LAX98IA061

NTSB incident investigation · McDonnell Douglas MD-80 · San Francisco, CA · December 20, 1997

Incident · No injuriesIncident investigationFinal report
Date
December 19, 1997, 18:15 local (Dec 20, 1997, 02:15 UTC)
Place
San Francisco, CA
Injuries
75 uninjured
Damage
No damage
Phase of flight
Taxi
Aircraft
N932ASMcDonnell Douglas MD-80
Weather
Visual (VMC) · Night/dark
Status
Completed · report May 4, 1998
Report
Approved by Office Director
FAA report
19971219041499I
Case key
29963

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

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Probable cause

An emergency evacuation due to fumes from a failed hydraulic line that entered into the cabin.

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.

Airframe/component/system failure/malfunctionTaxi - from landing
Hydraulic system,line - failureCause
Hydraulic system,line - fumesFactor
Miscellaneous/otherStanding - engine(s) not operating
Evacuation - performedPilot in command

Analysis

The captain ordered an emergency evacuation after noxious fumes and mist entered the aircraft during the taxi to the gate after landing. Examination of the aircraft found the source of the vapors as a failed hydraulic return line from the left-hand engine thrust reverser. Leaking fluid from the line was ingested into the aircraft's APU which had been started in accordance with normal procedures.

Factual narrative

On December 19, 1997, at 1815 hours Pacific standard time, the crew of an Alaska Airlines MD-80, N932AS, operating as Flight 536 from Palm Springs, California, to San Francisco, California, under 14 CFR Part 121, ordered an emergency evacuation after experiencing noxious fumes entering the aircraft. Visual meteorological conditions existed at the time. There was no damage to the aircraft and no injuries to the 5 crewmembers or to the 69 passengers.

According to the operator, the aircraft was taxiing to the gate after landing when fumes and mist began to enter the cabin through the air conditioning ducts. Although first noted as thin, the vapors quickly filled the cabin, reducing visibility, and causing respiratory distress along with burning eyes to crew and passengers. The crew elected to stop the aircraft on the taxiway near the intersection of "A" and "H" taxiways. The captain ordered an immediate evacuation over the aircraft's public address system. The crew estimated the evacuation was accomplished within 90 seconds.

After the evacuation, the flight attendants commented on having to divest passengers of carry-on baggage during the evacuation. A concern was that the baggage taken from the passengers could block the path to the exit(s). All flight attendants commented on how useful they found their flashlights to be. All retrieved their flashlights before proceeding to the exits and found them to be invaluable during the evacuation, as well as on the ground.

Subsequent investigation revealed the source of the vapors as a failed hydraulic return line from the left-hand engine thrust reverser. Leaking fluid from the line was ingested into the aircraft's APU that had been started by the flight crew after landing in accordance with normal procedures.

Aircraft

Registration
N932AS
Reported as
McDonnell Douglas MD-80
Category
Airplane
Engine
unknown
Damage
No damage
Flight
Part 121
Registered owner
Alaska Airlines
Airworthiness certificate
Standard, Transport
Departed
PSP · Palm Springs, CA
Destination
SFO
Flight plan
IFR
Airport
SFO · San Francisco

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
44
Certificate
Airline transport
Airplane ratings
Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Seat
Left
Flight hours
7,000 total

Weather

Conditions
Visual (VMC) · Night/dark
Wind
200° at 5 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
52 °F
Altimeter
30.00 inHg
Observed at
SFO

FAA reports on this event · 1

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