Helios Airways Flight 522

Helios Airways Flight 522
Helios Airways Flight 522

Artist's depiction of 5B-DBY being met by two F-16s of the Hellenic Air Force at 34000 ft
Accident summary
Date 14 August 2005 (2005-08-14)
Type Pilot incapacitation due to
hypoxia brought about by
depressurization, leading to
fuel starvation
Site Marathon, Greece
Passengers 115
Crew 6
Injuries 0
Fatalities 121 (all)
Survivors 0
Aircraft type Boeing 737-300
Aircraft name Olympia
Operator Helios Airways
Tail number 5B-DBY
Flight origin Larnaca International Airport
Stopover Athens International Airport
Destination Ruzyně International Airport

Helios Airways Flight 522 (HCY 522 or ZU522) was a Helios Airways Boeing 737-300 flight that crashed into a mountain on 14 August 2005 at 12:04 EEST, north of Marathon and Varnavas, Greece. Rescue teams located wreckage near the community of Grammatiko 40 km (25 mi) from Athens. All 121 on board were killed.

With 121 dead, this was 2005's deadliest aircraft crash to that date (it was exceeded two days later by the West Caribbean Airways Flight 708 crash, which killed 160) and was the second accident of the year that caused more than 100 fatalities, the first being Kam Air Flight 904 with 104 deaths. It is the 69th crash of a Boeing 737 (the most numerous passenger jet aircraft in the world) since it was brought into service in 1968.

Contents

Background

5B-DBY, the aircraft involved in the accident, is seen here at Ruzyne Airport in March 2005.

The aircraft involved in this incident was first flown on 29 December 1997 and had been operated by DBA until it was leased by Helios Airways on 16 April 2004 and nicknamed Olympia, with registration 5B-DBY.[1] Aside from the downed aircraft, the Helios fleet consisted of two leased Boeing 737-800s and an Airbus A319-111 delivered on 14 May 2005. The aircraft had arrived in Larnaca from London Heathrow at 01:25 that morning.[2]

The flight was scheduled to leave Larnaca, Cyprus at 09:00 local time, to Prague via Athens. The scheduled arrival time in Athens was 10:45.[3] Hans-Jürgen Merten, a 59-year-old German contract pilot hired by Helios for the holiday flights, served as the captain. Pampos Charalambous, 51, a Cypriot who flew for Helios, served as the first officer.[4] 32-year old Louisa Vouteri, a Greek national living in Cyprus who served as a chief purser, replaced a sick colleague.[5]

Flight and crash

Flight path of Helios 522-en.svg
Date: 14 August 2005
All times EEST (UTC + 3h), PM in bold
Time Event
0900 Scheduled departure
0907 Departs Larnaca International Airport
0912 Cabin Altitude Warning sounds at 12,040 feet (3,670 m)
0914 Pilots report air conditioning problem
0920 Last contact with crew;
Altitude is 28,900 feet (8,809 m)
0923 Now at 34,000 feet (10,400 m);
Probably on autopilot
0937 Enters Athens Flight Information Region
1012–1050 No response to radio calls from Athens ATC
1020 Athens ATC calls Larnaca ATC;
Gets report of air conditioning problem
1024 Hellenic Air Force (HAF) alerted
to possible renegade aircraft
1045 Scheduled arrival in Athens
1047 HAF reassured that the problem
seemed to have been solved
1055 HAF ordered to intercept by Chief of
General Staff, Admiral Panagiotis Chinofotis
1105 Two F-16 fighters depart Nea Anchialos
1124 Located by F-16s over Aegean island of Kea
1132 Fighters see co-pilot slumped over,
cabin oxygen deployed, no signs of terrorism
1149 Fighters see an individual in the cockpit,
apparently trying to regain control of aircraft
1150 Left (#1) engine stops operating,
presumably due to fuel starvation
1154 CVR records two MAYDAY messages
1200 Right (#2) engine stops operating
1204 Aircraft crashes in mountains
near Grammatikos, Greece

When the aircraft arrived from London Heathrow earlier that morning, the previous flight crew had reported a frozen door seal and abnormal noises coming from the right aft service door, and requested a full inspection of the door.[2][6] The inspection was carried out by a ground engineer who then performed a pressurization leak check. In order to carry out this check, the pressurisation system was set to "manual", and was not set back to "auto" on completion of the test.[7]

After the aircraft was returned into service, the flight crew overlooked the pressurisation system on three separate occasions: during the pre-flight procedure, the after-start check, and the after take-off check. During none of these checks did the flight crew notice the incorrect setting of the pressurisation system and did not set it back to "auto".[8] The aircraft took-off at 9:07[3] with the pressurisation system still set to "manual", and the aft outflow valve partially open.[9]

As the aircraft climbed, the pressure inside the cabin gradually decreased. As it passed through an altitude of 12,040 ft, the cabin altitude warning horn sounded.[3] The cabin altitude warning should have prompted the crew to descend to a lower altitude,[10] but it was misidentified by the crew as a take-off configuration warning, which signals that the aircraft is not ready for take-off, and can only sound on the ground.[10]

In the next few minutes a number of warning lights on the overhead panel in the cockpit illuminated. One or both of the equipment cooling warning lights came on to indicate low airflow through the cooling fans (a result of the decreased air density), accompanied by the master caution light. And the passenger oxygen light illuminated when, at an altitude of approximately 18,000 ft, the oxygen masks in the passenger cabin automatically deployed.[11][12]

Shortly after the cabin altitude warning sounded, the captain radioed the Helios operations centre and reported "the take-off configuration warning on" and "cooling equipment normal and alternate off line".[3] He then spoke to the ground engineer and repeatedly stated that the "cooling ventilation fan lights were off.[3] The engineer (the one who had conducted the pressurization leak check) asked "Can you confirm that the pressurization panel is set to AUTO?" The captain, however, disregarded the question and instead asked in reply, "Where are my equipment cooling circuit breakers?".[12] This was the last communication received from the aircraft.[13]

The aircraft continued to climb until it leveled off at FL340 (approx. 34,000 ft).[12] Between 09:30 and 09:40, Nicosia ATC repeatedly attempted to contact the aircraft, without success.[12] At 09:37 the aircraft passed from Cyprus FIR into Athens FIR, without making contact with Athens ATC.[12] Nineteen attempts to contact the aircraft between 10:12 and 10:50 also met with no response,[14] and at 10:40 the aircraft entered the holding pattern for Athens Airport, at the KEA VOR, still at FL340.[15] It would remain in the holding pattern, under control of the auto-pilot, for the next seventy minutes.[15]

Two F-16 fighter aircraft from the Hellenic Air Force 111th Combat Wing were scrambled from Nea Anchialos Air Base[citation needed] to establish visual contact. They intercepted the passenger jet at 11:24 and observed that the first officer was slumped motionless at the controls and the captain's seat was vacant.[16] They also reported that oxygen masks were seen dangling in the passenger cabin.[15]

Crash area of the flight in red

At 11:49, flight attendant Andreas Prodromou entered the cockpit and sat down in the vacant captain's seat.[17] Prodromou held a UK Commercial Pilot License,[18] but was not qualified to fly the Boeing 737. Crash investigators concluded that Prodromou's experience was insufficient for him to gain control of the aircraft under the circumstances.[17]

In any case, he did not have time to save the stricken aircraft. Almost as soon as he entered the cockpit, the left engine flamed out due to fuel exhaustion,[17] the plane left the holding pattern and started to descend.[19] Ten minutes after the loss of power from the left engine, the right engine also flamed out,[19] and just before 12:04 the aircraft crashed into hills near Grammatiko.[19]

The aircraft was carrying 115 passengers and a crew of 6. The passengers included 67 due to disembark at Athens, with the remainder continuing to Prague. The bodies of 118 individuals were recovered.[20] The passenger list included 93 adults and 22 people under the age of 18. The passengers comprised 103 Cypriot nationals and 12 Greek nationals.[21]

The Hellenic Air Accident Investigation and Aviation Safety Board (AAIASB) determined that the direct causal chain of events that led to the accident was

  • non-recognition by the pilots that the pressurisation system was set to "manual";
  • non-identification by the crew of the true nature of the problem;
  • incapacitation of the crew due to hypoxia, eventual fuel starvation and impact with the ground.[8]

Investigation

Suspicions that the aircraft had been hijacked were ruled out by Greece's foreign ministry. Initial claims that the aircraft was shot down by the fighter jets have been refuted by eyewitnesses and the government.

The flight data recorder and cockpit voice recorder were sent to Paris for analysis. Authorities served a search warrant on Helios Airways' headquarters in Larnaca, Cyprus, and seized "documents or any other evidence which might be useful in the investigation of the possibility of criminal offences."

Most of the bodies recovered were burned beyond visual identification by the fierce fires that raged for hours in the dry brush and grass covering the crash site. However, it was determined that a body found in the cockpit area was that of a male flight attendant[citation needed] and DNA testing revealed that the blood on the aircraft controls was that of flight attendant Andreas Prodromou, a pilot-in-training with approximately 260–270 hours of training completed. Autopsies on the crash victims showed that all were alive at the time of impact, but it could not be determined whether they were conscious as well. Prodromou was not originally scheduled to be on the flight; he joined the crew so he could spend time with his girlfriend, a fellow Helios flight attendant.[4]

The emergency oxygen supply in the passenger cabin of this model of Boeing 737 is provided by chemical generators that provide enough oxygen, through breathing masks, to sustain consciousness for about 12 minutes, normally sufficient for an emergency descent to 10,000 feet (3,000 m), where atmospheric pressure is sufficient to sustain life without supplemental oxygen. Cabin crew have access to portable oxygen sets with considerably longer duration. Emergency oxygen for the flight crew comes from a dedicated tank.

Previous pressurization problems

On 16 December 2004, during an earlier flight from Warsaw, the accident aircraft experienced a rapid loss of cabin pressure, and the crew made a successful emergency descent. The cabin crew reported to the captain that there had been a bang from the aft service door, and that there was a hand-sized hole in the door's seal. The Air Accident and Incident Investigation Board (AAIIB) of Cyprus could not conclusively determine the causes of the incident, but indicated two possibilities: an electrical malfunction causing the opening of the outflow valve, or the inadvertent opening of the aft service door.[22]

The mother of the first officer killed in the crash of Flight 522 claimed that her son had repeatedly complained to Helios about the aircraft getting cold. Passengers also reported problems with air conditioning on Helios flights.[23] During the two months before the crash, the aircraft's Environmental Control System required repair five times.[24]

Private investigation

One year after the accident, the Discovery Channel aired a documentary detailing a private investigation, made in cooperation with Advanced Aviation Technology Ltd., arguing that a design failure of the Boeing 737 may have contributed to the accident.

All wiring for the pressurization system was in one wiring loom to the outflow valve in the aft of the Boeing 737. During a Boeing 737-436 G-DOCE flight in May 2003, a failure in this loom opened the outflow valve, which caused the cabin to depressurize. The same wiring failure probably caused erroneous indications to the crew that the standby pressurization system had failed and that the outflow valve was fully closed and unresponsive to pilot input. After seeing indication of the standby pressurization failure, the crew switched the pressurization control to manual mode and made an emergency descent.[25]

Discovery Channel reported its findings on the G-DOCE incident to the Hellenic Republic's Air Accident Investigation & Aviation Safety Board.

The Board reported no evidence of wiring failure in Flight 522, and did not mention the G-DOCE incident. Because all available flight data showed the pressurization control in manual mode and the outflow valve open at a constant angle, and because there was no evidence the flight crew ever changed the pressurization mode, the Board concluded that the pressurization system had been set to manual for the entire flight, which caused the pressurization failure.[26]

Hoaxes

News media widely reported that shortly before the crash a passenger sent a text message indicating that one of the flight crew had become blue in the face, or roughly translated as "The pilot is dead. Farewell, my cousin, here we're frozen." Police later arrested Nektarios-Sotirios Voutas, who admitted that he had made up the story and given several interviews in order to get attention.[27][28] Voutas was tried by a court of first instance on 17 August 2005 and received a suspended 6-month imprisonment sentence under a 42-month probation term.[29]

Another hoax involved photographs allegedly showing the aircraft being chased by Greek fighter jets. The photos were actually of a Helios 737-800 (rather than the crashed 737-300) with the registration altered and the fighter jets added.[30]

Subsequent developments

  • The flight Larnaca-Athens-Prague has been renumbered ZU604/5.
  • The service between Larnaca and Prague was discontinued on 26 August 2005.
  • The company announced successful safety checks on their Boeing fleet 29 August 2005 and put them back into service.
  • The company renamed itself from "Helios Airways (www.flyhelios.com)" to "αjet (www.ajet.com)".
  • The Government of the Republic of Cyprus detained Ajet’s aircraft and froze the company’s bank accounts. Ajet no longer operates flights as of 11 June 2006.
  • In February 2011, the Federal Aviation Authority in the United States released an airworthiness directive requiring all Boeing 737 aircraft from -100 to -500 models to be fitted with two additional cockpit warning lights. These would indicate problems with take-off configuration or pressurisation. Aircraft on the United States civil register are required to have the additional lights by 14 March 2014.[31]

Lawsuits and criminal proceedings

Families of the dead filed a lawsuit against Boeing on 24 July 2007. Their lawyer, Constantinos Droungas, said "Boeing put the same alarm in place for two different types of dysfunction. One was a minor fault, but the other - the loss of oxygen in the cockpit - is extremely important". He also said that similar problems had been encountered before on Boeings in Ireland and Norway. The families are claiming 76 million euros in compensation from Boeing.[32]

In early 2008, an Athens prosecutor charged six people with manslaughter. Reports at the time said the suspects were two Britons, one Bulgarian national and three Cypriots.[33]

On 23 December 2008, Helios Airways and four of its officials were charged in Cyprus with 119 counts of manslaughter and of causing death by recklessness/negligence. The four officials were former chief pilot Ianko Stoimenov, chairman of the board Andreas Drakos, chief executive officer Demetris Pantazis, and operations manager Giorgos Kikidis. The trial began in November 2009, the state prosecutors finished presenting their case in June 2011.[34][35][36]

Relatives of the dead filed a class action suit against the Cypriot Government – specifically the Department of Civil Aviation – for negligence that led to the air disaster. They claim that the DCA was turning a blind eye to airlines’ loose enforcement of regulations, and that in general the department cut corners when it came to flight safety.[33]

Dramatization

The Canadian television series Mayday, which examines aerial incidents, their causes and results, created a documentary episode, titled Ghost Plane, about the disaster. Discovery Channel UK also produced a 45-minute documentary about the accident, titled Aircrash Unsolved: The Mystery of Flight 522.

See also

Other accidents caused by decompression resulting in pilot incapacitation due to hypoxia:

References

  1. ^ 737 Production list
  2. ^ a b AAIASB final report, section 1.1, page 3 (PDF page 15 of 198)
  3. ^ a b c d e AAIASB final report, section 1.1, page 4 (PDF page 16 of 198)
  4. ^ a b "Ghost Plane." Mayday
  5. ^ "Two trying to save jet ID'd ." News 24. Archived June 17, 2009 at the Wayback Machine
  6. ^ AAIASB final report, section 1.6.2.3.2, pages 21-2 (PDF pages 33-34 of 198)
  7. ^ AAIASB final report, section 3.2.3, page 159 (PDF page 171 of 198)
  8. ^ a b AAIASB final report, section 3.2.1, page 159 (PDF page 171 of 198)
  9. ^ AAIASB final report, section 1.16.2, page 66 (PDF page 78 of 198)
  10. ^ a b AAIASB final report, section 2.2.4, page 121 (PDF page 133 of 198)
  11. ^ AAIASB final report, section 2.2.4, page 122 (PDF page 134 of 198)
  12. ^ a b c d e AAIASB final report, section 1.1, page 5 (PDF page 17 of 198)
  13. ^ AAIASB final report, section 2.2.5, page 125 (PDF page 137 of 198)
  14. ^ AAIASB final report, section 1.1, pages 5-6 (PDF pages 17-18 of 198)
  15. ^ a b c AAIASB final report, section 1.1, page 6 (PDF page 18 of 198)
  16. ^ Don Phillips (16 August 2005). "Crash inquiry focuses on oxygen mask use". New York Times. http://www.nytimes.com/2005/08/15/world/europe/15iht-crash.html. Retrieved 2007-06-24. "The F-16 pilots reported seeing the co-pilot slumped in his seat and the captain's seat empty." 
  17. ^ a b c AAIASB final report, section 2.2.7, page 127 (PDF page 139 of 198)
  18. ^ AAIASB final report, section 1.5.3.4, page 15 (PDF page 27 of 198)
  19. ^ a b c AAIASB final report, section 1.1, page 7 (PDF page 19 of 198)
  20. ^ Greek "Αεροπορική τραγωδία" Flash.GR Archived April 15, 2009 at the Wayback Machine
  21. ^ Greek Ο κατάλογος των θυμάτων ERT[dead link]
  22. ^ AAIASB final report, section 1.18.1.1, page 102 (PDF page 113 of 198)
  23. ^ news in.gr - Βεβαρημένο το παρελθόν του αεροσκάφους που συνετρίβη, σύμφωνα με μάρτυρες
  24. ^ " Helios 737 crashed with no fuel and student pilot at the controls" Radar Vector, 2005-08-21
  25. ^ http://www.aaib.gov.uk/sites/aaib/cms_resources/dft_avsafety_pdf_029046.pdf
  26. ^ AAIASB final report, section 2.2.2, page 117 (PDF page 129 of 198)
  27. ^ Phillips, Don (16 August 2005). "Crash inquiry focuses on oxygen mask use". International Herald Tribune. http://www.iht.com/articles/2005/08/15/news/crash.php. Retrieved 2007-06-24. 
  28. ^ "Pilot 'alive when plane crashed'", CNN, 2005-08-17 Archived January 18, 2008 at the Wayback Machine
  29. ^ "Hoax crash SMS: Man freed". News 24. 2005-08-17. Archived from the original on September 30, 2007. http://web.archive.org/web/20070930221056/http://www.news24.com/News24/World/News/0,,2-10-1462_1755572,00.html. Retrieved 2007-06-24. 
  30. ^ "Fake Helios pictures identified", Flight International, 2005-08-17
  31. ^ Hradecky, Simon. "FAA requires separate configuration and cabin altitude warning lights on Boeing 737s". Aviation Herald. 
  32. ^ "Cyprus air crash victims' families make 76 mln eur legal claim against Boeing". Forbes (AFX News). 25 July 2007. http://www.forbes.com/business/feeds/afx/2007/07/25/afx3949967.html. Retrieved 2007-07-26. [dead link]
  33. ^ a b http://www.cyprus-mail.com/news/main.php?id=43215&cat_id=1 Archived April 15, 2009 at the Wayback Machine
  34. ^ Stefanos Evripidou (17 June 2011). "State wraps up Helios case". Cyprus Mail. http://www.cyprus-mail.com/cyprus/state-wraps-helios-case/20110617. Retrieved 29 June 2011. 
  35. ^ "Five charged for Helios jet crash". BBC News. 23 December 2008. http://news.bbc.co.uk/1/hi/world/europe/7798205.stm. Retrieved 4 May 2010. 
  36. ^ "Cyprus files charges over airline disaster". Reuters. 23 December 2008. http://uk.reuters.com/article/latestCrisis/idUKLN513095. 

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