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Flying Tiger Line Flight 66 was a scheduled international cargo flight from
Singapore Changi Airport Singapore Changi Airport, commonly known as Changi Airport , is a major civilian international airport that serves Singapore, and is one of the largest transportation hubs in Asia. As one of the world's busiest airports by international passe ...
, to Hong Kong's
Kai Tak Airport Kai Tak Airport was the international airport of Hong Kong from 1925 until 1998. Officially known as Hong Kong International Airport from 1954 to 6 July 1998, it is often referred to as Hong Kong International Airport, Kai Tak, or simply Ka ...
via a stopover at
Kuala Lumpur International Airport Kuala Lumpur International Airport (KLIA) is Malaysia's main international airport. It is located in the Sepang District of Selangor, approximately south of Kuala Lumpur and serves the city's greater conurbation. KLIA is the largest and ...
,
Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
. On February 19, 1989, the FedEx-owned Boeing 747-249F-SCD crashed while on its
final approach In aeronautics, the final approach (also called the final leg and final approach leg) is the last leg in an aircraft's approach to landing, when the aircraft is lined up with the runway and descending for landing.Crane, Dale: ''Dictionary of ...
. The aircraft impacted a hillside above sea level and from Kuala Lumpur, resulting in all four crew members being killed.


Aircraft and crew

The aircraft, registered as N807FT, made its first flight on 1 November 1979 before being delivered new to Flying Tiger Line on 11 December 1979. Its manufacturer serial number was 21828 and its construction number was 408. At the time of the accident, it had flown over 9,000 flight cycles and 34,000 airframe hours. The crew consisted of Captain Francis "Frank" Halpin (53); First Officer John "Jack" Robinson (54); and Flight Engineer Ronald Penton (70). Leonard Sulewski (53), an aircraft mechanic, was also on board.


Accident

The aircraft was assigned a
non-directional beacon A non-directional beacon (NDB) or non-directional radio beacon is a radio beacon which does not include directional information. Radio beacons are radio transmitters at a known location, used as an aviation or marine navigational aid. NDB are i ...
(NDB) approach to Runway 33 at Sultan Abdul Aziz Shah Airport, Kuala Lumpur, after having flown 30 minutes from
Singapore Changi Airport Singapore Changi Airport, commonly known as Changi Airport , is a major civilian international airport that serves Singapore, and is one of the largest transportation hubs in Asia. As one of the world's busiest airports by international passe ...
. In descent, the flight was cleared to "Kayell" with a morse code of "KL" of which four separate points on the ground were commonly called by Malaysian ATC albeit with different frequencies. Two separate radio beacons were identically coded "KL" as well as the VOR abbreviation (Kuala Lumpur shortened to "KL") and the airport was also sometimes referred to as "KL" by local ATC (instead of the full "Kuala Lumpur"). The crew was unsure to which point they were cleared, and the cockpit voice recorder revealed that the crew argued about which radios should be set to which frequencies and which approach was actually going to be conducted. (Even in the last few moments of the flight, the captain referenced the ILS approach for runway 33 which was named as inop on the flight release and the ATIS, additionally the crew was told by ATC that the ILS approach was not available.) ATC radioed to the flight, "Tiger 66, descend two four zero zero (about ), cleared for NDB approach runway 33." Captain Halpin, who interpreted it as "descend ''to'' four zero zero" replied with, "Okay, four zero zero" (meaning above
sea level Mean sea level (MSL, often shortened to sea level) is an average surface level of one or more among Earth's coastal bodies of water from which heights such as elevation may be measured. The global MSL is a type of vertical datuma standardise ...
, which was too low). The
Cockpit voice recorder A flight recorder is an electronic recording device placed in an aircraft for the purpose of facilitating the investigation of aviation accidents and incidents. The device may often be referred to as a "black box", an outdated name which has ...
also revealed several communication errors made by the flight crew prior to this miscommunication and a general casual nature of the Captain, who was the pilot-not-flying on this particular leg of the trip. During the final approach, numerous clear warnings were given by the on-board Ground Proximity Warning System which were all ignored entirely by the crew, and the aircraft impacted a hillside above sea level, killing all four crew on board; two pilots, a flight engineer and an aircraft mechanic. The subsequent fire burned for two days.


Causes

The First Officer had complained that he did not have an
approach plate Approach plates (or, more formally, instrument approach procedure charts) are the printed charts of instrument approach procedures that pilots use to fly instrument approaches during instrument flight rules (IFR) operations. Each country maintains ...
in front of him and had not seen the approach. From a pilot's perspective, this alone would be considered the cause of the crash because the approach plate (chart) provides the pilot with the courses and minimum altitudes necessary to execute the approach without impacting terrain. The chart would have indicated the minimum descent altitude of , preventing the accident. Flying an approach without referring to the approach plate is gross negligence. Additionally, the First Officer (FO), who was the pilot flying at the time, expressed concern about conducting the NDB approach and indicated a preference for the ILS for runway 15. However, the FO was not assertive and no further action was taken. The Captain dismissed his concern saying he was familiar with the airport and the approaches. A contributing factor to this accident was the non- ICAO phraseology used by Kuala Lumpur air traffic control and the Captain of the aircraft. This breakdown of communication contributed to the crew misinterpreting the instructions given. However, this particular controlled-flight-into-terrain accident ultimately resulted from a crew failure to adhere to the instrument approach procedure, poor crew resource management and poor situational awareness.


Procedure changes

The incident further stressed the need for increased awareness and training of crew resource management techniques and standard operating procedures. This accident is used as an example of 'what not to do' by flight training organizations such as
FlightSafety International Berkshire Hathaway Inc. () is an American multinational conglomerate holding company headquartered in Omaha, Nebraska, United States. Its main business and source of capital is insurance, from which it invests the float (the retained premiums ...
. The FAA video production using the original CVR recording and transcript is still used to study the events and how to improve current techniques. Much of this information is derived from that video.


See also

* List of aviation accidents and incidents involving CFIT *
Korean Air Flight 801 Korean Air Flight 801 (KE801, KAL801) was a scheduled international passenger flight operated by Korean Air. The flight crashed on August 6, 1997, on approach to Antonio B. Won Pat International Airport, in the United States territory of Guam, k ...


References

* Aviation Week & Space Technology 27.02.89 (24) * Flight Int. 17-12.01.1990 (p. 44) * ICAO Adrep Summary {{Aviation incidents and accidents in 1989
1989 in Malaysia Airliner accidents and incidents involving controlled flight into terrain Airliner accidents and incidents caused by pilot error Aviation accidents and incidents caused by air traffic controller error Aviation accidents and incidents in 1989 Aviation accidents and incidents in Malaysia Flying Tiger Line accidents and incidents Accidents and incidents involving the Boeing 747 February 1989 events in Asia