The crash of a two-month-old Boeing 737 MAX 8 jet claimed the lives of 189 passengers and crew members Oct. 29, just 13 minutes after takeoff from Jakarta, Indonesia. The airplane for Lion Air Flight 610 had logged only 800 hours and was touted to be the “top of the line” and “one of the best you can buy,” so, its short life raised concerns about several factors that seem to have contributed to the tragedy.

Then, on March 10, an Ethiopian Airlines plane crashed just minutes after takeoff, killing all 157 people on board, including eight Americans. Flight ET302 departed from Bole International Airport in Addis Ababa, Ethiopia, at 8:38 a.m. local time. The plane was headed to Nairobi, Kenya, when it lost contact with air controllers six minutes later. The Ethiopian Airlines jet was a new Boeing 737 Max 8 – the same type of plane that crashed in Indonesia.

The erratic behavior of the plane indicates it could have experienced the same problems that the pilots of Lion Air Flight 610 experienced before it crashed into the Java Sea. The Lion Air flight crew struggled to keep the airplane in an ascent as the front of the jet went into a nose dive more than two dozen times in its 11-minute flight. The Lion Air crew radioed for permission to return to Jakarta but crashed on the return. The same plane experienced nearly identical problems the night before, but the pilots were able to land safely in Jakarta.

The day after the Ethiopian Airlines crash, several nations grounded the Boeing 737 Max 8 aircraft. Cayman Airways and Indonesia’s national airlines both suspended Boeing 737 Max 8 aircraft, and Vietnam’s Civil Aviation Authority said it would not license the use of that model aircraft in the country until the problems are found and fixed. There are no Boeing 737 Max 8 jets in use there, but Vietjet Air has 100 Boeing 737s on order, including 20 Max 8 models.

Other countries grounding the Boeing jets were the U.K., France, Germany, the Netherlands, Poland, Australia, Malaysia, Singapore, Oman, and Turkey. There are nearly 500 Boeing 737 Max 8 jets in use worldwide, including some 74 in use by domestic airlines.

Oddly, Boeing and the U.S. Federal Aviation Administration (FAA) initially stood by the safety of the 737 Max 8. Boeing issued a statement March 11 saying the FAA would not mandate any further action, and that it did not “have any basis to issue new guidance to operators.” However, after an outcry from a growing number of U.S. Senators and other government officials, the plane was finally grounded in the United States on March 13. The plane is currently grounded worldwide while the investigation unfolds.

Malfunctioning hardware and software

After recovering the flight data recorders from the Lion Air crash, investigators zeroed in on malfunctioning angle of attack (AOA) sensors. The AOA sensors tell the flight crew the plane’s angle or degree of ascent or descent. The sensors’ data is communicated to the plane’s flight control system and tells it if the plane is in danger of stalling.

In its latest iterations of the 737 (Max 8 and 9), Boeing incorporated new automated stall-prevention system called a Maneuvering Characteristics Augmentation System (MCAS) as part of the flight control system. The MCAS can push the plane’s nose down unexpectedly, even when the aircraft is in the manual operational mode, CNN reported. While Boeing said pilots can override the automatic action by using extra force, safety experts and U.S. officials disagree. They explain that the automatic system can push the nose down so strongly that flight crews cannot pull it back up. In fact, data released by Indonesian investigators showed pilots of Flight 610 were pulling back on the control column with a force of as much as 100 pounds of pressure.

Within seconds after takeoff, numerous warnings began blasting in the cockpit of the doomed flight, including a stick shaker on the captain’s side. The stick shaker is a loud device that thumps and vibrates the control column to let pilots know they are in danger of losing lift on the wings. It was activated by an erroneous reading from the malfunctioning AOA sensor on the captain’s side, which indicated that the plane’s nose was too high.

Although the AOA sensor on the co-pilot’s side did not reflect the same reading, nor did it activate the copilot’s stick shaker, the erroneous reading triggered the MCAS to lower the aircraft’s nose. Despite the fluctuations in altitude, the flight crew was able to control the plane for the first 10 minutes of the flight, but the crew was not able to override the system’s final plunge.

The initial findings prompted U.S.-based Boeing to issue warnings as part of the Operations Manual Bulletin and the FAA followed with Airworthiness Directive 2018-23-51. The warnings were issued to all owners, operators and air carriers using the 737 MAX about the potential for erroneous readings from flight-control software on the aircraft. The manufacturer claimed its warning reinforced procedures that were included in the aircraft’s flight manual.

Boeing’s alleged failure to inform

However, the three largest pilots’ unions in the U.S., including the Southwest Airlines Pilots Association, the Allied Pilots Association at American Airlines Group Inc. (APA) and the Air Line Pilots Association (representing United Continental Holdings Inc.’s flight crews), along with Lion Air, refuted Boeing’s assertions about the warning. They claimed that Boeing withheld critical information about the new system and that the first time they learned about it was through the warnings issued by Boeing and the FAA following the Lion Air crash.

The discovery prompted the unions and their members to question what other information they have not been privy to about the new 737 models and how they can operate a plane without knowing about all the systems on board.

The new MCAS system was designed to operate only in rare conditions while pilots are flying the aircraft in manual operational mode. It is, most likely, for this reason, Boeing didn’t include the critical information in the flight manual for the 737. The pilots are demanding that the information is added and have said Boeing’s withholding of the information violated the aviation industry’s “safety culture.”

Additionally, although it isn’t clear why, the 737 is fitted with a separate component that makes it more difficult to pull back if a stall has been indicated.

Cleared to fly despite persistent problems

Flight 610 was not the first time the Lion Air aircraft encountered problems. It experienced airspeed and altitude problems on its last four flights including a flight from Manado, in North Sulawesi, to Denpasar, Bali, the day before Flight 610. Airspeed problems prompted technicians to change the AOA sensors as instructed by the Boeing troubleshooting manual. The plane was then declared fit to fly.

On its next flight, despite the roller-coaster takeoff, which would have sent some pilots back to the airport, the flight continued to its destination, Jakarta, Indonesia. Along the way, the plane experienced more of the same problems with airspeed, altitude and its AOA sensors. On the ground in Jakarta, maintenance crews addressed a problem with the pitot tubes, which measure air rushing over them to help determine air speed. The plane was, once again, declared fit to fly – sealing the fate of Flight 610 and the 189 souls on board.

Victims’ families seeking answers and justice

The investigation into both crashes is just beginning. These types of investigations typically take a year or longer to complete. Investigators will continue to examine myriad factors that appear to have contributed to the deadly flights, in addition to understanding how separate flights with similar conditions and problems ended so differently, to give the families of those who perished the answers they are seeking.

One family pushed for faster accountability by filing the first lawsuit, according to USA Today. The family of Dr. Rio Nanda Pratama filed suit against Boeing in November 2018 in the Circuit Court of Cook County Illinois, which serves as the headquarters to Boeing. Pratama was on Lion Air Flight 610 on his way home from a medical conference and preparing for his upcoming wedding on Nov. 11. Instead, his family and friends paid their last respects to Pratama five days before his scheduled nuptials. The company is currently facing nearly three dozen lawsuits as the result of the Lion Air Crash.

If you need additional information on the above subject, or any other matter dealing with aviation litigation, contact Mike Andrews, a lawyer in our Personal Injury & Products Liability Section, who leads the team of lawyers handling aviation litigation for the firm. LaBarron Boone in the firm’s Personal Injury & Products Liability Section also is investigating claims related to the Boeing 737 Max 8 crashes. Mike or LaBarron would be glad to talk with you about any potential claims.

Federal Aviation Administration (FAA)
USA Today
ABA Journal

Part of this story originally appeared in the December 2018 issue of The Jere Beasley Report. It has been updated to reflect new information after the Ethiopian Airlines crash.

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