Mayday (2013) s02e02 Episode Script
A Wounded Bird
1 It was just a small commuter plane, buzzing back and forth from one town to another - a journey of 86 minutes, one of many that day.
CRASHING SOUND, BEEPING No-one could ever have imagined that it would end like this - in drama and in death.
Yet, in 1995, two pilots with 26 passengers aboard, managed to defy the laws of gravity for nine minutes and 20 seconds when their aircraft, in effect, lost the use of a wing, struggling home like a wounded bird.
Help me hold it.
Help me hold it! Flying isn't always glamorous.
Regional airlines are like the buses of the air, trundling back and forth from one small city to another.
Crews operate several flights a day working for up to 15 hours.
They face interminable ground delays and often surly passengers.
If a flight gets cancelled they don't get paid, but they enjoy their work.
Atlanta Airport in Georgia has become one of the busiest in the world.
It's the home of a very successful regional airline - Atlantic Southeast.
ASA serves every town and city of the south-eastern United States with a fleet of 83 turbo-props.
built by the Brazilian firm, Embraer.
is a high-performance aircraft with state-of-the-art avionics and a top speed of 378m/h.
Today, after 18,000 successful flights for the last time.
Take off.
Check below the line.
There go your lights.
Captain Ed Gannaway and First Officer Matt Warmerdam have just flown in from Macon, Georgia.
Turn the lights on.
Going through the departure check list, they're now ready for their second flight of the day - flight ASA 529 to Gulfport, Mississippi.
Hi.
- Hi, honey.
- Hi there.
Flight attendant Robin Fech has been with ASA for just over two years.
Hi there.
Her cabin is a cramped space, only 31ft long.
Most of her 26 passengers are seasoned business travellers ranging in age from 18 to 69.
Among them are six engineers, two deputy sheriffs, a minister, two Air Force personnel, and even an aspiring flight attendant.
For them, the short trip to Gulfport, Mississippi, is a routine journey, but they're half an hour late on their schedule already.
Cue power set.
Auto feathers armed.
Captain Ed Gannaway, who has been with ASA for seven years, comes from a family of pilots.
He's a skilled and accomplished captain.
- V1.
- VR.
Paws ready, gear up.
TOWER: AC 529, confirm departure, flight heading 0-6-0 now.
We'll see ya.
The two men have only been flying together for four months but get along well.
At 6'3" and 200 pounds, Matt Warmerdam is a tight fit I think all pilots would agree a constant love-hate relationship.
It was, at the time, the fastest, sleekest turbo-prop around and it was also very tricky to master.
The thing was built like a Sherman tank.
BEEP - Hey, Robin.
- Hi? It'll be a couple more minutes like this - it's gonna smooth out.
A couple more minutes and I'll be able to get up? Yes, ma'am.
Alright.
Thank you.
See ya.
Good afternoon, ladies and gentlemen.
Welcome aboard Atlantic Southeast Airlines Flight 529 service to Gulfport, Mississippi.
Chuck Pfisterer, a nervous flyer, works for a paper company and is on his way to visit a new mill.
BEEP TOWER: AC 529, climb and maintain flight level 2-0-0.
2-0-0, AC 529.
is climbing towards its cruising altitude of 24,000 feet.
- 24.
- 24.
But the plane will never make it to this altitude.
CRASHING SOUND ELECTRONIC VOICE: Autopilot, engine control, oil.
WARMERDAM: The sound of that was tremendous.
It was as if someone had taken a baseball bat and hit an aluminium garbage can as hard as they could.
It was just a gigantic crashing sound and the airplane immediately lurched to the left.
Not knowing really what happened, I looked over and noticed everyone looking left out the window.
What I saw was very alarming.
The outer skin of the engine had been ripped off or, as I determined later, had peeled back because of some force.
I could see the components of the engine itself and I could see fluid leaving the engine and exiting the back of the wing.
ELECTRONIC VOICE: Autopilot Warning lights and chimes go off, signalling trouble in the left engine.
The autopilot trips off as a result and Gannaway takes control of the plane.
Autopilot, engine control, oil.
The plane is falling 5,500 feet a minute, the equivalent of over 90 feet every second.
DRAMATIC MUSIC Oil from the destroyed engine is seeping into the airconditioning pack, bringing smoke into the cabin.
Autopilot, engine control, oil.
Pack off.
We got the left engine out.
Left power lever.
Flight idle.
Unaware that the left engine is destroyed, the pilot tries to adjust its propeller to improve the plane's lift.
Left condition lever.
Left condition lever.
Feather.
Warmerdam attempts to feather the propeller which means changing the angle of the blades in order to minimise air resistance.
The warning light indicates fire in the left engine.
Left condition lever, fuel shut-off.
No matter what Gannaway does, the plane is still pulling violently to the left.
He struggles to counteract it by pushing hard to the right using both rudder and control column.
I need some help here.
I need some help on this.
The force of the crippled wing pulling to the left is relentless.
Without the efforts of the pilots to keep the plane stable it would roll into a spin and spiral down into the ground, killing everyone on board.
The engine has turned into a mass of misshapen, twisted metal fatally weakening the wing's aerodynamic capabilities and dragging it down.
The plane wants to keep turning left.
The pilots must push hard right on the rudder to the limit to keep them flying straight.
Captain Gannaway is confused.
Feathering the propeller has not reduced the drag.
He's so preoccupied with handling the emergency, he hasn't looked over his shoulder at the damaged engine yet.
You said it's feathered? It did feather.
What the hell is wrong with this thing? I don't know.
For now the pilots are focused on the plane's vital statistics - heading, altitude, speed and the power setting of its one good engine.
Well, these planes were designed to fly with one engine.
The airplane is capable of flying on one engine.
However, in the case of 529, not only do you have an engine that has malfunctioned and stopped running, but now it is broken from its normal mounted position and canted, which creates a very increased or dramatic aerodynamic effect on the airplane.
Autopilot The pilots have managed to slow the plane's catastrophic rate of descent but not halt it.
In fact, the air speed has actually increased to 224m/h.
Captain Gannaway is puzzled.
on one engine before and landed it without difficulty.
This plane has something very wrong.
Atlanta Centre.
AC 529 declaring an emergency.
We've had an engine failure.
We're out of 14-2 at this time.
AC 529, roger.
Left turn direct Atlanta.
Flight 529, now flying over Alabama, makes a left turn back towards Atlanta.
But the airport is almost 58 miles away.
Will they make it? The plane has begun to descend again and at breakneck speed.
Warmerdam cancels the master caution warning, finally silencing the plane's alarms.
Captain Gannaway experiments with his controls trying everything.
Suddenly the nose and the plane's speed slows to 186m/h.
AC 529, say altitude descending to.
We're at 11,600 at this time.
AC 529.
Alright, it's getting more controllable here.
The engine.
Let's watch our speed.
For the first time since the crisis began, the pilots can now turn their attention to the passengers.
Trimmed completely here.
I'm going to tell Robin what's going on.
BEEP Hi.
Okay, we had an engine failure, Robin.
We've declared an emergency.
We're diverting back to Atlanta.
Go ahead and brief the passengers.
This will be an emergency landing back in.
Alright.
Thank you.
Fech hasn't told the pilots what she has seen of the destroyed engine.
She assumes they already know.
AC 529, can you level off or do you need to keep descending? The plane is descending again at about 3,000 feet a minute.
Gannaway suddenly realises they won't make it to Atlanta.
We're gonna need to keep descending.
We need an airport quick.
Uh, okay, we're going to need to keep descending.
We need an airport quick.
Roll the trucks and everything out for us.
AC 529, West Georgia, the regional airport is at your 10 o'clock position and about 10 miles away.
But the air traffic controller, too preoccupied with handling the crisis aboard flight 529, fails to notify Emergency Services.
Flight 529 makes another wide left turn that brings it on course to land at West Georgia regional airport.
- Let's get out the engine failure checklist, - please.
Yeahum.
Um, engine failure in flight.
But they don't get a chance to diagnose their problem.
AC 529, say your heading.
Um, turning to about 3-10 right now.
AC 529, roger.
You need to be on a 0-3-0 for West Georgia regional, sir.
Roger, we'll probably turn right.
We're having difficulty controlling right now.
Assume brace positions.
Brace position? Good.
Good.
Ma'am, will you accept responsibility for opening the door when the plane stops? No.
Okay, um APU, if available, start.
Do you want me to start it? We gotta bring this thing down.
Put that off.
Getbring the ice off.
- BEEP - ELECTRONIC VOICE: Caution.
Caution.
AC 529, say your altitude now, sir.
Out of 7,000.
AC 529.
- BEEP - Trim fail.
Trim fail.
Oh, good start.
AC 529, I missed that, I'm sorry.
We're at a 6.
9 right now, AC 529.
BEEP - Okay, it's up and running, Ed.
- Alright, go ahead.
AC 529, West Georgia regional is your closest airport.
What kind of runway have they got? Yeah, what kind of runway has West Georgia regional got? West Georgia regional is 5,000 feet .
.
and is asphalt, sir.
FECH: Okay, I want you to remove any pens or sharp objects from your pockets.
I want you to remove your glasses and pour any drinks into the pocket of the seat in front of you.
Most folks on that flight were business folks that flew real frequent so, you know, there was no screaming or panicking of any sort.
PFISTERER: Based on the fact that I was gonna die I dealt with it in the best way that I could, which was just to try to absorb it .
.
accept it, and deal with it.
(sighs) Okay, Mum, practise.
Take your seatbelt off and on, okay? That's it.
Okay, if there's smoke and the door in front of us is blocked you've got to get down and crawl to the back, okay? So count the rows.
We've got to get down to the fifth row.
Okay, Mum.
The plane is still losing altitude far too quickly.
Can it make it to the airport in time? Atlanta Centre normally only controls flights at altitudes over 11,000ft.
For the last seven minutes, Flight 529 had been under this altitude and now the controller is having trouble locating them.
BEEPS AC 529, I've lost your transponder.
Say altitude.
We're out of 4.
5 at this time.
AC 529, I've got you now and the airport's at your Saysay your heading now, sir.
Uh, we are heading 0-8-0.
Roger.
You need about 10 degrees left.
West Georgia regional airport is only eight miles away beneath the clouds - two minutes flying time.
But they're not sure they can keep airborne that long.
I'll tell you what.
Let me put you on approach.
He works that airport and will be able to give you more information.
Contact Atlanta approach at 1-2.
0.
Atlanta approach air traffic control.
It monitors planes within a much smaller airspace, including West Georgia regional airport.
has slowed its descent to 1,800 feet per minute, but that's still too fast.
They won't make it to the airport.
Seven minutes have passed.
For the first time, Captain Gannaway manages to catch a glimpse of the left engine.
Engine's exploded.
It's just hanging out there.
This was something his instruments hadn't told him.
It's no simple engine failure.
The engine is just dangling off the wing.
with a failed engine but not when it's torn apart.
This is something his training hasn't prepared him for.
He wishes he could see through the clouds.
Atlanta approach, AC 529.
AC 529.
Atlanta approach here.
Yes, sir, we're with you declaring an emergency.
AC 529, roger.
Expect localiser runway 3-4 approach and could you fly heading 1-8-0? Uh, no, sorry.
1-6-0.
Localiser frequency The controller's flight path several miles south before landing.
Gannaway knows he doesn't have the extra minutes that this will take.
We can get it in on a visual.
Just give us the vectors - we'll go the visual.
He asks for directions to take the plane straight in using the shortest possible route.
Suddenly, they're out of the clouds but the sight that greets them couldn't be worse.
In front of them, no airport - only forest and villages.
Captain Gannaway, who never stutters, does now.
Si-si-single engine checklist, please.
Where the hell is it? Robin Fech is puzzled.
Six minutes earlier, Warmerdam had told her the plane was turning back to Atlanta.
But all she can see now is Georgia countryside.
We're out of 1,900 at this time.
We're below the clouds - tell 'em.
TOWER: You're out of 1,900 now? Yeah, uh, we're VFR at this time.
Could you give us a vector to the airport? Turn left.
Fly heading 0-4-0 Bear, the airport's at your about 10 o'clock at six miles, sir.
Radar contact lost at this time.
The plane's low altitude shocks the controller.
1,900 feet.
Only a minute earlier, it had been at 3,400 feet.
The descent is far too fast.
Remember, brace yourselves.
Wait till the plane to come to a complete stop before we can get out, okay? Brace positions, please.
Brace positions.
Sir, heads down.
Heads down, please.
Robin Fech, too preoccupied by the safety of her passengers, looks out of a window and suddenly sees the tops of the trees.
She has but a few seconds left to strap herself in her jump seat before impact.
Brace positions.
Keep your heads down, everyone.
Hold on.
This is gonna be rough.
The airport is only four miles away but too far for the crippled plane.
The pilots have to attempt a crash landing in a field.
- Help me hold it.
- Over there.
Help me hold it.
Help me, help me hold it.
500.
Too low gear.
The plane's altitude voice alarm sounds warning the pilots that they're flying too close to the ground without their landing gear lowered.
Fuckin' land the plane.
The pilots will attempt to land on the plane's belly.
Help me, help me, help me hold it.
Help me hold it! Amy, I love you.
These are the last words on the cockpit voice recorder.
The plane is flying at 138m/h and only seconds away from impact.
50, low gear.
40, low gear.
30, low gear.
20, low gear (screams) (woman screams) The plane had landed in a small field in Burwell, a sleepy farming community near Carrollton, Georgia, where nothing major ever happens.
Many neighbours witnessed the plane coming down.
Bill Jeters and his wife lived in this house at the end of this field angled directly in the plane's path.
My wife was sitting at the kitchen table, reading, and she said, "Bill, we better get out of here "because the plane's going to hit the house.
" So about that time it started stopping.
I said, "Well, you call 911 "and I'll see if I can help the plane.
" Emergency? Yes, we have plane crashed in our backyard.
A plane crashed? Yes, get somebody out here.
Hurry.
ALARM RINGS Eight minutes had passed since First Officer Warmerdam had declared an emergency and asked Atlanta Centre for rescue vehicles to be alerted, but the controller hadn't passed on the message.
Minutes would make the difference now between life and death.
The local emergency services responded quickly but were still many miles away.
SIRENS WAIL For almost a minute after impact, there's an eerie silence.
The plane fuselage is broken in two.
Could anyone survive? As the dust settles, all 29 people on board are miraculously alive with only a handful seriously injured by the impact.
But a new disaster is gathering.
Fuel from the shattered wing tanks is pouring onto the ground.
SPARKING SOUND The last thing I remember is the sound of hitting the trees.
.
.
.
and then I honestly don't recall impact.
Captain Ed Gannaway has been knocked unconscious by a blow to the head during the impact.
When First Officer Matt Warmerdam regains consciousness he realises they're stuck.
The cockpit door is jammed and smoke is slowly seeping in.
He reaches for the emergency crash axe.
The cockpit window is the only way out.
The next immediate thought I had was now we're going to blow up, so get out of there.
It was burning, you know, right in the open, you know, so I just jumped over.
And I headed towards the opening and I walked out of the aircraft and I walked away from it.
The sparks ignite the fuel vapours creating a blazing fire.
Within seconds the fire spreads to the fuselage.
In the rear section of the plane the passengers are now trapped by flames burning at 1,800 degrees centigrade.
They can hear screams from the field outside where some passengers are already suffering from terrible burns.
To escape, they too have to run through the fire, not fall in it, hoping for the best.
I turned back and I looked at the aircraft and what I saw was that the opening that I had come through was basically fully engulfed in flames, and that the people that were exiting the aircraft were all on fire.
Some of them would roll in the grass to try and put the fire out and sometimes that made it worse because there was spent spilt fuel.
And then they would get even more ignited.
And the whole situation got uglier and uglier in the sense that you would all of a sudden see people with their clothing burned off.
You would see people with with red, uh, red skin that you could see was burnt.
You could actually see some people whose flesh .
.
was, like, dropping off their bodies or their faces.
Um, it was just a horrible situation that was taking place and it was getting worse and worse.
No.
(cries) Go.
Jump! Matt Warmerdam, his right shoulder dislocated, is banging the axe against the window with his left hand.
One gentlemen I saw was crawling completely engulfed in flames and another one thatmost of his clothes were torn off.
Now, whether they got torn off in the crash or he torn them off himself, I don't know.
I helped him away from the airplane and brought him up towards my brother-in-law's house and all he had on was his shorts, and his skin was SORROWFUL MUSIC FIRE CRACKLES Aircraft glass is much thicker than what you would see on, like, an automobile windshield.
It's several different composite layers that have been temper-treated together to make it a very, very tough surface.
And with each swing of the crash axe I was only able to chip away a small piece of glass.
I need some help! I'm looking around, left and right, and there's no other fools that close, you know, at that second.
But even though passenger David McCorkell believes that the plane might blow up at any second he goes to Matt Warmerdam's rescue.
Can you help me? Ah.
Oh! Hang on a second, hang on.
Hang on, I've got to get some air.
The oxygen cylinder in the closet behind the co-pilot's seat punctures.
It will make the cockpit fire much worse.
Okay.
Go ahead, go ahead.
Stop for a second.
Let me see if I can squeeze out.
Ah! Ah, stop pulling me.
No, no, it's too small.
Go ahead.
SIRENS WAIL By now, the rescue crews of the area had been notified.
Firemen, police officers, paramedics - all are hurriedly on their way to the crash site.
Will the fire trucks arrive in time to save Matt Warmerdam before the cockpit gets engulfed in flames? David McCorkell is exhausted trying to break the strong glass.
Suddenly a heat flame pops at him from below the cockpit.
He backs off, scared for his life.
You aren't going to let me die, are you? Now, more determined than ever, he bangs even harder and faster.
Then suddenly the weakened axe head flies off.
It's getting hot in here! Get me out! Guy Pope, a police officer, is the first rescue worker to reach the burning plane.
I was about three miles from here when I received the call.
And about half way here I could see the smoke, pretty heavy smoke, and I got out of the car and I ran up to the plane and when I went around the nose of the plane, uh, one of the passengers handed me a hatchet and said the pilot was inside.
I took the hatchet and started trying to cut a bigger hole.
I couldn't get around behind the cockpit because of the fire.
It was still burning pretty heavy, and there was an oxygen bottle there blowing the fire.
And, uh You know, it's just one of them things .
.
you see a man burn, you don't forget it.
This is live footage taken with a video from the windshield of a Georgia State Patrol police car as rescue workers are arriving at the site.
At this moment, all passengers are out of the two sections of the broken plane except pilots Ed Gannaway and Matt Warmerdam who remain prisoners of their cockpit.
Well, first off, I had to tear the back of the cockpit out.
It burnt and there was no door, visible door, or anything like that.
So I actually took my hands and tore it out.
When I started to pull him out he looked up and said, "Tell my wife, Amy, that I love her.
" I said, "No, sir, you tell her that you love her "because I'm getting you out.
" Inside the ambulance .
.
I worked with him and I thought that probably, he would not make it.
I took his name badge and pinned it on his underwear which was the only thing I'd left on him trying to cool him down because, if he died, at least someone would know who he was.
It was surprising when Matt was aware of everything around him and he kept trying to assure me that things were going to be okay.
He was comforting me 'cause at that particular time, I was crying.
Matthew actually took his burned hand and wiped a tear away.
They found Captain Gannaway dead in the cockpit.
He had struck his head on impact and never regained consciousness.
He died of burns and smoke inhalation.
The crash survivors, some with broken bones, and others with burns ranging from minor to 92% are rushed to various hospitals in Georgia.
13 passengers were brought to Tanner Hospital in Carrollton, 15 minutes away, where 'Code Black' was immediately applied, meaning everybody helps.
Dr Bobby Mitchell, after working a night shift, was awakened.
When I got to the hospital, some of the people that had survived the plane crash were already here.
The smell was initially just a wave of jet fuel that just hit you as the door opened and then that was mixed with just a pungent, horrible odour of burned flesh.
When a patient suffers a severe burn the skin is violated, - and the skin really is the major part of your immune - system.
When they are able to survive for a period of weeks it is not uncommon for them to die from other organ failure, which is what happened to a lot of the people that were on Flight 529.
I have never before or since dealt with so much physical devastation and emotional upheaval and so much sorrow and horror and sadness in one place at one time thanwe did on that day in this little small town hospital.
After a long day treating the horribly burned passengers, and witnessing the courage of some of them, Dr Mitchell was asked to assist the autopsy on Captain Ed Gannaway.
I looked down at him and kind of put my hand over him.
I told everybody, I hope wherever his spirit is that he knows what a good job he did and I just said, "You're the hero.
"I hope you know it, Captain Gannaway.
" Regional airlines are a North American phenomenon.
In the early 1960s, a small band of independent airlines first became known as 'air taxis' which, in time, became 'commuter airlines' then finally, 'regional airlines'.
In 1978, the US deregulated the airlines and as the small and mid-sized cities became the economic engine of the country, regional airlines prospered as never before.
The National Transportation Safety Board in the United States is responsible for investigating air disasters.
Its go-team is on duty 24 hours a day to fly to the scene of any major crash.
The NTSB will have several sub-groups working at the same time each examining a particular part of the plane.
Gordon Jim Hookey, an aerospace engineer, was in charge of the propeller maintenance group.
We went out to the crash site and, in the usual fashion, you just kind of look around and get a feel for where all the pieces are.
We came along.
The propeller assembly - that was missing.
Looking down through the dirt we could see the telltale marks, the beach marks, aroundalong the fracture surface that indicated it might have been a fatigue fracture.
During the last 10 minutes of Flight 529, no-one on board the plane suspected that the engine failure had been caused by a propeller blade fracture.
Hookey had good reason to be concerned by the broken propeller blade.
He had seen it all before.
Four years earlier, and crashed in woods in Georgia, killing all 23 people aboard, including former US Senator John Tower, of Texas, and space shuttle astronaut, Manley 'Sonny' Carter.
The NTSB's investigation of that incident had found the crash had been caused by a badly designed propeller control unit and they blamed the manufacturer, Hamilton Standard.
Then in March 1994, just 17 months before ASA529, on two separate commercial flights, identical propeller blades broke from metal fatigue over Canada and over Brazil.
In both cases, the aircraft involved managed to land safely.
These accidents pointed to serious problems in Hamilton Standard propellers and became a major crisis for the company.
Airlines were ordered by the government to carry out an inspection of all the 15,000 propeller blades in service.
Investigators found that the broken propeller had been declared suspect and been sent back to Hamilton Standard for inspection.
Once the ASA mechanics took the blade off the hub, as soon as they turned it over we marked down the serial number, so when we went back to do the records, we could immediately go to that particular blade.
Investigator Jim Hookey took the broken blade stub to Atlanta Airport.
From there it was sent to the NTSB laboratory in Washington.
By next morning blade No.
861398 was being examined under a scanning microscope.
Investigators found telltale deposits of chlorine, a corrosive substance known to eat into the inner walls of the propeller blade.
So then the question becomes, where did the chlorine come from? In two of the previous propeller failures, the problem had also been traced to corrosion caused by chlorine in the inner wall of the blade.
Flight 529's blade had also snapped off 13.
2 inches from the hub - very similar to the two previous blade failures.
Under the microscope, NTSB scientists saw that two cracks along the inner wall of the blade had joined to form a single fissure.
This had grown and grown until it circled the blade, at which point it snapped under the stress of normal operation.
But the NTSB scientists noted something else.
On the inner surface extending about 1½ inches from the fracture there was a series of sanding marks.
Hookey set off to Hamilton Standard intent on getting the maintenance records for the propellers.
What had been done to the blade when it had been recalled? At the factory, Hookey examined the blade's repair reports.
He noted the initials of the technician who did the work.
CSB - Christopher Scott Bender.
He was a young technician who worked at a Hamilton Standard propeller repair facility.
Christopher Bender had watched the news of the accident on television, little realising how he was involved in the accident.
I saw the Hamilton Standard prop on it and I was, like, "I hope this is not a prop failure.
" It was kind of in the back of my mind and that morning, they were like, you know, the NTSB is down there, FAA is investigating, and they have called in some of our engineers that go also down there, and it might be a prop failure.
And as soon as I heard that my heart just sank.
I was, like, I think I might even have cried a little bit because I was just emotionally overwhelmed that something that I had put my hands on, a procedure that somebody trusted me to do failed, and because of that, somebody had died.
After discovering the technician who had last worked on the propeller blade that had caused the crash of ASA 529, the NTSB now had to find out how the blade had passed inspection.
Propeller blades are hollow.
Inside, weights are inserted to balance the prop.
They're kept in place by a cork soaked in chlorine.
It was the chlorine that had caused the corrosion in the previous accidents.
However, on this blade, Bender had been unable to detect any evidence of corrosion.
He then did what he had been told to do - polish the inside of the blade.
The draft accident report we present to you today involves Atlantic South East Airlines Flight 529.
The NTSB found that by polishing the blade Hamilton Standard had unwittingly removed all traces of the crack and a later, more thorough ultrasound examination couldn't detect it.
The NTSB asked for more accountability for management at Hamilton Standard.
And so the final report read - "The fracture was caused by a fatigue crack from multiple corrosion pits "that were not discovered by Hamilton Standard "because of inadequate and ineffective corporate inspection "and repair techniques, training, documentation and communications.
" Some final questions still needed to be answered.
Why had the broken propeller blade destroyed the engine? In previous incidents the entire propeller had fallen away harmlessly.
But on Flight 529, blade loss unbalanced the propeller and led to uncontrollable high-speed shaking as the engine shuddered in its mountings.
This was the ominous hammering sound heard by the passengers.
It literally ripped the engine open and left the useless propeller jammed against the wing.
The flight crew weren't handling the engine failure as a true engine failure in that some mechanical malfunction occurred and the engine stopped running.
They didn't know that the engine actually had vibrated significantly and broken from its mount and actually canted or twisted on the wing.
The NTSB found that the rescue services might have arrived more quickly if controllers had heeded Matt Warmerdam's request for help on the ground given by radio 6½ minutes before the crash.
Another key NTSB recommendation was to replace the flimsy crash axe that had failed in Warmerdam's rescue with a sturdier model.
Investigators praised the crew of Flight 529 for the way they dealt with the crisis, calling their reactions reasonable and appropriate.
But the board could offer little advice on the one thing that had caused all these deaths - fire.
The conundrum is - how do you make a fuel burn in an engine but not ignite when it's spilt? One way to reduce the severity of post-crash fires is by utilising less flammable fuel.
In 1984, the Federation Aviation Administration and NASA decided to test a new safer fuel by staging an accident using a remote control plane.
Unfortunately, it was not a conspicuous success.
But the US Navy has been using a safer form of jet fuel called 'JP5' since the 1950s, yet it's not used in commercial aviation.
The primary reason that the civilian sector - commercial aviation - has not gone to a lower flammability fuel is a question of availability and distribution, and the cost.
It costs more to produce the JP5.
Everything comes down to money.
What's it going to cost to develop a system? What's it going to cost to implement the system? What's it going to do for the overall safety of the airplane? And who's going to pay for it? Personally, from a safety standpoint, I'll pay $2 extra in my ticket to know and to have that security.
Until a solution is found, there will continue to be stories like ASA 529.
On impact, everyone on this flight had survived, but the subsequent fire became the killer.
For the victims of the fire, recovery has been a slow, painful and excruciating process.
First Officer Matt Warmerdam was burned on 42% of his body.
Some other survivors suffered up to 90% burns.
Treatment included daily baths and removal of dead skin from burn wounds.
There would be years of skin graft operations, the 24-hour-a-day wearing of pressure garments to minimise scarring, chronic itching and soreness, and daily physical therapy.
Your ability to sense and feel through those areas is permanently changed for the worse.
Temperature control is lost.
When you walk from an airconditioned building into the outside, you take for granted that your body starts accommodating that, either by sweating or redirecting blood flow.
People with burns, especially horrible, large surface area burns, that's lost forever.
They have to plan everything they do.
They have to plan where they're going to be and the clothing much more carefully.
So there are emotional and physical things both, that are lost forever.
My medical treatments were quite extensive.
There was a lot of long nights talking with Amy, trying to get over the pain and despair of all that.
I think the plane crash - it just took the last bite and I stayed in the fire service for a while after that but my heart was never in it again.
I quit my job.
I was a vice president of a software company, travelling a lot, making very good money, and I went to work as a buyer in Alaska.
I also reconnected with my ex-wife and we got remarried, moved down to South Carolina and had all our kids move in with us.
So, yeah, I did change my life.
One year after the crash, the Military Fraternal Organisation of Pilots bestowed its prestigious medallion on Matt Warmerdam for his part in saving the lives of his passengers.
He accepted it in honour of the crew.
Seeking closure on the trauma of the crash, residents built a memorial to the victims of Flight 529, behind Shilo United Methodist Church, a short distance from the accident site in Burwell.
Much has changed for the company that manufactured Flight 529's propeller.
Now renamed Hamilton Sundstrand, it's part of the giant United Technologies Aerospace and Defense Group.
Flight 529 was the last time that one of its propellers failed in flight.
It's inspection and repair process was made more stringent, in some cases exceeding FAA requirements.
Since the three blade failures, there have been none whatsoever.
Of the 29 people aboard ASA Flight 529 only eight escaped with minor injuries.
Of the 21 others who received major injuries and burns, 10 subsequently died.
Flight attendant Robin Fech declined to be interviewed for this film.
Still suffering from the pain and anguish of that terrible day, she's never worked as a flight attendant again.
WARMERDAM: The best thing I ever could have done for myself was that day, two years ago, when I finished training, and took the controls of an ASA plane and flew again.
I stubbornly recaptured my dream and now that I'm doing it again it has been a joy.
It's what I do.
It's what I love.
It's what I always wanted to do with my life and I'm doing it again.
Captioned by the Seven Network Captioned by the Seven Network
CRASHING SOUND, BEEPING No-one could ever have imagined that it would end like this - in drama and in death.
Yet, in 1995, two pilots with 26 passengers aboard, managed to defy the laws of gravity for nine minutes and 20 seconds when their aircraft, in effect, lost the use of a wing, struggling home like a wounded bird.
Help me hold it.
Help me hold it! Flying isn't always glamorous.
Regional airlines are like the buses of the air, trundling back and forth from one small city to another.
Crews operate several flights a day working for up to 15 hours.
They face interminable ground delays and often surly passengers.
If a flight gets cancelled they don't get paid, but they enjoy their work.
Atlanta Airport in Georgia has become one of the busiest in the world.
It's the home of a very successful regional airline - Atlantic Southeast.
ASA serves every town and city of the south-eastern United States with a fleet of 83 turbo-props.
built by the Brazilian firm, Embraer.
is a high-performance aircraft with state-of-the-art avionics and a top speed of 378m/h.
Today, after 18,000 successful flights for the last time.
Take off.
Check below the line.
There go your lights.
Captain Ed Gannaway and First Officer Matt Warmerdam have just flown in from Macon, Georgia.
Turn the lights on.
Going through the departure check list, they're now ready for their second flight of the day - flight ASA 529 to Gulfport, Mississippi.
Hi.
- Hi, honey.
- Hi there.
Flight attendant Robin Fech has been with ASA for just over two years.
Hi there.
Her cabin is a cramped space, only 31ft long.
Most of her 26 passengers are seasoned business travellers ranging in age from 18 to 69.
Among them are six engineers, two deputy sheriffs, a minister, two Air Force personnel, and even an aspiring flight attendant.
For them, the short trip to Gulfport, Mississippi, is a routine journey, but they're half an hour late on their schedule already.
Cue power set.
Auto feathers armed.
Captain Ed Gannaway, who has been with ASA for seven years, comes from a family of pilots.
He's a skilled and accomplished captain.
- V1.
- VR.
Paws ready, gear up.
TOWER: AC 529, confirm departure, flight heading 0-6-0 now.
We'll see ya.
The two men have only been flying together for four months but get along well.
At 6'3" and 200 pounds, Matt Warmerdam is a tight fit I think all pilots would agree a constant love-hate relationship.
It was, at the time, the fastest, sleekest turbo-prop around and it was also very tricky to master.
The thing was built like a Sherman tank.
BEEP - Hey, Robin.
- Hi? It'll be a couple more minutes like this - it's gonna smooth out.
A couple more minutes and I'll be able to get up? Yes, ma'am.
Alright.
Thank you.
See ya.
Good afternoon, ladies and gentlemen.
Welcome aboard Atlantic Southeast Airlines Flight 529 service to Gulfport, Mississippi.
Chuck Pfisterer, a nervous flyer, works for a paper company and is on his way to visit a new mill.
BEEP TOWER: AC 529, climb and maintain flight level 2-0-0.
2-0-0, AC 529.
is climbing towards its cruising altitude of 24,000 feet.
- 24.
- 24.
But the plane will never make it to this altitude.
CRASHING SOUND ELECTRONIC VOICE: Autopilot, engine control, oil.
WARMERDAM: The sound of that was tremendous.
It was as if someone had taken a baseball bat and hit an aluminium garbage can as hard as they could.
It was just a gigantic crashing sound and the airplane immediately lurched to the left.
Not knowing really what happened, I looked over and noticed everyone looking left out the window.
What I saw was very alarming.
The outer skin of the engine had been ripped off or, as I determined later, had peeled back because of some force.
I could see the components of the engine itself and I could see fluid leaving the engine and exiting the back of the wing.
ELECTRONIC VOICE: Autopilot Warning lights and chimes go off, signalling trouble in the left engine.
The autopilot trips off as a result and Gannaway takes control of the plane.
Autopilot, engine control, oil.
The plane is falling 5,500 feet a minute, the equivalent of over 90 feet every second.
DRAMATIC MUSIC Oil from the destroyed engine is seeping into the airconditioning pack, bringing smoke into the cabin.
Autopilot, engine control, oil.
Pack off.
We got the left engine out.
Left power lever.
Flight idle.
Unaware that the left engine is destroyed, the pilot tries to adjust its propeller to improve the plane's lift.
Left condition lever.
Left condition lever.
Feather.
Warmerdam attempts to feather the propeller which means changing the angle of the blades in order to minimise air resistance.
The warning light indicates fire in the left engine.
Left condition lever, fuel shut-off.
No matter what Gannaway does, the plane is still pulling violently to the left.
He struggles to counteract it by pushing hard to the right using both rudder and control column.
I need some help here.
I need some help on this.
The force of the crippled wing pulling to the left is relentless.
Without the efforts of the pilots to keep the plane stable it would roll into a spin and spiral down into the ground, killing everyone on board.
The engine has turned into a mass of misshapen, twisted metal fatally weakening the wing's aerodynamic capabilities and dragging it down.
The plane wants to keep turning left.
The pilots must push hard right on the rudder to the limit to keep them flying straight.
Captain Gannaway is confused.
Feathering the propeller has not reduced the drag.
He's so preoccupied with handling the emergency, he hasn't looked over his shoulder at the damaged engine yet.
You said it's feathered? It did feather.
What the hell is wrong with this thing? I don't know.
For now the pilots are focused on the plane's vital statistics - heading, altitude, speed and the power setting of its one good engine.
Well, these planes were designed to fly with one engine.
The airplane is capable of flying on one engine.
However, in the case of 529, not only do you have an engine that has malfunctioned and stopped running, but now it is broken from its normal mounted position and canted, which creates a very increased or dramatic aerodynamic effect on the airplane.
Autopilot The pilots have managed to slow the plane's catastrophic rate of descent but not halt it.
In fact, the air speed has actually increased to 224m/h.
Captain Gannaway is puzzled.
on one engine before and landed it without difficulty.
This plane has something very wrong.
Atlanta Centre.
AC 529 declaring an emergency.
We've had an engine failure.
We're out of 14-2 at this time.
AC 529, roger.
Left turn direct Atlanta.
Flight 529, now flying over Alabama, makes a left turn back towards Atlanta.
But the airport is almost 58 miles away.
Will they make it? The plane has begun to descend again and at breakneck speed.
Warmerdam cancels the master caution warning, finally silencing the plane's alarms.
Captain Gannaway experiments with his controls trying everything.
Suddenly the nose and the plane's speed slows to 186m/h.
AC 529, say altitude descending to.
We're at 11,600 at this time.
AC 529.
Alright, it's getting more controllable here.
The engine.
Let's watch our speed.
For the first time since the crisis began, the pilots can now turn their attention to the passengers.
Trimmed completely here.
I'm going to tell Robin what's going on.
BEEP Hi.
Okay, we had an engine failure, Robin.
We've declared an emergency.
We're diverting back to Atlanta.
Go ahead and brief the passengers.
This will be an emergency landing back in.
Alright.
Thank you.
Fech hasn't told the pilots what she has seen of the destroyed engine.
She assumes they already know.
AC 529, can you level off or do you need to keep descending? The plane is descending again at about 3,000 feet a minute.
Gannaway suddenly realises they won't make it to Atlanta.
We're gonna need to keep descending.
We need an airport quick.
Uh, okay, we're going to need to keep descending.
We need an airport quick.
Roll the trucks and everything out for us.
AC 529, West Georgia, the regional airport is at your 10 o'clock position and about 10 miles away.
But the air traffic controller, too preoccupied with handling the crisis aboard flight 529, fails to notify Emergency Services.
Flight 529 makes another wide left turn that brings it on course to land at West Georgia regional airport.
- Let's get out the engine failure checklist, - please.
Yeahum.
Um, engine failure in flight.
But they don't get a chance to diagnose their problem.
AC 529, say your heading.
Um, turning to about 3-10 right now.
AC 529, roger.
You need to be on a 0-3-0 for West Georgia regional, sir.
Roger, we'll probably turn right.
We're having difficulty controlling right now.
Assume brace positions.
Brace position? Good.
Good.
Ma'am, will you accept responsibility for opening the door when the plane stops? No.
Okay, um APU, if available, start.
Do you want me to start it? We gotta bring this thing down.
Put that off.
Getbring the ice off.
- BEEP - ELECTRONIC VOICE: Caution.
Caution.
AC 529, say your altitude now, sir.
Out of 7,000.
AC 529.
- BEEP - Trim fail.
Trim fail.
Oh, good start.
AC 529, I missed that, I'm sorry.
We're at a 6.
9 right now, AC 529.
BEEP - Okay, it's up and running, Ed.
- Alright, go ahead.
AC 529, West Georgia regional is your closest airport.
What kind of runway have they got? Yeah, what kind of runway has West Georgia regional got? West Georgia regional is 5,000 feet .
.
and is asphalt, sir.
FECH: Okay, I want you to remove any pens or sharp objects from your pockets.
I want you to remove your glasses and pour any drinks into the pocket of the seat in front of you.
Most folks on that flight were business folks that flew real frequent so, you know, there was no screaming or panicking of any sort.
PFISTERER: Based on the fact that I was gonna die I dealt with it in the best way that I could, which was just to try to absorb it .
.
accept it, and deal with it.
(sighs) Okay, Mum, practise.
Take your seatbelt off and on, okay? That's it.
Okay, if there's smoke and the door in front of us is blocked you've got to get down and crawl to the back, okay? So count the rows.
We've got to get down to the fifth row.
Okay, Mum.
The plane is still losing altitude far too quickly.
Can it make it to the airport in time? Atlanta Centre normally only controls flights at altitudes over 11,000ft.
For the last seven minutes, Flight 529 had been under this altitude and now the controller is having trouble locating them.
BEEPS AC 529, I've lost your transponder.
Say altitude.
We're out of 4.
5 at this time.
AC 529, I've got you now and the airport's at your Saysay your heading now, sir.
Uh, we are heading 0-8-0.
Roger.
You need about 10 degrees left.
West Georgia regional airport is only eight miles away beneath the clouds - two minutes flying time.
But they're not sure they can keep airborne that long.
I'll tell you what.
Let me put you on approach.
He works that airport and will be able to give you more information.
Contact Atlanta approach at 1-2.
0.
Atlanta approach air traffic control.
It monitors planes within a much smaller airspace, including West Georgia regional airport.
has slowed its descent to 1,800 feet per minute, but that's still too fast.
They won't make it to the airport.
Seven minutes have passed.
For the first time, Captain Gannaway manages to catch a glimpse of the left engine.
Engine's exploded.
It's just hanging out there.
This was something his instruments hadn't told him.
It's no simple engine failure.
The engine is just dangling off the wing.
with a failed engine but not when it's torn apart.
This is something his training hasn't prepared him for.
He wishes he could see through the clouds.
Atlanta approach, AC 529.
AC 529.
Atlanta approach here.
Yes, sir, we're with you declaring an emergency.
AC 529, roger.
Expect localiser runway 3-4 approach and could you fly heading 1-8-0? Uh, no, sorry.
1-6-0.
Localiser frequency The controller's flight path several miles south before landing.
Gannaway knows he doesn't have the extra minutes that this will take.
We can get it in on a visual.
Just give us the vectors - we'll go the visual.
He asks for directions to take the plane straight in using the shortest possible route.
Suddenly, they're out of the clouds but the sight that greets them couldn't be worse.
In front of them, no airport - only forest and villages.
Captain Gannaway, who never stutters, does now.
Si-si-single engine checklist, please.
Where the hell is it? Robin Fech is puzzled.
Six minutes earlier, Warmerdam had told her the plane was turning back to Atlanta.
But all she can see now is Georgia countryside.
We're out of 1,900 at this time.
We're below the clouds - tell 'em.
TOWER: You're out of 1,900 now? Yeah, uh, we're VFR at this time.
Could you give us a vector to the airport? Turn left.
Fly heading 0-4-0 Bear, the airport's at your about 10 o'clock at six miles, sir.
Radar contact lost at this time.
The plane's low altitude shocks the controller.
1,900 feet.
Only a minute earlier, it had been at 3,400 feet.
The descent is far too fast.
Remember, brace yourselves.
Wait till the plane to come to a complete stop before we can get out, okay? Brace positions, please.
Brace positions.
Sir, heads down.
Heads down, please.
Robin Fech, too preoccupied by the safety of her passengers, looks out of a window and suddenly sees the tops of the trees.
She has but a few seconds left to strap herself in her jump seat before impact.
Brace positions.
Keep your heads down, everyone.
Hold on.
This is gonna be rough.
The airport is only four miles away but too far for the crippled plane.
The pilots have to attempt a crash landing in a field.
- Help me hold it.
- Over there.
Help me hold it.
Help me, help me hold it.
500.
Too low gear.
The plane's altitude voice alarm sounds warning the pilots that they're flying too close to the ground without their landing gear lowered.
Fuckin' land the plane.
The pilots will attempt to land on the plane's belly.
Help me, help me, help me hold it.
Help me hold it! Amy, I love you.
These are the last words on the cockpit voice recorder.
The plane is flying at 138m/h and only seconds away from impact.
50, low gear.
40, low gear.
30, low gear.
20, low gear (screams) (woman screams) The plane had landed in a small field in Burwell, a sleepy farming community near Carrollton, Georgia, where nothing major ever happens.
Many neighbours witnessed the plane coming down.
Bill Jeters and his wife lived in this house at the end of this field angled directly in the plane's path.
My wife was sitting at the kitchen table, reading, and she said, "Bill, we better get out of here "because the plane's going to hit the house.
" So about that time it started stopping.
I said, "Well, you call 911 "and I'll see if I can help the plane.
" Emergency? Yes, we have plane crashed in our backyard.
A plane crashed? Yes, get somebody out here.
Hurry.
ALARM RINGS Eight minutes had passed since First Officer Warmerdam had declared an emergency and asked Atlanta Centre for rescue vehicles to be alerted, but the controller hadn't passed on the message.
Minutes would make the difference now between life and death.
The local emergency services responded quickly but were still many miles away.
SIRENS WAIL For almost a minute after impact, there's an eerie silence.
The plane fuselage is broken in two.
Could anyone survive? As the dust settles, all 29 people on board are miraculously alive with only a handful seriously injured by the impact.
But a new disaster is gathering.
Fuel from the shattered wing tanks is pouring onto the ground.
SPARKING SOUND The last thing I remember is the sound of hitting the trees.
.
.
.
and then I honestly don't recall impact.
Captain Ed Gannaway has been knocked unconscious by a blow to the head during the impact.
When First Officer Matt Warmerdam regains consciousness he realises they're stuck.
The cockpit door is jammed and smoke is slowly seeping in.
He reaches for the emergency crash axe.
The cockpit window is the only way out.
The next immediate thought I had was now we're going to blow up, so get out of there.
It was burning, you know, right in the open, you know, so I just jumped over.
And I headed towards the opening and I walked out of the aircraft and I walked away from it.
The sparks ignite the fuel vapours creating a blazing fire.
Within seconds the fire spreads to the fuselage.
In the rear section of the plane the passengers are now trapped by flames burning at 1,800 degrees centigrade.
They can hear screams from the field outside where some passengers are already suffering from terrible burns.
To escape, they too have to run through the fire, not fall in it, hoping for the best.
I turned back and I looked at the aircraft and what I saw was that the opening that I had come through was basically fully engulfed in flames, and that the people that were exiting the aircraft were all on fire.
Some of them would roll in the grass to try and put the fire out and sometimes that made it worse because there was spent spilt fuel.
And then they would get even more ignited.
And the whole situation got uglier and uglier in the sense that you would all of a sudden see people with their clothing burned off.
You would see people with with red, uh, red skin that you could see was burnt.
You could actually see some people whose flesh .
.
was, like, dropping off their bodies or their faces.
Um, it was just a horrible situation that was taking place and it was getting worse and worse.
No.
(cries) Go.
Jump! Matt Warmerdam, his right shoulder dislocated, is banging the axe against the window with his left hand.
One gentlemen I saw was crawling completely engulfed in flames and another one thatmost of his clothes were torn off.
Now, whether they got torn off in the crash or he torn them off himself, I don't know.
I helped him away from the airplane and brought him up towards my brother-in-law's house and all he had on was his shorts, and his skin was SORROWFUL MUSIC FIRE CRACKLES Aircraft glass is much thicker than what you would see on, like, an automobile windshield.
It's several different composite layers that have been temper-treated together to make it a very, very tough surface.
And with each swing of the crash axe I was only able to chip away a small piece of glass.
I need some help! I'm looking around, left and right, and there's no other fools that close, you know, at that second.
But even though passenger David McCorkell believes that the plane might blow up at any second he goes to Matt Warmerdam's rescue.
Can you help me? Ah.
Oh! Hang on a second, hang on.
Hang on, I've got to get some air.
The oxygen cylinder in the closet behind the co-pilot's seat punctures.
It will make the cockpit fire much worse.
Okay.
Go ahead, go ahead.
Stop for a second.
Let me see if I can squeeze out.
Ah! Ah, stop pulling me.
No, no, it's too small.
Go ahead.
SIRENS WAIL By now, the rescue crews of the area had been notified.
Firemen, police officers, paramedics - all are hurriedly on their way to the crash site.
Will the fire trucks arrive in time to save Matt Warmerdam before the cockpit gets engulfed in flames? David McCorkell is exhausted trying to break the strong glass.
Suddenly a heat flame pops at him from below the cockpit.
He backs off, scared for his life.
You aren't going to let me die, are you? Now, more determined than ever, he bangs even harder and faster.
Then suddenly the weakened axe head flies off.
It's getting hot in here! Get me out! Guy Pope, a police officer, is the first rescue worker to reach the burning plane.
I was about three miles from here when I received the call.
And about half way here I could see the smoke, pretty heavy smoke, and I got out of the car and I ran up to the plane and when I went around the nose of the plane, uh, one of the passengers handed me a hatchet and said the pilot was inside.
I took the hatchet and started trying to cut a bigger hole.
I couldn't get around behind the cockpit because of the fire.
It was still burning pretty heavy, and there was an oxygen bottle there blowing the fire.
And, uh You know, it's just one of them things .
.
you see a man burn, you don't forget it.
This is live footage taken with a video from the windshield of a Georgia State Patrol police car as rescue workers are arriving at the site.
At this moment, all passengers are out of the two sections of the broken plane except pilots Ed Gannaway and Matt Warmerdam who remain prisoners of their cockpit.
Well, first off, I had to tear the back of the cockpit out.
It burnt and there was no door, visible door, or anything like that.
So I actually took my hands and tore it out.
When I started to pull him out he looked up and said, "Tell my wife, Amy, that I love her.
" I said, "No, sir, you tell her that you love her "because I'm getting you out.
" Inside the ambulance .
.
I worked with him and I thought that probably, he would not make it.
I took his name badge and pinned it on his underwear which was the only thing I'd left on him trying to cool him down because, if he died, at least someone would know who he was.
It was surprising when Matt was aware of everything around him and he kept trying to assure me that things were going to be okay.
He was comforting me 'cause at that particular time, I was crying.
Matthew actually took his burned hand and wiped a tear away.
They found Captain Gannaway dead in the cockpit.
He had struck his head on impact and never regained consciousness.
He died of burns and smoke inhalation.
The crash survivors, some with broken bones, and others with burns ranging from minor to 92% are rushed to various hospitals in Georgia.
13 passengers were brought to Tanner Hospital in Carrollton, 15 minutes away, where 'Code Black' was immediately applied, meaning everybody helps.
Dr Bobby Mitchell, after working a night shift, was awakened.
When I got to the hospital, some of the people that had survived the plane crash were already here.
The smell was initially just a wave of jet fuel that just hit you as the door opened and then that was mixed with just a pungent, horrible odour of burned flesh.
When a patient suffers a severe burn the skin is violated, - and the skin really is the major part of your immune - system.
When they are able to survive for a period of weeks it is not uncommon for them to die from other organ failure, which is what happened to a lot of the people that were on Flight 529.
I have never before or since dealt with so much physical devastation and emotional upheaval and so much sorrow and horror and sadness in one place at one time thanwe did on that day in this little small town hospital.
After a long day treating the horribly burned passengers, and witnessing the courage of some of them, Dr Mitchell was asked to assist the autopsy on Captain Ed Gannaway.
I looked down at him and kind of put my hand over him.
I told everybody, I hope wherever his spirit is that he knows what a good job he did and I just said, "You're the hero.
"I hope you know it, Captain Gannaway.
" Regional airlines are a North American phenomenon.
In the early 1960s, a small band of independent airlines first became known as 'air taxis' which, in time, became 'commuter airlines' then finally, 'regional airlines'.
In 1978, the US deregulated the airlines and as the small and mid-sized cities became the economic engine of the country, regional airlines prospered as never before.
The National Transportation Safety Board in the United States is responsible for investigating air disasters.
Its go-team is on duty 24 hours a day to fly to the scene of any major crash.
The NTSB will have several sub-groups working at the same time each examining a particular part of the plane.
Gordon Jim Hookey, an aerospace engineer, was in charge of the propeller maintenance group.
We went out to the crash site and, in the usual fashion, you just kind of look around and get a feel for where all the pieces are.
We came along.
The propeller assembly - that was missing.
Looking down through the dirt we could see the telltale marks, the beach marks, aroundalong the fracture surface that indicated it might have been a fatigue fracture.
During the last 10 minutes of Flight 529, no-one on board the plane suspected that the engine failure had been caused by a propeller blade fracture.
Hookey had good reason to be concerned by the broken propeller blade.
He had seen it all before.
Four years earlier, and crashed in woods in Georgia, killing all 23 people aboard, including former US Senator John Tower, of Texas, and space shuttle astronaut, Manley 'Sonny' Carter.
The NTSB's investigation of that incident had found the crash had been caused by a badly designed propeller control unit and they blamed the manufacturer, Hamilton Standard.
Then in March 1994, just 17 months before ASA529, on two separate commercial flights, identical propeller blades broke from metal fatigue over Canada and over Brazil.
In both cases, the aircraft involved managed to land safely.
These accidents pointed to serious problems in Hamilton Standard propellers and became a major crisis for the company.
Airlines were ordered by the government to carry out an inspection of all the 15,000 propeller blades in service.
Investigators found that the broken propeller had been declared suspect and been sent back to Hamilton Standard for inspection.
Once the ASA mechanics took the blade off the hub, as soon as they turned it over we marked down the serial number, so when we went back to do the records, we could immediately go to that particular blade.
Investigator Jim Hookey took the broken blade stub to Atlanta Airport.
From there it was sent to the NTSB laboratory in Washington.
By next morning blade No.
861398 was being examined under a scanning microscope.
Investigators found telltale deposits of chlorine, a corrosive substance known to eat into the inner walls of the propeller blade.
So then the question becomes, where did the chlorine come from? In two of the previous propeller failures, the problem had also been traced to corrosion caused by chlorine in the inner wall of the blade.
Flight 529's blade had also snapped off 13.
2 inches from the hub - very similar to the two previous blade failures.
Under the microscope, NTSB scientists saw that two cracks along the inner wall of the blade had joined to form a single fissure.
This had grown and grown until it circled the blade, at which point it snapped under the stress of normal operation.
But the NTSB scientists noted something else.
On the inner surface extending about 1½ inches from the fracture there was a series of sanding marks.
Hookey set off to Hamilton Standard intent on getting the maintenance records for the propellers.
What had been done to the blade when it had been recalled? At the factory, Hookey examined the blade's repair reports.
He noted the initials of the technician who did the work.
CSB - Christopher Scott Bender.
He was a young technician who worked at a Hamilton Standard propeller repair facility.
Christopher Bender had watched the news of the accident on television, little realising how he was involved in the accident.
I saw the Hamilton Standard prop on it and I was, like, "I hope this is not a prop failure.
" It was kind of in the back of my mind and that morning, they were like, you know, the NTSB is down there, FAA is investigating, and they have called in some of our engineers that go also down there, and it might be a prop failure.
And as soon as I heard that my heart just sank.
I was, like, I think I might even have cried a little bit because I was just emotionally overwhelmed that something that I had put my hands on, a procedure that somebody trusted me to do failed, and because of that, somebody had died.
After discovering the technician who had last worked on the propeller blade that had caused the crash of ASA 529, the NTSB now had to find out how the blade had passed inspection.
Propeller blades are hollow.
Inside, weights are inserted to balance the prop.
They're kept in place by a cork soaked in chlorine.
It was the chlorine that had caused the corrosion in the previous accidents.
However, on this blade, Bender had been unable to detect any evidence of corrosion.
He then did what he had been told to do - polish the inside of the blade.
The draft accident report we present to you today involves Atlantic South East Airlines Flight 529.
The NTSB found that by polishing the blade Hamilton Standard had unwittingly removed all traces of the crack and a later, more thorough ultrasound examination couldn't detect it.
The NTSB asked for more accountability for management at Hamilton Standard.
And so the final report read - "The fracture was caused by a fatigue crack from multiple corrosion pits "that were not discovered by Hamilton Standard "because of inadequate and ineffective corporate inspection "and repair techniques, training, documentation and communications.
" Some final questions still needed to be answered.
Why had the broken propeller blade destroyed the engine? In previous incidents the entire propeller had fallen away harmlessly.
But on Flight 529, blade loss unbalanced the propeller and led to uncontrollable high-speed shaking as the engine shuddered in its mountings.
This was the ominous hammering sound heard by the passengers.
It literally ripped the engine open and left the useless propeller jammed against the wing.
The flight crew weren't handling the engine failure as a true engine failure in that some mechanical malfunction occurred and the engine stopped running.
They didn't know that the engine actually had vibrated significantly and broken from its mount and actually canted or twisted on the wing.
The NTSB found that the rescue services might have arrived more quickly if controllers had heeded Matt Warmerdam's request for help on the ground given by radio 6½ minutes before the crash.
Another key NTSB recommendation was to replace the flimsy crash axe that had failed in Warmerdam's rescue with a sturdier model.
Investigators praised the crew of Flight 529 for the way they dealt with the crisis, calling their reactions reasonable and appropriate.
But the board could offer little advice on the one thing that had caused all these deaths - fire.
The conundrum is - how do you make a fuel burn in an engine but not ignite when it's spilt? One way to reduce the severity of post-crash fires is by utilising less flammable fuel.
In 1984, the Federation Aviation Administration and NASA decided to test a new safer fuel by staging an accident using a remote control plane.
Unfortunately, it was not a conspicuous success.
But the US Navy has been using a safer form of jet fuel called 'JP5' since the 1950s, yet it's not used in commercial aviation.
The primary reason that the civilian sector - commercial aviation - has not gone to a lower flammability fuel is a question of availability and distribution, and the cost.
It costs more to produce the JP5.
Everything comes down to money.
What's it going to cost to develop a system? What's it going to cost to implement the system? What's it going to do for the overall safety of the airplane? And who's going to pay for it? Personally, from a safety standpoint, I'll pay $2 extra in my ticket to know and to have that security.
Until a solution is found, there will continue to be stories like ASA 529.
On impact, everyone on this flight had survived, but the subsequent fire became the killer.
For the victims of the fire, recovery has been a slow, painful and excruciating process.
First Officer Matt Warmerdam was burned on 42% of his body.
Some other survivors suffered up to 90% burns.
Treatment included daily baths and removal of dead skin from burn wounds.
There would be years of skin graft operations, the 24-hour-a-day wearing of pressure garments to minimise scarring, chronic itching and soreness, and daily physical therapy.
Your ability to sense and feel through those areas is permanently changed for the worse.
Temperature control is lost.
When you walk from an airconditioned building into the outside, you take for granted that your body starts accommodating that, either by sweating or redirecting blood flow.
People with burns, especially horrible, large surface area burns, that's lost forever.
They have to plan everything they do.
They have to plan where they're going to be and the clothing much more carefully.
So there are emotional and physical things both, that are lost forever.
My medical treatments were quite extensive.
There was a lot of long nights talking with Amy, trying to get over the pain and despair of all that.
I think the plane crash - it just took the last bite and I stayed in the fire service for a while after that but my heart was never in it again.
I quit my job.
I was a vice president of a software company, travelling a lot, making very good money, and I went to work as a buyer in Alaska.
I also reconnected with my ex-wife and we got remarried, moved down to South Carolina and had all our kids move in with us.
So, yeah, I did change my life.
One year after the crash, the Military Fraternal Organisation of Pilots bestowed its prestigious medallion on Matt Warmerdam for his part in saving the lives of his passengers.
He accepted it in honour of the crew.
Seeking closure on the trauma of the crash, residents built a memorial to the victims of Flight 529, behind Shilo United Methodist Church, a short distance from the accident site in Burwell.
Much has changed for the company that manufactured Flight 529's propeller.
Now renamed Hamilton Sundstrand, it's part of the giant United Technologies Aerospace and Defense Group.
Flight 529 was the last time that one of its propellers failed in flight.
It's inspection and repair process was made more stringent, in some cases exceeding FAA requirements.
Since the three blade failures, there have been none whatsoever.
Of the 29 people aboard ASA Flight 529 only eight escaped with minor injuries.
Of the 21 others who received major injuries and burns, 10 subsequently died.
Flight attendant Robin Fech declined to be interviewed for this film.
Still suffering from the pain and anguish of that terrible day, she's never worked as a flight attendant again.
WARMERDAM: The best thing I ever could have done for myself was that day, two years ago, when I finished training, and took the controls of an ASA plane and flew again.
I stubbornly recaptured my dream and now that I'm doing it again it has been a joy.
It's what I do.
It's what I love.
It's what I always wanted to do with my life and I'm doing it again.
Captioned by the Seven Network Captioned by the Seven Network