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1987 — Dec 21, Petroleum Helicopters Inc. oil rig landing crash, Gulf of Mexico, off LA– 15

lornajarrettblanchard December 21, 1987

— 15 Planecrashinfo.com. “1987. Accident Details. Petroleum Helicopters Inc…Eugene Island”

— 15 United Press International. “A helicopter crash on a Gulf of Mexico oil…” 12-22-1987.

Narrative Information

Dec 21, AP: “Lafayette, La., Dec 21 — A helicopter carrying 13 offshore oil workers to begin a two-week shift in the Gulf of Mexico crashed and burned on the deck of an oil rig today, killing 12 of the workers and both pilots, the Coast Guard said.

“The lone survivor, identified as Anthony Fann, 23 years old, of Destrehan, La., was flown by Coast Guard helicopter 100 miles to the burn unit of West Jefferson Medical Center in suburban New Orleans. He was in critical condition with third-degree burns over 60 percent of his body, said Jim Pittman, a hospital spokesman….” (AP. “14 Killed as a Helicopter Crashes onto Oil Rig Off Louisiana Coast,” New York Times, 12-22-1987.)

Dec 22, AP: “Lafayette, La. (AP) – A helicopter carrying 13 offshore oil workers to begin a Christmas week shift in the Gulf of Mexico crashed and burned on the deck of an oil rig Monday, killing 12 of the workers and both pilots, the Coast Guard said. The lone survivor was flown by Coast Guard helicopter 100 miles to the burn unit of West Jefferson Medical Center in suburban New Orleans. He was reported in critical condition.

“Dabney Forestall, a rig worker who witnessed the accident said the helicopter appeared to be approaching the pad normally until “he had some kind of problems and he skidded off the heliport and hit the leg (of the platform). “It looked like the tail section possibly hit the leg, and he fell off the heliport and fell on the deck. They had a major explosion,” said Forestall.

“Chuck Kalnbach, a spokesman for the Coast Guard, said the rig’s operators confirmed 14 fatalities and said the bodies would be flown to Abbeville, where a morgue was set up.

“Edward Villarreal, division manager of Forest Oil Corp. which operated the rig, said the 13 oil workers were employed by Penrod Drilling. They were flying to the rig to begin a two-week Christmas shift, he said. The fire from the crash was quickly controlled before it spread to the rig, he said.

“The rig, identified as Penrod 83, is located about 60 miles south of Morgan City in the area of the Gulf known as Eugene Island, block 190.

“The survivor was identified as…an oil worker from Destrehan, La. A hospital spokeswoman said he suffered third-degree burns over 95 percent of his body. A Penrod spokesman said all of the dead Penrod employees were from Louisiana and Mississippi.” (Santa Fe New Mexican. “Helicopter Crash Kills 12 in Gulf,” Dec 22, 1987, p. 2.)

Dec 22, UPI: “Abbeville, La. — A helicopter crash on a Gulf of Mexico oil rig claimed its 15th victim today, an oil patch roughneck who suffered burns over 95 percent of his body in the explosion and fire. Anthony Fann, 23, of Destrehan, La., died at 10:38 a.m. at West Jefferson Hospital near New Orleans, a hospital spokesman said. Fann, his clothing burned completely away in the crash, had managed to crawl away from the wreckage moments before the craft exploded, said Dabney Forstall, a rig worker who witnessed the crash.

“The two helicopter pilots and 12 co-workers were killed in the crash shortly before noon Monday on the Penrod No. 83 rig, about 80 miles offshore in the Gulf of Mexico. The two helicopter pilots and 12 co-workers were killed in the crash shortly before noon Monday on the Penrod No. 83 rig, about 80 miles offshore in the Gulf of Mexico….

“Investigators from the National Transportation and Safety Board and the Federal Aviation Administration were expected to examine the wreckage today.

“`We don’t know an awful lot about what might have caused the crash,’ said Ralph White, general counsel in Dallas for the Penrod Drilling Co., the rig’s owner.”

“`There was wind, rain and fog,’ said Forstall, one of a dozen workers who were to be replaced by the arriving roughnecks. ‘It looked like he (the helicopter pilot) tried to touch down on the heliport and either the wind or he had some kind of problem and he skidded off…and hit the (supporting) leg.’

“Witnesses said the Aerospatial SA330 Puma twin-engine helicopter flipped, fell 25 feet off the helipad to the main deck below, exploded and burst into flames on the main deck, which sits about 100 feet above the water….

“The passengers were all from Louisiana and Mississippi.”

Planecrashinfo.com: 13 passengers and 2 crewmembers. Notes “The helicopter crashed while attempting to land on an oil rig. Improper planned approach. Clearance not maintained.”

Sources

Associated Press. “14 Killed as a Helicopter Crashes onto Oil Rig Off Louisiana Coast,” New York Times, 12-22-1987. Accessed 10-13-2016 at: http://www.nytimes.com/1987/12/22/us/14-killed-as-a-helicopter-crashes-onto-oil-rig-off-louisiana-coast.html

Planecrashinfo.com. “1987. Accident Details. Petroleum Helicopters Inc…Eugene Island.” Accessed 10-13-2016 at: http://www.planecrashinfo.com/1987/1987-71.htm

Santa Fe New Mexican. “Helicopter Crash Kills 12 in Gulf.” 12-22-1987, p. 2. Accessed at: http://www.newspaperarchive.com/FullPagePdfViewer.aspx?img=108305025

United Press International. “A helicopter crash on a Gulf of Mexico oil…” 12-22-1987. Accessed 10-13-2016 at: http://www.upi.com/Archives/1987/12/22/A-helicopter-crash-on-a-Gulf-of-Mexico-oil/7400567147600/

20th Century

1987 — Dec 7, Pilots Shot/Plane Crash, Pacific Southwest #1771, near Cayucos, CA — 43

lornajarrettblanchard December 7, 1987

— 44 Airdisaster.com. “Special Report: Pacific Southwest Airlines Flight 1771.”[1]

— 43 Aviation Safety Network. Criminal Occurrence description. “Pacific Southwest Airlines.”

— 43 Duwe, Grant. Mass Murder in the United States: A History. McFarland, 2007, p. 28.

— 43 NationMaster.com, Encyclopedia, List of Notable Accidents on Commercial Aircraft

— 43 Notable California Aviation Disasters. “The 1980s.” Oct 23, 2008 update.

— 43 NTSB. NTSB Identification DCA88MA008. Pacific Southwest Airlines…Dec 7, 1987.[2]

Narrative Information

Airdisaster.com: “A Call comes in to the San Luis Obispo County, California Sheriff’s Office citing a small plane crash in the mountains of southern California. Detective Bill Wammock is the first to arrive on the scene. He recalls “nothing that resembled an airliner… we went on for hours, before we heard the news reports of a missing airliner, believing that we were dealing with a small airplane full of newspapers that had crashed. We saw no pieces of the aircraft that were larger than, maybe, a human hand. It did not look like a passenger aircraft.”

“Two days later, an FBI Agent working the scene found what appeared to be the barrel and trigger of a handgun. Forensic Analysts examined the pieces, and found a small piece of skin wedged between the trigger and the barrel. By matching the skin prints to the passenger manifest, investigators were able to conclude that the gun had been in the hand of USAir employee David Burke at the time of impact.

“December 7, 1987, was not a typical day for USAir employee David Burke. Two weeks prior, Burke had been placed on unpaid leave, awaiting the outcome of an investigation into whether he had stolen $68.00 from a drink fund set up by Flight Attendants. The date of Burke’s appearance before the Board of Appeals at USAir was today.

“In the hearing, Burke admitted to the act and pleaded for leniency, citing his family’s well-being. Despite telling the members of the committee that he was “regrettably sorry,” and that his “children would have no one to support them,” Burke’s pleas for his job went unheard, and he was summarily dismissed by his supervisor, Raymond Thompson. As Burke left his office after the hearing, Thompson’s secretary wished him to “have a nice day.” Burke paused, turned around, and replied “I intend on having a very good day.”

“David Burke then purchased a ticket on Pacific Southwest Airlines flight 1771, a daily non-stop along PSA’s “Pacific Highway” between Los Angeles and San Francisco. This flight was also taken by Burke’s supervisor, Raymond Thompson, every day on his commute home from the USAir Headquarters at LAX.

“Using his USAir employee credentials, which had not been seized and were later found at the crash site, David Burke bypassed security at Los Angeles International Airport and stepped aboard the BAe-146 aircraft, armed with a loaded 44-magnum pistol. Upon entering the aircraft, Burke scrawled a note onto an air-sickness bag which read:

“It’s kind of ironical, isn’t it? I asked for leniency for my family, remember? Well, I got none, and now you’ll get none.”

“As the aircraft reached its cruising altitude of 29,000 feet, Burke calmly vacated his chair and made his way to the lavatory, dropping the air-sickness bag in his supervisor’s lap as he passed. Moments later, he emerged with the handgun, and immediately shot Thompson. The sound of the gunshot is picked up on the cockpit voice recorder, and seconds later the sound of the cockpit door opening is heard. A female, presumed to be a Flight Attendant, advises the cockpit crew that “we have a problem.” The Captain replies with “what kind of problem?” Burke then appears at the cockpit door and announces “I’m the problem,” simultaneously firing two more shots that fatally injure both pilots.

”Several seconds later, the CVR picks up increasing windscreen noise as the airplane pitches down and begins to accelerate. A final gunshot is heard as Burke fatally shoots himself. Airspeed continues to build until 13,000 feet, when traveling at a velocity of 1.2x Mach, the aircraft breaks apart and the Flight Recorders cease functioning.

”All 44 passengers and crew aboard PSA Flight 1771 died as the aircraft crashed into a Farmer’s field in the Santa Ana Hills. The accident spelled the end of Pacific Southwest Airlines, which in April of the following year was absorbed into USAir. A federal law was passed which required “immediate seizure of all airline employee credentials” upon termination from an airline position. Most importantly, however, the Federal Aviation Administration adapted policy to require that all members of any airline flight crew, including the Captain, be subjected to the same security measures as are the passengers.” (Airdisaster.Com. “Special Report: Pacific Southwest Airlines Flight 1771.”)

Nationmaster.com: “December 7 – Pacific Southwest Airlines Flight 1771, a BAe 146, is hijacked and deliberately crashed near Cayucos, California by a disgruntled airline employee. All 43 people on board, including the hijacker, are killed.” (NationMaster.com. Encyclopedia, “List of Notable Accidents…on Commercial Aircraft.”)

NTSB: “A RECENTLY DISCHARGED USAIR EMPLOYEE BOARDED PSA FLT 1771 AFTER HAVING LEFT A GOODBYE MESSAGE WITH FRIENDS. HE BYPASSED SECURITY AND CARRIED ABD A BORROWED 44 CALIBER PISTOL. A NOTE WRITTEN BY THIS PSGR, FOUND IN THE WRECKAGE, THREATENED HIS FORMER SUPERVISOR AT USAIR, WHO WAS ABOARD THE FLT. AT 1613, THE PLT RPTD TO OAKLAND ARTCC THAT HE HAD AN EMERGENCY AND THAT GUNSHOTS HAD BEEN FIRED IN THE AIRPLANE. WITHIN 25 SECONDS, OAKLAND CTR CONTROLLERS OBSERVED THAT PSA 1771 HAD BEGUN A RAPID DESCENT FM WHICH IT DID NOT RECOVER. WITNESSES ON THE GND SAID THE AIRPLANE WAS INTACT AND THERE WAS NO EVIDENCE OF FIRE BEFORE THE AIRPLANE STRUCK THE GND IN A STEEP NOSE-DOWN ATTITUDE. THE CVR TAPE REVEALED THE SOUNDS OF A SCUFFLE AND SEVERAL SHOTS WHICH WERE APPARENTLY FIRED IN OR NEAR THE COCKPIT. THE PISTOL WAS FOUND IN THE WRECKAGE WITH 6 EXPENDED ROUNDS. FAA RULES PERMITTED AIRLINE EMPLOYEES TO BYPASS SECURITY CHECKPOINTS.” (NTSB. NTSB Identification DCA88MA008…Pacific Southwest Airlines…Dec 7, 1987.)

Notable California Aviation Disasters: “Number 8 of California’s “10 Worst Crashes”

“Date / Time: Monday, December 7, 1987 / 4:16 p.m.

“Operator / Flight No.: Pacific Southwest Airlines (PSA) / Flight 1771

“Location: Near Paso Robles, Calif.

“Details and Probable Cause: David A. Burke, 35, was a 14-year employee of USAir, a company which, six months previously, had purchased Pacific Southwest Airlines (PSA) and was now in the process of absorbing it under the USAir name.

“Burke recently had been suspended by the company for petty theft after he allegedly stole $69 from in-flight cocktail receipts. After an unsuccessful meeting with his supervisor to get his job back, Burke armed himself with a borrowed .44 Magnum revolver and used his unsurrendered USAir identification badge to bypass the metal detection system at Los Angeles International Airport. He also had purchased a ticket on the same PSA flight that his supervisor, Raymond F. Thomson, was taking to San Francisco.

“Once the British Aerospace BAe-146-200A four-engine jetliner (N350PS), named “The Smile of Stockton,” was airborne, Burke wrote a message on an air-sickness bag: “Hi Ray. I think it’s sort of ironical that we ended up like this. I asked for some leniency for my family. Remember? Well, I got none and you’ll get none.”

“While the aircraft was cruising at 22,000 feet over the central California coast, the cockpit crew heard two shots in the passenger cabin and radioed a frantic message to Oakland air traffic controllers: “There’s gunfire aboard!” Moments later, the plane entered a high-speed nosedive and smashed onto a cattle ranch approximately 15 miles southwest of Paso Robles and near the small coastal town of Cayucos.

“FBI agents and aviation investigators sifting through the wreckage came across a gun, containing six spent cartridges, as well as the ominous handwritten note on the air-sickness bag, both of which were eventually traced back to Burke.

“Additional information soon came to light: A fellow USAir co-worker admitted to having lent the gun and ammunition to Burke, and a farewell message had been left by Burke on his estranged girlfriend’s telephone answering machine.

“Investigators at the crash site were also able to retrieve the plane’s cockpit voice recorder, which subsequently revealed, following the initial two gunshots, the sounds of a “tremendous” commotion and struggle in the cockpit, three more shots, the groan of the pilot or co-pilot, and then, after several moments had passed, a final shot.

“Investigators theorized that after shooting Thomson, Burke made his way to the front of the plane and shot both pilots on the flight deck, and then himself. The pilotless aircraft went into a steep, 700-mph dive and crashed.

‘No one aboard the plane survived Burke’s murderous rampage. Among the passengers killed were Chevron USA President James R. Sylla, 53, of San Francisco, three additional Chevron executives, and Dr. Neil Webb, the president of Dominican College of San Rafael (now known as Dominican University of California).

“As a result of the crash, a federal law was passed that required the “immediate seizure of all airline employee credentials” upon an individual’s termination from an airline position. The PSA Flight 1771 disaster also led to legislation requiring that all airline employees and flight crews pass through the same security checkpoints and metal detection systems that passengers do.

“The worst aviation disaster in San Luis Obispo County history.

“Fatalities: 43 — all 38 passengers and 5 crew members.” (Notable California Aviation Disasters. “The 1980s.” Oct 23, 2008 update.)

Sources

Airdisaster.com. “Special Report: Pacific Southwest Airlines Flight 1771.” When double-checked 10-22-2016, was no longer active. Accessed at: http://www.airdisaster.com/special/special-pa1771.shtml

Aviation Safety Network. Criminal Occurrence description. “Pacific Southwest Airlines…Flight number 1771…Monday 7 December 1987…British Aerospace BAe-146-200…” Accessed 10-22-2016 at: https://aviation-safety.net/database/record.php?id=19871207-0

Duwe, Grant. Mass Murder in the United States: A History. McFarland, 2007.

National Transportation Safety Board. NTSB Identification DCA88MA008. Washington, DC: NTSB, 1-4-1989 (Probable Cause approval date). Accessed 10-22-2016 at: http://www.ntsb.gov/about/employment/_layouts/ntsb.aviation/brief.aspx?ev_id=20001213X32679

NationMaster.com. Encyclopedia. “List of Notable Accidents and Incidents on Commercial Aircraft.” Accessed 12-15-2008 at: http://www.nationmaster.com/encyclopedia/List-of-notable-accidents-and-incidents-on-commercial-aircraft Inactive when double-checked 10-22-2016.

Notable California Aviation Disasters. “The 1980s.” 10-23-2008 update. Accessed 10/20/2009 at: http://www.jaydeebee1.com/crash80s.html Inactive when checked 10-22-2016.

[1] All other sources we cite note 43 fatalities.

[2] Notes location as San Luis Obispo, CA. Cayucos is in San Luis Obispo Co. and about nineteen miles from SLO.

20th Century

1987 — Nov 23, Ryan Air Flight 103 (Beechcraft 1900C) approach crash, Homer, AK– 18

lornajarrettblanchard November 23, 1987

–18 Aviation Safety Network. Accident description. “…Beechcraft 1900C…Ryan Air Service.”

–18 B3A (Geneva, Switzerland). “Crash of a Beechcraft 1900C in Homer: 18 killed.”

–18 NTSB. AAR. Ryan Air Service, Inc., Flight 103, Beech Aircraft Corp. … 12-20-1988, ii.

–14 OJP, DOJ. Community Crisis Response Team Training Manual: 2nd Ed. (Appendix D).[1]

Narrative Information

ASN: “Location: Homer Airport, AK…

“Phase: Approach.

“Nature: Domestic Non Scheduled Passenger

“Departure airport: Kodiak Airport, AK…

“Destination airport: Homer Airport…

“Flight number: 103

“Narrative: Flight 103 was fully loaded (all 19 seats occupied; 1437 pounds of cargo) when it took off from Kodiak runway 07. The aircraft lifted off the runway, fell back and accelerated for about another 15 knots before it became airborne. The aircraft was approaching Homer at 18:19 when it was cleared for the localizer/DME approach to runway 3. The crew reported a 2-mile final 5 minutes later. On short final the wings were seen to rock back and forth; the aircraft then dropped steeply to the ground in a rather flat attitude, struck the airport perimeter fence and slid to a stop on its belly….” (ASN)

NTSB: “Abstract: About 1825 on November 23, 1987, a Beech Aircraft Corporation 1900C (Be 1900), N401RA, operated by Ryan Air Service, Inc., crashed short of runway 3 at the Homer Airport, Homer, Alaska. Flight 103 was a scheduled Title 14 Code of Federal Regulations Part 135 flight operating from Kodiak, Alaska, to Anchorage, Alaska, with intermediate stops in Homer and Kenai. Both flight crewmembers and 16 passengers were fatally injured; 3 passengers were seriously injured

“The National Transportation Safety Board determines that the probable cause of this accident was the failure of the flightcrew to properly supervise the loading of the airplane which resulted in the center of gravity being displaced to such an aft location that airplane control was lost when the flaps were lowered for landing.” (p. ii.)

“Executive Summary: About 1825 on November 23, 1987, a Beech Aircraft Corporation 19OOC (Be 1900), N401RA, operated by Ryan Air Service, Inc., crashed short of runway 3 at the Homer Airport, Homer, Alaska. Flight 103 was a scheduled Title 14 Code Federal Regulation Part 135 flight operating from Kodiak, Alaska, to Anchorage, Alaska, with intermediate stops in Homer and Kenai. Both flightcrew members and 16 passengers were fatally injured; 3 passengers were seriously injured….

The safety issues discussed in the report include:

The performance of the Beach 1900;
The Federal Aviation Administration’s oversight of Ryan; and
Ryan’s management of its operation.

“Safety recommendations were addressed to the Federal Aviation Administration and the National Fire Protection Association.” (p. v.)

“History of the Flight…. On November 23, 1987, Ryan Air Service, Inc. (Ryan), was operating a Beech (Be) 19OOC, N401 RA, as a regularly scheduled, passenger flight from Kodiak, Alaska, to Anchorage, Alaska, with intermediate stops in Homer and Kenai, Alaska. N40l RA, as RYA 102, departed Anchorage, where its fuel tanks were filled at 1605, and it arrived in Kodiak at 1709.

“In Kodiak, the airplane was redesignated as RYA 103 with the same flightcrew. Seventeen male passengers, many of whom were hunters, and 2 female passengers, boarded the airplane and occupied the 19 available seats.

“The airplane was emptied of cargo and no fuel was added. The Kodiak station agent stated that the first officer asked that the airplane be loaded “with 1,500 pounds of cargo.” The agent thought the first officer’s request was unusual because previous Be 1900 pilots, when operating with a full passenger load, had asked for 1,100 or 1,200 pounds of cargo. The station agent also said that the first officer told her, “Before we could get the 1,500 pounds on board, it would bulk out.”

“The baggage loader stated that, with the assistance of the captain and first officer, he loaded cargo into the compartments. In addition to suitcases, gun cases, frozen crabs, and two dogs in kennels, the cargo included “approximately 13-14 pieces” of packaged venison that weighed 795 pounds. The venison, which was destined for Kenai, had been stored overnight. The teletyped loading information from the Kodiak station agent to the Homer station agent indicated that 160 pounds of cargo was destined for Homer, 1,010 pounds for Kenai, and 267 pounds for Anchorage (a total of 1,437 pounds).

The baggage loader stated that, after loading the cargo, the tailstand was “about 1 inch from the ground,” and the lowest to the ground that he had ever seen a tailstand. He stated that typically the tailstand came to within “3 to 4 inches, maybe more” of touching the ground…. [p. 1.]

“A passenger on RYA 103 testified that he thought the airplane would “never become airborne” during the takeoff. He said that after the main gear lifted off the runway, the airplane then fell back to the runway and “accelerated for about another 15 knots” before it became airborne. The passenger stated that the airplane then seemed to climb out rather steeply….

“Ground witnesses described RYA 103 when it was on a short final approach to the Homer airport. Its wings began to rock back and forth and then it dropped steeply to the ground in a rather flat attitude. The airplane struck the airport perimeter fence before sliding to a stop on its belly…. [p. 2.]

“Wreckage and Impact Information…. According to rescue personnel, none of the passenger seats were found attached to the floor or side wall seat tracks. Seat back frames were twisted and bent, and several had separated from the pivot bracket that attached them to the seat pan frame. Seat pan frames had separated and were bent downward. The seat pan fabric that supports the seat cushion was torn through. Several seats were missing one or both seat legs, while some seats had separated legs. The seatbelts were found attached to the seats and were fully operational…. There was no fire.

“Medical and Pathological: The captain and 13 passengers were found fatally injured at the wreckage. The first officer and 6 passengers were alive. They were transported to local hospitals where their conditions were stabilized. The seven survivors were then transported by air to hospitals in Anchorage. The first officer and one passenger died en route and two passengers died in the Anchorage hospital on November 24. The 18 who were killed died as a result of the blunt force musculoskeletal and internal injuries that had been sustained during the impact sequence.” [p. 8.]

“Three passengers who survived had sustained serious injuries. A 16-year-old male in seat 3-B, a

26-year-old male seated in either seat 7A or seat 8A, and a 22-year-old female who had been in seat 6B….” [p. 10.]

“Crash: The passenger seats were certificated according to the inertia loads in 14 CFR 23.561, i.e., 3.0 G. upward, 3.0 G. downward, 9.0 G. longitudinal, and 1.5 G. lateral. These values are increased by 1.33 to take into account the strength of the fittings or attachments for the seats. Beech exceeded the requirements 14 CFR Part 23 and statically tested the seats to the following criteria: 5.25 G. upward, 8.25 G. downward, 12 G. longitudinal, and 2.85 G. lateral. The three-place bench seat was tested to 4.2 G. upward, 7.2 G. downward, 12 G. longitudinal, and 2.4 G. lateral.

“Using the airplane’s attitude at impact, an assumed impact velocity, and the crush damage to the fuselage, the Safety Board determined the values of the average accelerations that occurred at initial impact along the airplane’s longitudinal, lateral, and vertical axes. The range of those accelerations were 7.01 to 10.40 Gs. longitudinal, 4.8-7.23 Gs. lateral, and 19.80-35.7 Gs. vertical. The vertical velocity change was about 42 feet per second….” [p. 10.]

“Flight 103 Weight and Balance…. The landing weight of RYA 103 at Homer was calculated at 184.3 pounds over the maximum allowable landing weight, with a CC located 11.20 inches aft of the limit….” [p. 13.]

“Ryan Air Service, Inc. …. the person who was appointed in 1984 to be the director of operations was dismissed in February 1987. He told the Safety Board that he personally investigated employee allegations of improper weight and balance determinations and disciplined employees when they failed to follow correct procedures. For example, he disciplined a station agent who, according to several company pilots, attempted to coerce pilots to fly overweight aircraft…. [p. 16.]

“FAA Surveillance…. The FAA recorded 22 enforcement actions against Ryan from December 1980 to the time of the accident. Ten letters of corrections concerned pilot recordkeeping (3), airport security (2), hazardous materials (l), operations specifications (2); a forward observer seat

(1), and multiengine operation with inoperative instruments or equipment installed (1). Six warning letters concerned recordkeeping (2), maintenance (2), use of noncurrent aeronautical charts (l), and airport security (1)…. On March 3, 1985, Ryan Air Service, Inc., paid a $9,000 civil penalty for using the services of a nonqualified pilot-in-command for commuter air carrier operations. This penalty was the most that Ryan had actually paid in fines for violations of FARs.

“On September 17,1986, an FAA inspector was contacted by a former Ryan Air Service mechanic. The Ryan employee stated that he was representing three Ryan pilots who alleged that Ryan was pressuring its pilots to fly overweight/unsafe aircraft. The pilots were willing to cooperate with the FAA by providing documentary evidence of alleged instances of Ryan’s overweight operations and direct testimony that Ryan’s management condoned and encouraged the overweight operations. However, they were willing to cooperate with the FAA only on the condition that they be granted immunity from prosecution by the FAA. One of the pilots was the captain of RYA 103, who was a first officer at the time.

“The FAA inspector forwarded the request for immunity to his superiors in the flight standards division of the FAA’s Alaska Region. In turn, that request was forwarded to the Alaska Regional Counsel. The request for immunity was denied. The FM inspector was told of the decision, and he informed the former Ryan Air Service mechanic who had made the request. The Regional Counsel said that after deliberating the matter, only the U. S. Attorney was empowered to grant immunity. He did not contact the U.S. Attorney because he considered it a third party request with “little or no support.” There is no evidence that he took other action on the request. However, in response to the allegations, the FAA’s FSDO inspected Ryan’s weight and balance procedures and examined records of weight and balance calculations of Ryan flights performed during the prior 30-day period. The result of this inspection was the finding of one incorrect weight and balance determination of a Ryan flight. As a result, the FSDO processed a violation against Ryan.

“At the time of the accident, one FAA Enforcement Investigative Report relating to recordkeeping, pilot training, and testing was in progress. Findings were a result of a February 1987 base inspection of Ryan. The POI, who had documented the alleged violations, characterized the violations as “flagrant” and testified that he initially had recommended a total of $250,000 in civil penalties against Ryan. He based the size of the recommended civil penalty on a FAA formula which provided the maximum civil penalty of $1,000 for each violation, multiplied by the number of months that each violation existed. The POI had submitted the recommended civil penalty with what he considered sufficient supporting documentation through his superiors within the FSDO-63 and the flight standards division of FAA’s Alaska Regional Office. All recommended penalties were then forwarded to the FAA’s Alaska Regional Counsel. The Regional Counsel’s office twice returned the violation enforcement case to the POI. They asked for additional documentation to support the recommended penalties. In reconsidering the sanction, the POI stated that he had considered recommending that Ryan’s Air Carrier Operating Certificate be suspended; however, such action would have seriously affected Ryan’s work force and would have disrupted air service to a number of small communities in Alaska. As a result, the POI decided to propose a large civil penalty, which he believed would have as much of an impact on Ryan as a certificate suspension but without impact to its employees or passengers. In addition, he believed that a civil penalty was consistent with previous FAA actions against similar alleged violations which were upheld in various appeal processes.” [end of p. 20.]

“After the second disapproval of the recommended penalty, the POI recalculated his recommended sanction against Ryan, using a formula provided to him by the Regional Counsel and then resubmitted the violation enforcement case along with a new recommendation that Ryan be assessed a $25,000 civil penalty. The Regional Counsel’s office subsequently reduced the amount of the recommended civil penalty to $16,500 because it believed the supporting evidence was inadequate….

“Following the accident and after allegations about the safety of Ryan’s operations and the degree of its compliance with Federal Aviation Regulations (FARs), the Alaska Regional Counsel, on December 30, 1987, issued an Order of Investigation of Ryan Air Service, Inc., to determine Ryan’s compliance with FARs. The FAA assembled a team of inspectors to conduct a special inspection of Ryan Air Service, Inc. The inspection began in early January 1988.

“During its inspection of Ryan’s maintenance facilities, the special inspection team found that during the previous 6 months, Ryan’s airplanes had not been maintained in accordance with an FAA-approved maintenance manual. That is, Ryan’s methods of rounding the number of hours accrued by an airplane at times resulted in required inspections being performed several hours after the inspection has actually been required. The leader of the inspection team stated that violations found by the team were “sufficiently obvious” and that he believed Ryan’s intent to violate FARs could be discerned. As a result of the team’s findings, the evidence from the November 23, 1987, accident, and previous documented deficiencies, the FAA discontinued the inspection and initiated a consent order. Under this order, Ryan agreed to cease operations until changes in company management and procedures had been carried out. Ryan agreed to the consent order and ceased its operations in January 1988. Ryan resumed operations, on a considerably smaller scale than before the accident in the summer of 1988….

“Accident History: According to the Safety Board’s accident/incident data, Ryan airplanes were involved in 10 accidents with 12 fatalities to the time of the accident….” [p. 21.]

“Aircraft Performance…. The results of the investigation indicate that the loss of control of Ryan Air flight 103 resulted directly from an excessively aft CG [center of gravity]. The out-of-limits CG occurred because the aft cargo compartment had been loaded with from 1,600 to 1,800 pounds of cargo. With the passenger and fuel load present on RYA 103, any cargo weighing more than approximately 850 pounds in the aft compartment would have displaced the CG beyond the aft limit. The CC would have moved still further aft as the airplane consumed fuel.

“The investigation indicated that the total weight of the cargo including carry-on articles and the two hunting dogs was 2,283 pounds. Assuming an allowance of 150 pounds for carry-on articles,

then RYA 103 was overloaded about 600 pounds beyond the first officer’s request. This resulted in a CG that was 8 to 11 inches aft of the aft limit.

“The Safety Board believes that the baggage handler may have become confused when the first officer said, “Before we get the 1,500 pounds on board, it would bulk out.” Had the airplane been loaded in accordance with the first officer’s request of 1,500 pounds, the accident might have been avoided. A 1,500-pound cargo load, assuming that 250 pounds was placed in the forward compartment, would have resulted in a CG about 3.5 inches aft of the rear limit, and according to the results of the flight test, even with the CG this far aft of the limit the airplane could have been controllable….” [p. 23.]

“….the Safety Board believes that because of the extreme aft CG, and pilot actions to regain airplane control following flap extension, the airplane stalled as the pilot raised the flaps….”

“Pilot Performance: The evidence indicates that the flightcrew of RYA 103 disregarded company procedures in loading the airplane. They failed to properly complete the weight and balance card before they began to taxi, and they failed to accurately determine within an acceptable CC range the amount of cargo that should have been loaded into the airplane. Further, they recorded an incorrect CG in the airplane log. Because Ryan developed and the FAA accepted crew procedures for each of these steps, the Safety Board attempted to examine why the crew failed to follow them.

“The evidence indicates that the first officer, within proximity to the captain, gave improper directions to the ramp agent on the amount of cargo to place on the airplane. The captain failed to counter the direction of the first officer as he should have. It is possible that the first officer’s status within the company, a managerial figure involved in training, may have influenced the captain to keep silent when prudence should have dictated otherwise.

“Yet, given the first officer’s position in the company, as someone responsible for the training of others, the Safety Board is concerned about his disregard of regulations and procedures. As a training instructor, he should have been especially sensitive to the need for strict adherence to [end of p. 24] procedures concerning weight and balance. However, he was a relatively junior pilot on the Be 1900 with considerably less experience on that airplane than he had accrued on single-engine and light, twin-engine airplanes. It is possible that his direction to the ramp agent reflected more his knowledge of other, less sophisticated airplanes with their considerably smaller cargo capacities and where such procedures, while improper, may not have had the same effect on airplane control as they had on the more sophisticated Be 1900. Moreover, in the Alaskan aviation environment, such attitudes often characterize what the Safety Board has referred to in the past as the “bush pilot syndrome” This syndrome describes “a pilot’s casual acceptance of the unique hazards of flying in Alaska to a pilot’s willingness to take unwarranted risks to complete a flight.” The Safety Board believes that, given the first officer’s extensive experience flying light, relatively unsophisticated aircraft in remote areas of Alaska and his relative inexperience in flying sophisticated aircraft in scheduled 14 CFR Part 135 operations, he may have manifested this attitude in giving directions to the ramp agent in Homer….” [p. 25.]

Sources

Aviation Safety Network. Accident description. “…Date: Monday 23 November 1987. Time: 18:25. Type: Beechcraft 1900C. Operator: Ryan Air Service…Fatalities: 18 / Occupants: 21.” Accessed 10-23-2016 at: https://aviation-safety.net/database/record.php?id=19871123-0

B3A (Bureau of Aircraft Accident Archives, Geneva, Switzerland). “Crash of a Beechcraft 1900C in Homer: 18 killed.” Accessed 10-23-2016 at: http://www.baaa-acro.com/1987/archives/crash-of-a-beechcraft-1900c-in-homer-18-killed/

National Transportation Safety Board. Aircraft Accident Report. Ryan Air Service, Inc., Flight 103, Beech Aircraft Corporation 1900C, N401RA, Homer, Alaska, November 23, 1987 (NTSB/AAR-88/11). Washington, DC: NTSB, 12-20-1988, 93 pages. Accessed 10-23-2016 at: http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-reports/AAR88-11.pdf

Office of Justice Programs, United States Department of Justice. Community Crisis Response Team Training Manual: Second Edition (Appendix D: Catastrophes Used as Reference Points in Training Curricula). Washington, DC: OJP, U.S. Department of Justice. Accessed at: http://www.ojp.usdoj.gov/ovc/publications/infores/crt/pdftxt/appendd.txt

[1] Have no explanation of OJP fatality error. OJP erroneously notes 12 survivors when in fact there were three.

20th Century

1987 — Nov 23, Ryan Air Flight 103 (Beechcraft 1900C) approach crash, Homer, AK– 18

lornajarrettblanchard November 23, 1987

–18 Aviation Safety Network. Accident description. “…Beechcraft 1900C…Ryan Air Service.”

–18 B3A (Geneva, Switzerland). “Crash of a Beechcraft 1900C in Homer: 18 killed.”

–18 NTSB. AAR. Ryan Air Service, Inc., Flight 103, Beech Aircraft Corp. … 12-20-1988, ii.

–14 OJP, DOJ. Community Crisis Response Team Training Manual: 2nd Ed. (Appendix D).[1]

Narrative Information

ASN: “Location: Homer Airport, AK…

“Phase: Approach.

“Nature: Domestic Non Scheduled Passenger

“Departure airport: Kodiak Airport, AK…

“Destination airport: Homer Airport…

“Flight number: 103

The safety issues discussed in the report include:

The performance of the Beach 1900;
The Federal Aviation Administration’s oversight of Ryan; and
Ryan’s management of its operation.

“Safety recommendations were addressed to the Federal Aviation Administration and the National Fire Protection Association.” (p. v.)

“Three passengers who survived had sustained serious injuries. A 16-year-old male in seat 3-B, a

26-year-old male seated in either seat 7A or seat 8A, and a 22-year-old female who had been in seat 6B….” [p. 10.]

“Accident History: According to the Safety Board’s accident/incident data, Ryan airplanes were involved in 10 accidents with 12 fatalities to the time of the accident….” [p. 21.]

“The investigation indicated that the total weight of the cargo including carry-on articles and the two hunting dogs was 2,283 pounds. Assuming an allowance of 150 pounds for carry-on articles,

then RYA 103 was overloaded about 600 pounds beyond the first officer’s request. This resulted in a CG that was 8 to 11 inches aft of the aft limit.

“….the Safety Board believes that because of the extreme aft CG, and pilot actions to regain airplane control following flap extension, the airplane stalled as the pilot raised the flaps….”

Sources

[1] Have no explanation of OJP fatality error. OJP erroneously notes 12 survivors when in fact there were three.

20th Century

1989 — Nov 15, Tornado, Madison County, Huntsville, Alabama — 21

lornajarrettblanchard November 15, 1987

— 21 Grazulis. Significant Tornadoes 1680-1991. 1993, p. 1290.

— 21 National Climatic Data Center. Storm Data, Vol. 31, No. 11, Nov 1989, pp. 23-24.

— 21 NCDC. Storm Events Database. Tornado, F4, AL, Madison Co., 11-15-1989, 16:30 CST.

— 21 National Weather Service WFO Birmingham, AL. Huntsville Tornado, Nov. 15, 1989

Breakout of Fatalities (from NCDC Storm Data, p. 24)

Female 68 Mobile Home

Female 61 Commercial

Female 48 Auto

Male 47 Commercial

Male 45 Auto

Male 36 Auto

Male 30 Auto

Female 67 Apartment

Female 22 Apartment

Male 7 Auto

Female 49 Auto

Female 86 Auto (died Dec 8)

Female 52 Apartment (died Dec 5)

Male 46 Auto

Female 40 Auto

Male 33 Commercial

Female 50 Commercial

Female 23 Auto

Female 25 Apartment

Female 2 Auto

Narrative Information

Grazulis: “AL NOV 15, 1989 1630 21k 463 inj 800y 19m F4. MADISON — A devastating tornado struck the southern portion of Huntsville. Alter first touching down lm SSW of Madkin Mountain on the Redstone Arsenal, it cut a swath from SW to NE through a business and heavily populated residential section. The tornado struck during evening rush hour along US-231. Homes, schools office buildings, apartments, and businesses were ripped apart. Eighteen of the 21 deaths occurred in the area between the intersection of Airport Road and US-231, and the intersection of Airport Road and Whitesburg Road. Twelve of the deaths were in cars, four were in commercial buildings, four were in apartments, and one was in a trailer. Most of those killed in cars were just going about their normal business, and not fleeing or seeking shelter in a car. The Jones Valley Elementary school sustained a direct hit and had its upper story ripped off and scattered. The school still contained 37 children and 12 adults, many of them on the second floor. They found safety under a stairway on the first floor. The second floor would have been a death trap. All manner of buildings, transmission towers, vehicles, churches, and four shopping centers were destroyed. $100,000,000.” (Grazulis. 1993, 1290.)

NCDC Storm Data: “A devastating tornado struck the southern portion of the City of Huntsville cutting a swath of destruction from southwest toward the northeast through a business section and a heavily populated residential area. Twenty-one people died and 463 were injured as a result of the tornado. Eighteen people died in the tornado, and three others at later dates, from injuries sustained in the tornado….The tornado struck during the beginning of rush hour in Huntsville and, while at its strongest, moved through a business area, crossing two major north-south highways. Twelve of the 21 deaths (57 percent) occurred in automobiles. Most of those killed in the cars were in the process of performing normal tasks as opposed to fleeing in or seeking the automobiles for safety….Eighteen of the twenty-one fatalities occurred in the area between the intersection of Airport Road and U.S. Highway 231 and the intersection of Airport Road and Whitesburg Road. Twelve of the deaths occurred in automobiles, four in apartments, and four in commercial buildings….” (NCDC. Storm Data, Vol. 31, No. 11, Nov 1989, p. 23.)

NWS WFO Birmingham: “Huntsville, Alabama, was struck by a deadly tornado around 4:30 pm on Wednesday, November 15, 1989. From an initial touchdown point on the Redstone Arsenal, the storm cut a destructive, 18.5-mile swath on its northeast trek across the southern sections of Huntsville. Plowing through businesses and heavily populated residential areas of the city, the tornado left a tragic legacy; 21 dead, 463 injured and damage estimated at 100 million dollars. Twelve of the 21 fatalities occurred in automobiles as many persons were homeward bound during the afternoon rush hour. The storm was rated an F4 on the Fujita Tornado Intensity Scale.” (NWS WFO Birmingham, AL. Huntsville Tornado, Nov. 15, 1989.)

Sources

Grazulis, Thomas P. Significant Tornadoes 1680-1991: A Chronology and Analysis of Events. St. Johnsbury, VE: Environmental Films, 1993.

National Climatic Data Center. Storm Data, Vol. 31, No. 11, Nov 1989. Asheville, NC: NCDC, NOAA, US Dept. of Commerce. Accessed 5-11-2016 at: http://www1.ncdc.noaa.gov/pub/data/swdi/stormevents/pub-pdf/storm_1989_11.pdf

National Climatic Data Center, NOAA. Storm Events Database. Tornado, F4, Alabama, Madison County, 11-15-1989, 16:30 CST. Accessed 5-11-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=9980232

National Weather Service Weather Forecast Office, Birmingham, AL. Huntsville Tornado, Nov. 15, 1989. NWS. 1-4-2009 at: http://www.srh.noaa.gov/bmx/significant_events/1989/11_15/index.php

20th Century

1987 — Nov 15, Tornadoes, TX (10 deaths) and LA (1) — 11

lornajarrettblanchard November 15, 1987

— 11 National Climatic Data Center, NOAA. Storm Events Database. Tornadoes, 11-15-1987.

Louisiana ( 1)

— 1 DeSoto Parish. F3, 1987-11-15, 18:45 CST. NCDC.NOAA. Storm Events Database.

Texas (10)

— 10 Grazulis, Thomas P. Significant Tornadoes 1680-1991. 1993, pp. 516, 1987-1988.

— 10 National Climatic Data Center, NOAA. Storm Events Database. Tornadoes, 11-15-1987.

Breakout of Texas Tornado Fatalities by County:

— 1 Anderson County, south-southwest of Palestine. Mobile home; male, 49. NCDC. SED.[1]

— 2 Burleson County, 7 miles from Caldwell. Mobile home. NCDC. Storm Events Database.

— 1 Cherokee County, Lakeview community west of Jacksonville. Mobile home; boy, 2-mo.[2]

— 1 Cherokee County, Mixon. Mobile home; female, 77. NCDC. Storm Events Database.[3]

— 3 Madison Co., northeast of Normangee. Mobile home. NCDC. Storm Events Database.[4]

— 2 Smith County, Whitehouse. Mobile home; female, 69, daughter, 45. NCDC SED.

Narrative Information

Grazulis: “TX NOV 15, 1987 1215 2k 12inj 500y 10m F2. BURLESON/MILAM–Moved NNE from 3m N of Caldwell to the Six Mile community, south of Gause. Passing through rural areas, this tornado totally destroyed dozens of houses and trailer homes and snapped acres of trees. Many vehicles were destroyed, and livestock was killed. The two deaths were residents of a trailer, 7m N of Caldwell. Five houses were destroyed in the Six Mile community….

“TX NOV 15, 1987 1400 3k 2inj 200y 10m F2. MADISON/LEON — Moved NNE from 2m E of George, passing near Mecca, to 3m NE of Normangee, to 3m E of Leona. Just NE of Normangee, the tornado wrecked a trailer and killed three of the four occupants. It destroyed four homes, 10 barns, and 15 vehicles and trailers. Over 79,000 feet of wire fencing was taken out by flying debris. Twenty- two dwellings and 26 barns were damaged.

“TX NOV 15, 1987 1503 lk 59inj 250y 11m F3. ANDERSON — Moved NNE from 111n SSW of Palestine to town. Nearly 200 residences and a school were damaged or destroyed, as were 86 businesses. One school was destroyed. There was $15,000,000 damage in Palestine, and $4,300,000 more damage outside the city limits. A man was killed in a trailer that was destroyed. Near the start of the path, the tornado passed through a church camp, where 600 campers had left 20 minutes earlier.

“TX NOV 15, 1987 1545 4k 81inj 500y 33m F3. CHEROKEE/SMITH — Moved NNE from Pierce’s Chapel, Mount Haven, Lakeview, west of Jacksonville, Love’s Lookout, Mixon, 4m W of Troup, Whitehouse, to near New Chapel Hill. All four deaths occurred in trailers; an infant and an elderly woman died in Cherokee County; a mother and daughter died in Smith County. Thirty-five trailers were destroyed and 33 other residences were damaged in Cherokee County alone, which had a $13,000,000 loss.” (Grazulis 1993, pp. 1987-1988.)

Sources

Grazulis, Thomas P. Significant Tornadoes 1680-1991: A Chronology and Analysis of Events. St. Johnsbury, VE: Environmental Films, 1993.

National Climatic Data Center. Storm Events Database. Tornado, Search Results for all U.S. States and Areas, 11-15-1987. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/listevents.jsp?eventType=%28C%29+Tornado&beginDate_mm=11&beginDate_dd=15&beginDate_yyyy=1987&endDate_mm=11&endDate_dd=15&endDate_yyyy=1987&hailfilter=0.00&tornfilter=0&windfilter=000&sort=DT&submitbutton=Search&statefips=-999%2CALL

National Climatic Data Center. Storm Events Database. Tornado, F3, Louisiana, DeSoto Parish, 1987-11-15, 18:45 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10043000

National Climatic Data Center. Storm Events Database. Tornado, F3, Texas, Anderson County, 1987-11-15, 15:03-15:15 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10137362

National Climatic Data Center. Storm Events Database. Tornado, F2, Texas, Burleson County, 1987-11-15, 12:15 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10137358

National Climatic Data Center. Storm Events Database. Tornado, F3, Texas, Cherokee County, 1987-11-15, 15:45-16:40 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10137364

National Climatic Data Center. Storm Events Database. Tornado, F2, Texas, Madison County, 1987-11-15, 14:00 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10137360

National Climatic Data Center. Storm Events Database. Tornado, F3, Texas, Smith County, 1987-11-15, 16:15 CST. NCDC/NOAA, Asheville, NC. Accessed 10-23-2016 at: http://www.ncdc.noaa.gov/stormevents/eventdetails.jsp?id=10137366

[1] NCDC. Storm Events Database. Tornado, F3, Texas, Anderson County, 1987-11-15, 15:03-15:15 CST. Notes “In addition to the one fatality, 59 people were injured in Anderson County.”

[2] NCDC. Storm Events Database. Tornado, F3, Texas, Cherokee County, 1987-11-15, 15:45-16:40 CST.

[3] Notes: “In addition to the two fatalities, 75 people were injured in Cherokee County. Thirty-five mobile homes were destroyed in the county and 6 more were damaged.”

[4] Notes a 4^th person survived.

20th Century

1987 — Nov 15, Continental Airlines Flight 1713 DC-9 takeoff crash, Denver, CO — 28

lornajarrettblanchard November 15, 1987

— 28 B3A (Geneva, Switzerland). Crash of a Douglas DC-9 in Denver: 28 killed.”

— 28 NTSB. AAR. Continental Airlines, Inc., Flight 1713…Stapleton International Airport…

Narrative Information

NTSB Executive Summary: “On November 15, 1987, Continental Airlines, Inc., flight 1713, a McConnell Douglas DC-9-14, N626TX, was operating as a regularly scheduled, passenger-carrying flight between Denver, Colorado, and Boise, Idaho. The airplane was cleared to take off following a delay of approximately 27 minutes after deicing. The takeoff roll was uneventful, but following a rapid rotation, the airplane crashed off the right side of runway 35 left. Both pilots, 1 flight attendant, and 25 passengers sustained fatal injuries. Two flight attendants and 52 passengers survived.

“The National Transportation Safety Board determines that the probable cause of this accident was the captain’s failure to have the airplane deiced a second time after a delay before takeoff that led to upper wing surface contamination and a loss of control during rapid takeoff rotation by the first officer. Contributing to the accident were the absence of regulatory or management controls governing operations by newly qualified flightcrew members and the confusion that existed between the flightcrew and air traffic controllers that led to the delay in departure.

“The safety issues discussed in this report include:

Pilot training;
Aircraft deicing procedures; and
Wingtip vortex generation and lifespan.

“Recommendations concerning these issues were addressed to the Federal Aviation Administration, the National Fire Protection Association, the American Association of Airport Executives, the Airport Operators Council International, and Continental Airlines, Inc.” (p. v.)

“….Medical and Pathological Information….Postmortem examinations were performed by the City and County of Denver’s Coroner’s Office. The autopsies revealed that 11 passengers (including an infant), the captain, the first officer, and 1 flight attendant died of multiple blunt force traumatic impact injuries; 5 passengers died of head injuries secondary to blunt trauma, and 9 passengers died of mechanical asphyxia….Two passengers died after being transported to the hospital….

“Interior Damage and Occupant Injuries. There was extensive damage to the forward left side of the airplane. The fuselage was missing on the left side from aft of the boarding door to about station 466. No one in a window set in rows 2-9 on the left side survived. Cabin dividers, overhead compartments, and passenger seats were ejected during the impact and were found along the wreckage path….Rows 10-15 were inverted and in an area of extreme compression. All occupants in this area required extrication. All survivors in this area had serious injuries and eight of the nine passengers who died of traumatic asphyxia were seated in this section…. [p. 20.] ….

“The Captain’s Actions. The Safety Board notes several decision-making deficiencies of the captain of flight 1713. The Safety Board believes that he should have realized that he was exposing the airplane to airfoil contamination for too long a period and should have returned to the deicing pad for another deicing before takeoff. In addition, he showed poor judgment in allowing an inexperienced first officer to attempt a takeoff in weather conditions such as those that existed at Denver. Further, from data recovered from the CVR and the FDR, it appears that he did not attempt to arrest the first officer’s rapid rotation of the airplane during the takeoff.

“Although the captain was an experienced pilot with apparently better than average flying skills, he was relatively inexperienced as a captain on air carrier turbojet airplanes, and he had very little total flying time in the DC-9. He was not seasoned in either the supervision or judgment of first officers, nor was he familiar with the unique characteristics of the DC-9-10 series airplane in icing conditions. Although he was taught about DC-9 cold weather operations during his ground training and simulator sessions, he had never actually encountered ground icing conditions in a DC-9 before the accident….In addition, he did not understand the intent of the company procedures concerning taxi from the gate through the deice pad and on to the runup pad. His failure to contact ground control for clearance to taxi to the deice pad precipitated a series of events that caused a portion of the 27-minute delay between deicing and takeoff. Following the accident, those procedures were modified to state that a flight should not taxi beyond the north side of concourse D until clearance is received from ground control.

“Company procedures also required the captain to inspect the airplane if the takeoff is delayed for more than 20 minutes after deicing. The captain did not examine the wings or cause the wings to be examined even after 27 minutes had elapsed….

“The captain had never flown with the first officer and knew nothing of his flying skills or background, although he did realize that the first officer was new to Continental.[1] He allowed the first officer to be the flying pilot on the first leg of this trip sequence into relatively poor weather, presumably so that he, the captain, would make the landing on the return leg to Stapleton, in perhaps equally poor weather. Although weather takeoffs are generally assumed to be less demanding than weather landings, and the general tradition is for two airline pilots to always ‘trade legs,’ a much wiser course of action would have been for the captain to have conducted the takeoff at Denver and then to have allowed the first officer to take over flying duties for the rest of that leg. The captain could then have flown the return leg and made the weather approach and landing back at Denver.” [p. 37.]

“Crew Pairing. The Safety Board believes that the captain’s basic inexperience as a DC-9 pilot together with his inexperience as a captain supervising the actions of first officers left him unprepared for the rapid rotation by the first officer into the aerodynamic stall regime. A more experienced DC-9 captain may have been better able to (a) notice that a rapid rotation was occurring, (b) arrest the rotation by blocking the yoke, and finally, (c) perhaps allow the airspeed to build up to the point where the takeoff could be successfully completed.

“In summary, the Safety Board believes that the pairing of pilots with limited experience in their respective positions can, when combined with other factors, such as adverse weather, be unsafe and is not acceptable. The Safety Board believes that although the pilots of flight 1713 had previously demonstrated competence in their duties, compromises in the decision-making process occurred as a result of inexperience in their respective positions. Subsequently, their pairing on the same flight was a factor in the accident….” [p. 38.]

“The Role of the Clearance Delivery and Ground Controllers and Continental Flight 594 in the Takeoff Delay of Flight 1713.

“The Safety Board believes that the air traffic control facility at Stapleton was unaware of the locations of Continental flights 594 and 1713 for extended periods of time after they began taxiing and that this lack of awareness contributed to the delay between deicing and takeoff for flight 1713. Procedural errors on the part of both flightcrews also contributed to this delay.

“The airport was not equipped with ASDE,[2] and the visibility varied somewhat but generally was such that tower personnel could not see beyond the ends of the terminal concourses at Stapleton. Not being able to in some manner see airplanes they are supposed to be controlling places a great burden on the controllers in the tower. Had the controllers been able to locate flights 594 and 1713 on the ramp via radar as they progressed to the takeoff position, the points of confusion and the subsequent takeoff delays may not have occurred. The Safety Board notes that Stapleton Airport is scheduled to have an SDE-3 installed in 1989, a slip from its original installation date of September 1988. The installation and certification of the equipment should take about 4 months according to FAA sources. The Board is concerned, then, that this airport will have gone without ASDE through two winter weather seasons with associated periods of low visibility since this accident….” [p. 39.] (NTSB)

Sources

B3A (Bureau of Aircraft Accidents Archives), Geneva, Switzerland. “Crash of a Douglas DC-9 in Denver: 28 killed.” Accessed 10-26-2016 at: http://www.baaa-acro.com/1987/archives/crash-of-a-douglas-dc-9-in-denver-28-killed/

National Transportation Safety Board. Aircraft Accident Report. Continental Airlines, Inc., Flight 1713, McDonnell Douglas DC-9-14, N626TX, Stapleton International Airport, Denver, Colorado, November 15, 1987 (NTSB/AAR-88/09). Washington, DC: NTSB, 9-27-1988, 90 pages. Accessed 10-26-2016 at: http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR8809.pdf

[1] In “Conclusions” section, p. 43, it is written as sixth “Finding” that “The first officer had a record of performance difficulties before joining Continental and continued to have difficulty in Continental’s DC-9 training program.”

[2] Airport Surface Detection Equipment.

20th Century

1987 — Oct 20, USAF Jet Crash, Ramada Inn, Wayne Township, near Indianapolis, IN– 10

lornajarrettblanchard October 20, 1987

–10 European Stars and Stripes. “Drive-shaft wear cited in AF jet crash report.” 1-14-1988, 3.

–10 Frederick Post, MD. “Controllers never replied. Tape of jet fighter’s…” 11-25-1987, B3.

–10 Kokomo Tribune, IN. “Fighter crash changes routine.” 1-18-1988, 8.

–10 Pharos-Tribune, Logansport, IN. “Controllers on Job Hours After Crash.” 12-14-1987, 3.

–10 Pharos-Tribune, Logansport, IN. “Indianapolis Jet Crash Claims…10^th Victim.” 10-30-87.

–10 Pharos-Tribune, Logansport, IN. “Worn Part Cause of Jet Crash.” 1-13-1988, 1.

–10 Stars and Stripes. “Probe clears controller in crash of Air Force jet.” 12-11-1987, 7.

— 9 Baugher, Joseph F. 1969 USAF Serial Numbers. 1-10-2012 revision.

— 9 Pacific Stars and Stripes. “Experts question wisdom of controllers…crash.” 10-25-1987, 4.

— 9 Pharos-Tribune, Logansport, IN. “Fighter Pilot Grounded After…Crash.” 10-26-1987, 13.

— 9 Pharos-Tribune, Logansport, IN. “Jet Hits Hotel…No Time to React.” 10-21-1987, 7.

— 9 Pharos-Tribune, Logansport, IN. “Pilot Did All He Could.” 10-22-1987, p. 8.

— 9 USFA TR 14. Ramada Inn Air Crash and Fire, Wayne Township, Indiana (Oct 20, 1987).

— 9 Wisconsin State Journal, Madison. “Controllers faulted in jet crash.” 10-24-1987, 2.

–>7 Kokomo Tribune, IN. “Death toll rising from crash of jet.” 10-20-1987, 1.

Narrative Information

Baugher: “Ling-Temco-Vought A-7D-4-CV Corsair II….6207 (4450th TG)[1] lost power while on cross-country flight. Pilot glided aircraft 30 mi in to Indianapolis but got bad information from ATC[2] and came in with too steep a descent. Pilot ejected and aircraft struck a Ramada Inn at the airport, killing 9 on ground. Pilot absolved of any blame.” (Baugher, Joseph F. 1969 USAF Serial Numbers. 1-10-2012 revision.)

CheckSix.com: “….At 9:11 a.m., and while flying at 32,000 over the Indiana-Ohio border, Teagarden…[who had] been recently assigned to the 4450th Tactical Training Group – notified controllers at Indianapolis International Airport that his aircraft had sustained some sort of engine failure about 15 miles southwest of the city and he was gliding to Indianapolis to attempt an emergency landing….Controllers at Indianapolis directed Teagarden – who had more than 2,000 hours of flight time in fighter jets – towards Runway 5L and instructed him increase his sink rate sharply to give him maximum runway…

“But, due to the low cloud ceiling of 800 feet above the ground, and poor visibility conditions, consisting of fog, over Indianapolis at the time, Teagarden was at still at 3100 feet above sea level when he overflew the runway’s threshold, which would place him 50 yards short of the overrun of the runway. So he was forced to make an alternate plan to land on Runway 32 instead, and the controller he told him to “go around again” – despite having no engine power.

“Teagarden made a right turn to head east away from the airport, but continued to lose altitude – descending from 3100 feet to 2000 feet – just to the east of Interstate 465 at the eastern edge of the airport, where controllers lost him from the radar scope. As his altitude continued to drop, Teagarden was forced to eject from the aircraft 500 feet above ground. The plane, now powerless and pilotless, made a slight left turn towards the Park Fletcher business development….

“The Corsair clipped the roof of the Bank One branch in the 5600 block of Bradbury Avenue, and bounced back into the air. Continuing to remain aloft, it flew across the street, hit an embankment, went 25 feet airborne, and then smashed into the front of the Airport Ramada Inn.

“The plane’s cockpit and engine shot into the hotel’s main lobby, and the jet fuel on board ignited on impact, causing a fireball that covered the entire front of the hotel up to the fourth floor. The jet’s wings tore into the upper floors of the hotel, and spread out debris on top of the hotel’s carport.

“A minute after the impact, crash trucks from Indianapolis Airport arrived on the scene, and used foam to extinguish the fire, which was brought under control within minutes. At the same time, other personnel from the Airport fire department carried out search and rescue efforts throughout the building, as it was evacuated completely by Ramada Inn staff and guests.

“Luckily, the city of Indianapolis had recently prepared and rehearsed a mass disaster plan – in preparation for the Pan-American Games, which took place in the city two months prior. The eagerness of volunteer emergency workers descended on the crash site resulted in the undocumented removal of the dead and injured prior to the arrival of the coroner.

“When the smoke had cleared, it was determined that seven people, all Ramada Inn employees, were killed when the jet struck the lobby, and two more employees died of smoke inhalation when they became entrapped in the hotel’s laundry. Injuries were reported among fiver hotel guests, one of which died ten days after the crash from burns. Also injured were two firefighters and Major Teagarden….

“Ultimately, the government paid at over $8 million to the injured and the families of those who died in the Ramada Inn….[3]

“For more than two years, the charred building stood as a reminder of the tragedy. The hotel owners never rebuilt because they couldn’t decide on an appropriate design. Currently, a parking lot stands on the site.” (Check-Six.com. “Flying in an Analog…in Indianapolis, Indiana 20 October 1987.”)[4]

United States Fire Administration Overview

USFA: “On October 20, 1987 at 0911, the control tower at the Indianapolis Airport was advised by the pilot of an A-7D Corsair single-engine military aircraft of an intended emergency landing due to engine failure. The Airport Fire Department began its normal response to set up on the intended

runway.

“Due to low weather ceiling and poor visibility the plane overshot the intended runway, circled the airport and attempted to fly to an alternate runway. The Fire Department, having seen this, attempted to follow the aircraft. The pilot, unable to maintain altitude, ejected from the aircraft at approximately 500 feet.” (USFA TR 14, p. 1)

“The unoccupied aircraft careened off the roof of a Bank One branch building in the 5600 block of Bradbury Avenue in Wayne Township, crossed the street, hit an embankment, went airborne for approximately 25 feet and bellied into the front of the Ramada Inn. The aircraft shattered into many pieces, sending the cockpit and engine into the lobby and its wings to the top of the carport and upper floors of the hotel, simultaneously igniting its approximately 20,000 lbs. of fuel….” (USFA TR 14, p. 2)

“A giant fireball momentarily engulfed the entire outside front of the hotel to about the fourth floor….”

“Nine employees of the hotel were killed, all in the lobby and areas adjacent to the lobby. Four non-fire fighters were injured: an employee, a visitor to the hotel, a guest and the pilot. The visitor’s injuries were critical. In addition, three fire fighters were injured…

“Arriving within one minute of the aircraft’s impact, the Airport Fire Department crash crew began a fire suppression and rescue operation which later proved to be the most important factor in minimizing deaths and injuries.”

Investigation

“…. The Ramada Inn is a 7-story brick building with l65 rooms. It is located in an area called Park Fletcher within the Wayne Township jurisdiction, less than one half mile from the airport….” (USFA TR 14, p. 2)

“Approximately 130 guests were registered at the Ramada Inn the day of the fire plus an unknown number of employees…. “ (USFA TR 14, p. 3)

“Within a minute after ignition, Airport Crash Truck 23 arrived on the scene and began attacking the fire with AFFF (foam) from the northwest corner of the building. Crash Truck 24 approached from the northeast corner of the building and joined Truck 23 in applying AFFF on the fire. Airport Unit 27 stopped on Bradbury Avenue, which was blocked by debris from the aircraft and from the damaged Bank One building. Its crew put on airpacks and entered the west side of the building looking for victims. Airport Unit 25 with two EMT’s treated a burned employee who was coming through the east door. Another person, who had just stopped to use the phone at the hotel, was very badly burned and was found lying in the grass north of the carport. He was transported to the hospital by a private ambulance that happened to pass by. Information was obtained from one of the victims that people were trapped in the laundry room.

“Within approximately three minutes the main body of the fire was knocked down.

“A major concern of the Airport Fire Chief at this time was whether the plane was carrying any armaments. The Airport Chief advised the Wayne Township Deputy Chief of this situation and radioed the Indianapolis Airport Authority to ask whether the aircraft had weapons aboard. An Indianapolis police officer was dispatched to the hospital to interview the pilot, who had survived a low-level bail-out and was conscious and in good condition after a quick medical check. It was learned from him that there were no armaments aboard, but the delayed information had already in turn delayed the search for victims….” (USFA TR 14, p. 5)

“…a person from the south side area of the building…jumped from a third floor room onto the first floor roof of the kitchen area. This person was transported to the hospital for treatment for smoke inhalation and possible fractures….” (USFA TR 14, p. 6)

“Only two guests were assisted from the hotel by the fire department during the whole incident. The others apparently left by designated exits. The guests and employees who were in the restaurant, banquet rooms, and kitchen left by exits opening directly to the outside from these areas….

“Three bodies were found in an area behind the reception desk on the first floor. Another body was found in an office behind the reception area. Two bodies were found in an office off the lobby area. Three bodies were found in the laundry room, located down the hall from the lobby. All fatalities were later identified as employees of the hotel. A temporary morgue was setup at the northeast end of the parking lot.

“Overhaul of the second, third, and fourth floors, north side, revealed numerous pieces of the aircraft in several rooms. The main fuselage was located in the center of the building on the second floor. A large section which was believed to have been a part of the right wing was found on the collapsed carport. It still contained some fuel and had to be lifted off by use of a crane. The nosewheel and strut were located in the middle of Bradbury Avenue. The left main gear was located in the southwest corner of the Bank One parking lot. The ejection seat and canopy were located behind the bank building, a few hundred feet away.” (USFA TR 14, p. 7-8)

“As stated earlier, there were nine fatalities. Four were burned beyond recognition and had to be identified by utilizing medical and dental records. The remaining five died essentially from smoke inhalation and some thermal burns. All the victims had high levels of carbon monoxide, ranging form 4.1 percent to 76.8 percent. Those with the higher levels were located a distance away from the lobby. According to the Indianapolis Medical Examiner, these high levels of CO indicate that the victims had a momentary awareness of what was happening.

“Those injured by the fire included one female employee who was in the laundry room and escaped through the east end exit of the building. She was transported to the hospital for treatment of burns to the face and hands. According to Chief Lamb, she said she had run through smoke to an exit with which she was familiar. All of those who stayed behind in the laundry room died.

“Another injury victim was a hotel guest, rescued from the kitchen roof on the south side. He was transported to the hospital for treatment for smoke inhalation and possible fractures. A third victim received burns over 95 percent of his body. He had entered the hotel to use the telephone and was outside heading toward his vehicle parked next to the carport when the plane crashed. He was transported to the hospital.

“The pilot who parachuted from the plane landed a few blocks from the scene and was transported to the hospital for treatment of shock and possible muscle strains.

“One fire fighter from the Airport Fire Department was transported and admitted to the hospital for smoke inhalation. Two Wayne Township fire fighters were treated for smoke inhalation and released….” (USFA TR 14, p. 8)

“The roof of the Bank One building was struck by the plane’s landing gear, which caused about 40 percent of the roof on the southwest side to collapse. There was no fire in this building….” (USFA TR 14, p. 10)

“Military Liaison — A large part of the nation is exposed one way or another to hazardous military cargo. Immediate contact with the military must be established to enable emergency services to assess the risk when such cargo is involved in a fire. If the pilot had not been available for questioning, there would have been a long delay in determining what was on the plane. As it was, there was some delay. Also, some incorrect information was received from Air Force personnel on the scene as to the presence of armaments, according to Chief Lamb. It was difficult initially even to find out where the plane had come from to seek additional information on it. (USFA, pp. 11-12)

Newspapers:

Oct 20, Kokomo Tribune/AP: “Indianapolis (AP) — A jet fighter crashed a mile short of an Indianapolis International Airport runway today, plowing into a hotel where at least seven people died and others were injured as the plane exploded in a “fireball,” police and witnesses said.

“Up to 25 people were missing and seven were confirmed dead in the accident at the 220-room Ramada Inn Airport, which occurred just after 9 a.m., said Robert Duncan, an attorney for the Indianapolis Airport Authority.

“Up to 10 people were transported to area hospitals, said Larry Curl, a spokesman for the fire department rescue units on the scene.

“The A-7D Corsair jet fighter went down about one mile east of the airport, first hitting a bank building and slamming into the north side of the building.

“The hardest hit areas were the second and third floors of the hotel, with the point of impact at the second floor, just above the main lobby. Black smoke poured from the building.

“The pilot of the plane, which was a Pennsylvania Air National Guard jet fighter,[5] bailed out before the crash, and apparently was not seriously injured, a broadcast reporter at the scene said.

“Jim Yanuzzi, 38, of Flemington, N.J., a guest staying in a second-floor room in the east end of the motel, said he heard “a big explosion and the whole building shook. “I went to the door, opened the door, and the hall was full of black smoke. I went back into the room, grabbed a chair and broke out the window.” He said he jumped onto the roof of a first-floor structure and then climbed down a ladder to get to the ground. Outside, Yanuzzi said he saw a man on fire rolling on the ground and several women running out of the motel.

“A temporary morgue was established at the east end of the hotel. Authorities believe 107 people were in the building at the time.

“Firefighters continued to search room-to-room for more people….

“There are numerous hotels on the east side of the airport area, about 10 miles from downtown Indianapolis.

“Bob Horn, executive assistant manager at the nearby Adam’s Mark Hotel, said: “There are a lot of casualties that they are taking out of the building. The hotel ran close to full last night.” Horn said the plane scraped the front of Bank One and crashed into the front of the hotel, “right in front of the canopy.” “There is a lot of emergency equipment in front of the hotel and it’s pretty badly burned,” Horn said. “For the type of disaster there is not that much confusion going on. The building is on fire and the majority of people are out of the building that were able to leave,” he said.

“A disaster center was immediately set up, and streets in the area were closed off.

“Col. William Lofink, deputy commander of 112^thTactical Fighter Group, Pennsylvania Air National Guard, said the airplane was an Air Force A7-D assigned to Nellis Air Force Base, Nev.

He said it was en route from Greater Pittsburgh International Airport to Tinker Air Force Base in

Oklahoma on a routine training mission.[6] “We do a lot of cross-country on weekends,” Lofink said. “He came here on Friday and left at 9:02 a m this morning. He left out of here and the next thing we heard was that he went down.”

“Mort Edelstein of the Federal Aviation Administration office in Chicago said the jet fighter crashed while attempting an emergency landing at the Indianapolis International Airport He confirmed it was a Pennsylvania Air National Guard plane. The military will be conducting the investigation into the accident, Edelstein said.

“The A-7 Corsair is an old, single-engine, single-seat attack jet that was used extensively during the Vietnam War. It is no longer flown by the active Air Force, but is still operated by Air National Guard units in at least 10 states. The A-7 is a subsonic plane designed for ground attack. The plane can be equipped with 20mm or 30mm machine guns and can carry a variety of missiles and bombs under its wings. Built in the 1960s and 1970s by the LTV Aerospace and Defense Co., the plane is 46 feet long and has a wing span of about 39 feet The plane is easily distinguished for its engine inlet, which is located directly below the nose.” (Kokomo Tribune, IN. “Death toll rising from crash of jet.” 10-20-1987, 1.)

Oct 21, Pharos-Tribune/AP: “Indianapolis (AP) – When an Air Force jet fell out of the sky and exploded in a fireball into a westside Ramada Inn, none of the nine victims even had a chance to react.

“”The only thing I saw was devastation,” said eyewitness John Mentzer. “If anyone was in the lobby area they are gone. It was like a napalm bomb. The heat, the flames. It collapsed the whole front of the building.” “I would say those who were killed were killed immediately,” said Jim McCue, director of operations at the Indianapolis Airport Authority. “By the time I got there, the Ramada was on fire,” said Steve Blaser, one of the first people to reach the damaged seven-story hotel…. ‘One was on fire. He was running around and went between two cars. I was screaming at the two guys to get him on the ground. He stumbled to the ground, then we put the fire out with our coats. “All of his clothes were burned off, with just a few rags here and there. His hair was all burned. He was burned badly.” Blaser said. “The fire did not want to go out.”….

“John Kassis, a scientist at the Indiana Department of Environmental Management, said the bubble atop the A7-D Corsair, an Air Force attack jet, came off with a bang. The pilot, Air Force Maj. Bruce Teagarden, 35, of Las Vegas, ejected from the plane a split second later. He suffered only minor bruises in his parachute ride to the ground. Mentzer, vice president of Cummins-Allison , said Teagarden landed in a grassy area between 500 and 800 feet in front of the plant, just northwest of the motel.

“The jet, which had lost power, clipped the roof of a Bank One branch across the street from the Ramada Inn before crashing into the lobby area of the hotel. Bank One security director Fred Roesener said it was amazing that no one in the bank was hurt. The roof, he said, “peeled itself back like the lid on a sardine can.”….

“Eyewitness Bob Eames said it appeared the plane was heading toward a gas station before it hit the motel. “The owner (of the gas station) said, ‘Run. Everybody run.’ I ran in the gas station and got everybody out. By that time, the plane bounced off the street into the lobby of the Ramada Inn. That’s when the big explosion happened,” he said. “We ran back toward the plane and saw a guy get out of his car. He was on fire. He was running, and somebody got him down and wrapped him up in a coat. It was terrible”.” (Pharos-Tribune, Logansport, IN. “Jet Hits Hotel. For the Victims, No Time to React.” 10-21-1987, 7.)

Oct 21, Pharos-Tribune/AP: “Indianapolis (AP) – Something as simple as a bird or as complicated as a fuel interruption can cause the engine failure that led to fiery crash of an Air Force jet, killing nine people at an Indianapolis hotel. “There is no history of mechanical problems for this engine. Gas turbine engines do flame out, and that can occur for a variety of reasons,” said William Campbell, director of communications for Allison Gas Turbine. Campbell said the General Motors Corp. subsidiary manufactured 1,400 of the TF-41D engines that powered the single-engine, A-7D Corsair attack jet. Production of the engine was halted in 1983, Campbell said.

“The Corsair was developed in the 1960s for the Navy, was used extensively in Vietnam and still

is flown off aircraft carriers. The Air Force, which still has 370 of the jets in its inventory, has mostly retired the craft to the Air National Guard, with the exception of the unit that used the jet involved in the Tuesday morning crash.

“An A-7D based with the 4450^th Tactical Group at Nellis Air Force Bass in Nevada crashed into a Ramada Inn while pilot Maj. Bruce L. Teagarden was attempting an emergency landing at Indianapolis International Airport.

“A check of the engine’s serial numbers determined that it had been manufactured in 1972 and had 3,000 hours of service, Campbell said. “We have no way of knowing what caused the problem,” Campbell said Tuesday. “The Air Force will conduct an investigation….

“Engine failure was also blamed in the crash of an Air Force A-7D Corsair in August of 1985 near Tinker AFB in Oklahoma. Two people were killed when the jet crashed into a house. All but two of the A-7Ds had Allison engines like the one in the jet fighter that crashed at Indianapolis, the other two produced by Pratt & Whitney.

“The crash followed an engine ‘flameout,’ which means the flame that ignites the jet’s fuel had been extinguished. The flame acts much like a sparkplug in an automobile, and without it the engine will stop.

“Campbell said an interruption in the fuel supply can cause such a flameout, as can the entry of a

foreign object, such as a bird, into the powerful turbine engine under the fuselage that distinguishes the A-7D. “You just don’t know. The pilot needs to be interviewed to find out the circumstances he was under,” Campbell said.

“The plane was found in good working order during a four-hour inspection Monday at Greater Pittsburgh International Airport, where Tuesday’s flight originated. Col. Lawrence Santerini, group commander of the 112th Tactical Fighter Group of the Pennsylvania Air National Guard, said mechanics there thought the engine was in good condition.

“Campbell said the company began manufacturing the engine in a joint project with Rolls-Royce during the 1960s. A fact sheet on the aircraft states the engine provides 13,390 pounds of thrust for the 45-foot, 7-inch plane. The A-7D has a maximum range of 2,871 miles with its normal fuel load of 1,425 gallons.

“The jet that crashed had traveled approximately 350 miles from Pittsburgh.

“The engine’s service record shows that it had been flown 1,100 hours since its last major overhaul. It was due to be overhauled again after 400 more hours. “That’s not too long and the record indicates the engine received satisfactory service,” Campbell said…. “The engine is still in front-line aircraft of the U.S. Navy”.” (Pharos-Tribune, Logansport, IN. “Engine Failure Cause is Hard to Pinpoint.” 10-21-1987, 7.)

Oct 21, AP: “Greensburg, Pa. (AP) – A pilot whose jet crashed into a hotel near the Indianapolis International Airport, killing nine people, attended a friend’s funeral and visited his in-laws before taking off on his ill-fated trip.[7]

“Air Force Maj. Bruce L. Teagarden, 35, of Las Vegas, Nev., ejected at about 800 feet [300] before his A-7D Corsair jet exploded in a fireball into the Ramada Inn Airport hotel Tuesday morning. He was treated at an Indianapolis hospital and released.

“The Greensburg Tribune-Review reported today that Teagarden flew to southwestern Pennsylvania last weekend to attend the funeral of a man he met while the two were attending West Virginia University during the 1970s. The man, Gary Swisher, also a pilot, was buried in his hometown of Mannington, W.Va.[8] “He was sad, but he took Gary’s death in stride,” his mother, Mrs. Hiram Teagarden of Mount Morris, told the Tribune-Review.

“Teagarden grew up in the Greene County community of Mount Morris, just north of the Pennsylvania-West Virginia border, and graduated from WVU in 1975. He spent Monday night with his in-laws, Regis and Elizabeth Susalla of Plum, just east of Pittsburgh. Susalla said Teagarden talked about his wife, Katherine, and their two children.” (Pharos-Tribune, Logansport, IN. “Pilot Attended Funeral Day Before.” 10-21-1987, 7.)

Oct 21, Pharos-Tribune/AP: “Indianapolis (AP) — The Air Force plane that crashed into a hotel killing at least nine people approached the airport from too high an altitude on his first try and had to go around again, an airport official said.

“Pilot Maj. Bruce J. Teagarden, 35, of Las Vegas, Nev., notified the tower at about 9:12 a.m. of his emergency. Three minutes later, the plane crashed into a hotel and engulfed it in flames, said Robert Spitler of the Indianapolis Airport Authority. The plane skimmed the roof of a bank and crashed into the Ramada Inn Airport hotel at 9:15 a.m….

“”He’d come down, but could not get rid of the altitude quick enough and came over the airport too high,” Spitler said.

“The controllers earlier decided to have him land at another runway, giving the pilot a chance to circle and get closer to the ground, he said.

“Spitler said the last communication from the pilot was that “he was making a right turn, and that he was going to have to get out. He was looking for an open field, and he was going to have to get out of the airplane”.” (Pharos-Tribune, Logansport, IN. “Plane Was Too High on 1^st Try.” 10-21-1987, 7.)

Oct 22, Pharos-Tribune/AP: “Indianapolis (AP) — An Air Force general is confident investigators will learn what caused the engine of a Corsair A-7D attack jet to fail and send the craft crashing into a hotel, but he says it may take more than a month to do so. Brig. Gen. Joel T. Hall of Nellis Air Force Base, Nev., said the investigation into Tuesday’s crash that killed nine employees of the Airport Ramada Inn hotel could last as long as 40 days. But he said he was sure the seven-member Air Force Mishap

Investigation Board would find the reason behind it. “I wouldn’t say that 100 percent we are always successful, but my experience is that we are always able to determine what caused it,” Hall said Wednesday. “Pretty much when it is a mechanical thing, we can generally find out.”

“A memorial service for the nine hotel employees, who ranged from an assistant manager to a pair of busboys, was to be held at a downtown church today.

“Six other people were injured, and one, Tom Murray, 41, of Indianapolis, remained in “very critical condition” at Wishard Memorial Hospital today with third-degree burns on 95 percent of his body.

“The crash occurred Tuesday morning when the jet experienced engine failure 15 miles south of

Indianapolis, overshot an emergency landing at Indianapolis International Airport and plowed into the hotel’s lobby while circling back. The pilot, Maj. Bruce L. Teagarden, said he aimed the

crippled plane for an open field but could not control it….

“Hall said he began questioning Teagarden Wednesday, but the process was moving slowly. “He has some emotional problems, and it is going to take several days to walk through this.” “It’s tragic. I understand the anguish. But he did the best he could. Air Force policy is to minimize the loss of life in a crash, and as best we can determine that’s what he did,” Hall added.

“The Air Force investigators were expected to remain on the scene two weeks. By Wednesday evening they had recovered most of the single jet engine that powered the Corsair. Hall said the remaining jet wreckage should be pulled from the hotel by Friday….” (Pharos-Tribune, Logansport, IN. “Pilot Did All He Could.” 10-22-1987, p. 8.)

Oct 24, Wisc. State Journal/AP: “Indianapolis (AP) — Air traffic controllers probably made “a bad call” in their directions to the pilot of an Air Force jet that crashed into a hotel, killing nine of its employees, an aviation safety official says….John Galipault, president of Aviation Safety Institute in Worthington, Ohio, said tower personnel at Indianapolis International Airport may have disregarded alternatives that could have prevented the disaster.

“The Aviation Safety Institute is a recognized authority on air safety that conducts independent crash investigations and maintains a data bank of all air incidents.

“Galipault said that after controllers realized Teagarden was too high on his initial approach they should have told him to spiral right immediately instead of going the length of the runway, the Indianapolis News reported Friday. Teagarden might then have been able to steer his A-7D around for another try at the same runway, Galipault said. “I think it’s probably a bad call,” Galipault told the newspaper. “He’s continuing to lose altitude and they should have spun him right there.”

“However, Federal Aviation Administration officials said an initial review indicates air controllers acted properly. “Now these guys who are saying the controller should have done such and such, you know, that’s really nothing more than Monday morning quarterbacking or second guessing after the fact,” said FAA chief spokesman John Leyden. FAA officials have not released any information on the exchanges between the pilot and the controllers.” (Wisconsin State Journal, Madison. “Controllers faulted in jet crash.” 10-24-1987, 2.)

Oct 25, Pacific Stars and Stripes/UPI: “Indianapolis (UPI) – The crash of a disabled Air Force into a hotel lobby could have been averted had air traffic controllers on duty done a better job, an aviation safety expert and two former controllers said in a published report Friday…. James Tanner of Terre Haute, who served as president of Local 358 of the Professional Air Traffic Control Organization, called it “a cardinal sin” to allow the plane to turn over a populated area.” (Pacific Stars and Stripes, Tokyo. “Experts question wisdom of controllers in A-7D crash.” 10-25-1987, 4.)

Oct 26, Pharos-Tribune/AP: “Indianapolis (AP) – The Air Force has paid more than $50,000 in claims in the six days since a military jet lost power and crashed into a Ramada Inn hotel here, killing nine people and injuring six others. As of noon Sunday, the Air Force…had paid $50,427 on 55 property claims stemming from the accident last Tuesday, said Capt. Grant Berggren, an Air Force claims officer. Also, 15 to 20 hotel employees had received an average of about $500 apiece from the Air Force claims office to help them get through the first few days after the crash, said Robert Taylor, who was food and beverage director at the Ramada. “At this point the Air Force has been giving some emergency assistance. That is minimal. When you have rents and doctor bills due, you need assistance,” Taylor said Saturday….

“Meanwhile, Thomas Murray, 37, a salesman from Carmel who had stopped at the hotel to use a

telephone moments before the crash, remained in critical condition Sunday at Wishard Memorial

Hospital with burns over 95 percent of his body. The other injured have all been treated and released….

“The jet pilot returned to Nevada Saturday and, in accordance with standard procedure, will be grounded at least until the Air Force investigation is completed, Air Force officials say. “Also, he will not fly until a flight surgeon determines that he is emotionally and physically able,” said Col. William H. Johnson, who said Maj. Bruce L. Teagarden, 35, remains distraught about the crash. Teagarden…returned Saturday to Nellis Air Force Base, Capt. Ron McGee said Sunday.” (Pharos-Tribune, Logansport, IN. “Fighter Pilot Grounded After Ramada Crash.” 10-26-87, 13.)

Oct 30, Pharos-Tribune/AP: “Indianapolis (AP) – A salesman severely burned by fuel from the Air Force jet that crashed into the Airport Ramada Inn has died, raising the death toll from the crash to 10. Thomas D. Murray, 37, of Carmel, had stopped at the hotel to make a telephone call moments before the Oct. 20 crash, which instantly killed nine other people — all Ramada Inn employees….

“Murray died at 5:23 p.m. Thursday at Wishard Memorial Hospital in Indianapolis, hospital officials said. He had suffered third-degree burns over 95 percent of his body and chemical burns to his lungs, the hospital said. “He said he had just got done using the telephone in the lobby and was walking to his car” when the crash occurred, Kevin R. Fitchey, an emergency medical technician, said at the time.

“Murray, the father of four children ages 2 to 14, was treated at Wishard’s Burn Unit, where immediately following the crash doctors performed a procedure to restore circulation in his body. His burned skin was bathed in antibiotics and his body completely swathed in bandages. He was kept heavily sedated after the accident and was prevented from talking by a tube inserted in his throat to keep his airway from closing, said his physician, Dr. Shirley A. Madison.

“Murray’s clothing burst into flames when the jet crashed, and witnesses arriving on the scene struggled to put out the fire with a coat. “He had just fallen down. He was on fire and most of his clothes were burned off,” Fitchey said. “He was in shock and he said, ‘Help me, help me.”

“Murray was a district sales manager for Haynes International Inc., a metal products company in Kokomo….” (Pharos-Tribune, Logansport, IN. “Indianapolis Jet Crash Claims its 10^th Victim.” 10-30-1987, 1-2.)

Nov 24, AP: “Des Plaines, Ill. (AP) — The pilot of a powerless jet fighter asked whether he was nearing populated areas moments before his craft crashed into an Indianapolis hotel, but air traffic controllers never replied, according to a tape released Tuesday….

“Authorities have said that Maj. Teagarden, 35, couldn’t see the ground 10 tell if his plane was near a populated area because of clouds and that he didn’t see the ground until he was about 800 feet above it. “I’ll be dead-sticking it in. And say if there is any kind of housing area close to me in case I have to get rid of this thing,” Maj. Teagarden said on the tape.

“”I can’t answer the question as to why that transmission was not responded to,” Federal Aviation

Administration spokesman David Erickson told reporters after playing the tape at a news conference. “I don’t know what was going through the controller’s mind,” Mr. Erickson said. He said that would be part of the Air Force’s investigation of the accident, but declined to discuss the investigation. In an interview, Mr. Erickson said that when the pilot asked the question he was still over rural land about eight miles southwest of the Indianapolis International Airport. Mr. Erickson said even if the pilot had veered his plane away from the hotel after he overshot the runway, it likely would have hit a warehousing area or a shopping center. “Right or left, it’s take your pick.”

“While the FAA has no set procedure for answering questions about whether a potential crash site is populated, Mr. Erickson said, “it’s a question that … if the controller knows, he tells them.” “I believe the controllers did what they thought was the right thing to do,” he said.

“Except for Maj. Teagarden’s five “Mayday” distress calls, the voices of the controllers and the pilot sounded calm on the tape. “Mayday, Mayday. This is Chaps 2-4 (Maj. Teagarden’s call sign). I just lost an engine,” the pilot first told controllers. Later a controller asked, “Chaps 2-4, will you be able to accept a turn away from the airport for traffic?” “Negative. I’ve got to get on the ground,” replied Maj. Teagarden, who was flying from Pittsburgh to his home base near Las Vegas, Nev.

“Controllers gave Maj. Teagarden weather and local altimeter settings. But the tapes do not indicate they asked for his rate of descent. Mr. Erickson said the controllers could monitor the plane’s rate of descent on radar.

“Mr. Erickson said that after Maj. Teagarden missed one runway, controllers told him to turn right toward a second runway, “the closest runway possible and into the wind,” but that prompted the pilot to say: “And Chaps 2-4 is no joy.” “By ‘no joy,’ he meant, “I do not see the airport,” Mr. Erickson said.

“Although Maj. Teagarden managed to turn the unarmed jet right toward the second runway, the plane was gliding too fast and he missed. “Unable. Unable, and it looks like I might have to get out of it, and I’m going down in a housing area,” Maj. Teagarden told the tower seconds before he ejected. The plane clipped the corner of a bank, skidded across a street and crashed into the lobby of the Ramada Inn.” (Frederick Post, MD. “Controllers never replied. Tape of jet fighter’s last minutes released.” 11-25-1987, B3.)

Dec 11/AP: “Indianapolis (AP) — No action is expected against the air traffic controller who did not respond when the pilot of a powerless Air Force jet warned he might have to crash and asked if he was near a populated area, a federal official said….Mori Edelstein of the Federal Aviation Administration’s regional office in Des Plaines, III., said the controller didn’t do anything wrong

“He apparently didn’t hear the guy,” Edelstein said in a telephone interview.

“The FAA’s official investigation of the incident is finished, but it has not been released publicly.

The agency will turn over its report to the Air Force, which is conducting the only other investigation into the crash.

“The pilot, Maj. Bruce L. Teagarden, tried unsuccessfully to restart the engine of the jet when its

power went out not far from Indianapolis International Airport….” (European Stars and Stripes, Darmstadt. “Probe clears controller in crash of Air Force jet.” 12-11-1987, 7.)

Dec 14, AP: “Indianapolis (AP) — Two air traffic controllers who dealt with a disabled military jet that crashed into a hotel and killed 10 people returned to their jobs within three hours of the fatal crash, published reports say. One of their supervisors said there was no reason why the controllers could not return to work, but a former controller says the two should have remained off the job at least for the rest of the day.

“The Indianapolis Star reported Saturday that one controller, whom it identified as Richard D. Arnold, not only completed his normal shift on the day of the Oct. 20 crash, but also returned to

work 7½ hours later….” (Pharos-Tribune, Logansport, IN. “Controllers on Job Hours After Crash.” 12-14-1987, 3.)

Jan 13, AP: “Las Vegas, Nev. (AP) — Mechanics knew a driveshaft spline[9] was prone to excessive wear more than a year before the part failed in an Air Force jet that crashed into an Indianapolis hotel, an Air Force report said. The part was not replaced in the doomed A-7D Corsair fighter, however, because the jet’s engine had undergone maintenance just prior to a directive ordering the driveshaft splines be inspected during compressor maintenance, the report said. The engine of the A-7D Corsair fighter jet flamed out several miles from Indianapolis and the plane crashed into the Airport Ramada Inn, killing 10 people on Oct. 20…

“The report released Tuesday [Jan 12] also said that there was confusion between air traffic controllers and the pilot, whose initial distress call was blocked by other radio calls.

“”It’s pretty evident what happened,” said Maj. Victor Andrijauskas, a spokesman at Nellis Air force Base, where the plane and its pilot were based. “To make it simple, it was a driveshaft that attached to a turbine that failed. When it failed, it precluded the engine from getting fuel, air and ignition.”

“The pilot, Maj. Bruce Teagarden, told Air Force investigators he made every effort to point the plane away from populated areas, but the aircraft still banked to the right when he ejected. “(After ejection) I was looking right over the tail of the airplane and it wasn’t going where I aimed it,” said Teagarden. “It was in a right bank. I saw it going right for a big building.”

“The report revealed that Air Force mechanics had noticed excessive wear on the drive-shafts of three jets similar to the one that crashed.” (Pharos-Tribune, Logansport, IN. “Worn Part Cause of Jet Crash.” 1-13-1988, 1.)

Jan 14/AP: “Las Vegas, Nev. (AP)…. The report said problems with drive-shaft splines — teeth that fit into grooves on the turbine to drive various parts of the engine — were first noticed by Air Force mechanics overhauling an A-7D engine in November l984. Excessive wear also was found on two jets in March 1986 and May I986. A directive to check drive-shaft splines during compressor work on Corsairs went into effect in October 1986, four months after the doomed jet’s final compressor maintenance, according to the report….

“The pilot was about 800 feet above the ground when he broke out of clouds and began searching for an area to eject, the report said. He saw a pie-shaped field, aimed the plane at it and ejected while about 300 feet above the ground. Teagarden has been grounded until a flight evaluation board determines whether he acted properly.” (European Stars and Stripes. “Drive-shaft wear cited in AF jet crash report.” 1-14-1988, 3.)

Jan 18/AP: “Indianapolis (AP) — An Air Force spokesman says the crash of a fighter jet into an Indianapolis hotel has prompted the Air Force to check oil samples for signs of engine wear after every long-distance flight….An Air Force report released this week blamed the crash on worn splines that prevented the craft’s jet turbine from locking into the driveshaft, cutting off the flow of fuel and air. Master Sgt. Glen Everett of Nellis Air Force Base, Nev., which conducted the investigation, said oil samples now will be taken and checked for metal particles that would indicate engine wear after every long-distance flight.” (Kokomo Tribune, IN. “Fighter crash changes routine.” 1-18-1988, p. 8.)

Sources

Baugher, Joseph F. 1969 USAF Serial Numbers. 1-10-2012 revision. Accessed 3-10-2012 at: http://www.joebaugher.com/usaf_serials/1969.html

European Stars and Stripes, Darmstadt, Germany. “Drive-shaft wear cited in AF jet crash report.” 1-14-1988, p. 3. http://newspaperarchive.com/FullPagePdfViewer.aspx?img=133602955

European Stars and Stripes, Darmstadt, Germany. “Probe clears controller in crash of Air Force jet.” 12-11-1987, 7. At: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=133601760

Frederick Post, MD. “Controllers never replied. Tape of jet fighter’s last minutes released.” 11-25-1987, B3. At: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=14143935

Kokomo Tribune, IN. “Death toll rising from crash of jet.” 10-20-1987, p. 1. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=115546721

Kokomo Tribune, IN. “Fighter crash changes routine.” 1-18-1988, 8. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=113628915

Pacific Stars and Stripes, Tokyo, Japan. “Experts question wisdom of controllers in A-7D crash.” 10-25-1987, 4. http://newspaperarchive.com/FullPagePdfViewer.aspx?img=133293897

Pharos-Tribune, Logansport, IN. “Controllers on Job Hours After Crash.” 12-14-1987, 3. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109405354

Pharos-Tribune, Logansport, IN. “Fighter Pilot Grounded After Ramada Crash [Indianapolis].” 10-26-1987, 13. At: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109404452

Pharos-Tribune, Logansport, IN. “Indianapolis Jet Crash Claims its 10^th Victim.” 10-30-1987, p. 1. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109404522

Pharos-Tribune, Logansport, IN. “Jet Hits Hotel. For the Victims, No Time to React.” 10-21-1987, p. 7. At: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109404340

Pharos-Tribune, Logansport, IN. “Pilot Did All He Could.” 10-22-1987, p. 8. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109404365

Pharos-Tribune, Logansport, IN. “Worn Part Cause of Jet Crash.” 1-13-1988, p. 1. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=109405832

United States Fire Administration. Ramada Inn Air Crash and Fire, Wayne Township, Indiana (October 20, 1987) (Technical Report Series 014). Emmitsburg, MD: USFA, National Fire Data Center, Federal Emergency Management Agency, 47 pages. Accessed 10-24-2016 at: http://www.interfire.org/res_file/pdf/Tr-014.pdf

Wisconsin State Journal, Madison. “Controllers faulted in jet crash [Indianapolis].” 10-24-1987, p. 2. Accessed at: http://newspaperarchive.com/FullPagePdfViewer.aspx?img=162135016

[1] The 4450 Tactical Group is now an inactive USAF unit. It was a classified unit, active from Oct 15, 1979 to Oct 5, 1989, developed to fly F-117 “Stealth” aircraft. The unit was officially headquartered at Nellis AFB, Nevada, but operationally located at Tonopah Test Range, NV. “The 4450^th TG…operated the A-7D Corsair II as a surrogate trainer for the F-117A, and…later the A-7D’s were used for F-117A chase testing and other weapon tests at the Nellis Range.” (Wikipedia. “4450^th Tactical Group.” 3-3-2012 modification.)

[2] Air Traffic Control.

[3] This may well not be accurate. From The Reporter: “On 2 April 1992, the United States reached settlement in the last three lawsuits arising out of the crash of an A-7D aircraft into the Ramada Inn near the Indianapolis airport on 20 October 1987. All claims and litigation arising out of this mishap have now been settled….As a result of this mishap, 168 claims were filed against the Air Force, of which 150 claims (including 3 wrongful death claims) were settled administratively under the Military Claims Act for $1.9 million…. (The Reporter. “A-7D Crash, Ramada Inn, Indianapolis, Indiana.” Vol. 19, No. 2, p. 17.)

[4] No sources are cited at any point in this material.

[5] This, apparently, was a “misdirection.” This was a USAF plane “enroute to Nevada’s Tonopah Test Range and Nellis AFB…,” where it was stationed. (Check-Six.com. “Flying in an Analog…in Indianapolis, Indiana 20 October 1987.”). See, also, later newspaper reports cited below.

[6] Ibid.

[7] Which raises the question – was Major Teagarden allowed by the USAF to fly the A-7D cross-country just to attend his friend’s funeral, under the classification of a “training” mission?

[8] Major Gary Swisher “who was killed October 8 when his fighter plane crashed in North Carolina.” (Check-Six.com. “Flying in an Analog…in Indianapolis, Indiana 20 October 1987.”)

[9] “Splines are ridges or teeth on a drive shaft that mesh with grooves in a mating piece and transfer torque to it, maintaining the angular correspondence between them…” (Wikipedia. “Spline (mechanical).” 1-21-2012 mod.)

20th Century

1987 — Sep 30, Residence Fire, Milwaukee, WI — 12

lornajarrettblanchard September 30, 1987

— 12 National Fire Protection Association. Key Dates in Fire History. 1996.

— 12 NFPA. The U.S. Fire Problem Home Fires with Ten or More Fatalities (1980-2007). 2008

— 12 NFPA. U.S. Unintentional Fire Death Rates by State. December 2008, p. 26.

— 12 USFA. Four House Fires that Killed 28 Children (USFA-TR-020). December 1987, 1.

Narrative Information

USFA: “At approximately 0442 on September 30, 1987, the Milwaukee Fire Department received a public telephone alarm from an unknown person advising the dispatcher of a residential fire at 1738 North 23rd Street. Thus began the most tragic residential house fire in the city’s history. The pre-dawn blaze killed 12 people, 10 of whom were children under the age of nine. Three adult occupants escaped unassisted….

“That a total of 15 people occupied the property at the time of the fire points to one of the major reasons why this fire took such a toll and serves as a sad reminder that poverty and overcrowding create an especially dangerous potential for disaster. Moreover, the home had no smoke detectors and a high fire loading in large part due to the bedding, clothes, and other household items of the 15 occupants. An open stairwell to the second floor enabled the fire and smoke to travel unimpeded from the first floor – trapping the occupants.” (USFA. Four House Fires that Killed 28 Children, 1987)

“Had working smoke detectors been present it is likely that at least some lives would have been saved. Neighbors heard cries for help. Some of the occupants had awakened and succeeded in escaping. The adults and most of the children who died were found in locations other than their beds, indicating that they too had been aroused from sleep and had made an attempt to flee the fire. With more lead time the number of survivors likely would have been greater. The lesson of how critical smoke detectors are to saving lives is taught once again in this fire and in the others discussed later in this report….

Three weeks before the fire a city building inspector, responding to complaints from the home’s principal tenant, checked conditions and noted over 20 code violations. Most of the violations, however, posed no immediate threat. The inspector also was reported by the local press to have mentioned after the fire that detectors were absent, but that fact was not included in the list of repairs and improvements cited in the inspector’s report. Whether the inspector did or did not note the absence of detectors is a subject of controversy. The owner of the building claimed that the house had had two functioning smoke detectors – one upstairs and one downstairs, but evidence of them was not found….” (USFA. Four House Fires that Killed 28 Children, 1987, 6)

“The cause of the pre-dawn blaze in the 93-year-old wood frame house has not been determined. The house was not equipped with smoke detectors. A Milwaukee city ordinance requires smoke detectors in all homes built before 1980; occupants were responsible for detector installation in rental properties such as the house in this incident….

“At the time of the fire, the house was occupied by 15 people, five adults and 10 children, most of whom were related. The main tenant was in the process of getting settled after moving north from southern Florida. Her sisters and brother, and seven of their children, had joined her and her two children in Milwaukee. A friend and another friend’s child were also staying there at the time. The fire killed two of the adults and all 10 children….” (USFA. Four House Fires that Killed 28 Children, 1987.)

“All the victims died of smoke inhalation, according to the medical examiner. Carbon monoxide levels ranged from 60-90 percent – much higher than the 45-50 percent considered lethal.” (USFA. Four House Fires that Killed 28 Children, 1987, p. 8)

Sources

National Fire Protection Association. Key Dates in Fire History. 1996. Accessed 2010 at: http://www.nfpa.org/itemDetail.asp?categoryID=1352&itemID=30955&URL=Research%20&%20Reports/Fire%20statistics/Key%20dates%20in%20fire%20history&cookie%5Ftest=1

National Fire Protection Association. The U.S. Fire Problem. “Home Fires with Ten or More Fatalities (1980-2007).” Quincy, MA: NFPA, April 2008 update. Accessed at: http://www.nfpa.org:80/itemDetail.asp?categoryID=953&itemID=30981&URL=Research%20&%20Reports/Fire%20statistics/The%20U.S.%20fire%20problem

National Fire Protection Association (John Hall, Jr.). U.S. Unintentional Fire Death Rates by State. Quincy, MA: NFPA, 31 pages, December 2008.

United States Fire Administration. Four House Fires that Killed 28 Children (USFA-TR-020). Emmitsburg, MD: National Fire Data Center, USFA, FEMA, December 1987, 112 pages. Accessed at: http://www.usfa.dhs.gov/downloads/pdf/publications/tr-020.pdf

20th Century

1987 — Aug 16, Northwest Airlines Flight 255 takeoff crash, hits cars, Detroit, MI — 156

lornajarrettblanchard August 16, 1987

— 156 Associated Press. “Some of the Deadliest Plane Crashes on Takeoff.” 8-20-2008.

— 156 NTSB. AAR. Northwest Airlines, Inc…Detroit Metropolitan Wayne County Airport…

— 156 Sanders, D. E. A. (Chair). The Management of Losses Arising from… 2002, p. 177.

Narrative Information

NTSB Abstract: “About 2046 eastern daylight time on August 16, 1987, Northwest Airlines, Inc., flight 255 crashed shortly after taking off from runway 3 center at the Detroit Metropolitan Wayne County Airport, Romulus, Michigan. Flight 255, a McDonnell Douglas DC-9-82… N312RC, was a regularly scheduled passenger flight and was en route to Phoenix, Arizona.

“According to witnesses, flight 255 began its takeoff rotation about 1,200 to 1,500 feet from the end of the runway and lifted off near the end of the runway. After liftoff, the wings of the airplane rolled to the left and the right about 35” in each direction. The airplane collided with obstacles northeast of the runway when the left wing struck a light pole located 2,760 feet beyond the end of the runway. Thereafter the airplane struck other light poles, the roof of a rental car facility, and then the ground. It continued to slide along a path aligned generally with the extended centerline of the takeoff runway. The airplane broke up as it slid across the ground and postimpact fires erupted along the wreckage path. Three occupied vehicles on a road adjacent to the airport and numerous vacant vehicles in a rental car parking lot along the airplane’s path were destroyed by impact forces and/or fire.

“Of the persons on board flight 255, 148 passengers and 6 crewmembers were killed; 1 passenger, a 4-year-old child, was injured seriously. On the ground, two persons were killed, one person was injured seriously, and four persons suffered minor injuries.

“The National Transportation Safety Board determines that the probable cause of the accident was the flightcrew’s failure to use the taxi checklist to ensure that the flaps and slats were extended for takeoff. Contributing to the accident was the absence of electrical power to the airplane takeoff warning system which thus did not warn the flightcrew that the airplane was not configured properly for takeoff. The reason for the absence of electrical power could not be determined.” (pp. i-ii.)

Sources

Associated Press. “Some of the Deadliest Plane Crashes on Takeoff.” 8-20-2008. Accessed at: http://www.usatoday.com/news/world/2008-08-20-1787172586_x.htm

National Transportation Safety Board. Aircraft Accident Report. Northwest Airlines, Inc., McDonnell Douglas DC-9-82, N312RC Detroit Metropolitan Wayne County Airport, Romulus, Michigan, August 16, 1987 (NTSB/AAR-88/05). Washington, DC: NTSB, 5-10-1988, 138 pages. Accessed 10-27-2016 at: http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-reports/AAR88-05.pdf

Sanders, D.E.A. (Chair), et al. The Management of Losses Arising from Extreme Events. GIRO, 2002, 261 pgs. At: http://www.actuaries.org.uk/__data/assets/pdf_file/0009/18729/Sanders.pdf

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