Air Emergency (2003–…): Season 1, Episode 2 - Unlocking Disaster - full transcript
On United Airlines flight 811, the cargo door suddenly opens in-flight and tears a portion of the fuselage. The crew attempts landing back in Honolulu.
Modern airliners are one of the most complex
and reliable machines in common use
but occasionally, delays in fixing a known defect
have led to disaster.
This is a story of one of the most terrifying
and avoidable accidents in recent history.
When a Boeing 747 suffered a devastating
explosion at high altitude,
the crew and passengers faced
an unprecedented crisis.
It is also a story of how one family's grief
led to a relentless investigation
to uncover the full disturbing truth.
Lee died for nothing
You've got to find out why he died,
and you just gotta make sure
that it never happens again.
And it reveals how other known
problems in aircraft design
have continued to go uncorrected,
causing further avoidable accidents.
So would I be surprised if it happen again?
I would be surprised if it didn't happen again.
It is a matter a time.
One of the most shocking cases
of a known design flaw being ignored for years,
would finally take its toll on the
United Airlines 747
bound from Honolulu to Auckland, New Zealand.
As flight 811
prepared for takeoff,
the crew were concerned with another
kind of threat that had recently led to tragedy
We were in the aftermath of Lockerbie
and I had instructed the crew
to be particularly aware
because it was a through flight from Los Angeles
going through to New Zealand.
So, in my pre-flight briefing
I ask them to make sure
that they checked any baggage
that looks suspicious or anything
because we wanted to be extra cautious
Flight 811 was heavily loaded
337 passengers, packed cargo holes
and a full fuel load.
The doors closed on time.
and the plane left the gate just before
two o'clock in the morning
for a routine eight-hour flight.
While we were going to New Zealand on vacation
some place that we had really...
it was interesting
and somebody told me how beautiful it was
This was a dream come true.
I was seated in what was called the upper deck
I had an ratification for 5 years.
and to call my mileage-plus-points for
United Airlines
and I purchased a business class ticket
to Auckland New Zealand and Sydney Australia
now I am going to finally
make that dream vacation I always wanted
to get to Australia
laying on a beach somewhere
and forget about airplanes,
forget about accidents
and get this out of my mind for a while.
On the flight deck Captain David Cronin
was hugely experienced,
just two months
short of retirement
Rotate
I flew almost 35 years with United Airlines
I've got over 30,000 hours of flight time
and flew just about everything,
military as well as a civilian
My co-pilot, our First Officer was
Al Slader and I've known Al at that time
for probably 20 years
and the Second Officer Mark Thomas
was the first time I had flown with him,
but we got along real well
The pilots wanted to climb to 33,000 feet
above the Pacific Ocean...
...to avoid turbulence from bad weather.
We did notice that there
were thunderstorms
a 100 miles south right on course which
was rather unusual for that time at night.
So, I left the seat belt sign on.
Captain Cronin's decision,
to keep people fastened in their seats,
would save the lives of many
We were still climbing out,
and the seatbelt-sign was still on
and I am just basically getting ready to
serve beverages and
to talk everyone in for the evening
because it was it gonna be a long flight
down to New Zealand
OKAY,
tell them we're gonna detour over the land
Center United Airlines 811,
we are detouring
Bad weather here
It will be to the left of the course
A hundred miles from Honolulu
as Flight 811 climb through 23,000 feet,
a critical malfunction was about to occur.
There was now a huge air pressure difference
between the inside and outside of the aircraft.
Suddenly, passengers sitting just above
and behind the cargo door heard a noise
a kind of a grinding noise
I heard a sound like a thud
In the next nanosecond
it was pure pandemonium
We lost number 3
going down
It looks like we have lost engine number 3
and we are descending rapidly
We are coming back
The next thing I knew: I found myself
on the stairwell hanging onto the rungs
and I immediately knew
it was an explosive decompression
The cargo door had torn off
and ripped a huge section of the plane with it.
The pressurized air inside blasted out
with explosive force.
I immediately thought
of Lockerbie.
We actually thought it was a bomb
that went off.
It was hell on earth.
Everything on the airplane that wasn’t
fastened down, tied down or secured,
would became airborne.
The noise was incredible.
Everything in front of us was gone.
Where we were sitting
we were about six inches from the hole, so...
...there was nothing in front of us
or to the side of us
the whole side of the plane was gone
actually my feet were dangling down the hole
I first thought we were not gonna make it.
I just didn't think there was any hope.
With the pressurized air blown out,
the lack of oxygen at 23,000 feet was now
suffocating the passengers and crew
It felt like someone kicked me in the stomach
and knocked the wind out of me
and I remember I was trying
to catch my breath...
...and couldn't
first wrap those oxygen masks and put them on
but the oxygen masks in that cabin,
they were ripped off the ceiling
and they weren't there.
I remember thinking to myself:
this is what it feels like to suffocate.
We are doing an emergency descend
The pilots could tell from their instruments
that the number 3 engine was failing,
but they couldn't tell
the full extent of the damage.
Their priority was to get the plane down
to a level where they could breath normally.
Put your mask on, Dave
But the pilots didn't know that the explosion
had destroyed the entire oxygen supply
We're not getting any oxygen
I cannot get any either
With the plane heading steeply down and no word
from the cockpit, the cabin crew feared the worst
I remember thinking that the cockpit
which is in the upper deck
had probably blown off the airplane too
because as far as we could see
there was nothing there.
now we're doing this nosedive,
my next thought was oh my god we are
going straight down and gonna crash into the sea
With its airframe ruptured,
severe damage to the right wing and engines
and the crew forcing it down
in an emergency descent,
the problems on flight 811 have only just begun.
Two minutes after suffering
a devastating explosive decompression
Flight 811 was still in the steep
emergency descent,
passing rapidly through 15000 ft
to reach breathable air.
I think there blew a door or something
Tell a flight attendant to get prepared
for an evacuation
The crew finally begun to level out
at a safer altitude.
but they now faced a barrage of problems.
The most immediate was the disintegration
of the number 3 engine, nearest to the explosion.
You don't have any fire indications?
I don't have anything.
OKAY, we lost number 3
let's shut it down.
OKAY, ready for number 3 shutdown.
Checklist!
yeah number 3.
Before you shut down number 3,
the generator went off
It looks alright to try it now.
That has stopped the vibration anyway.
procedure
main boost pumps
Center, here United 811,
We need the equipment standby,
company notify please.
We got a control problem
Center wing, left brake valves,
Start to open the fuel
I am dumping
One stewardess has been seriously injured by
falling debris as Laura Brentlinger helped her.
The full gravity of their situation
suddenly became clear
Laura Brentlinger:
As I'm holding her in my arms I looked up
and as I looked up
that was the first time I saw this tremendous hole
on the side of the aircraft
there was just a void.
and seats were missing and
I immediately knew that we had lost passengers.
Five rows of seats have been blown out
in the decompression
killing 9 passengers
On the flight deck, the crew
had turned the stricken plane back to Honolulu
but with 18 miles still to go
the crisis now go far worse
we got a hell out of control problem, here
I've got almost full rudder on this
I am dumping everything
We have a problem with number 4 engine?
Debris from the explosion had also damaged
the number 4 engine.
If it would fail completely,
the implications were severe.
If you're on two engines
and you weigh 700,000 pounds
that is a big deal,
simply because with that kind of weight,
two engines are not going
to keep you in the air.
you're going to come down
and you maintain 240
We are losing altitude
Center, United 811,
I have you on radar
We lost engine number 3
and we don't have full power on engine number 4
we can hold altitude right now
We are dumping fuel
I haven't talked to anybody yet
Can nobody go downstairs to take a look
Yeah, let's see what is happening down there
I think I have we lost the compressor
I got take off power on this thing
Although the number 4 engine was failing
the pilots pushed it
along with the remaining engines to full power
a setting they should not be run on
for more than four minutes.
but the nearest land was 15 minutes away.
I look out the window
on the right hand side and I see flames,
big flames
and I know what flames in engines mean
it's not good.
The pilots were unaware
that the number 4 engine was now on fire.
you got 250 knots,
watch your heading, watch your heading
you wanna go direct Honolulu
okay I am gonna go downstairs
and see what the hell is going on
Go ahead, run down and see what is happening
I saw the flight engineer descend
down the stairwell
when I saw him I my relief was:
oh my God they're alive
and there is a huge sense of relief for me.
He saw the hole, turned as white as a sheet
and I screamed to him:
Dear God, please get us down
We got a fire out there,
Oh, yeah,
we got a fire in number 4
Go through the procedure
Shut down the engine
We got a fire on the right side.
We are on two engines, now
the whole right side is just gone
from about the one right back to ...
it's just open
You are just looking outside.
It looks like a bomb
The fuselage
Yes, the fuselage,
it is just open
OKAY, It looks like we're got a bomb
that went off at the right side
The whole right-side is gone
From above the right back
Lost anybody?
some people have probably gone,
I don't know
I knew that we had lost people
I didn't know how many
In fact I didn't know,
until the next day how many were lost
It's a terrible thing when you're a captain
of an airplane and you lose passengers.
Lee Campbell, flying home to New Zealand
was sitting in row 10,
just in front of the cargo door.
I woke up with such a stabbed
because I'd seen Lee standing by the bed
just with a grey jacket over his arm
and a small smile on his face
I woke up, it faded
and then we woke up in the morning
we discussed this, and it was strange in the night
such a perfect dream of Lee, standing there
And then, the radio came on
and the first item of the news:
there have been a problem with United...
...the aircraft and I see that was Lee,
that is Lee's
and my blood just ran cold
I knew he was dead...
...from that moment
We evidently had a bomb or something
a big section of the right side the airplane
is missing
I wouldn't go any faster than I had to
I wouldn't get it over 240 knots.
OKAY, what is our stall-speed?
I wouldn't go below 240
yeah
see if we are gonna make this.
we didn't know that we're gonna make it back,
so we were preparing to ditch that airplane
at night in the Pacific Ocean
which has never been done before.
In the cabin,
the crew prepared for the braadworst
my training kicked in
and now I'm got on my jump-seat
and started instructing the crew
We have to prepare the cabin,
we have to prepare for ditching.
which I thought was inevitable
You are trying to get a life-vest on
and I do remember thinking:
I'm not sure this is going to matter
because when we hit the water
I just imagined that the plane just falls apart
I knew that if we hit the water,
it would be same as hit the ground
and there would be very few if any
survivors so
my mind went to ...
anything that meant something to me
in that point my life it was my son
Believing they were going to die,
one passenger took these photographs
in the hope they'll be found in the wreckage
and give clues to the cause of the crash.
For 15 minutes,
the plane steadily lost altitude
then, at 4,000 feet,
the first glimmer of hope
After an imponderable time I remember,
one of the passengers began to point
out of the windows
on the right side
and everybody looked
and we looked to this little window
from wherever we were
and we could see a point of light
and another point of light
and another point,
pretty soon you could make out a coastline
okay, I've got lights over here.
21 miles out
we are in big shape
At Honolulu Airport, an emergency was declared.
All other aircraft were diverted.
and the rescue services prepared
for the crash landing of a fully loaded airliner.
you want to give me some speeds?
150 is gonna be your 2 engine
OKAY, how many souls on board?
standby United 811
I don't know how many is on board
200 and ...
I don't have the paperwork in front of me here
We are too busy right now.
two hundred and something
Six minutes from the airport
the crew now had to slow the overweight plane
for landing
but the effect of this was unknown.
What's going to happen when I start coming
out with flaps
and the landing gear
we're either going to land on the airport,
in the water
or downtown Honolulu
alright so far
But the flaps were damaged
and could not fully extend.
This meant the flight 811
would have to land dangerously fast
Okay, we have the airport,
United 811
811 is cleared to land at 8L
Cleared to land, 8L, United 811 heavy
As the unstable 747 lined up for landing,
the pilots knew they would only have one attempt.
but even if they got it on the runway,
the nagging question remained:
would the stress of impact cause the damaged
and overweight aircraft to disintegrate?
Severely damaged, with an unstable air frame
and losing altitude on just two engines,
Flight 811 now began its final approach
to Honolulu Airport.
A two engine approach
We still had no idea
how far off the ground we were
if you're going to make it to Honolulu or not
but that seem like an appropriate time ...
(We probably going to try and land somewhere)
...to get the passengers in the braced positions
that was where we start yelling from
'get down to brace positions'
Every molecule in my body combined to express:
"Get this damn airplane on the ground"
How are we doing on the hydraulics?
The hydraulics are good.
Your brakes?
Normal hydraulics.
So, we got breaks, but
gonna have reversing on engine 1 and 2
Though I thought maybe there was a chance
that we were going to be able to attempt to land
That thought came to my mind
What happens now,
Do we impact, do we explode?
Do we fall out out this huge hole?
Despite dumping fuel,
the aircraft was still critically overweight.
But without full flaps to keep it in the air,
it had to approach fast.
1000 down
The danger was that the undercarriage
could shear off and the plane break up
190 knots
185 knots
Real slow, real slow, David
Coming up on the glide-slope
Let's try the gear.
No one knew it the explosion had damaged
the landing gear.
I remember Laura saying
she didn't hear the landing gear go down
And I didn't hear the landing gear go down
so that's another thought
maybe they cannot get the landing gear down
Maybe it's not down.
Gear down, cleared to land.
Everything has taken care of,
as far as we know.
00:23:44,904 --> 00:23:45,980
00:23:58,300 --> 00:23:59,976
00:24:03,397 --> 00:24:04,759
00:24:04,784 --> 00:24:06,784
Halve the power
00:24:15,871 --> 00:24:17,871
50 ft
Set off the trim
30 ft
0 ft
We are on
The gear is holding
We landed, real fast
that was my next concerns that
we were going to stop at the end of the run way,
That we're just gonna keep going.
In all of a sudden we were slowing down,
slowing down.
and I said: oh my God, we've landed,
we are on the ground.
The people started applauding.
Probably the best landing I've ever made.
When we are finally stopped on the runway,
we deployed all 10 shoots
and the flight attendants
evacuated all of the passengers.
It's amazing how fast it all went
In less than 45 seconds,
330 people were off the airplane
We're probably 20 feet off the ground
I would have stepped out that airplane
without a slide. I want to get off so bad.
Fortunately there was a slide
I stepped into the abyss,
fell under the slide
whooshed down to the bottom of the thing
and then you hit the big runway
the slide kicked me up, flew me up into the air
and my thought was:
oh my God,
How am I going to survive this whole thing.
and I'm gonna get wiped out here on the evacuation
because it just really threw me.
and I landed and scraped up my legs pretty badly
and landed on my feet
and it wasn't until that
moment that I had the sense of
I'm here I'm OK,
I'm on the ground
when we got all our switches off,
I ran through the airplane,
make sure there was no one else on the airplane,
came up to door 1 L,
went down the slide I came around the front
and I saw that humungous hole in the side,
and I just couldn't believe it
By the grace of God, we made it
and it was an awesome experience
I would never want to go through that again.
It was crazy, it was wild
it was scary
All at the same time
I just thought that that was the end
we were gonna die.
I mean, that was my first thought.
that this is the end
But for the families
of the 9 people who were killed,
the ordeal was only beginning.
Kevin and Susan Campbell's
son Lee had been flying home
About 3:00 PM, I think,
they said there were no New Zealanders involved
but we just knew that it was Lee.
and then about a quarter of an hour later,
we got a phone call from Chicago
and they just said that they regret to inform us
that our son was missing, presumed dead.
and I guess about another an hour after that,
a policeman arrived at the door,
and he took one look at us
and he said:" I can see that you heared the news."
That was just an awful, awful day.
And it certainly didn't get much better
for a long, long time
Although Lee's body had not been recovered,
the Campbells flew straight to
the wrecked aircraft in Honolulu.
Your initial feeling is, that you want to be as
close to the spot where your relative died,
and that was the aircraft.
We had to immediately go
and see the aircraft.
The damage inside was horrific,
just a total mess.
The hole in the side of the aircraft
was much bigger than I had thought it would be,
even though we'd seen
television news reports
It was so sad to get there
and actually see where Lee's seat had been.
The legs of the seat were still there,
the hole in the fuselage beside him
and still a window!
But the Campbell's desire
to find the cause of Lee's death...
...inevitably brought them face to face
with dreadful details.
They took us to the medical examiner's
office as well
They found body-parts and that sort of thing.
They didn't actually showed us the body parts,
but they showed us bits and pieces they
had recovered from the engines.
we got the medical examiner's
report on what they had recovered
We really would have preferred that
it was Lee, who went through the engine,
because it would have been
an immediate death
It was a 4 minute of fall down to the ocean
We know that the people could have been alive
as they were falling.
and when you think about that,
that's just horrific.
As it became clear that their son's body
would never be found,
the Campbells' need to find
the cause of the accident that killed him...
...grew stronger.
Lee died for nothing
You've got to find out why he died.
you just gotta make sure
that it never happens again.
The Campbells embarked on a relentless personal
investigation that would last nearly two years.
The loss of their son and
they would stop at nothing to uncover the truth
Two months after the accident on flight 811...
...when the NTSB held preliminary hearings...
...the Campbells made sure they were there.
But they soon grew frustrated
the NTSB would not complete its report for months
so the Campbells took matters into their own hands
We'd certainly were not going to leave
until the NTSB did come up with the findings
we were going to follow through
and when the hearings ended
they had said that we could take
whatever we wanted of the press table
And Susan walked up to the table
and said: "This is a really good set-up here"
We grabbed the box
and loaded in all of the documents
that we could find out there.
Kevin is the most honest of people I know,
but here he was, taking something that
we haven't specifically been told we could take.
we're heading out the door,
just as the NTSB were arriving back in
with the trolley, to pick up all the documents.
we were out the door,
went into a taxi and go on.
We quickly realized
we've got a really good set of papers
a lot of things
that haven't been released to the public
We're able to really start out an investigation
The unpublished documents
revealed a disturbing catalogue
of problems with the forward cargo door
going right back to its original design.
Instead of a plug door that gets jammed
into its frame as the aircraft pressurizes,
Boeing opted for an outward opening door
this allowed for more cargo space
but was not fail safe like the plug design
So, Boeing built what they believe
was a foolproof locking mechanism
What they do is:
they build in multiple redundancies
to make sure the door is properly latched
and does not open.
You build it into a point that it is extremely
improbable that the door would ever open.
So what went wrong on flight 811 ?
The Campbells soon discovered that the problem
lay in the design of the locking mechanism
To lock the cargo-door on the 747,
electric motors rotate C-shaped latches
around pins in the door frame
A handle than moves arms,
known as locking sectors,
over the top at the C- latches
to prevent them from reopening.
But as early as 1975,
problems were found with the locking sectors
Kevin Campbell, an engineer by training,
built a model
to show the weakness in the Boeing design.
Initially,
the locking sectors were made of aluminium
and in 1975,
Boeing realized that they weren't strong enough.
and they doubled up the aluminium
to make it double thickness
but it still wasn't strong enough.
A lot of the airlines didn't even
put the doublers on it anyway
The weakness of the aluminium drastically increase
the risk of the door, accidentally opening
With the aluminium locking sectors
if the C-locks try to back-wind open electrically,
it would just push the locking
sector out of the way.
It just simply wasn't up to the job
it was designed for
For 20 years, 747's have been flying
with this crucial weakness.
The Campbells wonder what else remain
to be revealed
They redouble their efforts
to uncover the full truth
behind the accident
that have killed their son
We bought a car and set off to the United States
to see as many people who were involved
with the accident as possible
We started at Seattle down to Denver,
cross to Chicago through to Washington DC,
down to Kentucky, on to Miami
and back across to San Diego
back up through San Francisco
and then back to Seattle
And that was just one trip.
The Campbells soon found
that a shockingly similar incident of Flight 811
had given clear warnings
of the dangers in the cargo door
in 1987, two years before Flight 811,
a Pan Am 747 have been climbing out at Heathrow
when it failed to pressurize at 20,000 feet.
The pilots had to turn back.
When I got back to Heathrow,
they found that the door was hanging open
1.5" at the bottom
and all of the locks were open.
when I got to the maintenance-base
they found that all of the locking sectors
where either bend or broken.
Why have the C-latches turned
and bent back the locking sectors?
Boeing claimed that the ground crew
must have mishandled the mechanism.
The door have been closed manually
and what they said happened:
It was that the guy wound the C-locks closed
98-turns of speed wrench
They closed the outer handle
and then went on to open again
and to be in a position I found
when the aircraft got back
he would have had to wind them open 98 turns
and this is just absolutely ridiculous.
But the Campbells' investigation uncovered another
vital clue to why the C-latches had turned.
A report by Pan Am engineers highlighted
problems with the door's electrical system.
It had a fault in the S2 master latch lock switch
that should have turned off the power to the door,
when the outer handle was closed.
This was an alarming finding
when the outer handle was closed
the S2 master locks switch was meant
to disconnect the power supply,
and stop the C-latch
motors from turning,
so could this have failed
allowing the motors to open the door.
To find out,
Boeing ask the airlines to do a simple test.
Close the outer handle, then press the switch
to open the door and see what happens
When they hit the switch,
it actually worked,
Boeing thought that this is not going to work,
but it actually worked,
There was power to the door locks
with the outer handle closed
and the locks out of the move
and I started to force the locking
sectors out of the way,
A few days later the airline started ringing in
and saying it was damaging their planes
So, Boeing stopped the test
but it meant that on those aircraft
the S2 switch has failed,
which is a silent failure.
and all of those aircraft
were likely to have the same problem
Now, we are just waiting for a short circuit
to open the doors.
the Campbells now became convinced that
the accident on flight 811
began with the failure of the S2 switch
power remained on to the C-latch motors.
All it took was a short circuit
in the 20-year-old wiring
which have been found on other aircraft
to start the motors up
The aluminium locking sectors were too
weak to stop the latches turning
And the cargo door burst open
the NTSB determines
that the probable cause of this accident was
After waiting a year
for the NTSB report,
Kevin and Susan Campbell expected
it to match their theory
of what had led to the accident on flight 811.
I had assumed that we'll have a report coming out
that this was an electrical malfunction
and we are staggered when they came out
that the door had been mishandled.
The report focused
entirely on the fact
that the door lock must've been
mishandled by the ramp attendant
That was disappointing,
and we felt that they must have been
at a different hearing from the one we were at.
so how had the NTSB come to their conclusion?
There was other evidence that we
had found during our investigation
of improper procedures
by the United mechanics and ramp people
so we were convinced
that there was some
we could use the word 'abuse'
being done on the doors.
The doors were abused
and were not maintained very well.
We concluded
that the probable cause was mechanical.
For the Campbells, the NTSB's failure to
mention the electrical problems
just wasn't good enough.
What they say happened:
the door was closed.
the C-locks didn't fully close
that is partially closed
just hanging on the pins
and then I close the locking sector
but that just simply can't happen
because that part of the locking sectors
are still intact.
That simply cannot happen.
You cannot close the locking sector unless
the C-locks are in the fully locked position.
It is the only way
that the locking sector will close
and just closing this manually
you can't exert enough force
to actually damage this part of the locking sector
All it does: it just bats up against here
if the C-locks are not fully closed,
it just suddenly bats up against them
and goes no further.
They went back to
investigating the accident on Flight 811
and soon found disturbing evidence of
how it could and should have been prevented.
After the Pan Am incident in 1987
it turned out
that Boeing had issued a directive to the airlines
on how to correct the weak aluminium
locking sectors
The airworthiness directive that came out
was to replace the aluminum sectors
with steel sectors
that could not be bent.
and there were some additionally and some interim
requirements for inspections to be performed
until they what they call 'terminating action'
the steel sectors were installed
The fix was cheap and simple
but getting it done was not.
The actual cost of the modification
changing these locking sectors
to steel was $2,000 per aircraft,
but it took 10 hours to do it
and that's where the money was.
taking the aircraft our of service for 10 hours
That is millions of dollars.
The Campbells found that back in 1987,
the FAA who are meant to enforce improvements,
had given the airlines
18 months to comply with the modification.
Within a year, Lee Campbell and 8 others
would die in an avoidable accident.
So why weren't the airlines forced
to fix the problem sooner?
If these large commercial airplanes are grounded,
it would lead to economic disaster.
So what they do is:
they lobby in the regulatory agency:
in the United States that is the FAA
to allow them to do the fixes over time
When the airplanes are in for normal maintenance
That way,
they're not taken out of service
but when they do that,
when they allow the airlines, the air carriers
and the manufacturers
to fix these over time,
in essence what the FAA is doing is a gambling
with the lives of passengers and crew
that are flying the airplane
through the time they're not fixed.
After the deaths on flight 811,
the FAA instantly shorten the
deadline for fixing the cargo door
from 18 months to just 30 days
It was only when United had gone
from when the airline's first resort...
...to one of the airline's of last
resort and New Zealand
But they, just totally out of the blue
invited us over to see them,
and when we got there
they were just doing a PR exercise on us.
But we just laid into them
pointed out we all got it wrong
and you could see them changing
realizing that we did know
what we were talking about.
That we put a lot of serious effort into it
One of them actually broke down
because he never had to meet next of kin before
and it ended up with
the vice president of the United Airlines
taking his round the maintenance facility
and he had people running off in all directions
just to get the information that we wanted,
questions answered,
We could go anywhere that we wanted.
Everything was laid off
at that stage they realize we really did know
what we're talking about
The pressure of the Campbell's campaign
eventually began to pay off.
The vital piece of evidence
that could prove them right, the cargo door,
still laid two miles down
in the Pacific Ocean
but as articles appeared in the American press
the NTSB commissioned the US Navy to
search for it
A hundred miles south of Honolulu
a deep submersible began to troll the sea-bed.
We went to Honolulu and waited there
Well, they had their attempts
and they finally recovered the door from 14,000ft,
which was the deepest recovery ever at that time.
and we were phoned within an hour
that it had coming out of the water
But before the Campbells could see it,
the door was swiftly removed
to Boeing's plants in Seattle.
The Campbells went in hot pursuit.
We went over to Boeing.
They wouldn't show it to us,
so they reckon that the crucial pieces
had gone to the NTSB,
so again we got in the car,
driving to cross to Washington DC
We arrived at Ron Schleede's office and
Ron looks at his watch and said:
I can give you five minutes
so about three hours later we had
the pieces that they had recovered in our hand.
They acknowledge that our conclusion was correct:
it was an electrical malfunction
they said they would fix the planes.
He would make sure it never happens again
But just hold your breath:
the report will never be changed.
Even with the evidence
of an electrical malfunction in their hands,
the NTSB refused to change their report.
Then, in June 1991, fate intervened.
A four-year-old United 747
was sitting on the apron in New York
when the C-latch motor started up
and the door opened itself.
There was no way
that they could hide it any longer.
They simply couldn't deny that
there was an electrical malfunction
Finally the NTSB publicly issued a revised report
that concurred with the Campbell's version
There was an inadvertent failure
of either the switch of the wiring
that caused an uncommanded opening of the door.
That's nice that other people know it
that you're right and had been all along
and the support that they had given you
was vindicated
The Campbells spent thousands of dollars
of their own money on their campaign
They were never interested in
a financial settlement for Lee's death,
but they did persuade United Airlines and Boeing
to set up a university scholarship in his name.
I couldn't have lived with myself
if we did not investigate this
that is something we both felt we needed to do.
We didn't even discuss it
We just knew
that is what we had to do.
But despite long and public campaigns
like that of the Campbells,
critics fear that the airline industry
has not learned the lessons from Flight 811
The regulatory agencies they have a dual charge
One is to encourage aviation
and another thing is aviation safety.
and when they get a position where you have
economics up against air-safety
they can choose for the side of Economics
rather than safety
Serious accidents, caused by known defects
have continued to occur
In the 1990's, known problems
with icing on aircraft wings
caused a series of crashes.
At least three planes have had fatal fires
due to known dangers from flammable
insulation material.
and in 1996, a fully laden 747 blew itself up...
...when known faults in the wiring are thought
to have ignited flammable vapors in the fuel tanks
Inevitably, experts are skeptical
about the aviation industry's record...
...of balancing profit against prevention
We've seen the wiring problem
both in the United Air 811
what you'll eventually turned out
to be the cause of that accident
and also in TWA 800, where we had
an explosion in the center line fuel tank
The industry answer
to 20 and 30 year old wiring
and when the wiring can pray,
break, crack, cause a short
which can either ignite fuel like in a TWA 800
or open a cargo door like in Flight 811
and what the industry says:
Don't touch it , don't go in there,
don't inspected it, don't try to fix it
don't try to remove it
because it so brittle
If you go and try to fix it,
you can do more damage than you do good.
and that's what I call 'the ostrich approach'
to maintenance and safety
"We've decided that you can have
a spark of ignition...
...in the centerline fuel tank,
of a large air carrier,
but so far we've been lucky,
we've only had one every 10 years,
we'll only brought up 3 or 4 airplanes,
To go and replace its wiring
would ground all these airplanes
It will be astronomically expensive,
One airplane every 10 years,
one airplane every 5 years
200, 300 people cost to do in business"
That's a great economic analysis.
Unless it is your mother or your child,
that is on-board of one of these airplanes,
that happened to pay the price
for their economic satisfaction
For some of the survivors of Flight 811,
the cost has been heavy.
Each crew member handled it differently.
I know there are still 2 crew members that
have never set foot on an aircraft again.
It was very difficult for me.
I was diagnosed with the severe
post traumatic stress disorder
You can't reason, you can't think
making the slightest decision is very difficult
you're just a total loss
so it's very difficult to cope with.
Subtitles
Rein Croonen
Narrated by:
David Bamber
and reliable machines in common use
but occasionally, delays in fixing a known defect
have led to disaster.
This is a story of one of the most terrifying
and avoidable accidents in recent history.
When a Boeing 747 suffered a devastating
explosion at high altitude,
the crew and passengers faced
an unprecedented crisis.
It is also a story of how one family's grief
led to a relentless investigation
to uncover the full disturbing truth.
Lee died for nothing
You've got to find out why he died,
and you just gotta make sure
that it never happens again.
And it reveals how other known
problems in aircraft design
have continued to go uncorrected,
causing further avoidable accidents.
So would I be surprised if it happen again?
I would be surprised if it didn't happen again.
It is a matter a time.
One of the most shocking cases
of a known design flaw being ignored for years,
would finally take its toll on the
United Airlines 747
bound from Honolulu to Auckland, New Zealand.
As flight 811
prepared for takeoff,
the crew were concerned with another
kind of threat that had recently led to tragedy
We were in the aftermath of Lockerbie
and I had instructed the crew
to be particularly aware
because it was a through flight from Los Angeles
going through to New Zealand.
So, in my pre-flight briefing
I ask them to make sure
that they checked any baggage
that looks suspicious or anything
because we wanted to be extra cautious
Flight 811 was heavily loaded
337 passengers, packed cargo holes
and a full fuel load.
The doors closed on time.
and the plane left the gate just before
two o'clock in the morning
for a routine eight-hour flight.
While we were going to New Zealand on vacation
some place that we had really...
it was interesting
and somebody told me how beautiful it was
This was a dream come true.
I was seated in what was called the upper deck
I had an ratification for 5 years.
and to call my mileage-plus-points for
United Airlines
and I purchased a business class ticket
to Auckland New Zealand and Sydney Australia
now I am going to finally
make that dream vacation I always wanted
to get to Australia
laying on a beach somewhere
and forget about airplanes,
forget about accidents
and get this out of my mind for a while.
On the flight deck Captain David Cronin
was hugely experienced,
just two months
short of retirement
Rotate
I flew almost 35 years with United Airlines
I've got over 30,000 hours of flight time
and flew just about everything,
military as well as a civilian
My co-pilot, our First Officer was
Al Slader and I've known Al at that time
for probably 20 years
and the Second Officer Mark Thomas
was the first time I had flown with him,
but we got along real well
The pilots wanted to climb to 33,000 feet
above the Pacific Ocean...
...to avoid turbulence from bad weather.
We did notice that there
were thunderstorms
a 100 miles south right on course which
was rather unusual for that time at night.
So, I left the seat belt sign on.
Captain Cronin's decision,
to keep people fastened in their seats,
would save the lives of many
We were still climbing out,
and the seatbelt-sign was still on
and I am just basically getting ready to
serve beverages and
to talk everyone in for the evening
because it was it gonna be a long flight
down to New Zealand
OKAY,
tell them we're gonna detour over the land
Center United Airlines 811,
we are detouring
Bad weather here
It will be to the left of the course
A hundred miles from Honolulu
as Flight 811 climb through 23,000 feet,
a critical malfunction was about to occur.
There was now a huge air pressure difference
between the inside and outside of the aircraft.
Suddenly, passengers sitting just above
and behind the cargo door heard a noise
a kind of a grinding noise
I heard a sound like a thud
In the next nanosecond
it was pure pandemonium
We lost number 3
going down
It looks like we have lost engine number 3
and we are descending rapidly
We are coming back
The next thing I knew: I found myself
on the stairwell hanging onto the rungs
and I immediately knew
it was an explosive decompression
The cargo door had torn off
and ripped a huge section of the plane with it.
The pressurized air inside blasted out
with explosive force.
I immediately thought
of Lockerbie.
We actually thought it was a bomb
that went off.
It was hell on earth.
Everything on the airplane that wasn’t
fastened down, tied down or secured,
would became airborne.
The noise was incredible.
Everything in front of us was gone.
Where we were sitting
we were about six inches from the hole, so...
...there was nothing in front of us
or to the side of us
the whole side of the plane was gone
actually my feet were dangling down the hole
I first thought we were not gonna make it.
I just didn't think there was any hope.
With the pressurized air blown out,
the lack of oxygen at 23,000 feet was now
suffocating the passengers and crew
It felt like someone kicked me in the stomach
and knocked the wind out of me
and I remember I was trying
to catch my breath...
...and couldn't
first wrap those oxygen masks and put them on
but the oxygen masks in that cabin,
they were ripped off the ceiling
and they weren't there.
I remember thinking to myself:
this is what it feels like to suffocate.
We are doing an emergency descend
The pilots could tell from their instruments
that the number 3 engine was failing,
but they couldn't tell
the full extent of the damage.
Their priority was to get the plane down
to a level where they could breath normally.
Put your mask on, Dave
But the pilots didn't know that the explosion
had destroyed the entire oxygen supply
We're not getting any oxygen
I cannot get any either
With the plane heading steeply down and no word
from the cockpit, the cabin crew feared the worst
I remember thinking that the cockpit
which is in the upper deck
had probably blown off the airplane too
because as far as we could see
there was nothing there.
now we're doing this nosedive,
my next thought was oh my god we are
going straight down and gonna crash into the sea
With its airframe ruptured,
severe damage to the right wing and engines
and the crew forcing it down
in an emergency descent,
the problems on flight 811 have only just begun.
Two minutes after suffering
a devastating explosive decompression
Flight 811 was still in the steep
emergency descent,
passing rapidly through 15000 ft
to reach breathable air.
I think there blew a door or something
Tell a flight attendant to get prepared
for an evacuation
The crew finally begun to level out
at a safer altitude.
but they now faced a barrage of problems.
The most immediate was the disintegration
of the number 3 engine, nearest to the explosion.
You don't have any fire indications?
I don't have anything.
OKAY, we lost number 3
let's shut it down.
OKAY, ready for number 3 shutdown.
Checklist!
yeah number 3.
Before you shut down number 3,
the generator went off
It looks alright to try it now.
That has stopped the vibration anyway.
procedure
main boost pumps
Center, here United 811,
We need the equipment standby,
company notify please.
We got a control problem
Center wing, left brake valves,
Start to open the fuel
I am dumping
One stewardess has been seriously injured by
falling debris as Laura Brentlinger helped her.
The full gravity of their situation
suddenly became clear
Laura Brentlinger:
As I'm holding her in my arms I looked up
and as I looked up
that was the first time I saw this tremendous hole
on the side of the aircraft
there was just a void.
and seats were missing and
I immediately knew that we had lost passengers.
Five rows of seats have been blown out
in the decompression
killing 9 passengers
On the flight deck, the crew
had turned the stricken plane back to Honolulu
but with 18 miles still to go
the crisis now go far worse
we got a hell out of control problem, here
I've got almost full rudder on this
I am dumping everything
We have a problem with number 4 engine?
Debris from the explosion had also damaged
the number 4 engine.
If it would fail completely,
the implications were severe.
If you're on two engines
and you weigh 700,000 pounds
that is a big deal,
simply because with that kind of weight,
two engines are not going
to keep you in the air.
you're going to come down
and you maintain 240
We are losing altitude
Center, United 811,
I have you on radar
We lost engine number 3
and we don't have full power on engine number 4
we can hold altitude right now
We are dumping fuel
I haven't talked to anybody yet
Can nobody go downstairs to take a look
Yeah, let's see what is happening down there
I think I have we lost the compressor
I got take off power on this thing
Although the number 4 engine was failing
the pilots pushed it
along with the remaining engines to full power
a setting they should not be run on
for more than four minutes.
but the nearest land was 15 minutes away.
I look out the window
on the right hand side and I see flames,
big flames
and I know what flames in engines mean
it's not good.
The pilots were unaware
that the number 4 engine was now on fire.
you got 250 knots,
watch your heading, watch your heading
you wanna go direct Honolulu
okay I am gonna go downstairs
and see what the hell is going on
Go ahead, run down and see what is happening
I saw the flight engineer descend
down the stairwell
when I saw him I my relief was:
oh my God they're alive
and there is a huge sense of relief for me.
He saw the hole, turned as white as a sheet
and I screamed to him:
Dear God, please get us down
We got a fire out there,
Oh, yeah,
we got a fire in number 4
Go through the procedure
Shut down the engine
We got a fire on the right side.
We are on two engines, now
the whole right side is just gone
from about the one right back to ...
it's just open
You are just looking outside.
It looks like a bomb
The fuselage
Yes, the fuselage,
it is just open
OKAY, It looks like we're got a bomb
that went off at the right side
The whole right-side is gone
From above the right back
Lost anybody?
some people have probably gone,
I don't know
I knew that we had lost people
I didn't know how many
In fact I didn't know,
until the next day how many were lost
It's a terrible thing when you're a captain
of an airplane and you lose passengers.
Lee Campbell, flying home to New Zealand
was sitting in row 10,
just in front of the cargo door.
I woke up with such a stabbed
because I'd seen Lee standing by the bed
just with a grey jacket over his arm
and a small smile on his face
I woke up, it faded
and then we woke up in the morning
we discussed this, and it was strange in the night
such a perfect dream of Lee, standing there
And then, the radio came on
and the first item of the news:
there have been a problem with United...
...the aircraft and I see that was Lee,
that is Lee's
and my blood just ran cold
I knew he was dead...
...from that moment
We evidently had a bomb or something
a big section of the right side the airplane
is missing
I wouldn't go any faster than I had to
I wouldn't get it over 240 knots.
OKAY, what is our stall-speed?
I wouldn't go below 240
yeah
see if we are gonna make this.
we didn't know that we're gonna make it back,
so we were preparing to ditch that airplane
at night in the Pacific Ocean
which has never been done before.
In the cabin,
the crew prepared for the braadworst
my training kicked in
and now I'm got on my jump-seat
and started instructing the crew
We have to prepare the cabin,
we have to prepare for ditching.
which I thought was inevitable
You are trying to get a life-vest on
and I do remember thinking:
I'm not sure this is going to matter
because when we hit the water
I just imagined that the plane just falls apart
I knew that if we hit the water,
it would be same as hit the ground
and there would be very few if any
survivors so
my mind went to ...
anything that meant something to me
in that point my life it was my son
Believing they were going to die,
one passenger took these photographs
in the hope they'll be found in the wreckage
and give clues to the cause of the crash.
For 15 minutes,
the plane steadily lost altitude
then, at 4,000 feet,
the first glimmer of hope
After an imponderable time I remember,
one of the passengers began to point
out of the windows
on the right side
and everybody looked
and we looked to this little window
from wherever we were
and we could see a point of light
and another point of light
and another point,
pretty soon you could make out a coastline
okay, I've got lights over here.
21 miles out
we are in big shape
At Honolulu Airport, an emergency was declared.
All other aircraft were diverted.
and the rescue services prepared
for the crash landing of a fully loaded airliner.
you want to give me some speeds?
150 is gonna be your 2 engine
OKAY, how many souls on board?
standby United 811
I don't know how many is on board
200 and ...
I don't have the paperwork in front of me here
We are too busy right now.
two hundred and something
Six minutes from the airport
the crew now had to slow the overweight plane
for landing
but the effect of this was unknown.
What's going to happen when I start coming
out with flaps
and the landing gear
we're either going to land on the airport,
in the water
or downtown Honolulu
alright so far
But the flaps were damaged
and could not fully extend.
This meant the flight 811
would have to land dangerously fast
Okay, we have the airport,
United 811
811 is cleared to land at 8L
Cleared to land, 8L, United 811 heavy
As the unstable 747 lined up for landing,
the pilots knew they would only have one attempt.
but even if they got it on the runway,
the nagging question remained:
would the stress of impact cause the damaged
and overweight aircraft to disintegrate?
Severely damaged, with an unstable air frame
and losing altitude on just two engines,
Flight 811 now began its final approach
to Honolulu Airport.
A two engine approach
We still had no idea
how far off the ground we were
if you're going to make it to Honolulu or not
but that seem like an appropriate time ...
(We probably going to try and land somewhere)
...to get the passengers in the braced positions
that was where we start yelling from
'get down to brace positions'
Every molecule in my body combined to express:
"Get this damn airplane on the ground"
How are we doing on the hydraulics?
The hydraulics are good.
Your brakes?
Normal hydraulics.
So, we got breaks, but
gonna have reversing on engine 1 and 2
Though I thought maybe there was a chance
that we were going to be able to attempt to land
That thought came to my mind
What happens now,
Do we impact, do we explode?
Do we fall out out this huge hole?
Despite dumping fuel,
the aircraft was still critically overweight.
But without full flaps to keep it in the air,
it had to approach fast.
1000 down
The danger was that the undercarriage
could shear off and the plane break up
190 knots
185 knots
Real slow, real slow, David
Coming up on the glide-slope
Let's try the gear.
No one knew it the explosion had damaged
the landing gear.
I remember Laura saying
she didn't hear the landing gear go down
And I didn't hear the landing gear go down
so that's another thought
maybe they cannot get the landing gear down
Maybe it's not down.
Gear down, cleared to land.
Everything has taken care of,
as far as we know.
00:23:44,904 --> 00:23:45,980
00:23:58,300 --> 00:23:59,976
00:24:03,397 --> 00:24:04,759
00:24:04,784 --> 00:24:06,784
Halve the power
00:24:15,871 --> 00:24:17,871
50 ft
Set off the trim
30 ft
0 ft
We are on
The gear is holding
We landed, real fast
that was my next concerns that
we were going to stop at the end of the run way,
That we're just gonna keep going.
In all of a sudden we were slowing down,
slowing down.
and I said: oh my God, we've landed,
we are on the ground.
The people started applauding.
Probably the best landing I've ever made.
When we are finally stopped on the runway,
we deployed all 10 shoots
and the flight attendants
evacuated all of the passengers.
It's amazing how fast it all went
In less than 45 seconds,
330 people were off the airplane
We're probably 20 feet off the ground
I would have stepped out that airplane
without a slide. I want to get off so bad.
Fortunately there was a slide
I stepped into the abyss,
fell under the slide
whooshed down to the bottom of the thing
and then you hit the big runway
the slide kicked me up, flew me up into the air
and my thought was:
oh my God,
How am I going to survive this whole thing.
and I'm gonna get wiped out here on the evacuation
because it just really threw me.
and I landed and scraped up my legs pretty badly
and landed on my feet
and it wasn't until that
moment that I had the sense of
I'm here I'm OK,
I'm on the ground
when we got all our switches off,
I ran through the airplane,
make sure there was no one else on the airplane,
came up to door 1 L,
went down the slide I came around the front
and I saw that humungous hole in the side,
and I just couldn't believe it
By the grace of God, we made it
and it was an awesome experience
I would never want to go through that again.
It was crazy, it was wild
it was scary
All at the same time
I just thought that that was the end
we were gonna die.
I mean, that was my first thought.
that this is the end
But for the families
of the 9 people who were killed,
the ordeal was only beginning.
Kevin and Susan Campbell's
son Lee had been flying home
About 3:00 PM, I think,
they said there were no New Zealanders involved
but we just knew that it was Lee.
and then about a quarter of an hour later,
we got a phone call from Chicago
and they just said that they regret to inform us
that our son was missing, presumed dead.
and I guess about another an hour after that,
a policeman arrived at the door,
and he took one look at us
and he said:" I can see that you heared the news."
That was just an awful, awful day.
And it certainly didn't get much better
for a long, long time
Although Lee's body had not been recovered,
the Campbells flew straight to
the wrecked aircraft in Honolulu.
Your initial feeling is, that you want to be as
close to the spot where your relative died,
and that was the aircraft.
We had to immediately go
and see the aircraft.
The damage inside was horrific,
just a total mess.
The hole in the side of the aircraft
was much bigger than I had thought it would be,
even though we'd seen
television news reports
It was so sad to get there
and actually see where Lee's seat had been.
The legs of the seat were still there,
the hole in the fuselage beside him
and still a window!
But the Campbell's desire
to find the cause of Lee's death...
...inevitably brought them face to face
with dreadful details.
They took us to the medical examiner's
office as well
They found body-parts and that sort of thing.
They didn't actually showed us the body parts,
but they showed us bits and pieces they
had recovered from the engines.
we got the medical examiner's
report on what they had recovered
We really would have preferred that
it was Lee, who went through the engine,
because it would have been
an immediate death
It was a 4 minute of fall down to the ocean
We know that the people could have been alive
as they were falling.
and when you think about that,
that's just horrific.
As it became clear that their son's body
would never be found,
the Campbells' need to find
the cause of the accident that killed him...
...grew stronger.
Lee died for nothing
You've got to find out why he died.
you just gotta make sure
that it never happens again.
The Campbells embarked on a relentless personal
investigation that would last nearly two years.
The loss of their son and
they would stop at nothing to uncover the truth
Two months after the accident on flight 811...
...when the NTSB held preliminary hearings...
...the Campbells made sure they were there.
But they soon grew frustrated
the NTSB would not complete its report for months
so the Campbells took matters into their own hands
We'd certainly were not going to leave
until the NTSB did come up with the findings
we were going to follow through
and when the hearings ended
they had said that we could take
whatever we wanted of the press table
And Susan walked up to the table
and said: "This is a really good set-up here"
We grabbed the box
and loaded in all of the documents
that we could find out there.
Kevin is the most honest of people I know,
but here he was, taking something that
we haven't specifically been told we could take.
we're heading out the door,
just as the NTSB were arriving back in
with the trolley, to pick up all the documents.
we were out the door,
went into a taxi and go on.
We quickly realized
we've got a really good set of papers
a lot of things
that haven't been released to the public
We're able to really start out an investigation
The unpublished documents
revealed a disturbing catalogue
of problems with the forward cargo door
going right back to its original design.
Instead of a plug door that gets jammed
into its frame as the aircraft pressurizes,
Boeing opted for an outward opening door
this allowed for more cargo space
but was not fail safe like the plug design
So, Boeing built what they believe
was a foolproof locking mechanism
What they do is:
they build in multiple redundancies
to make sure the door is properly latched
and does not open.
You build it into a point that it is extremely
improbable that the door would ever open.
So what went wrong on flight 811 ?
The Campbells soon discovered that the problem
lay in the design of the locking mechanism
To lock the cargo-door on the 747,
electric motors rotate C-shaped latches
around pins in the door frame
A handle than moves arms,
known as locking sectors,
over the top at the C- latches
to prevent them from reopening.
But as early as 1975,
problems were found with the locking sectors
Kevin Campbell, an engineer by training,
built a model
to show the weakness in the Boeing design.
Initially,
the locking sectors were made of aluminium
and in 1975,
Boeing realized that they weren't strong enough.
and they doubled up the aluminium
to make it double thickness
but it still wasn't strong enough.
A lot of the airlines didn't even
put the doublers on it anyway
The weakness of the aluminium drastically increase
the risk of the door, accidentally opening
With the aluminium locking sectors
if the C-locks try to back-wind open electrically,
it would just push the locking
sector out of the way.
It just simply wasn't up to the job
it was designed for
For 20 years, 747's have been flying
with this crucial weakness.
The Campbells wonder what else remain
to be revealed
They redouble their efforts
to uncover the full truth
behind the accident
that have killed their son
We bought a car and set off to the United States
to see as many people who were involved
with the accident as possible
We started at Seattle down to Denver,
cross to Chicago through to Washington DC,
down to Kentucky, on to Miami
and back across to San Diego
back up through San Francisco
and then back to Seattle
And that was just one trip.
The Campbells soon found
that a shockingly similar incident of Flight 811
had given clear warnings
of the dangers in the cargo door
in 1987, two years before Flight 811,
a Pan Am 747 have been climbing out at Heathrow
when it failed to pressurize at 20,000 feet.
The pilots had to turn back.
When I got back to Heathrow,
they found that the door was hanging open
1.5" at the bottom
and all of the locks were open.
when I got to the maintenance-base
they found that all of the locking sectors
where either bend or broken.
Why have the C-latches turned
and bent back the locking sectors?
Boeing claimed that the ground crew
must have mishandled the mechanism.
The door have been closed manually
and what they said happened:
It was that the guy wound the C-locks closed
98-turns of speed wrench
They closed the outer handle
and then went on to open again
and to be in a position I found
when the aircraft got back
he would have had to wind them open 98 turns
and this is just absolutely ridiculous.
But the Campbells' investigation uncovered another
vital clue to why the C-latches had turned.
A report by Pan Am engineers highlighted
problems with the door's electrical system.
It had a fault in the S2 master latch lock switch
that should have turned off the power to the door,
when the outer handle was closed.
This was an alarming finding
when the outer handle was closed
the S2 master locks switch was meant
to disconnect the power supply,
and stop the C-latch
motors from turning,
so could this have failed
allowing the motors to open the door.
To find out,
Boeing ask the airlines to do a simple test.
Close the outer handle, then press the switch
to open the door and see what happens
When they hit the switch,
it actually worked,
Boeing thought that this is not going to work,
but it actually worked,
There was power to the door locks
with the outer handle closed
and the locks out of the move
and I started to force the locking
sectors out of the way,
A few days later the airline started ringing in
and saying it was damaging their planes
So, Boeing stopped the test
but it meant that on those aircraft
the S2 switch has failed,
which is a silent failure.
and all of those aircraft
were likely to have the same problem
Now, we are just waiting for a short circuit
to open the doors.
the Campbells now became convinced that
the accident on flight 811
began with the failure of the S2 switch
power remained on to the C-latch motors.
All it took was a short circuit
in the 20-year-old wiring
which have been found on other aircraft
to start the motors up
The aluminium locking sectors were too
weak to stop the latches turning
And the cargo door burst open
the NTSB determines
that the probable cause of this accident was
After waiting a year
for the NTSB report,
Kevin and Susan Campbell expected
it to match their theory
of what had led to the accident on flight 811.
I had assumed that we'll have a report coming out
that this was an electrical malfunction
and we are staggered when they came out
that the door had been mishandled.
The report focused
entirely on the fact
that the door lock must've been
mishandled by the ramp attendant
That was disappointing,
and we felt that they must have been
at a different hearing from the one we were at.
so how had the NTSB come to their conclusion?
There was other evidence that we
had found during our investigation
of improper procedures
by the United mechanics and ramp people
so we were convinced
that there was some
we could use the word 'abuse'
being done on the doors.
The doors were abused
and were not maintained very well.
We concluded
that the probable cause was mechanical.
For the Campbells, the NTSB's failure to
mention the electrical problems
just wasn't good enough.
What they say happened:
the door was closed.
the C-locks didn't fully close
that is partially closed
just hanging on the pins
and then I close the locking sector
but that just simply can't happen
because that part of the locking sectors
are still intact.
That simply cannot happen.
You cannot close the locking sector unless
the C-locks are in the fully locked position.
It is the only way
that the locking sector will close
and just closing this manually
you can't exert enough force
to actually damage this part of the locking sector
All it does: it just bats up against here
if the C-locks are not fully closed,
it just suddenly bats up against them
and goes no further.
They went back to
investigating the accident on Flight 811
and soon found disturbing evidence of
how it could and should have been prevented.
After the Pan Am incident in 1987
it turned out
that Boeing had issued a directive to the airlines
on how to correct the weak aluminium
locking sectors
The airworthiness directive that came out
was to replace the aluminum sectors
with steel sectors
that could not be bent.
and there were some additionally and some interim
requirements for inspections to be performed
until they what they call 'terminating action'
the steel sectors were installed
The fix was cheap and simple
but getting it done was not.
The actual cost of the modification
changing these locking sectors
to steel was $2,000 per aircraft,
but it took 10 hours to do it
and that's where the money was.
taking the aircraft our of service for 10 hours
That is millions of dollars.
The Campbells found that back in 1987,
the FAA who are meant to enforce improvements,
had given the airlines
18 months to comply with the modification.
Within a year, Lee Campbell and 8 others
would die in an avoidable accident.
So why weren't the airlines forced
to fix the problem sooner?
If these large commercial airplanes are grounded,
it would lead to economic disaster.
So what they do is:
they lobby in the regulatory agency:
in the United States that is the FAA
to allow them to do the fixes over time
When the airplanes are in for normal maintenance
That way,
they're not taken out of service
but when they do that,
when they allow the airlines, the air carriers
and the manufacturers
to fix these over time,
in essence what the FAA is doing is a gambling
with the lives of passengers and crew
that are flying the airplane
through the time they're not fixed.
After the deaths on flight 811,
the FAA instantly shorten the
deadline for fixing the cargo door
from 18 months to just 30 days
It was only when United had gone
from when the airline's first resort...
...to one of the airline's of last
resort and New Zealand
But they, just totally out of the blue
invited us over to see them,
and when we got there
they were just doing a PR exercise on us.
But we just laid into them
pointed out we all got it wrong
and you could see them changing
realizing that we did know
what we were talking about.
That we put a lot of serious effort into it
One of them actually broke down
because he never had to meet next of kin before
and it ended up with
the vice president of the United Airlines
taking his round the maintenance facility
and he had people running off in all directions
just to get the information that we wanted,
questions answered,
We could go anywhere that we wanted.
Everything was laid off
at that stage they realize we really did know
what we're talking about
The pressure of the Campbell's campaign
eventually began to pay off.
The vital piece of evidence
that could prove them right, the cargo door,
still laid two miles down
in the Pacific Ocean
but as articles appeared in the American press
the NTSB commissioned the US Navy to
search for it
A hundred miles south of Honolulu
a deep submersible began to troll the sea-bed.
We went to Honolulu and waited there
Well, they had their attempts
and they finally recovered the door from 14,000ft,
which was the deepest recovery ever at that time.
and we were phoned within an hour
that it had coming out of the water
But before the Campbells could see it,
the door was swiftly removed
to Boeing's plants in Seattle.
The Campbells went in hot pursuit.
We went over to Boeing.
They wouldn't show it to us,
so they reckon that the crucial pieces
had gone to the NTSB,
so again we got in the car,
driving to cross to Washington DC
We arrived at Ron Schleede's office and
Ron looks at his watch and said:
I can give you five minutes
so about three hours later we had
the pieces that they had recovered in our hand.
They acknowledge that our conclusion was correct:
it was an electrical malfunction
they said they would fix the planes.
He would make sure it never happens again
But just hold your breath:
the report will never be changed.
Even with the evidence
of an electrical malfunction in their hands,
the NTSB refused to change their report.
Then, in June 1991, fate intervened.
A four-year-old United 747
was sitting on the apron in New York
when the C-latch motor started up
and the door opened itself.
There was no way
that they could hide it any longer.
They simply couldn't deny that
there was an electrical malfunction
Finally the NTSB publicly issued a revised report
that concurred with the Campbell's version
There was an inadvertent failure
of either the switch of the wiring
that caused an uncommanded opening of the door.
That's nice that other people know it
that you're right and had been all along
and the support that they had given you
was vindicated
The Campbells spent thousands of dollars
of their own money on their campaign
They were never interested in
a financial settlement for Lee's death,
but they did persuade United Airlines and Boeing
to set up a university scholarship in his name.
I couldn't have lived with myself
if we did not investigate this
that is something we both felt we needed to do.
We didn't even discuss it
We just knew
that is what we had to do.
But despite long and public campaigns
like that of the Campbells,
critics fear that the airline industry
has not learned the lessons from Flight 811
The regulatory agencies they have a dual charge
One is to encourage aviation
and another thing is aviation safety.
and when they get a position where you have
economics up against air-safety
they can choose for the side of Economics
rather than safety
Serious accidents, caused by known defects
have continued to occur
In the 1990's, known problems
with icing on aircraft wings
caused a series of crashes.
At least three planes have had fatal fires
due to known dangers from flammable
insulation material.
and in 1996, a fully laden 747 blew itself up...
...when known faults in the wiring are thought
to have ignited flammable vapors in the fuel tanks
Inevitably, experts are skeptical
about the aviation industry's record...
...of balancing profit against prevention
We've seen the wiring problem
both in the United Air 811
what you'll eventually turned out
to be the cause of that accident
and also in TWA 800, where we had
an explosion in the center line fuel tank
The industry answer
to 20 and 30 year old wiring
and when the wiring can pray,
break, crack, cause a short
which can either ignite fuel like in a TWA 800
or open a cargo door like in Flight 811
and what the industry says:
Don't touch it , don't go in there,
don't inspected it, don't try to fix it
don't try to remove it
because it so brittle
If you go and try to fix it,
you can do more damage than you do good.
and that's what I call 'the ostrich approach'
to maintenance and safety
"We've decided that you can have
a spark of ignition...
...in the centerline fuel tank,
of a large air carrier,
but so far we've been lucky,
we've only had one every 10 years,
we'll only brought up 3 or 4 airplanes,
To go and replace its wiring
would ground all these airplanes
It will be astronomically expensive,
One airplane every 10 years,
one airplane every 5 years
200, 300 people cost to do in business"
That's a great economic analysis.
Unless it is your mother or your child,
that is on-board of one of these airplanes,
that happened to pay the price
for their economic satisfaction
For some of the survivors of Flight 811,
the cost has been heavy.
Each crew member handled it differently.
I know there are still 2 crew members that
have never set foot on an aircraft again.
It was very difficult for me.
I was diagnosed with the severe
post traumatic stress disorder
You can't reason, you can't think
making the slightest decision is very difficult
you're just a total loss
so it's very difficult to cope with.
Subtitles
Rein Croonen
Narrated by:
David Bamber