Copa Airlines Flight 201

{{Short description|1992 aviation accident in Panama}} {{Infobox aircraft occurrence | occurrence_type = Accident | name = Copa Airlines Flight 201 | image = Copa Airlines Boeing 737-204Adv HP-1205-CMP at Miami International Airport on 26 April 1992.jpg | caption = HP-1205-CMP, the aircraft involved in the accident, photographed in April 1992 | date = 6 June 1992 | summary = Instrument malfunction leading to [[pilot error]], resulting in [[in-flight breakup]] | site = [[Darién Gap]], near [[Tucutí]], [[Panama]] | coordinates = {{coord|7|54|42|N|78|1|18|W|type:event|display=inline,title}} | occupants = 47 | passengers = 40 | crew = 7 | fatalities = 47 | survivors = 0 | aircraft_type = [[Boeing 737#737-200|Boeing 737-204 Advanced]] | aircraft_name = | operator = [[Copa Airlines]] | IATA = CM201 | ICAO = CMP201 | callsign = COPA 201 | tail_number = HP-1205CMP | origin = [[Tocumen International Airport]] | stopover = | stopover0 = | last_stopover = | destination = [[Alfonso Bonilla Aragón International Airport]] }} '''Copa Airlines Flight 201'''<ref>{{Cite web|title=ICAO Description Summary|url=http://mid.gov.kz/images/stories/contents/296_en.pdf|url-status=live|archive-url=https://web.archive.org/web/20160304231619/http://mid.gov.kz/images/stories/contents/296_en.pdf|archive-date=March 4, 2016|access-date=November 4, 2021|website=[[ICAO]]}}</ref> was a regularly scheduled passenger flight from [[Tocumen International Airport]] in [[Panama City]], Panama, to [[Alfonso Bonilla Aragón International Airport]] in [[Cali]], Colombia. On 6 June 1992, the [[Boeing 737-200|Boeing 737-204 Advanced]] operating the route rolled, entered a steep dive, disintegrated in mid-air, and crashed into the jungle of the [[Darién Gap]] 29 minutes after takeoff, killing all 47 people on board. The [[in-flight breakup]] was caused by faulty instrument readings and several other contributing factors, including incomplete training.

Flight 201 is the deadliest accident in Panamanian aviation history, and the only fatal crash in the history of [[Copa Airlines]].<ref name="The Internet Movie Database">{{cite episode|title=The Mysterious Crash of Flight 201|series=Nova|network=PBS|date=30 November 1993}} [[IMDB]] [https://www.imdb.com/title/tt0957980/ 0957980]. </ref><ref name="flight201infoc" />

== Background == The aircraft was a 12-year-old [[Boeing 737#737-200|Boeing 737-200 Advanced]] [[Aircraft registration|registered]] {{Airreg|HP|1205|CMP}}. It had been leased to Copa from [[Britannia Airways]] just two months before the crash and held full Britannia Airways livery but with the Copa branding.<ref>{{Cite web |title=AIRFRAMES.ORG - Aircraft Registration HP-1205CMP |url=https://www.airframes.org/reg/hp1205cmp |url-access=registration |access-date=2025-09-02 |website=www.airframes.org}}</ref> The flight crew consisted of Captain Rafael Carlos Chial (53), First Officer Cesareo Tejada (25), and five flight attendants.<ref name="flight201infoa">{{cite web|url=https://www.latimes.com/archives/la-xpm-1992-06-08-mn-121-story.html |title=47 Killed in Crash of Panama Airliner |work=Los Angeles Times |date=8 June 1992 |access-date=2012-08-16}}</ref>

== Accident == {{Location map many |Colombia |width = 280 |float = |border = |caption = Location of the accident and departure/destination airports |alt = The locations of the accident and departure airports shown on a map of Colombia. |relief = 1 |AlternativeMap = | |label1 = Panama City Airport |label1_size =  |position1 = left |background1 =  |mark1 = |mark1size =  |link1 =  |lat1_deg = 9 |lat1_min = 4 |lat1_sec = 17 |lat1_dir = N |lon1_deg = 79 |lon1_min = 23 |lon1_sec = 1 |lon1_dir = W | |label2 = Cali Airport |label2_size = |position2 =  |background2 =  |mark2 = Green pog.svg |mark2size = |link2 = |lat2_deg = 3 |lat2_min = 32 |lat2_sec = 35 |lat2_dir = N |lon2_deg = 76 |lon2_min = 22 |lon2_sec = 53 |lon2_dir = W | |label3 = |label3_size = |position3 =  |background3 =  |mark3 = Airplane Crash.svg |mark3size = 10 |link3 = |lat3_deg = 7 |lat3_min = 58 |lat3_sec = 59.09 |lat3_dir = N |lon3_deg = 77 |lon3_min = 56 |lon3_sec = 0.16 |lon3_dir = W | }} Flight 201 took off from runway 21L at [[Tocumen International Airport]] in [[Panama City, Panama|Panama City]] at 8:37 pm local time as a scheduled passenger flight to [[Cali]], Colombia, with 40 passengers and 7 crew members.<ref name="The Internet Movie Database"/> Among the passengers were Colombian merchants conducting business in Panama.<ref name="The Internet Movie Database"/> At 8:47 pm, about 10 minutes after takeoff, Captain Chial contacted Panama City Air Traffic Control, requesting weather information. The controller reported that there was an area of very bad weather {{convert|30|-|50|mi|nmi km}} from their position.

At 8:48 pm, Captain Chial made another radio contact requesting permission from Panama City ATC to fly a different route due to the severe weather ahead. The new route would take the plane over [[Darién Province]]. One minute later, at 8:49 pm, Panama City Control Center received a third message from Captain Chial, who reported reaching cruising flight level of 250 (about {{convert|25000|ft|m|disp=or}}).

Problems with the aircraft began shortly before completion of the return to course after diverting from the storm. [[Attitude director indicator|ADI]] began to display false data to the pilots, by only occasionally updating their bank angle, due to a short circuit, confusing the pilots. Finally, at 20:56, Flight 201 banked to the right and entered a steep dive at an angle of 80 degrees to the right and began to roll uncontrollably while accelerating towards the ground. Despite the attempts by Captain Chial and First Officer Tejada to level off, the airplane continued its steep dive until it exceeded the speed of sound and started to break apart at {{convert|10,000|ft|m}}. Most of the bodies had their clothes torn off and were thrown away from the aircraft.<ref name="The Internet Movie Database" /> Flight 201 crashed into a jungle area within the Darien Gap at {{convert|486|kn|km/h mph}}, killing all 47 onboard.<ref>{{cite news |author= |date=June 11, 2012 |title=Explosión en avion: fallecen 47 personas |trans-title=Plane explosion: 47 people die |url=http://www.eltiempo.com/archivo/documento/MAM-133013 |access-date=June 11, 2012  |work=El Tiempo |language=es}}</ref>

At 8:57 pm, Tocumen Air Traffic Control tried unsuccessfully to make contact with the flight until it received a radio message from a KLM DC-10 aircraft that was approaching the airport, reporting that they intercepted a distress signal from Flight 201's transponder in an area between the Colombian border and Darien Province, several kilometres away from their position. After several unsuccessful attempts to contact the lost plane, Tocumen ATC finally declared a full emergency in the airport and informed the Colombian ATC centre at Bogota about the missing plane. At dawn the next day, search aircraft were sent to Flight 201's last known position.<ref name="The Internet Movie Database"/><ref>{{cite news|date=9 June 1992|title=Official: Ill-fated plane was caught in electrical storm|url=https://news.google.com/newspapers?nid=1309&dat=19920609&id=F7JUAAAAIBAJ&pg=3784,3727972|newspaper=New Straits Times}}</ref>

After 8 hours, searchers spotted the first pieces of wreckage in the jungle of the Darien Gap.<ref name="Panama Plane Wreckage Found">{{cite news|date=9 June 1992|title=Panama Plane Wreckage Found|url=https://news.google.com/newspapers?nid=1370&dat=19920609&id=towmAAAAIBAJ&pg=6561,1445751|newspaper=Manila Standard}}</ref> Because of the remoteness of the area and the difficulty of access, it took rescue personnel 12 hours to reach the site.<ref name="The Internet Movie Database"/><ref>{{cite news|date=9 June 1992|title= Jungle hampers crash site efforts|url=https://news.google.com/newspapers?nid=861&dat=19920609&id=aPVHAAAAIBAJ&pg=987,4425721|newspaper=The Victoria Advocate}}</ref>

Because the bodies of the victims and various parts of the aircraft's fuselage were scattered in a radius of {{convert|10|km|mi|sigfig=1}}, the recovery process was extremely difficult. After investigators reached the crash site, the investigation to find the cause of the crash began.<ref>{{cite news|date=8 June 1992|title=47 are killed in crash of Panama jet|url=https://news.google.com/newspapers?nid=1314&dat=19920608&id=I7IyAAAAIBAJ&pg=4085,5548517|newspaper=The Spokesman-Review}}</ref>

== Nationalities of the victims ==

The aircraft was carrying 47 people: 40 passengers and a crew of seven. Fatalities included 36 Colombians, 8 Panamanians, 2 Americans, and 1 Italian. {|class="sortable wikitable" |- !Nationality||Passengers||Crew||Total |- |Colombia||36||0||36 |- |Panama||1||7||8 |- |United States||2||0||2 |- |Italy||1||0||1 |- class="sortbottom" |'''Total'''||'''40'''||'''7'''||'''47''' |}

== Examination and investigation == [[Image:VMS Artificial Horizon.jpg|thumb|An Attitude Director Indicator with integrated localiser and glideslope and split-cue flight director command bar indicators. Due to a short circuit, the indicators on flight 201 showed faulty readings, confusing the pilots.]]

The [[cockpit voice recorder]] was recovered and flown to Panama City, then to the United States, for analysis by the [[National Transportation Safety Board]].<ref name="The Internet Movie Database"/> However, NTSB analysts discovered that the tape was broken due to a maintenance error. It was repaired, but the recording on the tape was from another flight. Crash investigators had better luck with the [[flight data recorder]], which showed the plane was in a high-speed dive before breaking up.<ref name="The Internet Movie Database"/> The FDR also showed that the aircraft suddenly banked several times in less than a second, which was considered unprecedented for a commercial aircraft.

The trouble was later traced to a faulty wiring harness in the [[Attitude Director Indicator]] (ADI) instruments. The wires were frayed due to damage by long-term over-stress, which caused an intermittent short circuit in the flow of data from the Captain’s side Vertical Gyro (VG), VG-1, to the Captain’s side ADI. Because the FDR received information from VG-1, it was displaying incorrect information, and "sudden" bankings of the aircraft, which the FDR recorded, were, in fact, much more gradual.

This issue was compounded on the accident flight. There are two main ADI displays, fed independently by their own VG – one ADI/VG pair for the Captain, a separate pair for the First Officer. In case one of the VGs has a problem, the crew can manually switch either ADI to use the other VG. The switch of the Captain's ADI was found at the scene of the accident in the "Both on VG-1" position, feeding both of the ADIs from the same, intermittently faulty, Captain’s side VG. As a consequence, both the ADIs would momentarily stay unchanged (no new data making it through), leading the crew to believe the plane was still flying in a particular attitude, thereby prompting a further control input by the crew, expecting the ADI to show that they had achieved the new attitude as requested. In essence, the ADIs told the crew the plane was still banking left, thereby prompting more pilot input to bank right. This reaction rolled the aircraft to almost 80 degrees and caused it to go into a steep dive, with no chance for recovery.<ref name="The Internet Movie Database" />

There is, however, a third (backup) ADI which receives its information from a third, independent, VG. The investigation team found that this backup ADI (stand-by) was, in all probability, available to the pilots during the intermittent failure of the main instruments systems (the post-impact damage of the stand-by indicator showed that it was operating properly up to impact with the ground), but due to an ineffective cross-checking procedure done by the pilots, the backup ADI was not used correctly to identify the problem and select a reliable source of attitude information. As the CVR was damaged prior to the flight, it is not known whether the difference between the pilots’ ADIs and the backup ADI was noticed or discussed.

Another factor contributing to the crash was that the Copa Airlines' ground training simulator program was ineffective, as it did not present enough information relating to the differences between aircraft and crew resource management to give to the flight crew knowledge to overcome intermittent attitude indicator errors and to maintain control of an aircraft with the ADI/VG auxiliary instruments. Moreover, on the accident aircraft, the pilots were trying to apply what they had learned in the simulator relating to this issue; however, due to the movement of the ADI's switch to the position of "Both on VG-1" and the insufficient information during their training, the reference from VG-2 was lost and the pilots were unable to identify the problem as a consequence.<ref name=flight201infob>{{cite web|url=http://www.pprune.org/tech-log/498311-1992-crash-copa-airlines-737-south-america-storm-encounter.html |title=1992 crash of Copa Airlines 737 in South America in storm encounter|access-date=2012-08-16}}</ref><ref name="flight201infoc">{{cite web |last=Ranter |first=Harro |title=ASN Aircraft Accident Boeing 737-204 HP-1205CMP Tucuti |url=http://aviation-safety.net/database/record.php?id=19920606-0.html |access-date=2012-08-16 |website=Aviation Safety Network |publisher=[[Flight Safety Foundation]]}}</ref>

Another factor contributing to the crash was the non-standard cockpit configurations between aircraft in the fleet of the company, including inconsistencies between aircraft and the simulators used for training. This confused the pilots about determining the setting of the ADI switches for the aircraft that was being operated at the time.

Despite bearing some similarities to other [[Boeing 737 rudder issues|incidents related to the Boeing 737 during the 1990s]] (such as [[United Airlines Flight 585]]), the possibility of rudder deflection in flight was discarded as a possible cause of the crash. However, Flight 201 was registered in the category of "accidents related to suspicious rudder deflection".

===Eyewitness accounts=== In the morning of the next day, Colombian and Panamanian radio stations were reporting that some residents of Tucutí and other villages nearby to the crash site said that on the night of the accident they felt a very strong explosion; meanwhile, others said that they saw a burning object that was falling from the sky towards the jungle.<ref>{{cite news |date=June 8, 1992 |title=Un Boeing 737 panameño se estrella en la selva con 47 personas a bordo |trans-title=A Panamanian Boeing 737 crashes in the jungle with 47 people on board. |url=http://hemeroteca.abc.es/nav/Navigate.exe/hemeroteca/madrid/abc/1992/06/08/094.html |access-date=August 26, 2013  |work=ABC Hemeroteca |language=es}}</ref>

However, these reports were eventually dismissed by the head of Panama's civil aviation authority, Zosimo Guardia, who argued that the plane could not have exploded before crashing.<ref name="Panama Plane Wreckage Found"/>

==Aftermath==

=== Response from Copa Airlines === In the wake of the disaster, Copa gave flights to Panama City to the families of the victims; the main executive members of Copa Holdings declared a permanent emergency meeting session at the airline's main headquarters in Panama City.

Copa Airlines had to strengthen its training program for flight crews: in particular, for pilots learning to fly different types of aircraft, and in several skills such as overcoming intermittent Attitude Director Indicator (ADI) errors and the ability to maintain control of the aircraft during instrument failures in adverse weather conditions. Copa also had to reconfigure the operations of its fleet via a major overhaul.{{Citation needed|reason=Reliable source needed for the whole sentence|date=February 2015}}

The accident remains the deadliest plane crash in Panamanian aviation and Copa Airlines' history as of {{CURRENTYEAR}}.<ref name="flight201infoc" />

=== Lawsuits === As a result of the accident, the relatives of those who perished in the crash filed 49 wrongful death lawsuits against [[Lucas Industries|Lucas Aerospace]], one of the part suppliers of the Boeing 737. The case was settled out of court for an undisclosed amount.<ref>{{cite web|url=http://www.kmalawfirm.com/walker/|title=Kaplan, Massamillo & Andrews, LLC|website=www.kmalawfirm.com|access-date=5 February 2018}}</ref>

In 1993, one of the relatives of Clariza Bernal Luna, one of the US passengers that were on the flight, filed a lawsuit against Copa Airlines in a Texas federal court, alleging that the airline had sold a ticket to the passenger through a travel agency in Houston, although the airline has no operations centre in Texas. The case was eventually dismissed by the court on 30 March 1994.<ref>{{cite web |title=LUNA v. COMPANIA PANAMENA - 851 F.Supp. 826 (1994) - upp82611547 |url=http://www.leagle.com/decision/19941677851FSupp826_11547 |access-date=5 February 2018 |website=Leagle.com}}</ref>

==Media coverage== A year after the crash, the story of the crash of Flight 201 and its investigation was featured in a [[WGBH-TV|WGBH]], [[BBC]], and [[Norddeutscher Rundfunk|NDR]] documentary. It was screened in the United States in the [[PBS]] ''[[Nova (American TV program)|NOVA]]'' series as ''Mysterious Crash of Flight 201'' on 30 November 1993,<ref name="The Internet Movie Database"/> and in the United Kingdom in the ''[[Horizon (BBC TV series)|Horizon]]'' series as ''Air Crash - The Deadly Puzzle'' on 14 February 1994.<ref>{{cite web|url=http://ftvdb.bfi.org.uk/sift/title/506127|archive-url=https://web.archive.org/web/20090208141112/http://ftvdb.bfi.org.uk/sift/title/506127|url-status=dead|archive-date=8 February 2009|title=Air Crash - The Deadly Puzzle (1994)|access-date=5 February 2018}}</ref>

The crash was also the subject of a Season 14 episode of the [[Discovery Channel (Canada)|Discovery Channel]]/[[National Geographic (Canadian TV channel)|National Geographic]] series ''[[Mayday (Canadian TV series)|Mayday]]''. The episode featuring Flight 201, titled "''Sideswiped''", premiered in March 2015.<ref name="Mayday Sideswiped">{{Cite episode |title=Sideswiped |series=[[Mayday (Canadian TV series)|Mayday]] |network=[[Discovery Channel Canada]] / [[National Geographic Channel]] |season=14 |number=4 |year=2015}}</ref>

==See also== {{Portalbar|Panama|Colombia|Aviation|1990s}} * [[Sriwijaya Air Flight 182]] * [[West Air Sweden Flight 294]] * [[Air India Flight 855]] * [[List of accidents and incidents involving airliners by location]]

==References== {{Reflist}}

==External links== * [https://data.ntsb.gov/Docket?ProjectID=15961 NTSB docket which includes Spanish and English copies of the final report] * {{ASN accident|id=19920606-0}} * [https://www.planecrashinfo.com/1992/1992-21.htm PlaneCrashInfo.Com – COPA Flight 201 Entry] * [http://www.airliners.net/search?registrationActual=G-BGYL&display=detail Pictures of the plane in Britannia Airways livery – Airliners.Net]

{{Aviation incidents and accidents in 1992}} {{Authority control}} {{Portal bar|Aviation|Panama|1990s}} [[Category:Aviation accidents and incidents in 1992]] [[Category:Airliner accidents and incidents caused by instrument failure]] [[Category:Aviation accidents and incidents in Panama]] [[Category:1992 in Panama]] [[Category:Aviation accidents and incidents involving the Boeing 737 Original]] [[Category:Copa Airlines accidents and incidents]] [[Category:June 1992 in North America]] [[Category:Aviation accidents and incidents caused by loss of control]]