ASN Aircraft accident Boeing 747-412 9V-SMT Auckland International Airport (AKL)

Home » Database » 2003

Status:	Final
Date:	Wednesday 12 March 2003
Time:	15:28
Type:	Boeing 747-412
Operator:	Singapore Airlines
Registration:	9V-SMT
MSN:	27137/990
First flight:	1993-08-04 (9 years 7 months)
Total airframe hrs:	43627
Cycles:	6712
Engines:	4 Pratt & Whitney PW4056
Crew:	Fatalities: 0 / Occupants: 20
Passengers:	Fatalities: 0 / Occupants: 369
Total:	Fatalities: 0 / Occupants: 389
Aircraft damage:	Substantial
Aircraft fate:	Repaired
Location:	Auckland International Airport (AKL) ( New Zealand)
Phase:	Takeoff (TOF)
Nature:	International Scheduled Passenger
Departure airport:	Auckland International Airport (AKL/NZAA), New Zealand
Destination airport:	Singapore-Changi International Airport (SIN/WSSS), Singapore
Flightnumber:	286

Narrative:
Singapore Airlines flight SQ286 taxied to runway 23L at Auckland's International Airport and was cleared for takeoff. When the captain rotated the airplane for lift-off the tail struck the runway and scraped for some 490 metres until the airplane became airborne. The tail strike occurred because the rotation speed was 33 knots less than the 163 knots required for the airplane weight. The rotation speed had been mistakenly calculated for an airplane weighing 100 tonnes less than the actual weight of 9V-SMT. A takeoff weight transcription error, which remained undetected, led to the miscalculation of the takeoff data, which in turn resulted in a low thrust setting and excessively slow takeoff reference speeds. The system defences did not ensure the errors were detected, and the airplane flight management system itself did not provide a final defence against mismatched information being programmed into it.
During the takeoff the airplane moved close to the runway edge and the pilots did not respond correctly to a stall warning.

Probable Cause:

The final report did not contain a "Probable cause".

Accident investigation:

Investigating agency:	TAIC New Zealand
Status:	Investigation completed
Duration:	252 days (8 months)
Accident number:	03-003
Download report:	Final report

Classification:

Tailstrike
Forced landing on runway

Follow-up / safety actions

NTSB issued 5 Safety Recommendations
TAIC issued 5 Safety Recommendations

Issued: 24-OCT-2003	To: Boeing	047/03
Implement a FMS software change on all various Boeing aircraft models that ensures any entries (such as V speeds and gross weight) that are mismatched by a small percentage are either challenged or prevented. (Closed acceptable)
Issued: 31-OCT-2003	To: Singapore Airlines	048/03
Establish procedures that ensure comprehensive, independent verification of all essential take-off data, such as the TOW, reference speeds and thrust setting, is accomplished at key points before engines are started. (Closed acceptable)
Issued: 31-OCT-2003	To: Singapore Airlines	049/03
Reaffirm to all company pilots that, when faced with delays, safety should not be compromised in an attempt to minimise any time loss. (Closed acceptable)
Issued: 31-OCT-2003	To: Singapore Airlines	050/03
Develop guidelines for the use of the third pilot, for the times one is carried. (Closed acceptable)
Issued: 31-OCT-2003	To: Singapore Airlines	051/03
Use this accident scenario as a topic for pilot recurrency training or LOFT in simulators to enhance pilot awareness and CRM skills. The training should introduce similar errors for pilots to discover. The training should also ensure pilots treat all warnings, such as a stick shaker, as real warnings and make sure they respond appropriately until the threat has passed. (Closed acceptable)
Issued: 08-MAR-2005	To: FAA	A-05-3
Require Honeywell to modify its flight management system (FMS) software to annunciate warnings to the flight crew when a takeoff reference speed is changed by a value that would impede the airplane\'s ability to safely take off, and require all operators of airplanes with Honeywell FMS computers to incorporate this software modification. (Closed - Unacceptable Action)
Issued: 08-MAR-2005	To: FAA	A-05-4
Require Honeywell to modify its flight management system (FMS) software to prevent entry of airplane weights that would result in landing weights below zero fuel weight or operating empty weight, and require all operators of airplanes with Honeywell FMS computers to incorporate this software modification. (Closed - Unacceptable Action)
Issued: 08-MAR-2005	To: FAA	A-05-5
Require Honeywell to modify its flight management system (FMS) software either to inhibit manual entries in the gross weight field or to allow the takeoff gross weight to be uplinked directly into the FMS, and require operators of airplanes with Honeywell FMSs to incorporate this software modification. (Closed - Acceptable Action)
Issued: 08-MAR-2005	To: FAA	A-05-6
Require Honeywell to conduct a study of its flight management system computers to identify any additional improvements that may be necessary for error checking and confirming that the entered takeoff and landing performance information is correct and reasonable. (Closed - Acceptable Action)
Issued: 08-MAR-2005	To: FAA	A-05-7
Require companies other than Honeywell that manufacture flight management systems (FMS) that are installed on 14 Code of Federal Regulations Part 25 airplanes to study their FMS computers to identify any improvements that may be necessary for error checking and confirming that the entered takeoff and landing performance information is correct and reasonable. (Closed - Acceptable Action)

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Photos

accident date: 12-03-2003
type: Boeing 747-412
registration: 9V-SMT

Map

This map shows the airport of departure and the intended destination of the flight. The line between the airports does not display the exact flight path.
Distance from Auckland International Airport to Singapore-Changi International Airport as the crow flies is 8385 km (5241 miles).

This information is not presented as the Flight Safety Foundation or the Aviation Safety Network’s opinion as to the cause of the accident. It is preliminary and is based on the facts as they are known at this time.

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