HONOLULU — In the final moments of her life, Hawaii Health Director Loretta Fuddy clung to the hand of her deputy after a small plane taking them back to Honolulu crashed in the ocean off the island of Molokai.

Fuddy, who gained notoriety in 2011 for her role in making President Barack Obama's birth certificate public, was one of nine people onboard the flight that went down Wednesday. She was the only one who died.

In the water, Fuddy held hands with deputy director Keith Yamamoto as he tried to help her relax, said the Rev. Patrick Killilea, who consoled Yamamoto after the ordeal.

"He recounted how he said he helped Loretta into her life jacket and he held her hand for some time," the priest said. "They were all floating together and she let go and there was no response from her."

Coast Guard rescuers who arrived after making the half-hour flight from Oahu to the neighbor island said Thursday that the single-engine turboprop aircraft wasn't visible when they got there, only the nine passengers floating across about a half-mile of water littered with random debris.

The rescuers in two helicopters and an HC-130 airplane said the people were in clusters and acted calm when help arrived.

"I'm sure they were exhausted," Aviation Survival Technician P.J. Ornot said. The passengers were wearing inflatable yellow life jackets, floating on their backs in the water, he said.

Rescue swimmer Mark Peer said when he swam to Fuddy, she was unresponsive and he couldn't find a pulse.

"It was not a good feeling," he said.

The crash occurred when the single engine of the 2002 Cessna Grand Caravan failed soon after it took off from Molokai and made its turn toward Honolulu, said Richard Schuman, owner of Makani Kai Air, operator of the plane.

Schuman said the pilot did his best to get the plane down safely and keep the passengers together in the water. Asked how they survived, he responded: "Will."

"There's only one engine on that plane, and when it quits on you, you just have to deal with it in that moment," he said.

Three passengers were pulled from the water by the two Coast Guard helicopters, and Maui fire crews picked up others. One person swam ashore.

Other details remained sketchy Thursday on how Fuddy, 65, was killed and how the others survived. Molokai General Hospital Vice President Randy Lite said Fuddy's body will remain at the hospital until an autopsy is conducted.

Schuman said he did not yet know why the engine failed because he has not been able to see the plane. The aircraft had no previous problems, he said.

Federal Aviation Administration spokesman Ian Gregor said investigators planned to speak with the pilot, whose name was not released, and some passengers about the crash as they seek more details.

However, the location of the wreckage, combined with wind and wave conditions, likely means it won't be recovered, said NTSB spokesman Eric Weiss.

Gov. Neil Abercrombie said Fuddy was loved and respected.

"Her knowledge was vast, her counsel and advice always given from her heart as much as from her storehouse of experience," he said.

About 100 Health Department employees lined up to pay their respects to Fuddy's family members who attended a gathering in her memory at the department's parking lot Thursday.

Immediately after the crash, Fuddy's body was taken to a care home at Kalaupapa, where Killilea, the pastor of Kalaupapa's St. Francis Church, said he made the sign of the cross on her forehead as she lay on a gurney surrounded by nurses and the distraught Yamamoto.

Three survivors were transported by helicopter to a Honolulu hospital, two declined to be medically evacuated, and three were taken to Molokai General Hospital with minor injuries, officials said.

Molokai hospital staff helped them dry their clothing and gave them a place to rest until they could get rooms at the island's only hotel, Lite said. They checked out of the hotel early Thursday.

No further information was available on the other passengers or the pilot.

Fuddy and Yamamoto were on the flight after an annual visit to Kalaupapa, where the state exiled leprosy patients until 1969. The area is accessible only by plane or mule.

The leprosy settlement on Kalaupapa is still run by the Health Department, though only a few former leprosy patients continue to live there.

The NTSB had no records of accidents for Makani Kai Air dating back to 1962, while the FAA had records of only two minor incidents that resulted in no injuries.

In 2012, a piece of trash got caught in a helicopter causing the pilot to abort takeoff. In 1998, a pilot heard a noise in the main rotor and landed in an open field with no injuries.