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Statement at the NTSB Public Board Meeting on Final Report of Crash of USAir flight 427, Springfield, Virginia
Jim Hall
National Transportation Safety Board (NTSB), Board Meeting, Crash of USAir flight 427, Aliquippa, PA, Springfield, Virginia

Good morning. This is a meeting of the National Transportation Safety Board to discuss a draft report on our investigation of the crash of USAir flight 427 near Aliquippa, Pennsylvania on September 8, 1994.

I am Jim Hall, Chairman of the NTSB. With me here are Vice Chairman Robert T. Francis, Member John A. Hammerschmidt, and Member George Black. Member John Goglia has recused himself from participation in this investigation because of his participation on USAir's behalf in this investigation before his appointment to the Board.

This meeting - as with all of our Board Meetings - is being held under the Government in the Sunshine Act, which requires multi-Member federal agencies to conduct much of their business in open session. While the public has been invited here to observe the proceedings, only the Board Members and the NTSB staff will actually participate in the discussion.

This will be a long and technical meeting, and because of that we have prepared a 60-page information handout that is available for everyone in this room that we hope will help you to follow the proceedings.

In our audience are approximately 100 members of families of those who died aboard USAir flight 427. Let me say to them that, on behalf of the Safety Board, we appreciate you being here today, and trust that when we finish, you and all the American people will believe that everything possible has been done to determine what caused this tragedy.

On September 8, 1994, about 7:03 p.m. eastern time, USAir flight 427, a Boeing 737-300 crashed near Aliquippa, Pennsylvania, while maneuvering to land at Pittsburgh International Airport on a flight from Chicago. All 132 persons aboard - 127 passengers, 2 pilots and 3 flight attendants - were killed in the crash.

The crash precipitated the longest and one of the most technically challenging investigations in Safety Board history. In the past 4 ½ years, we have held two public hearings on this investigation, and conducted a seemingly endless series of tests - from computer simulations and kinematic studies to wake vortex flight tests to examinations of hardware from dozens of aircraft. The discussion in this meeting will cover the scope of the tests and research associated with this investigation.

During the course of this investigation, we have issued 20 safety recommendations focusing on flight data recorders, the 737's rudder and rudder control system, and pilot training. We will hear from staff what action government and industry have taken with those recommendations.

No one has been affected more by this accident, of course, than the family members of those who perished aboard flight 427. But I'd like to give you some idea of the dedication of our investigators in their search for a cause. Since the day this accident occurred, one of our investigators here today has traveled to Boeing in Seattle 14 times, to Parker Hannifin in California 12 times, and to other locations multiple times. He has logged 143,500 miles flying to manufacturers and research facilities around our country, and spent about 6 months in hotel rooms. Similar travel schedules have been recorded by other investigators, both from the Safety Board and from other organizations.

And these are the result of all that effort, two binders containing a 500-page draft report. Because of the complexity of this investigation, for the first time in the history of the Board, this Sunshine meeting might carry over into a second day.

All this work, which has encompassed as much as 100,000 hours of investigative time by government and industry groups, has been accomplished to fulfill our mission to determine the probable cause of this accident and, even more important, to find ways to prevent it from happening again.

This has truly been an international effort. Technical advice and other assistance has been provided by the United Kingdom, Russia, France, Australia, Denmark, Canada, Germany, New Zealand and Brazil. I especially wish to acknowledge the considerable support provided by David King and others at the U.K. Air Accident Investigation Branch, and Dr. Alfred Belan and others from the Interstate Aviation Committee in Moscow.

I cannot overstate the importance of our work in this investigation, because the crashes of USAir flight 427 and United Airlines flight 585 in Colorado Springs have raised questions in many minds about the design and operation of the 737's rudder system. The Boeing 737 is the most popular airline model in the world. There are more than 3,000 of them in service worldwide, and they have amassed 91 million flight hours. In their 31 years of service, 737s have reportedly carried the equivalent of the population of the entire world - almost 6 billion people. At any given moment, 800 737s are in the air around the world.

Today's discussion will also include the considerable work that has been done on United flight 585 and on a non-fatal incident involving Eastwind Airlines flight 517 in 1996.

We wish it had not taken us 4 ½ years to get to this point, but the complexity of the investigation, coupled with the appalling lack of flight data recorder information, necessitated a long, comprehensive investigation. We don't yet know what the final product will be, but I think the American people can be confident that the work done by the governmental agencies and the elements of industry during this monumental effort has already resulted in safety improvements. We need to determine if more needs to be done.

Mr. Goelz, would you please introduce the staff that will present this report to the Board.


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