Once the plane climbed into the sky, Haueter figured it was safe. The critical time was takeoff and landing. When a plane was flying faster than 200 knots, pilots could easily recover from a hardover.
Hewett and an FAA test pilot flew out over the Atlantic and put the plane through the maneuvers, kicking the rudder right and left. The plane flew poorly because its controls seemed to be out of alignment, but the pilots found no problem with the rudder. They returned to Richmond.
Before Bishop got on the plane for the second flight, Haueter warned him about Hewett. “Look, the purpose of this is I want to know your perceptions. Don’t let anybody talk you out of anything. Take a piece of paper so you can write something down immediately after it happens so it will be fresh. We want to know how similar this is to what you had the night of the ninth, as best as you can recall.”
Bishop took the controls and flew the same as he had on June 9. Without warning, Hewett gave a quick hand signal. An FAA pilot behind them pushed a button that suddenly moved the rudder 4.5 degrees. The plane started to roll.
Bishop quickly stomped on the opposite rudder pedal, which stopped the roll and made the plane roll back toward wings level.
Was that what happened on June 9? Hewett asked.
No, Bishop said, the test was much slower. “This isn’t even a tenth of what we felt that night.”
“Well, it was dark out, you weren’t expecting it,” Hewett said. He seemed to be offering excuses to show that Bishop had exaggerated.
“This wasn’t even close,” Bishop said.
Haueter had studied dozens of suspicious 737 incidents since the crash and had found reasonable explanations for nearly every one. Many were yaw damper problems, some were autopilot malfunctions, and lots were encounters with wake turbulence. But the more he studied Eastwind, the more it matched Flight 427. He believed Bishop’s account, which was corroborated by the first officer, that the rudder pedal would not move. The flight data recorder also verified their accounts and showed that the plane was cross-controlled, meaning that the rudder was turned at the same time the ailerons were going the other direction. The only problem in the pilots’ stories was their confusion about the timing of the events, which was common for all pilots. Haueter concluded that the Eastwind incident was eerily similar to 427, with one important difference. The plane’s speed was 250 knots, well above the crossover point, so Bishop was able to recover before it crashed.
On the two-year anniversary of the crash, by pure coincidence, John Cox took a USAir 737 to Pittsburgh. He was scheduled for his six-month training session at USAir’s simulator center near the Pittsburgh airport. As the plane approached the city, Cox was sitting in Row 8 of coach, studying a pilot handbook about things that can go horribly wrong on a plane—engine fires, takeoff stalls, autopilot failures. The passengers sitting around him might have gotten heartburn if they had seen what he was reading, but to Cox it was like studying for final exams.
The USAir emergency checklist had been improved because of Flight 427. Now there was a procedure for “Uncommanded Yaw or Roll,” which called for the pilot to turn off the autopilot, grab the wheel firmly, and turn off the yaw damper. The cover of the checklist also had changed, listing the general approach for pilots anytime a plane was in trouble:
Maintain aircraft control
Analyze the situation
Identify the emergency
Use the appropriate checklist
Cox wasn’t nervous about his six-month checkup, but he wanted to make sure he aced it. He double-checked the list of maximum fuel temperatures and silently recited the engine fire procedure (“Auto-throttle off, throttle idle, start lever cutoff, fire handle pull. If light doesn’t go out in thirty seconds, rotate handle”). As the flight attendants prepared the 737’s cabin for arrival in Pittsburgh, he was so caught up in preparing for calamities that he didn’t notice the time—7:03 P.M.
Two years to the minute since Flight 427 had crashed into the hill.
The next day in the simulator, he dealt with one crisis after another. He was climbing out of Philadelphia, leveling off at 10,000 feet when bang!—the No. 2 engine seized up. He went through the memory procedure for an engine fire. Once the situation was under control, he pulled out the checklist and started going through it with the first officer. An instructor pounded on the cockpit door, pretending to be a flight attendant.
“What is going on!? What was that bang?” the instructor shouted.
The weather in the simulated Philly was lousy, so Cox diverted the plane to Baltimore and landed with one engine. He then departed for Charlotte and found horrible weather there, too. He had to use the 737’s auto-land system, which can land the plane in thick fog. More mishaps followed. The plane began to stall after takeoff. Another engine problem. And then his beeper went off.
He glanced down at the beeper and saw the number. It was LeGrow, the union’s chairman for the Flight 427 investigation. At the next break Cox walked to the pay phone and called him.
“Hey, Herbie, what’s going on?” Cox asked.
“John Boy, have you checked your Aspens?” LeGrow asked, referring to the ALPA voice mailbox system.
“No.”
“You’re going to like it,” LeGrow said. “Kenny has the safety recommendations. They couldn’t be any better. They are just what we wanted.”
“Yes!” Cox said, punching his fist in the air like a pitcher who just struck out a .300 hitter.
He walked back to the simulator and told the instructor, “Four-twenty-seven is drawing to a close. And we’re going to like the results.”
Greg Phillips’s recommendations for the 737 had come back to life because Laynor, the safety board official who had blocked them, had retired. They found a much more receptive audience in Bernard Loeb, the new head of aviation safety, and his deputy, Ron Schleede. That broke the logjam and meant that Haueter and Phillips could try again to get approval. The recommendations that were going to the board members were essentially the same list from Phillips’s memo eighteen months earlier. They called for sweeping changes to the 737 and the way it was flown. They did not specify what Boeing should do—“We don’t want to be junior engineers telling them how to do it,” Haueter said—but they essentially meant that Boeing would have to install a limiter on the rudder or change the ailerons so pilots would have more roll control. The list also called for fixes to the yaw damper, a better method for pilots or mechanics to detect a jam in the valve, a new cockpit indicator to show pilots when the rudder moved, and new procedures telling pilots how to respond to a hardover.
Cox was ecstatic when he returned to St. Petersburg the next day, calling the recommendations a watershed event that would prevent future crashes. “I’m so happy, I am doing double back flips,” he exulted. “We’ve now got the mechanism in these recommendations to fix the airplane.”
McGrew was feeling burned out. He was overdue for a vacation and felt drained. His son said he looked like he had aged five years since the crash. It had been only two. He had lost enthusiasm for the investigation and thought that others at Boeing were in the same rut. In the first two years there had been a high level of energy throughout the company to solve the mystery, but nearly everyone had since moved on to other projects and now when they worked on 427 it was hard to get them fired up again.
To make matters worse, he had been removed from his job as the 737 chief engineer and given a different position, overseeing new Boeing models. It was a lateral move, but he did not want to go. His bosses didn’t mention burnout as a reason for his reassignment, but McGrew figured that was one of the factors. He stayed involved in the Flight 427 effort, but he found less time each week to work on the investigation.
He was frustrated at the NTSB’s lack of effort in studying the pilots. Sure, the human factors team had pursued several leads that Boeing wanted, but McGrew had heard that Brenner, the NTSB human factors investigator, believed the pilots had their feet on the floor and never knew when the rudder went in. How could Brenner say such a thing? There was no conclusive proof of that, and in McGrew’s view, there was evidence to the contrary. McGrew and most people at Boeing still believed that Emmett or Germano (most likely Emmett, since he was the flying pilot) had mistakenly slammed his foot on the pedal and then pulled back on the control column, stalling the airplane and causing the crash.
McGrew and other Boeing officials had been traveling the world to reassure airlines about the safety of the plane. They were under tremendous scrutiny. A series of stories in the Seattle Times said Boeing had not responded to the rudder problems, despite many incidents. McGrew found that allegation preposterous. He said the company had thoroughly investigated the incidents and had found no systemic problem.
He said he felt no pressure from Boeing management to defend the plane and had done so only because there was no evidence that the rudder system had malfunctioned. Likewise, he said, the company’s costs for lawsuits had no effect on what he did. “If it’s a ton of money, that’s too bad,” he said one day while driving up Interstate 405 to a meeting. “If there’s something wrong, you’ve got to fix it.” He was convinced that Emmett and Germano just got into a situation that was over their heads.
McGrew and other officials thought it was time to throw the equivalent of a Hail Mary pass. They would go over Haueter’s head directly to the board members, the five political appointees who would vote on the probable cause. Rick Howes, the Flight 427 coordinator in Boeing’s air safety investigation office, made a courtesy call to Haueter. Howes said Boeing was going to be “aggressive” in informing the board.
The result was a spiral-bound booklet called the “Boeing Contribution to the USAir Flight 427 Accident Investigation Board.” It was the classic Boeing approach—slick color renderings of what Germano saw from the cockpit and a view from behind the plane, matched with Boeing’s analysis. The renderings were the same ones that Haueter had seen on the posters in the conference room a year and a half earlier, but this time they had Boeing’s comments on why the plane was innocent: