Twenty-year-Old Declan Sullivan was filming practice on the lift when it tumbled, claiming the life of the college junior from suburban Long Grove.
The report says the staff of the football team likely would not have used the lifts had they seen an updated weather forecast predicting higher winds.
The university president takes the ultimate responsibility; however, no one has been disciplined or punished.
The report comes on the heels of the Indiana Occupational Safety and Health Administration's report published a month ago. That IOSHA report placed the blame on the university. Monday's report by Notre Dame mirrored many of those same findings.
"The Sullivans entrusted Declan to our care. We failed to keep him safe," said Notre Dame University President Rev. John Jenkins.
Monday morning, Jenkins accepted, in no uncertain terms, responsibility for the October 27 accident that took 20-year-old Declan Sullivan's life. The film major was on a hydraulic lift, 35 feet in the air, shooting football practice when a 53 mph wind gust sent the lift crashing.
However, in releasing Monday's report, Jenkins also added that no one would be disciplined.
"The people involved on that day had a protocol and procedures," said Jenkins. "They followed that conscientiously. As you saw, wind was checked eight times before practice. Those protocols and procedures were not adequate."
Those protocols stated that lifts would be grounded if winds were in excess of 35 mph. The last time anyone checked the winds, at 2:46 p.m, the wind speeds were still acceptable. But that changed minutes later.
"The updated data at 2:54 indicates wind gusts above our threshold, above 35 mph," said Notre Dame Executive Vice President Dr. John Affleck-Graves. "Had our staff been aware of this data they likely would have grounded the lifts."
Add to that lack of knowledge a lift that, because of its weight distribution and height, was more susceptible to tipping; and those, says the university, were the main reasons behind the accident.
To prevent this from happening again Notre Dame says it will implement eight recommendations included in the study. Among them:
- Adoption of the international wind-speed standard of 28 mph to operate lifts.
- Access to real-time weather information during lift operation.
- -Establish a stronger culture of safety, with one person ultimately responsible for practices.
In response to Monday's report, Mike Miley, a spokesperson for Declan Sullivan's family had this to say: "The family is grateful for the detail with which the university put forth their findings...and we hope it lays the framework to make the organization safer...In the middle of all this tragedy we know Declan's death will serve to help others and to prevent this from happening again."
While the university says that lifts can be used safely and that they will continue to do so at some events, football practice is not one of them. Automated cameras will now record those practices.