What happened
On 22 January 2002, an Icelandair Boeing 757-208, registration TF-FIO, was performing a scheduled flight from Keflavik to Oslo Gardermoen. During the approach to runway 01L, the aircraft encountered a strong tailwind and a shortened approach path, which caused the flight to become unstabilized. The crew was also dealing with intermittent loss of ILS raw data on the commander's instruments.
At approximately 580 feet altitude, the commander initiated a missed approach. During the subsequent go-around maneuver, the aircraft entered a violent sequence of pitch changes. The aircraft first pitched up significantly, followed by a rapid nose-down input that resulted in a steep dive. During this maneuver, the aircraft reached a maximum pitch attitude of -49 degrees and experienced a peak load factor of +3.59 g's. The airspeed surged to 251 knots, significantly exceeding speed limits. The intensity of the maneuver caused significant chaos in the cabin, with loose items and even fluids from the lavatories being displaced throughout the aircraft.
The investigation
The Norwegian Safety Investigation Authority (NSIA) examined flight data recorder (FDR) information and interviewed the crew and passengers. The investigation established that the aircraft's structure remained intact despite the extreme load factors and overspeed. The investigation also noted that the aircraft continued its scheduled flight to Stockholm without a thorough technical inspection following the event.
Findings
- The primary cause of the upset was the failure to adhere to Standard Operating Procedures (SOP) regarding stabilized approaches and go-around planning.
- The crew failed to maintain a stabilized approach profile due to high workload, a strong tailwind, and a shortened approach path.
- The crew's cooperation broke down during the go-around, with conflicting manual control inputs contributing to the extreme pitch oscillations.
- The commander's focus was primarily on the intermittent ILS technical issues rather than the structural implications of the flight exceedances.
- The decision to continue the flight to the next destination without a comprehensive technical inspection was identified as a safety concern.
Safety action
Following the investigation, several recommendations were made, including a review of operational procedures for discontinued approaches and flight crew training regarding unstabilized approaches. Additionally, the investigation suggested that airlines should review procedures for providing support to passengers and crew following such serious incidents.