FLIGHT 5481

Investigative Reporters and Editors, Inc. The IRE Journal, Jul/Aug 2004 by Alexander, Ames

When disaster strikes, it can be difficult to see beyond the immediate carnage. But after the dead are laid to rest, the fires put out and the wreckage cleaned up, there remains the question on everyone's mind: Why? The investigation following a tragedy means reporters and editors must re-focus their energies on the greater picture - using everything at their disposal - from dusty records to the latest technology to survivor and witness stories.

FATAL CRASH REVEALS COMMUTER AIRPLANE MAINTENANCE FLAWS

Moments after takeoff, the pilots of US Airways Express Flight 5481 knew they were in trouble.

Their overloaded commuter plane took off from Charlotte Douglas International Airport at a dangerously sharp angle on the morning of Jan. 8, 2003, and they could do nothing to bring the nose down. The plane stalled, and slammed into the tarmac, killing all 21 aboard.

Investigators with the National Transportation Safety Board soon began to focus on a one-plane maintenance hangar in West Virginia, where mechanics had worked on the plane just two days earlier. There, a mechanic had been asked to tackle a job he'd never done before: adjusting critical flight cables that help control the plane's pitch. With his trainer's approval, the mechanic skipped steps in the maintenance manual, and made mistakes - mistakes that made it hard for pilots to control the plane, the NTSB found.

The revelations about Flight 5481 left a team of Charlotte Observer reporters with a fundamental question: Is there much risk it could happen to other planes?

To answer that question, I teamed up with aviation reporter Ted Rccd and database editor Ted Mellnik for an investigation that ultimately revealed a pattern of shortcomings in the way commercial planes are maintained and inspected.

A pattern of neglect

Airlines are spending less to maintain their planes, we found, and mechanics are checking them less often. Federal oversight, meanwhile, hasn't kept up with the trend to outsource more repair work.

Outsourced maintenance has increased dramatically as airlines struggle to cut costs; contractors now do about half of all maintenance on the nation's commercial planes. But our research showed that contract repair stations receive far less regulatory scrutiny than the airlines' own maintenance shops.

Since 1994, we discovered, maintenance problems have contributed to 42 percent of fatal U.S. airline accidents - up from 16 percent the previous decade. Faulty maintenance contributed to three of the past live fatal U.S. airline crashes, and likely played a role in a fourth accident, still under investigation.

Maintenance problems cause many less-publicized mishaps as well.

Charles Banks, a retired Texas businessman, was in the rear bathroom of a Continental Airlines DC-10, headed for a Hawaiian vacation May 21, 1998, when he was knocked to the floor, then thrown to the ceiling and back to the floor. he suffered two cracked vertebrae in the incident, which also seriously injured three flight attendants.

At first, authorities blamed the episode on turbulence. But NTSB investigators later found the real culprit: a defect in the autopilot system. The year before the accident, the plane's autopilot malfunctioned more than 50 times, according to maintenance records.

Airlines have invested millions to lix other serious problems, such as pilot error. But faulty maintenance, an equally preventable problem, has never received the attention it deserves, experts say.

The newspaper's findings have begun to resonate in Washington. Partly in response to the Observer's stories, members of Congress have called for federal studies to examine the use of unlicensed repair stations, and to determine whether the Federal Aviation Administration is doing enough to ensure the safety of the fast-growing regional airline industry.

Mechanics, safety experts and members of Congress have praised the series. Often, our stories explained, when mechanics find signs of improper maintenance on planes, they fix the problems but don't report them for fear of reprimand. Now, unions are developing systems to allow more anonymous reporting.

Putting it together

As we began our eight-month project, we learned there was no road map for tracking down the information we needed. No daily newspaper had previously sought to define, on such a large scale, the recent pattern of maintenance shortcomings throughout the airline industry. Documenting the pattern required months of data analysis, records research and interviews.

This was one of the most data-intensive projects the Observer has undertaken. We examined seven federal databases. Reporters worked for months to obtain some of the databases from the FAA, and then consulted many experts around the country to make sense of the data. Among other things, this data showed us that FAA inspectors visit airline maintenance shops about three times more often than the contract repair stations that do comparable amounts of work. But when FAA inspectors visit contract repair stations, we discovered, they are more likely to find problems.