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Lion Air Flight 610

Coordinates: 5°46′15″S 107°07′16″E / 5.77083°S 107.12111°E / -5.77083; 107.12111
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See also: Boeing 737 MAX groundings

Lion Air Flight 610
PK-LQP, the aircraft involved in the accident
Accident
Date29 October 2018 (2018-10-29)
SummaryLoss of control in flight
SiteJava Sea, off the north coast of Karawang Regency, Indonesia
5°46′15″S 107°07′16″E / 5.77083°S 107.12111°E / -5.77083; 107.12111
Aircraft
Aircraft typeBoeing 737 MAX 8
OperatorLion Air
IATA flight No.JT610
ICAO flight No.LNI610
Call signLION INTER 610
RegistrationPK-LQP
Flight originSoekarno–Hatta International Airport, Tangerang, Indonesia
DestinationDepati Amir Airport, Pangkal Pinang, Indonesia
Occupants189
Passengers181
Crew8
Fatalities189
Survivors0
This article is part of a series about the Boeing 737 MAX
Accidents

Lion Air Flight 610 (JT610/LNI610)[a] was a scheduled domestic passenger flight from Soekarno–Hatta International Airport, Tangerang, to Depati Amir Airport, Pangkal Pinang, in Indonesia. On 29 October 2018, the Boeing 737 MAX operating the route, carrying 181 passengers and 8 crew members, crashed into the Java Sea 13 minutes after takeoff killing all 189 occupants on board. It was the first major accident and hull loss of a 737 MAX, a then recently-introduced aircraft. It is the deadliest accident involving the Boeing 737 family. One diver also died during recovery operations.

The subsequent investigation, led by the National Transportation Safety Committee (NTSC), revealed that a new software function in the flight control system caused the aircraft to nose down. That function, the Maneuvering Characteristics Augmentation System (MCAS), had been intentionally omitted by Boeing from aircraft documentation for aircrews, so the Lion Air pilots did not know about it nor know what it could do. Investigators concluded that an external device on the aircraft, the angle-of-attack (AoA) sensor, was miscalibrated due to improper maintenance which sent erroneous data to MCAS. In turn, MCAS responded by pushing the nose down. The problem had occurred on the same aircraft during its immediately preceding flight, and the pilots had recovered using a standard checklist for such a "runaway stabilizer" condition.

During the accident flight, the AoA sensor again fed erroneous data to the MCAS, which pushed the nose of the aircraft down. The pilots did not properly follow the checklist, with the result that MCAS remained active and repeatedly put the aircraft into an unsafe nose-down position until it crashed into the water.

After the accident, the United States Federal Aviation Administration and Boeing issued warnings and training advisories to all operators of the Boeing 737 MAX series, reminding pilots to follow the runaway stabilizer checklist to avoid letting the MCAS cause similar problems. The company also said that a software update would be made available to update the behavior of MCAS. These training advisories were not fully followed, however, and similar issues caused the crash of Ethiopian Airlines Flight 302 on 10 March 2019, prompting a worldwide grounding of all 737 MAX aircraft.

The final report by the National Transportation Safety Committee (NTSC) of Indonesia criticized Boeing's design and the FAA's certification process for MCAS and said the issues were compounded by maintenance issues and lapses by Lion Air’s repair crews and its pilots, as well as Xtra Aerospace, a US-based company that supplied Lion Air with the AoA sensor.

Aircraft and crew

[edit]

The aircraft involved was a Boeing 737 MAX 8, registration PK-LQP, line number 7058, and powered by two CFM International LEAP engines.[1] and was delivered new to Lion Air on 13 August 2018.[2][3] At the time of the accident, the aircraft had flown about 800 hours in service.[4] This was the first accident involving a 737 MAX since the type's entry into service on 22 May 2017,[5] and the deadliest accident involving a Boeing 737.[6]

The accident aircraft had recently received a replacement angle-of-attack (AoA) sensor. The used replacement sensor was supplied by a US-based company, Xtra Aerospace. Subsequent investigations found that the sensor was likely miscalibrated when sent out by Xtra Aerospace, and that Lion Air’s maintenance crews did not test the sensor before returning the aircraft to service.[7][8][9]

The flight's cockpit crew included Captain Bhavye Suneja (31), an Indian national,[10] who had flown with the airline for more than seven years and had about 6,028 hours of flight experience (including 5,176 hours on the Boeing 737) and received his training in California;[11][12][13] and First Officer Harvino (41),[14][b] an Indonesian who had 5,174 hours of flight experience, 4,286 of them on the Boeing 737. The six flight attendants were also Indonesians.[15]

Flight details and accident

[edit]
Map showing flight path of Lion Air Flight 610

The aircraft took off from Jakarta on 29 October 2018 at 6:20 am local time (28 October 2018, 11:20 pm UTC) and was scheduled to arrive at Depati Amir Airport in Pangkal Pinang at 7:20 am.[16] It took off in a westward direction before circling around to a northeast heading, which it held until crashing offshore northeast of Jakarta in waters estimated to be as much as 35 m (115 ft) deep.[17][18] The flight crew had requested clearance to return to the Jakarta airport 19 nmi (35 km; 22 mi) into the flight.[19][20] The accident site was located 34 km (18 nmi; 21 mi) off the coast of the island of Java.[21]

Communication between air traffic control (ATC) and Flight 610 was suddenly lost at 6:33 am.[22] ATC informed the National Search and Rescue Agency, which deployed three ships and a helicopter to the area.[23] At 7:30 am, the agency received reports that Flight 610 had crashed a few kilometres (miles) from an offshore oil platform.[24] Workers on the platform reportedly saw the aircraft crash with a steep nose-down angle.[25] Boats from the platform were immediately deployed and debris from the crashed aircraft was found shortly after.[26]

Victims

[edit]

On board the aircraft were 189 people: 181 passengers (178 adults, one child, and two infants), as well as six cabin crew and two pilots.[27] All 189 passengers and crew on board were killed.[28][29]

Among the passengers were 38 civil servants. They consisted of 20 Ministry of Finance employees,[18] 10 Audit Board of Indonesia employees,[30] two auditors from the Finance and Development Inspection Agency [id],[31] three Ministry of Energy and Mineral Resources employees,[32] and three Indonesian National Police officers.[33] There were also three public prosecutors,[34] six members of Bangka Belitung Regional People's Representative Council members,[35] and three judges of Indonesia's High Court and National Court.[36]

Two confirmed foreigners were among those on board: The pilot was an Indian citizen[10] and one passenger was an Italian citizen, former professional cyclist Andrea Manfredi.[37][38]

Response

[edit]

On 29 October, Indonesia's Transportation Ministry ordered all of the country's airlines to conduct emergency inspections on their 737 MAX 8 aircraft. The ministry also launched a special audit on Lion Air to see if any problems existed with its management system.[39] The Transportation Ministry announced that all Indonesian Boeing 737 MAX 8 aircraft were airworthy and were allowed to resume normal operations on 31 October.[40]

A Basarnas spokesperson confirmed to reporters that the aircraft had crashed;[41] Muhammad Syaugi, head of Basarnas, later confirmed that casualties had occurred, without specifying a number.[17]

Indonesian Minister of Transportation Budi Karya Sumadi giving a press conference on the crash of Flight 610

The Transportation Ministry set up crisis centres in Jakarta[42] and Pangkal Pinang.[43][44] Lion Air offered free flights for the families of the victims to Jakarta. On 30 October, more than 90 relatives were flown to Jakarta for the identification of the victims.[45] Chairman of Lion Air Edward Sirait stated that accommodation had been provided for the relatives, and later added that relatives should go to Halim Perdanakusuma International Airport for further information.[46] The Indonesian National Police announced that a trauma-healing team would be provided for the relatives of the victims.[47]

Indonesia's People's Representative Council announced on 29 October that they would examine the standard operating procedures of Lion Air and the airworthiness of the aircraft. They would also examine the health history of the crew of Flight 610.[48][needs update] The speaker of the People's Representative Council, Bambang Soesatyo, later asked the government to enforce stricter rules for the aviation industry and to audit every airliner in the country.[49] On 1 November, Indonesian Minister of Transportation Budi Karya Sumadi announced that the government would evaluate every low-cost carrier in Indonesia.[50]

As 20 of the passengers were employees of the Indonesian Ministry of Finance, Sri Mulyani, the Indonesian finance minister, immediately visited the Indonesian Search and Rescue Agency's office in Jakarta, seeking coordination and further information.[51] She later announced that Finance Ministry employees should wear a black ribbon for a week to commemorate the victims.[52] Posthumous awards were issued to the 20 victims and scholarships to their children.[53]

Minister of Health Nila F Moeloek[54] and Minister of Transportation Budi Karya Sumadi visited the relatives of the victims. Indonesian President Joko Widodo, who was attending a conference in Bali during the crash,[55] visited the recovery efforts at the Port of Tanjung Priok the next day.[56]

The Australian Department of Foreign Affairs and Trade announced that its staff would be banned from flying on Lion Air, as well as its subsidiary airlines Batik Air and Wings Air, until the cause of the accident was known.[57] The Indonesian Minister of Transportation, Budi Karya Sumadi, later stated that his ministry would hold talks with the Australian government about the warning.[58][59][needs update]

The government-owned social insurance company Jasa Raharja announced that the victims' families would each receive 50 million rupiah (US$3495) in compensation.[60]

In the immediate aftermath of the crash, the Indonesian media were warned by Indonesian Broadcasting Commission for their unethical coverage of the crash. Some media were accused of pushing the family members to answer unethical questions.[61] Chairman of Indonesia's Alliance of Independent Journalists (AJI), Abdul Manan, stated that images of debris were broadcast repeatedly and inappropriately. This, in turn, traumatized relatives of the victims. In response, some Indonesians voiced their anger and disappointment on social media.[62]

On 31 October, Transportation Minister Budi Karya Sumadi temporarily suspended Lion Air's technical director Muhammad Arif from his duties based on the crash investigation. Budi said the ministry had also suspended an unspecified number of Lion Air technicians who had cleared the aircraft for its final flight.[63]

Recovery operations

[edit]
Aerial view of Lion Air Flight 610 crash site

Indonesia's National Search and Rescue Agency (Basarnas) launched a search-and-rescue operation, with assistance from the Indonesian Air Force,[64] the Indonesian Navy,[65] and the Republic of Singapore Navy. Basarnas dispatched about 150 people in boats and helicopters to the site of the accident.[17] Civilian vessels also responded to the reports of a downed aircraft, and the crew of a tugboat reported to authorities in Tanjung Priok that they had witnessed an aircraft crash at 6:45 am and located debris in the water at 7:15 am.[16][41] The Indonesian Agency for Assessment and Application for Technology deployed the research ship Baruna Jaya, which had been previously used in the search for Adam Air Flight 574 and Indonesia AirAsia Flight 8501.[66]

Officials from Basarnas announced that the search-and-rescue operation would be conducted for seven days and be extended by three days if needed. A command centre was set up in Tanjung Priok.[67]

On 29 October, the director of operations for Basarnas said that all on board were presumed dead and that the first human remains had been recovered.[68] Divers had located fragments of the aircraft's fuselage and assorted debris, but had yet to find the onboard flight recorders.[68] Air Marshal Muhammad Syaugi, head of Basarnas, suggested that most of the victims were still inside the fuselage, as in the days following the crash rescue personnel only managed to recover a small number of body parts.[69] Poor underwater visibility and strong sea current hampered the search and rescue effort.[70]

On the same day, Basarnas published the area of the search-and-rescue operation, divided into two main areas. The first was a 62 nmi (115 km; 71 mi) long underwater search area, while the second was a "visual search" area, 124 nmi (230 km; 143 mi) wide.[71]

On 30 October, the search area was divided into 13 sectors. The search area was widened to 150 nmi (280 km; 170 mi),[72] reaching as far as Indramayu to the east. Approximately 850 personnel from the National Search and Rescue Agency, National Armed Forces and volunteers participated in the operation.[73] At least 13 bodies were retrieved from the crash site.[74] Indonesian officials confirmed that faint pings had been heard in the search area.[75]

On 31 October, acoustic "pings" were reported to have been detected, no further than 3 km (1.6 nmi; 1.9 mi) from the group of eight current search points, which were possibly from one of the underwater locator beacons (ULBs) attached to the aircraft's flight recorders.[76]

The first victim was identified on 31 October.[77] At the time, more than a dozen body parts had been found by authorities. Some of the parts had drifted more than 5 km (2.7 nmi; 3.1 mi) in the sea current. Police also reported that 152 DNA samples had been collected from the victims' relatives.[77] Hundreds of pieces of the aircraft had also been recovered; all of them were transported to Tanjung Priok, Jakarta.[78] Authorities stated that the search area for dead bodies and debris would be focused in the sea off Karawang Regency, a coastal area of Java close to the crash site, as analysis showed that the sea currents in the area would bring debris to the south. A command centre was set up in Tanjung Pakis, Karawang, to oversee the salvage effort.[78]

On the same day, authorities widened the search area from 10 to 15 nmi (19 to 28 km; 12 to 17 mi). In all, 39 ships (including four equipped with sonar) and 50 divers were deployed to the search area.[79] The National Police announced that 651 personnel had joined and assisted in the search-and-rescue operation.[80] Officials stated that the operation, starting from 31 October, would focus on finding the fuselage of the aircraft and the flight recorders.[81]

The joint search-and-rescue team announced on 31 October that at least three objects, one of which was suspected to be one of the aircraft's wings, were found in the search area.[82] Officials confirmed that "pings" from the aircraft's ULBs were also heard near the area.[83]

On 1 November, searchers recovered Flight 610's flight data recorder (FDR), which was located at a depth of 32 m (105 ft).[13]: 240  The cockpit voice recorder (CVR) was reported as not yet found.[84][85] Haryo Satmiko, deputy chief of National Transportation Safety Committee (NTSC) (Indonesian: Komite Nasional Keselamatan Transportasi), the body investigating the crash, told journalists that the device's poor condition was evidence of the "extraordinary impact" of the crash, which had separated the memory unit from its housing.[86][87] Despite the damage, investigators were able to recover data from the aircraft's most recent 19 flights spanning 69 hours, and planned to begin analysis on 5 November.[87]

On 2 November, the joint search-and-rescue team deployed more than 850 personnel and 45 vessels to the crash site. The aerial search area was widened to 190 nmi (350 km; 220 mi) and the "underwater search area" was widened to 270 nmi (500 km; 310 mi).[88] Joint search-and-rescue team announced that some engine parts were found in the search area.[89] One of the aircraft's landing gear was recovered in the afternoon.[90] Meanwhile, the Disaster Victim Identification team stated that at least 250 body parts had been recovered from the crash site.[91]

A volunteer rescue diver died during the search on the afternoon of 2 November, likely from decompression sickness.[92][93]

A second landing gear and both of the aircraft's engines were recovered by search-and-rescue personnel, and the main body of the aircraft was located, 7.5 nmi (13.9 km; 8.6 mi) from the coast of Tanjung Pakis and about 200 m (220 yd) from the location where the FDR was discovered. Divers were immediately dispatched to the area. Faint "pings" from the ULB attached to the aircraft's cockpit voice recorder were also heard.[94][95][96]

On 4 November, nearly 1,400 personnel, including 175 divers, were dispatched to the crash site; 69 ships, five helicopters and thirty ambulances were also dispatched.[97] The Head of the National Search and Rescue Agency Muhammad Syaugi announced that the search-and-rescue operation would be extended for another three days.[98]

On 10 November, Basarnas ended its search for victims,[99] but on 22 November, were continuing to search intensively for the CVR.[100]

On 23 November, investigators concluded the victim identification process. Out of 189 people on board, 125 (89 men and 36 women) were identified, including the two foreigners. Another 64 bodies were unaccounted for.[101]

Lion Air paid US$2.8 million for a second attempt to search for the CVR between 19 and 29 December, using the offshore supply vessel MPV Everest.[13]: 243 [102][103] Divers detected a signal from an underwater locator beacon coming from underneath the aircraft wreckage and were able to fix the approximate position of the CVR, but did not succeed in recovering it.[13]: 243 

The NTSC funded a further underwater search using Indonesian Navy vessel KRI Spica, which started on 8 January 2019 and continued until the CVR was recovered on 14 January.[13]: 244 [104][105] The cockpit voice recorder was found at a depth of 30 m (98 ft) covered by mud that was 8 m (26 ft) thick.[106][107][108]

Investigation

[edit]

International assistance

[edit]

The Lion Air aircraft flight recorders were retrieved with assistance from Singapore's Transport Safety Investigation Bureau, which sent on 29 October 2018, three specialists and an underwater locator beacon detector to help recover the devices.[109] The Australian Transport Safety Bureau sent two of its personnel to assist the Indonesian NTSC with the downloading process of the FDR.

In August 2019, an early draft of the NTSC report was leaked.[110] The report in circulation blamed design and oversight lapses playing a key role in the Lion Air Flight 610 crash and also identified pilot and maintenance errors as causal factors among a hundred elements of the crash chronology, without ranking them.[111][112] Lion Air expressed objections because NTSC's draft, according to a source who requested anonymity, attributed 25 lapses to Lion Air out of 41 lapses found.[113] Also, doubts arose about the acceptability of some photographs used in the investigation, as they could be fabricated evidence of repair to the doomed Lion Air MAX. The company opposed raising an issue about the photographs in the final accident report.[114]

A Boeing technician and engineering team and a team from the US National Transportation Safety Board arrived on 31 October to help with the investigation being conducted by the NTSC.[115] Personnel from the US Federal Aviation Administration (FAA) and engine manufacturer GE Aviation were also sent to Indonesia. A team from Singapore that had already arrived on the night of 29 October was to provide assistance in recovering the aircraft's flight recorders. The Australian Transport Safety Bureau sent two of its personnel to assist with the downloading process of the FDR.[116]

Previous flight problems

[edit]

The aircraft was used on a flight from Ngurah Rai International Airport, Bali, to Soekarno-Hatta International Airport, Jakarta, the night before the crash. Detailed reports from that flight revealed that the aircraft had suffered a serious incident, which left many passengers traumatized. Passengers in the cabin reported heavy shaking and a smell of burnt rubber inside the cabin. At one point, the aircraft had dropped more than 61 m (200 ft) in a few seconds.[117] The seat-belt sign was never turned off from takeoff to landing. A recording of ATC communications indicated that the pilot had called a "pan-pan."[118] The crew later decided to cancel the pan-pan and continue the flight to Jakarta.[117]

The aircraft's maintenance logbook revealed that the aircraft suffered an unspecified navigation failure on the captain's side, while the first officer's side was reported to be in good condition.[119]

Passengers recounted that the aircraft had suffered an engine problem and were told not to board it, as engineers tried to fix the problem. While the aircraft was en route to Jakarta, it had problems maintaining a constant altitude, with passengers stating that it was like "a roller-coaster ride."[120] The chief executive officer of Lion Air, Edward Sirait, said the aircraft had a "technical issue" on Sunday night, but this had been addressed in accordance with maintenance manuals issued by the manufacturer. Engineers had declared that the aircraft was ready for takeoff on the morning of the accident.[121][122] Information later emerged that a third pilot was on the flight to Jakarta and told the crew to cut electrical power to the stabilizer trim motors. This method is a standard memory item in the 737 checklist and, on this flight, it fixed the problem.[123] Subsequently, the National Transportation Safety Committee confirmed the presence of an off-duty Boeing 737 MAX 8 qualified pilot in the cockpit but did not confirm the role of this person in fixing the problem, and denied that any recording existed of the previous flight in the CVR of Lion Air Flight 610.[124]

Early assessment of potential factors

[edit]

The erratic nature of the flight path led Indonesian aviation expert Gerry Soejatman to speculate that the pitot tubes, used in the airspeed indication system, may have played a role in the crash; they had contributed to previous crashes.[125][126]

The Indonesian Meteorology, Climatology, and Geophysical Agency reported that the weather was clear around the time of the crash, with winds at 9.3 km/h (5 kn) from the northwest. Visibility was good with no cumulonimbus clouds.[127] Police Hospital Chief Musyafak said that an examination of the body parts indicated that explosion or fire on board the aircraft was unlikely.[128]

Flight abnormalities

[edit]
Speed and altitude graph of Flight 610

Aviation experts noted some abnormalities were seen in the altitude and the airspeed of Flight 610. Just three minutes into the flight, the captain asked the controller for permission to return to the airport as the aircraft had flight-control problems.[129] About eight minutes into the flight, data transmitted automatically by the aircraft showed it had descended to about 1,500 m (5,000 ft), but its altitude continued to fluctuate. The mean value of the airspeed data transmitted by Flight 610 was around 300 kn (560 km/h; 350 mph), which was considered by experts to be unusual, as typically aircraft at altitudes lower than 3,000 m (10,000 ft) are restricted to an airspeed of 250 kn (460 km/h; 290 mph). Ten minutes into the flight, the data recorded the aircraft dropping by more than 910 m (3,000 ft). The last recorded altitude of the aircraft was 760 m (2,500 ft).[130][131]

November 2018 findings

[edit]

On 5 November, the NTSC announced that Flight 610 was still intact when it crashed into the sea at high speed, citing the relatively small size of the pieces of debris. The impact was so powerful that the strongest part of the aircraft was obliterated.[132] The NTSC also stated that the engines of Flight 610 were still running when it crashed into the sea,[133] indicated by high engine speed. Further examination of the aircraft's instruments revealed that one of the aircraft's airspeed indicators had malfunctioned for its last four flights, including the flight to Denpasar.[134]

On 7 November, the NTSC confirmed that problems had occurred with Flight 610's AoA sensors on the third and fourth last flight before the crash. Thinking that it would fix the problem, the engineers in Bali then replaced one of the aircraft's AoA sensors, but the problem persisted on the penultimate flight, from Denpasar to Jakarta. Just minutes after takeoff, the aircraft abruptly dived. The crew of that flight, however, had controlled the aircraft by following inflight procedures and decided to fly at a lower-than-normal altitude. They then managed to land the aircraft safely and recorded a 20° difference between the readings of the left and the right AoA sensors.[135] NTSC chief Soerjanto Tjahjono told the press that future reporting or actions, enacted to prevent similar problems on similar aircraft, would be decided by Boeing and U.S. aviation authorities.[136]

On 28 November, Indonesia investigators said the Lion Air jet was not airworthy on the flight before the crash. Several relatives of the crash victims filed lawsuits against Boeing.[137]

Preliminary report

[edit]

On 28 November, the Indonesian NTSC released its preliminary accident investigation report.[138] After airspeed and altitude problems, an AoA sensor was replaced and tested two days earlier on the accident aircraft.[139] Erroneous airspeed indications were still present on the subsequent flight on 28 October, which experienced automatic nose-down trim.[139] The runaway stabilizer non-normal checklist was run, the electric stabilizer trim was turned off, and the flight continued with manual trim; the issues were reported after landing.[139] Shortly after takeoff on 29 October, issues involving altitude and airspeed continued due to erroneous AoA data and commanded automatic nose-down trim via the MCAS.[139] The flight crew repeatedly commanded nose-up trim over the final ten minutes of the flight.[139] The preliminary report did not state whether the runaway stabilizer trim procedure was run or whether the electric stabilizer trim switches were cut out on the accident flight.[139]

Leeham News, which principally covers Airbus, Boeing, Bombardier, and Embraer issues,[140] reported that the crew did not have a clear knowledge that trim runaway checklist will disengage MCAS.[141]

Boeing pointed to the successful troubleshooting conducted on 28 October as evidence that the MCAS did not change runaway stabilizer procedures,[142] and emphasised the longstanding existence of procedures to cancel MCAS nose-down commands.[143]

Cockpit voice recorder

[edit]

The CVR was found on 14 January 2019.[107] On 21 January 2019, the NTSC announced that it would not release transcript from the CVR until the final report was released.[144] Following the Ethiopian Airlines Flight 302 crash on 10 March 2019, however, the data from the CVR of the Lion Air Flight 610 were shared among the investigators; media citing anonymous sources reported that the CVR recorded the pilots mentioning several problems, trying to climb, and checking the quick-reference handbook for a solution.[145] NTSC denied these claims, but stated the pilots began to panic at the end of the flight.[146]

Final report

[edit]

The NTSC released its final report into the accident on 25 October 2019.[147] The report listed nine "Contributing Factors":

Contributing factors [are] define[d] as actions, omissions, events, conditions, or a combination thereof, which, if eliminated, avoided or absent, would have reduced the probability of the accident or incident occurring, or mitigated the severity of the consequences of the accident or incident. The presentation is based on chronological order and not to show the degree of contribution.

1. During the design and certification of the Boeing 737-8 (MAX), assumptions were made about flight-crew response to malfunctions that, even though consistent with current industry guidelines, turned out to be incorrect.

2. Based on the incorrect assumptions about flight-crew response and an incomplete review of associated multiple flight deck effects, MCAS's reliance on a single sensor was deemed appropriate and met all certification requirements.

3. MCAS was designed to rely on a single AoA sensor, making it vulnerable to erroneous input from that sensor.

4. The absence of guidance on MCAS or more detailed use of trim in the flight manuals and in-flight crew training, made it more difficult for flight crews to properly respond to uncommanded MCAS.

5. The AoA DISAGREE alert was not correctly enabled during Boeing 737-8 (MAX) development. As a result, it did not appear during flight with the miscalibrated AoA sensor, could not be documented by the flight crew, and was therefore not available to help maintenance identify the miscalibrated AoA sensor.

6. The replacement AoA sensor that was installed on the accident aircraft had been miscalibrated during an earlier repair. This miscalibration was not detected during the repair.

7. The investigation could not determine that the installation test of the AoA sensor was performed properly. The miscalibration was not detected.

8. Lack of documentation in the aircraft flight and maintenance log about the continuous stick shaker and use of the runaway stabilizer NNC meant that information was not available to the maintenance crew in Jakarta, nor was it available to the accident crew, making it more difficult for each to take the appropriate actions.

9. The multiple alerts, repetitive MCAS activations, and distractions related to numerous ATC communications were not able to be effectively managed. This was caused by the difficulty of the situation and performance in manual handling, NNC execution, and flight-crew communication, leading to ineffective CRM application and workload management. These performances had previously been identified during training and reappeared during the accident flight.

— Source: Komite Nasional Keselamatan Transportasi (KNKT; English: NTSC), "Aircraft Accident Investigation Report"[13] (Abbreviations: ATC = Air Traffic Control; NNC = Non-Normal Checklists; CRM = Crew Resource Management)

The report stated that 31 pages were missing from the airplane's logbook. The NTSC recommended that Lion Air improve the duration and content of its safety management system training, including the identification of equipment hazards, such as the continuous stick shaker and trim runaway, which the pilot on the previous flight did not report. The Indonesian Directorate General of Civil Aviation was urged to improve its oversight of airlines and maintenance organizations.[148][149]

Aftermath

[edit]

Reaction

[edit]

Potential cause

[edit]

The CFM LEAP engines used on the 737 MAX have a higher bypass ratio and have a larger nacelle than the engines of previous Boeing 737 models, requiring them to be placed further forward and upwards on the wing compared to previous models. This de-stabilises the aircraft pitch at high AoAs due to a change in aerodynamics.

The MCAS was designed to mitigate this aerodynamics issue in the 737 MAX series, automatically commanding the aircraft to pitch downwards if its AoA was too high, but out of two AoA sensors on the aircraft, MCAS would only read data from a single sensor.[150] Former Boeing engineers expressed the opinion that a nose-down command triggered by a sensor single point of failure is a design flaw if the crew is not prepared, and the FAA was evaluating a fix of the possible flaw and investigating whether the pilots' transition training is adequate.[151] A malfunction in the captain-side AoA sensor, as occurred on the flight, caused the MCAS system to continuously trim the aircraft nose-down, causing the plane to crash.[152]

FAA warnings

[edit]

On 7 November, on the basis of preliminary information gathered in the investigation of the Lion Air accident, the US FAA issued an emergency airworthiness directive requiring that amended operating limitations and procedures relating to erroneous data from an AoA sensor be inserted into the aircraft flight manual of each 737 MAX aircraft,[153][154] and urged all airlines operating Boeing 737 MAX 8s to heed the warnings.[155]

On 25 October 2019, after the release of the Final Report by NTSC, the FAA revoked the repair certification of Florida-based Xtra Aerospace LLC, which fixed an AoA sensor suspected of contributing to the crash.[156]

Pilot concerns

[edit]

During difference training, pilots of American Airlines and Southwest Airlines converting from earlier Boeing 737 Next Generation models to the 737 MAX were not informed of the MCAS linked to the fatal crash, leaving them concerned that they were possibly untrained with respect to other differences.[157] In November 2018, Aviation Week reviewed the 737 MAX flight-crew operations manual and found that it did not mention the MCAS.[158] American Airlines' Allied Pilots Association and Southwest Airlines Pilots' Association were also caught unaware.[159] The Wall Street Journal reported that Boeing had "decided against disclosing more details to cockpit crews due to concerns about inundating average pilots with too much information."[160]

On 15 November, the Air Line Pilots Association in the United States, representing 61,000 pilots, urged the FAA and NTSB to ensure pilots receive all relevant information addressing a "potential, significant aviation system safety deficiency."[161] The association's United Airlines branch, in line with its management, disagreed as the 737 pilot manual includes a standard procedure to shut down the flight-control behavior, and dismissed the MCAS implication in the accident as "speculation" based on the Boeing safety-warning bulletin and the follow-on FAA airworthiness directive.[162]

Boeing's defense

[edit]

In an internal message on 19 November 2018, Boeing CEO Dennis Muilenburg defended the flight-crew operations manual as describing the relevant function of MCAS.[163] On 20 November, Boeing was to hold a conference call with 737 MAX operators to detail the new MCAS not present in the Next Generation models.[164] The conference call was cancelled later, to be replaced by a series of regional calls to allow more questions.[165]

On 25 October 2019, after the release of the final investigation report by NTSC, Boeing President and CEO Dennis Muilenburg responded:

"We are addressing the KNKT's [NTSC's] safety recommendations, and taking actions to enhance the safety of the 737 MAX to prevent the flight control conditions that occurred in this accident from ever happening again. Safety is an enduring value for everyone at Boeing and the safety of the flying public, our customers, and the crews aboard our airplanes is always our top priority. We value our long-standing partnership with Lion Air and we look forward to continuing to work together in the future."[166]

In January 2020, newly released unredacted internal messages within Boeing employees reveal that they have mocked Lion Air with profanity, belittling the airline for requesting additional simulator training for their Boeing 737 MAX pilots in 2017 citing that Lion's sister airline (Malindo Air) have already operated the type.[167][168] Lion Air co-founder and former CEO Rusdi Kirana, currently the Indonesian ambassador to Malaysia, considered cancelling Lion Air's outstanding 190 Boeing aircraft orders – worth some $22 billion at list prices – over what he viewed as an attempt by Boeing to blame Lion Air for the crash.[143]

[edit]

On 31 December 2018, the family of the first officer filed a lawsuit against Boeing, claiming negligence. The lawsuit also claimed that the aircraft's sensors provided inaccurate flight data, causing its antistall system to improperly engage, as well as Boeing not providing proper instructions to pilots about how to handle the situation.[169]

In March 2019, victims' families reported irregularities, saying that Lion Air pressured them into signing away their rights to seek legal recourse for under compensation.[170][171]

The US Federal Aviation Administration revoked the aviation repair station certificate for Xtra Aerospace in October 2019, the company that supplied the faulty AoA sensor to Lion Air. The certificate revocation effectively put Xtra Aerospace out of business.[172]

In December 2020, a federal judge in Chicago froze the assets of attorney Thomas Girardi, as "finding that he misappropriated at least US$2 million in client funds that were due to the families of those killed in the crash".[173][174] He was disbarred from legal practice and ordered to return US$2.3 million in funds.[175]

Second accident and grounding

[edit]
Main article: Ethiopian Airlines Flight 302

On 10 March 2019, another 737 MAX 8, operated by Ethiopian Airlines (registration ET-AVJ), crashed shortly after takeoff from Addis Ababa; all 157 people on board perished. This raised further concerns about the safety of the 737 MAX and culminated in all 737 MAX aircraft being grounded worldwide for 21 months.[176]

Dramatization

[edit]
  • The accident was dramatized in the 21st season of the TV series Mayday in an episode entitled "Grounded: Boeing Max 8" and was mentioned as a flashback in the 24th season entitled "Deadly Directive".[177][178]
  • In February 2022, Netflix released Downfall: The Case Against Boeing, a documentary about the Lion Air Flight 610 and Ethiopian Airlines Flight 302 plane crashes.[179]
  • This accident was covered in depth on the Hard Landings Podcast, Episode 230 on 19 March 2024.[180]
  • The accident was also covered during the 5 part series 'American Scandal: Boeing' between 13 August and 10 September 2024. [181]

See also

[edit]

Notes

[edit]
  1. ^ JT is the IATA airline designator and LNI is the ICAO airline designator.[citation needed]
  2. ^ Harvino, like some Indonesians, only had a single name[11] - See Indonesian name

References

[edit]
  1. ^ "ASN Aircraft accident Boeing 737 MAX 8 PK-LQP Tanjung Bungin". Aviation Safety Network. Retrieved 6 May 2021.
  2. ^ Sutriyanto, Eko, ed. (15 August 2018). "Lion Air Datangkan Pesawat Baru Boeing 737 MAX 8 ke-10" [Lion Air Brings New 10th Boeing 737 MAX 8 aircraft]. Tribunnews.com (in Indonesian). Retrieved 28 October 2018.
  3. ^ "Factbox: 'Black boxes' the focus of probe in Indonesia's Lion Air crash". Reuters. 29 October 2018.
  4. ^ McKirdy, Euan; Faridz, Devianti; McKenzie, Sheena (29 October 2018). "Lion Air flight crashes en route from Jakarta to Pangkal Pinang". CNN. Retrieved 29 October 2018.
  5. ^ "Indonesia: Lion Air flight from Jakarta to Sumatra crashes". Al Jazeera. 29 October 2018. Retrieved 29 October 2018.
  6. ^ "ASN Aviation Safety Database". Aviation Safety Network. Retrieved 30 October 2018.
  7. ^ Suhartono, Muktita; Ramzy, Austin (25 October 2019). "Indonesian Report on Lion Air Crash Finds Numerous Problems". The New York Times. Retrieved 25 February 2024.
  8. ^ Gates, Dominic; Kamb, Lewis (24 October 2019). "Indonesia's devastating final report blames Boeing 737 MAX design, certification in Lion Air crash". The Seattle Times. Retrieved 25 February 2024.
  9. ^ Jolly, Jasper (25 October 2019). "Lion Air crash report 'criticises design, maintenance and pilot error'". The Guardian. ISSN 0261-3077. Retrieved 24 February 2024.
  10. ^ a b "Delhi captain among 189 dead in Lion Air plane crash was expected home for Diwali". Hindustan Times. 29 October 2018. Retrieved 15 July 2019.
  11. ^ a b Langewiesche, William (18 September 2019). "What Really Brought Down the Boeing 737 Max?". The New York Times. Retrieved 10 December 2019. His co-pilot was an Indonesian [...] who went by the single name Harvino[...]
  12. ^ Pheroze L. Vincent (18 October 2019). "Java plane crash shatters Delhi family". telegraphindia.com. Retrieved 12 April 2022. Bhavye passed out of Ahlcon Public School in 2005 before learning to fly at Bel-Air International in San Carlos, California.
  13. ^ a b c d e f "Aircraft Accident Investigation Report. PT. Lion Airlines Boeing 737 (MAX); PK-LQP Tanjung Karawang, West Java, Republic of Indonesia 29 October 2018" (PDF). National Transportation Safety Committee. Retrieved 26 February 2024. Public Domain This article incorporates text from this source, which is in the public domain.
  14. ^ "Family of Lion Air co-pilot sues Boeing in Chicago over fatal crash". Reuters. 28 December 2018. Retrieved 15 July 2019.
  15. ^ Baker, Sinéad (31 October 2018). "What we know about the victims of the Lion Air plane crash off Indonesia, where there were 'likely no survivors'". Business Insider. Retrieved 1 November 2018.
  16. ^ a b Chan, Francis; Soeriaatmadja, Wahyudi (29 October 2018). "Lion Air plane carrying 188 on board crashes into sea shortly after take-off from Jakarta". The Straits Times. Retrieved 29 October 2018.
  17. ^ a b c Massola, James; Rompies, Karuni; Rosa, Amilia; Noyes, Jenny (29 October 2018). "Lion Air flight crashes in Indonesia". The Canberra Times. Retrieved 29 October 2018.
  18. ^ a b Zhou, Naaman (29 October 2018). "Lion Air crash: officials say 188 onboard lost flight JT610 – latest updates". The Guardian. Retrieved 29 October 2018.
  19. ^ "Lion Air crash: Boeing 737 plane crashes in sea off Jakarta". BBC. 29 October 2018. Retrieved 29 October 2018.
  20. ^ "No plane, no flight data recorder – search & recovery continue off Jakarta". The Thaiger. 31 October 2018. Retrieved 31 October 2018.
  21. ^ Mahtani, Shibani; Rohmah, Ainur (29 October 2018). "Indonesian plane crashes into the sea with more than 180 on board". The Washington Post. Retrieved 29 October 2018.
  22. ^ Damarjati, Danu (29 October 2018). "Pesawat Lion Air Hilang Kontak Usai 13 Menit Terbang". Detik.com (in Indonesian). Retrieved 1 November 2018.
  23. ^ Danu Damarjati (29 October 2018). "Lacak Lion Air di Karawang, Basarnas Kirim 3 Kapal dan 1 Helikopter". Detik.com (in Indonesian). Retrieved 1 November 2018.
  24. ^ Bulan, Natalia; Palupi, Retno (29 October 2018). "Pihak Pertamina Sebut Pesawat Lion Air JT610 Jatuh di Dekat Fasilitasnya". TribunNews.com (in Indonesian). Retrieved 1 November 2018.
  25. ^ Awaluddin, Luthfiana (29 October 2018). "Petugas Pertamina Lepas Pantai di Karawang Kaget Lihat Lion Air Jatuh" [Pertamina Offshore Officers in Karawang Shocked See Lion Air Fall]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  26. ^ Rizki, Nur Azizah. "Puing Pesawat Lion Air Ditemukan di Perairan Karawang" [Lion Air Plane Debris Found in Karawang Waters]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  27. ^ "Indonesia's Lion Air Flight JT-610 crashes into the sea with 189 on board, officials say". CBS News. 29 October 2018. Retrieved 29 October 2018.
  28. ^ Azizah, Nur (29 October 2018). "Lion Air Jatuh, Basarnas: Keajaiban Kalau Ada yang Selamat" [Lion Air Falls, Basarnas: A Miracle if There Is a Survivor]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  29. ^ Hashim, Firdaus (29 October 2018). "Lion Air 737 Max 8 crash confirmed, 189 dead". Flightglobal. Retrieved 29 October 2018.
  30. ^ Sutrisno, Elvan Dany (29 October 2018). "10 Pegawai BPK Jadi Penumpang Lion Air JT 610, Ini Daftar Namanya" [10 BPK Employees Become Lion Air JT 610 Passengers, Here is the Name List]. Detik.com (in Indonesian).
  31. ^ Iin Yumiyanti (29 October 2018). "2 Auditor Andalan BPKP Jadi Korban Pesawat Lion Air yang Jatuh" [2 BPKP Mainstay Auditors Become Falling Lion Air Plane Victims]. Detik.com (in Indonesian).
  32. ^ "3 Pegawai Kementerian ESDM Jadi Korban Lion Air JT-610 Jatuh" [3 EMR Ministry Employees Become Falling Victims of Lion Air JT-610]. cnnindonesia.com (in Indonesian). CNN Indonesia. 29 October 2018.
  33. ^ "Tiga Anggota Polri Jadi Penumpang Lion Air JT-610 yang Jatuh" [Three Police Members Become Passengers of the Falling Lion JT-610]. cnnindonesia.com (in Indonesian). CNN Indonesia. 29 October 2018.
  34. ^ Irawan, Dhani. "3 Jaksa Jadi Korban Pesawat Lion Air JT 610, Ini Identitasnya". detiknews (in Indonesian). Retrieved 13 August 2023.
  35. ^ "6 Anggotanya Jadi Korban Lion Air, Ketua DPRD Babel Sebut Pengaruhi Kinerja Dewan" [6 of Its Members Become Victims of Lion Air, Chairperson of the Babel DPRD Called Influence on Board Performance]. Kompas.com (in Indonesian). 3 November 2018.
  36. ^ Saputra, Andi (29 October 2018). "Tiga Hakim Ada di Pesawat Lion Air yang Jatuh, MA Berduka". Detik.com (in Indonesian).
  37. ^ Collie, Jason; Williams, Sophie (29 October 2018). "Lion Air plane crash latest: 'No survivors' after Indonesia passenger jet crashes with 189 on board". London Evening Standard. Retrieved 29 October 2018.
  38. ^ Gasperetti, Marco (29 October 2018). "Andrea Manfredi, chi era il 26enne italiano morto nell'incidente aereo in Indonesia" [Andrea Manfredi, who was the 26-year-old Italian who died in the plane crash in Indonesia]. Corriere della Sera (in Italian). Retrieved 29 October 2018.
  39. ^ Tani, Shotaro (30 October 2018). "Indonesia orders inspection of all Boeing 737 Max 8 in country". Nikkei Asian Review. Retrieved 30 October 2018.
  40. ^ "Kemenhub Sudah Investigasi 11 Pesawat Boeing 737-MAX Lion Air, Hasilnya?" [Ministry of Transportation Has Investigated 11 Lion Air Boeing 737-MAX Aircraft, The Result?]. Detik (in Indonesian). Retrieved 7 November 2018.
  41. ^ a b Lamb, Kate (29 October 2018). "Lion Air passenger plane flying from Jakarta crashes into the sea – latest updates". The Guardian. Retrieved 29 October 2018.
  42. ^ Fauzi Rachman, Fadhly. "Pesawat Lion Air Jatuh, Menhub Bentuk Crisis Center" [Lion Air Plane Crashed, Menhub Forms Crisis Center]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  43. ^ "Bandara Depati Amir Pangkal Pinang Buka Posko Crisis Center - Tribun Jogja" [Depati Amir Airport, Pangkal Pinang Open Crisis Center Post - Tribune Jogja]. Tribun Jogja (in Indonesian). 29 October 2018. Retrieved 1 November 2018.
  44. ^ Hasibuan, Hisar. "Lion Air Jatuh, Crisis Center Dibuka di Jakarta dan Pangkal Pinang" [Lion Air Falls, Crisis Center Opens in Jakarta and Pangkal Pinang]. Harian MedanBisnis (in Indonesian). Retrieved 1 November 2018.
  45. ^ Dahnur, Heru. "Manajemen Berangkatkan Keluarga Penumpang Lion Air yang Jatuh ke Jakarta" [Management Departs Lion Air Passenger Families Who Fall into Jakarta]. Kompas (in Indonesian). Retrieved 1 November 2018.
  46. ^ Fida Ul Haq, Muhammad. "Lion Air Siapkan Penginapan Bagi Keluarga Penumpang Pesawat Jatuh" [Lion Air Prepares Lodging for Falling Passenger Families]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  47. ^ Indra Komara. "RS Polri Beri Trauma Healing ke Keluarga Korban Lion Air JT 610". Detik (in Indonesian). Retrieved 7 November 2018.
  48. ^ Nasrulhak, Akfa. "Komisi V DPR akan Cek SOP Kelaikan Pesawat Lion Air JT 610" [Commission V of the House of Representatives will Check the Feasibility of SOP for Lion Air JT 610]. Detik (in Indonesian). Retrieved 7 November 2018.
  49. ^ "Lion Air Jatuh, Bamsoet Minta Pemerintah Perketat Izin Penerbangan" [Lion Air Falls, Bamsoet Asks Government to Tighten Flight Permits]. Detik (in Indonesian). Retrieved 7 November 2018.
  50. ^ "Buntut Lion Air Jatuh, Jokowi Minta Aturan Penerbangan Murah Dikaji Ulang" [Following the fall of Lion Air, Jokowi Asks for Cheap Flights Review Rules]. Detik (in Indonesian). Retrieved 7 November 2018.
  51. ^ Rizki, Azizah. "20 Pegawainya Jadi Penumpang Lion JT 610, Menkeu Datangi Basarnas" [20 Employees Become Passengers of Lion JT 610, Minister of Finance Visits Basarnas]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  52. ^ Azanella Ayu, Luthfia. "Pita Hitam di Lengan, Tanda Duka dan Kehilangan Kementerian Keuangan" [Black Ribbons on Arms, Grief and Loss of the Ministry of Finance]. Kompas (in Indonesian). Retrieved 1 November 2018.
  53. ^ "Sri Mulyani Beri Penghargaan ke PNS Kemenkeu Korban Lion Air" [Sri Mulyani Gives Award to Civil Servants Ministry of Finance Lion Air Victims]. Detik (in Indonesian). Retrieved 7 November 2018.
  54. ^ Komara, Indra. "Menkes Temui Keluarga Staf Kemenkes Korban Lion JT 610 di RS Polri" [Minister of Health Meets Family of Ministry of Health Lion JT 610 Victims in Polri Hospital]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  55. ^ Nugroho, Wisnu. "Lion Air Jatuh, Jokowi: Belum Selesai Satu Musibah, Musibah Lain Datang Lagi" [Lion Air Falls, Jokowi: Not Over One Disaster, Another Accident Comes Again]. Kompas. Retrieved 1 November 2018.
  56. ^ "Saat Jokowi Tertunduk Hingga Pandangi Sepatu Bayi Milik Korban Pesawat Lion Air JT 610" [When Jokowi Bowed Down to Look at the Baby Shoes of the Lion Air JT 610 Victims] (in Indonesian). Tribun News. 31 October 2018. Retrieved 1 November 2018.
  57. ^ Thomas, Geoffrey (31 October 2018). "DFAT tells bureaucrats told not to fly with Lion Air, Batik Air or Wings Air". The West Australian. Retrieved 1 November 2018.
  58. ^ Kusuma, Hendra. "Australia Prohibits Its Officials from Riding on Lion Air, Minister of Transportation: We Talk with Us" [Australia Prohibits Its Officials from Riding on Lion Air, Minister of Transportation: We Talk with Us]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  59. ^ "Menhub Bakal Temui Australia Terkait Larangan Naik Lion Air" [The Minister of Transportation Will Meet Australia Regarding Lion Air Ride Ban] (in Indonesian). Liputan6. 31 October 2018. Retrieved 1 November 2018.
  60. ^ Damarjati, Danu. "Pihak Korban Tewas Lion Air Dapat Santunan Rp 50 Juta dari Jasa Raharja" [Lion Air Death Victim Can Get Rp. 50 Million from Jasa Raharja]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  61. ^ "KPI Ingatkan Pedoman Peliputan Jatuhnya Lion Air JT 610" [KPI Reminds Guidelines for Covering the Fall of Lion Air JT 610]. Detik (in Indonesian). Retrieved 7 November 2018.
  62. ^ "Lion Air crash: Indonesian media warned over 'unethical coverage'". ABC. Retrieved 7 November 2018.
  63. ^ "Direktur Lion Air Dirumahkan untuk Permudah Pemeriksaan KNKT" [The Director of Lion Air was sent home to simplify NTSC examination]. CNN Indonesia (in Indonesian). 31 October 2018. Retrieved 31 October 2018.
  64. ^ Ibrahim, Achmad; Wright, Stephen (29 October 2018). "Indonesia's Lion Air says it's lost contact with airplane". The Seattle Times. Associated Press. Retrieved 29 October 2018.
  65. ^ Irawan, Dhani. "TNI AL Kerahkan KRI hingga Tim Kopaska Cari Korban Lion Air JT 610" [Indonesian Navy Moves KRI to Kopaska Team Seeks Lion Air JT 610 Victims]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  66. ^ "Bawa 4 Alat Canggih, Kapal Riset BPPT Ikut Cari Lion Air JT 610" [Bringing 4 Sophisticated Equipment, BPPT Research Vessel Join Search for Lion Air JT 610]. Detik (in Indonesian). Retrieved 1 November 2018.
  67. ^ Azizah, Nur. "Basarnas Tetapkan Masa Evakuasi Lion Air JT 610 Selama 7 Hari" [Basarnas Sets the Lion Air JT 610 Evacuation Period for 7 Days]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  68. ^ a b Suhartono, Muktita; Beech, Hannah (28 October 2018). "Indonesia Plane Crash Adds to Country's Troubling Safety Record". The New York Times. Retrieved 30 October 2018.
  69. ^ Azizah, Nur. "Banyak Korban di Pesawat Lion Air, Basarnas Fokus di Penyelaman" [Many Victims on Lion Air Plane, Basarnas Focus on Diving]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  70. ^ Azizah, Nur. "Evakuasi Lion Air JT 610 Terkendala Arus Deras dan Jarak Pandang". Detik.com. Retrieved 1 November 2018.
  71. ^ "Ini Daftar dan Pembagian Tugas Kapal-Heli Pencari Lion Air JT 610". Detik. Retrieved 7 November 2018.
  72. ^ "Ini Peta Lokasi Pencarian Pesawat Lion Air JT 610". Detik. Retrieved 7 November 2018.
  73. ^ "Tim SAR Perluas Area Pencarian Korban Lion Air hingga Indramayu". Detik. Retrieved 7 November 2018.
  74. ^ "Total 33 Kantong Jenazah Korban Lion Air Dibawa ke RS Polri". Detik. Retrieved 7 November 2018.
  75. ^ "Pencarian Black Box Lion Air, Ping Locator Sempat Dapat Suara Samar". Detik. Retrieved 7 November 2018.
  76. ^ McKirdy, Euan; Watson, Ivan (31 October 2018). "Lion Air crash: Investigators detect 'pings' which could lead to flight recorders". cnn.com. Retrieved 31 October 2018.
  77. ^ a b Wildansyah, Samsudhuha. "Satu Korban Lion Air Teridentifikasi" [One Lion Air Victim Identified]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  78. ^ a b "Serpihan & bagian tubuh korban Lion Air jatuh dibawa ke crisis center Jakarta" [Fragments & body parts of Lion Air victims were taken to the Jakarta crisis center] (in Indonesian). Merdeka. 29 October 2018. Retrieved 1 November 2018.
  79. ^ Sukmana, Yoga. "Hari Ini, Area Pencarian JT 610 Diperluas, 4 Kapal Canggih Dikerahkan". Kompas. Retrieved 1 November 2018.
  80. ^ "Bantu Evakuasi Korban Lion JT 610, Polri Kerahkan 651 Personel". Detik.com. Retrieved 1 November 2018.
  81. ^ "Fokus Cari Badan Lion JT 610, Alat Sonar dan 50 Penyelam Dikerahkan". Detik.com. Retrieved 1 November 2018.
  82. ^ "KR Baruna Jaya Temukan Serpihan Diduga Sayap Lion Air di Dasar Laut". Detik. Retrieved 7 November 2018.
  83. ^ "KR Baruna Jaya BPPT Tangkap Sinyal Black Box Lion Air JT 610!". Detik. Retrieved 7 November 2018.
  84. ^ Alfons, Matius. "Bagian Black Box Lion Air PK-LQP yang Ditemukan Adalah FDR". Detik.com. Retrieved 1 November 2018.
  85. ^ Silviana, Cindy (November 2018). "Indonesian investigators examine black box from crashed jet". .reuters.com. Archived from the original on 1 November 2018. Retrieved 3 November 2018.
  86. ^ "Lion Air crash: 'Black box' from crashed jet retrieved". BBC. 1 November 2018. Retrieved 1 November 2018.
  87. ^ a b "Investigators Download 69 Hours of Data From Crashed Lion Air Jet". The Wall Street Journal. 4 November 2018. Retrieved 5 November 2018.
  88. ^ "Fokus Cari CVR Lion Air PK-LQP, 869 Personel Gabungan Dikerahkan" [Fokusram Search for Lion Air PKR CV-LQP, 869 Combined Personnel Deployed]. Detik (in Indonesian). Retrieved 7 November 2018.
  89. ^ "Penyelam Kopaska Temukan Bagian Mesin Lion Air PK-LQP" [Kopaska Divers Find Parts of Lion Air PK-LQP Engine]. Detik (in Indonesian). Retrieved 7 November 2018.
  90. ^ "Roda Lion Air Diangkat dari Dasar Laut, Ini Penampakannya" [Lion Air Wheel Lifted from the Sea Floor, This Appearance]. Detik (in Indonesian). Retrieved 7 November 2018.
  91. ^ "Tim DVI Polri Periksa 272 Bagian Tubuh Korban Lion Air" [The Indonesian National Police DVI Team Examines 272 Lion Air Victims' Body Parts]. Detik (in Indonesian). Retrieved 7 November 2018.
  92. ^ "Indonesian rescue diver dies while searching for victims of Lion Air jet crash". abc.net.au. 3 November 2018. Retrieved 3 November 2018.
  93. ^ "Lion Air crash claims another life". news.com.au. Retrieved 5 November 2018.
  94. ^ Safitri, Eva. "Tim SAR Temukan Mesin dan Satu Lagi Roda Lion Air PK-LQP" [SAR Team Find Engine and Another Lion Air PK-LQP Wheel]. detiknews (in Indonesian). Retrieved 26 October 2019.
  95. ^ Rahayu, Lisye Sri. "Bodi Lion Air PK-LQP Terdeteksi, Kondisinya Rapuh" [Lion Air PK-LQP body detected, fragile condition] (in Indonesian). Retrieved 28 November 2018.
  96. ^ Rahayu, Lisye Sri. "Penyelam Dikerahkan ke Lokasi Diduga Bodi Lion Air PK-LQP" [Divers Deployed to Locations Suspected of Lion Air Body PK-LQP] (in Indonesian). Retrieved 28 November 2018.
  97. ^ "Hari ke-7 Evakuasi Lion Air PK-LQP, 175 Penyelam Dikerahkan". Detik. Retrieved 7 November 2018.
  98. ^ "Operasi SAR Lion Air Diperpanjang 3 Hari, Fokus Evakuasi dan CVR". Detik. Retrieved 7 November 2018.
  99. ^ "Lion Air Search: CVR No Longer Transmitting Signals". Retrieved 23 November 2018.
  100. ^ "Indonesia keeps up search for crashed jet's black box as signal drops out". Channel NewsAsia. 22 November 2018. Archived from the original on 23 November 2018. Retrieved 23 November 2018.
  101. ^ "Indonesia wraps up Lion Air crash victim identification". The Jakarta Post. Retrieved 24 November 2018.
  102. ^ Creedy, Steve (14 December 2018). "Lion Air funds new search for cockpit voice recorder". Airline Ratings. Retrieved 14 December 2018.
  103. ^ "Search for cockpit voice recorder of crashed Lion Air resumes in Indonesia". The Nation. 20 December 2018. Retrieved 30 December 2018.
  104. ^ "Lion Air ends search for CVR but Indonesian investigators to launch their own". Malay Mail. 3 January 2019. Retrieved 3 January 2019.
  105. ^ "Indonesia to resume search for crashed Lion Air jet's cockpit voice recorder". Malay Mail. 8 January 2019. Retrieved 8 January 2019.
  106. ^ Sri Rahayu, Lisye (14 January 2019). "CVR Lion Air Diangkat dari Dasar Laut yang Tertutup Lumpur 8 Meter" [Lion Air CVR is lifted from the seabed covered in 8 meters mud]. Detik (in Indonesian).
  107. ^ a b "Indonesia Finds Cockpit Voice Recorder of Crashed Lion Air Jet". Bloomberg.com. Bloomberg News. 14 January 2019. Retrieved 14 January 2019.
  108. ^ Safitri, Eva (14 January 2019). "CVR Lion Air Ditemukan di Kedalaman 30 Meter Perairan Karawang" [Lion Air CVR Found in a Depth of 30 Meters Karawang Waters]. Detik (in Indonesian).
  109. ^ "Lion Air crash: Singapore offers assistance to Indonesia; no reports of Singaporeans on board". www.channelnewsasia.com. 20 October 2018. Archived from the original on 29 September 2019. Retrieved 29 September 2019.
  110. ^ Pasztor, Andy; Tangel, Andrew (22 September 2019). "Indonesia to Fault 737 MAX Design, U.S. Oversight in Lion Air Crash Report". The Wall Street Journal.
  111. ^ Pasztor, Andy; Tangel, Andrew (22 September 2019). "Indonesia to Fault 737 MAX Design, U.S. Oversight in Lion Air Crash Report". The Wall Street Journal. Retrieved 23 September 2019.
  112. ^ "Indonesia finds design flaw, oversight lapses in 737 MAX crash: WSJ". Reuters. 23 September 2019. Retrieved 23 September 2019.
  113. ^ "Boeing Crash Report Faces Pushback From Lion Air, Regulator". Bloomberg News. 23 September 2019. Retrieved 24 September 2019.
  114. ^ Suhartono; Levin (15 October 2019). "Pictures Raise Specter of Fake Evidence in 737 Max Crash Probe". www.bloomberg.com. Retrieved 16 October 2019.
  115. ^ Mufti, Riza (30 October 2018). "Boeing, US govt teams on way to join Lion Air crash investigation". The Jakarta Post. Retrieved 31 October 2018.
  116. ^ Mufti, Riza (30 October 2018). "Boeing, US govt teams on way to join Lion Air crash investigation". The Jakarta Post. Retrieved 31 October 2018.
  117. ^ a b "Pengakuan Penumpang Lion Air PK-LQP Denpasar-Jakarta: Semua Teriak Allahuakbar" [Recognition of Lion Air PK-LQP Denpasar-Jakarta: All Shouts of Allahuakbar] (in Indonesian). MSN. Retrieved 7 November 2018.
  118. ^ Kami, Indah Mutiara. "Lion Air PK-LQP Lapor Sinyal Urgen Pan-pan di Malam Sebelum Jatuh" [Lion Air PK-LQP Reports Urgent Pan-Pan Signal in the Night Before Fall]. detiknews (in Indonesian). Retrieved 13 November 2018.
  119. ^ "Ini Dugaan Masalah Lion Air PK-LQP di Malam Sebelum Jatuh di Karawang" [This is the Alleged Problem of Lion Air PK-LQP the Night Before the Fall in Karawang]. Detik (in Indonesian). Retrieved 7 November 2018.
  120. ^ Kami, Indah Mutiara (29 October 2018). "Kesaksian Penumpang Soal Masalah di Lion Air Denpasar-Jakarta" [Passenger Testimony on Problems at Lion Air Denpasar-Jakarta]. Detik.com (in Indonesian). Retrieved 1 November 2018.
  121. ^ Sapiie, Marguerite Afra; Dipa, Arya (30 October 2018). "Investigators mush examine Lion Air's claim to have resolved technical problem: Expert". The Jakarta Post. Retrieved 31 October 2018.
  122. ^ "Indonesia plane crash: Lion Air CEO Edward Sirait says aircraft had technical problem in previous flight". The Financial Express. 29 October 2018.
  123. ^ Levin, Alan; Suhartono, Harry (19 March 2019). "Pilot Who Hitched a Ride Saved Lion Air 737 Day Before Deadly Crash". The Jakarta Post. Retrieved 30 January 2023.
  124. ^ Swaragita, Gisela (21 March 2019). "KNKT confirms presence of third pilot who saved earlier Lion Air flight". The Jakarta Post. Retrieved 29 March 2019.
  125. ^ "Indonesia orders inspection of all Boeing 737-MAX airliners in wake of Lion Air crash, as concerns raised over pitot pipe". The Daily Telegraph. 30 October 2018. Retrieved 1 November 2018.
  126. ^ Goldman, Russell (30 October 2018). "Did a Small Metal Tube Bring Down an Indonesian Airliner?". The New York Times. Retrieved 1 November 2018.
  127. ^ Ibrahim, Gibran Maulana (29 October 2018). "BMKG: Tak Ada Masalah Cuaca Sesaat Sebelum Lion Air JT 610 Jatuh" [BMKG: There Is No Weather Problem Shortly Before Lion Air JT 610 Falls]. Detik.com. Retrieved 1 November 2018.
  128. ^ P., Gregorius Aryodamar (1 November 2018). "Polisi: Hasil Identifikasi Korban, Kecil Kemungkinan Lion Air Meledak" [Police: Result of Victim Identification, Likelihood of Lion Water Explodes] (in Indonesian). IDN Times.
  129. ^ McMah, Lauren (1 November 2018). "Heartbreaking photo of Lion Air crash aftermath". News.com.au.
  130. ^ Dewangga, Putra; Seta, Candra (31 October 2018). "Sebelum Jatuh, Lion Air JT 610 Terbang dengan Speed 340, Pilot Senior: Itu Tak Masuk Akal" [Before Falling, Lion Air JT 610 Flying with Speed 340, Senior Pilot: That Doesn't Make Sense]. Tribunnews.com (in Indonesian). Kompas Gramedia Group.
  131. ^ Pratama, Fajar (31 October 2018). "Ketinggian Naik-Turun, Lion Air JT 610 Diduga Terbang Terlalu Cepat" [Altitude Rise, Lion Air JT 610 Allegedly Flying Too Fast]. Detik.com (in Indonesian).
  132. ^ "Analisa KNKT: Pesawat Lion Air PK-LQP Langsung Pecah dan Terbelah Saat Menghantam Air Laut" [NTSC Analysis: The PK-LQP Lion Air Plane Breaks and Splits Directly When It Hit Sea Water] (in Indonesian). Tribun News. 5 November 2018. Retrieved 7 November 2018.
  133. ^ "KNKT: Mesin Pesawat Lion Air Masih Hidup saat Menyentuh Air" [KNKT: Lion Air's Engine is Still Alive when Touching Water] (in Indonesian). Okezone. 5 November 2018. Retrieved 7 November 2018.
  134. ^ "KNKT: Airspeed Indicator Lion Air PK-LQP Rusak di 4 Flight Terakhir" [KNKT: Lion Air PK-LQP Airspeed Indicator Damaged on Last 4 Flights]. Detik (in Indonesian). Retrieved 7 November 2018.
  135. ^ "KNKT Curigai Kerusakan AOA Penyebab Lion Air PK-LQP Jatuh" [KNKT Suspects AOA Damage Cause Lion Air PK-LQP Falls] (in Indonesian). CNN Indonesia. Retrieved 7 November 2018.
  136. ^ "Crashed Lion Air 737 had damaged air-speed indicators". Phuket: The Thaiger. 7 November 2018. Retrieved 7 November 2018.
  137. ^ "Lion Air jet was not airworthy on the flight before crash, Indonesia investigators say". The Guardian. 28 November 2018. Retrieved 28 November 2018.
  138. ^ "Preliminary Aircraft Accident Investigation Report" (PDF). National Transportation Safety Committee. November 2018. Archived from the original (PDF) on 17 October 2019. Retrieved 30 November 2018.
  139. ^ a b c d e f "Boeing Statement on Lion Air Flight 610 Preliminary Report" (Press release). Boeing. 27 November 2018.
  140. ^ "Leehan News and Comment : About". Leeham. 12 March 2019.
  141. ^ Fehrm, Bjorn (28 November 2018). "Indonesian authorities release preliminary Lion Air crash report". Leeham News.
  142. ^ Sean Broderick; Adrian Schofield (30 November 2018). "Lion Air Interim Report Highlights Confusion And Dysfunction". Aviation Week & Space Technology.
  143. ^ a b Hepher, Tim; Silviana, Cindy (3 December 2018). "Exclusive: Lion Air ponders cancelling Boeing jets in row over crash - sources". Reuters.
  144. ^ "No public details on crashed Lion Air voice recorder until final report: Indonesian official". Reuters. 22 January 2019. Retrieved 23 January 2019.
  145. ^ Cindy, Silviana; Freed, Jamie; Hepher, Tim. "Panic, surrender: Doomed Lion Air jet pilot's last words revealed in recovered recording". ABS-CBN News. Reuters. Retrieved 29 March 2019.
  146. ^ "Official: 3rd pilot helped on next-to-last Lion Air flight". The Public's Radio. 21 March 2019. Archived from the original on 11 April 2023. Retrieved 29 March 2019.
  147. ^ "Boeing 737 Max Lion Air crash caused by series of failures". BBC News. 25 October 2019. Retrieved 25 October 2019.
  148. ^ Neuman, Scott (25 October 2019). "Indonesia Report: Pilots, Ground Crew Share Blame With Boeing For Lion Air Crash". NPR. Retrieved 26 October 2019.
  149. ^ Togoh, Isabel. "Lion Air Crash Report Faults Boeing 737 MAX Design Flaws, Pilot Errors". Forbes. Retrieved 26 October 2019.
  150. ^ Bjorn Fehrm (14 November 2018). "Boeing's automatic trim for the 737 MAX was not disclosed to the Pilots". Leeham News.
  151. ^ Dominic Gates (14 November 2018). "FAA evaluates a potential design flaw on Boeing's 737 MAX after Lion Air crash". Seattle Times.
  152. ^ "Flawed analysis, failed oversight: How Boeing, FAA certified the suspect 737 MAX flight control system". The Seattle Times. 17 March 2019. Retrieved 22 March 2019.
  153. ^ "FAA Issues 737 MAX Emergency AD". Australian Aviation. Aviator Media. 8 November 2018. Retrieved 15 November 2018.
  154. ^ "EMERGENCY AIRWORTHINESS DIRECTIVE #2018-23-51" (PDF). U.S. Federal Aviation Administration. 7 November 2018.
  155. ^ "FAA Urges Airlines to Follow Boeing's Advice After 189 People Killed in 737 MAX Crash". Time. Retrieved 7 November 2018.
  156. ^ "U.S. FAA revokes certification of Xtra Aerospace after Lion Air crash". Reuters. 25 October 2019. Retrieved 29 October 2019.
  157. ^ Dominic Gates (12 November 2018). "U.S. pilots flying 737 MAX weren't told about new automatic systems change linked to Lion Air crash". Seattle Times.
  158. ^ Sean Broderick; Bill Carey; Guy Norris (12 November 2018). "Pilots Unaware Of 737 Max's Automatic Stall-Prevention System". Aviation Week Network.
  159. ^ Jon Hemmerdinger (13 November 2018). "Airline industry rushes to understand nuances in 737 Max systems". Flightglobal.
  160. ^ Ostrower, Jon (13 November 2018). "What is the Boeing 737 Max Maneuvering Characteristics Augmentation System?". The Air Current.
  161. ^ Hemmerdinger, Jon (15 November 2018). "ALPA asks regulators to address 737 Max safety concerns". Flightglobal.
  162. ^ Gates, Dominic (16 November 2018). "Dispute arises among U.S. pilots on Boeing 737 MAX system linked to Lion Air crash". Seattle Times.
  163. ^ Ostrower, Jon (19 November 2018). "Boeing CEO disputes MCAS details "intentionally withheld" from airlines". The Air Current.
  164. ^ Mary Schlangenstein; Julie Johnsson (19 November 2018). "Boeing to Hold Global Airlines Call for Queries After Crash". Bloomberg.
  165. ^ Koenig, David (21 November 2018). "Boeing delays call to discuss issues with its newest plane". Associated Press.
  166. ^ "Boeing Statement On Lion Air Flight 610 Investigation Final Report - Oct 25, 2019". MediaRoom. Retrieved 29 October 2019.
  167. ^ Baker, Sinéad. "A Boeing employee called Lion Air, the airline in the first 737 Max crash, 'idiots' for asking to have its pilots trained in flying the plane". Business Insider. Retrieved 17 January 2020.
  168. ^ "Boeing Mocked Lion Air Calls for More 737 Max Training Before Crash". www.bloomberg.com. 14 January 2020. Retrieved 17 January 2020.
  169. ^ McCoppin, Robert. "Lawsuit filed in Cook County claims negligence by Boeing in Lion Air crash in Java Sea that killed 189". chicagotribune.com. Retrieved 31 December 2018.
  170. ^ "Lion Air Crash Families Say They Were Pressured to Sign No-Suit Deal". The New York Times. 21 March 2019. Retrieved 22 March 2019.
  171. ^ "More families sue Boeing over Lion Air crash, citing defective design and 'inadequate safety warnings'". Washington Post. 21 March 2019. Archived from the original on 22 March 2019. Retrieved 22 March 2019.
  172. ^ Gates, Dominic (25 October 2019). "FAA shuts down Florida repair firm that supplied faulty Lion Air sensor on Boeing 737 MAX". The Seattle Times. Retrieved 28 February 2024.
  173. ^ "Judge freezes assets of famed L.A. lawyer Tom Girardi, citing millions unpaid to clients", by Matt Hamilton and Harriet Ryan, Los Angeles Times, 14 December 2020. Retrieved 16 December 2020.
  174. ^ "‘Real Housewives’ star Erika Jayne accused in scheme to embezzle from Lion Air settlements", by Jon Seidel, Chicago Sun-Times, 2 December 2020. Retrieved 16 December 2020.
  175. ^ "Tom Girardi Disbarred, Court Orders $2.3 Million Restitution (1)".
  176. ^ "Ethiopian Airlines crash is second disaster involving Boeing 737 MAX 8 in months". cnn.com. 10 March 2019. Retrieved 10 March 2019.
  177. ^ "Grounded: Boeing Max 8". Mayday. Season 21. Episode 4. National Geographic Channel.
  178. ^ "Air Crash Investigation | National Geographic". www.nationalgeographic.co.uk. 5 April 2021. Archived from the original on 6 April 2021. Retrieved 7 April 2021.
  179. ^ Kenigsberg, Ben (17 February 2022). "'Downfall: The Case Against Boeing' Review: Behind Two Fatal Crashes". The New York Times. Retrieved 19 February 2022.
  180. ^ "Lion Air flight 610". Hard Landings Podcast. 19 March 2024. Retrieved 10 April 2024.
  181. ^ "American Scandal: Boeing". Wondery. 13 August 2024. Retrieved 8 October 2024.

Further reading

[edit]
  • Robison, Peter (2021). Flying Blind: The 737 MAX Tragedy and the Fall of Boeing (Hardcover). New York: Doubleday. ISBN 978-0385546492.
[edit]
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