ANC04IA058

NTSB incident investigation · Boeing 757-251 · Anchorage, AK · May 31, 2004

Incident · Minor injuriesIncident investigationFinal report
Date
May 31, 2004, 14:13 local (22:13 UTC)
Place
Anchorage, AK
Injuries
1 minor, 187 uninjured
Damage
No damage
Phase of flight
Standing
Aircraft
N550NWBoeing 757-251
Weather
Visual (VMC) · Day
Status
Completed · report April 28, 2005
Report
Approved by Office Director
NTSB office
Alaska Regional Office
Parties
FAA-AL-ANC FSDO 03
FAA report
20040531010539I
Case key
59358

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the incident.

On this page

Probable cause

The failure of the flight attendant to follow the appropriate door opening procedure by remaining clear of the door handle when the passenger door was opened from the outside by customer service personnel, which resulted in a wrist injury to the flight attendant when she was struck by the door handle.

Sequence of events

NTSB’s coding before 2008: each occurrence and phase of flight, and the causes and factors under it. The codes are defined in NTSB’s coding manual.

Miscellaneous/otherStanding - engine(s) not operating
Procedures/directives - not followedFlight attendantCause
Door,passenger - activated

Analysis

After a Boeing 757-251 airplane arrived at a terminal gate and was parked, a flight attendant went to door 2L of the aircraft. The customer service agent (CSA) positioned outside the airplane on the jetway knocked on the door. This is the signal to the flight attendant that the door will be opened, if the flight attendant provides a visible "thumbs-up" signal to the agent on the jetway. The flight attendant reported that in response to the knock, she gave a thumbs-up, and stepped away from the door. The door did not open, but she heard a second knock. The flight attendant gave a second thumbs-up through the cabin door window. As she was giving the signal, the door handle came down on her wrist. The CSA reported that after his first knock, he did not receive a thumbs-up, and knocked a second time. The flight attendant inside the airplane then gave a thumbs-up signal. The CSA then opened the airplane door from the outside. During the door opening procedure, the inside handle of the door struck the flight attendant on the forearm. The flight attendant was taken to a local hospital where she was initially diagnosed with a fractured wrist. On June 23, 2004, the operator informed the NTSB Investigator-In-Charge that the injured flight attendant had a follow-up examination with her own physician in Minnesota. The physician took additional x-rays of the injured wrist and determined that it was not broken, but had sustained a sprain. The flight attendant continued to have pain, and had a magnetic resonance image (MRI) of her wrist on July 2, 2004, which was normal. Airline personnel provided a copy of their cabin operating standards, which states, in part: "To prepare cabin door for opening; 1. CSA knocks on door and awaits "thumbs-up" signal from FA. 2. FA gives thumbs-up signal to CSA to indicate that door is disarmed and safe to open. 3. CSA opens cabin door after FA moves hands clear of door." Additional information provided by the airline indicated that the door opening procedure precludes a second thumbs-up signal unless the CSA knocks a second time.

Factual narrative

On May 31, 2004, about 1413 Alaska daylight time (ADT), a cabin crewmember received a minor injury during the cabin door-opening procedure of a Boeing 757-251 airplane, N550NW, after parking at Gate B-10 of the Ted Stevens Anchorage International Airport, Anchorage, Alaska. The airplane was being operated as an instrument flight rules (IFR) scheduled domestic passenger flight under Title 14, CFR Part 121, when the incident occurred. The airplane, operated as Flight 843 by Northwest Airlines Inc., St. Paul, Minnesota, was not damaged. The 2 airline transport certificated pilots, 4 other cabin crewmembers, and the 181 passengers, were not injured. Visual meteorological conditions prevailed. An IFR flight plan was filed. The flight originated at the Minneapolis International Airport, Minneapolis, Minnesota, at 0850 ADT.

During a telephone conversation with the National Transportation Safety Board (NTSB) investigator-in-charge (IIC), on June 1, 2004, an air safety investigator with Northwest Airlines reported that after the airplane parked at the gate, the flight attendant was positioned at door 2L. The customer service agent (CSA) positioned outside the airplane on the jetway knocked on the door. This is the signal to the flight attendant that the door will be opened, if the flight attendant provides a visible "thumbs-up" signal to the agent on the jetway. The flight attendant reported that in response to the knock, she gave a thumbs-up, and stepped away from the door. The door did not open, but she heard a second knock. The flight attendant gave a second thumbs-up through the cabin door window. As she was giving the signal, the door handle came down on her wrist.

The jetway gate agent reported that after his first knock, he did not receive a thumbs-up, and knocked a second time. The flight attendant inside the airplane then gave a thumbs-up signal. The agent then opened the airplane door from the outside. During the door opening procedure, the inside handle of the door struck the flight attendant on the forearm. The flight attendant was taken to a local hospital in Anchorage, where she was initally diagnosed with a fractured wrist. Her wrist was placed in a temporary splint.

On June 23, the Northwest Airlines investigator informed the NTSB IIC that the injured flight attendant had a follow-up examination with her own physician in Minnesota. The physician took additional x-rays of the injured wrist and determined that it was not broken, but had sustained a sprain. The flight attendant continued to have pain, and had a magnetic resonance image (MRI) of her wrist on July 2, 2004, which was normal. The flight attendant did not return to work until July 11, 2004.

Northwest Airlines personnel provided a copy of their cabin operating standards, which states, in part: "To prepare cabin door for opening; 1. CSA knocks on door and awaits "thumbs-up" signal from FA (flight attendant). 2. FA gives thumbs-up signal to CSA to indicate that door is disarmed and safe to open. 3. CSA opens cabin door after FA moves hands clear of door." Additional information provided by Northwest Airlines indicated that the door opening procedure precludes a second thumbs-up signal unless the CSA knocks a second time.

Aircraft

Registration
N550NW
Reported as
Boeing 757-251
Category
Airplane
Serial number
26497
Engine
Pratt & Whitney PW2040, 37,500 lbs thrust, turbo fan
Damage
No damage
Flight
Part 121
Registered owner
Northwest Airlines Inc.
Airworthiness certificate
Standard, Transport
Departed
MSP · Minneapolis, MN
Destination
PANC · Anchorage, AK
Flight plan
IFR
Airport
PANC · Anchorage International

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew · 2

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
55
Injuries
None
Certificates
Commercial, Flight instructor, Airline transport, Flight engineer
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Role
Co-pilot
Age
57
Injuries
None
Certificates
Commercial, Airline transport
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--w/ waivers/lim

Weather

Conditions
Visual (VMC) · Day
Wind
140° at 13 knots, gusting 21
Visibility
10 statute miles
Lowest ceiling
7,500 ft overcast
Temperature
54 °F, dew point 43 °F
Altimeter
29.81 inHg
Observed at
PANC

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.

Other investigations on N550NW · 1

Matched to the same aircraft by N-number and date.