The crash of Alaska Airlines flight 261: Analysis - Reddit Like the end play check intervals, Alaska Airlines received FAA permission to extend their jackscrew lubrication intervals four times from 1987 to 1996 with no supporting data. DCA00MA023.aspx The lead mechanic that day was John Liotine, a rare Alaska Airlines employee who still took safety seriously. Captain Thompson was not happy with this reasoning. This Episode we take a look at a very preventable accident from January 2000, where an Alaska Airlines MD-80 lost all control of a vital mechanism used in ba. [38] Many residents of Seattle had been deeply affected by the disaster. Push push push, push the blue side up!, Okay, now lets kick rudder, left rudder, left rudder. 20 years later: Remembering the victims of Alaska Flight 261 More than half of these were directly related to jackscrew lubrication and end-play measurement. The flight, eventually bound for Seattle, crashed off the California coast on Jan. 31, 2000. When the jackscrew was hauled to the surface, investigators could not find any trace of grease on it, except for some old, dried out leftovers outside the normal working area of the screw. Are we flying? he said. At this time, pilots from aircraft flying in the vicinity reported in, with one pilot saying, "and he's just hit the water." Instead, all they could find was an oil slick and some light floating debris. On the basis of these measurements, the shift supervisors overruled Liotines earlier work order and cleared the plane to fly. The McDonnell Douglas MD-8-61 was made in Long Beach and was then . Stepping on the rudder pedals while upside down was no easy task. Thus the fundamental principle of redundancy was violated. Three seconds later, the fairing failed, and the stabilizer swung unimpeded on its hinge to a position of at least 14 degrees aircraft nose down. Following the procedures prescribed in the checklists, they tried cycling the motors on and off, checking the trim motor circuit breakers, and using the manual trim controls. As Thompson fought with all his might to regain control, Tansky shouted Mayday! but forgot to key his mic. Technical logs fell through the cracks; critical forms were left incomplete; paperwork was outright falsified to show work done when it was not. Thompson continued to think about ways to unjam the stabilizer. A cacophony of banging and roaring filled the cockpit. Alaska Airlines Flight 261 - Wikipedia 20 years after Alaska Flight 261 crash, families plan memorial at Sea Flight 261 began its journey last Monday--from Puerto Vallarta, Mexico, to San Francisco and Seattle--with no apparent problems. Despite Alaska Airlines numerous regulatory violations, the investigation ended in 2003 without any charges being filed. Then in 1999 Alaska Airlines retaliated against John Liotine, putting him on indefinite leave from his job and circulating false rumors about him; the airline sought to portray him in the media as a disgruntled employee who wanted to get back at supervisors who passed him over for promotion. By carefully measuring the divot, we could accurately determine the wear rates for each type of grease and also the rate from using no grease. There was nothing that Tansky and Thompson could have done to control the airplane. And so it was that on a sunny day in January 2000, 83 passengers and five crew boarded Alaska Airlines flight 261 in the resort city of Puerto Vallarta, Mexico, bound for San Francisco, California. Alaska Airlines Flight 261 was a flight from Licenciado Gustavo Daz Ordaz International Airport in Puerto Vallarta, Jalisco, Mexico, to Seattle-Tacoma International Airport in Seattle, Washington, United States, with an intermediate stop at San Francisco International Airport in San Francisco, California. The effect was immediate and catastrophic, as his inputs ripped out whatever threads remained on the jackscrew nut. Uh, you getting full nose trim down but are you getting any you dont get no nose trim up, is that correct? maintenance asked. Almost all of these recommendations were implemented. Push and roll! Thompson shouted, trying to coordinate with Tansky to roll the plane right-side-up. Among major US airlines, Alaska has charted perhaps the most unusual course across its long and fascinating history. In July 1988, the airline no longer used a flight hour limit rather it based C-checks on calendar time only so that the end play check was being performed every 26 months. PLANE CRASH, Alaska Airlines Flight 261, Pacific Ocean Families gather in Port Hueneme to honor Alaska Flight 261 crash [6], Beginning at 16:19 (00:19 UTC), the CVR recorded the sounds of at least four distinct "thumps", followed 17 seconds later by an "extremely loud noise", as the overstrained jackscrew assembly failed completely and the jackscrew separated from the acme nut holding it in place. Investigators later uncovered a critical maintenance issue with the aircraft, which meant that even after the flight crew deployed the speed brakes and control surfaces on the wings, they still could not stop the tragic crash.Join aviation engineers and experts to uncover the reasons behind some of the worlds most unforgettable plane crashes. Neither the flight crew nor company maintenance could determine the cause of the jam. Yeah, I heard it, said Thompson. They wished to avoid the mistakes made by Trans World Airlines in the aftermath of the TWA Flight 800 accident, in other words, TWA's failure to provide timely information and compassion to the families of the victims. The NTSB formed a Metallurgy Group which later determined that the threads inside the acme nut were worn down and incrementally sheared off by the jackscrew prior to the accident. In interviews with the Alaska Airlines mechanic at SFO, who last performed the lubrication, the task was shown to take about one hour, whereas the aircraft manufacturer estimated the task should take four hours. Two other airplanes had severely worn acme nuts, both from Alaska Airlines. It was clear that nobody had survived the crash. Having decided not to touch the trim system anymore, the crew now performed some final tests of the airplanes low speed handling. [6], Due to the extreme impact forces, only a few bodies were found intact,[5] and none were visually identifiable. Upon crossing the Mexican border while tracking north off the coast of San Diego, the CVR began to pick up the crew conversations regarding the jammed stabilizer and initial dive. I cant reach it! said Tansky. I didnt want to call you guys, said the flight attendant, but that girl theyre like, you better go up there and tell them., I need you strapped in, dear, said Thompson, cause Im going to release the back pressure and see if I can get it back.. Finally, at 16:19 and 21 seconds, the stop gave way with a faint thump. Season 1 Episode 5 Alaska Airlines Flight 261, a McDonnell Douglas MD-83 aircraft, experienced a fatal accident on January 31, 2000 over the Pacific Ocean. The pilots, 53-year-old Captain Ted Thompson and 57-year-old First Officer Bill Tansky, could not have known that they were about to play out the final chapter in a sordid story that had been building toward its conclusion for years. The maintenance technician, having received all the information he could get, said, Okay, thank you sir, see you there., Meanwhile, the conversation had apparently encouraged Captain Thompson to try moving the stabilizer again. In September of 1997, maintenance workers in Oakland performed the aforementioned test on N963AS and found a wear depth of exactly one millimeter. The original interval was 500 flight hours (graphic 12). The only layer of protection against a catastrophe was therefore the assumption that poorly trained, low-paid maintenance workers would apply enough grease. After the jackscrew failed, the plane pitched down -70 degrees and was rolling over to the left. The partial shearing likely caused the stabilizer to jam during climbout from Mexico but then the nut threads let loose when the crew attempted to operate the trim again which released the jam and allowed the jackscrew to pull up through the acme nut all the way to its bottom stop nut. Aviation accident over the Pacific Ocean in 2000, Inadequate lubrication and end-play checks, A block of altitudes assigned by ATC to allow altitude deviations. As any good crew should do, Thompson and Tansky then pulled out the checklists for a runaway or inoperative stabilizer. Sometime before 15:49 (23:49 UTC), the flight crew contacted the airline's dispatch and maintenance-control facilities in SeaTac, Washington, on a company radio frequency shared with operations and maintenance facilities at Los Angeles International Airport (LAX), to discuss a jammed horizontal stabilizer and a possible diversion to LAX. During the course of the investigation and in its final report, the NTSB issued a large number of recommendations, including that the lubrication procedure for the MD-80 series jackscrew be revised; that a more accurate method of measuring wear on the jackscrew be developed; that maintenance technicians be specifically taught how to grease and inspect jackscrews; that the FAA not approve lubrication interval extensions without the airline providing supporting data; that all airlines be surveyed to ensure compliance with jackscrew lubrication procedures; that a bulletin be issued instructing pilots not to troubleshoot inoperative flight controls; that maintenance personnel and dispatchers be trained not to suggest continuation of a flight that is experiencing a major malfunction; that the jackscrew be made easier for maintenance workers to access; that an inspector be required to sign off on every lubrication of the jackscrew; that all maintenance intervals for critical components be re-examined based on data analysis to ensure that they are not too long; that the application process for maintenance interval changes be reformed; that MD-80 series jackscrew inspections be made on a tighter schedule; that some failsafe mechanism be incorporated to ensure the redundancy of the MD-80 jackscrew; and that the FAA ensure future stabilizer designs cant have a single point of failure. The aircraft designers assumed that at least one set of threads would always be present to carry the loads placed on it; therefore, the effects of catastrophic failure of this system were not considered, and no "fail-safe" provisions were needed. Ameet Prasad lost his younger brother and two cousins in the crash. [32][33], Captain Thompson and First Officer Tansky were both posthumously awarded the Air Line Pilots Association Gold Medal for Heroism, in recognition of their actions during the emergency. On every level, it was a tragedy that did not need to happen and to this day, it serves as a grim example of the depths to which an airline may fall when oversight becomes too thinly stretched. [42], Two victims were falsely named in paternity suits as the fathers of children in Guatemala in an attempt to gain insurance and settlement money. The result was a chronic problem of Alaska Airlines MD-80s with poorly greased jackscrews. The jackscrew requires an inspection procedure known as the end play check to monitor the wear of the acme nut threads without having to remove the jackscrew assembly from the airplane. However, during the 1990s the quality of maintenance at Alaska Airlines began to slip significantly. The metal from which the jackscrew is made is ever so slightly harder than the metal used in the nut. The probable cause was stated to be "a loss of airplane pitch control resulting from the in-flight failure of the horizontal stabilizer trim system jackscrew assembly's trapezoidal nut threads. An FAA inspector who reviewed the 1996 extension said that the airline presented only Boeings recently extended lube interval as justification. Badly shaken witnesses reported the crash to air traffic control within seconds. [34] The Ted Thompson/Bill Tansky Scholarship Fund was named in memory of the two pilots. Kick! he shouted. When the stabilizer moves upward, downforce on the tail decreases, and the nose pitches down; similarly, when the stabilizer moves downward, downforce increases, and the nose pitches up. The block-on-ring test rigs were lubricated with grease where they made contact. As such, it is critically important that the jackscrew be kept in good working order, primarily through the liberal application of grease at regular intervals. Alaska Airlines Flight 261 crash documentary - Cutting Corners "These are reminders that we should keep telling people that we love them, and let them know how we feel because you never know what's going to happen," he said. In the cockpit, the pilots heard a loud clunk followed by two thumps, and the plane pitched steeply downward. The names of Morris Thompson and Ronald and Joyce Lake were used in schemes unrelated to them. It broke off nine minutes later, allowing the jackscrew and its attached stabilizer to slide up and out of the acme nut causing the fatal dive. Later, the NTSB found that while "the flight crew's decision to divert the flight to Los Angeles was prudent and appropriate", "Alaska Airlines dispatch personnel appear to have attempted to influence the flight crew to continue to San Francisco instead of diverting to Los Angeles". It might be mechanical damage too. The crew of a SkyWest airliner reported, "He's, uh, definitely out of control. [6], Systemic problems were identified by the investigation into the FAA's oversight of maintenance programs, including inadequate staffing, its approval process of maintenance interval extensions, and the aircraft certification requirements. The actual protocol at Alaska Airlines was to inspect the jackscrew for wear at every second C-check, a comprehensive multi-day inspection that every airplane undergoes approximately once a year. Inside the investigation, tensions were running high between Boeing who designed the jackscrew and Alaska Airlines who maintained it. However, the pilots were clearly under pressure to continue on to San Francisco, and maintenance technicians and dispatchers on the ground did not appreciate the direness of the situation. Based on the time since the last inspection of the jackscrew assembly, the NTSB determined that the acme-nut thread had deteriorated at 0.012 inches (0.30mm) per 1000 flight hours, much faster than the expected wear of 0.001 inches (0.025mm) per 1000 flighthours. [6] The captain then replied "ok right rudderright rudder," followed 18 seconds later by "gotta get it over againat least upside down we're flying. [6]:1011 First Officer William "Bill" Tansky, 57, had accumulated 8,140 total flight hours, including about 8,060 hours as first officer in the MD-80. SkyWest 5154, the MD-80 is one becoming two oclock about ten miles now. In some accidents, relatives of those who died can take some small comfort in the possibility that their loved ones never knew what hit them. "For that and for your loss . The investigation found that Alaska Airlines had fabricated tools to be used in the end-play check that did not meet the manufacturer's requirements. We noticed a lot of differences. [6], End-play checks were conducted during a periodic comprehensive airframe overhaul process called a "Ccheck". Refresh the page, check. The FAA approved the extension without assessing the effect this would have on individual inspection tasks that were tied to the C-check interval. The investigation uncovered a daunting list of operational problems and regulatory mistakes that led to the crash. Keep us advised.. The accident served as an inspiration for the fictionalized crash landing depicted in the 2012 movie Flight starring Denzel Washington. They had run out of altitude. Had it been inspected after 7,200 flight hours instead of 9,550, the excessive wear would have been discovered before the crash. [6], Using side-scan sonar, remotely operated vehicles, and a commercial fishing trawler, workers recovered about 85% of the fuselage (including the tail section) and a majority of the wing components. As they struggled to regain control, Thompson radioed Los Angeles and said, Center, Alaska two six one, we are in a dive here, and Ive lost control, vertical pitch! An overspeed warning blared in the cockpit. Bouquets of flowers started arriving at the company's headquarters in SeaTac, Washington the day after the crash. I dont anticipate any big problems once we get a couple of sub systems on the line. With the stabilizer angled 3.1 degrees toward nose down, more than the design maximum of 2.5 degrees, flight 261 immediately entered a high-speed dive, hurtling downward at more than 6,000 feet per minute. Japan Air Lines Flight 350 was a domestic flight flown by a McDonnell Douglas DC-8-61, registered as JA8061, from Fukuoka Airport in Fukuoka to Haneda Airport in Tokyo. Push and roll! Animation of Alaska Airlines Flight 261 Plane Crash - YouTube For several months he surreptitiously recorded his bosses violating safety rules and handed the tapes over to FAA investigators. Alaska Airlines jet was flying upside down | CBC News Alaska two sixty one, say again sir, said the controller. I clicked it off, Thompson said. National Geographic Documentary Japan Airlines Flight 123 & Air Disaster . The problem, again, was a lack of redundancy: if the threads on the nut failed, there was no other structure that could absorb the load, and the catastrophic failure of the trim system leading to the loss of the airplane was inevitable. The flight was a scheduled international passenger flight from Licenciado Gustavo Daz Ordaz International Airport in Puerto Vallarta, Jalisco, Mexico, to SeattleTacoma International Airport near Seattle, Washington, United States, with an intermediate stop at San Francisco International Airport near San Francisco, California. Subsequent DNA testing proved these claims to be false. Both pilots struggled together to regain control of the aircraft, and only by pulling with 130 to 140 lb (580 to 620 N) on the controls did the flight crew stop the 6,000ft/min (1,800m/min) descent of the aircraft and stabilize the MD-83 at roughly 24,400ft (7,400m). Uh, if you want to try it, thats ok with me, if not, thats fine. Furthermore, the pilots were reluctant to believe that the failure was mechanical, rather than electrical, in nature. alaska airlines flight 261 pilot drunk - lindoncpas.com We did both the pickle switches and the suitcase handles, he told the maintenance technician, and it ran away full nose trim down., And now were in a pinch, Thompson continued, so were holding, uh, were worse than we were.. These aircraft immediately contacted the controller. [6]:11 Thompson had flown for Alaska Airlines for 18 years and Tansky for 15; neither pilot had been involved in an accident or incident prior to the crash. [29] In December 2001, federal prosecutors stated that they were not going to file criminal charges against Alaska Airlines. Around that time, Alaska Airlines agreed to settle the libel suit by paying about $500,000; as part of the settlement, Liotine resigned.[28]. Oh yeah, let me get said Tansky. Repeated attempts to overcome the jam with the primary and alternate trim systems were unsuccessful. As part of a memorial vigil in 2000, a column of light was beamed from the top of the Space Needle. Speedbrakes! Captain Thompson called out, still trying to find ways to arrest the dive. Only by applying a continuous maximum nose up elevator input on his control column, a task which required enormous physical effort, was Captain Thompson able to maintain level flight. Following the crash and the damning FAA special inspection report, Alaska Airlines overhauled its maintenance program, including through its compliance with a new FAA airworthiness directive mandating that the jackscrew lubrication interval not exceed 650 flight hours. The crash of AS261 became a part of the federal investigation against Alaska Airlines, because, in 1997, Liotine had recommended that the jackscrew and gimbal nut of the accident aircraft be replaced, but had been overruled by another supervisor. Based on the airlines utilization rate at that time, this equated to 6,400 flight hours between inspections. In theory this was adequate, but only if the grease was applied correctly every time. The pilots pulled back as hard as they could on their control columns and deployed the flaps to try and slow down, but their efforts were utterly hopeless. All rights reserved. For their heroic efforts to save the plane, both pilots were posthumously awarded the Air Line Pilots Association Gold Medal for Heroism. Many did not apply grease to the entire length of the jackscrew as per the procedure. I had to wait as the priorities for recovery were the victims, the flight recorders, and then the tail. Robo ^Tir in Autos & Vehicles. The apology: 20 years later, Alaska Airlines CEO delivers soothing The NTSB Maintenance Group and my group examined the accident airplanes records and found that two years earlier, a lead mechanic at the airlines Oakland maintenance facility had found that the jackscrew end play was worn to its maximum limit of 0.040 inch. At 16:09, he said, Im gonna click it off. Shortly after the accident, Liotine discovered that the jackscrew nut he had inspected in 1997 was not in fact replaced and had actually gone on to cause the crash. Nine days after the accident, the first major piece of wreckage recovered was the horizontal stabilizer by Portland car accident lawyers. But we will be going into LAX, and Id anticipate us parking there in about twenty to thirty minutes.. Still, the pilots did not give up; Thompson thought it might be possible to roll out right-side-up using the rudder. The design of the jackscrew on the MD-80 series was identical to that of the original 1960s-era Douglas DC-9, which was certified to meet requirements stating that no reasonably probable single failure of the control system could jeopardize the controllability of the airplane. Flying Inverted | Cutting Corners | Alaska Airlines Flight 261 | 4K TheFlightChannel 1.43M subscribers 1.7M views 4 years ago Find out why this Alaska Airlines MD-83 crashed into the. Talk about lessons learned! After the flight crew stated their intention to land at LAX, ATC asked whether they wanted to proceed to a lower altitude in preparation for the approach. The last minutes of those on board the doomed MD-83 would have been sheer hell, as the plane went inverted, corkscrewed, pirouetted, and spun like a top during its final dive. Alaska Airlines Flight 261 Final Report Released - Aero-News Well see you at the gate. This would be the last transmission between flight 261 and Alaska Airlines maintenance. I dont think we should, if it can fly, its like . The massive aerodynamic force pushing up on the horizontal stabilizer was normally absorbed by the nut, but with its threads stripped, all that force was transmitted through the mechanical stop instead. Over the course of the investigation, the NTSB considered a number of potential reasons for the substantial amount of deterioration of the nut thread on the jackscrew assembly, including the substitution by Alaska Airlines (with the approval of the aircraft manufacturer McDonnell Douglas) of Aeroshell 33 grease instead of the previously approved lubricant, Mobilgrease 28. What a hard way to die: so an airline can make more money., ________________________________________________________________. With the jackscrew completely separated from the nut, aerodynamic forces acting on the stabilizer pushed it up beyond the normal full nose down position, halting only when the mechanical stop on the bottom of the jackscrew slammed into the nut. A big, huge plunge, thank you, said the controller. [43], The crash has appeared in various advance fee fraud ("419") email scams, in which a scammer uses the name of someone who died in the crash to lure unsuspecting victims into sending money to the scammer by claiming the crash victim left huge amounts of unclaimed funds in a foreign bank account. Upon being freed, however, it quickly moved to an extreme "nose-down" position, forcing the aircraft into an almost vertical nosedive. [7] Three Seattle-based flight attendants were also on board, completing the five-person crew. Upon subsequent examination, the jackscrew was found to have metallic filaments wrapped around it, which were later determined to be the remains of the acme-nut thread. [6], Between 1985 and 1996, Alaska Airlines progressively increased the period between both jackscrew lubrication and end-play checks, with the approval of the Federal Aviation Administration (FAA).
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