County Medical Examiner’s Office, testified that, as stated in the autopsy report, carbon dioxide poisoning triggered Cannon’s demise, and death was then due to acute pulmonary edema and congestion, brought on by a combination of cardiac and respiratory failure.
Luibel also testified, however, that it was not entirely clear which came first—the heart and respiratory failure or the troubling fluid on the lungs. That left some question as to what triggered the fatal chain of physiological events. In his testimony, Luibel ruled out a few possibilities, namely drowning, but indicated that asphyxiation—caused either by a total loss of breathing gas, or a fatal gas mix—could have initiated Cannon’s death. In that case, a faulty rig, not necessarily one with an empty Baralyme canister, could have been responsible. Carbon dioxide poisoning, as might occur from using a rig with an empty Baralyme canister, could also do damage to the heart and lungs. But, as Dr. Luibel testified, there were many unknowns about what happens when a person is poisoned by carbon dioxide. So it was hard to say for sure that CO2 poisoning was solely to blame for triggering Cannon’s death, although that’s what was stated in the autopsy report.
Lieutenant Commander Lawrence Raymond, who was to have been an aquanaut with the second team, had witnessed portions of the fatal dive on the support ship’s TV monitors and had overheard the divers’ helium-spiked reports coming from the PTC. He was called to testify as an expert on thermal factors. Dr. Raymond left little doubt that cold-induced stress played a large, possibly even decisive role, in Cannon’s death. He said the circumstances surrounding Cannon’s death were likely further complicated by the high pressure and the heat-sapping helium, whose combined effects were not entirely known.
Dr. Workman testified that if a diver breathing through an empty canister kept up a moderate level of physical activity, he could be dead within five to ten minutes. In Cannon’s stressful situation dangerous levels of carbon dioxide would have been reached even sooner. However, Workman and Raymond both noted that if Cannon was riding the bypass, as Barth and Blackburn found they had to, that might have extended his breathing time on the rig.
A further possibility was that Cannon was electrocuted. Sealab III had some grounding problems, and Cannon, the electronics engineer, knew that the worst of the leaking appeared to be around the electrical stuffing tubes, along the side of the habitat where power and other lines were connected. It was conceivable that before going to the hatch Cannon had split from Barth to take a look for himself at the bubbling exterior leaks—and a 440-volt jolt through the conductive saltwater could have sparked his demise. Some sort of vocal outburst such as Cannon made would be more likely in response to electric shock than to breathing a bad gas mixture, but no discussion about the yell that Blackburn and Reaves heard, nor the grunting sound that drew Barth’s attention to Cannon, was entered into the record. Electrocution was ultimately ruled out, as were asphyxiation and thermal stress. Since none of those was considered the most likely cause of death, then there was no need to dwell on the grounding problems, the failed jury-rigging of the hot water suits, the unheated PTC, the finicky Mark IX, the leaks, or even the hatch problem. Carbon dioxide poisoning was singled out as Cannon’s prime killer. With that settled, the board members still had to figure out how one Mark IX wound up with an empty canister.
The attention shifted to the diver in charge of the equipment, Paul A. Wells, a soft-spoken senior chief petty officer known to all his buddies as “P.A.” Wells, a diver for eighteen years, was universally admired for his integrity, reliability, and conscientiousness. He had been a plankton-eating member of the third Sealab II team and thoroughly impressed Bob Sheats, the exacting master diver and team leader. Wells was in his early forties and had spent most of his Navy career working with explosive ordnance and diving, like Blackburn. During World War II Wells had received a Purple Heart for service in the Marine Corps. The gold on his left sleeve signified an award for good conduct. Most important to his fellow divers was that a diving rig set up by P.A. was a rig you could trust. Everyone had complete confidence in P. A. Wells.
The board focused on the handling and preparation of the Mark IX rigs and their interchangeable canisters. On the ninth day Wells, who oversaw the rigs, was called as a witness and asked to recall his every action from the time he reported to the diving station on the Elk River on the morning of February 14, through the fatal dive three days later. Wells was not alone in the diving station, a workshop area on the Elk River that could bustle like a pit stop and was “sometimes utter chaos,” as Bill Schleigh, one aquanaut-to-be, told the board. Those in the diving station didn’t always recognize each other, a testament to how many more people were involved than during the first two Sealabs. Not everyone could remember exactly who gave what to whom, who did which job, or even who had assisted whom in filling canisters. Wells thought one of the aquanauts, Sam Huss, had given him a hand filling canisters, but Huss had no such memory. One person thought to have helped fill a canister could at first be identified only as “a huge man,” a description that fit two likely candidates.
Wells was certain that he had personally placed loaded canisters into three rigs. About the fourth he could not be so sure. He remembered putting all four rigs set up that Friday into a diving station storage bin. On Sunday morning, about thirty-six hours later, Wells learned that they were going to start the first dive sooner than planned to try to fix the leaks and that four Mark IX rigs were needed right away. Wells lifted them out of the storage bin, where they appeared to have been undisturbed. He had checked all the rigs previously and had no reason to believe anything had changed.
It was not common practice, but ordinarily the conscientious diver would have double-checked the canisters by opening each rig’s fiberglass backpack and unscrewing the lid of the phonebook-sized steel canister inside to verify that it was topped off with fresh Baralyme granules. To check each one would have taken only a minute or so, but Wells told the board that he’d gotten the distinct impression that this was “a hurry-up affair,” and he skipped the additional check. He carried each rig to the medical lock of the chamber where Barth, Blackburn, Cannon, and Reaves were being pressurized to six hundred feet on an expedited schedule.
In response to a question from Bond, Wells seemed to poke a hole in the empty canister theory when he pointed out that if a Mark IX canister had been completely empty, he would have been able to tell just by lifting the rig. Some in the room were skeptical, but Wells maintained that if a canister had been empty, he would have been tipped off by the lesser weight—about 17 percent less, eight pounds of Baralyme on a forty-seven-pound rig. Captain Mazzone offered a brief supportive comment and said the weight difference could be noticeable. Others privately agreed, and no one who knew Wells doubted his word.
Under the cold and harried circumstances, neither Cannon nor apparently anyone else in the PTC checked the canisters. After the first dive, Blackburn had put refilled canisters into the two rigs that Barth and Cannon used. That left two rigs that conceivably might have had empty canisters. If the empty canister theory was right, a deadly game of rig roulette was still on.
Before the board of investigation began, all four Mark IX rigs were packed up, with Wells’s
assistance, and then sent to Washington for analysis at the Experimental Diving Unit. It was this packing episode that cast the darkest shadow of doubt on Wells, at least for the three board members, including Commander William Leibold, who had watched closely as Wells packed the rigs, as had Bond and at least one other Sealab officer.
Under pointed questioning from Leibold and Commander Tomsky’s legal counsel, Wells acknowledged that in handling the rigs to pack them up he had not noticed any difference between the weight of the rig with the empty canister and the others. Wells did suggest that this might have been because the rig had some water in its canvas breathing bag. But Commander Leibold, a highly decorated war veteran who recently completed a tour as commanding officer of the Navy dive school and Experimental Diving Unit, disagreed: “You had water in the bags, but not much. I don’t believe it’s eight pounds so, then, is it possible that you wouldn’t know if there was an empty or full canister?”
“Possibly, but I feel right now, this time, here today, I could pick one out of six,” Wells said.
“But on the particular day that you did pick it up, you didn’t notice it?”
“No, not as you say, no.”
Wells offered no further explanation or excuses.
When the packed rigs arrived at the Unit, investigators went to work on several fronts, although their analyses did not include a look into whether an experienced diver could reliably distinguish, by weight, between Mark IX rigs with full and empty canisters. But the investigators did find that of the four rigs—numbered 1, 4, 5, and 8 on their fiberglass backpacks—three were in satisfactory, though not perfect condition for a dive at six hundred feet, but rig no. 5 was not, mainly because of its empty canister. But who wore rig no. 5? No record had been kept. To try to determine the number of Cannon’s rig, attention turned to the footage of Barth and Cannon at the hatch. This closed-circuit video was transferred to higher-quality film, enhanced and analyzed, frame by frame, to isolate the clearest possible view of the black, four-inch-high number painted on Cannon’s white backpack. A panel of eight expert interpreters was then asked to name the number they saw. Five said it appeared to be a 3, two said it was a 5, and one said it was an 8.
The only sure thing was that no one had used rig no. 8, the one left in the PTC. Presumably Reaves, had he made a dive, would have donned it. In the video of the second dive it appeared clear that Barth wore rig no. 1. That winnowed the options for Cannon, and also Blackburn, down to rigs 4 and 5. Presented with the choice of whether Cannon’s rig was numbered 4 or 5, the expert interpreters agreed it could not be a 4. Blackburn, who was never seen on camera, thought it was entirely possible that he had worn no. 5. His dive to save Cannon had been relatively brief, and during those harrowing minutes his extreme shortness of breath had forced him to ride the bypass constantly and circumvent the rig’s gas recycling system—including, perhaps, an empty canister. Barth, too, found himself having to ride the bypass on both his first and second dives. If not an empty canister, other factors, like the hose stiffener, could have been to blame, as Blackburn had told the board. One or more of these factors could have conspired against Berry Cannon, abetted by the severe cold and stress.
The possibility of tampering was also floated in the EDU report, which recommended the board look into what happened to the apparatus between the time of the accident and the analysis done four days later at EDU. Commander Tomsky strongly believed a saboteur may have been responsible for the empty canister before the rigs were ever locked into the chamber. While the opportunity for tampering existed, the board found the probability very small. Commander Tomsky had previously raised the specter of sabotage in the mysterious case of a valve that controlled the flow of pure oxygen to emergency breathing masks inside the deck decompression chamber. That valve, which was opened and closed by one of the many faucetlike controls around the outside of the chamber, should have remained closed while the aquanauts were inside but was twice found open. It had no direct bearing on Cannon’s death, but nonetheless fueled suspicions: If a saboteur really lurked among them, then the same malicious soul who opened the deck decompression chamber valve might also have been responsible for the empty canister. As for the open valve, if the decompressing divers had used the emergency system while still exposed to more than two or three atmospheres of pressure, the inhaled oxygen would have been toxic. At the very least it could have sent them all into convulsions.
After a diving officer’s routine check found the valve cranked open the second time, Tomsky tried but failed to get the Office of Naval Intelligence to launch a full investigation. Tomsky, still concerned, had Captain Mazzone set up a security watch. Mazzone obliged but he didn’t subscribe to the sabotage theory. To him, the valve opening seemed like the kind of mistake he’d seen before with numerous hands on board who were new to saturation diving and its specialized equipment.
After fourteen lengthy sessions, the board and its legal counsel took ten days before convening a final session, on March 24, 1969, to take some further testimony from key witnesses. Over the next couple of weeks, the board produced forty-seven unanimous opinions based on its sixty-six findings of fact. Virtually no one involved in the operation escaped criticism. The board settled on the empty canister theory and the resultant carbon dioxide poisoning as the most likely explanations for Cannon’s death, but conceded the theory was not certain. Its nineteen recommendations touched on many of the problems that had become obvious during the hearing, among them the need for better testing of the Mark IX, properly heated dive suits, strict adherence to the buddy system, a tighter organizational structure, and of course a hatch that was easier to open. The board also noted that Barth, Blackburn, Cannon, and Reaves should be officially commended for their efforts. The board’s harshest recommendations led to punitive letters of admonition for Tomsky and Wells.
Less severe than a letter of reprimand and certainly preferable to being recommended for trial by court-martial, the admonition was nonetheless a bitter retirement gift for Tomsky and he appealed the decision. He wrote a four-page letter to the secretary of the navy and argued that his admonition should be withdrawn. “None of the alleged derelictions on my part have been shown to have in any way contributed to the matter under investigation, i.e., the accidental death of Aquanaut Berry L. Cannon,” Tomsky wrote. “Had the Sealab III exercise been successful, I am certain that my superiors would have considered the organization and management of the operation as near perfect. The exercise was not successful due to material difficulties and failures, which had no relation whatsoever to my organization or management, and to an accident which would have been prevented had existing regulations and procedures been followed.”
He added: “Significance is attached to events which, without the benefit of hindsight, would be virtually unremarkable.” The “material difficulties and failures” that plagued Sealab III were clearly an issue. Tomsky was not alone in lamenting that the leaking lab, reengineered and repainted traffic-light yellow, was, in effect, a lemon. Captain Bond gave the Los Angeles Times an interview midway through the board of investigation in which he complained about the various equipment failures, calling them “unbelievable.” Still, if more rigorous tests of this three-hundred-ton lemon and its related hardware had been allowed, the various material difficulties and failures might have been revealed and addressed before anyone got hurt.
Tomsky considered requesting a full court-martial to pursue the matter further, and perhaps get a more favorable outcome for himself, but decided against it. Such a trial, he believed, would only hurt the morale of the Man-in-the-Sea personnel and generate some more undesirable headlines. As Tomsky and everyone knew, the Navy had weathered not only the Sealab III accident and investigation but a two-month-long inquiry into North Korea’s capture of the U.S. spy ship Pueblo in January 1968, a high-profile proceeding that took place in a nearby San Diego courtroom and came to a somber end just as the Sealab hearings did.
P. A. Wells accepted his puniti
ve letter, but Tomsky counted himself among the many who did not believe Wells was to blame. Tomsky’s boss, Captain William Nicholson, the head of the Deep Submergence Systems Project, wrote in a memo to his superiors that Wells’s admonition was “extreme and unnecessary,” and urged that it be reduced to a less severe “letter of caution.” Nicholson indicated that Wells would take the punishment hard, and he worried about “the probable impact of a ‘punitive letter’ to the self-censure of such a conscientious person as Chief Wells.” He was right to be concerned. Wells withdrew into a self-imposed exile, avoiding even his many longtime Navy friends. Bob Barth couldn’t help feeling that the Navy had lost two excellent men, not just one, on that fateful day. Years later, Wells had settled in Panama City, Florida, not far from Alligator Bayou, where Sealab I was built. He lived in a mobile home park called Venture Out. But as far as anyone could tell, he rarely did.
It is safe to say that few were satisfied with the outcome of the investigation. Wells had been made a scapegoat and the empty canister theory left too many questions unresolved. Many felt that the real problems plaguing the project had been glossed over, like the troubled habitat and the rush to meet the February deadline. Tomsky remained convinced that sabotage should have been given greater credence—for the empty canister, the oxygen valve, perhaps even some of the program’s other setbacks and delays.
In the investigation’s wake, the Navy offered public assurances that Sealab III would be repaired and the undersea experiment would go on, much as the Apollo mission had gone on despite the tragic launch pad fire. Berry Cannon would have wanted it that way, his friends knew. Funeral services for Cannon had been held on February 19, in Chula Vista, his wife’s nearby hometown, an exurban enclave between San Diego and the Mexican border where houses were just beginning to outnumber citrus groves. Mary Lou Cannon sometimes made the trip west from the couple’s Panama City home and stayed at her parents’ place with their sons—Patrick, age nine, Kevin, who had just turned five, and two-year-old Neal. She was in her parents’ little kitchen getting breakfast ready for the kids when a Navy chaplain appeared at the door of the bungalow on the morning of February 17, within hours of Berry’s predawn accident.
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