Hypoxia-induced crew incapacitation during emergency descent

Casualties unknown • Indianapolis, IN, US

A crew experienced multiple instances of unconsciousness due to hypoxia after an error led to a rapid loss of cabin pressure during flight.

What happened

While cruising at 33,000 feet, the cabin altitude warning horn activated. The captain identified that the right air conditioning pack had shut off. In an attempt to restart the pack, the captain and the flight engineer performed troubleshooting steps without utilizing a checklist.

As the cabin altitude rose to 14,000 feet, warning lights illuminated and oxygen masks deployed throughout the cabin. During the efforts to correct the cabin altitude, the flight engineer accidentally opened the outflow valve, which triggered a rapid loss of cabin pressure.

The resulting hypoxia caused the captain, the flight engineer, and the lead flight attendant to lose consciousness. The captain's loss of consciousness was attributed to a delay in donning his oxygen mask. The flight engineer lost consciousness after providing assistance to revive the flight attendant.

The first officer, who possessed 10 hours of experience in the aircraft, donned his oxygen mask immediately upon the initial warning horn sounding. Because he remained conscious, the first officer was able to initiate an emergency descent. During this descent, the captain, flight engineer, and flight attendant regained consciousness, allowing for an emergency landing at Indianapolis, Indiana. There were no injuries reported.

The investigation

The aircraft underwent inspection and flight testing the following day. The investigation found that the airplane's pressurization system functioned with no anomalies.

Probable cause

The rapid loss of cabin pressure was caused by the flight engineer inadvertently opening the outflow valve while attempting to correct the cabin altitude.

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Frequently asked questions

What happened in the 1996-05-13 Boeing 727-290 accident near Indianapolis, IN?

A crew experienced multiple instances of unconsciousness due to hypoxia after an error led to a rapid loss of cabin pressure during flight.

What aircraft was involved and where did it happen?

The accident on 1996-05-13 involved a Boeing 727-290, registration N775AT, operated by American Trans Air, at Indianapolis, IN.

What was the probable cause of the accident?

The rapid loss of cabin pressure was caused by the flight engineer inadvertently opening the outflow valve while attempting to correct the cabin altitude.

Investigation report by the U.S. National Transportation Safety Board (NTSB) historical archive. Original record: https://carol.ntsb.gov/event/20001208X05709. This page is a structured re-presentation; facts and quotes are in the National Transportation Safety Board (NTSB), United States.

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