Statement of Jim Hall, Chairman
National Transportation Safety Board
at Closing of NTSB Board Meeting
Final Report Crash of TWA Flight 800
August 23, 2000
Over the past two days, you have heard the NTSB staff present a great deal of complex, technological information on the investigation into the crash of TWA flight 800. In the final analysis, what it all tells us is that the 230 men, women, and children on board TWA flight 800 lost their lives, not as the result of a bomb or missile or some other nefarious act, but as the result of a tragic accident - an accident triggered by an ill-fated sequence of events in the center wing tank of an aging aircraft that was set in motion years before by the manufacturer's and the FAA's design and certification philosophy.
What is also evident is that we've learned a great deal over the past four years - especially about fuel flammability, possible ignition sources, and the wiring in aging aircraft. And, in the four years since the accident, much has been done to improve the safety of the not only the 747 fleet, but of other aircraft as well.
In December 1996, the Board recommended that the Federal Aviation Administration (FAA) study design changes to deal with heated, flammable vapors in aircraft fuel tanks and that they require operational changes to enhance the safety of those tanks. In April 1998, the Board issued another set of recommendations focused on aircraft wiring and the fuel quantity indication system. Today, we made four more recommendations that we believe will further enhance the safety of commercial aviation.
The FAA has taken a number of actions on our previous recommendations. They have issued almost 40 airworthiness directives (ADs) on fuel quantity indicator system wiring separation and inspections and modifications of fuel pumps, fuel quantity indicator system wiring, and the wiring in fuel tanks, and fuel pumps. They've also proposed a special AD to require a review of existing airplane fuel tank system designs and mandatory fuel tank maintenance and inspections. And, they're looking at the issue of aging wiring. I'm gratified to see that they're also doing a lot of work in the area of flammability reduction - including looking at minimizing flammable vapors and ground-based inerting. I trust that the FAA will be equally responsive to our new recommendations. I hope that, once the spotlight has moved away from this accident, the FAA's leadership will ensure that the promises they've made to the American people, the travelling public, and the TWA 800 families are fulfilled.
I recently came across the following quotation: "It is recommended that every effort be expended to arrive at a practical means by which flammable air/vapor mixtures are eliminated from fuel tanks." This was presented to the FAA by our predecessor agency, the Civil Aeronautics Board, on December 17, 1963, following the crash of Pan American flight 214 near Elkton, Maryland.
Almost 40 years later, it is imperative that at long last, the aviation community move with dispatch to remove flammable fuel/air mixtures from the fuel tanks of transport category aircraft.
But, these safety improvements are not the only improvements to come out of this tragedy. In the months following the crash of flight 800, the President and Congress gave the NTSB the important mission of being the federal coordinator for services to the families of the victims of aviation disasters. Because of that action, all airlines flying in the United States must have a family assistance plan in place that must be activated following an accident. Taking care of families is now at the forefront of the airlines' planning - not as an afterthought. And, as a result, families are now treated with the compassion and care that they deserve. Families in other transportation-related accidents have also benefited from this change - the Board now launches family assistance personnel to all accident scenes.
Before I continue, I want to recognize Peter Goelz and Betty Scott for stepping forward, long before the legislation was passed and at my request, to provide this much needed assistance to the TWA 800 families. They've set the standard for others to follow and we are all appreciative of their efforts.
This Board meeting does not mark the end of the TWA flight 800 lessons to be learned and implemented. Because we believe the reconstructed wreckage can provide invaluable insights for aviation professionals, the Safety Board has, over the years, allowed them to visit the hangar at Calverton to view the wreckage and discuss information gained during the accident investigation.
In fact, Member Goglia has personally briefed more than 400 maintenance personnel at Calverton. In the near future, the Safety Board will inaugurate its own training academy - the centerpiece of which will be the flight 800 reconstruction - so that future generations of aviation professionals and accident investigators from around the world can learn the lessons that it has to teach.
Before I close, I want to express my appreciation and admiration to the Safety Board staff who worked so hard for so long on this investigation. Your dedication and tenacity not only produced an exhaustive, well-researched report, but they have also helped create a safer aviation system as well.
I know that everyone involved with this investigation - the investigators, the writers and editors, the Public Affairs staff, the Family Affairs staff, the Office of Research and Engineering under the leadership of Dr. Vern Ellingstad, and the management and administrative staff - all sacrificed untold hours away from their families - often missing weekends, holidays, and many special family occasions so that the travelling public will be safer. Every office and every person at the Safety Board was touched by this accident and contributed in untold ways to the investigation. I want to thank you all for your selflessness, energy, integrity, and determination to find the cause of this accident and to prevent similar accidents in the future. You truly represent the epitome of public service and we are all indebted to you.
But, I want to especially thank Dr. Bernie Loeb for his leadership in this investigation. Dr. Loeb directed the activities of the staff as they pursued every theory under investigation in this accident during a period of unprecedented activity for the Board. As many of you know, just two months before flight 800 crashed, Valujet flight 592 crashed in the Everglades. And, since then we have had a number of other accidents, including KA flight 801, AA flight 1420, EgyptAir 990, Alaska Airlines flight 261, several cargo plane crashes, and the JFK, Jr. and Payne Stewart accidents. The NTSB and the American people are fortunate to have someone of Dr. Loeb's caliber in charge of the Office of Aviation Safety.
I also want to acknowledge that this is Barry Sweedler's last Board meeting. Barry is retiring from the Board after 31 years of dedicated service. Barry, we all wish you and your family god speed as you move on to new challenges.
On a personal note, I want to also thank my Special Assistant, Lieutenant Colonel (retired) Deb Smith, for her efforts and assistance throughout the investigation. Let me pause to let you see the names of all the Safety Board Staff who have been an integral part of this investigation.
I also want to again thank the parties to the investigation for their persistence and assistance. Your expertise and advice has been invaluable to us over the past four years. I believe that this investigation has shown once again that the party system works and that participants in our process have much to contribute in developing the factual record of an accident and enhancing the analytical process. And, I want to thank the many individuals from the various industrial, academic, government, and military organizations that assisted us both on scene and throughout the investigation for your contributions to this endeavor.
Finally, I want to thank the flight 800 families for your patience and understanding as the Safety Board worked over the past four years to discover the cause of this accident. I know that this Board meeting may not bring you the closure you seek - but I hope that it will allow you to move forward.
Nothing we do here can ever compensate for the tremendous loss you have suffered. However, I hope that the knowledge that we know what happened and are working to ensure that it will not happen again will provide you some modicum of comfort.
This Board meeting is adjourned.