It appears now as though the aircraft was landed after having lost partial hydraulics, both engines, much of the instrumentation, some control surfaces, and possibly some of the fuel system. It landed without the use of flaps. In an interview yesterday, both the Captain and the First Officer stated that there were "no computers alive" and that they were flying on back-ups assisted by the RAT (Ram Air Turbine). The First Officer said that they deployed the RAT and had very limited hydraulics and no flaps, and that they dropped the gear by using gravity.

-- Rachel Gibson (rgibson@hotmail.com), August 29, 2001

Answers

It will (as always) take a long time for the full investigation to be completed, but here are more preliminary details from Aviation Week:

URL: http://www.aviationnow.com/avnow/news/channel_maint.jsp? view=story&id=news/rts0827.xml

In-Flight Problem Starved Air Transat A330

By AviationNow.com Staff

27-Aug-2001 10:08 AM U.S. EDT

An Air Transat Airbus A330 en route to Lisbon that lost power to both engines and made an emergency landing in the Azores last week had enough fuel to make its scheduled trip when it left Toronto, the airline reports.

The lack of a fueling error on the trip's front end means investigators are focusing on events during the flight itself to explain why the twin-engine widebody ran out of fuel about two-thirds of the way through its flight to the Portuguese capital on Aug. 25. Representatives from Transport Canada, Airbus, and Rolls-Royce are among the team of technical experts dispatched to the scene following the incident.

Details released thus far remain sketchy. The airline confirmed that Flight 236, carrying 291 passengers and 13 crew members, had a "technical problem" while cruising at 39,000 feet about 30 minutes from the Azores islands. The plane rapidly lost fuel, and the captain elected to head for a Portuguese military base on the island of Terceira.

Flight 236 lost power in both of its Rolls-Royce Trent 772s "several minutes" before landing, but made the airfield. Everyone on board evacuated safely, although several passengers sustained significant injuries during the evacuation. The plane landed at 0417 local time on Aug. 25 (2317 Toronto time Aug. 24).

It is not clear if both engines were operating when the fuel problem struck. Several reports say the pilots had shut down one of the Trents because of an unrelated problem, then discovered the fuel issue.

When the plane ran out of fuel, it reportedly was about 10 minutes from land, meaning the crew was forced to glide the plane in and had no electrical power. Batteries and the ram air turbine gave the crew some power to work with, but they prepared for the worst, telling passengers and air traffic controllers that a water landing was possible.

On touchdown, eight of the A330's 10 tires blew - likely because the lack of electrical power took away the plane's anti-skid feature, meaning the tires locked up as soon as the pilots applied the brakes. Despite the tire failures, the pilots managed to stop the plane on the runway. Ninety seconds later, the A330 was empty.

"It seems clear that our pilots did an outstanding job," said Air Transat President Denis Jacob. "Evacuating such an aircraft in 90 seconds required quick and decisive action on the part of cabin personnel, with the goal being a rapid evacuation of the aircraft."

With a fueling error ruled out, investigators are looking at several explanations for what happened, including a fuel system failure that would have caused a major leak, a maintenance-related problem, or flight crew error - such as an inadvertent fuel dump.

Transport Canada moved quickly to make sure Air Transat doesn't have major procedural problems by suspending the carrier's A330 extended twin-engine operations (ETOPS) authority, which cuts the maximum diversion time allowance from 120 minutes to 60 minutes. The time is a reflection of how close, in minutes of flight time, an overwater flight must stay to alternate airports. "The suspension will remain in effect until Transport Canada is satisfied that no safety deficiencies exist," the regulator said.

Transport Canada is also reviewing the carrier's maintenance program, and will "conduct increased surveillance" of the carrier to ensure compliance with the Canadian Aviation Regulations.

"The measures announced by Transport Canada have a minor impact on the day to day operations of Air Transat's three Airbus A330s and no impact on its other 21 aircraft, nor does it impact its license, nor its transatlantic operations," the carrier said.

Air Transat, based in Montreal, has a fleet of 24 jets - two A330- 200s, one A330-300, four A310s-300s, six L-1011-500s, seven L-1011- 100s, and four 757-200s - and specializes in charters. It flew 3.5 million passengers in 2000. In 15 years, it has not "had any accidents causing injury," the airline said, adding that Flight 236 was the third emergency evacuation in its history.

Over the weekend, the airline flew one of its L-1011s to the Azores to pick up Flight 236's passengers and take them to Lisbon.

Air Transat's claim that enough fuel was loaded in Toronto means Flight 236's problems were not similar to another famous Canadian fuel-starved flight: Air Canada 143, otherwise known as The Gimli Glider.

That July 1983 incident was caused by a series of events that left the plane's fuel gauges inoperative, forcing en-route refuelers and the flight crew to calculate the amount of fuel on board by hand. But they all used an incorrect multiplier in their calculations - a standard value instead of a metric value - and mistakenly overestimated the amount of fuel on board.

The plane, headed for Edmonton from Ottawa, ran out of fuel about halfway into its journey. After the pilots realized they wouldn't make Winnipeg - their first diversion choice - they ended up landing in Gimli at a former Canadian Air Force base that was converted into an auto racing facility.

-- Andre Weltman (aweltman@state.pa.us), August 30, 2001.

The tires probably burst due to a hard landing. The anti-skid does not operate until the wheels start rolling. A generator in each wheel sends signals to a computer which then pulsates the brakes in order that the wheels turn at the same speed. This article does not mention any skidding and I would suspect that as the plane was operating on RAM power which will only supply the very basic needs of the aircraft the anti-skid was probably disabled.

If this plane has a glass cockpit, the gages are shown on the screen and the computer may not be properly indicating the fuel level signals from the fuel measuring system located in the tanks.

This emergency may have been an oversight of the ground personnel or the pilots but judging from the way these men handled this situation, an electrical or mechanical failure would be the most likely.

-- David Williams (DAVIDWILL@prodigy.net), August 30, 2001.

Headline: A330 Overwater Flameout Raises ETOPS Issues

Source: Frances Fiorino, Aviation Week & Space Technology, 31-Aug- 2001 9:48 AM U.S. EDT

URL: http://www.aviationnow.com/avnow/news/channel_maint.jsp? view=story&id=news/ts2360830.xml

NEW YORK - The Aug. 24 shutdown of both 71,000-lb.-thrust Rolls-Royce Trent 700 engines on an Air Transat Airbus A330-200 transiting the Atlantic Ocean stunned industry--and promptly stirred regulators, airlines and manufacturers to action, initiating engine and fuel system inspections and probes of training and maintenance practices.

In the wake of the near-catastrophic event, flight safety experts can be expected to revisit all aspects of extended twin-engine overwater operations.

Just last week, Canadian Transport Minister David Collenette revealed Air Transat agreed to a request by Transport Canada to implement special ETOPS training sessions for all flight crew as well as to review proper procedures, which include fuel management and the need to divert to the nearest alternate airport at first sign of engine- related emergency. In addition, Air Transat initiated a comprehensive review of the safety of its maintenance and operations and has provided Transport Canada with a corrective action plan.

The Portuguese safety board, the Gabiente de Pevencao e Investigacao de Acidentes com Aeronaves (GPIAA), is leading the investigation, with assistance from the Transport Safety Board of Canada and DCGA, the French civil aviation authority. GPIAA's preliminary report determined that both engines failed as a result of fuel starvation, and that a low-pressure fuel line on the No. 2 engine, Rolls-Royce Trent 700 serial no. 41055, had failed "probably as a result of its coming into contact with an adjacent hydraulic line" (see p. 36).

Montreal-based Air Transat Flight TS236, an A330-200, C-GITS, departed Toronto Lester B. Pearson Airport as scheduled, at 8:10 p.m. (EST) on Aug. 23, en route to Lisbon, with 293 passengers and 13 crewmembers. The twin-engine aircraft is certified to operate under the ETOPS 120-min. rule, that is, permitted to divert with one operable engine to an airport that is up to 2 hr. away.

Flight TS236 was cruising at Flight Level 390 (39,000 ft.). At 0536Z, the flight crew became aware of a fuel imbalance between the left and right wing main fuel tanks. At about 0541Z, the crew, concerned about the lower-than-expected fuel quantity indication, elected to divert from the intended flight route to Lajes Field (LPLA), which is located on the northeast tip of Terceira Island in the Azores--850 mi. west of Lisbon.

At 0548Z, the crew ascertained a leak might be the cause of the fuel loss and declared an emergency to Santa Maria Oceanic Control. At 0613Z, with Flight 236 135 mi. distant from Lajes, the flight crew alerted air traffic control of the failure of the right Rolls-Royce Trent 772-211B engine.

About 13 min. later, about 85 naut. mi. from Lajes at an altitude of about FL345, the left engine failed. The flight crew advised ATC that ditching at sea was a possibility.

The aircraft, which has a range of 5,600 naut. mi., and can accommodate up to 406 passengers in high-density configuration, became a glider. Its fuel supply--tanks have a maximum capacity of 36,750 U.S. gal.--was apparently depleted.

The cabin crew prepared the passengers for ditching at sea and issued brace command. ATC provided radar vectors to the flight crew, who proceeded on an engines-out night visual approach in what the GPIAA described as good weather conditions--wind 330 deg. at 8 kt., visibility unlimited, few clouds at 2,500 ft. and 5,000 ft. and temperature at 19C.

When the A330 touched down on Lajes' 10,865 X 300-ft. Runway 33 at 0646Z, eight of 10 tires ruptured. The GPIAA report said small fires that started in the main gear wheels were extinguished by crash response vehicles in position at the field. "There was no evidence of fire on the engine or fuel system," an Air Transat official said.

The GPIAA said nine passengers and two cabin crewmembers received minor injuries in the emergency evacuation, which, according to Flight Director Meleni Tesic, was completed in 90 sec. Reportedly, there was no fire or smoke in the cabin.

Passengers described the landing as "brutal" and "hysterical" and some accused the cabin crew of panicking. Tesic said there "was absolutely no panic in the cabin." With no PA system, she explained, attendants must shout as loudly as possible so passengers can hear safety instructions. Some passengers may have misconstrued the shouting for panic behavior.

Capt. Robert Piche said at a press conference he was "fully confident" the aircraft was loaded with fuel when the flight departed Toronto Pearson. He said he had minimum power with which to control the aircraft on descent to Lajes.

Passengers and the public hailed the flight crew as heroes, but Piche dismissed this, saying, "I was only doing my job . . . . we train for the worst." First Officer Dirk DeJager agreed. Piche, 49, and with 30 years of airline experience has been employed by Air Transat for nearly five years. DeJager, 28, has been flying with Air Transat for about five years.

No one had to be reminded of possible endings for the TS236 story. Lajes, a U.S. air base from which air crews and support troops are deployed, has high terrain to 1,925 ft. 2.75 naut. mi. west, and 503 ft. 0.25 naut. mi. east. From October to May, strong winds create hazardous crosswinds.

Immediately following the incident, the Transportation Safety Board of Canada suspended that country's largest charter airline from operating 120-min. ETOPS for its three A330s in a fleet of 24 aircraft, and launched a special audit of the carrier's maintenance practices. It also increased surveillance of Air Transat's aviation program to ensure compliance with Canadian Aviation Regulations. "The issue is that a leak in a pipe should not result in two engine shutdowns. That is a serious concern," said TSB Chairman Benoit Bouchard.

Air Transat called the rule "normal" and "a usual procedure in this type of circumstance" and did not expect it to have more than a minor impact on day-to-day operations. The carrier is to continue to fly ETOPS under the 60-min. rule, that is, an engine-out aircraft must be no more than 1 hr. from an airport. This means Air Transat will fly routes closer to land masses.

As a precautionary measure, Air Transat completed inspections of its engines on its A330s. Air Canada, which operates eight A330s, all of which have Rolls-Royce Trent 700 engines, undertook and completed inspection of the powerplants to ensure no mechanical conditions existed of the type that may have contributed to the Air Transat emergency.

On Aug. 29, Airbus issued an AOT (All Operators Telex) to operators of Airbus aircraft equipped with Rolls-Royce Trent 700s, saying the source of Air Transat's fuel leak is "a damaged fuel feed pipe." Further, it says the damage is "due to interference with the hydraulic pipe from the aft hydraulic pump in the vicinity of the HP fuel pump inlet" and that the interference can result in "a significant fuel leak." It says the pipes are modified as part of Rolls-Royce service bulletin RB211-29-C625. Complete application of the SB would ensure adequate clearance, according to the AOT, adding that the SB appears to "be partially applied on the affected engine."

The aim of the AOT is to launch a one-time inspection of the A330/Trent 700 fleet and spare engines, to ensure there is no interference between the parts in question and to complete that inspection within 72 hr. of receipt of the AOT.

Air Transat late last week was trying to regain its equilibrium. The carrier, a subsidiary of a leading Canadian travel services company, Transat A.T., began operations in 1987. Air Transat operates charters from Canada and Europe to southern destinations. It has a total fleet of 24 aircraft, including three A330s (two -200s and one -300), four A310-300s, six Lockheed L-1011-500s, seven L-1011-10s and four Boeing 757-200s. The airline says it transported 3.5 million passengers last year.

The company has not had any accidents causing injury, nor has the aircraft involved in the Lajes occurrence been implicated in another incident. According to Air Transat President and CEO Denis Jacob, the carrier has had 54 minor events out of 2,800 listed for Canada's total air industry.

The Lajes incident, however, is the second emergency evacuation for the carrier within seven days. On Aug. 18, smoke issued from the cabin ceiling lights of an L-1011 as it taxied to the departure runway at Orlando, Fla., with 324 passengers and 14 crew on board, The pilot ordered an evacuation that resulted in a few minor injuries.

The crippled A330 sat on Lajes sole runway, forcing the airport to cease flight operations, stranding about 600 passengers, until Aug. 28, when repair crews arrived with equipment to move the aircraft.

-- Andre Weltman (aweltman@state.pa.us), September 04, 2001.

Thanks for the update, Andre. I haven't bothered posting ensuing articles, but this story is still front and centre in Canadian news. Re ETOPS, as soon as the accident happened, Transport Canada limited Transat's overseas flights from 120 minutes away from a landable airport to 60 minutes. AFAIK, that's as far as the ETOPS issue went, with this airline anyway.

Other stuff: a Montreal paper dug into Piche's past to learn he had been caught smuggling marijuana and spent two years in a Georgia prison for it. Didn't tarnish the significance of his recent piloting accomplishment, though.

Airbus had issued service bulletins in the past warning airlines to be sure not to get fuel line and hydraulics line too close together when working on the engines. As you've gleaned, this particular airplane's engine was replaced five days prior to the incident. It is surmised that chafing of one on the other caused the leak, which was a huge one. It would appear that somehow the crossfeed was activated to pump fuel from the left tank to the right one, where the leak was situated. The jury is still out on whether the activation was caused by pilots, by software, or by some other as yet unexplained action.

Back to the service bulletin. The Globe and Mail has published several articles with supposedly inside information indicating that a supervisor signed-off the engine replacement work against the wishes of the head mechanic, who may or may not have taped a telephone conversation in which the supervisor wanted the airplane back in action regardless of the mechanic's wishes. The mechanics' union has gotten involved, speaking publicly about this situation when apparently it did not have the right to.

In short, it's quite a mess. Transat's sales are plummeting, as are the value of its shares. So, while ETOPS may or may not be a general concern for two-engine airplanes on over-water flights, airplane maintenance issues appear to be taking precedence at the moment.

-- Rachel Gibson (rgibson@hotmail.com), September 04, 2001.