Pilots couldn't have saved Flight 111

Friday, March 28, 2003 Back The Halifax Herald Limited

Peter Parsons / Herald Photo
Swissair crash victim relatives Miles Gerety and Margie Topf discuss the Transportation Safety Board report in Halifax on Thursday. Mr. Gerety called for an investigation into an entertainment system aboard Swissair Flight 111.

Peter Parsons / Herald Photo
Transportation Safety Board head investigator Vic Gerden holds a thermal insulation blanket in Halifax on Thursday after releasing the final report on the crash of Swissair Flight 111.


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They didn't have a chance
Pilots couldn't have saved Flight 111 from fire, report finds

By Susan LeBlanc / Staff Reporter

The 229 people aboard Swissair Flight 111 had no chance.

That's what the final report into the Sept. 2, 1998, crash, released Thursday in Halifax, concludes after 4 1/2 years of investigation.

The report by the Transportation Safety Board of Canada said a hidden fire in the cockpit ceiling - sparked by faulty wiring, fuelled by highly flammable materials and worsened by inadequate fire detection and response systems - left the pilots with little ability to prevent their deadly plummet into the Atlantic Ocean off Peggys Cove.

"Even if the pilots could have foreseen the eventual deterioration due to the fire, because of the rapid progression of the fire, they would not have been able to complete a safe landing in Halifax," lead investigator Vic Gerden said.

The TSB said if "readily ignitable" metallized insulation blankets were not present inside the aircraft walls, "this accident would not have happened."

But the board said it's not its job to assign blame, and did not pinpoint a sole factor in the accident that killed all 215 passengers and 14 crew.

Despite much speculation about wiring connecting the jet's inflight entertainment system, the TSB stopped short of saying the system by itself sparked the fire.

Yet a handful of victims' relatives who were in Halifax, while praising the TSB's work, said the system was at fault.

"The spark came from that system. And the way that system got into that plane is a scandal," said Miles Gerety, a Connecticut lawyer who lost his brother, Pierce, on the flight, which was bound for Geneva from New York.

Mr. Gerety was referring to a recent media report that said the system, unique to Swissair planes, was certified by a private U.S. firm that the Federal Aviation Administration had criticized in the past.

Mr. Gerden said investigators found, among the 250 kilometres of airplane wire, evidence the entertainment system wiring was likely a source of initial arcing, or a short-circuit, that ignited insulation blankets.

But another type of wiring, which experts couldn't identify, was also in play, Mr. Gerden told a news conference attended by international media.

The board said flying is now safer worldwide thanks to its $57-million probe, and released nine new safety recommendations.

The new recommendations, bringing to 23 the total issued since the Swissair crash, aim to:

- Reduce risks associated with thermal insulation materials, and ensure new materials are certified properly;

- Ensure supplemental systems - such as the entertainment system - are properly vetted and installed;

- Establish standards for circuit-breaker resetting;

- Get better-quality cockpit voice recorder data;

- Have new aircraft able to record more flight data;

- Have image recording systems installed in cockpits; and

- Harmonize international rules for protection of cockpit voice and image recordings.

Since the crash, plane diversions due to on-board smoke have risen everywhere, Mr. Gerden said.

"People are taking the approach that it's a serious issue if you have smoke," he said.

Thermal insulation blankets, which go by the brand name Mylar among others, are being removed from the 700 U.S. aircraft that have them. Another 1,900 planes worldwide - but no Canadian ones - also have them.

Mr. Gerden said the red flag concerning flammable materials is "probably the most important legacy" of the probe.

As well, he said the FAA has sent out 50 airworthiness directives on the MD-11 aircraft - none of which fly in Canada - to eliminate potential fire sources.

The TSB also wants built-in fire detection systems on all planes, but Mr. Gerden said the timing on that is up to industry and regulators - the FAA in the U.S. and Transport Canada here.

Research chemist Robert Kauffman, who did wiring research for investigators of the 1996 crash of TWA Flight 800 off Long Island, N.Y., said arcing may have been occurring on the Swissair plane for a while, but no one knew.

"If you had some type of sensor that could have alerted someone several flights before that this problem was starting to happen, then it would have helped," he said from the University of Dayton Research Institute in Dayton, Ohio.

Though the MD-11 that crashed off Peggys Cove was only seven years old, wear can occur among wires bundled with "knife-edge" clamps, Mr. Kauffman said.

Mr. Gerden said there have been only 15 inflight fires on large commercial aircraft worldwide in the past 30 years.

Of the 20 pieces of Flight 111 wiring that showed arcing, half had so-called Kapton insulation and half had another type.

Still, Mr. Gerden said the TSB can't say the insulation is problematic. He said the board has recommended better wiring testing.

Another area that concerned investigators was the way crews respond to fires.

The Flight 111 crew, pilot Urs Zimmermann, 49, and co-pilot Stefan Loew, 36, followed a standard emergency checklist - and such checklists can take too long, said the TSB.

Computer modelling showed the fire started on the right side of the cockpit ceiling and moved toward the passenger cabin.

But when the pilots, following their checklist, turned off electrical power to the cabin, air recirculation fans stopped. Starved of oxygen, the fire was drawn back into the cockpit.

A year ago, a lawyer representing victims' families suing Swissair said all lawsuits would be settled within months. He said combined payouts would reach hundreds of millions of dollars.

Inquiries to Swiss International Airlines - formed after Swissair went bankrupt in October 2001 - were directed to Zurich, but a spokesman was unavailable.

The nine-metre section of the plane the TSB reconstructed, plus boxes of other wreckage, go to the airline's insurer.

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