UPS A306 at Birmingham on Aug 14th 2013, contacted trees and touched down outside airport

Last Update: June 4, 2015 / 16:10:22 GMT/Zulu time

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Incident Facts

Date of incident
Aug 14, 2013

Classification
Accident

Airline
UPS

Aircraft Registration
N155UP

Aircraft Type
Airbus A300

ICAO Type Designator
A306

A UPS Airbus A300-600, registration N155UP performing freight flight 5X-1354 from Louisville,KY to Birmingham,AL (USA) with 2 crew, was on approach to Birmingham's runway 18 at 04:51L (09:51Z) but touched down near the intersection Airport Road/Tarrant Huffman Road about 0.8nm short of the runway in open terrain, burst into flames leaving a trail of debris of about quarter of a nautical mile and coming to a stop about 0.55nm before the runway threshold and slightly left of the extended center line. Both crew were killed. The area has been cordoned off. No people on the ground or houses on the ground were affected.

Local police reported a large cargo aircraft crashed just outside the airport and said - following the Mayor's announcement of both crew having died - that both crew are still unaccounted for.

The FAA confirmed a UPS cargo aircraft crashed at Birmingham Airport. The FAA later declined comments on the condition of the crew (following Birmingham City Mayor's announcements the crew had perished in the crash), but in the afternoon (local time) confirmed both flight crew were fatally injured in the crash.

Birmingham Shuttlesworth International Airport reported a UPS Cargo Airbus A300 went down just outside the airport perimeter fence, so far there is no word on the fate of the crew and damage to the aircraft (repeated after the City Mayor made his announcements).

The Mayor of Birmingham said, that both crew perished in the crash.

UPS confirmed on Twitter one of their aircraft was involved in an incident at Birmingham,AL Airport. The airline has no verified information on the condition of their crew.

Airbus confirmed N155UP suffered an accident shortly after 09:50Z while on approach to Birmingham,AL arriving as flight 5X-1354 from Louisville,KY. The aircraft was produced in 2003 and had accumulated roughly 11,000 flight hours in 6,800 flight cycles. A team of Airbus specialists have been dispatched to Alabama to join the investigation by the NTSB, members of the French BEA are also going to join the investigation.

The NTSB have dispatched a go-team of 26 investigators to Birmingham,AL. An on site press conference has been scheduled at 16:00L (21:00Z).

In their first press conference on Aug 14th 2013 the NTSB reported the A300-600F N155UP flight 5X-1354 crashed while on approach to runway 18 of Birmingham. There were three impact points prior to the final position of the wreckage over a distance of about 200 yards (200 meters). It appears the aircraft contacted a number of trees on the top of the hill prior to the first point of impact on the ground. The overwing section was extensively damaged by fire, the tail section was still smouldering preventing the black boxes to be recovered, the NTSB is optimistic to recover the boxes the next day. The investigation will "begin in earnest tomorrow morning". Initial information, subject to verification, suggests the crew did not issue a distress call.

In their second press conference on Aug 15th the NTSB reported the black boxes were recovered at about 11:00L after 3 hours of work, the boxes were blackened and sooted, the NTSB however is optimistic to retrieve good data from the boxes. The boxes are being shipped to Washington for analysis where they should arrive in the evening. It should be known on Friday (Aug 16th) whether there are good data on the boxes. Preliminary information shows no evidence of an engine's uncontained failure or fire prior to impact, there is also no evidence of a pre-impact ingestion of foreign objects. The radar data have been obtained. There are no indications of failure of runway/approach lighting, subject to verification. Runway 06/24 was closed at the time of the accident for maintenance of runway center line lights.

In their third press briefing on Aug 16th 2013 the NTSB said, the "recorders did their job", there are good data, the cockpit voice recorder as well as the flight data recorder hold the entire flight. The captain (ATPL, 8,600 hours total, 3,200 hours on type) was pilot flying, the first officer (ATPL, 6,500 hours total, 400 hours on type) was pilot monitoring, the crew briefed the LOC approach runway 18, 2 minutes prior to the end of recording the aircraft received landing clearance on runway 18, 16 seconds before end of recordings there are two audible alerts by the GPWS "Sink Rate! Sink Rate!", 13 seconds prior to end of recording one crew member said "runway in sight", 9 seconds prior to end of recording sounds consistent with impact occurred. The flight data recorder contains more than 400 parameters requiring verification that these parameters are valid, this process takes time. It holds 70 hours of data including the entire accident flight. There were two controllers on duty at Birmingham tower, one controller was taking a break as permitted. The remaining controller observed the crash, he saw sparks and a large bright orange flash that he interpreted as breaking of a power line, he saw the landing lights, then no longer saw the landing lights and instead saw a large orange glow, he activated the crash button. There were no alerts regarding minimum safe altitude issued by his radar system. The crew started their "duty day" in Rockford,IL at 9:30pm on Aug 13th and flew to Peoria,IL as flight 5X-617 on A306 N161UP, then to Louisville,KY again as flight 5X-617 on N161UP before departing for the accident flight 5X-1354 on N155UP.

In their fourth and last press conference on Aug 17th the NTSB reported, the flight data recorder data have been validated. First results suggests the flight control inputs and flight control surface movements correlate, the engine parameters were normal. The flight data recorder stopped a few seconds prior to the cockpit voice recorder. The autopilot was engaged until the end of flight data recording end, the speed was about 140 KIAS as selected by the autoflight system consistent with the expected approach speed. The flight data recorder also confirmed the Sinkrate GPWS alerts. A checkflight by FAA on the PAPI system confirmed the PAPIs were indicating correctly to 1/100th of a degree. The aircraft had been updated to comply with all service bulletins and airworthiness directives.

On Feb 20th 2014 the NTSB released a number of documents into their public docket as part of the scheduled public hearing into the crash. The factual report submitted by the investigators states, that the aircraft performed a LOC 18 approach to Birmingham following an eventless flight with the crew, according to testimonies by ground personnel at Louisville in good/normal mood, intercepting the localizer at 2500 feet MSL. After crossing BASKN at 2500 feet the aircraft began the descent, the rate of descent increased to 1500 fpm and the aircraft descended through the decision altitude (1200 feet MSL, 556 feet AGL) at 1500 feet per minute rate of descent. An aural "sink rate" alert was raised by the EGPWS at 235 feet AGL (1536 fpm), 7 seconds after the sink rate the aircraft contacted tree tops and terrain about 1.2nm short of the runway threshold, portions of the aircraft came to rest about 0.75nm from the runway threshold. The captain (58, ATPL, 6,406 hours total, 3,265 hours on type) was pilot flying, the first officer (37, ATPL, 4,721 hours total, 403 hours on type) was pilot monitoring. The factual report also stated, that the charts used by the crew still showed the remark "When VGSI inop, procedure NA (not authorized) at night" that had been cancelled and revoked by the FAA in December 2011. The charts were only updated following the crash. The flight data recorder showed the aircraft was on autopilot maintaining 2500 feet while intercepting the localizer, the autopilot captured the localizer successfully and subsequently tracked the localizer until end of recording. A vertical speed of -700 fpm was selected into the master control panel, the aircraft began to descend below 2500 feet MSL consistent with intercepting the glidepath, 26 seconds after the begin of the descent the vertical rate was increased to 1500 fpm in the master control panel followed by the change of target altitude from 2500 feet to 3775 feet MSL. 45 seconds after the vertical speed was increased to -1500 fpm the EGPWS sounded "Sink Rate", an immediate response reduced the rate of descent to about -500 fpm. The control column position began to move towards nose up commands, 8 seconds after the EGPWS warning the autopilot disconnected (not stated whether disconnected by pilot command or automatically disconnected), an autopilot disconnect aural warning occurred, the autothrottle changed from speed to retard mode and the recording ended showing 7 degrees nose up and 138 KIAS at 14 feet AGL at last recording. The factual report regarding the cockpit voice recording shows the crew believed they were kept high and were complaining just after reading the final landing checklist and decided to use vertical speed. Shortly after the missed approach altitude was selected, both crew again commented they were too high for the approach, then the first officer commented "thousand feet", instruments cross checked, no flags, the captain remarked "DA is twelve hundred", then called 2 miles, shortly after the EGPWS sounded "Sink Rate", the captain got visual with the runway, the first officer confirmed runway in sight, the captain stated "autopilot's off", the autopilot cavalry charge (disconnect) sound was recorded following by first sounds of impact within a second after the begin of the cavalry charge, the EGPWS sounded "too low Terrain", the captain asked "Did I hit something?" followed by exclamations from both crew and sounds of impact until end of recording.

On Sep 9th 2014 the NTSB conducted their board meeting to determine the cause of the crash and concluded the probable causes of the crash were:

- the crew continued an unstabilized approach into Birmingham-Shuttlesworth International Airport in Birmingham, Ala.

- the crew failed to monitor the altitude and inadvertently descended below the minimum descent altitude when the runway was not yet in sight.

Contributing factors were:

- the flight crew's failure to properly configure the on-board flight management computer

- the first officer's failure to make required call-outs

- the captain's decision to change the approach strategy without communicating his change to the first officer

- flight crew fatigue

The NTSB stated the final report will become available in a number of weeks.

On Jun 1st 2015 the NTSB released a companion video (see below, following a dispute on youtube the video was removed late Jun 1st and re-released on Jun 4th 2015) and the final report.

The NTSB analysed: "At 0442:05, the controller vectored the flight 10¨¬ right to join the localizer and to maintain 3,000 ft. According to UPS guidance, once vectored off of the FMC lateral track, the first officer, as PM and at the direction of the PF, should have used the CDU to clear the previous navigation routing and flight plan discontinuity and to sequence the FMC so that it only reflected the anticipated approach waypoints to be flown. However, postaccident review of downloaded FMC data indicated that, although the first officer activated the approach, she did not verify the flight plan was sequenced for the approach. Additionally, the captain did not call for the first officer to verify the flight plan. These omissions resulted in the FMC generating meaningless vertical guidance to the runway."

The NTSB analysed further: "For the autopilot to capture the profile glidepath, the autopilot profile mode must be armed by pushing the profile button, and the flight plan must be verified in the FMC. Because the flight plan had not been properly sequenced in the FMC and the autopilot profile mode may not have been armed,97 the autopilot was unable to capture the profile glidepath as the airplane approached it, and the airplane never began a descent on the 3.28¡Æ profile glidepath to runway 18."

The NTSB analysed that there were a number of cues available indicating that the route discontinuity prevented a proper sequencing of the flight plan and profile, on the Primary Flight Display, Navigation Display as well as the flight mode announciators.

The NTSB analysed: "At 0446:25, about 10 seconds after completing the Before Landing checklist, the first officer queried the captain about the airplane¡¯s descent, stating, ¡°let¡¯s see you¡¯re in¡¦vertical speed¡¦okay,¡± and the captain responded ¡°¡¦yeah I¡¯m gonna do vertical speed, yeah he kept us high.¡± The captain initially set the descent rate at 700 fpm and 17 seconds later changed it to 1,000 fpm. Then, 14 seconds later, the captain then increased it to 1,500 fpm. At 0446:54, the captain commented, ¡°and we¡¯re like way high,¡± to which the first officer responded, ¡°about...a couple hundred ft...yeah.¡± With limited time and altitude available on the approach, the first officer¡¯s workload was further increased because she had to mentally process the change from the profile approach to vertical speed approach method. Additionally, the pace of her PM duties would have further increased her workload because the 1,500 fpm descent rate was about twice as fast as the normal descent rate on approach of 700 to 800 fpm. The NTSB concludes that the captain¡¯s change to a vertical speed approach after failing to capture the profile glidepath was not in accordance with UPS procedures and guidance and decreased the time available for the first officer to perform her duties."

The NTSB continued: "The flight crew should have continued to monitor the airplane¡¯s altitude but did not; neither crewmember noticed that the airplane was nearing or had reached the minimums altitude and the first officer did not make the subsequent required altitude callouts of ¡°approaching minimums¡± (1,300 ft msl) and ¡°minimums¡± (1,200 ft msl). These callouts should have elicited either a ¡°landing/continuing¡± (if the airport was in sight) or ¡°go-around, thrust, flaps¡± (if the airport was not in sight) response from the captain and would have further alerted the crew to their proximity to the ground. Because the flight crew was flying a nonprecision approach in instrument conditions, extra vigilance was required to ensure that the airplane did not descend below the minimums altitude without the airport being in sight.

The NTSB analysed that during training a number of deficiencies in conducting non-precision approaches had been noted with the captain of the flight, including: "looking at the radio altimeter instead of the barometric altimeter for height above airport, getting behind on a localizer approach using vertical speed, descending to an incorrect altitude on a nonprecision approach using vertical speed, using vertical speed during a descent when profile or level change would have worked better, using decision altitude instead of minimum descent altitude and flying below minimums, and failing to communicate to the PF that he had an inadequate descent rate."

The NTSB analysed: "The captain is responsible for setting the tone in the cockpit for the entire flight, and this is even more critical during the approach and landing phase of flight when workload is higher. The captain did perform the approach briefing in accordance with the operator¡¯s guidance and adhere to SOPs for the takeoff, cruise, and initial descent phases of flight. However, during this flight, the captain demonstrated poor decision-making by continuing the approach after the profile did not capture, failing to communicate the change in the approach method, not monitoring the descent rate and altitude, and failing to initiate a go-around when the approach was unstabilized below 1,000 ft. The NTSB concludes that the captain¡¯s poor performance during the accident flight was consistent with past performance deficiencies in flying nonprecision approaches noted during training; the errors that the captain made were likely the result of confusion over why the profile did not engage, his belief that the airplane was too high, and his lack of compliance with SOPs."

The NTSB analysed that the first officer has not managed her layover of 62 hours properly to avoid fatigue leading the NTSB to the analysis: "In summary, there were several decisions made by the first officer that contributed to her fatigue, which could have been mitigated by alternate choices. The first officer could have more effectively managed her sleep/wake schedule during her extended layover in San Antonio to minimize further adverse effects when she returned to night duty on August 12. Additionally, the first officer could have taken full advantage of her sleep opportunities in the days preceding the accident but instead she had extensive PED use, the timing of her return trip from Houston to SAT, did not secure a sleep room in SDF on the morning August 13, and later that day was outside of her hotel room for about 5 hours. Finally, when the first officer recognized that she was tired, she could have followed company guidance and called in fatigued. The NTSB concludes that the first officer poorly managed her off-duty time by not acquiring sufficient sleep, and she did not call in fatigued; she was fatigued due to acute sleep loss and circadian factors, which, when combined with the time compression and the change in approach modes, likely resulted in the multiple errors she made during the flight."

The NTSB wrote: "Although the flight crew set up and briefed a Continuous Descent Final Approach (CDFA) approach using the profile method, when the captain changed the autopilot to vertical speed mode, the approach essentially became a 'dive and drive' approach." and continued: "Although CDFA was one of the techniques taught at UPS, the guidance for CDFA was found in the PTG, which is not an FAA-approved or -accepted manual."

The NTSB analysed: "By not properly sequencing the approach and leaving the original navigation path direct to KBHM in the FMC, a flight plan discontinuity was introduced that prevented the autopilot from engaging in profile mode, even though the 3.28¢ª glidepath was programmed into the FMC and the profile mode was armed. Further, and in spite of the flight plan discontinuity, the FMC constructed a glidepath for the approach using the 3.28¢ª angle and the total length of all the navigation legs in the FMC, including the improper direct-to-KBHM leg. Because this length was unrealistically long, the altitude of the glidepath was unrealistically high for the airplane¡¯s actual distance from the runway, rendering the glidepath meaningless."

Birmingham Shuttlesworth International Airport offers a Localizer Approach and a RNAV(GPS) Approach to runway 18, length 7,099 feet/2,160 meters.



NOTAMs (released AFTER the crash, no NOTAMs related to runway 18 prior to the crash):
08/036 (A0368/13) - NAV ILS RWY 18 LLZ/DME U/S. 14 AUG 11:01 2013 UNTIL UFN. CREATED: 14 AUG 11:02 2013

08/035 (A0367/13) - RWY 18/36 CLSD. WIE UNTIL UFN. CREATED: 14 AUG 10:56 2013

Metars:
KBHM 141106Z 00000KT 9SM FEW005 OVC070 23/22 A2999 RMK AO2 FEW005 FU
KBHM 141053Z 01003KT 10SM OVC070 23/22 A2999 RMK AO2 SLP146 T02330222
KBHM 140953Z 34004KT 10SM FEW011 BKN035 OVC075 23/22 A2997 RMK AO2 SLP141 T02330222
KBHM 140904Z 00000KT 10SM SCT010 BKN075 23/22 A2996 RMK AO2
KBHM 140853Z 00000KT 10SM BKN010 OVC075 23/22 A2997 RMK AO2 CIG 006V013 SLP138 T02330217 52000
KBHM 140848Z 33003KT 10SM OVC010 23/22 A2997 RMK AO2 CIG 006V013
KBHM 140753Z 00000KT 9SM OVC008 23/22 A2996 RMK AO2 CIG 007V011 SLP137 T02330217
KBHM 140734Z 00000KT 10SM BKN010 BKN016 23/22 A2996 RMK AO2
KBHM 140712Z 00000KT 9SM SCT006 BKN016 23/22 A2997
KBHM 140712Z 00000KT 9SM SCT006 BKN016 23/22 A2997 RMK AO2
KBHM 140653Z 00000KT 10SM OVC006 23/22 A2997 RMK AO2 CIG 005V009 SLP141 T02330217
KBHM 140553Z 00000KT 7SM OVC004 23/22 A2998 RMK AO2 SLP142 60002 T02330222 10250 20228 403110228 56005
Aircraft Registration Data
Registration mark
N155UP
Country of Registration
United States
Date of Registration
Egdemdnqmmf ch k Subscribe to unlock
TCDS Ident. No.
Manufacturer
AIRBUS
Aircraft Model / Type
A300 F4-622R
Number of Seats
ICAO Aircraft Type
A306
Year of Manufacture
Serial Number
Aircraft Address / Mode S Code (HEX)
Engine Count
Engine Manufacturer
Engine Model
Engine Type
Pounds of Thrust
Main Owner
Mjnqhdl kje qemchj kmphcpekAdpAnnqiecnfmkbem h ffAgkfpldelbjglAjkbhpgleeAklk Subscribe to unlock
Incident Facts

Date of incident
Aug 14, 2013

Classification
Accident

Airline
UPS

Aircraft Registration
N155UP

Aircraft Type
Airbus A300

ICAO Type Designator
A306

This article is published under license from Avherald.com. © of text by Avherald.com.
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