Top Disastrous Runway Plane Crashes | Mayday Compilation | Wonder

[Music] foreign was very windy as a typhoon Bears down on Taiwan a 747 hurdles down the runway at Chiang Kai-shek airport view one V1 your chances of being in an airplane crash are vanishingly small at a certain time the plane kind of lost it on October the 31st 2000 159 passengers could not beat the odds the news session people they were killed by the fire and small many are left wondering I was in the rear section of the aircraft could the key to surviving a plane crash be a matter of choosing the right seat arrived as far away as you can hey major [Music] Singapore Airlines flight 6 taxis to the runway through heavy wind and rain at taipei's Chiang Kai-shek Airport Taiwan sits inside Asia's Infamous typhoon alley and tonight the island nation is bracing for the worst every year we have three to four typhoon it was a terrible night for a stormy weather strong wind heavy rain typhoon Zhang sen with Winds of 160 kilometers an hour it's closing in fast flight 6 needs to get airborne before the brunt of the storm hits even a 747 can't take off in an actual typhoon the closer the storm gets the more likely is that these guys are going to get stuck in Taipei there are 179 people on board the overnight flight to Los Angeles including business traveler Francois parole being a frequent flyer I was not too concerned about the weather because that did not bother me in the past our all has requested an aisle seat the only one available on this flight is in row 65. the second last row of the plane he has no idea how important his seating assignment will become as far as I could tell everything was normal and we were going to take off as usual [Music] Singapore six for your information surface win zero two zero at two four cousin four three thank you sir Singapore six let me know when it hits 30. if the crosswind hits 30 knots the crew will have to abandon their takeoff as we were taxing down the runway it was I I remember that it was very windy and that the plane was moving left to right [Music] Singapore six you want to clear for takeoff Runway zero five left okay toga Captain Phong Chi Kong decides to proceed with the takeoff okay my control the 747 accelerates towards takeoff speed 290 kilometers an hour you won V1 as the plane was gaining speed to take off at a certain time the plane kind of lost it I took the safety position then I felt the airplane spinning around it's like inside of a merry-go-round I thought I was going to die these tanks are loaded with 125 000 kilograms of fuel it ignites immediately then I opened my eyes and I saw a fireball coming at me I was lucky enough to bend down and hide from the fire coming by me I got burns on my hands and my arm [Music] foreign emergency vehicles Runway zero five left Singapore six do you read Singapore six [Music] let's go go I was smoking the airplane it was we couldn't breathe [Music] everybody move forward quickly once you're on the plane run as far away as you can and there was an older person before me and he had difficulties moving and so I was able to lift him up so that he could move his way yeah run away from the plane there was a stewardess there she showed me the direction where to run and then we were asked to run away as fast as possible Rescuers must battle both the flames and the violent storm it takes about 15 minutes to control the fire and 45 minutes to extinguish all of them so it's a difficult task for the firefighters the massive 747 has broken into pieces of the 179 passengers and crew 83 are dead most victims were seated in the middle of the plane where the fuel-fed fire was most severe unfortunately the Miss session passengers they were killed by the fire and small the 96 survivors include all three Pilots some passengers in first class and everyone in the rear section where Francois paron was seated the Terrace section they were broken apart from the midsection and there was less fire in the tail section and most people survived [Music] foreign [Music] busiest airports is immediately closed it's now up to the aviation Safety Council of Taiwan to determine the cause of the disaster [Music] when I went to the crestside I can see all the wreckage spread on the wrong way and most of the wreckage were already burned by the post impact fire Jeff wise is an expert in aviation accidents and their causes when you're an investigator looking at a crash scene you have to keep an open mind you have to assume it could be any conceivable factor from the Machinery to the human factors to the weather to who knows what much of the wreckage is on a Runway adjacent to five left investigators first thought is did Fierce winds blow the plane off course the weather in Taiwan the whole Taiwan is very bad in cks airport the gas up to 50 to 60 knots as the typhoon moves in the winds grow even stronger making the investigators work next to Impossible during the stormy weather it's difficult to do anything outside at the accident side they can even stand on the runway because the winds is very strong let's get inside this will have to wait close examination of the crash site is put off until the storm passes but investigators want to talk to the flight crew right away Thomas Wang is the asc's lead human factors investigator as the investigators we believe that we should interview pilot or operator as soon as possible because we believe that human memory will fake over time just as a machine has certain failure modes ways in which it will most likely break a human being has specific ways in which they're more likely to fail psychologically and this is what a human factors investigator is looking for Captain Feng Chi Kong is interviewed within hours of the crash [Music] Nikolai there was something on the runway V1 just as we hit B1 there's something there was something on that Runway could you tell what it was no we could not see all the way down the runway collided we tried to pull up but it was too late we called for an evacuation but the intercom was dead you betrayed let's go go go go we attempted to get everyone out of the plane as quickly as possible but the fire was so intense there was something on that Runway that should not have been there the focus of the investigation now shifts from the weather to a potential obstacle on the runway but the search for answers will have to wait until Karma Skies return to Taipei [Music] the morning after a fiery crash that claims 83 lives Chiang Kai-shek airport remains closed thousands of passengers are stranded for Singapore Airlines the accident Mars an excellent safety record it's the company's first fatal crash in 28 years media speculation focuses on the Pilot's decision to take off in the face of an oncoming typhoon [Music] with the weather now improving investigators scour the wreckage for Clues flight 6 collided with something on the runway they need to figure out what it was difficult for us to collect all of the information all of their wreckage because it's blown to everywhere accidents during takeoff can involve more than one aircraft in 91 a Skywest Metro liner preparing to take off from Los Angeles was crushed by a US Air 737 attempting to land on the same Runway [Music] 34 people were killed Italy's worst air disaster unfolded on a foggy morning in Milan when an sas md-87 collided on takeoff with a Cessna that was crossing the runway no one on either plane survived the impact 118 people died any signs of another plane and no other flights on accounted for but a Chiang Kai-shek airport this is quickly ruled out all of the debris appears to be from just one plane flight six he didn't hit a plane investigators need to identify the thousands of pieces of mangled wreckage part of the flap assembly right wing the precise location of the pieces should tell them how the 747 came apart on closer inspection they make an unexpected find it looks like pieces of construction equipment are mixed in with the aircraft debris strewn across the pavement it wouldn't be hard to imagine some large object being blown into an engine or knocking out the windshield there's lots of things that could have happened [Music] Chiang Kai-shek airport has three runways Runway six is at the airport's South End Runway 5 left is the one flight six was using parallel to that is Runway five right a Runway closed for construction thank you investigators consider the possibility that loose material from the construction site could be the culprit maybe the heavy strong Wing brought out something and the Heat the aircraft and the aircraft then then crash just after the takeoff if construction material was not properly secured it might have blown onto Runway 5 left directly into the plane's path something there but investigators soon find evidence that tells a different story tire tracks on Runway 5 right heading straight towards the construction equipment this Runway has been closed for weeks there should be no fresh tracks on it we can actually see the time Mark of this aircraft starting from the take a point all the way to the first impact point we can still see that great time mark on the wrong way the tire marks on Runway 5 right lead investigators to a startling conclusion this is our point of impact it now seems more than likely that some unimaginable error occurred putting flight 6 on the wrong Runway we have to compare the time Mark with the data we collect from the file data recorder and we put it together the only way to confirm the flight's route is to find the black boxes the black box is the fly recorder and the copy voice recorder if we have them then we can probably find out what actually happened both the flight data recorder and the cockpit voice recorder are stored in the rear of the plane the least damaged section investigators are able to study the information within a day of the crash when we get information out of the recorder we read it then we can know the exact position of the aircraft they compare positioning information from the flight data recorder to a satellite image of the airport it confirms their Theory please he's lining up with the wrong Runway somehow the plane ended up on Runway five right instead of five left 1243 meters down the runway he collage with a construction equipment it was supposed to be here how did they end up here instead it doesn't seem like a very obvious mistake to take off on a wrong Runway it seems like the kind of thing that shouldn't happen ever under any circumstances foreign for investigators it's hard to believe that such a fundamental error occurred Wang decides to interview Captain Fong again usually we'll do an initial interview right after the accident and there may be way for another day or two then we will reinterview again maybe at that time they can tell more about what happened did you received this notice [Music] of course I did everyone did we discussed it during our breathing Wang learns that the flight crew received written notice that Runway 5 right was closed tell them we'll take five left according to the flight data recorder you are not on five left the accident took place on five right you collided with the construction equipment on Five Rights here's the point of impact you were taking off from the wrong Runway impossible we were on five left [Music] I'm sure of it three Pilots believe they were on the correct Runway zero five left even after the accident happened what makes you so sure you're on five left the controller would have said if we weren't pick up four six Runway zero five left win zero two zero at two eight gust five zero clear for takeoff with no planes ahead of them the Singapore Pilots received Advanced clearance to take off as soon as they reached the runway clear for takeoff Runway zero five left Singapore six what puzzles investigators is why air traffic controllers didn't notice that the 747 had turned onto the wrong Runway I couldn't see them in that weather when interviewed the controllers describe how the storm limited visibility that night to about 600 meters they confirmed Runway five left that's the last I heard from them hmm 1600 meters between the runway and the tower there's no way he saw them [Music] thank you the crew assumed that the tower was monitoring their progress but the controller had lost sight of the plane investigators now try to determine if the pilots themselves were lost in the storm how was the visibility could you see where you were going the whole time couldn't see very far but we could see far enough Syrian or study the map while I follow the taxi lights it led us directly to the runway okay green lights are here it appears that the crew had no trouble seeing their route as they taxied yet flight 6 still ended up on the wrong Runway was this the map you were using yes you didn't have any trouble reading it I wasn't reading it my first officer and relief pilot were following the map I only glanced at it when the route changed they changed the route yes Wang learns that the ground controller issued a last-minute change for their route to the runway Singapore six request Taxi Singapore six taxider Runway zero six by a taxiway correction Runway zero five left via taxiway Sierra Sierra West Cross and November I missed that what was it Sierra Sierra West Cross and November Papa Pilots have to deal with last minute changes all the time the situation becomes complicated it becomes hairy now you've got a typhoon bearing down on you you've got time pressure you're also having to deal with a difficult environment for taxing you've got cross winds you've got gusts so you're under pressure foreign ERS need to understand how the crew responded to that pressure they turned to the cockpit voice recorder if there was any confusion in the cockpit on the way to the runway the recording could reveal it CVR can provide investigators a sense of what the environment that the pilot are actually working in tell them we'll take five left what's the latest weather this is the latest zero two zero three six gust 52 still within limits that's better more on the hip inside the crew runs through all the mandatory procedures texting slowly okay turning left it's getting great a lot of rather work here Crosswinds yeah that don't seem confused what they heard was a crew that was calm that was focused that was doing what they needed to do they're doing the procedure checklist they check the weather they discuss the safety issues so if pilot doing everything they supposed to do why didn't accident happen foreign [Music] Taiwanese investigators still can't answer why the crew of Singapore Airlines flight 6 made the fatal error of turning onto the wrong Runway they hope the crew's last moments of conversation can provide a clue I'm going to go very slow here otherwise we're scared [Music] okay nine knots [Music] normally a 747 taxis about 25 knots on this night they're going nine knots they're doing exactly what they should have done taking it nice and slow ly you've not only got to deal with the massive surface area of the tail fin behind you but you've got a very slick slippery runway okay win's okay for our view the pilot is pretty much follow the procedure and follow what they have to do next one next one's N1 okay second right second right that's right the plane must now taxi 260 meters further before turning onto Runway 5 left but it doesn't so why did they turn here investigators study the Pilot's work records looking for anything that could help explain their mistake we will collect the Pilot's training record at least for three years before the accident Captain Feng Chi Kong started with Singapore Airlines as a Cadet over 20 years ago he'd flown out of this airport more than 10 times first officer Latif Serrano was a former officer in the Singapore Army flown with Captain Kong several times before almost all his hours were on the 747. the relief pilot Captain un Kang Lang had eight years experience and was used to Long flights so for a commercial pilot they are very experienced team every one of them was a better than average pilot they all had excellent records and yet somehow they made an unbelievable mistake the why the three Pilots cannot tell the difference when they take off from 05 right something must have led the crew to take a wrong turn but exactly what remains a mystery foreign to find out what went wrong on flight 6. investigators decide to put themselves in the pilot seat the cockpit of a 747 at Chiang Kai-shek airport all right let's get going in similar weather conditions they follow the route taken by flight 6. we want to know what the Pilot's working environment and what outside environment may affect their decision situation awareness or their decision making during that night they taxi slowly towards Runway 5 left matching Captain Fong's speed okay take the turn on N1 nice and slow the plane turns onto the final taxiway from this point the flight 6 crew should have taxied past Runway five right towards the turn for Runway five left now we continue on to five right how could they have missed that sign it's huge signs marking five right are clearly visible from the cockpit but investigators see nothing that would tell a pilot the runway is out of service there is no indication that this Runway is closed green lights as far as I can see they were seeing ambiguous information there were some signs that it was a Runway there were some signs it wasn't a Runway but because they were expecting to see a Runway that's what they saw but inside the cockpit there is an indication that the plane is on the wrong Runway the instrument Landing system isn't locking onto a beacon that should be dead ahead this should tell you something's not right if the plane had been on the correct Runway the display would have been centered before departing Pilots programmed the plane's computer to lock onto a beacon at the end of their designated Runway flight 6's navigation system would have been scanning for that signal just before takeoff the beacon was clearly off to their left not ahead of them investigators need to know how the pilots could have missed this obvious sign they once again studied the information from the FDR and compare it to the cockpit voice recorder okay [Music] it's coming in fast the longer we delay the worse it's going to get agreed the voice recording reveals that the crew wanted to get off the ground before conditions got any worse challenging environment and the longer they wait the more challenging it's going to get typhoon Zhang sen is bearing down on Taipei threatening to ground all flights at Chiang Kai-shek Airport the crew of flight 6 knows their 14-hour journey to Los Angeles is on the verge of being canceled four gust 4-3 relief pilot hung needs to carefully calculate the crosswinds checking to see if they've exceeded 30 knots the point at which they will have to abort the flight wind direction during takeoff is critical let's want to fly into a headwind to attain maximum lift a strong crosswind can literally blow a plane Off The Runway win zero two zero at two eight gusts five zero near it for takeoff right now the pilots are passing signs that clearly identify the runways what happens in the next few seconds is the key to why they missed them zero two zero from the left zero to zero the winds consume the crew's attention they were scrupulously looking at the tables to figure out if they had exceeded the crosswind component they were checking it so meticulously they weren't paying attention to something else 28.5 it's getting close to 30 sir okay the captain was taxing the aircraft in very slow speed and the first officer is doing the before takeoff checklist and the relief pilot is working on the crosswind component so all pilot they are occupied by something they do not have enough attention to actually check which Runway they are texting on to I'm going to go very slow here otherwise we're scared okay nine knots the crew was so concerned with taxiing safely to the runway that they stopped paying attention to where they were headed they believe they are making a right turn onto the correct Runway unfortunately that's not the correct Runway that's zero five right what you've got to hear is a classic case of tunnel vision you've got pilots who are working under enormous stress time pressure the safety of their passenger of concern and so their ability to deal with multiple streams of information is becoming narrower and narrower foreign [Music] ERS also consider the possibility that Captain Fong's Extreme Caution might in fact have worked against him [Music] the captain intentionally takes it slowly the captain says to the crew keep it slow be careful let's really focus on what we're doing and they do but they focus on the wrong things Captain Fong was taxiing at a speed of nine knots about 16 kilometers an hour because the turn took so long Captain thong might have thought he'd gone further than he really did so much time had passed that he may have thought he had already reached Runway five left one of the real heartbreaking moments of this tragedy is that instant when they come so close to noticing that something's wrong just before takeoff the crew had one last chance to avoid disaster first officer points out they're nowhere near the center line of the runway the PVD hasn't lined up it should have been a warning to the crew that something was wrong never mind we can see the runway just fine Captain Fong ignores the warning big irony of this crash is that they were taking off in very dangerous circumstances near the limit of what their plane was capable of handling but it wasn't the weather that did them in but rather the pressure of dealing with the storm distracted them from what turned out to be the real question were they in the right place ready sir that's aderon in to win the human brain is always trying to convince itself that has a complete picture of what's going on and so that when contradictory information comes in there's a tendency called confirmation bias to ignore it and to concentrate on what you think is happening okay my control V1 V1 what happened next was inevitable there's something there is the point of impact the clues were there they in garden the entire tragedy would have been avoided if the crew had picked up even one of these Clues it's finally clear why Singapore Airlines flight 6 ended up on the wrong Runway s of planes taking off during the annual typhoon season the challenge now is to make sure it never happens again foreign 's Aviation Safety Council recommends Swift changes to Pilots procedures and training [Music] they recommend more frequent communication between controllers and pilots who are taxiing in poor weather Pilots must now report each of their movements to the controller as they make them new checklists are also designed which include a visual confirmation step forcing Pilots to confirm that they're on the correct Runway before they take off Chiang Kai-shek airport comes under criticism for keeping an out of service Runway lit and for failing to either barricade or clearly mark it closed Chiang Kai-shek was not compliant with current International Airport regulations they didn't have the ground radar that would have told the tower where this plane actually was in aviation fatal crashes are the most powerful catalysts for change following the disaster authorities install ground radar at the airport in Taipei it allows the tower to track a plane's position even in bad weather Singapore Airlines comes down hard on the pilots of flight 6. the captain and first officer both lose their jobs one of the lessons of this accident is that you could have an exemplary crew performing their duties with utmost care and they still make a mistake with fatal consequences [Music] crash of flight 6 also highlights another lesson the decisions passengers make before takeoff including where to sit can sometimes make the difference between life and death following his brush with death at taipei's Chiang Kai-shek Airport has reason to take credit for his own Survival it was just basic survival Instinct and we had no time to think about what's happening when I realized that my life was at risk I had a thought for my family and that gave me the energy to do something to save my life [Music] they say that fear is contagious and that's particularly true in a closed environment where people are fairly densely clustered together we'll move forward quickly fear is contagious but so is courage [Music] all right the accident in Taiwan raises the question what can passengers do to improve their odds of surviving when disaster strikes although experts do not all agree statistics suggest some seats are safer than others Studies have found that there is a slightly higher percentage of survival in the back of an aircraft during a crash the tail section can break away from the main fuselage and the wings where fuel is stored though opinions vary some statistics show that passengers seated at the rear of the plane have the highest average survival rate 69 percent in the overwing section that number drops to 56 percent in the forward section your odds of surviving a crash are less than even 49 percent [Music] many experts believe that sitting within five rows of an exit gives you the best chance of survival also aisle seats are slightly safer than window seats I was sitting on a nail seat in the rear of the aircraft most accidents take place on takeoff and in landing so if you're concerned about surviving on an airplane that's the time to pay attention this plane is equipped with 10 exits four at the front four at the back and one over each Wing leave the passengers listen to the safety breathing they know what they have to do in the first seconds and they know how to get out of the aircraft in the seat pocket in front of you there's a safety card on it there's a diagram that shows you how to get to the exits look at it just put in your mind what you have to do to get there because when things go crazy and the smoke and the Darkness you won't be able to figure it out [Music] one statistic stands out above all others your chances of being in an airplane crash are vanishingly small foreign people are on board this British air tours flight within minutes nearly half of them will be dead this should not really evacuate Evacuate the aircraft didn't even get air book it didn't run off the Runway and yet still 55 people were killed for investigators it's a familiar routine reconstructing the final moments inside the cabin the wreckage and the flight data recorders in the end they turn to a psychologist to help them figure out how a survivable emergency turned into one of British aviation's most horrific disasters it's just before six in the morning on August the 22nd 1985. Manchester's airport is coming to life [Applause] you're being prepped for departure [Applause] departure British air tours Flight 28 is scheduled to take 131 passengers from Manchester to the Greek island of Corfu British air tours is a division of British Airways specializing in low-cost flights to vacation destinations it's a chilly morning a slight breeze is blowing ideal flying weather [Music] most of the passengers on this early morning flight are traveling on vacation [Music] Greece with her boyfriend Charlie thickson right to the fur a year and um that's one of the reasons we were so excited about it you know it was our first holiday together Captain Peter terrington is in command I was just the senior training captain on the fleet first officer Brian love is being trained by terrington he was going to perform the takeoff and Landing as part of his training all right Captain yep uh briefing then Brian Airfield emergencies you handling the aircraft what are the four things you're going to stop for fire failure configuration warning or you shutting stop okay so you bring the thing to a stop and I'll take over the aircraft and leave you to deal the emergency Alias of ATC okay if you've talked about the possibility of an emergency and talked over what you will do then if it actually happens it's easier to recall those items okay mine start two starting two oil pressure Rising okay go on 45 26 27 28 29. 129 plus two on board Captain all strapped Outdoors are closed down automatically thank you Arthur the crew is flying at Boeing 737 [Music] it takes just four minutes for the plane to reach the foot of the runway Vito's 28 you are clear for Techo the 737 has 3 000 meters to get to takeoff speed [Music] the engines are pushed to high power by the window looking out of the window everything was normal the plane was going quite fast 80 knots check we heard a dog foot which sounded as if it came from outside I was really Keen to see what was going on outside but couldn't see anything Captain terington needs to act fast stop and immediate reaction was to stop we were quite a few knots below our decision speed so I very quickly closed the throttles and applied reverse thrust we fill the aircraft slowing down and after we've blown a tire and I didn't know so we just waited to hear it [Music] don't Hammer the brakes I thought the tire that might have gone and would cause some damage the undercarriage if we break too strongly probably nothing I wouldn't worry and just assumed that maybe a tired burst so it wasn't really alarmed at that point my thought at that time was oh okay we're gonna get off this plane and probably have to move all the luggage onto another plane and and take off soon passengers on the left side of the plane see the real problem I could see orange Flames inside the back of the engine and at that point I thought it's obviously not a burst tire that wouldn't cause that and this is perhaps something a bit more serious let me buy I'm not staying there but at that point I knew that I wanted to get off the plane and and I wasn't happy at all I I knew that there was a fire and I just wanted to get away from the fire smoke is seeping into the cabin please sit down I'm a nearest exit was at the back I didn't want to go to the back because the smoke was coming in there so I decided in my mind that I was going to go through the front I said to Charlie come on we're going and that's when I started going towards the front of the plane stop it 28 Mike we're abandoning takeoff [Music] a lot of fire thank you playing on fire Runway 24 from where he's sitting Captain tarrington can't see how bad the fire is he needs advice from the tower we have to get the passengers off I would do by the starboard side tarrington decides to pull off the Runway [Music] to the starboard side please [Music] fire drill number one shutting down two evacuate evacuate please stay calm before the flight crew leaves the cockpit they must complete a 15-step checklist parking brick set speed break down but time is running out we had a an evacuation checklist but it was four pages long and the last item was to get the passengers off engine and Apu fire warning switches this didn't cover my problem at all on the 737 there are four cabin doors the two in the back are covered in flames and smoke leaving only two for 137 people then a mechanical problem eliminates one of those right it was really bang it's really trying to open it was really hard to open [Music] the back of the cabin is filling with smoke it's making breathing difficult passengers Rush forward it just seemed to go on forever before they started evacuating it's going to blow up with all of us on it engine and Apu file warning switches right now all 137 people on board are alive but with every second their odds of surviving are decreasing flight 28 is becoming a death trap [Music] the jam door on the right side of British air tours Flight 28 leaves the crew no choice you must get the passengers out from the side of the plane that's burning the fire service were already around shooting foam up the slide and came into the galley floor we wanted to start to Accurate the passengers but there's a bit of a bottleneck and nobody was coming forward the aisle is quite narrow where the galley is and there were part of a manual pushing forward and I could see this boy that was really sort of pushed against the wall [Music] he couldn't get out so I pulled him by his T-shirt had the yellow t-shirt on and he he sort of tumbled forward and after that everybody sort of just tumbled in behind me we just directs them down the slide in training they tell you to you know bring people to the door and you tell them to um jump desperate to get people off the plane quickly the person returns to the jam door after several attempts he manages to force it open the only time I turned around was to make sure that Charlie was following me [Music] one thing I did see when I looked back was people go into the front towards the front of the plane where the seats are and pushing the seats forward folding them down as they went along so people were trying to rush forward from the back the Chute was open and people were just jumping up straight onto the Chute as I got to the bottom didn't look back at all this was just wanting to get up dozens of passengers have made it off the plane but there are still many more inside but it was smoldering and it was black thick black smoke Charlie had said that after you'd gone this black smoke came down he said and everybody was screaming and panicking he said people are going to die in there standby power switch Captain Peter terrington and his first officer Brian love are still aboard the burning airplane and they still haven't completed the steps required to evacuate there was four tons of fuel coming out of that aircraft Wing tank you go bro go bro I can see quite a lot of flames completing the checklist would put their lives at risk the items as we could and then we both went out of the Flight Deck window there are no more passengers at the exits so Joanna Toff decides to see if anyone else is left in the cabin [Music] you could touch it it was so thick and you could take it was it was awful [Music] foreign [Music] just a bit further down in the cabin she was really disorientated I mean I suppose we all were really we just didn't have any idea what was going on put it onto the slide she was taking off the phone the fireman was telling me to come on thinking well I'm not finished you know we've not finished yet went off re-enters the cabin the Thick Smoke makes it as hard to see as it is to breathe it's really dark and quiet I've never seen anything like it I could see the light from the door anyway by then so I knew where the door was the smoke forces tarp to abandon her search just minutes after pulling off the Runway British air tours Flight 28 has been consumed by fire we got out of a flight deck which was relatively intact and when we turned around on the ground we saw a complete wreck of an aircraft and it would have happened in a matter of seconds it was a dreadful 54 people are dead another would die in hospital [Music] [Music] there was nothing wrong really with us we thought nothing physical wrong with us but our lives changed you know just in those in those few hours thank you I couldn't breathe I was virtually able to do I couldn't create that the smoke was coming in and everybody just stood up and ran out it was just in my Panic getting out it was when the smoke came you just couldn't see anything at all I couldn't see anybody it takes 125 firefighters more than two hours to put out the fire news of the disaster soon spreads around the world British prime minister Margaret Thatcher flies to Manchester to visit the scene aircraft of this accident will be thoroughly investigated it has to be [Music] this is the fourth major commercial air disaster of the year in June of 1985 an Air India jet exploded over the Atlantic Ocean 329 people were killed Weeks Later 137 people died when a Delta Airlines flight crashed at Dallas-Fort Worth Airport and just 10 days before the Manchester crash the deadliest single aircraft accident in history Japan Airlines Flight 123 a fully loaded 747 slammed into a mountain killing 520 people British air tours Flight 28 adds 55 new victims to the list of casualties 1985 is now the deadliest year in the history of commercial Aviation the flying public is getting nervous Britain's air accidents investigation Branch sends a team to Manchester to unravel the events that led to the catastrophe among them Stephen Moss he'll be inspecting the plane's engines this should not really have happened the aircraft didn't even get airborne it didn't run off the Runway and yet still 55 people were killed Chris prothero is also on the team his focus is on the Fire we were aware from initial reports that the fire had entered the the aircraft very rapidly as the aircraft came to a halt and that that was a focus for me it doesn't take too long for Steven Moss to figure out where the trouble started he seized damage to the plane that was not caused by fire well the first thing we noticed clearly was the the hole in the underside the wing and right next to it was a gaping hole inside of the engine seems that one had led to the other [Music] to get a plane loaded with passengers off the ground you need to generate massive thrust that power is created when air travels through the front of the engine to a series of compressor fans it's then ignited and the exhaust pushes the plane forward something had clearly gone very wrong with flight 28's left engine investigators look for Clues on the runway and in the cabin hoping to discover why so many people died [Music] entering the cabin for the first time there was a as with all aircraft fires there's an overwhelming and pungent smell burning plastic burnt fuel burning material had dropped down onto seats and so that the aisles were filled up with with the remains of overhead lockers a scene of of devastation the damage in the cabin is revealing it's almost completely charred up high but is relatively intact down low it was clear that they had not been flashover in this particular case a flashover occurs when the gases in an enclosed space becomes so hot that they ignite incinerating everything around them the way flight 28's cabin is charred tells protheroe about the nature of the fire many of the seat squab cushions even things like the emergency evacuation cars which are just plastic laminated cards were pretty much undamaged that you could have wiped them off and put them on another aircraft that nobody would have known they'd been in this accident whereas at the upper levels in the fuselage there was a great deal of heat damage and this is not a characteristic of a flashover [Music] the fire in the cabin had been severe but should not have been catastrophic this leaves investigators with two questions why did so many people die [Music] and what caused the fire the answer to the second question may be outside the plane lying on the runway investigators find a large piece of dome-shaped metal along the plane's path Stephen Moss can see it's from a piece of the engine called a combustor can it looks like they've been a separation of the can from the front end from the back end the combustion chamber of the 737s jet engines contains nine combustor cans it's where Fuel and air are mixed and ignited so each can needs to withstand intense Heat Moss suspects the fractured cans somehow blew apart and destroyed the plane's left engine it struck an underwing fuel tank access panel and put a sizable hole in there which directly led to the release of a vast quantity of fuel proving the piece of the combustion can penetrated the wing is easy it fits neatly into the hole in the wing this was clearly that if you like the root cause of the accident the engine on the plane is a pratt and Whitney jt8d for Moss that's of grave concern the time was probably the most widely used jet engine on Commercial Air transport in world and it was obviously pretty urgent that we try and find the the cause of this one in order to prevent other aircraft having the same problem there are tens of thousands of combustor cans in service around the world one of them erupted in Manchester [Music] needs to find out why it failed and fast investigators looking into the deadly fire on board British air tours flight 28 study the plane's maintenance log they discover the combustor can that ruptured had previously been repaired we needed to look at that repair and and how effective it was during a routine inspection a year and a half earlier mechanics had found small cracks in some of the combustor cans it was certainly not uncommon to find fatigue cracks in the in in the cans they're operating in a high temperature environment foreign s get various schemes for repairing these cracks investigators find mechanics repaired the cracks according to a procedure laid out in the engine repair manual they welded them closed but the crack on can number nine was unusually long the overhaul manual did not give any limit on the lengths of crack that could be repaired and it was a longer crack than had been experienced before uh it was still repaired after the repaired cans were put back in the engine mechanics had no way of knowing the weld didn't effectively seal the crack that's because the cans can't be inspected while the engine is on the plane since the repair there were 11 reports of slow acceleration from the engine that exploded in Manchester a damaged combustor can could have been a reason for the problem but troubleshooting guides available to mechanics in Manchester didn't list that as a potential cause instead Pratt and Whitney offered other ways to fix the acceleration problem it didn't seem to ring any great alarm bills with them if if you like it they'd seen it before and it had never turned out to be anything serious so mechanics in Manchester made Minor Adjustments to fix the plane's idle speed and kept the plane in operation cockpit voice recordings reveal that the crew of Flight 28 was aware there was a problem with slow acceleration slow acceleration on number one engine the day before yesterday I was on the flight yes sir engineer signed off on it but the log entry LED Captain tarrington to believe that the problem had been fixed [Music] a comment in the catalog for for the flight before the last one that the engine was slow and accelerating it wasn't apparent as a serious problem and because the engineers had done some work and the aircrafts have been flying the previous day with no no problems the idle speed adjustments didn't fix the real problem cracked combustor can and it reached the breaking point on flight 28. [Music] stopping 28 Mike we're abandoning takeoff [Music] wait please stay calm the airline had inspected the cans I think there is no doubt that they would have seen the problem [Music] investigators now know the origins of the Manchester disaster the welded crack in combuster can number nine gave way as Flight 28 spared down the runway the front of the can was ejected from the engine and put a hole in the underside of the left wing that led to a huge fuel leak onto the damaged engine which caused the fire engine fires are not uncommon the body of a 737 is insulated with fire retardant material to protect the cabin investigators still don't understand how a fire outside the plane spread into the cabin as quickly as it did fire inspector Chris prothero finds part of the answer from viewing photographs of the plane As It sped down the runway it was clear from these photographs and there was a very Dynamic phase to the fire whilst the aircraft was at speed on the runway which produced this energetic turbulent sort of blow torching type of fire visually anyway trailing behind the aircraft a press photo from the day of the crash leads protheroe to a new Theory the photographs of the aircraft that appeared in the Press showed the left thrust reversal are deployed the general impression that one got visually from that photograph was that the thrust reversals had effectively blowtorched fire against the side of the fuselage and that that if you like was the explanation as to why the fire had penetrated so quickly that photograph and the implications of it actually therefore loomed quite large stop there are several ways to bring a speeding jetliner to a halt one is with the brakes don't Hammer the brakes another is with the engine's thrust reverses thrust reverses redirect the exhaust from the jet engine forwards this helps slow the plane down looked as though the thrust reverses had simply blown this big fire on the left of the aircraft against us directly onto the side of the aircraft directly onto the rear fuselage that would explain why the fire destroyed the cabin so quickly it now seems possible that Captain tarrington made the fire worse by trying to slow his plane down but prathero has two good reasons to doubt his theory one is the location where charring from the burning exhaust gas or e-flux was found the e-flux impinges on the fuselage further up closer to the roof the the crown skins of the of the aircraft so actually the penetration that we had low down did not fit with that and the other reason is by the time the thrust reverses were deployed the left engine had already exploded the engine would have needed considerable exhaust we did calculations to confirm that the residual thrust from that engine would not have had the energy to have this effect that confirmed that the thrust reverses couldn't actually have played any role or significant role anyway in the in the fires severity clearly something other than the thrusters had caused the fire to spread so quickly prothero looks more closely at the data after examining weather reports from the day of the accident he finds the answer the wind was the main factor that determined the severity of the fire in terms of its attack on the outside of the aircraft how rapidly it penetrated the aircraft and it also affected the conditions inside the cabin believing he had blown a tire Captain tarrington made a fateful decision stop it 28 Mike we're abandoning takeoff well when we when we heard the third and we we closed the throttles it was my assumption that we were going to turn off the Runway clear the runway ask air traffic for an engineer to come out and check the tires like a highway an Airport runway has a series of exits Captain tarrington chose one called link Delta then we got the additional information of a fire warning the brain was already programmed to carry out the uh the stock the crew had been aware that they had a fire but didn't really appreciate at the time that the nature of the fire the severity of the fire so they had turned off the runway Captain tarrington turned his plane to the right and brought it to a stop he couldn't have realized that doing so would make the problem far worse there was a cross with a slight crosswind from the left side of the aircraft that was carrying the fire that was burning from the fuel that was pulled underneath the left wing it carried that fire aft rear woods and took over and under the rear fuselage in between the wing and the tail plane the wind wrapped the fire around the back of the plane into the cabin if there'd been no wind at all I think the situation would have been very much more benign investigators have discovered how the fire started and the conditions that caused it to penetrate the cabin now investigator Ed Trimble must solve the biggest mystery surrounding the Manchester accident here we had an aircraft which had aborted the takeoff for good reason I had taxed it off and stopped in a taxiway in an expeditious Manner and yet 55 people had lost their lives so there was a big question as to precisely why that had occurred [Music] investigators learned that most of the Dead were not found in the worst burned parts of the plane [Music] autopsies will point to the real killer on flight 28. [Music] of the 54 people who died in the cabin only six had suffered serious Burns all the rest died from smoke inhalation it seems the smoke in the cabin was particularly lethal survivors tell investigators that the smoke was unbearable if the smoke was really black and and it was it was it was almost touching it was it was it was really weird and they see the the effect of that was shocking immediately that you took one breath of the smoke you began to feel debilitated and you knew that if you took another breath or two you weren't going to make it at the time of the Manchester accident the effects of fire on an airplane had been well studied and understood but the effects of smoke were not to figure out what made the smoke so toxic Trimble decides to recreate the fire that burned on flight 28. we were trying to model not only the gases which were produced but also the kind of threat levels which were produced the smoke that filled the plane was from materials burning inside the cabin the foam in the seats the wool in the carpets and the plastic overhead bins all release poisonous fumes those conditions are recreated by burning those same materials Trimble discovers the passengers on flight 28 inhaled smoke that contained a deadly blend of poisonous gases including high levels of carbon monoxide and hydrogen cyanide now he desperately needs to find out if there's any way to protect airline passengers from that kind of smoke so it seems to be pretty clear that unless we could protect people's respiratory systems from The Assault from such combustion gases there was little that we could do to improve survival chances from aircraft fires over the course of five weeks investigators run dozens of tests experimenting with different filters [Music] they burn nearly a quarter tonne of material to create the necessary smoke their dramatic conclusion it may have been possible to save passengers lives there is not the slightest out in my mind that in these situations in an aircraft cabin if it is being assaulted by combustion gases your chances of survival are vastly improved if you have smoker protection British air tours Flight 28 had only enough smoke hoods for the crew they were never used trimble's Research indicates that smoke hoods for passengers could have saved lives there were hoods available both of the filter type and the breathable gas type which can provide a very high level of protection to people in these circumstances [Music] many of the passengers on flight 28 would have survived with a few more minutes of breathing time [Music] it was it was in a blink of an eye you know from from the time you know we stopped on the runway you know just within a few minutes and it was all over really [Applause] a full Boeing 737 is designed to be evacuated in less than two minutes so even without additional time more of the passengers on flight 28 should have been able to get off [Music] discover why so many people never made it off the plane investigators turn to an unlikely source for the answer [Music] by law airplane manufacturers must prove their planes can be evacuated quickly and safely when the 737 was introduced in the UK Boeing demonstrated that 130 people could get off the plane in just 75 seconds all public transport aircraft are certificated to the same criteria and that is that the total complement of passengers must be capable of evacuating from the aircraft using half the exits and the aircraft as channel one side and the other within a maximum of 90 seconds but 90 seconds after Flight 28 came to a stop most of the passengers were still on board [Music] why the evacuation of Manchester wasn't achieved in 90 seconds is because the conditions in a real fire evacuation are completely different from the certification conditions the certification evacuation is conducted in clear conditions with no smoke that reduces vision and overwhelms passengers within minutes of coming to a stop flight 28 filled with thick black smoke is a smoke began to spill into the rear cabin and then floor forwards essentially that induced immediate panic in those who were so affected by the smoke because of their respiration I mean the typical comment was I took one breath of smoke and I felt and stole my lungs for solidified you can imagine under these conditions the people have got to get away from the smoke and the people did this by basically clambering over the seats and other people in front of them in less than five minutes what should have been a survivable accident turned deadly to prevent future tragedies Britain's civil aviation Authority decides to learn more about people Helen Muir is a psychologist and a leading expert on how airplane design can influence survival he's asked to study the behavior of passengers on flight 28 to figure out why so many died what we had to learn learned to do was to design the Aircraft Interior so even if we had what we might say was dysfunctional behavior in totality we could accommodate the needs of individuals and their desperate rush to get out Muir configures a cabin to duplicate Flight 28 and fills it with volunteers then to have them act as though the plane's on fire she offers money to the first ones off and that produced behavior that was quite unbelievable people went over suits they went round past each other all sorts of things and indeed when survivors from the actual match distraction came and saw the videos they said yeah this is that's how it was [Music] the evacuation of Flight 28 was slowed by the fact that passengers became jammed in the bulkhead opening separating the main cabin from the galley [Music] investigators discover the Log Jam was created by the design of the Boeing 737 the bulkhead opening was 22 and a half inches wide just enough for one person to fit through but what they wanted to know was how much wider would they have to make it for people not to get stopped and locked we were trying to do as much as we could to recreate the situation which had happened at Manchester and then to systematically vary the Aircraft Interior to see what changes would improve the situation for passengers muirs tests showed the narrow bulkhead opening created bottlenecks that flight attendants had to constantly clear increasing the width to 30 inches greatly improved the movement of passengers but we shown through repeat testing that if you change the minimum Gap from 20 to 30 inches you would dramatically improve the speed at which people could get out and you'd reduce the likelihood of people falling and slipping and so on as a result of Helen Muir's work a recommendation was made to increase the space between the bulkhead walls to 30 inches and introduce strip lighting to help guide passengers to exits even when they are blinded by smoke Muir also found a way to improve cabin safety without redesigning the cabin conducted research on the behavior of the cabin crew in emergencies and found that passengers get off a plane much faster with a highly assertive crew [Music] it's because we don't want people really making their own decisions we want people to do exactly what the cabin crew or the procedures State and we don't want people hesitating particularly at the door Helen Muir's research prompted manufacturers to redesign cabins to make them safer but one safety feature remains controversial smoke hoods Ed Trimble believes they should be mandatory on all commercial flights without a doubt without a doubt Alan Muir is less convinced she studied how smokeodes affect passenger Behavior and is worried they would slow down the orderly evacuation of an airplane we know you've only got one and a half to half that we don't want to have is something which is difficult to put on so it slows people getting down the most important lesson of British air tours Flight 28 is that seconds matter it's now universally accepted that it takes 90 seconds from the first sign of fire before it becomes unsurvivable the passengers on flight 28 lost valuable time when the starboard side door jammed the investigators determined that the slide mechanism deployed too early preventing the door from opening there was a floor that led the slide containers lid to jam if the door is open too quickly after the Manchester accident Boeing quickly redesigned the system so that couldn't happen but the recommendations made by the aaib weren't adopted quickly enough to save lives six years later in 1991 a Boeing 737 slammed into another plane on the runway in Los Angeles and caught fire many of the 22 people who died were overcome by smoke before they could get out but in 2005 the crash of an Air France jet in Toronto showed how much has changed since the Manchester accident all 309 people got off that plane in just 90 seconds no one died [Music] some major changes to commercial airliners came about because of a flight never left the ground that's the only way I can resolve it with the death of 55 for my passengers the fact that flying is now safer I can't imagine anybody you know doesn't wish that it hadn't happened you know despite what's been learned and despite maybe the subsequent lies I've been changed you know you give anything for it not to have happened in 1979 chaos when the FAA grounds every DC-10 in America you can imagine if one of your real Workhorse airplanes is grounded it's a terrible situation the reason look at this American Airlines flight 191. see it hey go right come on come on it only got about 300 feet above the ground what do you got as investigators search for evidence one of the Bush and bolts in the worst air disaster in U.S history there's the ball this is a fracture point they face intense media pressure to identify the cause some very crucial photographs that showed the aircraft on its final to fatal plunge the shocking images May finally explain we need to see those slams why 271 people died seconds after leaving the ground made it made it [Music] easy [Music] [Music] any updates on the weather surface wind 20 degrees at 22 knots nothing but Blue Skies on a Friday afternoon the seasoned crew of American Airlines flight 191. makes final preparations for takeoff spoilers are from Chicago's O'Hare Airport Captain Walter Lux was scheduled to have the weekend off but is covering for a friend this crew was a very experienced crew the captain had approximately 22 000 hours of flying time of which about 3 000 hours were in the DC-10 so he was a very very experienced pilot in the aircraft the dc-10's three-engine layout makes it one of the most recognizable passenger Jets on the runway flown by almost every major airline the DC-10 was a very popular airplane it was one of the first jumbo Jets so the airlines were able to put twice as many people on board the airplane and only feed three engines instead of four so it was much more economical for them because they could eliminate a lot of flights and still carry the same number of passengers American 191 good afternoon taxing into position on Runway 32 right now American 191 thank you packaging hole in Runway 32 right flaps and slats to 10. [Music] takeoff and Landing are the most crucial and most difficult and busiest times in the cockpit it's the Friday before Memorial Day there are 258 passengers on board for the flight to Los Angeles on this flight a live feed from a video camera mounted in the cockpit allows passengers to watch the takeoff from the cabin it's a new feature for American Airlines it was simply showing the runway and what the pilots were seeing as you took off or as you came in for a landing so it was just like a movie for the passengers American 191 you are clear for takeoff [Music] underway you have control I have control Runway clear okay setting takeoff thrust here we go apply take off power you've got three engines pushing you down the runway ing the Pilot's view from the cockpit is a thrill for many on board at 304 PM the plane is seconds away from lifting off the one you accelerate to V1 which is the the speed Beyond which you can no longer abort the takeoff so you have to keep going you have to take off no matter what happens rotate [Music] seconds later you reach rotation speed this is when you let the pilot lift the nose the uh the front wheel would come off the Runway [Music] damn there's the turbulence not too rough did you see that [Music] I've lost power to my side the captain's instruments suddenly go dead looks like we've lost number one and he's lost power from the left engine but the plane is already airborne have to keep going you have to climb out and if there's something wrong with the airplane even if the problems are critical your best hope is to keep going to climb contact ATC and come around and land somehow somewhere look at this [Music] equipment I need equipment blew an engine the DC-10 should be able to climb with only two engines these multi-engine planes are specifically designed to take off with one engine out they are designed to climb out at a Brisk greater speed and to climb to Safe altitude with one of the engines missing Pilots are trained to cope with this kind of emergency first they need to get as far from the ground as they can altitude is critical there's a saying that Pilots have the three things you need are altitude AirSpeed and an idea they put their plane into a steeper climb forward speed drops to have room to play with if you have the altitude now you can look around and try to figure out what went wrong and try to Institute some corrective measures [Music] correct correct the plane is banking sharply to the left it's only 325 feet from the ground they were applying full right aileron because the left wing was going down and by applying full right ailer and what you're doing is trying to lift that Wing back up that has gone down he might try to turn the ailerons the other way harder and if that still doesn't work something's clearly wrong I can't hold it American 191 heavy do you copy he's not talking to me losing power from one engine should not be causing the plane to bank passengers have a frightening view of the ground below the pilots can't get the altitude they need and they're banking further and further to the left come on come on 300 feet we're losing altitude the cockpit camera gives passengers a glimpse of their fate but they are not the only ones whose lives are in danger a trailer park just north of the airport is home to thousands of people oh God and the plane is heading straight for it [Music] Witnesses on the ground can clearly see flight 191 flying on its side [Music] foreign well certainly would be a very very scary thing and you would certainly know that you were about to die [Music] there he goes the DC-10 crashes into an airport hangar at the edge of the airport the full load of fuel instantly ignites DC-10 with 271 Souls on board has gone down Northwest of Runway 32 right it only got about 300 feet above the ground and it traveled maybe 4 600 feet or so beyond the end of the runway before it crashed into a field [Applause] as soon as we pulled out of the station we could see the column of smoke and as of course as we get closer and closer it was heavier and you could see how big the site was less than a minute after takeoff There is almost nothing left of flight 191. everything was was smoldering and I remember seeing pieces of the aircraft that were very recognizable such as the landing gear and I remember seeing one of the engines also Rescuers find a horrifying scene you saw what what was recognizable as torsos body parts it just brought back the human element and being realized and thought about the people who were on board [Music] as they begin assessing the full scope of the disaster they have very little hope that anyone has survived American Airlines flight 191 has crashed just short of the trailer park beside Chicago's O'Hare Airport the DC-10 has also obliterated a hangar beyond the runway there were some distinct odors jet fuel certainly that was that was the overpowering order and then uh the Eerie quiet I remember once the fire is under control the search for survivors can begin but as you walk the scene it was it was pretty obvious pretty quickly that there were no survivors it was very very frustrating to realize that no matter what your training was there was nobody there that you could help old 271 people on board are dead two workers inside the hangar have also been killed it's the worst Aviation disaster in U.S history [Music] a lot of people saw this happen let's see what they can tell us the national Transportation safety board must now figure out what went wrong on flight 191 this is a Breaking News special report good evening an American Airlines DC-10 crashed just after takeoff this afternoon from Chicago's O'Hare International Airport it's the kind of action which unfortunately really grabs the imagination of the public and can do so much to cast a stain on the reputation of an airline of an aircraft on air travel in general thousands of people fly aboard dc-10s every day if there's a floor in the plane investigators need to find it before more people are killed the states were very high for the NTSB to get this investigation right the airlines wanted the public to understand that this was fundamentally a safe aircraft they are eager to hear from the many people who saw the crash especially those with the best view controllers in the tower [Music] look at this look look at this the controllers reveal that flight 191's left engine didn't simply fail the engine fell off the plane just after they left it off so far if you were sitting on the left hand side of the airplane what you would have seen was the number one engine on the left side rotated up and flipped back and disappeared behind you yeah that's the last thing Airline passenger wants to see these engines are actually designed to go back up over the wing in case of failure so that they will miss the tail as they go by and not cause damage to the tail section they will go over the tail the engine has landed 760 meters from the end of Runway 3-2 right the team scours the tarmac for any pieces that came from the plane how's the DC-10 lose an engine the smallest piece of evidence could be of vital importance never seen anything like this that is not supposed to happen the engineering is supposed to be so robust that that will not occur so when that happens you'll have the undivided attention of everybody involved in investigation because that's a big deal in the entire history of commercial Aviation there have only been a handful of similar incidents but concerns over the safety of the DC-10 are not new this is the third major accident for the plane in the last five years there's a series of fatal accidents that were very high profile in the news and the name DC-10 kept appearing time again in headlines led the public to wonder what was going on in this airplane in 1972 American Airlines flight 96 lost its rear cargo door shortly after takeoff from Detroit 10 was at almost 12 000 feet when the door blew out causing an explosive decompression that severed essential control cables the pilots were able to make a successful emergency landing saving all on board [Music] two years later the 346 people aboard Turkish Airlines flight 981 we're not so lucky they all died when their DC-10 crashed into a forest in France after suffering a similar cargo door failure public confidence in the airplane was fairly low at this point and a lot of people would not fly on that airplane they would book another trip or book another airline to stay away from the airplane they say if it's a DC-10 that put me on another flight I don't particularly like flying dc-10s but you know it's the only flight we can take so we take it investigators desperately need to know how an engine fell off a plane carrying 271 people they searched the charred debris for the plane's flight recorders you've got a plane that has destroyed on impact as this plane was the data from the uh from the recorders can be essential because that really is your only source of information the team is able to recover both black boxes but the recorders are heavily damaged it will take time to analyze the data thank you what you got the investigative team soon makes another Discovery swallow the pushing bolts split right in two it could prove to be crucial [Music] found a bolt that had broken question that was raised was did this board break before the accident and cause it or did it break as a result of the accident the left and right engines of the DC-10 are mounted to the wings through a rigging system known as the pylon the bolt found on the runway is one of the few holding it in place [Music] the badly damaged bolt was found closer to the start of the runway suggesting that it may have been the first thing to come off the plane so what do you think the investigative team believe they have found the culprit this would explain it the NTSB is under enormous pressure to explain how an engine could simply fall off a widely used passenger jet thank you two days after the crash they hold a news conference to announce that they found the cause a broken bolt irritable there's a nut still attached to part of the bolt this is a fracture Point well I arrived at the scene of the investigation and it was a press conference going on at that time in which the vice chairman of the safety board was speaking and he had just concluded Michael marks is a metallurgist with the NTSB what did you guys say about the bolt he said this is it this is why the engine came off he's an expert in fractures and failures of airplane parts it was related to me that he had indicated that a bolt that was found on the runway was involved in the engine separation tell me you have more evidence than that when I visually looked at it I could see nothing on the bolt that would indicate anything out of the ordinary which all I could do is say this bolt didn't have any pre-existing cracking on it or had anything that that would indicate that it had a weakness in the structure this thing broke when it hit the runway not before so not exactly our Smoking Gun we need more information and to announce that you basically have some kind of cause for that engine separation without really looking at it it was not a good idea to come out with this at that particular time and so more caution was needed okay look we gotta forget about the media and focus on the evidence it turned out that it didn't cause the accident but going in you don't know what is going to turn out to be important and what's just a red herring the confusion of the press conference only increases the pressure there's no room for any more mistakes for now the team can only study the wreckage for Clues they hope there is enough of the plane left to help them make sense of what happened hold on let me see that okay good anything from the main crash that goes over here anything from the runway any engine or Wing Parts goes to that side well my first priorities would be to look at the actual Parts the actual separation where is it that this thing broke this is definitely part of the pylon I never seen one break like that the pylons are mounted under the wings each one is strong enough to suspend a 5 300 kilogram engine the pylon is designed very well I mean it's a strength wise so it basically could take a lot of load much more load than new and normally see in the course of the airplane life the pylon gets its strength from two internal bulkheads one forward and one aft these bulkheads also provide secure points of attachment ensuring that the engines are firmly fixed to the wings it's also designed to have multiple load paths so that it's what they call fail stay design it seems incredible that a pylon one of the strongest parts of the plane could have broken perhaps the Fail-Safe design is flawed if so it could be just a matter of time before another pylon breaks in mid-air hey what happened I need to see the rest of the power as some investigators search the wreckage near the airport for the rest of the broken pylon others are finally able to listen to the cockpit voice recorder it should reveal if the pilots had any indications of a problem as they were taking off okay go ahead American 191 thank you taxing hold Runway 32 right flaps this last attack the taxi and takeoff roll are perfectly routine American 191 underway there is no indication the pilots were having any problems sounds pretty routine so far [Applause] is that it one of the tricky things about this accident for investigators was that the nature of the damage was such that the cockpit voice recorder itself was rendered inoperable so that was a big loss of of Clues the voice recorder was powered by the left engine damn once it fell off the recording stopped thanks about the last thing they heard on there was just damn and that was the end of the recording and that told him absolutely nothing they may never know what happened in the cockpit after the engine fell off the flight data recorder is also nearly useless because of the extreme way the plane was flying a lot of the data makes no sense this isn't gonna help us but at the hangar there's been some progress investigators have recovered all the pieces of the pylon Michael marks may now be a step closer to figuring out why it broke apart now I had an indication that maybe that this is this is the area that we really should be looking at so in doing that you needed to get more detailed inspections of it you needed to get it to the laboratory back in Washington DC investigators also examined the plane's history for anything that might relate to this catastrophic failure John Golia spent nine years as a senior maintenance expert for the NTSB instantly if we know we had an engine for Honor you're going to go right for the maintenance records you're going to go right to the history of the airplane they had the engine of the end of March eight weeks before the accident the left engine was removed for Servicing any time that you have an airplane that's been into maintenance just before a crash that also raises all sorts of warning flags all sorts I'm gonna go down to Tulsa see what they did if you have an investigation that involves maintenance you don't go inside the hangar you don't follow that trail you're going to miss some issues why the pylon broke is not the only question that needs to be answered damn I've lost power to my son looks like we've lost number one two of the dc-10's three engines kept working the plane had the power it needed to keep climbing and then get back to the airport in fact you could lose a second engine shortly after I left off and you would still be able to power the aircraft around but somehow experienced Pilots weren't able to fly This Plane after losing just one engine with 273 people dead after an engine fell off a plane FAA makes a drastic decision on June the 6th 1979 the agency grounds every DC-10 in the United States [Applause] 138 planes in total well you can imagine if one of your real Workhorse airplanes is grounded disrupting flights and conveniencing passengers generating headlines it's a terrible situation you spend 100 million dollars for an airplane you can't leave it sitting around very long costing you a lot of money every day to have that airplane on the ground old foreign based dc-10s are banned from entering U.S airspace the pressure on investigators mounts as the effects of America's worst air disaster spread across the globe foreign [Music] Michael marks believes the shattered pieces from the engine pylon may explain why flight 191 fell from the sky they work for yourself happened before the crash I don't know why when looking at the after bulkhead in detail there was a one very puzzling thing a close examination reveals a crack in the metal that clearly developed slowly over time it's a Telltale sign that the pylon bulkhead was already damaged before the crash you can see where it spread the crack that Michael marks finds runs along the top edge of the AFT bulkhead the cracks were consistent with a fatigue phenomenon or a cyclic Behavior a crack extending from repeated loads each time the load occurs you then have an extension of the crack the microscopic examination gives Marx another clue a dent on the pylon bulkhead at exactly the point where the crack began there is also a deformation that was on one of the fractures at that time was not absolutely sure what it all meant because it just showed a deformation looks like something hit the pylon and what or when okay I'll see what I can find take notes on everything got it the information is available it's on the hang of floor it's in the minds of those people we just have to ferret it out investigators arrange to watch as another DC-10 undergoes the same maintenance that was performed on flight 191 just weeks before the crash can you tick me up and show me how the engines mounted we're going to talk to the to the people involved most likely it's going to be the maintenance personnel and we're going to ask them pointed questions you know on what have you done have you done this job before what kind of problems did you encounter did you follow the paperwork to the letter religiously step one step two step three they found procedures that were not in the manual they found procedures that the manufacturer didn't recommend be performed to save time the airline has modified a key maintenance procedure a wing mounted engine on a DC-10 is a 24-hour Adventure which is extremely long so there's a lot of pressure on it getting whatever is broken repaired and getting the airplane back in the sky the normal procedure for servicing an engine involves removing it from the pylon and leaving the pylon attached to the wing there are hundreds of connections to be undone procedures from the manufacturer would deem to be too time consuming and they could do it faster better cheaper so they were deviating from the procedures the quicker way involves taking out just three bolts the engine is removed from the wing while still attached to the pylon it saves about 200 man hours of Labor it was easier the attached points from the pylon to the wing were accessible the attach points from the engine to the pylon were much more difficult to take apart and put back together removing is not the issue it's the attempt to reinstall well stock is where the problem comes from left a bit maneuvering the pylon into position with an engine attached to it is a tricky procedure trying to put the engine and the pylon back together some thirteen thousand pounds for the engine and two thousand pounds for the pylon it's not easy they were using the forklift and this forklift is not very manageable it cannot be finely controlled as far as the altitude is concerned the minimum movement on the forklift was like something on the order of a quarter of an inch and we're talking about trying to fit something together that might be in the order of thousandths of an inch Whoa stop stop so you get just slightly the wrong angle and you get too much pressure on it and you're gonna crack those fittings I'm sure they didn't realize that how quickly they could get in trouble doing it the way they were doing it I think I know what happened a possible explanation surfaces take her down for the mysterious Dent found on the pylon from flight 191. the team in Tulsa calls Marx what do you got they describe how the maintenance Crews struggled to fit the pylon attachment into the mounting bracket or Clevis and then it all came together just like a bolt of lightning to clevis itself had produced this deformation that was on the fracture monks concludes that on the accident plane the clevis must have slammed into the top of the pylon bulkhead as the engine was being reattached the impact could have started the crack that led to the pylon's failure and to the crash itself the maintenance people that did this operation which cracked the pylon probably didn't hear anything and bang or crack or anything like that okay bring her up we call it work around so they work around the manual to get the job done quicker but in the the process never gets the proper vetting if you will review from engineering and from the manufacturer and sometimes those alternate methods have unintended consequences over the next eight weeks each time the plane took off the stress that the massive engine put on the pylon made the crack grow larger the engine is not only imparting a Thrust load but it's also imparting a sideways load so each time you have this load it breaks a little bit more and more and more it was only a matter of time before the pylon snapped and the engine fell off so the process was flawed and the people made adjustments to a flood process to try to make it work and collectively that is a recipe for disaster how long have you been putting the engines on this way not sure but every airline does it even more worrying the mechanics at American Airlines are not the only ones cutting Corners the airline's shared processes and since this engine change was so time consuming and costly they were all looking for a better way of doing it at fast about a cheaper way to do it and so when one would discover it a process to use that maybe made the engine change go quicker the others were very quick to adopt it and that's exactly what we see here we need to get the entire fleet inspected for this it is now clear why the engine fell from the plane but what happened after that is still a mystery flight 191 could have landed safely with one missing engine 273 people died in a horrific crash the plane was completely flyable it was in bad shape it had lost an engine it lost several critical systems but it was still airworth and was still able to fly what happened in that cockpit [Music] the crash of Flight 191 has a devastating effect on the entire airline industry it was a huge economic problem for the airlines because their major airplane was now on the ground and they couldn't fly it and of course I think it had a big impact on the public as well have you seen this so why weren't the pilots able to save their plane after losing one engine [Music] a chance photograph taken just before the crash May provide some answers there was certainly one very famous photograph that was published in many newspapers and the aircraft in semi-inverted position almost ready to strike the ground everyone saw this picture I want you to track down all the pictures you can and get them blown up I want to see those wings you got it these photographs that can do so much to horrify the public can have a real use for the accident investigators by examining photographs taken just prior to the crash they might be able to tell whether the pilots made some mistake when they configured their plane for takeoff flaps and ailerons look fine by blowing up and zooming in on the Leading Edge of the wing the aircraft investigators were able to determine what was going on that hydraulic fluid if the fluid leaked from the plane's hydraulic system it might explain why the plane was so hard to control sometimes the crucial element in air crash investigation can be some very small subtle detail from which everything else can devolve several of the dc-10's hydraulic lines run along the Leading Edge of the wing look at this it's the area that was damaged the most when the engine Broke Free we need to see those slats American 191 thank you it's actually an old Runway 32 right flaps and slats to 10. the plane slats are extended before takeoff they're essential for providing the lift needed to get the plane Airborne the slats are on the Leading Edge of the wing and when you deploy the slats they move out forward so there is a longer distance to go and therefore is moving faster and it creates more of a lift the vacuum above the wing if the hydraulic system controlling the slats failed it could explain the plane's loss of control [Music] investigators discover that while all the slats on the right wing were extended for takeoff some on the left wing were not it's a configuration that's normally impossible you have One Wing that is flying in the other Wing that isn't and when you have a wing that's flying and one that isn't the one that isn't flying dips and the one that is flying continues to fly which means the airplane goes into a row they conclude that the engine hit the wing with enough Force to rupture the hydraulic lines the fluid keeping the slats extended on the left wing would have drained quickly without fluid some slats on the left wing retracted causing that Wing to lose lift the plane began to roll the actual stalling speed was 124 knots for the airplane in this at this weight and configuration I'm losing it the fact that this slat had retracted raised the stalling speed to 159 knots from 124 knots so it was a huge difference without the slats they needed to be flying much faster than normal to avoid stalling one final question remains why couldn't the pilots recover from the stalled wing investigators recreate the takeoff in a flight simulator to find out we're ready Let's Travel [Music] [Music] B1 This Crew had almost 5 000 hours in this aircraft you couldn't ask for a more experienced crew in this airplane and if anybody was going to be able to fly that airplane in that condition it would have been this crew [Music] Italy after the slats retract there are dramatic warnings in the cockpit is a stall warning system that will advise the pilots when the airplane is about to stall it's called a stick Shaker and when you're nearing the stall speed your stick will actually start to shake to warn you of this the stick Shaker does exactly as the name suggests it vibrates the control column to get the Pilot's attention if you get a stall warning you obviously lower the nose and you apply full power and you fly it out of the stall it lowered the nose let the airspeed increase they actually would have been fine the plane was recoverable it was landable the simulator tests show that once the pilots are alerted to the problem it is possible to recover [Music] if the pilots on flight 191 had known they were stalling they could have been able to save their plane it seems possible that somehow they didn't know investigators study the cockpit warning system on the DC-10 and make a crucial discovery when the engine fell off it severed hydraulic systems its severed electrical systems I've lost power to my side glass number one it resulted in a loss of instrumentation and of warning devices as soon as the left engine came off the warnings that could have saved the plane were disabled they bring in a new test pilot to fly the simulation okay Elsa what they don't tell him we're ready let's try one is that all the warnings have been disconnected V1 from that position in the cockpit you can't see that left wing and you they didn't even know the engine was actually gone they thought it had just stopped looks like we've lost number one when Pilots they lose an edge when we lose engine power This Plane actually lost an engine without warnings the test pilot is in the same plight as the American Airlines crew he has no idea his plane has stalled the stick Shaker stall warning device had been functioning it's very easy to imagine that the pilot flying the airplane would have put the nose down and would have avoided a stall for banking correct correct since they don't know about the stall they follow the procedure for an engine failure on takeoff sealed their fate Pilots were taught at that point in time that if you lost an engine the whole idea was to get more altitude faster and get away from the ground so if you lost a second engine you would have that much more altitude to play with and so you were taught to pull back on the wheel and go back to the minimum safe flying speed to get away from the ground reduced speed of 153 knots reducing speed to 153 knots reducing speed by lifting the nose is the exact opposite of what pilots need to do when a plane is about to storm it makes the skull worse and the roll more severe following the checklist for a single engine failure made what happened next inevitable and doomed everyone on board if they didn't know they were stalling they didn't stand a chance the pilots flew the plane exactly as they'd been trained to do exactly as procedure demanded that they fight the pilots were doing absolutely the right thing there was absolutely nothing that he could have done he was powerless he was along for the ride the NTSB concludes the pilots were not at fault at American Airlines maintenance practices for not enforcing proper procedures [Music] feya mandates that stick shakers be installed on both Pilots control columns and that the warning system be powered by more than one engine the plane's Hydraulics are also redesigned with special plugs to prevent slats and other control surfaces from retracting if the lines are cut when the airplane were grounded as a result of this accident we found a number of other airplanes with cracked in a fleet inspectors find eight more dc-10s with damaged pylons was very scary when it when the inspections uncovered so many other airplanes were problems that was very very scary because every one of those had the potential of being another accident and had we not done the grounding and we may have had that had yet another accident before we realized that the width and breadth of the problem this kind of accident never happened again this engine never fell off this kind of airplane again in the general sense though it teaches us how to look at safety it teaches us how to look at the culture of training and procedures in the air and procedures on the ground Whoa stop stop one final outcome of the flight 191 disaster Airlines reconsidered the idea of sending live video to passengers in the cabin the passengers were able to see the airplane going into this dive and were able to see their own demise in the pack the cockpit camera was abandoned but the shocking photo of flight 191's last moments remains an image that both the Airlines and the FAA likely wish could be erased they would much rather have people think of air travel as cramped seats bad food luggage being lost then with dying foreign [Music] taxi cross Runway 2-4 left contact ground point six five one February the 1st 1991. Los Angeles International Airport LAX 246 heading 270 contact Los Angeles Parker thank you US Air 1493 you're clear to land 2-4 left would be 93. traveling at 240 kilometers per hour U.S Air flight 1493 descends towards Runway 24 left what the hell I pointed to the aircraft and yelled US Air is crashing the aircraft was fully engulfed in flanks but the full scope of this tragedy is far greater than anyone can imagine at one of the busiest airports in the world a Boeing 737 has just exploded in Flames upon Landing I think the thought process in the tower was it was 1991 it was one of the first nights of the first Gulf War and I think the thing that was foremost in our mind was maybe it was a bomb that went off on the aircraft as firefighters bring the blaze under control Rescuers begin searching for survivors about five minutes after the incident occurred we got a call from an emergency vehicle amid the wreckage they have made an alarming Discovery one that forces everyone involved to re-examine every detail of the last 15 minutes [Music] [Music] U.S Air flight 1493 cruises towards Los Angeles International Airport [Music] LAX is a central hub for international Travelers [Music] just confirm the visual approach for US Air 1493 is 2-4 left correct USA 1493 for the approach Captain Colin Shaw is managing radio communications [Music] first officer David Kelly is at the controls [Music] with 89 passengers on board the flight isn't quite full [Music] well I've been on a business trip to Columbus Ohio I went from the business meetings to Columbus airport and got on a U.S Air flight that was non-stop to Los Angeles I planned a lot of good things and good times for that weekend there 1493 air I would there will be traffic pass above you on the South Side as the Boeing 737 nears Los Angeles the approach controller tells the pilots to make a quick descent they will need to stay clear of a flight passing above them okay I'll expedite through four US Air 1493 foreign landing at LAX can be a challenge for Pilots the airspace around the airport is often thick with traffic on average a plane arrives or departs every 50 seconds four runways handles both takeoffs and Landings taxiways intersect the runways at dozens of locations the airport can be a maze of stops and starts for Pilots following instructions issued by controllers you got the left side inside yeah we're out of four US Air 1493 thanks for your help contact Los Angeles Tower 133 decimal nine good night good night [Music] gear down all right you gave three Bells yes I did [Music] perched 12 stories above the ground Tower controllers have a Hawk's eye view of traffic coming and going from the airport it was a busy night there was a lot of airplanes we had numerous arrivals and departures during that time of the night so it was a typical day Elliot bran is the clearance delivery controller the primary duties of the clearance delivery controller is issuing the routes of flight and the flight plans to the pilots as they come out of the computer a flight script is printed out so you get a piece of paper with the call sign type aircraft root of flight I issue the clearance to the pilot and then I pass the strips the flight information to the next controller brand shares flight information with four other controllers two ground controllers who handle planes moving between the gates and the runways and two local controllers who are responsible for planes taking off and Landing tonight local controller Robin washer is overseeing the two North runways at LAX 24 left and 24 right she uses the flight strips to keep track of flights departing and arriving the USR 23 taxing a position and hold Runway 2-4 left foreign [Music] US Air flight 1493 is about 13 kilometers from LAX [Music] the pilots configure their plane for landing speed bricks still working for a living all right the laps are going one reps now the pilots radio The Lax tower for landing instructions UIC 1493 inside Rome Tower Robin washer is busy with other planes she doesn't respond to their radio call Skywest 569 tax in a position Hall two four left traffic will cross downfield okay two four left position in the hall sky was 569. Wing West 5006 Tower 30 green lights to 10. gear flaps Landing clearance remains [Music] just six kilometers from the airport the US air jet still doesn't have the okay to land Sundance 518 taxi cross Runway 2-4 left contact ground 0.65 when you're off the Runway good night [Music] Captain Shaw contacts the tower for the second time in less than a minute he needs washer's permission to land US Air 1493 for the left side or left 246 heading 270 contact Los Angeles departure night but she's still focused on other planes out of a thousand feet flight 1493 is now one minute from the runway it's what pilots call short final sometimes due to other priorities that take place an aircraft might not get a landing clearance until a short final 1493 you're clear to land 2-4 left 1493 thank you looks real good you're coming out of 500. [Music] US Air 737 has barely touched down it erupts in flames and crashes through Los Angeles International Airport I saw U.S air touchdown and as he got about mid about third way down the runway attacks away 45 the aircraft was fully engulfed in flames [Music] the supervisor ran past me to pick up the crash phone and alert the emergency vehicles to respond a bullet the flight there was a tremendous crunching sensation and there was this extraordinary shower of Sparks that shot by my window thank you good God Rosa Reynoso is a plain clothes officer with the airport police we see the aircraft engulfed in fire my partner and I were probably about 500 yards from it alert 33 Runway 24l affirmative alert 33. the initial moments were very scary very chaotic I remember just thinking to myself oh God please get some more people out here get me fired get me officers get me somebody because this is not good [Applause] in the tower there's no time to dwell on what's happened other aircraft are still coming in to land controllers must direct them to safety 12 wins 240 at eight you are cleared to land Runway two four right use caution he just had an aircraft go off the Runway in flames thank you the cabin of Flight 1493 is filling with toxic smoke some passengers rushed to a door at the rear of the plane I probably got seven or eight rows down the aisle and and then I encountered a cluster of passengers standing in the uh in the aisle not moving I thought to myself there must be an opening in the front of the plane that allowed for this tremendous quantity of smoke to roll into the plane so quickly and so I stumbled forward to the the cockpit area and there was tremendous fire on both sides of the plane I said to myself my gosh there's no way you're going to get out of this airplane David you're trapped outside some have escaped the plane Rosa Reynoso is the first emergency responder to arrive at the scene the Firearms intense it was it was very very hot I mean almost singing us she needs to act fast to help passengers away from the burning wreckage passengers are trying to escape the fire had engulfed the doors so some of the people that were fine jumped out of the plane Into the Fire more emergency Personnel arrive within minutes some people were on fire someone were scratched cut up some of them had broken legs it was pretty traumatic and I think you just start operating them knowing that you have to do the right thing and try and save these people David Koch is still inside I suddenly saw a crack of light and my God was a miracle the the crack opened up and I suddenly realized that I had opened the galley door but now he faces another Hood he can't even see the ground through the fire and smoke I said myself what the hell and jumped out I landed on the ground and I then started calling my hands and knees away from the airplane I had a great sense of guilt why did I not go back into the airplane and say follow me I think if I'd gone back into the cabin I might have passed out and fallen on the floor and died and that's how I've come to terms with the fact that I I got out but didn't help anybody else out search for survivors continues firefighters make a stunning find this is rescue one we've got a propeller down here in the wreckage the discovery of a propeller has horrifying implications there's two planes down here as soon as we found out that information we started actively looking to see uh what aircraft if any were missing so we started looking at the flight strips that were already Departed and then we looked at the ones that were still pending and then we called the departure control radar controller to find out which ones they've talked to in the last five six minutes what about Skywest 5569 no we haven't heard from them Skywest 569 taxing a position hold Runway 2-4 left okay two four left position on the hole Skywest 569. staff can account for all of the aircraft except for Skywest 5569 a Fairchild Metro liner Bound for Palmdale California emergency Personnel find parts of the smaller plane strewn across Runway 24 left there were 12 people on board the flight none have survived what's left of their plane is crushed between US Air 1493 and an abandoned building near the runway my first thought was oh my god there was someone else under there and we didn't even realize it there's even more loss of life on board the larger plane twenty are dead two others are mortally wounded first officer Kelly has survived but Captain Shaw has not the disaster thrusts LAX into the media spotlight America's runways according to the nation's Pilots the most dangerous part of the flight in the months and years leading up to the crash increasing traffic was becoming a safety concern at Los Angeles International Airport Los Angeles International Airport 33 near collisions over the last four years that's one every month and a half the accident confirms safety issues need to be addressed the national Transportation safety board sends its go team to LAX to investigate it was kind of a horrific scene the front end of the airplane was uh was impaled on the captain's side against the building and uh with a close inspection we could see parts of another aircraft underneath investigators can see that the two planes collided at an intersection on Runway 24 left the scenario of the accident resulted in two planes being on the runway at the same time the runway was occupied and that's something that should never happen when a landing clearance is granted reducing collisions on U.S runways is a priority for investigators from the NTSB we had runway incursions on the most wanted list from 1990 here at the safety board and it's a major concern for the whole industry a Runway incursion is simply when an inappropriate object is is out on a Runway that's going to be used for a takeoff or Landing some of the world's worst Airline disasters have taken place on runways in March 1977 on the island of Tenerife 583 people died when two Boeing 747s collided on the runway in January 1990 a Beechcraft King Air 100 was struck by a Boeing 727 attempting to land in Atlanta later that year in Detroit another Boeing 727 smashed straight into a dc-9 carrying 44 people Runway incursions uh occur due to some failure in the existing system has happened some directive has not been followed some inattention has is present in in the scenario of a Runway incursion one of these planes was cleared for too far left [Music] investigators need to find out why there were two planes on Runway 24 left at the same time one of the principal objectives was to immediately see if we could find out what error had taken place that would allow that situation to occur part of that answer May lie in the wreckage but 24 hours after the crash the investigation is at a near standstill there's too much fuel on board the 737 crawling through the wreckage would be dangerous the aircraft had about 6 000 pounds maybe a thousand gallons of fuel on board how long is this going to take the uh the the Saturday was spent uh defueling the aircraft and that's a a very slow process that took almost all day before the fire department could declare that the the scene was safe with airplane Parts littering the airport LAX is running at half capacity two of the four runways are shut down that's causing chaos for travelers [Music] when the NTSB team finally gets access to the wreckage they're under enormous pressure to act quickly they must gather all the information they need so the airport can be fully reopened their investigation has a dual purpose they must figure out what caused the Collision they also want to know why so many passengers got trapped and died in the burning aircraft we're not sure what went on we don't have a recording of it but there were some altercations with people trying to get hurt of other people making matters worse one of the emergency exit doors is inside the plane partially blocking the exit if you follow the instructions on the card the exit card it will tell you to throw that exit out this did not take place so the right over the wing exit was I would say partially obstructed by that large hatch the NTSB concludes that A reduced number of exit doors made it impossible for many of the passengers to escape with no way out they were overcome by toxic smoke as it filled the cabin while some investigators analyze wreckage of the crash site others focus on air traffic control well first and foremost we look at the communications then we also look at the procedures within the facility and how those are applied and where they indeed followed to learn more the NTSB collects the audio tapes of the controller's communications with the planes investigators wonder what instructions were given to the pilots in the moments leading up to the crash they also want to know what the flight Crews were saying during those crucial seconds did the pilots follow their instructions the cockpit voice recorders should provide investigators with the answer [Music] but then Bob McIntosh gets some bad news about the Skywest Metro liner no voice recorder great we recognized looking at the onboard equipment that Skywest 569 did not have a CVR flight recorder installed and uh that was disappointing to us at the time of the crash commuter planes were not required to carry cockpit voice recorders this means the only Skywest conversations caught on tape are radio communications recorded in the control tower the two cockpit crew members would have exchanged words would have been listening to the air traffic information that was coming into their cockpit all the time and we recognized that that was a valuable piece of data that we lost using the air traffic control tapes and just one CVR investigators try to find out which of the two aircraft in the Collision was actually cleared to use Runway 24 left [Music] the answer will raise alarming questions about the safety of all passengers flying to and from LAX 246 you're used to holding short of 47. the investigation into the deadly Collision on Runway 24 left focuses on Robin washer's conversations with the two planes involved investigators begin with the smaller plane 23 attacks in a position minutes before the accident the pilots of the metro line are waited for permission to take off Skywest 569 taxi into position and hold Runway 2-4 left traffic will be cracking downfield we use the tapes to try to visualize like a local controller would where the aircraft would be on the runway Pilots of the Skywest Metro liner turned their plane onto the runway and stopped at intersection 45. they had to wait for another plane to cross the runway downfield okay two four left position 569. okay stop her out there from the air traffic control tapes the NTSB can tell that the pilots of the metroliner followed all their instructions correctly all right let's keep going responsibility for the accident must lie elsewhere investigators probe the tapes further they look at washer's Communications with the U.S air Pilots USA 1493 for the left side 2-4 left thank you US Air 1493 you're clear to land 2-4 left a US Air 1493 was cleared to land on the same Runway during the time this cow West 569 was still sitting in position on that same Runway we're DeLand too far left 1493 Skywest 569 right at intersection 45. how long has it been there [Music] one minute seven seconds the ad traffic control tapes revealed that Robin washer instructed both the Sky West Metrolina and the U.S Air flight to use Runway 24 left at the same time when you are New York what the hell [Music] when we're examining the recorded voice Communications what we try to do is to put ourselves in the position of the controller what which you have seen what would she have heard what would she have done investigators need to know what Robin washer was doing at the time of the crash they look at the other flights that she had under her control Wings West 5006 taxi cross Runway 2-4 left they learned that in the moments before the Collision washer began to lose track of some of those flights no sir hold short Wings West 5006 taxi across Runway 2-4 left winds West 5006 was an aircraft that was on the north side of Runway 2-4 left who wanted to cross to the south side Wings must five thousand six ground Tower and when she was ready to cross the aircraft the crew did not respond [Music] washer spent nearly a full minute of her time trying to re-establish radio contact with the flight crossing the runway can I hear the rest of that Exchange West 5006 on frequency again change radio sorry about that they advised her they they had inadvertently been on another frequency I thought and that created a distraction for the local controller but investigators discover that that flight wasn't the only aircraft Robin washer was fixated on in the moments before the crash foreign with US Air 1493 less than a minute from touchdown washer hears from another Wings West aircraft flight 5072 when Wings West 5072 called to say that he was ready for departure it was obvious to us that she didn't understand who this aircraft was Wings was 50 72 are you at 47 or full length we're out full length okay hold short investigators need to hear from washer herself I couldn't find the flight progress trip they hope to learn why she didn't recognize a flight that was under her control I confirmed the strip so I asked my supervisor to help me francina I need a strip for Wings West 5072 foreign she explains that as the pilots of the metroliner waited on the runway for permission to take off he was searching for another flight's progress trip before she could get back on track U.S Air flight 1493 crashed into the back of the metroliner NTSB investigators now know that human error played a major role in the collision at LAX remarkably when she cleared the U.S Air flight to land Robin washer simply forgot about the metroliner waiting on the runway occurred it was a con is a situation that no controller wants to go through you train your whole career for this not to happen and when it does happen it's uh you can't even describe the feelings that you go through a situation like this could potentially happen to anybody we are all human after the accident washer left her job at LAX and never worked as an air traffic controller again but investigators believe there are likely more causes to this accident than one person's fatal error anytime that you do an investigation it's easy to point the blame at one individual what you want to do is to say why did this occur and what can we do to prevent a reoccurrence answers to those questions begin to emerge as the NTSB examines the daily routine in the control tower in the weeks before the accident it was one of those you don't know you have a problem until you have a problem runs out another disaster was narrowly averted seven months before the Collision a landing DC-10 flew just over an Airbus waiting on the runway to take off at LAX Los Angeles airport has always been known as one of the number one Runway incursion airports in the system and changes were overdue controllers at LAX produce documentation showing that immediately after that close call they alerted officials that the control tower was understaffed they also explained that regions around the northern runways were invisible to controllers because their view was blocked by a light Tower foreign we went up in the tower climbed the stairs and asked the air traffic controllers to step aside while we sat in their chairs and looked out the window The View that the air traffic controller was presented with had an obstruction a light pole that produced a glare and it was a light that lit up the airport ramp [Music] Robin washer may not have been able to see the Sky West Metrolina as it sat out on the runway NTSB investigators look at other tools she could have used to detect the Forgotten plane surface radar is generally used during periods of low visibility it is a tool by which the local controller should they so choose be able to visually confirm on that scope that an aircraft is indeed where it says it is ground radar displays all aircraft and ground vehicles moving around the airport but on the night of the accident that system wasn't working you're holding short is that correct sir yes ma'am we're holding short it was in constant out of service in service out of service in service and gave the management a lot of trouble the system was not very reliable and we did Lodge complaints to have it fixed and to upgrade the system as soon as we could investigators learned that just four days before the accident officials at LAX had formally asked the FAA to treat the failing ground radar with the highest priority the radar drive and the some of the drive mechanism had some ring gears and uh and Spur Gears that they had to go to machine shops and literally make that part because it would wear out on a regular basis uh trying to rotate the antenna we looked into this particular problem and learned that Los Angeles had been slated to receive a new system in 1988 however that date had slipped in at that time they were not sure when they were going to get a new radar system with the ground radar system out of commission and with her view of the runway impeded by blinding lights Robin washes chances of discovering her error were Slim investigators turned their attention to the cockpit of the U.S Air flight they wonder why the pilots didn't see the metroliner out on the runway and abort their Landing well most of us in the pilot Community would recognize that it's our job to scan that Runway and find aircraft that might be out there or anything else prior to Landing like old planes the Metro liner is equipped with lights to make it more visible at night there are strobe lights on the wingtips and the tail navigation lights on the wings and a colored anti-collision beacon on top of the vertical stabilizer we were concerned about the the Skywest lighting and uh and had to look at the flight operations manual and we found that the operating procedure for that company was to turn on the strobe lights only after clearance for takeoff so no other lights were required okay thank you the metroliner wasn't yet cleared for takeoff so the only lights that would have been lit while it waited on the runway were the navigation lights on the wings and tail and the anti-collision beacon on the tail NTSB investigators then use a helicopter to put themselves in the position of the U.S air Pilots as they were making the approach to Runway 24 left we went up and we actually flew that Final Approach in order to verify uh what we what we thought might be the condition of obscuration they positioned a metroliner on the runway in the same spot where the Collision occurred sure enough we could not see that that aircraft parked out there at spot 45 and 47. you just couldn't see it looks real good [Music] the investigation determines the lights on the Metro liner with the same color and brightness as the runway lights the plane may have been all but invisible to the pilots of US Air 1493. you're coming out of 500. the anti-collision beacon in particular would have been lost in a sea of Lights foreign [Music] safety board releases its report controller error is determined to be a cause of the runway Collision [Music] we're in the in the business of determining why something happened you may call it a cause or causes or contributing factors but our job ends when the next accident is prevented preventing accidents on the runways of LAX would prove to be a much greater challenge than investigators could imagine the collision between U.S Air flight 1493 and a Skywest metro-liner alarms the public the accident seems to prove that controllers cannot safely handle the increasing traffic at Los Angeles International Airport the NTSB investigation points to Robin washer's failure to maintain awareness of the flights under her control as one cause of the accident but the report also points to a failing system in the air traffic control facilities at LAX in the months and years following the accident improvements are made to air traffic facilities in an attempt to make the airport a safer place the failing ground radar system is finally replaced with a newer model today at Los Angeles Tower we have the newest system out there each arrival or departure they're taxing on the taxiways or on the runways have a call sign and type aircraft associated with it so you have positive identification of all aircraft at all times policies governing the way flight progress strips are handled in the tower are put in place ground controllers now organize the strips before they make their way to the local controller the extra set of eyes reduces the local controller's workload five years after the crash a new air traffic control tower is built at LAX the tower is 16 stories higher three times larger and offers controllers Clear unobstructed Sight lines new regulations concerning aircraft lighting are also put in place it becomes mandatory for Pilots to turn on all their lights before they move out onto a Runway [Music] but despite the improvements the rate of Runway incursions at LAX only goes up [Music] throughout the 90s and even into the 2000s I would describe it as a common event LAX certainly was one of the worst airports we had for a number of incursions 10 years after the accident more serious Runway incursions were happening at LAX than at any other airport in the United States they had double digit Runway incursions and serious Runway incursions almost every year and in fact in 2007 they actually had 21 Runway incursions in an attempt to reduce the problem once and for all the Federal Aviation Administration begins work on a new system of Runway lights to keep planes apart on the ground Railway set a slight system is a series of Runway entrance lighting that we put at taxiways or take off whole lighting that we actually put on the runway itself the system is fully automatic it uses a series of red lights embedded in the runways and taxiways the lights warn Pilots if there is conflicting traffic the when we established illuminate red tells a pilot that it is unsafe or a vehicle driver that it is unsafe to either Cross or enter that Runway and it triggers because there is an aircraft Landing or departing there's some other traffic on the runway the runway status light seems to be one of the most effective systems we have for preventing Runway incursions and certainly the serious one-wing courses in April 2009 the technology was installed at Los Angeles International Airport prototypes of the system have also been installed at Dallas Fort Worth and San Diego by 2011 Runway status lights will be a key feature at dozens of airports across the United States the equipment we're using at Los Angeles Tower today is much better than the equipment that we used back in 1991. it's been upgraded it's much more reliable and it gives the controllers the tools they need to make sure that the runways are clear and to keep the aircraft moving though new technology can never guarantee 100 safety the improvements at LAX have restored public confidence in the airport even among those who survived Flight 1493 I spent a couple of days in intensive care at a local hospital and I had nightmares by the way following uh my release from from the hospital for uh quite a number of days but I'm doing fine now I have no problem up with getting on airplanes and and flying and I've got great confidence in the airline system foreign [Music]

Channel: Wonder

Views: 1,242,437

Keywords: Wonder, wonder channel, survivial videos, survival stories, i shouldn't be alive, wonder i shouldn't be alive, outdoor channel, extreme documentary, mayday air disaster, mayday air crash investigation, mayday compilation, plane crash compilation, plane crash compilation 2022, plane crash investigation, plane crash landing, plane crashes caught on camera, plane crash video, plane crash documentary, real plane crashes caught on camera, real plane crash survivors stories

Id: uEuxsWmtYnk

Length: 182min 54sec (10974 seconds)

Published: Mon Nov 21 2022