# NTSB IAD97FA052: McDonnell Douglas DC-9-82, N275AA, Cleveland, OH, March 6, 1997 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Field investigation · Final report - Date: March 5, 1997, 21:07 local (Mar 6, 1997, 01:07 UTC) - Place: Cleveland, OH - Coordinates: 41.430133, -81.82048 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=41.4301&lon=-81.8205&mi=10 - Phase of flight: [Landing](https://openairdocs.org/ntsb-phases/550) (OpenAirDocs' grouping) - Highest injury: Minor injuries - Injuries: 3 minor, 106 uninjured - Status: Completed, report February 28, 2000 - Report: Approved by Office Director - NTSB case key (mKey): 28129 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=IAD97FA052 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/28129/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=28129 - Page: https://openairdocs.org/ntsb/IAD97FA052 ## Probable cause The pilot in command did not maintain control while utilizing the full auto-land system. Factors to this accident were a contaminated runway, a crosswind, and inadequate guidance provided in the aircraft manual. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of control - on ground/water, landing - roll - terrain condition - slush covered (contributing factor) - terrain condition - snow covered (contributing factor) - weather condition - crosswind (contributing factor) - autopilot - continued, pilot in command (cause) - directional control - not maintained, pilot in command (cause) - aircraft manuals - inadequate (contributing factor) ## Analysis The DC-9 was number 2 for the ILS approach behind a commuter airplane, and was placed in holding while chemicals were applied to the runway due to snow and slush. The DC-9 captain requested a braking action report, which the tower controller relayed to the commuter airplane that had not yet landed. A braking action report was not received prior to the DC-9 landing. The captain elected to continue the approach with full auto-land selected to a contaminated runway, without a braking action report and a crosswind component of 13 knots. On the runway, the auto-pilot responded and attempted to return the airplane to the centerline of the runway. After 18 seconds and with the airplane's nose drifting left, the captain disengaged the auto-pilot, and applied full right rudder and brake to stop the left drift. The DC-9 departed the left side of the paved runway approximately 5,500 feet down the 8,998 foot runway, and facing 80 degrees left of the runway heading. A review of the manual revealed that the operator's flight manual contain no guidance or limitations for pilots regarding the use of full auto land and roll-out on contaminated runways ## Factual narrative HISTORY OF FLIGHT On March 5, 1997, about 2107 eastern standard time, a McDonnell Douglas DC-9-82, N275AA, operated as American Airlines flight 320, was substantially damaged as it slid off the left side of runway 5R during landing rollout at Cleveland Hopkins International Airport (CLE), Cleveland, Ohio. The certificated airline transport pilot, first officer, and four flight attendants were uninjured. Three of the 103 passengers reported minor injuries. The scheduled domestic passenger flight, was conducted under 14 CFR Part 121. Night instrument meteorological conditions existed and a instrument flight rules flight plan was filed for the flight which originated from the Dallas/Fort Worth International Airport, Dallas/Fort Worth, Texas, at 1824. A review of the Federal Aviation Administration radar data and the Cockpit Voice Recorder (CVR) revealed that flight 320 was vectored to and cleared for the ILS 5R approach, at 2100. Less than 2 minutes later, flight 320 was instructed to switch to the tower frequency and told that "there's commuter traffic four miles ahead. He's going to give a braking action report." The local controller cleared flight 320 to land and stated "wind three five zero at one six", at 2102:33. The pilot responded with a request for a braking action report, and the controller was heard answering, "I don't know sir. It (the runway) just opened up. We had chemicals applied to the runway. You'll be number two to the runway. As soon as I get something, I'll let you know." On the CVR, the controller was heard requesting a braking action report from the commuter, at 2103:53. After the commuter landed, the tower controller again requested a braking action report, but was unsuccessful. At 2105:29, the commuter switched to the ground frequency and attempted to give a braking action report, but was unable due to frequency congestion. The Flight Data Recorder (FDR) from flight 320 captured the touch down, at 2106:46. The airplane traveled 5,500 feet down the 8,998 foot runway, exiting the left side after taxiway "Romeo". The airplane stopped facing about 80 degrees left of the runway heading. The accident occurred during the hours of darkness at about 041 degrees 24.5 minutes North latitude, and 81 degrees 51 minutes West longitude. FLIGHT CREW INFORMATION CAPTAIN The Captain held an Airline Transport Pilot Certificate for airplane single and multiengine land, and was type rated in the DC-9 in November, 1995, with additional type ratings for the Embraer 120 and the Boeing 727. He had accumulated nearly 900 hours of Pilot-in-Command time in the DC-9, with over 2,525 hours Second-in-Command time. He possessed both Flight Instructor and Flight Engineer (Turbojet) Certificates. His most recent Federal Aviation Administration (FAA) First Class Medical Certificate was issued on January 22, 1997, with no limitations or waivers. The Captain was hired in October 1984, and flew as a Flight Engineer on the Boeing 727. This was the second day of the Captain's trip, and the second leg for the day. His reported total flying experience was 14,500 hours. FIRST OFFICER The First Officer held an Airline Transport Pilot Certificate for airplane single and multiengine land, and was type rated in the L300. He had accumulated 2,700 hours Second-in-Command time in the DC-9. He possessed a Flight Engineer (Turbojet) Certificate for Boeing 727. His most recent FAA First Class Medical Certificate was issued on October 21, 1996, with no limitations or waivers. The First Officer was hired in January, 1990, and flew as a Flight Engineer on the Boeing 727. This too, was his second day of his trip, and the second leg for the day. His reported total flying experience was 5,200 hours. APPROACH The CVR/DFDR and the captain's statement indicated that he flew a coupled approach with auto-land and rollout programmed. The Manufacturer's Flight crew Operating Manual (FCOM) and the Aircrew Operations Manual (AOM) both state that the use of auto-land had a crosswind component limitation of 15 knots, that may be reduced by the prevailing visibility. AIRCRAFT INFORMATION The airplane was equipped with two Pratt & Whitney JT8D engines. Each engine had 20,000 pounds of thrust, with reverse available. The left engine had accumulated 1,044 hours since last inspection, and the right had accumulated 7,839 hours. A review of the airplane's maintenance records did not reveal any repetitive discrepancies related to the engines, brakes or flight controls. METEOROLOGICAL INFORMATION Weather at Cleveland, Detroit (Alternate #1), and Indianapolis (Alternate #2)was: KCLE (Cleveland Hopkins International Airport) at 060154Z: Winds 350013KT; Visibility 1/2 SM; Snow Fog; Ceiling 100 FEET OVERCAST; TEMPERATURE 33 DEGREES FAHRENHEIT; DEWPOINT 32 DEGREES FAHRENHEIT; ALTIMETER 29.77 Inches HG. SPECI KDTW (Detroit Metro Airport) at 060134Z: Winds 31006KT; Visibility 1 3/4 SM; LIGHT SNOW; MIST; Ceiling 600 OVERCAST; TEMPERATURE 32 DEGREES FAHRENHEIT; DEWPOINT 30 DEGREES FAHRENHEIT; ALTIMETER 29.85 Inches HG. SPECI KIND (Indianapolis International Airport) at 060112Z: Winds 31015KT; Visibility 6SM; MIST; Ceiling 1,600 OVERCAST; TEMPERATURE 32 DEGREES FAHRENHEIT; DEWPOINT 30 DEGREES FAHRENHEIT; ALTIMETER 30.04 Inches HG. American Airlines Dispatch sent a message to flight 320 at 2058. It stated, "Cleveland implemented an internal ground stop for aircraft landing Cleveland until 2115. The airport management has closed runway 5L for treatment. Runway 5R will close after that, also for treatment. Users can expect up to 30 minutes of airborne holding." AERODROME INFORMATION The CLE elevation was 792 feet msl, and was located about 9 miles southwest of Cleveland. It was owned and operated by the City of Cleveland, and was certificated in accordance with the applicable provisions of Title 14 CFR Part 139. It had a Federal Aviation Administration (FAA) approved snow and ice control plan in accordance with 14 CFR Part 139.313. CLE was the winner of the Balchen/Post award for snow and ice control in the large commercial airport category for the winter of 1995-1996. Runway Conditions CLE runway 5R was concrete, 8,999 feet long, 150 feet wide, and transverse grooved full length. Runway 5R was configured and approved for category II instrument landings, and was equipped with high intensity runway edge lights, and centerline lights. It was equipped with pavement surface condition sensors, which detected and reported pavement surface conditions, and were used to plan and initiate snow removal operations. Prior to and following the accident, all sensors recorded surface conditions as wet, with surface temperatures varying between 32 and 34 degrees Fahrenheit. The CLE operations department logbooks and written statements taken from airport operations and maintenance personnel, reported that the runway was covered with less than 1/8 inch of slush, at 2033, and snow plows were not considered because the amount of snow was insufficient to plow. Radar data showed that Flight 320 was put in holding at the outer marker at 2041. The CLE operations department logbooks showed entries for CLE maintenance personnel applying sodium formate to runway 5R/23L, at 2046, and finished, at 2055. CLE operations personnel issued a Notice to Airmen (NOTAM), at 2059, which stated: "Runway 5R/23L has a thin cover of wet snow. Chemical applied 30 feet either side of centerline. (Tapley braking action for runway) 5R: 35-30-24." Sodium Formate was applied to combat the snow and ice which began to accumulate on the runway. The application procedure utilized for applying the chemical was two trucks, one on each side of the runway centerline and about 10 feet from the center. Each truck traveled about 20 to 30 mph, applying potassium acetate through a pre-wetting system to the sodium formate. It was dispensed at a ## Aircraft - Registration: [N275AA](https://openairdocs.org/deregistered/N275AA-2008-11-06), registration cancelled 2008-11-06, S/N 49272, built 1984 (OpenAirDocs) - Reported make and model: McDonnell Douglas DC-9-82 - Registry model: [Mcdonnell Douglas DC-9-82(MD-82)](https://openairdocs.org/model/mcdonnell-douglas-dc-9-82-md-82) (registry code 3022082) (OpenAirDocs) - Registry engine: [Pratt & Whitney JT8D series](https://openairdocs.org/engine/pratt-whitney-jt8d-series) (registry code 52053, turbo-jet) (OpenAirDocs) - Category: Airplane - Serial number: 49272 - Airframe hours: 37922 - Engines: P&W JT8D 20000 lbs thrust turbo fan - Damage: Substantial damage - Flight: Part 121 - Operator: American Airlines, Inc. - Registered owner: Marmid Aircraft Leasing Corp - Airworthiness certificate: Standard, Transport - Departed: DFW, DAL/FORT WORTH, TX - Destination: CLE - Flight plan: IFR - Airport: CLE, Cleveland Hopkins Intl, runway 5R, 8,998 × 150 ft, concrete ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 42; flight engineer, airline transport, flight instructor; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--no waivers/lim.; seat: left; flight hours: 14,500 total, 4,500 in this make and model, 13,000 as pilot in command ## Weather - Conditions: Instrument (IMC), Night/dark - Wind: 350° at 13 knots - Visibility: 0.5 statute miles - Lowest ceiling: 100 ft overcast - Temperature: 34 °F - Altimeter: 29.00 inHg - Observed at: CLE ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 19970305013089A](https://openairdocs.org/incident/19970305013089A), Mar 5, 1997: Doug DC982, Cleveland, OH. Slid off runway landing. Right main gear collapsed. Punctured fuel tank. Failed check traction. Wind, icy surface. (-23) no narrative ## Docket (13 files) The files NTSB released with the investigation on March 2, 1999, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=28129. 7.9 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 448 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437022&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF - Digital Flight Data Recorder Factual Report (item 2, .PDF, 754 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437026&FileExtension=.PDF&FileName=Digital%20Flight%20Data%20Recorder%20Factual%20Report-Redacted.PDF - Operations Group and Aircrew/Check Airmen Interviews (item 3, .PDF, 1.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40100647&FileExtension=.PDF&FileName=Operations%20Group%20and%20Aircrew%2FCheck%20Airmen%20Interviews-Master.PDF - CVR Specialist's Report (item 4, .PDF, 928 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437023&FileExtension=.PDF&FileName=CVR%20Specialist%27s%20Report-Redacted.PDF - Airport Specialist's Factual Report (item 5, .PDF, 1.8 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437024&FileExtension=.PDF&FileName=Airport%20Specialist%27s%20Factual%20Report-Redacted.PDF - Recorded Radar Study (item 6, .PDF, 1.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437027&FileExtension=.PDF&FileName=Recorded%20Radar%20Study-Redacted.PDF - Witness Reports (item 7, .PDF, 164 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437029&FileExtension=.PDF&FileName=Witness%20Reports-Redacted.PDF - Supplement C (item 8, .PDF, 403 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40100652&FileExtension=.PDF&FileName=Supplement%20C-Master.PDF - Supplement D (item 9, .PDF, 488 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40100653&FileExtension=.PDF&FileName=Supplement%20D-Master.PDF - Supplement E (item 10, .PDF, 115 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437025&FileExtension=.PDF&FileName=Supplement%20E-Redacted.PDF - Supplement S (item 11, .PDF, 72 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40100655&FileExtension=.PDF&FileName=Supplement%20S-Master.PDF - Statement of Party Representatives to NTSB Investigation (item 12, .PDF, 80 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437028&FileExtension=.PDF&FileName=Statement%20of%20Party%20Representatives%20to%20NTSB%20Investigation-Redacted.PDF - Release of Aircraft Wreckage, NTSB Form 6120.15 (item 13, .PDF, 83 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40437030&FileExtension=.PDF&FileName=Release%20of%20Aircraft%20Wreckage,%20NTSB%20Form%206120.15-Redacted.PDF From the NTSB's public API. 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