Related Accidents / Incidents

The Indian Airlines Flight 605 accident involved several key safety issues; Low Speed Awareness, Flight Deck Design and Flight Crew Interface with Aircraft Systems, Crew Resource Management and Piloting Techniques, and an Unstabilized Final Approach. Similar and related accidents are listed below under each safety category. A summary of the related accidents is included below the accident categories and listing of accidents. Some related accidents, similar to Indian Airlines Flight 605, fall into multiple accident categories. Turkish Airlines Flight 1951 falls in all four categories and has the strongest resemblance to many elements of the Indian Airlines Flight 605 accident.

Low Speed Awareness Accidents / Incidents

  • Boeing 737-3Q8, G-THOF, Bournemouth Airport, Hampshire, England, September 23, 2007
  • Empire Airlines Flight 8284, Aerospatiale Alenia ATR 42-320, N902FX, Lubbock, Texas, January 27, 2009
  • Colgan Air, Inc., Continental Connection Flight 3407, Bombardier DHC-8-400, N200WQ, Clarence Center, New York, February 12, 2009
  • Turkish Airlines Flight 1951, Boeing 737-800, TC-JGE, Amsterdam Schiphol Airport, February 25, 2009

Flight Deck Design / Systems-Avionics Confusion / Auto-thrust Accidents

  • Air Inter Flight ITF 148, Airbus A320-111, Strasbourg, France Date: January 20, 1992
  • Air France Flight 072, Boeing 747-428B, F-GITA, Tahiti Faa'a International Airport - Papeete, French Polynesia, September 12, 1993
  • China Airlines Flight 140, A300B4-622R, B1816, Nagoya, Japan, April 26, 1994
  • TAM Lineas Aereas Flight 3054, Airbus A320, Sao Paulo Congonhas Airport, Brazil, July 17, 2007
  • Turkish Airlines Flight 1951, Boeing 737-800, TC-JGE, Amsterdam Schiphol Airport, February 25, 2009

Crew Resource Management / Incorrect Pilot Technique Accidents

  • United Airlines Flight 227, Boeing Model 727-22, N7030U, Salt Lake City (SLC), Utah, November 11, 1965
  • Empire Airlines Flight 8284, Aerospatiale Alenia ATR 42-320, N902FX, Lubbock, Texas, January 27, 2009
  • Colgan Air, Inc., Continental Connection Flight 3407, Bombardier DHC-8-400, N200WQ, Clarence Center, New York, February 12, 2009
  • Turkish Airlines Flight 1951, Boeing 737-800, TC-JGE, Amsterdam Schiphol Airport, February 25, 2009 

Unstabilized Final Approach Accidents

  • United Airlines Flight 227, Boeing Model 727-22, N7030U, Salt Lake City (SLC), Utah, November 11, 1965
  • Empire Airlines Flight 8284, Aerospatiale Alenia ATR 42-320, N902FX, Lubbock, Texas, January 27, 2009
  • Turkish Airlines Flight 1951, Boeing 737-800, TC-JGE, on Approach to Amsterdam Schiphol Airport, February 25, 2009

Summaries of the Listed Accidents

United Airlines Flight 227, Boeing Model 727-22, N7030U / Salt Lake City (SLC), Utah / November 11, 1965

United Airlines Flight 227, a Boeing 727, crashed during an attempted landing at Salt Lake City Airport. The captain failed to recognize and arrest an excessive sink rate on final approach, resulting in a touchdown 335 feet short of the runway. The main landing gear sheared off, causing a breach in the fuselage, and the airplane caught fire while sliding down and off the right side of the runway.

See accident module

Air Inter Flight ITF 148, Airbus A320-111, Strasbourg, France Date: January 20, 1992

Air Inter Flight 148 was on a scheduled night flight between Lyon and Strasbourg, France. The flight departed Lyon at 1740 local time. The crew originally planned to fly an approach to runway 23 at Strasbourg. However, runway 05 was the active runway and the crew, after being advised that an approach to runway 23 would create delays, accepted the approach to runway 05. At that time, the airplane was very close to the point where the approach would begin. During the initial phases of the approach, while maneuvering to align with the runway, the flight began a very steep descent, after which no further transmissions were heard from the aircraft. The aircraft impacted La Bloss Mountain at an elevation of 2,620 feet, 0.8 nautical miles (nm) left of the final approach course and 10.5 nm from the end of the runway. Eighty two passengers and five crew members died in the accident.

The Commission of Investigation determined that the cause of the accident was the development of an unusually high descent rate that was not corrected by the crew. The investigation retained two hypotheses regarding the cause of the descent:

  1. (quite probable) misunderstanding involving vertical mode (resulting either from an omission to change the trajectory reference, or from poor execution of the command to change it) or of an error in displaying the consigned value (mechanical digital display of the numeric value given out during the briefing).
  2. (very improbable) hypothesis of a malfunction of the Flight Control Unit (FCU) (fault in the push-button used for changing mode, or corruption of the consigned value, displayed by the pilot on the FCU before it is captured by the Autopilot computer).

See accident module

China Airlines Flight 140, A300B4-622R, B1816, Nagoya, Japan, April 26, 1994

China Airlines Flight 140 from Taipei, Taiwan to Nagoya - while the co-pilot was manually flying the ILS approach to runway 34 at Nagoya, and descending through 1,000 feet, he inadvertently activated the go-around switches (also referred to as the GO lever) on the throttles, activating the auto-throttle go-around mode. This resulted in a thrust increase and a climb above the glide path. The first officer attempted to return to the glide path using forward yoke. Subsequent engagement of the autopilot while in go-around mode caused the trimmable horizontal stabilizer (THS) to drive the stabilizer towards its nose up limit as compensation for the manual control inputs via the yoke.

See accident module

TAM Lineas Aereas Flight 3054, A320, Sao Paulo Congonhas Airport, Brazil, July 17, 2007

Just after touch-down, idle reverse was selected on engine 1, followed within 2 seconds by the selection of max reverse. Following reverser 1 selection, the ATHR disconnected as per design and remained disconnected to the end of recording. With the engine 2 throttle being in the Climb position, the engine 2 EPR remained at approximately 1.2 corresponding to the EPR at the time of ATHR disconnection, the ground spoilers did not deploy, and the autobrake was not activated. Maximum manual braking actions began 11 seconds after touch-down. Rudder inputs and differential braking were applied during the landing roll. The aircraft overran the runway at approximately 100 Kts.

The airplane skidded off the runway and flew over a major roadway, striking a gas station and a TAM cargo terminal building where people were working. The airplane immediately burst into flames upon impact with the buildings. There were 187 people onboard with no survivors and numerous people were killed or injured on the ground.

Boeing 737-3Q8, G-THOF, Bournemouth Airport, Hampshire, England, September 23, 2007

The Boeing 737-300 was on approach to Bournemouth Airport following a routine passenger flight from Faro, Portugal. Early in the ILS approach the auto-throttle disengaged with the thrust levers in the idle thrust position. The disengagement was neither commanded nor recognized by the crew and the thrust levers remained at idle throughout the approach. Because the aircraft was fully configured for landing, the air speed decayed rapidly to a value below that appropriate for the approach. The commander took control and initiated a go-around. During the go-around the aircraft pitched up excessively; flight crew attempts to reduce the aircraft's pitch were largely ineffective. The aircraft reached a maximum pitch of 44º nose-up and the indicated airspeed reduced to 82 kt. The flight crew, however, were able to recover control of the aircraft and complete a subsequent approach and landing at Bournemouth without further incident.

The investigation identified the following causal factors:

  1. The aircraft decelerated during an instrument approach, to an airspeed significantly below the commanded speed, with the engines at idle thrust. Despite the application of full thrust, the aircraft stalled, after which the appropriate recovery actions were not followed.

The investigation identified the following contributory factors:

  1. The autothrottle warning system on the Boeing 737-300, although working as designed, did not alert the crew to the disengagement of the autothrottle system.
  2. The flight crew did not recognize the disengagement of the autothrottle system and allowed the airspeed to decrease 20 kt below Vref before recovery was initiated.

Empire Airlines Flight 8284, Aerospatiale Alenia ATR 42-320, N902FX, Lubbock, Texas, January 27, 2009

On January 27, 2009, about 0437 central CST, an Avions de Transport Régional Aerospatiale Alenia ATR 42-320, N902FX, operating as Empire Airlines flight 8284, was on an instrument approach when it crashed short of the runway at Lubbock Preston Smith International Airport, Lubbock, Texas. The captain sustained serious injuries, and the first officer sustained minor injuries. The airplane was substantially damaged.

The National Transportation Safety Board determined that the probable cause of this accident was the flight crew's failure to monitor and maintain a minimum safe airspeed while executing an instrument approach in icing conditions, which resulted in an aerodynamic stall at low altitude. Contributing to the accident were 1) the flight crew's failure to follow published standard operating procedures in response to a flap anomaly, 2) the captain's decision to continue with the unstabilized approach, 3) the flight crew's poor crew resource management, and 4) fatigue due to the time of day in which the accident occurred and a cumulative sleep debt, which likely impaired the captain's performance.

Colgan Air, Inc., Continental Connection Flight 3407, Bombardier DHC-8-400, N200WQ, Clarence Center, New York, February 12, 2009

On February 12, 2009, about 2217 eastern standard time, a Colgan Air, Inc., Bombardier DHC-8-400, N200WQ, operating as Continental Connection flight 3407, was on an instrument approach to Buffalo-Niagara International Airport, Buffalo, New York, when it crashed into a residence in Clarence Center, New York, about 5 nautical miles northeast of the airport. The 2 pilots, 2 flight attendants, and 45 passengers aboard the airplane were killed, one person on the ground was killed, and the airplane was destroyed by impact forces and a postcrash fire.

The National Transportation Safety Board determined that the probable cause of this accident was the captain's inappropriate response to the activation of the stick shaker, which led to an aerodynamic stall from which the airplane did not recover. Contributing to the accident were (1) the flight crew's failure to monitor airspeed in relation to the rising position of the low-speed cue, (2) the flight crew's failure to adhere to sterile cockpit procedures, (3) the captain's failure to effectively manage the flight, and (4) Colgan Air's inadequate procedures for airspeed selection and management during approaches in icing conditions.

Turkish Airlines Flight 1951, Boeing 737-800, TC-JGE, Amsterdam Schiphol Airport, February 25, 2009

Turkish Airlines Flight 1951, a Boeing 737-800, was flying from Istanbul Turkey to Amsterdam Schiphol Airport, on February 25, 2009.

During the accident flight, while executing the approach by means of the instrument landing system with the right autopilot engaged, the left radio altimeter system showed an incorrect height of -8 feet on the left primary flight display. This incorrect value of -8 feet resulted in activation of the 'retard flare' mode of the autothrottle, whereby the thrust of both engines was reduced to a minimal value (approach idle) in preparation for the last phase of the landing. Due to the approach heading and altitude provided to the crew by air traffic control, the localizer signal was intercepted at 5.5 NM from the runway threshold with the result that the glide slope had to be intercepted from above. This obscured the fact that the autothrottle had entered the retard flare mode. In addition, it increased the crew's workload. When the aircraft passed 1000 feet height, the approach was not stabilized so the crew should have initiated a go around. The right autopilot (using data from the right radio altimeter) followed the glide slope signal. As the airspeed continued to drop, the aircraft's pitch attitude kept increasing. The crew failed to recognize the airspeed decay and the pitch increase until the moment the stick shaker was activated. Subsequently the approach to stall recovery procedure was not executed properly, causing the aircraft to stall and crash.

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