Statuts: | Accident investigation report completed and information captured |
Date: | samedi 6 juin 1992 |
Heure: | 21:00 |
Type/Sous-type: | Boeing 737-204 Advanced |
Compagnie: | COPA Panama - Compañía Panameña de Aviación |
Immatriculation: | HP-1205CMP |
Numéro de série: | 22059/631 |
Année de Fabrication: | 1980-01-15 (12 years 5 months) |
Heures de vol: | 45946 |
Cycles: | 17845 |
Moteurs: | 2 Pratt & Whitney JT8D-15 |
Equipage: | victimes: 7 / à bord: 7 |
Passagers: | victimes: 40 / à bord: 40 |
Total: | victimes: 47 / à bord: 47 |
Dégats de l'appareil: | Détruit |
Conséquences: | Written off (damaged beyond repair) |
Lieu de l'accident: | 13 km (8.1 milles) SW of Tucutí ( Panama)
|
Phase de vol: | En vol (ENR) |
Nature: | Transport de Passagers Intern. |
Aéroport de départ: | Panama City-Tocumen International Airport (PTY/MPTO), Panama |
Aéroport de destination: | Cali-Alfonso Bonilla Aragón Airport (CLO/SKCL), Colombie |
Numéro de vol: | 201 |
Détails:A Boeing 737-204 aircraft, operated by COPA Panama, was destroyed when it crashed near Tucutí, Panama. All 40 passengers and seven crew members were killed.
COPA Flight 201 took off from runway 21L at Panama City-Tocumen International Airport at 20:36. Destination of the flight was Cali, Colombia. The flight intercepted Airway A321 and climbed to the cruising altitude of FL250. At 20:46 the flight contacted the Panama City controller and requested weather information.
The controller reported that there was an area of very bad weather at 30-50 miles. Last radio contact was at 20:48 when the crew reported reaching FL250.
During the flight there was an intermittent failure of the main attitude indicator due to a short circuit. This was not noticed by the flight crew, who attempted to adjust the aircraft attitude based on the false information from the attitude indicator.
They lost control of the aircraft which entered a steep descent and started to disintegrate at FL100, and impacting the ground 80 degrees nose down.
Probable Cause:
The probable causes of this accident include:
a) loss of control of the aircraft because the flight crew followed false information from an attitude indicator that operated intermittently.
b) lack of visible horizon during cruise flight due to night and approaching bad weather.
c) insufficient cross-checking between the primary and emergency (stand-by) attitude indicators to identify intermittent attitude errors and to select a reliable source of (correct) attitude information.
d) non-standard cabin configurations between aircraft in the fleet of the company, which required the crew to determine how to set the switches based on the aircraft was being operated at the time.
e) incomplete ground crew training simulator, as it did not present "differences between aircraft" and "crew resource management" in sufficient detail to give the crew knowledge to overcome intermittent attitude indicator errors and to maintain control of the aircraft.
Sources:
» Final Report released by the Directorate of Civil Aviation, Panama
Photos
accident date:
06-06-1992type: Boeing 737-204
registration: G-BGYL
Plan
Ce plan montre l'aéroport de départ ainsi que la supposée destination du vol. La ligne fixe reliant les deux aéroports n'est pas le plan de vol exact.
La distance entre Panama City-Tocumen International Airport et Cali-Alfonso Bonilla Aragón Airport est de 695 km (434 miles).
Accident location: Exact; as reported in the official accident report.
Les informations ci-dessus ne représentent pas l'opinion de la 'Flight Safety Foundation' ou de 'Aviation Safety Network' sur les causes de l'accident. Ces informations prélimimaires sont basées sur les faits tel qu'ils sont connus à ce jour.