Ten servicemen who died in an RAF special forces transport aircraft that exploded in mid-air after being hit by groundfire in Iraq were the victims of “serious systemic failures” by the Ministry of Defence, a coroner said yesterday.

Two reports by experts written in 2002 and 2003 warned the MoD that the fuel tanks on the wings of Hercules aircraft were vulnerable to enemy fire and recommended that they be fitted with explosion-suppressant foam (ESF). No action was taken, however.

The men were killed in 2005. David Masters, the Wiltshire Coroner, concluded their inquest, saying of the reports: “Effectively, in my judgment, this means, ‘Get on and do it’. Despite all the recommendations, a decision – unrecorded – was taken not to proceed.”

Witnesses at the hearing at Trowbridge, Wiltshire, claimed that if Hercules Flight XV179 had been fitted with the protective foam, the nine RAF men and one soldier who died might have survived.

Mr Masters concluded, however: “Very sadly I don’t think this inquest can determine [that] if ESF had been fitted the ten who died would have survived the attack. What it can determine is that the explosion that led to the wing breaking in two would not have occurred, because there would have been no explosion. The ten who died had just lost their opportunity for survival.”

The families of the victims said that they felt their relatives had been let down by the RAF. They said that “the world would be watching” to see whether the coroner’s recommendations were followed up by the MoD.

Sarah Chapman, the sister of Sergeant Bob O’Connor, one of the victims, said: “Those failings have caused the deaths of ten fine men.”

Failure to fit the foam to the fuel tanks constituted a serious failure and was a factor in the tragedy, Mr Masters said. Since the explosion, which resulted in the highest toll of casualties from a single incident during Britain’s campaign in Iraq, the MoD has been fitting the foam to all operational Hercules, at £350,000 to £600,000 per aircraft.

The coroner, who recorded a narrative verdict, was also highly critical of the failure to circulate intelligence to all RAF crews that insurgents had fired on two US Black Hawk helicopters from exactly the same spot earlier that day.

The RAF Hercules C130K aircraft had taken off from Baghdad and was flying at low altitude en route to Balad. The Hercules was with 47 Squadron attached to special forces. The only soldier on board, acting Lance Corporal Steven Jones, 25, served with an SAS signals unit.

The aircraft was targeted by an arc of ground fire, and the fuel tank on the right wing was hit by a medium-calibre antiaircraft round. The heat and blast generated by the impact detonated a mix of fuel vapour and air that had built up inside the fuel tank.

The crew was not aware of the attack on the two Black Hawks. “The system in place failed the captain and crew of that aircraft and this should never be allowed to happen again,” the coroner said.

An intelligence officer who gave evidence at the inquest said he had no idea that an RAF Hercules was due to fly over the same area so soon after the attack on the American helicopters. No flight plan had been filed by the crew of XV179 “because of the [special forces] nature of its tasking”, the coroner said.

Air Vice-Marshal Stephen Hillier, Air Officer Commanding No 2 Group, responsible for the Hercules fleet, admitted that the coroner had uncovered “processes” that had been “inadequate in some areas”.

“We were not able to provide the crew with all the up-to-date intelligence and tactical advice concerning potential vulnerabilities; and the MoD did not take all available information into account in developing equipment to protect against likely threats,” he said. “For these shortcomings, I would like to apologise on behalf of the RAF and the MoD.”

He added that the decision not to fit ESF was as a result of an “incorrect judgment”.

Bob Ainsworth, the Armed Forces Minister, admitted that the MoD should have acted more quickly to fit ESF to the RAF’s Hercules fleet; and Air Chief Marshal Sir Glenn Torpy, Chief of the Air Staff, apologised for the shortcomings highlighted by the coroner and promised that lessons would be learnt from “this tragic loss”.

Coroner’s advice

— All combat aircraft should be fitted with a fuel-tank protective systems, eg, explosion-suppressant foam

— A review must be carried out of weapons classification taught at the Air Warfare Centre at RAF Waddington to ensure that aircrews are aware of all projectile-firing arms in theatres such as Iraq

— Family members should be allowed legal aid to fund lawyers to represent them at future inquests

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