On Root Cause Analysis, Timelines, and the Trump Assassination Attempt

The Trump assassination attempt in Butler, Pennsylvania, occurred on July 13, 2024. After 90 days, we still only have preliminary information on the matter. The US Senate report is the most detailed summary of the matter to date. And we are missing one of the essential three analytical tools for determining root causes–the causal factor timeline.

Timelines and Causal Factor Timelines

Timeline

A timeline is a chronological sequence of events. It lists what happened and when, providing a straightforward account of the events as they unfolded. A possible event example for the Trump assassination attempt might be “5:51 p.m.: Secret Service is notified of a suspicious person.”

Causal Factor?Timeline

A causal factor timeline goes beyond just listing events. It analyzes the underlying causes and contributing factors that led to each event. This type of timeline aims to identify root causes and systemic issues.

Instead of just noting when the Secret Service was notified of a suspicious person, a causal factor timeline would explore why the notification was delayed, what communication failures occurred, and how these factors contributed to the overall incident.

A Practical Example from a Failure?Analysis

Our team had completed their staff interviews and had performed some initial fault tree analysis. In this case, they were building a process model to simulate some of the chemical analysis results that had occurred during the failure sequence.

This was a quick turnaround, so I asked the team to build a causal factor timeline based on their work to date.

“I did not think this would be as useful as it is,” stated the project manager as we looked at the initial causal factor timeline. “You can see the influence multiple contractors had on distracting the operators that day.”

“Yes, it would have been easy to blame it on operator error,” I replied. “But you can really see better how much was going on. Let’s find out their management policies and which manager approved having everyone on site that day.”

The project manager added, “It’s also obvious that the rain was not a factor that day. I think the shift supervisor was sending us on a wild goose chase and covering his butt.”

Some Current Timelines

The US Secret Service (USSS) provided a timeline in their presentation of the preliminary report released a little over two months after the event, on September 20, 2024. However, it was not in the report itself.

Media Outlets

Some media outlets have published their version of events as early as a week after the event.

Timeline of Trump rally shooting in Butler, PA, assassination probe (usatoday.com)

A timeline of how the attempted assassination of former President Trump unfolded | PBS News

Senator Ron?Johnson

Two weeks after the attempted assassination, US Senator Ron Johnson provided a detailed timeline in his office’s report.

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These timelines typically outline the narrative sequence of events leading up to and during the incident. They do not explore systemic issues or causal factors contributing to the incident.

Causal Factors

In its preliminary report, the US Secret Service provided the following factors that led to the shooter getting multiple shots at the former President.

• Discrepancies in the understanding and expectations of how various elements of the site security planning would be accomplished.
• Communications deficiencies included gaps in the co-location of law enforcement resources to share information, the variety of radio frequencies/channels used (again without the co-location of physical personnel to convey information), and the capability of agency personnel to clearly convey the Secret Service’s protective needs.
• Some local police entities supporting the Butler venue had no knowledge that there were two separate communications centers on site (i.e., the Secret Service security room and the Butler County Emergency Services Mobile Command Post).
• Several nearby local law enforcement entities were employed to provide mutual aid?—?a fact the Secret Service advance team was not initially made aware at the time of the police meeting.
• The local tactical team operating on the second floor of the AGR building?—?a team that was providing mutual aid support?—?had no prior contact with Secret Service personnel before the rally.

One week after the event, on July 21, 2024, US Sen. Ron Johnson (R-Wis.) released preliminary findings relating to the assassination attempt.

1. Secret Service did not attend a security briefing provided to local special weapons and tactics (SWAT) and sniper teams the morning of July 13, 2024;
2. Local law enforcement said communications were siloed and they were not in frequent radio contact directly with Secret Service;
3. Local law enforcement notified command about Crooks prior to the shooting and received confirmation that Secret Service was aware of the notification;
4. Following the shooting Secret Service was seen on the roof of the American Glass Research (AGR) building with local law enforcement; photos of the shooter were sent to the Bureau of Alcohol, Tobacco and Firearms (ATF) for facial recognition; and
5. Secret Service was initially not going to send snipers to the rally, according to local law enforcement.

The US Senate Interim Joint Report, chaired by Senator Ron Johnson, provided the following failures.

1. USSS failed to clearly define responsibilities for planning and security at the July 13 rally.
2. USSS failed to ensure the AGR Building was effectively covered.
3. USSS failed to effectively coordinate with state and local law enforcement.
4. USSS failed to provide resources for the July 13 rally that could have enhanced security.
5. USSS failed to communicate information about the suspicious person to key personnel and failed to take action to ensure the safety of former President Trump.

Six Essential Communication Visuals

One month after the assassination attempt, I discussed the six essential visuals needed for all strategic communications. These are covered under the I in FINESSE.

(7) Trump Assassination Attempt Provides Example of Essential Visuals for Communicating with FINESSE | LinkedIn

Root Cause?Analysis

There are several good root cause analysis methodologies that I have discussed elsewhere. In our standard method, called FAST (Frame, Analyze, Summarize, and Transmit), we use three techniques at a minimum.

The Casual Factor Timeline of the 1st Trump Assassination Attempt

A causal factor timeline is needed for both an effective analysis and communication. It’s been three months, and we should have seen one from the US Secret Service or the FBI by now.

References:

U.S. Secret Service Releases Summary of Mission Assurance Investigation into the Attempted Assassination of Former President Donald Trump, YouTube September 20, 2024.

Sen. Ron Johnson, Preliminary Findings from Investigation into Trump Assassination Attempt, US Senate, 2024

Bipartisan Interim Report Examining U.S. Secret Service Security Failures and Assassination Attempt on Former President Trump, US Senate, 2024.