Chronology of events and tragic mistakes
The plane took off from Sukhum airport at 10:21 Moscow time. There were 181 people on board – 174 passengers and seven crew members. The flight took place at an altitude of just over 10,000 meters, and at 12.39 preparations for landing began at Leningradsky Pulkovo. The aircraft commander warned that the landing will take place using the most common route glide path system in aviation (cockpit instrument approach system – socialbites.ca).
However, on May 21, two days before the accident, the system at Pulkovo Airport was shut down for scheduled maintenance, according to a warning page. But the crew was not acquainted with the data.
At 12:45, after the start of the descent, the pilots contacted the controller and received confirmation for a gradual decrease in altitude. Descending to the level of 1800 meters, the crew had to reapply to the controller and request information about the review of the airspace, but he did not do this, essentially continuing to descend blindly.
At this time, the sky over Pulkovo airport was cloudy, and the weather was rapidly deteriorating: until 13.00 it was raining, the sky was covered with clouds, which made landing difficult. The captain of the plane relied on the help of the vehicles and made the final decision to lower the liner.
At 13.02, the plane was already at an altitude of 600 meters. Despite the weather conditions, the pilots saw the marks on the ground and even increased the landing rates. At 13.05 the aircraft descended to a height of 150 meters, but the navigator did not give the “Assess” command it was supposed to give as it approached the decision altitude (the height at which the landing procedure can be safely interrupted and circumvented). – “socialbites.ca “).
At the same time, the technical indicators available to the pilots indicated that it is necessary to go around: according to the rules, the vertical speed of the aircraft after landing below the decision should not be higher than 6 m / s. height, but the liner had already won by 7.5 m /.
This fact was ignored not only by the pilots, but also by the dispatchers. This was due to the fact that at about 13.05 in Pulkovo the controllers changed, and the new employee did not notice the deviation and excessive landing of the aircraft from the allowable trajectory. Otherwise, he had to order the pilots to climb.
Violation of the rules of the flight guide led to the appearance of a significant instability of the aircraft, only a minute before the landing of the ship, the destabilization during the landing approach, the buildup of overload. At 13.06 the plane hit the ground hard, split from the middle of the fuselage and began to fall apart.
“The plane breaks down, people fly from it”
Footage from the crash scene posted on the Web by an eyewitness of the events shows people standing on the lawn near the runway, some passengers from the destroyed cruise ship managed to retrieve their luggage. The author of the video claimed to have seen the bodies of the dead.
Natalia Minaeva, one of the users of the network, shared her memories in the comments to the shooting with the destroyed liner. She was then 10 years old, and she witnessed the disaster while sitting at the window of the plane preparing to take off from Leningrad.
“Our ship was moving slowly on the runway, and the plane in Sukhumi was landing. Suddenly, there was a collision, as if the hard skin was torn, and then the picture no longer fit my childish worldview – the plane was falling apart, people were flying through it, some incomprehensible fragments, suitcases. And the tail of the plane was literally at us flew right. From the eyes of a child it looked like a movie, ”the woman wrote.
He added that his plane never took off, stopped and half an hour later the passengers were asked to leave the cabin and returned to the airport building. On the way, Natalia saw how crowds of people near the crashed Tu-154 were crowding, many shouting, bags and toys scattered everywhere, in some places hastily abandoned stretchers. Some bodies weren’t even covered, and the woman admitted she didn’t realize how real what happened to her was.
“We waited another six hours at the airport for our departure, we changed the crew. A woman was sitting next to him, half of his hair was burnt, his cheek was covered in blood. The passenger said that the fuselage broke through a row of seats after that,” he said.
The day after the disaster, on May 24, the newspaper Izvestia published an article about the events.
It was reported that 11 people lost their lives and 38 people were injured. Crew members survived, but the commander was hospitalized “in a critical condition”.
“During the landing approach at 280 km/h, the plane broke, the tail part came off. After ploughing the dividing grass, the crushed lining stopped in a space between two concrete strips. If the fuel had flared up, the plane would have turned into a torch,” he said.
The tail part of the aircraft remained on the runway, the nose part and the winged middle part flew 80 meters. When the exact death toll was calculated, it turned out that the accident cost the lives of 15 people. There were two children among them.
causes of plane crash
According to the results of the special commission of the USSR State Aviation Inspection, which investigated the incident, the aircraft made a rough landing due to the inconsistency in the actions of the crew and dispatchers. The aircraft commander and pilots did not pay due attention to the pre-landing preparations.
In addition, the landing controllers did not provide the crew with the necessary information about obstacles to landing and did not warn that the ship was losing altitude in a dangerous area. Due to incorrect calculations by the pilots, the aircraft may begin a steep descent.
On the other hand, the commander did not give clear instructions in time to ensure a safe landing of the Tu-154 and did not check the necessary parameters of the approach before making the decision to land at Pulkovo airfield. The pilots, in turn, repeatedly ignored the go-around instructions. This caused the vehicle to become unstable and made a normal landing impossible. It was clear that the pilots were unaware of the advice in the flight manual, which could prevent the plane from making a hard landing.
In addition, according to the conclusions of experts, the interaction between crew members was insufficient, and their assessment of the aircraft’s position relative to the runway was distorted. A key role here can be played by weather conditions that complicate the landing: the downpour distorted the runway projection.
Regarding the last point, the report also indicates that due to the violation of the rest regime and the increased workload, the pilots did not adequately coordinate their actions (this was due to the early departure of the Leningrad-Sukhum-Leningrad flight, which started approximately). 5 am).
While trying to figure out why the crew wasn’t sticking around, the commissioners found that the pilots were guided by the psychological attitude for first-time landing so that no one doubted their professionalism. They also did not fully understand the dangers of an uncontrolled descent at low altitude.
Punishment for the crew and lessons for the future
After the plane crash, First Deputy Minister of Civil Aviation Aleksey Goryashko ordered those responsible to be disciplined. Thus, one of the air traffic controllers and co-pilot who controlled the approach of the Tu-154 for landing (he was also excluded from the list of candidates for the appointment of aircraft commanders), the deputy head of Pulkovo Airport for ATC, the flight crew and the commanders of the flight crew received heavy reprimands.
The senior controller was dismissed for a period of three months. The instructor pilot, who served as the aircraft commander, was asked to take action after his temporary disability passed.
The head of the Leningrad Civil Aviation Department was instructed to correct the deficiencies that the commission found during the investigation of the causes and details of the accident.
The leadership of civil aviation departments, organizations, enterprises and airlines, commanders, engineers, pilots and dispatchers of all enterprises in the aviation industry were instructed to study data on the incident. At the same time, employees were advised to use a methodological manual to avoid hard landings.
In addition, the crew had to be tested for knowledge of obvious changes in the flight instructions of the Tu-154 aircraft. Increased control over how they add to flight documents, how crews perform in-flight technology, and how they interact with each other in accordance with instructions.
“Just passing can save the situation”
In situations like the Pulkovo incident, it’s important to remember that flight safety expert Alexei Vlasov said in an interview with Gazeta that if the crew commander isn’t sure about the success of the landing, he should stick around. .Ru.
“In general, such a precaution should be taken in two scenarios: deterioration of meteorological conditions (these are precipitation, heavy fog, wind shear) where the commander does not see the runway until the decision height, and an unstable landing approach, as on the Tu-154 or at a high altitude. when there is vertical speed or when the flight speed does not meet the restrictions,” he said.
The pilot performs many actions in a certain order and has no right to miss or mess anything up. However, it is during descent that the probability of error increases many times over by human nature.
The expert emphasized that in total, 70% of the plane crashes in the world are due to the fault of the human factor. The most common violations are an error in piloting technique or loss of spatial position (spatial disorientation).
“It is important to closely monitor the flight process, so in civil aviation there are at least two pilots, they are constantly watching each other,” said Vlasov.
Speaking about the consequences of a difficult landing, the expert noted: in 2019, with the Sukhoi Superjet 100 at Sheremetyevo Airport, a disaster, apparently similar to the tragedy in Pulkovo, showed that the structure of the aircraft was destroyed by such a landing, as a result of which the risk for passengers increases significantly.
“In a difficult landing, everything will depend on the power of the aircraft. Since there are limitations and restrictions on destruction, nothing can be done if the destructive overload exceeds the values obtained at landing. Only one transition can save the state – this is an authoritative bug fix, ”summed Vlasov.
Source: Gazeta
