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Air Crash Investigation - Season 26 - Episode 05: Crash Landing (Eagle Airways Flight 2300)
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00:02Controllers in Islamabad watch as Air Blue Flight 202 head straight towards a massive hill.
00:09He's not turning.
00:14They issue urgent warnings.
00:17Turn left immediately.
00:18But fail to prevent a disaster.
00:20Marine ahead.
00:21They're going down!
00:30It's the worst accident in Pakistan's aviation history.
00:36When investigators listen to the CVR, they hear the pilots realise they're in danger.
00:42Terrain, sir!
00:45Took steps to avoid it.
00:48Turning left.
00:49But were unable to save the lives of 152 people.
00:54Why aren't we turning left?
00:56The crew knew what they had to do.
01:00They had reported that they were doing what they were supposed to do.
01:04And yet, the aircraft continued to fly in the wrong direction.
01:09D-D-D-D!
01:14Pulls up!
01:34Air Blue Flight 202 begins its early morning descent towards Islamabad, Pakistan.
01:46There are 146 passengers and 6 crew on board the Airbus A321.
01:57A Blue 202.
01:59Expect arrival to Islas runway 30.
02:01Followed by circling approach to land runway 12.
02:05Understood.
02:05It'll be Islas down to Minima.
02:07And then left downwind.
02:10Okay.
02:13Captain Parvez Chowdhury is one of the airline's most experienced pilots.
02:20Najam Qureshi is a former Air Blue pilot who flew with Captain Chowdhury.
02:27Captain Chowdhury had a lifetime of experience flying with the Pakistan International Airline.
02:32He had a very successful carrier.
02:34And he was pretty much approaching the end of his carrier.
02:37Air Blue 202 clear to 3900 for ILS approach to runway 30.
02:41Followed by circling approach to land on 1, 2.
02:45First officer, Sayed Ahmed, has less commercial experience.
02:50He's a former F-16 fighter pilot and squadron leader in Pakistan's Air Force.
02:56Air Blue 202 clear to 3900 for ILS.
03:01230.
03:03Clear to descend to 3900.
03:10He had about 300,000 the type.
03:13So just brand new.
03:14Learning the differences between the Air Force flying and the commercial flying.
03:20Pakistan's capital, Islamabad, is a city of more than 800,000 people.
03:26It's surrounded by the Himalayan foothills to the north and northeast.
03:34The mountainous terrain means the only approach to Islamabad's runway is from the south.
03:41Due to the wind direction today, planes are landing on runway 1, 2.
03:46They must circle the airport and make a visual approach to the other end of the runway.
03:54It is always safer to land with a headwind as compared to a tailwind.
03:59When the winds change beyond a certain limit, the air traffic controller will switch the runways.
04:05That will ensure the plane lands in a headwind.
04:11Thick clouds envelop the airport, making landings difficult.
04:17China Southern is going around and diverting back to Urumqi.
04:20China Southern confirming, diverting back to Urumqi.
04:25Attention all landing aircraft.
04:27China Southern is diverting due to weather.
04:31If at any point you lose sight of the airfield,
04:36you should abandon the approach completely and carry out the missed approach procedure.
04:44Flight 202 is now less than 10 minutes from landing.
04:54Gear down.
05:00Gear down.
05:01Gear down.
05:04The plane reaches the minimum altitude to which the pilots can descend without the runway in sight.
05:12As soon as you see the runway, you turn right, and then after that you're supposed to keep the runway
05:17in sight.
05:20Commencing right turn, heading 352.
05:25Call it in.
05:28Air Blue 202.
05:30Maintaining right.
05:31Maintaining 2-500 and turning right.
05:33Heading 352.
05:35Air Blue 202.
05:36Confirming at 2-500.
05:39Turning right.
05:39Heading 352.
05:46Air Blue 202.
05:48initiates the first turn of the circling approach continue on the circle for
05:54landing on runway 12 caution low clouds and visibility maintain visual with the
06:00airport even in the poor weather it is up to the pilots to decide whether they
06:07should continue the approach or not depending whether they have it on the
06:11side the controller expects to see the lights of the airbus as it flies past the
06:20airfield
06:28radar I can't see air blue 202 what's his current location please he's approaching
06:34the no-fly zone north of the airfield instruct him to turn left immediately
06:41flight 202 is much further north than expected and needs to turn left for
06:47the approach to runway one to a blue to zero to turn left heading 180
06:56confirm he has visual with the ground if not instruct him to climb and execute a
07:00missed approach a blue to zero to confirm you have a field in sight the controllers
07:08had radar they could see what the aircraft was doing they could see that the aircraft was not
07:14doing what the procedure said they should be doing ask again air blue two zero two please confirm you have
07:23visual with the ground
07:34visual with the ground
07:37he's confirming visuals
07:41he's not turning
07:44controllers can see that flight 202 is rapidly approaching the hills north of the airport
07:56in the cockpit the pilots are struggling to turn their plane away from the mountains ahead
08:03the low standard of the airfield
08:04why aren't we turning left
08:15Why is there turning left
08:17Terrain ahead
08:19pull up
08:22Terrain ahead
08:24pull up
08:25Instruct him to turn left immediately
08:30the controllers can't believe what they're seeing here's a guy with 25 000 hours and
08:37he's flying directly towards a mountain in the cabin passengers have become aware that
08:44something's not right they're approaching the 5 000 foot magala hills terrain ahead pull up sir we are
08:59going down there we're going down message from radar turn left immediately terrain ahead pull up
09:21flight 202 has crashed into the magala hills seven miles from the airport
09:29the wreckage lies at an altitude of nearly 3 000 feet it will be difficult for rescuers to reach
09:40the site we couldn't get access to it with a car or a truck even with helicopters there was no
09:48place
09:48to set down so the only way to get to the accident site was with a long slow climb it
09:59takes more than
09:59half an hour for rescuers and volunteers to make their way up the steep hill to the crash site
10:05in hopes of finding survivors when crews do reach the site they find a scene of complete devastation
10:33a hundred and fifty two people died in the saxon it's the worst accident in pakistan's aviation
10:40history why did a modern airplane fly into well-known mountains north of the airport in islamabad
11:00investigators arrive at the accident site to study the wreckage of air blue flight 202
11:09when an aircraft flies into mountains there are really two areas that we're looking at in terms of
11:15the root cause one is a sudden and unexpected loss of control the other would be the aircraft has
11:25actually stayed in control of the pilots and still somehow been flown into a mountain
11:34an analysis of the engines shows that they were fully functional at the time of impact and capable of
11:41producing maximum thrust
11:46okay good work everyone start heading back down right so the stabilizer was set at 3.5 degrees nose up
11:56landing gear was down engines at climb power so configured for landing but climbing at full power
12:07an examination of the electrical and mechanical components that we could find
12:11there was no obvious damage or mechanical failure they were trying to land here
12:20but then they slam into the margala hills seven miles north of the runway
12:27how did they get so far off course
12:33for an approach that was supposed to be a very tight approach because of the existence of the hills
12:40that is extraordinary
12:43they were approaching from the southeast for landing here on runway one two
12:56scattered clouds rain visibility was at 3.5 kilometers challenging conditions
13:08could the cloudy conditions have been a factor in the accident
13:14when an aircraft flies into high ground one thing that is almost certainly a factor is poor visibility
13:23low cloud fog call it what you will
13:28visibility would have been an issue but you don't need to see the margala hills to know that they're there
13:39so
13:40everyone knows towards the northeast of the runway there are mountains they're clearly marked on the maps
13:46terrain ahead
13:47so we're going down
13:48pull up
13:57can the controller explain why the crew of flight 202 couldn't avoid the mountains
14:04radar control informed him he'd be doing the circling approach to runway one two
14:08a blue 202 expect arrival at irless three zero followed by circling approach to land runway one two
14:17and he understood the approach
14:20yes sir he did
14:23understood it'll be irless down to minima
14:26and then left downwind
14:30and then
14:31that's when i assume control
14:34as he began the right turn to the circling approach
14:41the circling approach involves four carefully timed turns
14:46the first to the right followed by a left turn that takes the plane parallel to the runway
14:53the two final turns lined the plane up for the landing on runway one two
14:59pilots must keep the runway in sight for the duration of this approach
15:07after about a minute i expected to see him fly by
15:13but he never did i asked the crew if they had the runway in sight and they confirmed that they
15:20did
15:21air blue 202 please confirm you have visual with the ground
15:28air blue 202 visual with the ground
15:32but he kept flying further and further away from the airport directly towards the hills
15:40after breaking off from the approach they are supposed to turn after 30 seconds
15:45instead they kept going for almost two minutes
15:49we tried to stop him several times
15:54it was too late message from radar turn left immediately
16:08we couldn't prevent
16:13what happened
16:20it's all here on the radar track
16:29crew knew what they had to do
16:32they reported that they were doing what they were supposed to do
16:37and yet the aircraft continued to fly in the wrong direction
16:46how could the pilots have ended up so dangerously off course
16:58investigators look into the background of flight 202's pilots to determine if the approach into
17:05islamabad was mishandled
17:09captain had years of experience with major airlines
17:15captain chowdhury has been flying for more than 40 years
17:20he has accumulated more than 25 000 flying hours throughout his career
17:25but only about 1 000 of those were on the airbus
17:33the first officer however is a whole different story
17:38first officer syed ahmed had far fewer hours than the captain
17:43the former fighter pilot had recently joined the airline and had accumulated only 286 hours on airbus a320 airplanes
17:56two very different pilots one during the end of his career with thousands of hours of experience
18:04and the other just starting off his commercial career
18:08but neither of them had a ton of experience with the airbus a321
18:16the pilot's lack of experience on this type of plane play a role in the accident
18:25experience is generally considered to be an asset
18:29the only potential downside is that of course if you've got a lot of experience of one particular thing
18:36it actually might be more difficult to learn how to operate this new type of aircraft
18:49okay so they're supposed to perform their approach within this area anything
18:54beyond this is outside the airport's 4.3 mile protection zone
19:00okay let's see his track
19:04investigators examine flight 202's radar track to see how the pilots set up their approach all right
19:14so they make their first turn here
19:20and then head straight out of the protection zone
19:25and this left turn takes them directly into the margala hills
19:31the radar track shows that the pilots flew closer and closer to the mountains surrounding islamabad
19:39wouldn't they have gotten a warning that they're approaching the hills
19:49yes sir it should have sounded 60 seconds before impact
19:56the enhanced ground proximity warning system looks downward to see the height that you're at above
20:05ground but it also looks ahead to see any terrain that you're flying towards
20:14if they got a warning why didn't they try to pull up or turn to avoid it
20:25did the pilots of flight 202 get any warning of an impending collision
20:32the crew would have been given pictures on their navigation display of the approaching terrain
20:38and they would have been given aural warnings so since they flew directly into the terrain
20:46has the enhanced ground proximity warning system completely failed
21:01don't leave me in suspense did they get any ground proximity warnings
21:15the cockpit data shows that in the final minute of the flight the crew got 21 separate warnings
21:22about the rising terrain ahead
21:29okay so that answers that
21:34over 21 times we saw terrain terrain pull up terrain ahead pull up there's no way that the captain missed
21:42that warning the enhanced ground proximity warning system was working properly
21:47terrain if the warning system was operating why would the pilots ignore it and allow the accident to
21:56happen terrain ahead pull up if you hear a full terrain pull up warning from the egpws the reaction should
22:04be
22:04immediate it should be to apply full power pull the nose of the aircraft up get it moving away
22:10from the ground and that should be done before any questions are asked
22:19why didn't the crew of air blue flight 202 act on terrain warnings and steer their plane away from the
22:27mountains islamabad air blue 202 investigators listen to the cockpit voice recording what are current
22:44conditions they focus on how the crew set up for landing
22:51it will be runway one two yes invisibility is crap
22:58the weather was marginal and marginal weather makes you nervous because you don't know whether
23:04you're going to be able to see anything at all and the captain clearly was nervous about this approach
23:13did the captain proceed with an approach he wasn't comfortable with
23:45it didn't make any sense for the captain to
23:47to be entering waypoints into the flight management system
23:51the circling approach is by definition a visual approach so there is no way that any pilot would
23:57normally do this
24:01then just two miles from the airport the pilots of air blue flight 202 hear of a flight landing ahead
24:09of
24:09them be advised that a pia 737 has landed on runway one two safely
24:17commencing right turn heading 352
24:23that could have caused the pilot to say hey if they can get in we can get in too
24:29it stops up so he starts his turn later than usual half a mile from the runway
24:42instead of breaking off early they had to continue on because of the low visibility and low ceilings
24:48and they did not break off to the right until the last possible point which was at the end of
24:52the runway
24:54that's the end of the day concerned with poor visibility captain chowdhury makes a baffling decision
25:00switch into nav mode for managed approach to runway one two there he goes switching to nav mode he can't
25:08be
25:08visual
25:11carrying out the circling approach using the autopilot to navigate is a violation of procedures
25:20as soon as you select the nav mode the plane starts to fly the pre-programmed uh waypoints
25:27and at this point captain chowdhury is normal flying the visual approach okay sir
25:36but are you visual
25:40i have a visual
25:45chowdhury
25:45chowdhury insists he can see the runway but investigators are certain he could not
25:51they can't see the airfield any longer because they've just got to the far side of it
25:56there is no airfield in sight
26:00so instead of turning left to fly parallel with the runway
26:05he keeps flying in this direction moving further and further from the airport
26:13sir we're reaching higher ground
26:16terrain ahead
26:18terrain ahead sir there's terrain ahead
26:22sir turn left
26:25terrain ahead
26:28it should be turning terrain ahead
26:31as the captain struggles to turn away from the hills
26:36controllers become concerned
26:38air blue 202 confirm you have airfield in sight
26:42what should i tell him sir
26:45tell them
26:49the crew doesn't reply straight away
26:52probably because the first officer knows full well that no they don't have visual contact with the
26:57airfield but he waits for his captain to tell him what to say
27:00air blue 202 please confirm you have visual with the ground
27:04terrain ahead
27:06air blue 202 visual with the ground
27:11in the end the crew tells air traffic control that they are in visual contact with the ground
27:19now that's not untrue but it's not the same thing as being visual with the airfield
27:23it feels more like a reply designed to get air traffic control off their backs
27:28sir we are approaching terrain ahead yes i know we are turning left
27:33pull the pull up sir
27:37the captain says he's turning left but he keeps flying directly towards the hills
27:47the
27:48investigators are unable to explain why captain chowdhury could not alter his course
27:53and steer away from the mountains
28:00sir turn left the final minute of the cvr reveals a picture of chaos
28:07and confusion pull the pull up sir sir pull up
28:14they're applying power trying to climb
28:19terrain ahead sir pull up sir
28:24investigators hear first officer ahmed pleading with his captain to pull up
28:29why aren't we turning left
28:31why aren't we turning left to pull up
28:35terrain ahead pull up terrain sir
28:41terrain ahead
28:42sir we're going down
28:44pull up
28:45message from radar turn left immediately
28:48pull up
28:50we're going down
29:01all they had to do
29:04will turn away from those hills
29:09despite reacting to the terrain warnings the pilots could not steer their plane away from the mountains
29:18i think they knew what was happening
29:20i think they knew that they had to turn left for some reason the aircraft didn't turn left
29:28will flight 202's flight data recorder explain why captain chowdhury didn't or couldn't
29:35turn and avoid the mountains can we see the altitude please
29:41the minimum altitude is 2500 feet
29:46investigators can see that chowdhury dialed in an altitude below what's permitted
29:52there's only one reason it would drop below that
29:58commencing right turn heading 352
30:07there's no earthly reason for doing it because the minimums are there for a very good reason
30:13the only reason why they ever break the minimums is because they can't see the ground properly and
30:18they want to get closer to it can we see the flight path
30:25you see he's way off course in heavy fog and has clearly lost visual let's see the autopilot modes
30:38so he asks the automation to take over
30:46more than four miles off course captain chowdhury makes his biggest error
30:51by switching modes on his autopilot
30:56the captain switched from heading mode to nav mode and the aircraft turned left to heading of 300
31:07towards the mountain
31:11the airbus now makes a left turn towards a predetermined waypoint bringing the flight dangerously close to the
31:19mountains he's approaching the no-fly zone north of the airfield
31:26from this point on air traffic control continued to urge the flight to turn left
31:31because they knew they were in the vicinity of the high mountainous terrain terrain
31:36ahead and we see what he's selecting
31:51he's dialing in a left turn
31:59captain chowdhury uses his heading knob to turn the plane sharply left away from the hills
32:08but the plane it keeps flying in the same direction it's not turning
32:24he's still in nav
32:28investigators investigators realized the captain forgot that his plane was in navigation mode
32:33and not heading mode which is required to turn the aircraft if the aircraft is flying in nav
32:41mode it will keep on flying on its predetermined course whether or not the crew change the heading select
32:49terrain ahead why aren't we turning left
32:55captain chowdhury doesn't realize that his inputs are futile
33:02in order to get from nav mode into heading mode you pull the knob out and that engages heading mode
33:08oh he forgot to pull it out he realizes his error and pulls the knob here at 40 seconds before
33:18impact
33:26ah
33:28when captain chowdhury tries to correct his error he only makes a bad situation worse
33:35yes sir turn left oh why is it turning left
33:45captain chowdhury has dialed in so many left turns that his last input is now to the plane's right
33:53the airbus takes the shortest route to get to that heading directly towards the margala hills
34:05he's in heading mode for the rest of the flight
34:13the investigation saw that the captain was so reliant on the automation that
34:16he was trying to turn the aircraft to the left asking why the aircraft wasn't turning to the left
34:22but he didn't even use his side stick and actually turn the aircraft to the left manually
34:27why aren't we turning left
34:30investigators now know why captain chowdhury was unable to turn left and avoid the mountains
34:37but one question remains
34:40why didn't the first officer recognize the mistakes and do something to correct them
34:45so we're going down
34:51one hundred knots check investigators find a possible explanation for the first officer's puzzling
34:59behavior v1 at the very start of flight 202 rotate as it took off for islamabad
35:10the flight starts with the pilots working efficiently as a crew positive rate europe
35:26the takeoff from karachi is textbook
35:34from initial pushback startup and all the little takeoff everything seemed normal
35:42we are clear to climb to flight explain to me why that is blue but the other symbols are white
35:50the pilots cordial relationship soon changes
35:56sir there on your display why is that symbol blue but the others are white you should know why that
36:04is
36:05i believe it's because the flight plan defers from the current route oh that's wrong it's because
36:11it's the one being navigated towards basic do you know how to modify this point
36:19from the main menu oh you don't need to return to the main menu you can do it on the
36:24screen
36:26what did they teach you in that so-called training of yours
36:31captain chowdhury is heard quizzing and berating his first officer this wasn't normal behavior it seems it
36:41was only really for the purpose of putting his first officer in his place making sure he
36:47knew who was in charge and to do as he was told what's he doing if you don't know how
36:56to use the flight
36:57management system then what use are you in the cockpit you might as well go back and help the girls
37:04serve tea
37:09yes sorry sir
37:18what about maximum thrust available for climb can you at least tell me what that is this has been
37:24going on for nearly an hour now torture
37:30radio ahead to islamabad for the weather
37:34do you know how to use the radio yes
37:40captain chowdhury is a very experienced pilot
37:43he should know that this is not how we behave on the flight deck of an airliner
38:02investigators wonder why captain chowdhury would act so aggressively towards his first officer
38:09he was recently treated for diabetes and hypertension but deemed fit to fly
38:18anything pilots who flew with him said he was demanding sometimes difficult
38:24but nothing at this level
38:27maybe it had more to do with him
38:31could the first officer's background have affected his captain's attitude towards him
38:41in pakistan there has been a hidden rivalry between air force pilots
38:46and the people who are in the commercial side already
38:49they feel that actually force guys they are taking away their opportunities
38:58investigators believe that the captain's abusive behavior might explain one of the mysteries of this
39:04tragedy why first officer ahmed never took control of the plane
39:11all the first officer had to do was to take manual control of the aircraft
39:15and fly it away from the mountain
39:21investigators scrutinize first officer ahmed's actions leading up to the crash of flight 202
39:27his first officer tells the captain to pull up three times and to turn left
39:33twice but he never says he's taking control
39:41if i was the first officer i'll take over the control pull back on the side stick to create the
39:47max
39:47performance maneuver apply toga thrust and keep climbing till i'm clear of the hills
39:54the team believes the captain's behavior earlier in the flight explains why the first officer allowed him to mishandle the
40:02approach
40:04if you don't know how to use the flight management system then what use are you in the cockpit
40:12we have the captain's behavior which was so overbearing so autocratic so nasty that it served to completely
40:22shatter the self-confidence of the first officer first officer ahmed allows procedures to be set aside
40:31switch into nav mode for managed approach to runway one two okay
40:39sir and then fails to take control when his captain flies the plane directly towards the mountains
40:47he was so worn down by the captain's harsh behavior that he just couldn't stand up to him he became
40:53a bystander
41:00the first officer clearly knows that what they're doing is wrong he knows that his captain
41:04is disoriented that the aircraft is on a collision course with a mountain and yet somehow he doesn't
41:13have it in him to intervene sir we are going down sir we're going down three and a half minutes
41:24after
41:24the start of the approach they're going down the airbus slams into the hills
41:33killing everyone on board
41:41this is one of the most extraordinary accidents i've seen
41:48there were no technical factors in this accident there was nothing wrong with the aircraft there
41:57was nothing wrong with the engines it was all a matter of human misjudgment and human error
42:10if he doesn't try the approach in nav mode there's no accident
42:17all the warning signs were there telling them what to do
42:22it should have been easy to recover very if he hadn't taken his first officer out of the picture
42:41it's hard to believe that somebody of his experience would make so many errors
42:48and mishandling of the aircraft uh say it i just it just defies logic
42:58the final report into the crash of air blue flight 202 makes several recommendations to pakistani airlines
43:07including better briefings on the circling approach procedures and better crew management training
43:16this accident shows that cockpit management in the atmosphere in the cockpit that's set by the captain
43:21is just as important as an operating aircraft and operating engines
43:26and in 2018 the airport in islamabad is replaced with a more modern airport with two runways that are
43:34well away from the hills that claim the lives of the 152 people on board flight 202
43:44as i learned more i really felt extremely bad i felt very very sad about that loss
43:59it was a preventable accident
44:01it was a preventable accident
44:01you
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