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Mountain guide death leads to Exum fine

A Jackson Hole climbing guide service paid a $7,350 fine for safety violations after state officials investigated the 2016 death of a guide who fell from the Grand Teton.

Exum Mountain Guides paid the fine and resolved two citations after an investigation by Wyoming’s Occupational Safety and Health Administration. The probe was prompted by the death of guide Gary Falk. The guide service agreed to review annually the personal safety gear that climbing guides use and document that inspection, according to recently released OSHA documents. Exum also agreed to document training about how to avoid contact with biological hazards, such as blood.

Falk, 42, died in a fall from the 13,775-foot Grand Teton on July 23, when he was descending the peak with young clients from a group called City Kids. Grand Teton National Park climbing rangers believe a knot Falk tied to make a tether from nylon webbing slipped and sent him plummeting 2,500 feet to his death. The tether — a four-foot loop or sling — was part of his personal gear and not supplied by Exum.

The investigation underscores an emerging awareness among businesses in the recreation and outdoors industry that they are subject to rules seeking to ensure safety — even in unconventional workplaces like ski resorts and wilderness areas. In recent years Wyoming OSHA has investigated the death of an ecology field worker slain and eaten by a bear or bears, a ski patroller killed in an avalanche and another patroller who died in a fall.

Recreation and outdoor businesses in Teton County and other resort areas present unconventional challenges when it comes to ensuring safe workplaces, John Ysebaert said. Ysebaert is the administrator of OSHA’s Office of Standards and Compliance.

“Many of the employers in Teton County come across hazards that are more unpredictable,” than those found in more traditional work settings, Ysebaert said.  With ski fatalities, bear maulings and climbing falls, “Teton County is unique in many of those circumstances.”

Federal rules, which Wyoming enforces, require employers to protect their employees according to certain standards. Rules can be specific regarding scaffoldings, hard hats and safety harnesses. But OSHA, Ysebaert said, “doesn’t have standards for preventing bear attacks.”

A successful climb to the summit

When he fell, Gary Falk had just successfully guided his group of three students from a program called City Kids, and their chaperone, to the top of the mountain, according to Grand Teton National Park’s accident report, made public by a FOIA request filed by the Jackson Hole News&Guide. He was preparing to safeguard the students with a belay rope as they rappelled one-at-a-time off a roughly 120-foot drop slightly below the summit. Each client would use a friction descending device known as an ATC. But because of a last-minute re-arrangement of climbing teams, Falk found himself one ATC short.

This is believed to be the last photo of Gary Falk alive, taken on the summit of the Grand Teton on July 23, 2016 and reproduced in the park accident report. The faces of his City Kids clients have were obscured by the National Park Service for privacy reasons. (Grand Teton National Park)

This is believed to be the last photo of Gary Falk alive, taken on the summit of the Grand Teton on July 23, 2016 and reproduced in the park accident report. The faces of his City Kids clients were obscured by the National Park Service for privacy reasons. (Grand Teton National Park)

After the chaperone slid down the rappel rope, Falk planned to retrieve the chaperone’s ATC with the belay rope. But the rope and ATC got stuck in a crack on the way up. From above, Falk tried to flip the jammed rope and ATC to free them. Rangers believe Falk was linked to the solid rappel anchor with his self-tied tether, also called a lanyard. He was probably leaning out with tension on the tether, possibly to see if he was making progress.

He “was immediately projected outward” and plunged to his death, the park report said. “This would be consistent with leaning out on a lanyard that fails,” the report said.

“…[E]vidence and witness statements suggest that he was using a 98 inch section of 9/16 [inch] blue tubular webbing tied in a loop with a water knot to tether himself to the anchor and that the knot came untied during his attempts to free the stuck rappel device,” the park report said.

Grand Teton climbing rangers examined Falk’s gear after they retrieved his body and found the 98-inch webbing still attached to the guide’s harness with a hitch knot. But its two ends were not tied together as they needed to be to form a tether.

Among the clues investigators used in their probe were burn-like marks on the tether webbing, possibly indicating stress from the friction of a knot pulling loose. They referenced studies — one 17 years old — that “focused on the tendency of water knots to slip and fail when the tails are of inadequate length and when the knots are cyclically loaded and unloaded.” Investigators found photographs from the climb that showed Falk’s water knot in which “one tail is visible and is of adequate length but the knot is not tightened.” They described a sequence of his activities before the accident during which the tether would have been loaded, or pulled on, and unloaded.

Employers must protect workers

Federal laws require employers to ensure their workers in hazardous places have protective gear that meets certain standards, Ysebaert said. Workers can supply their own gear if it meets those standards, and it is natural for climbing guides to do so.

OSHA cited Exum for violating a standard saying that when a worker supplies his or her own safety gear, the employer “shall be responsible to assure its adequacy, including proper maintenance.” Documents outlining settlement of the citations said “the employer has not conducted an assessment of the employees provided protective equipment to ensure its adequacy, including proper maintenance….”

Grand Teton National Park rangers included in their accident report a paper by Richard Wright, Eric Steffler and Tom Walters on the perils of the water knot. The paper includes this exploded-view illustration of one. When tied on 9/16ths-inch nylon webbing, repeated loading and unloading of the knot can cause it to slip within as few as 100 stress cycles. (Grand Teton National Park)

Grand Teton National Park rangers included in their accident report a paper by Richard Wright, Eric Steffler and Tom Walters on the perils of the water knot. The paper includes this exploded-view illustration of one. When tied on 9/16ths-inch nylon webbing, repeated loading and unloading of the knot can cause it to slip within as few as 100 stress cycles. (Grand Teton National Park)

Exum conducted gear training and assessment each year but “they just had not formalized it and were counting on experienced staff,” the settlement agreement states.

As a result of the OSHA investigation, “they have implemented inspection regimen for that and [agreed] to document that and have a log book … and to train on inspection procedures,” Ysebaert said. The inspection of self-supplied guides’ gear will occur once a year, and be documented. “It’s not practical for them [the company] to inspect [gear] each and every time,” or before each climbing trip, Ysebaert said.

A second citation said Exum did not have a written plan to limit guides’ exposure to bloodborne pathogens should they render first aid, as they might be expected to do. Exum agreed to write a plan.

Would inspections have saved a life?

“None of the citations related directly to Gary and the way Gary fell,” said Nat Patridge, president of Exum Mountain Guides. “What was revealed was we need to improve on our documentation. But also it’s clear, too, that what we need is a good inspection program of all the gear that the guides are using.

“We’re going to have our health and safety officer and the chief guides visually inspect all the guides’ gear that they will use at Exum while they’re guiding,” Patridge said. That will happen annually. But water knots inspected in June may go through hundreds of loading/unloading cycles by the end of the summer guiding season in September.

“The knot is strong if the tails are long enough,” Patridge said. “Just like when you tie into a rope, you have to make sure it’s tied perfectly. The knot always needs to be inspected every use.”

The water knot, also known as a ring bend or an overhand follow-through bend, may still have a place in mountaineering, despite its flaws. Climbers use them for a variety of tasks, including tying webbing into sling loops. Knotted slings and tethers are more versatile than permanently sewn versions of the equipment because they can be untied to be employed in a variety of configurations. They can, for example, be untied, threaded through bolts or around trees, and re-tied quickly without using up much sling length in the knot itself. Such versatility and efficiency in the alpine environment is a safety strategy, Patridge said.

Again, tests show that a water knot — specifically one made on 9/16-inch webbing like what Falk was using — must be tied with long tails and repeatedly checked. Tests show when water knots made with 9/16-inch webbing are repeatedly loaded and unloaded, one tail will eventually be pulled through the knot. In some instances, the tail will pull through and the knot will fail after only 100 loading/unloading cycles.

Rangers recovered Falk’s 9/16ths-inch-thick nylon webbing tether after the accident and discovered discoloration and stiffness at one end, possibly caused by friction when a water knot failed. (Grand Teton National Park)

Rangers recovered Falk’s 9/16ths-inch-thick nylon webbing tether after the accident and discovered discoloration and stiffness at one end, possibly caused by friction when a water knot failed. (Grand Teton National Park)

OSHA agreed that Falk knew how to properly tie a water knot. The guide was “highly certified, highly trained in the tying of that knot,” Ysebaert said. “That was not employer negligence.”

Double-checking knots throughout the season won’t be Exum’s task, the administrator said. “It’s not practical for [Exum] to inspect it each and every time.”

Patridge agreed that regular knot inspection is a guide’s responsibility. “We’re not going to inspect every knot every guide ties multiple times every day,” he said.

Awareness of OSHA grows

Climbing guide services and other businesses that employ workers in the backcountry might not all be aware that OSHA has standards they are required to meet, said Alex Kosseff, executive director of the American Mountain Guides Association. “It is something AMGA has become aware of largely as a result of this tragic accident,” he said. “We certainly will be looking at what happened here and working to determine if we need to share the information with guide services around the country about standards like this.”

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Awareness of OSHA rules is growing in the the related industry of climbing gyms, Kosseff said. But OSHA standards don’t eliminate all risk. “Even if that equipment had been inspected, that may not have had any bearing on this incident,” he said.

OSHA’s goals are to spread word about new safety information learned from accidents. In the case of the worker killed and eaten by a bear or bears, the employer had to develop a wilderness safety plan and make it available to other companies.

“That’s one of the ways we attempt to reach out,” Ysebaert said. In the case of a ski patroller killed in a fall, “we did come out with some rules for wearing head protection.”

Highly respected, experienced guide

Falk himself “was a beloved person and one of the best guides in this country,” Patridge said. He was a rare guide who was raising a family solely through his mountaineering profession, he said. “He was very diligent, very mindful and very aware of all the risks. There was no one better at taking care of their clients.”

“The process with OSHA was very positive,” Patridge said. “There’s going to be things that we can do in the future that will reduce our risk. Beyond that, he was just an amazing individual, friend, husband and father,” Patridge said. “There’s a big void now that he’s gone.”

 

OSHA’s agreement with Exum:


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About the Author

angus@wyofile.com |

Angus M. Thuermer Jr. is the natural resources reporter for WyoFile. He is a veteran Wyoming reporter and editor with more than 35 years experience in Wyoming. Contact him at angus@wyofile.com or (307) 690-5586. Follow Angus on Twitter at @AngusThuermer

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10 Responses to Mountain guide death leads to Exum fine

  1. Laurence Fortin March 8, 2017 at 3:31 pm #

    God bless his family and co-workers, this is a terrible loss for the community and I offer my sincere condolences. Thank you for the work and excellent details provided in this report Mr. Thuermer.

    Corona, California

  2. patty merchek February 27, 2017 at 11:00 am #

    Here’s won’t you don’t see in Angus’ story:

    Is OSHA doing work the NPS should be doing?

    There were three deaths involving the climbing concessionaires in the last three years.

    Was OSHA looking at those deaths?

    Did the NPS do anything other than prepare an incident report during the last three deaths?

    Do they have any responsibility to ensure the safety of visitors utilizing the concessionaires?

    Is the NPS mistakenly equating the climbing concessionaires with the regular joes out climbing on their own?

    Exum and the JH Mountain Guides have had deaths, near misses, and injuries over the years. Those events seem to be dismissed as the result of inherent objective hazards. They shouldn’t be.

    When the professionals can’t keep you safe doing the basics, maybe there’s a problem that people need to stop and evaluate.

    You won’t find GTNP doing that.

    jackson, Wyoming

  3. Paul Butler February 21, 2017 at 8:13 pm #

    Dealing with a worker safety agency can sometimes lead down a black hole of nightmarish bureaucracy, an experience that is likely the antithesis to what a mountain guide generally offers. Hopefully that isn’t the case here for the employer.

    Mazama, Washington

  4. Jay Pistono February 21, 2017 at 4:04 pm #

    Angus,, saving lives with critical thought and factual information- keep up the good work

    Wilson, Wyoming

  5. Keith Benefiel February 21, 2017 at 1:58 pm #

    In over fifty years of working with rope and related materials, I have learned things to share.
    “Half inch” tubular webbing is 9/16 inch wide, but barely 1/8 inch thick. It is for accessory use only and should never be used for life support! The ring-bend is notorious for “ratcheting” loose over repeated cycles. It should always be backed up with an overhand on each side. If the knot (bend) is loosely tied and not backed up, it can fail the FIRST time it is loaded. Backing the knot up ensures that there is sufficient tail. In Falk’s final photo, the ‘figure eight follow through” knot that connects the rope to the harness is loose and not properly “dressed”. It could fail if shock loaded.
    To anybody whose life depends on rope work, CHECK YOUR KNOT! Have your partner check it too. Being in the middle of a job, it’s easy to let that go. Don’t.

    Wilson, Wyoming

    • Sam Taggart February 22, 2017 at 12:06 pm #

      1/2 webbing and 9/16 are 2 different animals. 1/2 is rated for body weight only, but 9/16 is rated for a fall. and all webbing is really only about 1/8 thick (at the least the tubular) regardless of width. The 1/2, 9/16, 1 inch, etc refers to width only.

      For that application 1/2 inch would be scary but 9/16 is perfectly appropriate and used by climbers on a regular basis without incident. The takeaway is to inspect your knots on a regular basis and use plenty of tail.

      And there is nothing wrong with his tie in. He could probably have cinched it down a little bi t more, but it has more than enough tail.

      Golden, Colorado

      • Harry Morten February 26, 2017 at 5:19 pm #

        Pretty sure Gary was just using the webbing to support body weight. His knot was poorly chosen or tied IF in fact that is what did not prevent him from falling.

        Not all guides tie off and Exum needs to get that habit changed. Some just hold on to the belay rope.

        Of course most guides are not trying to free a stuck rope. However rockfall from above or a falling cliet could take down an untied guide.

        This was a guide’s error. Things happen but as Jeff Lowe once said, “Even objective hazards are no excuse for accidents.”

        Guides are human. They make mistakes. Not an excuse but just facts. None is perfect. That’s why climbing with protection is so popular.

        seattle, Washington

    • Simon Middlemass February 23, 2017 at 12:17 am #

      Keith – even 16mm tubular tape has a breaking strain of 14kn – bits of your body will pop before that breaks !!

      Aoraki-Mt Cook - New Zealand, Wyoming

  6. Jay Phipps February 21, 2017 at 11:02 am #

    Very informative and useful report. I for one will use it to help elevate awareness for those of us with “non-traditional” workplaces. Thank You.

    Olympia, Washington

  7. Bob Mullen February 21, 2017 at 6:32 am #

    Man I appreciate the depth of this report.

    Casper, Wyoming

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