Royal Marine, Benjamin McQueen, died during elite unit training following serious failures by the Ministry of Defence

Failures included:

• i. Not topping up breathable gas levels between the two dives;
• ii. The lack of a training requirement for all signals to be acknowledged;
• iii. Inadequate risk assessment for the combined use of the equipment used by Ben in training and failing to identify mitigating measures for the risks arising
• iv. A marked and inappropriate increase in the rate of training progression;
• v. Insufficiently firm instruction on when student drivers should surface;
• vi. Limitations in training in the Emergency Ascent Drill;
• vii. Not specifically training dive students to check their cylinder pressure after drills;
• viii. Inadequate consideration of the risk of a loss diver in selecting the most appropriate air cylinder for the stand-by diver;
• ix. Failure to ensure a full and rapid debrief of the student divers who surfaced in choosing where to deploy the standby diver;
• x. The lack of formal authorisation from Headquarters for some of the equipment being used; and
• xi. A lack of proactive engagement in the chain of command.

The inquest regarding the death of Benjamin McQueen, a 26-year-old young man from Southampton, concluded today that he died during diving training in Portland Harbour as a result of serious failings by the Ministry of Defence (MoD). This conclusion comes nearly five years after his death on 14 November 2018.

Ben enlisted for training as a marine at Commando Training Centre Royal Marines, joining 103 Troop on 7 December 2009. Following the 32-week course he passed for duty as a Royal Marine Commando on 10 September 2010.

It was clear to his family and those that knew him that Ben was an extremely well-liked and considerate human being as well as a competent and natural soldier. Ben stood out in his career reports for the excellence he brought to his role. He achieved his life ambition of serving his country by joining the Corps and being selected for an elite unit. It is during training for an elite unit that Ben lost his life.

Sir Ernest Ryder, the Coroner Judge appointed by the Chief Coroner sitting on behalf of the Coroner for Dorset, found that Ben’s death was caused by drowning during an arduous military training for operations with an elite unit at Portland Harbour.

Due to concerns of national security surrounding the circumstances of Ben’s death, the majority of the evidence was considered behind closed doors with only Ben’s family and security cleared legal representatives able to attend. Sir Ernest Ryder provided his open conclusions today at 2pm together with a security cleared “gist” of his factual findings made available to the public. He had previously provided more detailed findings with the public and media excluded.

In open court, Sir Ernest Ryder raised significant concerns about the planning and supervision of the training provided by the MoD that led to Ben’s death, finding in particular that the MoD:

• i. Not topping up breathable gas levels between the two dives;
• ii. The lack of a training requirement for all signals to be acknowledged;
• iii. Inadequate risk assessment for the combined use of the equipment used by Ben in training and failing to identify mitigating measures for the risks arising
• iv. A marked and inappropriate increase in the rate of training progression;
• v. Insufficiently firm instruction on when student drivers should surface;
• vi. Limitations in training in the Emergency Ascent Drill;
• vii. Not specifically training dive students to check their cylinder pressure after drills;
• viii. Inadequate consideration of the risk of a loss diver in selecting the most appropriate air cylinder for the stand-by diver;
• ix. Failure to ensure a full and rapid debrief of the student divers who surfaced in choosing where to deploy the standby diver;
• x. The lack of formal authorisation from Headquarters for some of the equipment being used; and
• xi. A lack of proactive engagement in the chain of command.

The family were particularly concerned that it took standby divers approximately 40 minutes to locate Ben and bring him to the surface.

The Health and Safety Executive (HSE), an interested person to Ben’s inquest, had already served the MoD with two improvement notices and following their earlier investigation, the MoD had also accepted two Crown Censures. These additional criticisms by Sir Ernest Ryder go beyond the HSE’s investigation and illustrate a level of overconfidence within the MoD when it comes to providing safe systems of training to its soldiers.

The Coroner Judge, having heard evidence as to what improvements had been implemented by the MoD since Ben’s death, also made four recommendations to the MoD via a Prevention of Future Death Report to ensure that lessons arising out of Ben’s death are learned.

Sebastian Del Monte of Hodge Jones & Allen said:

“It is clear from the Coroner’s conclusions that Ben’s death was preventable and is symptomatic of the Ministry of Defence’s opaqueness, which led to overconfidence surrounding safety and training processes. It is the family’s view that this complacency and lack of oversight caused the tragic death of a young man serving his country.

“Due to the lack of transparency and the need for a secure inquest the family has waited nearly five years to uncover what happened to their son. Inquests are difficult processes for any family but especially so in these circumstances. Ben’s family fought tirelessly and with dignity to learn the truth surrounding Ben’s tragic death. They did so to ensure that other families do not have to go through the same torturous process.”

Ben’s mother, Kathy McQueen, and Ben’s father, Colin McQueen said:

“Ben was a precious beloved son, brother, soldier, friend and is sorely missed. He lived his live to the full, a natural soldier with a humble heart. He had a fierce focus and determination to reach his best. His life was cut short because he was failed by the very organisation in which he put his trust. We do not know exactly what happened in Ben’s final moments, but we do believe Ben’s death was preventable. His legacy will be significant changes in dive training and ethos across the forces and an inspiration for others to face their fears as he so courageously did. We do not grieve as those who have no hope because we will see Ben again and his life and death have not been wasted.”

The inquest has received coverage on BBC News and The Independent.

The above content has been reproduced from a Hodge Jones & Allen press release.