All language subtitles for Air Disasters S18E01 Cockpit Failure 1080p PMTP WEB-DL DDP5 1 H 264-maldini_track3_[eng]

NARRATOR: Zurich
airport, November, 2001.

Crossair flight 3597 is one of
the few planes left to land.

The commander was
flying out of Zurich

for the last 20 years.

So he was really
used to this airport.

Crossair, three--

NARRATOR: The lone controller in
the tower tracks the approach.

Approach runway 28 for you.

I have ground contact,
we're continuing on.

Crossair 3597,
continue speed reduction

to final approach speed.

NARRATOR: But for some reason,
the crew can't find the runway.

Damn.

He said he saw the
runway 1.3 miles.

NARRATOR: And the
flight ends in disaster.

Crossair 3597,
this is Zurich tower.

Do you copy?

We have a possible
emergency and a--

He collided with the hill,
so obviously he was too low.

NARRATOR: A terrible
mistake sent

a passenger jet dangerously
off course, killing 24 people.

The clues will
lead investigators

to a trained professional,
with an astonishing past.

WOMAN: Ladies and gentlemen,
we are starting our approach.

MAN: We lost both engines.

WOMAN: Put the mask over your
nose, emergency descent.

MAN: Mayday, Mayday.

WOMAN: Brace for impact.

MAN: This is the last one.

MAN: It's going to crash.

NARRATOR: Crossair
flight 3597 is cruising

at 27,000 feet above Germany.

As the autopilot
flies the plane,

the crew begins reviewing
procedures for their landing.

According to the report, the
apron and taxiways are wet.

Braking actions not specified.

So the friction
report is missing?

Indeed.

That usually
means they haven't

been out to check lately.

Indeed.

NARRATOR: It's the
last flight of the day

on this busy European route.

The 410 mile journey from
Berlin South to Zurich

takes only an hour and a half.

There are many empty
seats on board.

A group of 21 passengers never
showed up for the flight.

Internet entrepreneur
Peter Hogenkamp

is returning from a
business trip in Germany

with his partner,
Jaqueline Badran.

On that day, we wanted
to take the train.

But we had to be in
Zurich for that opening

ceremony of that trade
show, so we said,

OK, so we need to go by plane.

Yes.

We have got
to get some sleep.

It had been a very busy
day, so we were very tired

when we arrived at the airport.

How are you?

NARRATOR: Among the passengers
is the girl band Passion Fruit,

Germany's answer
to the Spice Girls.

They're on their way to perform
the last show of a concert

tour.

Yes.

I was shocked when suddenly
all the Passion Fruits, all

the three of them
are coming over,

and they were sitting
right in front of us.

Just what I needed.

NARRATOR: Flight 3597
is an Avro 146 airliner.

It's a British made jet,
popular with regional airlines,

like Crossair.

Captain Hans Ulrich
Lutz is in command.

He's been with the airline
for more than 22 years,

having served as a
pilot and an instructor.

So, tell me about the
runway and the conditions.

Overcast with light snowfall,
visibility 3,000 meters.

NARRATOR: First
officer Stephan Lohrer

is a newcomer to the airline.

He's had his pilot's license
for just a year and a half.

He was hired by Crossair
right out of flight school.

Hello.

The Passion Fruits
were being quite noisy.

They were excited, I think, they
went from one gig to the other.

So, they were still in
their stage clothes.

I said, oh, my God,
do I really need this?

Can I just sleep?

It's probably OK to move.

We decided to move
back a few rows,

and change the side
where we were sitting,

so we were in a very
quiet area then.

WOMAN: Oh, my goodness.

Yes, oh, my gosh.

AIR TRAFFIC CONTROLLER:
Crossair 3597,

clear to flight level 160.

NARRATOR: The flight is
slightly behind schedule.

It's due to land in Zurich
in less than half an hour.

According to the
latest information,

we'll be using runway 14.

What kind of approach?

ILS approach.

OK.

NARRATOR: An ILS, or instrument
landing system approach,

means the pilots will
be guided to the runway

by radio signals beamed
from the airport.

And a decision
altitude of 1602 feet.

Call me 100 above minimums.

OK.

I'll call 100 above minimums.

NARRATOR: The plane's
sophisticated computers

will do most of the
work getting them down.

At Zurich airport, the
weather is getting worse.

It's snowing, and
visibility is dropping.

Crossair 3191, turn
left, heading 150.

NARRATOR: In the
tower, controllers

have started a nightly routine.

A supervisor sends out a
message, notifying crews

that runway 14 is being
taken out of service,

because of a
controversial new law.

Planes landing on
runway 14 must fly

over Germany on their approach.

But people in Germany have long
complained about the noise.

Because of the
political issue,

airplanes had to
fly over Switzerland

in their final descent
to the airport of Zurich,

for noise reasons.

There was no other operational,
or weather reasons, whatsoever.

It was purely political.

NARRATOR: Switzerland
has agreed to shut down

runway 14 after
10:00 PM, to keep

landing planes out
of German airspace,

and use runway two instead.

The crew hasn't received
this information yet.

But first officer Lohrer is
familiar with the new rule.

Should I ask if
it's still runway 14?

It's almost 10:00.

Yes, I'm pretty
sure it's still 14.

Zurich approach,
Crossair 3597,

please confirm the approach
in use is the ILS 14.

Crossair 3597,
you're identified.

It will be a VOR/DME,
approach runway 28 for you.

Oh, hell.

What next?

OK, fine.

NARRATOR: Unlike runway 14, with
its sophisticated instrument

landing system, runway 28 is
not equipped for ILS landings.

Instead, it has a less
accurate navigational system.

It's called VOR/DME.

A radio beacon sends
information to the aircraft

about its distance from the
runway, and whether it's left

or right of it.

It provides no guidance
on the plane's altitude.

Pilots would rather not
make VOR approaches,

because they place a greater
workload on the flight crew.

He would always prefer an
ILS approach, because he gets

guidance on the approach slope.

And he can also
use his autopilot

to guide him down, literally
on the ground to the runway.

NARRATOR: Because of its
less precise technology,

runway 28 was rarely
used for landings

before the new noise law.

OK, then, re
briefing for runway 28.

That would be chart 13-2.

NARRATOR: Now, captain Lutz
abandons the ILS approach

he was planning, and prepares
his first officer for

the new non precision approach.

Are you familiar
with the 28 approach?

Yes, I've done it
a couple of times.

NARRATOR: The crew goes over
every detail of how they

will approach Zurich airport.

Drazadingen Zurich,
east, 6,000 feet.

NARRATOR: There are only a few
planes left to land tonight.

3597.

NARRATOR: Including flight
3597, and two other Crossair

flights just ahead of it.

As the aircraft
approached the runway,

controllers need
to keep them apart.

Crossair 3597, reduce
speed to 180 or less.

Speed 180 or
less, Crossair 3597.

NARRATOR: Captain Lutz
makes the final turn to line

his jet up with the runway.

160 knots.

NARRATOR: The plane is now in
the thick of the heavy weather

surrounding Zurich.

At the airport, the
second to last Crossair

flight touches
down on runway 28.

Now, with only
flight 3597 to land,

the supervisor decides
to head home early.

The controller
handling the aircraft

is the only controller
left in the tower.

Crossair 3597,
continue speed reduction

to final approach speed.

PILOT: Zurich tower,
this is Crossair 3891.

NARRATOR: She gets
a report from one

of the planes that just landed.

PILOT: Visibility approaching
28 was borderline.

We could only see the
runway from 1.3 miles out.

NARRATOR: But Captain Lutz
knows Zurich airport well.

He continues toward the runway.

Gear down.

NARRATOR: The plane begins the
final stage of its approach.

Cabin crew,
prepare for landing.

NARRATOR: Captain Lutz
begins slowing the jet,

and puts it into
a steep descent.

Six miles is checked.

Yes.

Flaps 33.

Flaps 33 selected.

Final check.

Final check,
confirmed three greens.

Is checked.

116 knots.

NARRATOR: The descent
gets even steeper.

Full flaps set.

Checked.

Captain Lutz expects it to
come into view any second now.

100 above.

Do we have ground contact?

Yes.

NARRATOR: Passengers prepare
themselves for landing.

We were pretty
close to the airport,

so you think, OK, this
is going smoothly.

But it was dark,
and it was snowing,

so we couldn't see anything.

NARRATOR: In the
tower, the controller

monitors the flight to make sure
it's lined up with the runway.

Crossair 3597, cleared
to land, runway 28.

24, the minimum.

24.

NARRATOR: The flight has hit
minimum descent altitude,

2,400 feet above sea
level, 1,000 feet

above the ground near Zurich.

Minimum descent altitude is the
minimum height you can descend,

before you need to decide
whether you can see the runway,

and continue the
approach visually,

or you have to make a
decision to go around.

I have ground contact,
we're continuing on.

RECORDED FEMALE VOICE: 500, 500.

NARRATOR: Captain Lutz still
can't see the runway lights,

but knows that the flight ahead
of him has the same problem.

Damn.

He said he saw the
runway 1.3 miles.

NARRATOR: They should almost
be on top of the runway by now.

But for some reason,
they still can't see it.

Make a go around?

Yeah.

Crossair 3597,
cleared to land.

NARRATOR: The crew decides
to abort the landing.

Go around.

Go around.

NARRATOR: And pushes
the plane to its limits,

in an effort to get it to climb.

Captain Lutz throttles up
his plane's four jet engines,

as he aborts his landing
at the Zurich airport.

But it's too late.

There's not enough time for the
engines to get to full power,

and clear a tree covered hill
suddenly looming dead ahead.

Residents of a nearby
village witnessed flight's

3597's final moments.

I was walking
down with my dog.

All of a sudden, I
saw that aircraft

coming from behind the
forest, the little hill.

And I thought,
oh, it's very low,

and it's not on the
same route as aircrafts

normally are coming to land
at the airport of Zurich.

NARRATOR: The jet
clips the treetops.

Suddenly, it was
shaking very hard.

What's happening?

Something is wrong.

NARRATOR: Moments
later, the aircraft

plunges into the hillside.

Ah!

Crossair 3597,
this is Zurich tower.

Do you copy?

Crossair 3597, this is
Zurich tower, do you copy?

All of a sudden, the
whole sky in the West

was getting really
orange, like a big fire.

Like an explosion.

NARRATOR: The impact
tears the aircraft apart.

The wings broke off, and
the fuel is in the wings.

So the flames really sort
of shot inside the plane.

Crossair 3597,
this is Zurich tower.

Do you copy?

This is Zurich tower.

We have a possible emergency
in approach sector East.

I repeat, approach sector East.

NARRATOR: Crossair
3597 has crashed

near the village of Basserdorf,
Northeast of Zurich.

Some people have
survived the accident,

including Peter Hogenkamp
and Jacqueline Badran.

I don't have any memory
of how we really walked out,

because the back was cut off.

And we were just able
to walk out there.

NARRATOR: One member
of Passion Fruit

also survives, but her two
bandmates seated just one row

ahead of her have been killed.

Within minutes, emergency
workers get to the crash site.

Hey, over here.

Over here!

Over here!

NARRATOR: 24 of the 33
people on board Flight 3597

are dead, including Captain
Lutz and first officer Stephan

Lohrer.

Daniel Knecht, an investigator
from Switzerland's

Aircraft Accident Investigation
Bureau arrives on the scene.

DANIEL KNECHT: I got the
call from our rescue service,

about half past ten
in the evening.

Half an hour later, I
was on the accident site.

The rear part of the
fuselage was quite intact.

It was also the region
where most of the survivors

stepped out without injury.

NARRATOR: For Peter
Hogenkamp and his partner,

it appears moving to the rear
of the plane saved their lives.

I think it was just good luck.

I think it would have been a
whole different story if we

wouldn't have changed seats.

So, the Passion Fruits
may have saved our lives.

NARRATOR: While rescuers
care for the survivors,

Knecht and his team
survey the crash site.

The location of the wreckage,
far from the airport,

is of interest to
the investigators.

Four kilometers and 50
meters from the runway.

The aircraft was not
where he was intended to be.

He collided with a
hill East of runway 28,

so obviously he was too low.

And the first question was,
why was this aircraft too low?

NARRATOR: The black
box flight recorders

are found in the wreckage.

They're in good condition.

is the worst aviation
disaster on Swiss territory

in over a decade.

They're under pressure
to find answers fast.

While work continues
at the crash,

a command post is
established nearby.

Jean Overney heads the
Swiss Investigation Bureau.

He takes charge of
the Crossair file.

The public was very
anxious about this crash.

The media were raising
many questions,

so we naturally had to open a
more in-depth investigation.

NARRATOR: The accident
happened at the end

of a long day for Captain Lutz.

But given his
background, investigators

must consider other causes.

We knew that the captain
was very experienced.

He had about 17,000 flight hours
during his whole career, flight

instructor, flight examiner,
within the company,

for more than 20 years.

NARRATOR: The flight recorders
are sent to a lab in Paris

to extract their data.

At the same time,
investigators have

begun retrieving fragments of
wreckage from the crash site.

They look for telltale
signs of trouble.

DANIEL KNECHT: The position
of switches is very important.

Also, if you have some
indication panels, for example,

with bulbs in it, you
can, after a crash,

you can analyze the
different wires in the bulbs.

And then you can determine
which, for example,

indications, or even warnings,
were active at the moment

of the impact.

NARRATOR: An investigator comes
across an intriguing piece

of wreckage.

Oil gauges provide
information about the oil

flowing to the plane's
four turbofan engines.

Curiously, one of them
is installed upside down.

This raised a lot of questions
for us, and for the media.

Everyone wanted to
know how you could

fly a plane with an instrument
installed upside down.

It wasn't a very
important instrument.

You could still read it, even
if it was installed upside down.

NARRATOR: But if this obvious
problem was never fixed,

what else could be
wrong with the plane?

Obviously, there were
maintenance issues here.

We looked at how the
company was doing

the maintenance of the planes.

NARRATOR: While this
review is being launched,

investigators study
the plane's engines

to determine if
they were running

at the time of the crash.

Soil, tree branches, and other
debris lodged inside the engine

suggest they were.

We checked them
out visually, and we

saw that the four
engines were turning

at the moment of the accident.

NARRATOR: Authorities
need to be sure.

They will have to check
their findings against data

from the flight recorders.

In the meantime, the
location of the crash

suggests something
may have tragically

misled the crew on their
descent toward Zurich airport.

Knecht focuses on the
flight charts they

use to plan their approach.

Is the problem
with the approach,

or is the problem
with the aircraft?

This kind of question
was dominant when

we started the investigation.

Are you familiar
with the 28 approach?

Yes, I've done it
a couple of times.

NARRATOR: The approach
chart provides pilots

with directions to the runway.

Trazadingen Zurich.

NARRATOR: Details about
radio frequencies,

as well as altitudes and
speed for various stages

of the landing.

When investigators
study an approach

chart like the
one the crew used,

they make a shocking discovery.

The chart does not show
the hill the plane hit.

An approach chart is
a very important thing,

because an indication which is
not correct on this approach

chart could mislead a crew.

And so, easily make
them do something wrong.

So, tell me about the
runway and the conditions.

Overcast with light snowfall.

NARRATOR: A faulty chart would
certainly have been a danger

to a crew unfamiliar
with Zurich airport,

but Lutz had flown in and out
of Zurich countless times.

He and his first officer
were both based in the city.

The commander was flying
out of Zurich, I think,

for the last 15 to 20 years.

So he was really
used to this airport.

NARRATOR: Investigators conclude
that the approach chart,

while faulty, could
have tripped up

some crews, but not this one.

Some definitive news
finally arrives.

The engine data
from the black box

confirms the observations
at the crash site.

We could see, quite
easily, that the engines

worked absolutely normally.

NARRATOR: Another potential
cause of the accident

is eliminated from the
list, mechanical failure.

Investigators now consider
a different possibility.

I was covering the
approach West position

on the night of the accident.

NARRATOR: Could air
traffic control have

somehow mishandled the plane?

Investigators study records
from the night of the accident,

and make a disconcerting find.

Zurich airport's control
tower was understaffed

at the time of the accident.

He left before
his shift ended.

NARRATOR: The
supervisor in the tower

went home early, leaving
a lone controller to guide

flight 3597 in for its landing.

She was relatively young,
and let's say she didn't

have that much experience.

NARRATOR: Investigators
now study transcripts

of conversations
between that air traffic

controller and the flight crew.

Crossair 3597.

Cleared to land.

NARRATOR: They find no
indication the controller gave

the crew faulty
instructions, but they

do come across the
radio call by the pilot

of the Crossair flight that
landed minutes earlier.

PILOT: Crossair 3891.

Visibility approaching
28 was borderline.

We could only see the
runway from 1.3 miles out.

NARRATOR: That pilot warned of
poor conditions on the approach

to runway 28.

She had options.

NARRATOR: They wonder
why the controller

didn't shut the runway down.

Because of poor
visibility, she could

have reopened runway four,
in spite of the noise by law.

This would have
allowed the crews

to make an instrument approach.

But she didn't do that.

Thank you, Crossair 3891.

Have a good evening.

It would have been
much easier to fly ILS

approaches in this kind
of area, regardless

of this political issue.

NARRATOR: It's suspected that
without her supervisor present,

the controller
lacked the experience

to make such an important call.

So it's clear that
to make the decision

not to allow an
approach on runway 28,

and instead make
it on runway 14,

demanded a certain
kind of confidence,

a certain kind of courage.

NARRATOR: However, captain Lutz
also heard the same warning.

PILOT: Was borderline.

We could only see the
runway from 1.3 miles out.

Gear down.

NARRATOR: He kept
going in spite of it.

Investigators are now
certain that the controller

was in no way responsible.

A pilot can always say no.

He can always recheck
the clearance.

If he thinks that landing
is probably not possible,

he is free to retract
an approach clearance,

and ask for a different one.

NARRATOR: Jean Overney
can't understand why Captain

Lutz didn't do exactly that.

He should have
known that he didn't

have to make a non precision
approach in bad weather.

When we saw the mistake
the pilot had made,

we immediately asked ourselves,
well, how is it possible?

Because for an experienced
pilot, who was an instructor,

this was a really basic mistake.

NARRATOR: Overney is beginning
to wonder if something

in Lutz's long career is
hiding clues about his behavior

on the night of the accident.

out the possible causes of the
crash of Crossair flight 3597.

They hope the answer lies in
the cockpit voice recorder,

or CVR, of the doomed jet.

After waiting many days for
its data to be sent back

from France, they now
pore over it carefully,

listening for any clues
that might explain why

the plane was flying so
close to the ground, so far

from the airport.

HANS LUTZ: 16 knots.

LNAV is engaged.

NARRATOR: Authorities get
more than they expected.

Not only is the
CVR complete, but

Captain Lutz offers
a running commentary

on everything he does.

And on inbound track 275.

Speed is checked, flaps 18.

NARRATOR: It's practically
a roadmap to understanding

what went on in the cockpit.

HANS LUTZ: Flaps 33.

That's not usual,
that the pilot flying

is talking so much about what he
is doing, or what he is seeing.

And for the investigation,
this helped a lot.

100 above.

Do we have ground contact?

STEPHEN LOHRER (BY CVR): Yes.

NARRATOR: Investigators learned
that the crew of flight 3597

was looking for the
runway, and believed

it would soon come into view.

From the CVR, we saw
that the commander,

and also his co-pilot,
were not feeling some fear,

or feeling that something was
not going as they planned.

NARRATOR: But what
they didn't know

was that the plane was actually
four miles shy of its target.

Damn.

He said he saw the
runway 1.3 miles.

RECORDED FEMALE VOICE: 300.

NARRATOR: Captain Lutz obviously
thought his jet was closer

to the runway than it was.

Investigators consider
the possibility

he was misled by his distance
measuring equipment, or DME.

It's supposed to tell pilots how
far they are from the airport.

The DME indication would
have given this distance,

and then he would have
detected immediately--

Damn.

--that he was below
the approach pass.

NARRATOR: Perhaps the DME
from flight 3597 was faulty.

It's been recovered
from the wreckage,

but it's impossible to tell what
information it gave the pilots.

However, there is another way
to check whether the instrument

was functioning or not.

The DME distance is
not recorded on the FDR,

but on two occasions, the
pilots mentioned the distance.

Six miles is checked.

Yes.

NARRATOR: Investigators compare
the time Lutz checked his DME

with radar data on the
aircraft's location,

at that exact same time.

They can see that when Lutz's
instruments were telling him

he was six miles out, that's
precisely where he was.

So, we knew that
the pilots had

an indication for the distance
available at that time.

NARRATOR: An instrument
problem can now be crossed off

the list as a factor
in the crash, which

only heightens the mystery.

I have ground contact,
we're continuing on.

NARRATOR: If the
instrument was working,

why did Lutz think he
was closer to the runway

than he actually was?

The answer lies not
in what investigators

hear on the cockpit
voice recorder,

but what they don't hear.

I don't see anything
after six miles.

Do we have ground contact?

NARRATOR: Neither pilot
read out a DME check

after the six mile reading.

Yes.

NARRATOR: It tells investigators
that Lutz wasn't monitoring

his vital instruments during the
final minutes of his approach.

Instead, he was
preoccupied with spotting

the lights of the runway.

That's not what pilots
are supposed to do.

The pilot flying is
supposed to keep his eyes

on the instruments, because
all the information he needs

is there.

He only switches to flying
by sight when the non flying

pilot says runway in sight.

Only then can the captain take
his eyes off the instruments,

and fly by sight, because the
landing is performed visually.

NARRATOR: If Lutz had
checked his instruments,

he would have known how far
from the runway he actually was.

RECORDED FEMALE VOICE: 500.

NARRATOR: But how
had he ended up

such a long distance from it?

RECORDED FEMALE VOICE: 400.

Confirmed, three greens.

RECORDED FEMALE VOICE: 400.

Is checked.

116 knots.

NARRATOR: Further analysis
of the black box data

reveals that Lutz put his
plane into a steep descent,

as it began its final
approach to Zurich airport.

But it's readily
apparent his approach

profile was out of sync
with the trajectory

laid out in his chart.

The approach profile
for runway 28

calls for pilots to make a
gradual and steady descent,

which would bring
them to 2,400 feet,

after they've cleared
the hills around Zurich.

Then, pilots have to level off
until they spot the runway.

When investigators compare
the approach Lutz made,

with the approach profile
he was supposed to follow,

they find that his
overly steep descent

brought him to 2,400 feet well
before he cleared the hills.

Then, he continued to descend
until he hit the ground.

It's beginning to
look like Lutz had

violated one of the
cardinal rules of flying.

Aircraft making non
precision approaches

are supposed to level
off at minimum descent

altitude, or safe height, until
they have the runway in view.

This safe height is intended
to keep the aircraft

above any potential hazards.

DANIEL KNECHT: It's
really a basic error.

Every pilot is trained
to respect such minimums.

Not only with
VOR/DME approaches,

but also with ILS approaches.

NARRATOR: But Captain
Lutz kept his aircraft

in a steep descent, without
even pausing at 2,400 feet.

The logical next question
for investigators,

could he see the runway or not?

I have ground contact.

We're continuing on.

What does he mean
by ground contact?

NARRATOR: They need
to know if it was even

possible for Lutz
to see the runway

when he reported ground contact.

They retrace his
steps in a simulator,

programmed with the weather
he was facing that night.

Six miles from runway,
altitude 3,300 feet.

4.8 miles, 2,400 feet.

Still no runway in sight.

No, he couldn't
see the runway,

because there was a hill
between him and the runway.

And at that altitude, there
is no way he could see it.

NARRATOR: The
conclusion, captain

Lutz had clearly violated
his minimum descent altitude.

Whether there is
flat terrain or hills,

minimums are set accordingly.

And in no way you can
just pass the minimums,

whether there is hills or not.

NARRATOR: This discovery
raises questions,

not just about Lutz's actions,
but his young first officers

as well.

24, the minimum.

24.

We're continuing on.

NARRATOR: A first officer should
not let his captain breach

minimum descent altitudes.

NARRATOR: The co-pilot
could have said no, stop.

We can't see the runway.

We're not descending.

He considered his
captain an old pilot

with a lot of experience,
not making any mistakes.

Most probably, he was
trusting him too much.

And also, by being
submissive, maybe he

wouldn't speak up on time, just
to keep harmony in the cockpit.

NARRATOR: There were
no mechanical failures,

or instrument problems
with the plane.

Nor was the air traffic
controller negligent

in any way.

But it is now clear that
Captain Lutz made a series

of catastrophic piloting
errors that doomed flight 3597,

and claimed the
lives of 24 people.

Investigators dig deeper into
captain Hans Ulrich Lutz's

flying record, to see if there's
anything in his long background

that could explain why
he crashed flight 3597.

What they discover
is truly alarming.

Lutz applied to flight school
when he was 17 years old.

He was rejected
three times, because

of his lack of education.

He finally got his
license at the age of 20,

but continually failed
exams to upgrade,

due to his inadequate
comprehension

of navigation systems.

Captain Lutz may have
had a long career,

but it was not a stellar one.

Years of flying,
and flying hours

don't say anything
about competence.

NARRATOR: For some
reason, though,

his record as a
below average pilot

didn't prevent Crossair
from hiring him in 1979.

There was a red line
through his career,

where several incidents
happened before,

and he had missed
several checks.

Well, he had some limits.

But what's hard to
understand for me,

is that they were
identified, and the decision

was made to keep him flying.

NARRATOR: Captain
Lutz's limited abilities

continued in his new job.

While commanding a sightseeing
tour of the Swiss Alps,

he made a navigation error,
and ended up in Italy.

He only realized his
mistake when his passengers

spotted road signs in Italian.

In another incident, he wrecked
a one and a half million

dollar aircraft,
after inadvertently

retracting the landing
gear, while the plane

was still on the tarmac.

Lutz's failures forced Crossair
to fire him as an instructor,

but they allowed him to continue
flying passenger planes.

I personally do
pilot assessments.

And he would never have
gone through my assessment

with a positive recommendation.

OK.

Approach course 137.

NARRATOR: Investigators
wonder why Crossair

allowed Lutz to stay
on as a pilot, if he

was not entirely competent.

The answer appears to be, they
may have had little choice.

Investigators' first glimpse
into the problems at Crossair

came after they found the upside
down gauge at the crash site.

We had to check if the
employees had received

the proper training, if
they had the qualifications

required for this kind of work.

NARRATOR: No glaring
maintenance issues were found.

But a closer look at
Crossair's hiring practices

explains why Captain Lutz
was allowed to keep flying.

The airline may
have grown too fast

throughout the 80s and 90s.

The company
expanded very rapidly.

And with that success,
it's clear that you have

to quickly increase the staff.

Office workers, mechanics,
that's one thing.

But pilots, you have to
go out and find them.

In those days, they
were desperate for pilots.

And somehow, no
decision was made

to lay him off because of
his questionable performance

during his career.

NARRATOR: Captain Lutz's
failings caught up

with him on November 24, 2001.

Make a go around?

Go around.

NARRATOR: 24 people
paid with their lives.

After the accident
report was issued,

sweeping changes were made.

Swiss aviation authorities had
Crossair increase the number

of employees overseeing pilots.

They also scrutinized
other airlines,

to determine if there were
other substandard performers

like Lutz.

One thing is for sure,
that the selection process

has improved considerably.

And, of course,
awareness of people's

performance during their career
was increased considerably.

NARRATOR: Crossair went
out of existence in 2002.

It was folded into the
Swiss national carrier.

As Crossair became Swiss, they
adopted the previous Swissair

selection process.

And I can say today, which
is already nine years since,

that safety has
improved considerably,

and also quality of
the pilots that are

hired by companies like Swiss.

NARRATOR: Since the
crash of Flight 3597,

Zurich's runway 28
has been upgraded

with both an instrument
landing system,

and an automatic warning,
that alerts controllers when

a plane's approach is too low.

There has never been another
accident involving that runway.

But the Crossair tragedy, and
the circumstances that spawned

it, isn't an isolated case.

Regional airlines have boomed
worldwide since the 1980s,

particularly in the United
States, where they account

for half of all
flights, and carry

100 million passengers a year.

In the rush to fulfill consumer
demand for cheap air travel,

these airlines often hire
less experienced pilots,

and pay them far lower salaries
than their counterparts

at major carriers.

Some even neglect to test
their pilots for basic skills.

There is no such thing as
a compulsory pilot assessment

before they get
hired, does not exist.

NARRATOR: In February of 2009,
one of Colgan air's planes

crashed in Buffalo, New
York, killing 50 people.

The accident was
blamed on the actions

of an inexperienced
crew, an eerie reminder

of the Crossair disaster.

It underlined the
urgency of improving

oversight of smaller carriers.

If you're making a
product for a large company,

and you make a mistake, you
may lose part of the market.

You may lose some clients.

But an airline company
can lose a plane,

its crew, and passengers.

The stakes are very different.