Investigating The Gimli Glider Crash | Gimli Glide | Mayday: Air Disaster

by the next day the investigation has already begun bill taylor and diane rochello of canada's aviation safety bureau are among the first investigators of the scene i was a junior mechanical engineering at the time i had been working for transport canada for a year going to the field for the first time was very exciting it was uh it was new it was a major aircraft once we got into the fuel quantity indicating system i actually left diane to deal with the specifics of the computer system first bill taylor needs to confirm what everyone has been telling him that the plane is out of fuel investigators drain the tanks collecting less than 17 gallons of fuel the 767 can hold almost 24 000 gallons it's like having five tablespoons of fuel in a mid-sized car taylor next needs to examine the possibility that the fuel leaked out during the flight the other checks involved looking for any evidence of fuel having been lost they even went so far as to go into what they call the dry bay of the of the aircraft i'm a bit claustrophobic so i really wasn't too enthused about going up in there but i crawled up and had a look around with a flashlight and confirmed that there was no evidence of fuel having been lost in there that leaves taylor with only one conclusion flight 143 took off without enough fuel now investigators need to find out why in one piece diane rochello begins looking for the answer to that question in the plane's sophisticated electronics bay located beneath the cabin the 767 was a newer type aircraft and it did have a lot of computerized system and i guess back in 1982 these were coming onto the market at a fast rate and they were newer types of electronic system raw shiloh confirms that a computerized unit the digital fuel gauge processor had been malfunctioning on this plane there was no spare in montreal so it couldn't be replaced roshlo takes the component for testing it was decided early on that the unit the fuel processing unit would be taken to the manufacturer honeywell in indianapolis for testing and i was tasked with taking the unit so we went through all the testing procedure and then at one point we did discover that there was a malfunction with the unit during the testing we went more and more in depth and we found out that one of the circuit it's called an inductor coil it was a very very small part and it was encapsulated at manufacturer and encapsulated means it's covered with plastic you cannot visually see it because it's now covered with plastic and you can't see the inductor coil itself but once we took over the plastic case we could see that the solder joint had not been made properly which caused the malfunction in the system [Music] the faulty processor explains why pearson didn't have fuel gauges for the flight but doesn't explain why he didn't have enough fuel the inoperative gauges were clearly flagged ground crews wouldn't have relied on them when they were fueling the plane investigators confirmed that the ground crew did perform a manual check of the fuel before takeoff we just need to know what you did next yeah we did a manual check of both tanks and then we pump enough fuel for the trip deadlift flight 143 should have taken off with enough fuel for the trip okay thanks that helps [Music] investigators now have to figure out how one of the world's most advanced jetliners took off with half the fuel necessary for its flight [Music] the investigators know that with its fuel gauges out of service flight 143's fuel tanks were checked manually then the fuel for the trip to edmonton was added to the tanks [Music] but before the plane could be given more fuel a crucial calculation had to be carried out [Music] pilots need to know the weight of the fuel on their plane but fuel trucks pump jet fuel by volume in order for pilots and fuelers to communicate a simple routine translation between volume and weight has to be made investigators check and double check that math the fueling records from the day of the accident provide the answers they've been looking for this is a typical fueling record but when investigators examine the calculations for flight 143 and this is from flight 143 they look anything but straightforward the document clearly shows the amount of fuel in the right and left tanks but investigators are troubled by two particular numbers one converts volume to kilograms the other converts it to pounds he shouldn't have been using both so did you convert to pounds or to kilograms to pound oh take to kilo can i see that again further interviews with the technicians and crew reveal that the events on flight 143 ah now i don't know what i did were caused by human error involving poor calculations and ultimately inadequate training okay fellas we've finished the technicians refueling flight 143 got muddled in their calculations while converting the volume coming out of the fuel truck to the weight of the fuel in the plane's tanks no one who saw the calculations that day noticed the basic error [Music] in 1983 canadian ground crews were used to converting the amount of fuel leaving their trucks into pounds the 767 was the first plane in air canada's fleet to have metric fuel gauges its fuel should have been measured not in pounds but in kilograms which requires a different calculation [Music] flight 143 needed 22 300 kilograms of fuel for the trip but pilots and technicians let it leave with 22 300 pounds instead [Music] because a pound is about half a kilogram the plane only got half the fuel it required which explains why pearson's flight computer told him he had plenty of fuel he entered the wrong amount of fuel to start with in the past the flight engineer calculated the fuel loads this accident raised an important question whose job was it with the two-man crew better training is definitely an issue in an incident such as that if everyone is is trained and the lines are drawn as to who's responsible for what then there's no ambiguity on it that people know what they're responsible for in this case it was sort of open-ended they really we weren't aware who was responsible for the final say on this field stuff [Music] a subsequent inquiry found that none of those involved that day was trained in metric calculations not the ground technicians not the pilots i had not received any uh neither of us had received any uh training at all on doing these calculations the computer that had replaced the 767's flight engineer was broken and no one knew who should be doing its job air canada 143 was essentially down a man and the goal is to prevent a recurrence of this particular event and also we also find out other systems that might have been either at fault or maybe they could cause a problem in the future and you do try to prevent recurrence all right it took a string of mechanical and human failures for flight 143 to run out of fuel but another failure that day may have saved some lives if the plane's nose gear had not collapsed it would have taken pearson much longer to stop the plane could have slid into the people who were at the strip that day which would have had catastrophic results there could have been more injuries or even loss of life pearson and quintel were partly blamed for their roles in the incident a government inquiry recommended that air canada re-evaluate the training of flight crews and ground technicians in metric fuel conversions it also recommended that the airline keep more spare parts such as fuel gauge processors rick dion retired in 2003 after a long career as air canada's coordinator of maintenance control first officer maurice kintel was promoted to captain in 1989 captain bob pearson went on to fly 10 more years for air canada his experience at gimli shaping the rest of his career as a commercial pilot this experience affected me mostly by giving me making me more relaxed as a pilot giving me the feeling that as much as i've trained for all those years that there's always that question about how you're going to perform when when the chips are down and i now have the feeling that no matter what as long as an aircraft stay together i would get it safely back on the ground and so it's been a relaxing experience it's the knowledge that you know under stress you can perform before that you don't know you just hope you will and you train you train for it but you never know with the things that they had to deal with was magnificent i think that got proven in the simulator in vancouver they tried out this same circumstances with several crews and they all crashed probably the most important thing that came out of it was a realization that when something new is is introduced uh special attention and training needs to be uh accomplished for people to be aware what they're dealing with when we had landed and and the airplane was all in one piece i thought wow i got another chance to fly again because of a tragedy like that once you take your deck of cards and fire it in the air you're truly free and i guess from that point of view gimli could one i could i find it very difficult to say but gimli was maybe almost the best thing that ever happened to me next to meeting my wonderful wife and marrying her [Music] two days after the landing at gimli air canada's 767 was back in the air on its way to winnipeg for repairs a quarter century later that same plane is still in service and it still carries the nickname that bob pearson earned it the gimli glider you

Channel: Mayday: Air Disaster

Views: 172,988

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Id: 9N_irxps-14

Length: 13min 11sec (791 seconds)

Published: Wed May 05 2021