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Ethiopian Airlines Flight 302

Ethiopian Airlines Flight 302 was a scheduled international passenger flight from Addis Ababa Bole International Airport in Ethiopia to Jomo Kenyatta International Airport in Nairobi, Kenya. On 10 March 2019, the Boeing 737 MAX 8 aircraft which operated the flight crashed near the town of Bishoftu six minutes after takeoff, killing all 157 people aboard.

Ethiopian Airlines Flight 302
ET-AVJ, the aircraft involved, seen on 8 February 2019, approximately one month before the accident.
Accident
Date10 March 2019 (2019-03-10)
SummaryMCAS design flaw
SiteTulu Fara village near Bishoftu, Ethiopia
8°52′37″N 39°15′04″E / 8.87694°N 39.25111°E / 8.87694; 39.25111Coordinates: 8°52′37″N 39°15′04″E / 8.87694°N 39.25111°E / 8.87694; 39.25111[1]
Aircraft
Aircraft typeBoeing 737 MAX 8
OperatorEthiopian Airlines
IATA flight No.ET302
ICAO flight No.ETH302
Call signETHIOPIAN 302
RegistrationET-AVJ
Flight originAddis Ababa Bole International Airport, Addis Ababa, Ethiopia
DestinationJomo Kenyatta International Airport, Nairobi, Kenya
Occupants157
Passengers149
Crew8
Fatalities157
Survivors0

Flight 302 is Ethiopian Airlines's deadliest accident to date, surpassing the fatal hijacking of Flight 961 resulting in a crash near the Comoros in 1996.[2][3] It is also the deadliest aircraft accident to occur in Ethiopia, surpassing the crash of an Ethiopian Air Force Antonov An-26 in 1982, which killed 73.[4]

This was the second MAX 8 accident in less than five months after the crash of Lion Air Flight 610.[2][5][6][7] Both crashes prompted a two-year worldwide long term grounding of the jet and an investigation into how the aircraft was approved to service.

Aircraft and crew

The aircraft was a Boeing 737 MAX 8, registered ET-AVJ manufacturer's serial number 62450, (construction number 7243), powered by two CFM International LEAP-1B engines.[8] The aircraft was manufactured in October 2018 and delivered on 15 November 2018, making it around four months old at the time of the accident.[9] It had flown from Johannesburg, South Africa as ET858 the night prior.[10]

The captain of the plane was Yared Getachew, 29, who had been flying with the airline for almost nine years[11] and had logged a total of 8,122 flight hours, including 4,120 hours on the Boeing 737.[a] He had been a Boeing 737-800 captain since November 2017, and Boeing 737 MAX since July 2018.[12] At the time of the accident, he was the youngest captain at the airline.[13] The first officer, Ahmed Nur Mohammod Nur, 25, was a recent graduate from the airline's academy with 361 flight hours logged, including 207 hours on the Boeing 737.[b][12][13]

Accident

Flight 302 was a scheduled international passenger flight from Addis Ababa to Nairobi. The aircraft took off from Addis Ababa at 08:38 local time (05:38 UTC) with 149 passengers and 8 crew on board.[5]

One minute into the flight, the first officer, acting on the instructions of the captain, reported a "flight control" problem to the control tower.[15]

Two minutes into the flight, the plane's MCAS system activated, pitching the plane into a dive toward the ground. The pilots struggled to control it and managed to prevent the nose from diving further, but the plane continued to lose altitude.[16]

The MCAS then activated again, dropping the nose even further down. The pilots then flipped a pair of switches to disable the electrical trim tab system, which also disabled the MCAS software. However, in shutting off the electrical trim system, they also shut off their ability to trim the stabilizer into a neutral position with the electrical switch located on their yokes. The only other possible way to move the stabilizer would be by cranking the wheel by hand, but because the stabilizer was located opposite to the elevator, strong aerodynamic forces were pushing on it.[17]

As the pilots had inadvertently left the engines on full takeoff power, which caused the plane to accelerate at high speed, there was further pressure on the stabilizer. The pilots' attempts to manually crank the stabilizer back into position failed.[17]

Three minutes into the flight, with the aircraft continuing to lose altitude and accelerating beyond its safety limits, the captain instructed the first officer to request permission from air traffic control to return to the airport. Permission was granted, and the air traffic controllers diverted other approaching flights. Following instructions from air traffic control, they turned the aircraft to the east, and it rolled to the right. The right wing came to point down as the turn steepened.[17]

At 8:43, having struggled to keep the plane's nose from diving further by manually pulling the yoke, the captain asked the first officer to help him, and turned the electrical trim tab system back on in the hope that it would allow him to put the stabilizer back into neutral trim. However, in turning the trim system back on, he also reactivated the MCAS system, which pushed the nose further down. The captain and first officer attempted to raise the nose by manually pulling their yokes, but the aircraft continued to plunge toward the ground.[17][18]

The aircraft disappeared from radar screens and crashed at almost 08:44, six minutes after takeoff.[14][2][8][19] Flight tracking data showed that the aircraft's altitude and rate of climb and descent were fluctuating.[20] Several witnesses stated the plane trailed "white smoke" and made strange noises before crashing.[21] The aircraft impacted the ground at nearly 700 miles per hour (610 kn; 1,100 km/h).[17] There were no survivors.[5]

It crashed in the woreda (district) of Gimbichu, Oromia Region,[22] in a farm field near the town of Bishoftu, 62 kilometres (39 mi; 33 nmi) southeast of Bole International Airport.[23] The impact created a crater about 90 feet (27 m) wide, 120 feet (37 m) long, and wreckage was driven up to 30 feet (9.1 m) deep into the soil. Wreckage was strewn around the field along with personal effects and body parts.[17][24][25]

Emergency response

Shortly after the crash, police and a firefighting crew from a nearby Ethiopian Air Force base arrived and extinguished the fires caused by the crash.[26] Police cordoned off the site, and Ethiopian Red Cross personnel and air crash investigators moved in. Together with local villagers, they sifted through the wreckage, recovering pieces of the aircraft, personal effects, and human remains. Trucks and excavators were brought in to assist in clearing the crash site. Human remains found were bagged and taken to Bole International Airport for storage in refrigeration units typically used to store roses destined for export, before being taken to St. Paul's Hospital in Addis Ababa for storage pending identification.[24][27] Personnel from Interpol and Blake Emergency Services, a private British disaster response firm contracted by the Ethiopian government, arrived to gather human tissue for DNA testing, and an Israel Police forensics team also arrived to assist in identifying the remains of the two Israeli victims of the crash.[28][29] The Chinese railway construction firm CRSG, later joined by another construction firm, CCCC, brought in large scale equipment including excavators and trucks. They recovered both flight recorders on the 11th of March, with the first being found at 9 am and the second flight recorder found at 1 pm.[c][30][31] The black boxes were given to Ethiopian Airlines and were sent to Paris for inspection by the BEA, the French aviation accident investigation agency.[32]

Passengers

The airline stated that the flight's 149 passengers had 35 different nationalities.[33] Crash victim positive identification was announced on September 13, 2019. Nearly a hundred disaster victim identification (DVI) experts from 14 countries supported the Interpol Incident Response Team (IRT) mission.[34]

Passengers by nationality[35]
Nationality Deaths
Kenya 32
Canada 18
Ethiopia 9
China 8[d]
Italy 8
United States 8
France 7
United Kingdom 7
Egypt 6
Germany 5
India 4
Slovakia 4
Austria 3
Russia 3
Sweden 3
Israel 2
Morocco 2
Poland 2
Spain 2
Belgium 1
Djibouti 1
Indonesia 1
Ireland 1
Mozambique 1
Nepal 1
Nigeria 1
Norway 1
Rwanda 1
Saudi Arabia 1
Serbia 1
Somalia 1
Sudan 1
Togo 1
Uganda 1
Yemen 1
Total 149

All passengers and crew on board, 157 in total, were killed in the accident.[2] Many of the passengers were travelling to Nairobi to attend the fourth session of the United Nations Environment Assembly.[37] A total of 22 people affiliated with the United Nations (UN) were killed, including seven World Food Programme staff, along with staff of the United Nations office in Nairobi, the International Telecommunication Union, and the office of the United Nations High Commissioner for Refugees.[38][39] The Deputy Director of Communications for UNESCO, two staff of General Electric,[40] a retired Nigerian diplomat and senior UN official who was working on behalf of UNITAR, and a staff member of the Sudan office of the International Organization for Migration were also among the dead.[41][42] The airline stated that one passenger had a United Nations laissez-passer.[33] The flight was considered a "UN shuttle" due to its role in linking the African Union headquarters as well as other UN offices in Addis Ababa to the United Nations Office at Nairobi, the organisation's headquarters in Africa.[43][44][45][46] The Addis Ababa-Nairobi route is also popular with tourists and business people. An employee of the Norwegian Red Cross, a British intern with the Norwegian Refugee Council, an environmental agent for the Association of Arctic Expedition Cruise Operators, four Catholic Relief Services staff, and a senior Ugandan police official on assignment with the African Union peacekeeping force in Somalia were also killed.[47][48]

Notable victims on-board included the Italian archaeologist and Councillor for Cultural Heritage of Sicily, Sebastiano Tusa, and Nigerian-Canadian academic Pius Adesanmi.[49][50] Slovak politician Anton Hrnko lost his wife and two children in the crash.[2] Other notable victims included Christine Alalo, a Ugandan police commissioner and peacekeeper serving with the African Union Mission in Somalia.[51]

Responses

Ethiopian Prime Minister Abiy Ahmed offered his condolences to the families of the victims.[5] Ethiopian Airlines CEO Tewolde Gebremariam visited the accident site, confirmed that there were no survivors and expressed sympathy and condolences.[52] Boeing issued a statement of condolence.[53]

The Ethiopian parliament declared 11 March as a day of national mourning.[54] During the opening of the fourth United Nations Environment Assembly in Nairobi, a minute of silence was observed in sympathy for the victims.[55] President Muhammadu Buhari of Nigeria, in his condolence message on behalf of the government and the people of Nigeria, extended his sincere condolences to Prime Minister Abiy Ahmed of Ethiopia, the people of Ethiopia, Kenya, Canada, China and all other nations who lost citizens in the crash.[56]

On 11 March, the FAA commented that the Boeing 737 MAX 8 model was airworthy. However, due to concerns on the operation of the aircraft, the FAA ordered Boeing to implement design changes, effective by April. It stated that Boeing "plans to update training requirements and flight crew manuals in response to the design change" to the aircraft's Maneuvering Characteristics Augmentation System (MCAS). The changes will also include enhancements to the activation of the MCAS and the angle of attack signal.[57] Boeing stated that the upgrade was developed in response to the Lion Air crash but did not link it to the Ethiopian Airlines crash.[58]

On 19 March, the U.S. Secretary of Transportation, Elaine L. Chao, sent a memo to the U.S. Inspector General asking him to "proceed with an audit to compile an objective and detailed factual history of the activities that resulted in the certification of the Boeing 737-MAX 8 aircraft."[59]

Flight International commented that the accident would likely increase unease about the Boeing 737 MAX felt in the aftermath of the Lion Air Flight 610 accident in October 2018, which similarly occurred shortly after take-off and killed everyone aboard.[60] Boeing shares dropped 11% over the weekend;[61] by 23 March, Boeing had lost more than $40 billion in market value, dropping some 14% since the crash.[62]

Groundings

After the Ethiopian Airlines crash, China and most other civil aviation authorities grounded the airliner over perceived safety risks. Boeing CEO Dennis Muilenburg assured President Donald Trump the airplane was safe, in response to Trump's social media comments.[63] Having new evidence of accident similarities, the U.S. Federal Aviation Administration (FAA) grounded the aircraft on March 13, 2019, reversing a Continued Airworthiness Notice issued two days prior.[64][65][66] About 30 MAX aircraft were flying in U.S. airspace at the time and were allowed to reach their destinations.[67] By March 18, regulators grounded all 387 MAX aircraft in service with 59 airlines worldwide and making 8,600 flights each week.[68] Several ferry flights were operated with flaps extended to circumvent MCAS activation.

The grounding subsequently became the longest ever of a U.S. airliner.[69][70] As of January 2020, another 400 newly manufactured aircraft await delivery to airlines pending the aircraft's return to service.

Investigation

 
The MAX uses an adjustable stabilizer, moved by a jackscrew, to provide the required pitch trim forces. Generic stabilizer illustrated.

The Ethiopian Civil Aviation Authority (ECAA), the agency responsible for investigating civil aviation accidents in Ethiopia, investigated the accident. The aircraft manufacturer, Boeing, stated that it was prepared to work with the United States National Transportation Safety Board (NTSB) and assist Ethiopian Airlines.[53] The United States Federal Aviation Administration also assisted in the investigation.[71]

Both the cockpit voice recorder and the flight data recorder were recovered from the crash site on 11 March.[72] The French aviation accident investigation agency BEA announced that it would analyze the flight recorders from the flight.[73] BEA received the flight recorders on 14 March.[74] On 17 March, Ethiopia's transport minister Dagmawit Moges announced that "the black box has been found in a good condition that enabled us to extract almost all the data inside" and that the preliminary data retrieved from the flight data recorder show a clear similarity with those of Lion Air Flight 610 which crashed off Indonesia.[75]

On 13 March 2019, the FAA announced that new evidence found on the crash site and satellite data on Flight 302 suggested that the aircraft might have suffered from the same problem which the aircraft operating Lion Air Flight 610 had suffered from. Investigators discovered the jackscrew that controlled the pitch angle of the horizontal stabilizer of Flight 302, was in the full "nose down" position. The finding suggested that, at the time of the crash, Flight 302 was configured to dive, similar to Lion Air Flight 610.[76] Due to this finding, some experts in Indonesia suggested that the Indonesian National Transportation Safety Committee (NTSC) should cooperate with Flight 302's investigation team.[77] Later on the evening, the NTSC offered assistance to Flight 302's investigation team, stating that the committee and the Indonesian Transportation Ministry would send investigators and representatives from the government to assist with the investigation of the crash.[78]

Preliminary report

On 4 April 2019, the ECAA released the preliminary report on the crash.[14] The preliminary report does not specifically mention MCAS but rather states "approximately five seconds after the end of the ANU (aircraft nose up) stabilizer motion, a third instance of AND (aircraft nose down) automatic trim command occurred without any corresponding motion of the stabilizer, which is consistent with the stabilizer trim cutout switches being in the "cutout" position".[14]

Approximately one minute into the flight, an airspeed of 238 knots (441 km/h; 274 mph) was selected. About 12 seconds later, the autopilot disengaged. The preliminary report asserts that the thrust remained at takeoff setting (94% N1) and the throttles did not move for the entire flight.[14][79] In the next 30 seconds the stabilizer trim moved 4.2 degrees nose down, from 4.6 to 0.4 units.[80] In the next 10 seconds the trim moved back up to 2.3 units as a result of pilot input and the pilots agreed on and executed the stabilizer trim cut-out procedure, cutting power to the trim motor operated by MCAS.[14]

Interim report

On 9 March 2020, the ECAA released an interim report on the crash. This report stated that the left and right angle of attack (AOA) values deviated by 59°. The AOA disagree message did not appear. The left minimum operating speed and left stick shaker speed was computed to be greater than the maximum operating speed without any invalidity detection. The pitch Flight Director bars disappeared then reappeared with left and right displaying different guidance. The left stick shaker activated. The nose-down trim (MCAS) triggered four times. The right over-speed clacker activated. On the third MCAS trigger there was no corresponding motion of the stabilizer, which is consistent with the stabilizer trim cutout switches being in the "cutout" position at that moment. The MCAS design relied on single AOA sensor inputs making it vulnerable to undesired activation. The difference training from B737NG to B737 MAX was inadequate.[12]

Final report

On 23 December 2022, the ECAA released the final report in the crash, which stated:[81]

Repetitive and uncommanded airplane-nose-down inputs from the MCAS due to erroneous AOA input, and its unrecoverable activation system which made the airplane dive with the rate of -33,000 ft/min [−170 m/s] close to the ground was the most probable cause of the accident.

On 27 December 2022, the NTSB released its comments on the accident separately from the final report, saying that the Ethiopian authorities failed to include them in or append them to their report.[82] The NTSB's comments read in part:[83]

Overall, the US team concurs with the EAIB's investigation of the MCAS and related systems and the roles that they played in the accident. However, many operational and human performance issues present in this accident were not fully developed as part of the EAIB investigation. These issues include flight crew performance, crew resource management (CRM), task management, and human-machine interface. It is important for the EAIB's final report to provide a thorough discussion of these relevant issues so that all possible safety lessons can be learned.

The BEA also submitted comments to the draft final report, in which it disagrees with some aspects of the Ethiopian findings, specifically regarding crew performance. The introduction to the BEA's comments reads in part:[84]

The BEA globally agrees with the analysis of the crew performance for phases 4 and 5 of the accident scenario. However, the BEA considers that some aspects of the analysis of the crew performance in the first phases of the flight are insufficiently developed and could improve the understanding of what could have been done by the crew which could have modified the outcome of the flight.

Reactions to the investigation

Statements from parties

Ethiopian Airlines said MCAS was "to the best of our knowledge" active when the aircraft crashed.[85][86] According to Ethiopian transport minister Dagmawit Moges, the crew "performed all the procedures repeatedly provided by the manufacturer but was not able to control the aircraft".[87][88][89] Bjorn Fehrm from Leeham News stated the preliminary report confirms "the Flight Crew followed the procedures prescribed by FAA and Boeing in Airworthiness Directive 2018-23-51",[80] released shortly after the Lion Air crash.

Boeing's CEO Dennis Muilenburg said on 29 April that if "you go through the checklist...it calls out actions that would be taken around power management and pitch management of the airplane. It also refers to the cutout switches, that after an activation that was not pilot-induced, that you would hit the cutout switches. And, in some cases, those procedures were not completely followed".[90][91][92]

A data spike in the flight data[14] led to speculations about a bird or other debris hitting the plane as it was taking off, shearing away the airflow sensor.[93] These speculations were dismissed by Ethiopian Airlines, and Chief investigator Amdye Ayalew Fanta stated there was no indication of such damage.[93][94][95][96]

On 25 April, The Aviation Herald submitted 25 questions that have arisen in the aftermath of the accident to the FAA's Flight Standardization Board (FSB) regarding their draft for certification of the Boeing 737 MAX aircraft.[1] Earlier, it stated that a copy of the version of section 2.6 of the Flight Operations Manual, "Operational Irregularities", in use by Ethiopian Airlines at the time of the crash was dated 1 November 2017 and did not include material from the Operator's Bulletin issued by Boeing on 6 November 2018.[1]

Expert analysis

Based on the preliminary report, The Aviation Herald comes to the conclusion: "Neither of the three crews" (JT-43, JT-610, ET-302) "would have been forced to react under time pressure in order to prevent a crash, [...] without the technical malfunctions [of the angle of attack sensors] and the nose down trim inputs."[1]

According to The Air Current aviation journal and The Seattle Times, the preliminary report shows the pilots initially followed the procedure to disable runaway trim, but the recovery effort did not succeed.[97][98] Pilots have demonstrated in simulator that the trim wheels cannot be moved in severe mis-trim conditions combined with a high airspeed.[99][100] As the pilots on Flight 302 pulled on the yoke to raise the nose, the aerodynamic forces on the tail's elevator would create an opposing force on the stabilizer trim jackscrew that would prevent the pilots from moving the trim wheel by hand.[93][98][101]

The resolution for this jammed trim issue is not part of Boeing's current 737 manual according to The Air Current.[97] The Seattle Times reports pilots on the 737-200 were trained for this failure, but later models became so reliable that this procedure was no longer necessary.[97][98]

Experts theorize that the difficulty to trim made it necessary for the flight crew to release the cutout, and try to use electronic trim in an effort to correct the out-of-trim configuration.[80][102] According to Bjorn Fehrm (Leeham News) and Peter Lemme at this time the airplane was flying "at 375kts and MCAS was never designed to trim at these Speed/Altitude combinations".[80][102]

Pilot analysis

John Cox, a former 737 pilot and pilots' union safety representative, and Chesley Sullenberger, who successfully ditched US Airways Flight 1549 in the Hudson River, both did Flight Simulator replications of Flight 302. Cox described the rapid onset of unforeseen events as a "...breeding ground for confusion and task saturation." Sullenberger commented that "Even knowing what was going to happen, I could see how crews would have run out of time and altitude before they could have solved the problems."[103] While defending the pilots' actions, Sullenberger was also highly critical of allowing someone with only 200 hours of flight experience to be first officer.[104]

Dramatization

See also

Notes

  1. ^ Yared had 4,120 hours on the Boeing 737 regardless of variant, but only 103 hours on the Boeing 737 MAX, while 4,017 hours were on the Boeing 737 Next Generation.[12] Ethiopian names do not have family names, so Ethiopian people are addressed by their given names.
  2. ^ Ahmed had 207 hours on the Boeing 737 regardless of variant, but only 56 hours on the Boeing 737 MAX.[14] His remaining 151 hours were on the Boeing 737 Next Generation.[12]
  3. ^ East Africa Time
  4. ^ Including one Hong Kong resident[36]

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Further reading

  • Robison, Peter (2021). Flying Blind: The 737 MAX Tragedy and the Fall of Boeing (Hardcover). New York: Doubleday. ISBN 978-0385546492.

External links

  • "Preliminary Report - Aircraft Accident Investigation Bureau" (PDF). Ministry of Transport (Ethiopia). 4 April 2019.
  • "Interim Report - Aircraft Accident Investigation Bureau" (PDF). Ministry of Transport (Ethiopia). 9 March 2020.
  • Leggett, Theo; Browning, Simon (16 June 2019). "Battle over blame - Ethiopian Airlines rejects accusations of pilot error". BBC News. BBC.

Analysis of preliminary report: timeline and human factor

  • "Ethiopian 302 – Even Without Answers, The Data Tells a Story". Visual Approach (Courtney Miller). 5 April 2019.
  • "ET302 crash report, the first analysis". Leeham News and Analysis (Bjorn Fehrm). 5 April 2019.

Difficulty to trim

  • Boeing 737 Unable to Trim Cockpit video (Full flight sim). 19 April 2019 – via YouTube.737NG simulator demonstration of the difficulty to trim in an out-of-trim situation similar to the accident.
  • "Vestigial design issue clouds 737 Max crash investigations". The Air Current (Jon Ostrower). 4 April 2019. — Graphical illustration of the trim issue.

Summary of the 737 Max crashes

  • The real reason Boeing's new plane crashed twice. Vox Videos. 15 April 2019 – via YouTube.
  • "What went wrong inside Boeing's cockpit?". BBC News. 17 May 2019.

ethiopian, airlines, flight, scheduled, international, passenger, flight, from, addis, ababa, bole, international, airport, ethiopia, jomo, kenyatta, international, airport, nairobi, kenya, march, 2019, boeing, aircraft, which, operated, flight, crashed, near,. Ethiopian Airlines Flight 302 was a scheduled international passenger flight from Addis Ababa Bole International Airport in Ethiopia to Jomo Kenyatta International Airport in Nairobi Kenya On 10 March 2019 the Boeing 737 MAX 8 aircraft which operated the flight crashed near the town of Bishoftu six minutes after takeoff killing all 157 people aboard Ethiopian Airlines Flight 302ET AVJ the aircraft involved seen on 8 February 2019 approximately one month before the accident AccidentDate10 March 2019 2019 03 10 SummaryMCAS design flawSiteTulu Fara village near Bishoftu Ethiopia 8 52 37 N 39 15 04 E 8 87694 N 39 25111 E 8 87694 39 25111 Coordinates 8 52 37 N 39 15 04 E 8 87694 N 39 25111 E 8 87694 39 25111 1 AircraftAircraft typeBoeing 737 MAX 8OperatorEthiopian AirlinesIATA flight No ET302ICAO flight No ETH302Call signETHIOPIAN 302RegistrationET AVJFlight originAddis Ababa Bole International Airport Addis Ababa EthiopiaDestinationJomo Kenyatta International Airport Nairobi KenyaOccupants157Passengers149Crew8Fatalities157Survivors0 Interactive fullscreen map Flight 302 is Ethiopian Airlines s deadliest accident to date surpassing the fatal hijacking of Flight 961 resulting in a crash near the Comoros in 1996 2 3 It is also the deadliest aircraft accident to occur in Ethiopia surpassing the crash of an Ethiopian Air Force Antonov An 26 in 1982 which killed 73 4 This was the second MAX 8 accident in less than five months after the crash of Lion Air Flight 610 2 5 6 7 Both crashes prompted a two year worldwide long term grounding of the jet and an investigation into how the aircraft was approved to service Contents 1 Aircraft and crew 2 Accident 3 Emergency response 4 Passengers 5 Responses 5 1 Groundings 6 Investigation 6 1 Preliminary report 6 2 Interim report 6 3 Final report 7 Reactions to the investigation 7 1 Statements from parties 7 2 Expert analysis 7 3 Pilot analysis 8 Dramatization 9 See also 10 Notes 11 References 12 Further reading 13 External linksAircraft and crew EditThe aircraft was a Boeing 737 MAX 8 registered ET AVJ manufacturer s serial number 62450 construction number 7243 powered by two CFM International LEAP 1B engines 8 The aircraft was manufactured in October 2018 and delivered on 15 November 2018 making it around four months old at the time of the accident 9 It had flown from Johannesburg South Africa as ET858 the night prior 10 The captain of the plane was Yared Getachew 29 who had been flying with the airline for almost nine years 11 and had logged a total of 8 122 flight hours including 4 120 hours on the Boeing 737 a He had been a Boeing 737 800 captain since November 2017 and Boeing 737 MAX since July 2018 12 At the time of the accident he was the youngest captain at the airline 13 The first officer Ahmed Nur Mohammod Nur 25 was a recent graduate from the airline s academy with 361 flight hours logged including 207 hours on the Boeing 737 b 12 13 Accident EditFlight 302 was a scheduled international passenger flight from Addis Ababa to Nairobi The aircraft took off from Addis Ababa at 08 38 local time 05 38 UTC with 149 passengers and 8 crew on board 5 One minute into the flight the first officer acting on the instructions of the captain reported a flight control problem to the control tower 15 Two minutes into the flight the plane s MCAS system activated pitching the plane into a dive toward the ground The pilots struggled to control it and managed to prevent the nose from diving further but the plane continued to lose altitude 16 The MCAS then activated again dropping the nose even further down The pilots then flipped a pair of switches to disable the electrical trim tab system which also disabled the MCAS software However in shutting off the electrical trim system they also shut off their ability to trim the stabilizer into a neutral position with the electrical switch located on their yokes The only other possible way to move the stabilizer would be by cranking the wheel by hand but because the stabilizer was located opposite to the elevator strong aerodynamic forces were pushing on it 17 As the pilots had inadvertently left the engines on full takeoff power which caused the plane to accelerate at high speed there was further pressure on the stabilizer The pilots attempts to manually crank the stabilizer back into position failed 17 Three minutes into the flight with the aircraft continuing to lose altitude and accelerating beyond its safety limits the captain instructed the first officer to request permission from air traffic control to return to the airport Permission was granted and the air traffic controllers diverted other approaching flights Following instructions from air traffic control they turned the aircraft to the east and it rolled to the right The right wing came to point down as the turn steepened 17 At 8 43 having struggled to keep the plane s nose from diving further by manually pulling the yoke the captain asked the first officer to help him and turned the electrical trim tab system back on in the hope that it would allow him to put the stabilizer back into neutral trim However in turning the trim system back on he also reactivated the MCAS system which pushed the nose further down The captain and first officer attempted to raise the nose by manually pulling their yokes but the aircraft continued to plunge toward the ground 17 18 The aircraft disappeared from radar screens and crashed at almost 08 44 six minutes after takeoff 14 2 8 19 Flight tracking data showed that the aircraft s altitude and rate of climb and descent were fluctuating 20 Several witnesses stated the plane trailed white smoke and made strange noises before crashing 21 The aircraft impacted the ground at nearly 700 miles per hour 610 kn 1 100 km h 17 There were no survivors 5 It crashed in the woreda district of Gimbichu Oromia Region 22 in a farm field near the town of Bishoftu 62 kilometres 39 mi 33 nmi southeast of Bole International Airport 23 The impact created a crater about 90 feet 27 m wide 120 feet 37 m long and wreckage was driven up to 30 feet 9 1 m deep into the soil Wreckage was strewn around the field along with personal effects and body parts 17 24 25 Emergency response EditShortly after the crash police and a firefighting crew from a nearby Ethiopian Air Force base arrived and extinguished the fires caused by the crash 26 Police cordoned off the site and Ethiopian Red Cross personnel and air crash investigators moved in Together with local villagers they sifted through the wreckage recovering pieces of the aircraft personal effects and human remains Trucks and excavators were brought in to assist in clearing the crash site Human remains found were bagged and taken to Bole International Airport for storage in refrigeration units typically used to store roses destined for export before being taken to St Paul s Hospital in Addis Ababa for storage pending identification 24 27 Personnel from Interpol and Blake Emergency Services a private British disaster response firm contracted by the Ethiopian government arrived to gather human tissue for DNA testing and an Israel Police forensics team also arrived to assist in identifying the remains of the two Israeli victims of the crash 28 29 The Chinese railway construction firm CRSG later joined by another construction firm CCCC brought in large scale equipment including excavators and trucks They recovered both flight recorders on the 11th of March with the first being found at 9 am and the second flight recorder found at 1 pm c 30 31 The black boxes were given to Ethiopian Airlines and were sent to Paris for inspection by the BEA the French aviation accident investigation agency 32 Passengers EditThe airline stated that the flight s 149 passengers had 35 different nationalities 33 Crash victim positive identification was announced on September 13 2019 Nearly a hundred disaster victim identification DVI experts from 14 countries supported the Interpol Incident Response Team IRT mission 34 Passengers by nationality 35 Nationality DeathsKenya 32Canada 18Ethiopia 9China 8 d Italy 8United States 8France 7United Kingdom 7Egypt 6Germany 5India 4Slovakia 4Austria 3Russia 3Sweden 3Israel 2Morocco 2Poland 2Spain 2Belgium 1Djibouti 1Indonesia 1Ireland 1Mozambique 1Nepal 1Nigeria 1Norway 1Rwanda 1Saudi Arabia 1Serbia 1Somalia 1Sudan 1Togo 1Uganda 1Yemen 1Total 149All passengers and crew on board 157 in total were killed in the accident 2 Many of the passengers were travelling to Nairobi to attend the fourth session of the United Nations Environment Assembly 37 A total of 22 people affiliated with the United Nations UN were killed including seven World Food Programme staff along with staff of the United Nations office in Nairobi the International Telecommunication Union and the office of the United Nations High Commissioner for Refugees 38 39 The Deputy Director of Communications for UNESCO two staff of General Electric 40 a retired Nigerian diplomat and senior UN official who was working on behalf of UNITAR and a staff member of the Sudan office of the International Organization for Migration were also among the dead 41 42 The airline stated that one passenger had a United Nations laissez passer 33 The flight was considered a UN shuttle due to its role in linking the African Union headquarters as well as other UN offices in Addis Ababa to the United Nations Office at Nairobi the organisation s headquarters in Africa 43 44 45 46 The Addis Ababa Nairobi route is also popular with tourists and business people An employee of the Norwegian Red Cross a British intern with the Norwegian Refugee Council an environmental agent for the Association of Arctic Expedition Cruise Operators four Catholic Relief Services staff and a senior Ugandan police official on assignment with the African Union peacekeeping force in Somalia were also killed 47 48 Notable victims on board included the Italian archaeologist and Councillor for Cultural Heritage of Sicily Sebastiano Tusa and Nigerian Canadian academic Pius Adesanmi 49 50 Slovak politician Anton Hrnko lost his wife and two children in the crash 2 Other notable victims included Christine Alalo a Ugandan police commissioner and peacekeeper serving with the African Union Mission in Somalia 51 Responses EditEthiopian Prime Minister Abiy Ahmed offered his condolences to the families of the victims 5 Ethiopian Airlines CEO Tewolde Gebremariam visited the accident site confirmed that there were no survivors and expressed sympathy and condolences 52 Boeing issued a statement of condolence 53 The Ethiopian parliament declared 11 March as a day of national mourning 54 During the opening of the fourth United Nations Environment Assembly in Nairobi a minute of silence was observed in sympathy for the victims 55 President Muhammadu Buhari of Nigeria in his condolence message on behalf of the government and the people of Nigeria extended his sincere condolences to Prime Minister Abiy Ahmed of Ethiopia the people of Ethiopia Kenya Canada China and all other nations who lost citizens in the crash 56 On 11 March the FAA commented that the Boeing 737 MAX 8 model was airworthy However due to concerns on the operation of the aircraft the FAA ordered Boeing to implement design changes effective by April It stated that Boeing plans to update training requirements and flight crew manuals in response to the design change to the aircraft s Maneuvering Characteristics Augmentation System MCAS The changes will also include enhancements to the activation of the MCAS and the angle of attack signal 57 Boeing stated that the upgrade was developed in response to the Lion Air crash but did not link it to the Ethiopian Airlines crash 58 On 19 March the U S Secretary of Transportation Elaine L Chao sent a memo to the U S Inspector General asking him to proceed with an audit to compile an objective and detailed factual history of the activities that resulted in the certification of the Boeing 737 MAX 8 aircraft 59 Flight International commented that the accident would likely increase unease about the Boeing 737 MAX felt in the aftermath of the Lion Air Flight 610 accident in October 2018 which similarly occurred shortly after take off and killed everyone aboard 60 Boeing shares dropped 11 over the weekend 61 by 23 March Boeing had lost more than 40 billion in market value dropping some 14 since the crash 62 Groundings Edit Main articles Boeing 737 MAX groundings and List of Boeing 737 MAX groundings After the Ethiopian Airlines crash China and most other civil aviation authorities grounded the airliner over perceived safety risks Boeing CEO Dennis Muilenburg assured President Donald Trump the airplane was safe in response to Trump s social media comments 63 Having new evidence of accident similarities the U S Federal Aviation Administration FAA grounded the aircraft on March 13 2019 reversing a Continued Airworthiness Notice issued two days prior 64 65 66 About 30 MAX aircraft were flying in U S airspace at the time and were allowed to reach their destinations 67 By March 18 regulators grounded all 387 MAX aircraft in service with 59 airlines worldwide and making 8 600 flights each week 68 Several ferry flights were operated with flaps extended to circumvent MCAS activation The grounding subsequently became the longest ever of a U S airliner 69 70 As of January 2020 another 400 newly manufactured aircraft await delivery to airlines pending the aircraft s return to service Investigation Edit The MAX uses an adjustable stabilizer moved by a jackscrew to provide the required pitch trim forces Generic stabilizer illustrated The Ethiopian Civil Aviation Authority ECAA the agency responsible for investigating civil aviation accidents in Ethiopia investigated the accident The aircraft manufacturer Boeing stated that it was prepared to work with the United States National Transportation Safety Board NTSB and assist Ethiopian Airlines 53 The United States Federal Aviation Administration also assisted in the investigation 71 Both the cockpit voice recorder and the flight data recorder were recovered from the crash site on 11 March 72 The French aviation accident investigation agency BEA announced that it would analyze the flight recorders from the flight 73 BEA received the flight recorders on 14 March 74 On 17 March Ethiopia s transport minister Dagmawit Moges announced that the black box has been found in a good condition that enabled us to extract almost all the data inside and that the preliminary data retrieved from the flight data recorder show a clear similarity with those of Lion Air Flight 610 which crashed off Indonesia 75 On 13 March 2019 the FAA announced that new evidence found on the crash site and satellite data on Flight 302 suggested that the aircraft might have suffered from the same problem which the aircraft operating Lion Air Flight 610 had suffered from Investigators discovered the jackscrew that controlled the pitch angle of the horizontal stabilizer of Flight 302 was in the full nose down position The finding suggested that at the time of the crash Flight 302 was configured to dive similar to Lion Air Flight 610 76 Due to this finding some experts in Indonesia suggested that the Indonesian National Transportation Safety Committee NTSC should cooperate with Flight 302 s investigation team 77 Later on the evening the NTSC offered assistance to Flight 302 s investigation team stating that the committee and the Indonesian Transportation Ministry would send investigators and representatives from the government to assist with the investigation of the crash 78 Preliminary report Edit On 4 April 2019 the ECAA released the preliminary report on the crash 14 The preliminary report does not specifically mention MCAS but rather states approximately five seconds after the end of the ANU aircraft nose up stabilizer motion a third instance of AND aircraft nose down automatic trim command occurred without any corresponding motion of the stabilizer which is consistent with the stabilizer trim cutout switches being in the cutout position 14 Approximately one minute into the flight an airspeed of 238 knots 441 km h 274 mph was selected About 12 seconds later the autopilot disengaged The preliminary report asserts that the thrust remained at takeoff setting 94 N1 and the throttles did not move for the entire flight 14 79 In the next 30 seconds the stabilizer trim moved 4 2 degrees nose down from 4 6 to 0 4 units 80 In the next 10 seconds the trim moved back up to 2 3 units as a result of pilot input and the pilots agreed on and executed the stabilizer trim cut out procedure cutting power to the trim motor operated by MCAS 14 Interim report Edit On 9 March 2020 the ECAA released an interim report on the crash This report stated that the left and right angle of attack AOA values deviated by 59 The AOA disagree message did not appear The left minimum operating speed and left stick shaker speed was computed to be greater than the maximum operating speed without any invalidity detection The pitch Flight Director bars disappeared then reappeared with left and right displaying different guidance The left stick shaker activated The nose down trim MCAS triggered four times The right over speed clacker activated On the third MCAS trigger there was no corresponding motion of the stabilizer which is consistent with the stabilizer trim cutout switches being in the cutout position at that moment The MCAS design relied on single AOA sensor inputs making it vulnerable to undesired activation The difference training from B737NG to B737 MAX was inadequate 12 Final report Edit On 23 December 2022 the ECAA released the final report in the crash which stated 81 Repetitive and uncommanded airplane nose down inputs from the MCAS due to erroneous AOA input and its unrecoverable activation system which made the airplane dive with the rate of 33 000 ft min 170 m s close to the ground was the most probable cause of the accident On 27 December 2022 the NTSB released its comments on the accident separately from the final report saying that the Ethiopian authorities failed to include them in or append them to their report 82 The NTSB s comments read in part 83 Overall the US team concurs with the EAIB s investigation of the MCAS and related systems and the roles that they played in the accident However many operational and human performance issues present in this accident were not fully developed as part of the EAIB investigation These issues include flight crew performance crew resource management CRM task management and human machine interface It is important for the EAIB s final report to provide a thorough discussion of these relevant issues so that all possible safety lessons can be learned The BEA also submitted comments to the draft final report in which it disagrees with some aspects of the Ethiopian findings specifically regarding crew performance The introduction to the BEA s comments reads in part 84 The BEA globally agrees with the analysis of the crew performance for phases 4 and 5 of the accident scenario However the BEA considers that some aspects of the analysis of the crew performance in the first phases of the flight are insufficiently developed and could improve the understanding of what could have been done by the crew which could have modified the outcome of the flight Reactions to the investigation EditMain article Reactions to the Boeing 737 MAX groundings Statements from parties Edit Ethiopian Airlines said MCAS was to the best of our knowledge active when the aircraft crashed 85 86 According to Ethiopian transport minister Dagmawit Moges the crew performed all the procedures repeatedly provided by the manufacturer but was not able to control the aircraft 87 88 89 Bjorn Fehrm from Leeham News stated the preliminary report confirms the Flight Crew followed the procedures prescribed by FAA and Boeing in Airworthiness Directive 2018 23 51 80 released shortly after the Lion Air crash Boeing s CEO Dennis Muilenburg said on 29 April that if you go through the checklist it calls out actions that would be taken around power management and pitch management of the airplane It also refers to the cutout switches that after an activation that was not pilot induced that you would hit the cutout switches And in some cases those procedures were not completely followed 90 91 92 A data spike in the flight data 14 led to speculations about a bird or other debris hitting the plane as it was taking off shearing away the airflow sensor 93 These speculations were dismissed by Ethiopian Airlines and Chief investigator Amdye Ayalew Fanta stated there was no indication of such damage 93 94 95 96 On 25 April The Aviation Herald submitted 25 questions that have arisen in the aftermath of the accident to the FAA s Flight Standardization Board FSB regarding their draft for certification of the Boeing 737 MAX aircraft 1 Earlier it stated that a copy of the version of section 2 6 of the Flight Operations Manual Operational Irregularities in use by Ethiopian Airlines at the time of the crash was dated 1 November 2017 and did not include material from the Operator s Bulletin issued by Boeing on 6 November 2018 1 Expert analysis Edit Based on the preliminary report The Aviation Herald comes to the conclusion Neither of the three crews JT 43 JT 610 ET 302 would have been forced to react under time pressure in order to prevent a crash without the technical malfunctions of the angle of attack sensors and the nose down trim inputs 1 According to The Air Current aviation journal and The Seattle Times the preliminary report shows the pilots initially followed the procedure to disable runaway trim but the recovery effort did not succeed 97 98 Pilots have demonstrated in simulator that the trim wheels cannot be moved in severe mis trim conditions combined with a high airspeed 99 100 As the pilots on Flight 302 pulled on the yoke to raise the nose the aerodynamic forces on the tail s elevator would create an opposing force on the stabilizer trim jackscrew that would prevent the pilots from moving the trim wheel by hand 93 98 101 The resolution for this jammed trim issue is not part of Boeing s current 737 manual according to The Air Current 97 The Seattle Times reports pilots on the 737 200 were trained for this failure but later models became so reliable that this procedure was no longer necessary 97 98 Experts theorize that the difficulty to trim made it necessary for the flight crew to release the cutout and try to use electronic trim in an effort to correct the out of trim configuration 80 102 According to Bjorn Fehrm Leeham News and Peter Lemme at this time the airplane was flying at 375kts and MCAS was never designed to trim at these Speed Altitude combinations 80 102 Pilot analysis Edit John Cox a former 737 pilot and pilots union safety representative and Chesley Sullenberger who successfully ditched US Airways Flight 1549 in the Hudson River both did Flight Simulator replications of Flight 302 Cox described the rapid onset of unforeseen events as a breeding ground for confusion and task saturation Sullenberger commented that Even knowing what was going to happen I could see how crews would have run out of time and altitude before they could have solved the problems 103 While defending the pilots actions Sullenberger was also highly critical of allowing someone with only 200 hours of flight experience to be first officer 104 Dramatization EditThe crash was mentioned in the 21st season of the TV series Mayday in an episode entitled Grounded Boeing Max 8 105 106 In February 2022 Netflix released Downfall The Case Against Boeing a documentary about the Lion Air Flight 610 and Ethiopian Airlines Flight 302 plane crashes 107 In September 2022 Amazon Prime released Flight Risk a feature documentary about the two Boeing 737 MAX crashes 108 See also EditEthiopian Airlines accidents and incidents Lion Air Flight 610 the other Boeing 737 MAX accident which occurred four months priorNotes Edit Yared had 4 120 hours on the Boeing 737 regardless of variant but only 103 hours on the Boeing 737 MAX while 4 017 hours were on the Boeing 737 Next Generation 12 Ethiopian names do not have family names so Ethiopian people are addressed by their given names Ahmed had 207 hours on the Boeing 737 regardless of variant but only 56 hours on the Boeing 737 MAX 14 His remaining 151 hours were on the Boeing 737 Next Generation 12 East Africa Time Including one Hong Kong resident 36 References Edit a b c d Crash Ethiopian B38M near Bishoftu on Mar 10th 2019 impacted terrain after departure avherald com Archived from the original on 1 May 2019 Retrieved 4 May 2019 a b c d e Ethiopian Airlines No survivors on crashed Boeing 737 BBC News 10 March 2019 Archived from the original on 10 March 2019 Retrieved 10 March 2019 Ranter Harro Ethiopian Airlines aviation safety 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Airlines crash Fox News Retrieved 15 July 2019 Grounded Boeing Max 8 Mayday Season 21 Episode 4 National Geographic Channel Air Crash Investigation National Geographic www nationalgeographic co uk 5 April 2021 Archived from the original on 6 April 2021 Retrieved 7 April 2021 Downfall Chilling documentary makes a case that Boeing s greed cost hundreds of lives 17 February 2022 Retrieved 18 February 2022 Flight Risk Amazon 8 September 2022 Retrieved 27 December 2022 Further reading EditRobison Peter 2021 Flying Blind The 737 MAX Tragedy and the Fall of Boeing Hardcover New York Doubleday ISBN 978 0385546492 External links Edit Preliminary Report Aircraft Accident Investigation Bureau PDF Ministry of Transport Ethiopia 4 April 2019 Interim Report Aircraft Accident Investigation Bureau PDF Ministry of Transport Ethiopia 9 March 2020 Leggett Theo Browning Simon 16 June 2019 Battle over blame Ethiopian Airlines rejects accusations of pilot error BBC News BBC Analysis of preliminary report timeline and human factor Ethiopian 302 Even Without Answers The Data Tells a Story Visual Approach Courtney Miller 5 April 2019 ET302 crash report the first analysis Leeham News and Analysis Bjorn Fehrm 5 April 2019 Difficulty to trim Boeing 737 Unable to Trim Cockpit video Full flight sim 19 April 2019 via YouTube 737NG simulator demonstration of the difficulty to trim in an out of trim situation similar to the accident Vestigial design issue clouds 737 Max crash investigations The Air Current Jon Ostrower 4 April 2019 Graphical illustration of the trim issue Summary of the 737 Max crashes The real reason Boeing s new plane crashed twice Vox Videos 15 April 2019 via YouTube What went wrong inside Boeing s cockpit BBC News 17 May 2019 Portals Aviation Africa Retrieved from https en wikipedia org w index php title Ethiopian Airlines Flight 302 amp oldid 1143837429, wikipedia, wiki, book, books, library,

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