Air Algérie Flight 6289

Air Algérie Flight 6289 (AH6289) was a domestic passenger flight which crashed at the Aguenar – Hadj Bey Akhamok Airport in Algeria on 6 March 2003, killing all but one of the 103 people on board.[1][2][3]

Air Algérie Flight 6289
7T-VEZ, the aircraft involved in the accident, seen here on 29 August 1999
Accident
Date6 March 2003 (2003-03-06)
SummaryEngine failure on take-off aggravated by pilot error
SiteAguenar – Hadj Bey Akhamok Airport, Tamanrasset, Algeria
22°47′N 5°31′E
Aircraft
Aircraft typeBoeing 737-2T4
Aircraft nameMonts du Daia
OperatorAir Algérie
IATA flight No.AH6289
ICAO flight No.DAH6289
Call signAIR ALGERIE 6289
Registration7T-VEZ
Flight originAguenar – Hadj Bey Akhamok Airport, Tamanrasset, Algeria
StopoverNoumérat – Moufdi Zakaria Airport, Ghardaia, Algeria
DestinationHouari Boumediene Airport, Algiers, Algeria
Occupants103
Passengers97
Crew6
Fatalities102
Injuries1
Survivors1

Witnesses recalled that one of its engines exploded and caught fire just seconds after takeoff. The landing gear was still extended when this happened. It then rose sharply and stalled. The final report concluded that the cause of the crash was engine failure on take-off.

The accident was the deadliest plane crash to occur on Algerian soil until being surpassed by the Algerian Air Force Il-76 crash in 2018. It was also Air Algérie's deadliest plane crash until it was surpassed 11 years later by Air Algérie Flight 5017, a McDonnell Douglas MD-83 that crashed in Mali killing all 116 people on board.[4][5]

Background
NationalityPassengersCrewTotal
Algeria78684
Canada505
France909
Germany101
Japan101
Netherlands202
United Kingdom101
Total976103

Flight 6289 had been scheduled to land at Noumérat – Moufdi Zakaria Airport. The aircraft was a Boeing 737-2T4, named Monts du Daia,[6] and was equipped with two Pratt & Whitney JT8D-17A engines. The aircraft entered service on 9 December 1983, and flew for more than 40,000 hours before the crash.[1][2] The unnamed male captain, aged 48, allegedly had 10,760 hours and 10 minutes of flight experience, including 1,087 hours and 46 minutes on the Boeing 737-200 as captain.[1][2] Meanwhile, Yousfi Fatima, the female first officer, aged 44, allegedly had 5,219 hours and 10 minutes of flight experience, including 1,292 hours and 42 minutes on the Boeing 737-200. Fatima was also Algeria's first female airline pilot.[1][2][7]

The first officer was the pilot flying (PF), while the captain was the pilot not flying (PNF). Both switched roles the moment the engine failure occurred.[1][2]

Timeline

At about 14:08 UTC, Air Traffic Control cleared the plane to taxi to Runway 02 and the plane left the gate.[1][2]

At 14:12, Air Traffic Control cleared the plane to line up and take off on Runway 02.[1][2]

At 14:13, the plane took off, and the first officer requested landing gear retraction. The request was immediately followed by a loud thumping noise recorded on the aircraft's Cockpit Voice Recorder (CVR), apparently caused by the rupture of the left engine. The plane veered left, and the first officer let out a chain of exclamations.[1][2]

At 14:15, the captain told the first officer that he was taking over control of the aircraft and insisted she let go of the controls so that he could control the plane. The first officer then handed the controls over to the captain and offered to retract the landing gear. The captain did not respond. The first officer alerted air traffic control about the situation, saying "we have a small problem". The stick shaker then activated and de-activated twice. The Ground proximity warning system (GPWS) then sounded a "don't sink" alarm and was followed by the stick shaker activating a third time and continued operating until the CVR stopped recording. The GPWS then sounded a second "don't sink" alarm and the CVR stopped recording, along with the Flight Data Recorder (FDR). The aircraft was still airborne when the recordings ended. Without the landing gear being retracted, additional drag was apparently created and the plane began to lose speed at a high rate. Eventually, the plane stalled and crashed. Upon impact, fuel was spilled and ignited, causing the aircraft to burst into flames. It then skidded along the ground, striking the airport's perimeter fence, and crossing a road, before coming to a stop. Air traffic control immediately declared an emergency.[1][2]

Aftermath

96 of the 97 passengers and all of the six crew members perished, a total of 102 people. The sole survivor of the accident was a 28-year-old male Algerian soldier. He was seated in the last row with his seat belt unfastened (as indicated in his statement), and was ejected from the plane upon impact, escaping from the accident. The man was found in a coma with multiple injuries.[8] However, he regained consciousness the next day. Doctors said that his injuries were not life-threatening.[9]

Investigation

Before the accident flight, the aircraft's weight and balance and fuel load were both examined and no problems were reported.

Two of the witnesses, a ground engineer who worked on the accident aircraft, and an air traffic controller who was in the tower at the time of the accident gave statements to the investigators. The ground engineer said:

"I was on the parking lot and I saw the plane take off on runway 02. Just after take-off, the aircraft swerved slightly to the left, then righted itself on the track and at that moment I noticed that the aircraft was losing speed and altitude, still with its landing gear down, until the moment of the crash, when there was a total explosion."

The air traffic controller stated:

"DAH 6389 [sic – correct flight number was 6289] B732 IMMAT: 7T-VEZ asked to be cleared for take off 1402 GMT. At 1405 GMT, it was cleared for take off with a temperature of 23°, QNH: 1019. Cleared by ALGER CCR to [an] initial [flight level] FL280, just after the takeoff from runway 02 (1405) a kind of explosion was heard, the alarm was immediately activated, the pilot said [']we have a small problem[']. . . the plane began to fall and crashed near the threshold of runway 20; the emergency plan was immediately activated as planned. 1) Aerodrome rescue services at 1415. 2) Civil services at 1416. 3) Hospital just afterwards. Then the rest of the services mentioned in the emergency plan."

The flight instruments and flight recorders were investigated in the BEA laboratory in Paris, France. The aircraft's engines were sent to Belgium for investigation. The last FDR parameters indicated that the aircraft was 335 feet (102 m) above ground level (AGL) and was traveling at a speed of 126 knots (233 km/h; 145 mph). Investigators determined that the left engine's HP (high pressure) turbine had ruptured, damaging the LP (low pressure) turbine in the process. This caused a drop in power to the engine, though it did not shut down completely according to the flight recorders.[1][2]

Crew resource management

The engine failure suddenly created a heavy workload for the flight crew. The captain took control only of the aircraft eight seconds after the engine failed. As he had done this at a critical phase, the captain could not initiate any emergency procedures. In addition, he used non-standard terminology. The first officer failed to properly perform her PNF duties, and even had her hands on the controls when the stall warning sounded, indicated by the captain saying telling her to let go of "let go" and "take your hand off". The "gear up" callout is supposed to be made by the PF, and carried out by the PNF. While still the PF, first officer made the "gear up" callout as required, but after becoming PNF, the first officer continued to ask the captain if the landing gear should be retracted and could even have performed the action herself because of the transfer of control, however the first officer did not retract the gear as captain did not respond to her request, presumably because he had a heavier workload as he was now the PF. The first officer had also failed to monitor the speed. The aircraft crashed into the ground tail-first. The flight crew's actions following the engine failure were informal, did not adhere to standard operating procedures (SOP), and did not utilize crew resource management (CRM).[1][2]

Conclusion

The final report was published with the following:

"The accident was caused by the loss of an engine during a critical phase of flight, the non-retraction of the landing gear after the engine failure, and the Captain, the PNF, taking over control of the airplane before having clearly identified the problem.

The following factors probably contributed to the accident:

  • the perfunctory flight preparation, which meant that the crew were not equipped to face the situation that occurred at a critical moment of the flight;
  • the coincidence between the moment the failure occurred and the request to retract the landing gear;
  • the speed of the event that left the crew little time to recover the situation;
  • maintaining an inappropriate rate of climb, taking into account the failure of one engine;
  • the absence of any teamwork after the engine failure, which led to a failure to detect and correct parameters related to the conduct of the flight (speed, rate of climb, configuration, etc.);
  • the takeoff weight being close to the maximum with a high aerodrome altitude and high temperature;
  • the rocky environment around the aerodrome, unsuitable for an emergency landing."

[9]

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See also

References
  1. "Report on the accident on 6 March 2003 at Tamanrasset to the Boeing 737-200 registered 7T-VEZ operated by Air Algérie". www.bea.aero. Bureau d'Enquêtes et d'Analyses pour la Sécurité de l'Aviation Civile. Archived from the original on 13 June 2012. Retrieved 21 December 2018.
  2. Collins, Pete (9 February 2015). AIR CRASH INVESTIGATIONS - IN-FLIGHT ENGINE FAILURE - The Crash of Air Algérie Flight 6289. Lulu.com. pp. 11, 12, 14, 15, 16, 17, 21, 22. ISBN 9781312904668.
  3. "DCA03RA029". www.ntsb.gov. National Transportation Safety Board. Retrieved 21 December 2018.
  4. Ranter, Harro. "ASN Aircraft accident Boeing 737-2T4 7T-VEZ Tamanrasset Airport (TMR)". aviation-safety.net. Aviation Safety Network. Retrieved 9 April 2017.
  5. Karimi, Faith; Smith-Spark, Laura. "Air Algerie crash: 'Disintegrated' plane found in Mali". CNN. Retrieved 9 April 2017.
  6. Guttery, Ben R. (1 January 1998). Encyclopedia of African Airlines. Ben Guttery. p. 15. ISBN 9780786404957.
  7. "LES ALGERIENS DE MONTREAL" [THE ALGERIANS OF MONTREAL]. www.facebook.com (in French). Retrieved 22 May 2020.
  8. "102 morts dans le crash du Boeing" [102 dead in Boeing crash]. La Dépêche du Midi (in French). 7 March 2003. Retrieved 22 May 2020.
  9. "Tamanrasset: 102 mortsdont 6 Français" [Tamanrasset: 102 dead including 6 French]. Le Nouvel Observateur (in French). 11 March 2003. Archived from the original on 7 January 2014. Retrieved 31 December 2013.


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