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Korean Air Cargo Flight 8509 was a Boeing 747-2B5F, registered HL7451 and bound for Milan Malpensa Airport, that crashed due to instrument malfunction and pilot error on 22 December 1999 shortly after take-off from London Stansted Airport where the final leg of its route from South Korea to Italy had begun. The aircraft crashed into Hatfield Forest near the village of Great Hallingbury, close to but clear of some houses. All four crew on board died.[2][1]

Korean Air Cargo Flight 8509

The 747 involved in the accident, in 1992.
Accident
Date	22 December 1999
Summary	Crash on takeoff due to instrument malfunction and pilot error[1]
Site	Great Hallingbury, England, United Kingdom 51°51′23″N 0°12′59″E
Aircraft
Aircraft type	Boeing 747-2B5F
Operator	Korean Air Cargo
IATA flight No.	KE8509
ICAO flight No.	KAL8509
Call sign	KOREAN AIR 8509
Registration	HL7451
Flight origin	Gimpo International Airport, Seoul, South Korea
1st stopover	Tashkent International Airport, Tashkent, Uzbekistan
2nd stopover	London Stansted Airport, England, United Kingdom
Destination	Milan Malpensa Airport, Milan, Italy
Occupants	4
Passengers	0
Crew	4
Fatalities	4
Survivors	0

The aircraft

The aircraft involved was a 19-year-old Boeing 747-200F freighter registered HL7451. First flown on 4 April 1980, the aircraft had completed 15,451 flights with a total flight time of 83,011 hours before its fatal flight.[2][3][4]

INU failure and failed repair

Following the plane's departure from Tashkent on the previous flight segment, one of its inertial navigation units (INUs) had partially failed, providing erroneous roll data to the captain's attitude director indicator (ADI or artificial horizon). The first officer's ADI and a backup ADI were correct, a comparator alarm called attention to the discrepancy, and in daylight, the erroneous indication was easily identified. The ADI's input selector was switched to the other INU and the correct indications returned.[2]

At Stansted, the engineers who attempted to repair the ADI did not have the correct Fault Isolation Manual available and did not think of replacing the INU. One of them identified and repaired a damaged connecting plug on the ADI. When the ADI responded correctly to its "Test" button, they believed the fault had been corrected, although this button only tested the ADI and not the INU. The ADI's input selector was left in the normal position.[2]

Flight crew

The flight crew consisted of 57-year-old Captain Park Duk-kyu (Hangul: 박득규, Hanja: 朴得圭, RR: Bak Deuk-gyu, M-R: Pak Tŭkkyu), 33-year-old First Officer Yoon Ki-sik (Hangul: 윤기식, Hanja: 尹基植, RR: Yun Gi-sik, M-R: Yun Kishik), 38-year-old Flight Engineer Park Hoon-kyu (Hangul: 박훈규, Hanja: 朴薰圭, RR: Bak Hun-gyu, M-R: Pak Hun'gyu), and 45-year-old maintenance mechanic Kim Il-suk (Hangul: 김일석, Hanja: 金日奭, RR: Gim Il-seok, M-R: Kim Ilsŏk).[5][6] The captain was a former colonel and pilot in the Republic of Korea Air Force and a highly experienced airman,[7] with a total of 13,490 flying hours – 8,495 of which were accumulated flying Boeing 747s. The first officer, in contrast, was relatively inexperienced with just 195 hours of flying experience on the 747 and a total of 1,406 flight hours. The flight engineer, like the captain, had a lot of experience flying 747s – 4,511 out of his 8,301 total flight hours were accrued in them. The maintenance mechanic had been involved with the failed INU repair.[7]

Flight

It was dark when the plane took off from London Stansted Airport, with the captain flying.[7] When the captain tried to bank the plane to turn left, his ADI showed it was not banking, but the comparator alarm sounded repeatedly.[7] The first officer, whose own ADI would have shown the true angle of bank, failed to participate in full crew resource management techniques, saying nothing to challenge his captain's actions nor made any attempt to take over the flight with his own controls. The older and more experienced flight engineer did call out "Bank!, Bank!, Look!, Bank!"^{[citation needed]} in 19 seconds, but the captain ignored his warnings, continued to ignore the chiming alarm,[2] made no verbal response, and actually continued to increase the left bank angle.[7] At 18:38, 55 seconds after take-off, Flight 8509's left-wing dragged along the ground, then the aircraft plunged into the ground at a speed of between 250 and 300 knots (460 and 560 km/h; 290 and 350 mph)^{[citation needed]}, in a 40° pitch down and 90° left bank attitude.[2] The aircraft exploded on impact.[7]

Aftermath

After the investigation, the United Kingdom's Air Accidents Investigation Branch (AAIB) issued recommendations to Korean Air to revise its training program and company culture, to promote a more free atmosphere between the captain and the first officer.[7] The first recommendation of the AAIB's final accident report was that:

Korean Air continue to update their training and Flight Quality Assurance programmes, to accommodate Crew Resource Management evolution and industry developments, to address issues specific to their operational environment and ensure adaptation of imported training material to accommodate the Korean culture.[2][8]

The AAIB also recommended the airline review its maintenance procedures. The second and third recommendations are that:

Korean Air continues to review its policy and procedures for maintenance support at international destinations with a view to deploying sufficient of its own full-time engineers at the outstation or delegating the entire task to another operator or third-party maintenance organisation locally-based at the destination (Full Technical Handling). If neither of these approaches is practicable then the support arrangements must be detailed and of such clarity, as to preclude confusion. Korean Air reviews its policy and procedures to ensure that a copy of the relevant pages of the Technical Log and any other transit certification documents are left on the ground at the point of departure.[2]

In popular culture

A March 2012 episode of Mayday also called Air Crash Investigation in the U.K. and the rest of the world (Season 11 Episode 7) titled "Bad Attitude" or "Stansted Crash" investigates this accident.[7]

See also

• Impact of culture on aviation safety

References

External links

• "The AAIB interim report" – BBC – Friday 24 December 1999 (Archive)
• "AAIB Bulletin S2/2000 SPECIAL." Air Accidents Investigation Branch (Archive)
• Cockpit Voice Recorder transcript and accident summary
• Boeing Expresses Condolences After Korean Air Crash – Boeing (Archive)
• Boeing to Assist in Korean Air Investigation – Boeing (Archive)
• "KE-8509 Crash May Be Due to Instrument Failure." – The Chosun Ilbo
• "KAL Team Joins Flight KE-8509 Investigation." – The Chosun Ilbo (Archive)

На других языках

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[de] Korean-Air-Flug 8509

Am 22. Dezember 1999 verunglückte auf dem Korean-Air-Flug 8509 (Flugnummer: KE8509 bzw. KAL8509) ein Frachtflugzeug des Typs Boeing 747-200F kurz nach dem Start vom Flughafen London-Stansted infolge eines Instrumentenfehlers. Die vier Besatzungsmitglieder kamen bei dem Unfall ums Leben.

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- [en] Korean Air Cargo Flight 8509

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[fr] Vol Korean Air Cargo 8509

Le vol 8509 Korean Air Cargo était un vol entre Londres au Royaume-Uni et Milan en Italie, qui s'est écrasé le 22 décembre 1999 peu après le décollage de l'aéroport de Londres Stansted. Les quatre membres d'équipage sont morts dans l'accident.

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[it] Volo Korean Air Cargo 8509

Il volo Korean Air 8509 era un volo cargo della Korean Air dall'aeroporto Internazionale di Seul-Gimpo con due scali programmati all'aeroporto Internazionale di Tashkent e all'aeroporto di Londra-Stansted e destinazione finale l'aeroporto di Milano-Malpensa. Il 22 dicembre 1999 il Boeing 747 che operava il volo a causa di un errore del pilota e di un'avaria alla strumentazione precipitò a terra poco dopo il decollo provocando la morte di tutti e 4 i membri dell'equipaggio.

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[ru] Катастрофа Boeing 747 под Лондоном

Катастрофа Boeing 747 под Лондоном — авиационная катастрофа, произошедшая в среду 22 декабря 1999 года в графстве Эссекс. Грузовой самолёт Boeing 747-2B5F-SCD авиакомпании Korean Air Cargo выполнял плановый рейс KE8509 (позывной — KAL 8509) по маршруту Лондон—Милан—Ташкент—Сеул, но через 55 секунд после взлёта внезапно перешёл в сваливание и рухнул на землю в 2,4 километрах от лондонского аэропорта Станстед. Погибли все находившиеся на его борту 4 члена экипажа — 3 пилота и наземный инженер.

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