Aviation on January 13, 1982, an Air

Aviation

On January 13, 1982, an Air Florida operated Boeing 737 crashed. Flight 90, with call-in nickname Palm 90, was schedule to fly from Washington, D.C. To Fort Lauderdale via Tampa. The flight crashed seconds after takeoff, just a mile from the Washington National Airport (Kaye, 2009). The Palm 90 disaster was the "the first major airline accident attributed to organizational factors," (Ciavarelli, 2007, p. 1). Some of the potential causes of the disaster are attributed to organizational factors such as Air Florida being an "upstart airline" that was willing to "cut corners," (cited by Kaye, 2009). A "poor decision chain" that included inadequate staff training, errors in judgment, "inappropriate procedures," and communication breakdowns were the primary factors in the accident (Ciavarelli, 2007, p. 2).

Weather was an intervening factor, but it was human error that caused the crash itself. At the time of scheduled departure, there was a blizzard in the area that was severe enough to shut down local schools. In fact, "The airport was closed for most of the day due to the severe weather, but was re-opened just prior to the accident," (Ciavarelli, 2007, p. 1). If robust safety procedures had been followed, the Palm 90 disaster could have been averted.

Pilot error was a major reason for the Palm 90 disaster. "Instead of leaving the cockpit to make a visual inspection, Capt. Larry Wheaton relied on an employee stationed inside the terminal to glance at the plane" to check for potential weather-related problems such as ice on the wing (Kaye, 2009). Furthermore, the pilot and co-pilot both neglected to turn on the anti-ice mechanism "that would have thawed the engines and ensured proper power readings on their cockpit instruments," (Kaye, 2009). Furthermore, Boeing had published air safety bulletins that specifically warned pilots about snow and ice on the wings; either the pilots never received the bulletins or chose to ignore them (Ciavarelli, 2007). The National Air Disaster Alliance also claimed that the pilot was inexperienced (Kaye, 2009).

Part Two

The Loss Causation Model is one developed by Bird and Germaine (cited by OHS Body of Knowledge, 2012). It is a relatively simple linear model that reveals five main stages to an accident. The Loss Causation Model places accidents within an organizational culture and social context. It can be readily applied to the Air Florida Palm 90 disaster.

The first component of the model is a lack of control, meaning a lack of adequate safety standards or inadequate compliance with existing safety standards. Clearly the pilots did not comply with known safety standards regarding de-icing the wings before taking off in bad weather. Furthermore, Air Florida as a new company had not provided employees with sufficient safety training. There was, as Ciavarelli (2007) puts it, no safety culture in place.

Second, basic causes of the accident include personal and job factors. In the case of the Air Florida accident, the co-pilot is heard as being timid on the flight recorder and might have prevented the accident had he been more confident and willing to speak up to his superior. Other job factors include the lack of training offered to assisting personnel such as flight attendants.