There was no indication of any type of problem that could have warned the pilots of the impending disaster that would force them to crash-land the DC-10 that carried 285 passengers and eleven crew members. One engine gave way due to metal fatigue and as a result parts of it broke off and just like shrapnel the bits and pieces tore into three hydraulic systems of the DC-10. This meant that the pilots lost control of the aircraft the only thing it can do was to turn right. Later on, other pilots tried to understand what really happened to flight UA232 and using simulators they discovered that it was impossible to land that aircraft safely. Flight UA232 crashed into a runway at an airport in Sioux, Iowa. There was extensive damage to the DC-10 there were 110 fatalities including an infant. Everyone on board could have died, except for the skill and bravery of the pilot as well as the coordinated effort of the emergency response units that waited for them below.
Background
It was already past noon, on July 19, 1989, when the flight crews, flight attendants, and all the passengers on board the ill-fated aircraft were looking forward to a safe flight. It was supposed to be a routine trip because Flight UA232 was regularly scheduled to fly from Denver, Colorado to Philadelphia and then Pennsylvania with only one intermediate stop at Chicago, Illinois (Krause, 2003, p.445). It should have been business-as-usual.
The DC-10 was in capable hands. On the flight deck was Captain Haynes who was a a28-year veteran. Haynes had at least 30,000 hours of flying experience under his belt (Kilroy, 2008, p.1). The First Officer was William Records and the Flight Engineer was Dudley Dvorak (Kilroy, 2008, p.1). After crossing Iowa the crew began a right turn to take the DC-10 to Chicago. Then all of a sudden there was trouble.
Something went terribly wrong and then they heard a loud explosion. It was said that human error played a major role in the failure to detect the metallurgical defect of the stage 1 fan disk of the engine (Kolstad, 1990, p.10). The National Transportation Safety Board determined the same saying that there was an inadequate consideration given to the “human factor limitations in the inspection and quality-control procedures used by the United Airlines engine overhaul facility” (Krause, 2003, p.445). The crack was never discovered and so flight UA232 was given the green light to continue hauling passengers back and forth from Denver to Pennsylvania.
There was “separation, fragmentation and forceful discharge of stage 1 fan rotor assembly parts from the No. 2 engine led to the loss of the three hydraulic systems that powered the airplane’s flight controls (Kolstad, 2003, p.1). The pieces that broke away from the disintegrated rotor cut through all the hydraulic systems making it extremely difficult to guide the plane and to at least make it glide in the event of a crash-landing (Reason, 2008, p.200).
One report said that the aircraft was designed with redundancy in the system and with regards to the controls there were three separate sets of hydraulic controls that if one will fail there would be two on standby. It was even reported that the “probability of losing all three hydraulic systems was considered by the designers to be less than one in a billion” (Reason, 2008, p.200). This is the reason why there were no emergency procedures that was creat to deal with this particular scenario (Reason, 2008, p.200). Haynes, Records, and Dvorak had to fly the plane using everything that they know and they also need all the help that they can get.
There were so many things that took place but remarkably it only took thirty minutes, from the time that the pilots heard the explosion to the time that they were fast approaching Sioux Gateway Airport, Iowa (Krause, 2003, p.445). Even if they can manage to the land the plane the absence of adequate emergency response units and other trained personnel will result in a significant loss of life because of asphyxiation and injuries that when left untreated will result in death. But this is not the case with UA232 and the responders present at Sioux airport’s runway.
Emergency Response
The reason why an almost out of control aircraft coming in too fast and heavy did not result in the death of all the people involved in the crash-landing can be attributed to the well-coordinated effort of the emergency response units on the ground. They were able to do so because they were prepared to tackle such type of crisis. It was discovered later that the Emergency Response Group in Sioux City had a disaster drill two years prior to the event wherein the organizers had drawn up a scenario similar to the upcoming emergency crash-landing: “a wide-bodied jet that did not serve Sioux City crashed on the airport’s close runway” (Reason, 2008, p.204). In addition there was one more thing that enhanced the preparation process; the organizers added another facet to the plan that allowed more services to participate and to even involve emergency response units coming from small communities around the Sioux area (Reason, 2008, p.204). This means that the whole community was ready to tackle an emergency as significant as UA232.
The drill that was conducted two years prior to the incident not only prepared the leaders of Sioux community to handle the crisis but it gave them an a clear idea how ineffectual their present management system can be in the event of a major disaster. But on that day when UA232 was about to crash there were 14 of the county’s basic life support ambulances that were dispatched to the Sioux airport (Hogan & Burstein, 2007, p.102). Eighty city firefighters, both on-duty and off-duty were also present at the crash site (Hogan & Burstein, 2007, p.102).
State officials from Iowa also took part in the emergency response and because of that the state emergency operations center was able to dispatch six Army National Guard helicopters from Boon, Iowa, near Des Moines (Hogan & Burstein, 2007, p.102). Iowa’s state-wide law enforcement agency also sent a teletype message that broadcasted a request that if there be ambulances located at a reasonable distance from Sioux airport should respond immediately (Hogan & Burstein, 2007, p.102).
The response was immediate and it was significant because there were 35 ambulances that came from 29 communities outside Sioux City. Aside from that there were also four civilian EMS helicopters that responded and remarkably these helicopters came as far as 70 miles away from Iowa, Nebraska and even South Dakota (Hogan & Burstein, 2007, p.102). The outsiders were an impressive group composed of “20 paramedics, 100 basic emergency medical technicians, and 40 outside fire departments” (Hogan & Burstein, 2007 p.102). It was indeed an overwhelming response that benefited the survivors of UA232.
At the same time the two local hospitals were able to activate their mass casualty plans and assembled resources and personnel (Abkowitz, 2008, p.242). Due to this immediate response the first patient that came their way experienced an “orderly and efficient medical disaster response system” (Abkowitz, 2008, p.242). This was critical because based on the investigation many died not by the impact of the crash itself but because of the circumstances in the crash site such as smoke inhalation. One could just imagine what the casualty rate could have been without the readiness of the emergency responders.
Al Haynes who became a sought-after speaker in management training seminars after the crash pointed to one crucial factor that made it possible for the convergence of ambulances, medical personnel, and other emergency response units from outlying districts and communities. The captain said that it can be attributed to a “mutual aid program” (Haynes, 2008, p.1). Gary Brown the Director of Emergency Services in Sioux devised a mutual aid program that enabled him to work with more communities in the general area and the captain added: “I have seen pictures in magazines where a fire truck is sitting on a country border while the house across the street burns because the communities do not have a mutual aid program” (Haynes, 2008, p.1). This was not the problem in the UA232 disaster response.
Due to the mutual aid program initiated by Brown, representatives from surrounding communities were invited into the meetings wwherethe Emergency Disaster Service would draw up plans and execute drills and so many leaders from the State of Iowa were familiar with Sioux City and they knew what to do in the event of a major disaster. This allowed the emergency dispatcher to easily contact one community to the next requesting help. Even those who are not part of the community aid program came to help (Haynes, 2008, p.1). In addition, the meeting conducted by Brown allowed for the inclusion of post-traumatic stress units (Haynes, 2008, p.1). The captain said that this health group was an invaluable part of the whole emergency response system.
Another factor that improved the chances of survival of the crash victims was the timing of the accident. Since the town of Sioux was alerted of the impending crash-landing in the afternoon, it coincided with the shift changes in the local hospitals and as a result the workers for the morning and evening shift were able to converge in the hospitals and they were ready to handle more patients than what was normally possible for a small town (Reason, 2008, p.202). As a direct result of the convergence of medical personnel in the two local hospitals, there was one doctor and assisting staff that could be assigned to every ambulance when it arrived adding to the efficiency of the triage system in place.
Aside from medical workers it was also important to have trained personnel that can handle crowd control, vehicular traffic, and the safety of the people who were there to assist or to know what happened to their loved ones aboard the plane. It so happened the day of the month in which the 185th Iowa Air National Guard was on duty and this means that there was 285 trained personnel who were there to help in dealing with the crash (Reason, 2008, p.202).
United Airlines also played a major role in coping with the disaster. The airline responded to the crash by directing large numbers of personnel from San Francisco and Seattle to assist the emergency response units and because of ,that there was at least one United Airlines employee for every family that went to the crash site (Reason, 2008, p. 206). It created a sense of order at Sioux City when it began to swell with people.
The DC-10 came in fast and strong at 215 knots which were 75 knots faster than normal and with a rate of descent of 1,854 feet per minute when the normal was only 300 feet per minute (Reason, 2008, p.) Thus, at the initial point of impact, there was an 18-inch hole that punctured the one-foot thick concrete (Reason, 2008, p.). There was a huge fireball because of the fuel that still remained in the tank and the plane broke into many sections. The impact, the destruction of the aircraft as well as the fire and smoke could have killed everyone but thanks to the emergency responders the survival rate was more than they could hope for.
Conclusion
The results of the simulator tests revealed that it was impossible to land UA232. The plane came in with an abnormal rate of descent and speed that bore a huge hole in the concrete, broke it into many sections and ignited a huge fire because of the fuel. Even if there were survivors all of them could have been killed afterwards because of asphyxiation from smoke and internal injuries that proved fatal to some. It was the well-coordinated emergency response built on the foundation of a mutual aid program between Sioux City and outlying communities that allowed emergency response units to efficiently gather near the runway to help. The Emergency Disaster Service at Sioux also played a major role especially when it comes to communication and coordinating local and even state resources to help cope with the disaster.
References
Abkowitz, M. (2008). Operational Risk Management: A Case Study Approach to Effective Planning and Response. New Jersey: John Wiley & Sons, Inc.
Flin, R. et al. (2008). Safety at the Sharp End. VT: Ashgate Publishing.
Hogan, D. & J. Burstein. (2007). Disaster Medicine. Lippincott Williams & Wilkins: PA.
Kilroy, Chris. (2008). “Special Report: United Airlines Flight 232.” Web.
Kolstad, J. (1990). “National Transportation Safety Board: Safety Recommendations.” Web.
Krause, S. (2003). Aircraft Safety: Accident, Investigations, Analyses, and Applications. New York: McGraw-Hill.
Reason, J. (2008). The Human Contributions Unsafe Acts, Accidents, and Heroic Recoveries. VT:Ashgate Publishing.