805
1992-FEB-15 · Swanton, Ohio, United States

Air Transport International — Flight 805

Air Transport International Flight 805, a Douglas DC-8-63F cargo flight, crashed during a second go-around attempt at Toledo Express Airport, killing all four people on board. The fatalities included three crew members and one non-revenue passenger. The aircraft became destabilized during two consecutive instrument approaches in nighttime, instrument meteorological conditions (IMC) with significant crosswinds. During the second missed approach, the captain took control from the first officer but quickly became spatially disoriented, likely due to physiological factors or a potential malfunction of his Attitude Director Indicator (ADI). This led to an extreme bank angle of 80 degrees and a nose-high pitch of 25 degrees. Although control was transferred back to the first officer who attempted a recovery, the aircraft struck the ground before it could be leveled.

Aircraft
Douglas DC-8-63F
Registration
N794AL
Phase
Cause
Souls on Board
4
Fatalities
4
Origin → Dest
Seattle–Tacoma International Airport, WA → Toledo Express Airport, OH
Report

Investigation Summary

The investigation into Flight 805 focused heavily on the transition between the first officer and the captain during a high-stress phase of flight. The first officer, who was the pilot flying, struggled to maintain the localizer and glide slope during both approaches, leading to multiple GPWS 'glideslope' and 'sink rate' warnings. The captain, Harry Baker, expressed significant frustration with the first officer's performance before taking manual control at 03:24:17. Shortly after taking control, the aircraft entered an unusual attitude. Investigators considered several mechanical possibilities, including a cargo shift of a heavy metal casting and a repeat of a previous incident where the cargo door had opened in flight, but both were ruled out. The focus shifted to the captain's Attitude Director Indicator (ADI). While the first officer's ADI appeared to be functioning correctly based on his recovery attempts, the captain's instrument could not be verified due to impact damage. The NTSB concluded that the captain likely suffered from spatial disorientation, potentially exacerbated by the 'somatogravic illusion' during acceleration and turning, or was misled by a failing ADI.

Final Conclusions

The National Transportation Safety Board determined the probable cause was the flight crew's failure to recognize or recover from an unusual aircraft attitude in a timely manner. This attitude resulted from the captain's spatial disorientation, which was attributed to physiological factors and/or a failed attitude director indicator. The NTSB also noted deficiencies in crew resource management (CRM) and the first officer's inability to stabilize the initial approaches.

Video Analysis

Captain Flying Blind | Air Transport International Flight 805 — A detailed look at the crash of ATI 805, examining how a veteran captain lost control of his DC-8 during a missed approach in Ohio.

If playback is blocked, the owner has disabled embedding — use the link above.

Airframe & Maintenance

Airframe Hours
70,084
Cycles
22,804
Engines
Pratt & Whitney JT3D-7

Crew Experience

Captain

Total hours
16,382
On type
2,382

Harry Baker, age 59

First Officer

Total hours
5,082
On type
3,135

Tim Hupp, age 37. Hours on type include 1,148 as flight engineer.

Flight Engineer

Total hours
21,697
On type
7,697

Jose Montalbo, age 57

Systems & Failure Modes

i

Attitude Director Indicator (ADI)

A primary flight instrument showing the aircraft's pitch and roll; a suspected malfunction in the captain's unit may have contributed to his disorientation.

i

Ground Proximity Warning System (GPWS)

The system provided multiple 'glideslope' and 'sink rate' alerts during the final minutes, indicating the approach was severely destabilized.

i

Instrument Landing System (ILS)

The radio navigation system the crew failed to properly capture during two consecutive attempts in poor visibility.

Interesting Facts

  • 01The aircraft had previously suffered a cargo door opening in flight on November 13, 1991, but this was ruled out as a factor in the 1992 crash.
  • 02Thirteen people on the ground were injured, including 12 firefighters treated for smoke inhalation and one resident injured by falling plaster.
  • 03The captain had over 16,000 flight hours, yet succumbed to spatial disorientation during the missed approach.
  • 04The first officer attempted a recovery by leveling the wings and pulling the nose up, but ran out of altitude.
  • 05The NTSB issued no safety recommendations following the investigation.
  • 06The fourth occupant was Raman Patel, a pilot for Buffalo Airways traveling as a non-revenue passenger.

Safety Actions & Advisories

NTSB Formal Findings

Source ↗

Although the NTSB did not issue formal safety recommendations in the final report (AAR-92/05), the investigation highlighted critical deficiencies in Crew Resource Management (CRM) and the importance of aggressive recovery inputs during unusual attitude events.

Location

Swanton, Ohio, United States · 41.6325, -83.8012

Case File History

  1. New evidenceUpdated event timeline and findings.
  2. CorrectionUpdated event timeline and safety actions.

Related Cases

Case ID · ati805-1992Last updated · Filed

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