Bassersdorf accident report published

03. February 2004

The Swiss Aircraft Accident Investigation Bureau will today publish its report on the investigation into the loss of Crossair flight CRX 3597 near Bassersdorf, Switzerland, on November 24, 2001. The aim of the official report is to identify the causes of the accident for the purpose of prevention, rather than to attribute blame. If the Federal Public Prosecutor’s Office decides to open proceedings, SWISS is keen to see this case fully clarified.

The safety recommendations relating to SWISS were implemented shortly after the accident. The final findings on the precise course of events and the cause of the accident, two years after it occurred, do not demand any further actions, the report concludes.

Crossair flight CRX 3597 from Berlin Tegel crashed on approach to Zurich Airport on November 24, 2001.SWISS mourns the 24 people (21 passengers and three crew members) who lost their lives, and extends its deepest sympathies to the nine persons (7 passengers and 2 crew members) who survived, and to the deceased’s families and friends.

The captain dropped below the minimum flight height. The report does not reveal why the safety net inside and outside the aircraft failed to function.

The highly experienced captain had all the qualifications required for the flight. He was, in addition, an instrument flying specialist and training officer for the Federal Office for Civil Aviation.

Both Crossair and SWISS have always fulfilled all national and international safety requirements. Indeed, SWISS has adopted a best-practice approach to flight safety since its foundation, aligning its own flight safety measures and standards to the best in the airport sector.

Immediate actions taken

The report by the Aircraft Accident Investigation Bureau appears two years and two months after the accident. Crossair and, later on, SWISS embarked on their own investigations and took action in various way immediately after the event:

A special Crossair Operations task force commenced its work on the same night of November 24, 2001. Immediate steps were taken in collaboration with Skyguide and Unique Airport regarding weather minima and approach procedures for Runway 28.

All Crossair pilots were subjected to a screening process by outside specialists immediately after the accident.

One week after the event, a 28-page internal report had been compiled about the accident, the measures already implemented and the actions yet to be taken.

Further measures

SWISS has since introduced a totally revised Flight Safety Programme (FSP). The programme extends to crew recruitment, training and checks, as well as to workflows and procedures throughout the company’s operations.

SWISS has also adopted the additional safety measure - one that is far from usual in the air transport sector - of creating its own Flight Safety Advisory Board. The board consists of acknowledged independent international aviation safety specialists who conduct regular assessments of all aspects of flight safety within the company and report directly to the SWISS Board of Directors.

Recommendations of the Aircraft Accident Investigation Bureau

The eight recommendations now published by the Aircraft Accident Investigation Bureau relating to SWISS have all been put into practice already. The recommendation to install an enhanced ground proximity warningsystem in the company’s AVRO RJs and SAAB 2000s will be fully implemented by the end of 2004.

Recommendations of the Aircraft Accident Investigation Bureau

The eight recommendations now published by the Aircraft Accident Investigation Bureau relating to SWISS have all been put into practice already. The recommendation to install an enhanced ground proximity warning system in the company’s AVRO RJs and SAAB 2000s will be fully implemented by the end of 2004.

The following is a summary of the recommendations:

  • Crew-pairing – Rostering of flight crews: Following in-depth screening of all pilots, SWISS has systematised its roster planning and now stipulates five years’ flying experience for promotion to captain.
  • Pilot qualification checks: In a two-stage process, SWISS has put all its pilots through a screening programme and introduced a new retraining assessment system.
  • Review of in-house appraisal system: SWISS has comprehensively revised its pilot selection and quality assurance procedures, and has also set up a new database of individual qualifications as well as introducing a yearly appraisal process. This system extends to instructor training and monitoring as well as the systematic evaluation of flight data on all fleets.
  • Review of Crossair standard flight procedures: In consultation with the Federal Office for Civil Aviation, SWISS has made every possible effort to ensure standard flight procedures. Regarding the “minimum descent altitude” (MDA), the AVRO aircraft manufacturer, BA Aerospace, recommends, in its Manufacturer’s Operations Manual, the procedure practised by SWISS at the time of the accident.
  • Aircraft enhancement with Terrain Awareness and Warning System (TAWS) Installation operations are underway and will be completed by the end of 2004.
  • The Visual Descent Point (VDP) should be shown on approach maps. SWISS has asked its documentation provider to show the VDP on approach maps.
  • The profile of the terrain along the approach path should be indicated on approach maps SWISS has asked its documentation provider to show the profile of the terrain on approach maps.
  • Flight operations companies should have a Quality Assurance System to identify and correct any deficiencies in the behaviour or working procedures adopted by flight crews SWISS has revised its qualification guidelines for pilots in line with “best practice” standards and has implemented a comprehensive Quality Assurance system. The systematic flight data evaluation process has been extended to the regional fleet and an efficient reporting system with a high-performance database has been set up.

Legal implications

SWISS has reached an agreement with the families of 18 passengers, or the families have not filed any further claims within the statutory deadline in respect of the pre-payment that has already been made. Another agreement is due to be concluded shortly. SWISS has been informed that the families of 10 passengers have initiated law suits and legal action to protect their interests. The law suits and legal action have been initiated in Switzerland, Germany and Israel.

A pre-payment of 100,000 special drawing rights (CHF 209,750) was offered and paid to the families of the deceased and seriously injured passengers, and to the seriously injured passengers themselves, shortly after the accident. In the other cases, the pre-payment was CHF 30,000.

SWISS can confirm, on the basis of a verbal communication from the Federal Public Prosecutor’s Office, the information published in the media that the flight accident report is now with the Federal Public Prosecutor. SWISS is keen to have this case fully clarified.

The deadline for appealing against the flight accident investigation report is 30 days. SWISS will analyse the report in detail within this deadline and then decide whether to appeal against it.

Note to the media:

SWISS will not comment on this media release until after publication of the official report at 11 a.m. today.