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Aircraft Accident Report
"TWO HUMAN FACTORS WHICH BECAME THE CAUSE OF THE CRASH OF AMERICAN AIRLINES FLIGHT 1420's CRASH"
ABSTRACT
This report explains the two major human errors which lead to the American Airline Flight 1420's crash which flew off from "Dallas-Fort Worth International Airport" and was supposed to land on "Little Rock National Airport" on "June 1, 1999". The first cause was not changing the landing approach after coming to know that the weather conditions has changed at the "Little Rock National Airport" and the second reason was non-deployment of the spoilers automatically or manually. It will be proved in this report that both of them were the major causes through proper proofs. The Cockpit voice recorder(CVR) will be used for proving non-deployment of the spoiler was a reason and the detailed weather forecast and the communication between the flight crewmembers and the control room will server as the evidence for proving the former cause of accident stated above. After that all the subevents will be linked which will lead to the makingof the track which will finally lead to the major accident which happened.
Question: Develop a project by identifying no more than two human factor issues, using logic to explain the rational that you feel were significant elements in the error chain leading to the terminal event.
Explains the scope of the project. Assess the accident in terms of human factor errors by using the HFACS model.
Answer:
THE REPORT
"The Human Factors Analysis and Classification System"framework gives an apparatus to aid the examination procedure and target preparing and counteractive action endeavors.The individual methodology stresses hazardous acts coming about because of slips, lapses, fumbles,mistakes, and infringement of safety rules. The individual methodology blames the errors that lead to mishaps on human failings, for example, absent mindedness, poor inspiration, lack of regard, carelessness, and neglectfulness. It is a fact that most of the big accident occur while having human errors as their main cause. And so was the case with "American Airlines Flight 1420" which was anair trip from "Dallas-Fort Worth International Airport(DFW)" to "Little Rock National Airport" in the "United States". It happened on "June 1, 1999" when the " Flight 1420" overran the runway upon landing in "Little Rock" and had to face a crash. 145 people were sitting on the plane at the time of the crash, but only eleven out of 145 including the one of the captains and ten passengers were killed.
NHTSA once conducted a study in which the findings about accidents were eye opening, i.e. they found out that perhaps a two percent of accidents were caused due to environment reasons, two percent were caused because of transportation vehicles, and other two percent were backed with unknown reasons. It will be shocking to hear that perhaps a total of nighty four percent (94%) accidents were caused because of human errors. Which stands by the claim of this report which states that the American Airlines Flight 1420 crash's main reason was human errors. And the two main human errors which became the vital reason of the plane crash will be briefly discussed in this report. Two main human errors linking with so many small incidents which occurred right before the accident caused the major accident to occur.
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First of all, the two main causes of the accident were related to human errors. The first cause was the ignorance of the two pilots present on the planeregarding the weather circumstances at the airport upon which the plane was going to land i.e. "The Little Rock National Airport in the United States". Furthermore, the second important reason/cause which contributed to the accident was the automatic spoiler system. Both of these factors will be proved with respect to proper proofs, later in this report. The bad weather conditions at the landing airport, which were ignored, will be proved with the help of proper reports and data present in the files of the authorities who were in responsible of conveying the weather information and statistics to the people in the flight crew i.e. the two flight captains, and the failure of the spoiler system will be proved with the help of the "Cockpit Voice Recorder (CVR)". The plane which had to go through the accident, which is under discussion also, was furnished with a "Fairchild model A-100A CVR, serial number 53282". The CVR has the voice recording saved in it through four microphones,positioned at diversepoints. The four microphones placed at dissimilarsites, one was at the cockpit area, second was at the first officer's audio panel, another was at thecaptain's audio panel, another was at the interphone & public address system.When the spoilers are opened automatically, a specific type of sound is recorded in the CVR and can be heard later, and in case, if the spoiler system was unable to open automatically as prescribed, then it is manually operated and opened by one of the pilots, and in that case, a different type of voice is heard in the CVR.
The flight crewmembers believed, even after getting the severe weather conditions that the plane could stillscope the "Little Rock National Airport"prior the heavy storm, which they could not.Even one of the pilotseye contact was maintained with the runway as the planed headed for the last approach course.However, upon reaching near to the airport, they came to know to that the weather conditions were not the same as they expected, according to which they planed their approach.The flight team ought to have perceived that the way to deal with "runway 4R" ought not proceed on the grounds that the most extreme crosswind part for leading the arrival had been surpassedwhen the unexpected burst of wind-shear alert was collected. In light of the flight team's inability to sufficiently get ready for the methodology and the quickly falling apart climate conditions, the probability of securely finishing the methodology was diminishing, and the need to go in an alternate direction was logically expanding; thus, the flight group ought to have deserted the methodology that they were previously going to use. But they kept using the same approach.The thing which became the reason for the mishap was to continue using the same way with the arrival at the airport when the most extreme crosswind segment of the organization was surpassed.
The Second main cause of the accident wasthe team's (i.e. the two captains) inability to guarantee that the spoilers had reached out after touchdown. As discussed, the CVR did not record any sound of deployment of Spoiler's deployment, neither automatic nor manual. As explained that first the spoilers are automatically deployed: however, when that does not happen due to any reason, one of the pilots has to do that manually,which in this case did not happen. Even none of the pilots reported to the control room about the not opening of the spoilers, which was such a careless act. Many people have reported that this was such an unusual act as one of the pilots was a chief with 10,000 plus hours of flight time experience and majorly in the MD-80, which he was also flying at the time of the accident.
The auto spoiler framework did not work appropriately, and the spoilers did not naturally reach on the grounds that the spoiler handle was not controlled by any of the two pilots present on the plane.In order to guarantee that the spiller equipping has been finished prior to landing, a high state of operational excess should be there.
The two pilots neglected to confirm that the spoilers had naturally sent subsequent to landing, and the commander neglected to physically expand the spoilers when they didn't reach out automatically. Since spoiler organization is basic for ideal landing execution, strategies to guarantee that the spoilers have sent after the plane has touched down ought to be a compulsory piece of every air bearers' arrival tasks. The absence of spoiler sending drove legitimately to the flight team's issues in halting the plane inside the staying accessible runway length and keeping up directional control of the plane on the runway. The absence of spoiler arrangement was the absolute most significant factor in the flight group's powerlessness to stop the mishap plane inside the accessible runway length.Hence, we have to consider this as a major cause of the accident.
To conclude, it can be said that the two main factors which lead to the accident were none other than the flight team's (i.e. the captains) failure to stop using the same old approach which the had planned before even now when severe thunderstorms and the threats or dangers related to them and the flight operations had been spotted at the airport on which the plane was going to land and the flight team members' (i.e. the two captains) failure to make sure that the spoilers did not reach the ground level after the touchdown.The non-deployment of the spoilers was also because of flight team members' (i.e. the captains)weakened performance due to exhaustion and the stational trauma which was linked to the degermation to land under the conditions.At the end we came to know that the major reasons behind the accidents were human errors, because it's a global truth that almost every accident is backed by human errors, nearly 94% of the total accidents caused on the earth. It is also proven through the "Human Factors Analysis and Classification System (HFACS)" framework that it is a proven accident was caused by human errors i.e. if the pilots changed the landing approach after coming to know that the weather has changed, then the accident would not have even happened. Furthermore, if the crew members would have deployed the spoilers manually when the automatic deployment could not work then they could have been saved the day.Even if the spoilers were not opening after trying them manually, then the flight crewmembers should have immediately reported the control room about the situation so that they could suggest the pilots, another feasible solution. The personal standing at the control room could obviously find them a better way to cater the mentioned problem, as the pilots were in crisis situation, and could not think efficiently of a way out. If all these measures were taken by the flight crewmembers, then the 11 people including the flight' pilot's life could have been saved.
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