This is the first part of a two-part series on PIA flight PK8303 crash in May 2020. To read the second part, click here
At 9:32:24 am (UTC) on May 22, 2020, while on final approach to Karachi, the captain and first officer of Pakistan Internatinal Airlines (PIA) flight PL-8303 received radio communication from Karachi Air Traffic Control (ATC): "Sir, orbit is available if you want." The 58-year-old captain of the aircraft replied: "Negetive Sir, we are comfortable, and we can make it, Inshallah (God willing)."
So far, this exchange was understandable, but what happened next, which was recorded by the voice recorder in the cockpit, is not only eye-opening but shocking.
"He (the air traffic controller) will be surprised at what we have done," remarked Captain Sajjad Gul.
This is not just a sentence, but a line that encapsulates the sordid saga of PIA's destruction, in which the captain seems to boast about his cowboy piloting skills, speaking big words, i.e. the captain tells the first officer that they were flying too high but had managed to bring the plane down and land so fast, that the approach controller, who was briefing them, will be surprised to learn about their achievement.
Before we go into the details of the report, I would like to confess that I have read several reports about aircraft accidents from around the world; I have reported on the AirBlue crash into the Margalla Hills of Islamabad, PIA's ATRA crash in Havelian, the final reports on the Multan and Bhoja Air accidents. Of all those, I have never read such a horrible report of an error-filled flight in my life, where the captain of the plane makes every mistake and breaks every rule in the book that he could to reach only one end: destruction.
PK8303 and its doom
Pakistan's Aircraft Accident Investigation Board (AAIB) quietly released its final report on the crash of Flight PK8303 earlier this year amidst the commotion surrounding the general elections. The date imprinted on the final copy of the report is April 20, 2023, but the AAIB, the Civil Aviation Authority (CAA), or the Aviation Division, sat on this report for almost a year. One wonders why they delayed the report's release for so long if it was ready in April last year. Why has it not been brought forward until now?
PIA flight PK8303 crashed in Karachi on May 22, 2020, a few metres away from the runway of Karachi's Jinnah International Airport. The AAIB's final report on the accident is an eye-opening account of the final and decisive 30 minutes of the flight, during which the captain and his first officer made mistake after mistake.
The investigation report is divided into six different phases, and these phases describe the six critical phases of aircraft'sthe last and final flight, recording moment by moment and second by second the various technical and human actions taking place inside the aircraft.
The six phases
The timeline of the flight can be divided into six phases. The first phase is from the origin of the flight at Lahore's Allama Iqbal International Airport to its arrival at Karachi's Jinnah International Airport. From 07:55:00 To 09:15:06 (All the timings mentioned in this report are according to the Coordinated Universal Time or UTC. The local time when the plane crashed was 2.45 PM in the afternoon, or 09:45 per the report).
Before we get to important details about the final moments of the flight, something remarkable happened around 14 minutes into the flight. A crew member asked the captain and the first officer about food and refreshments, i.e. snacks. Both the captain and the first officer politely refused the snacks. Based on this conversation, it is assumed that both the captain and the first officer were fasting, as the flight took place during the month of Ramadan.
This would explain why the report recommended the civil aviation and PIA to ensure implementation of their rules regarding monitoring of in-flight food and drink periods for crew and fasting of captains and first officers.
Another important thing to come out of this report was that this particular aircraft did not suffer from any technical or mechanical fault, and the cause of the crash was not the plane but the crew and other human factors.
Rather, as a result of this report, the true technical and mechanical capability of the aircraft was revealed, and how it kept flying even in the worst conditions until the very last moment.
The plane took off from Lahore's Allama Iqbal International Airport at 8:05:30 (UTC) in the morning and left for Karachi. At 8:24:24, the plane was handed over to Karachi Area Control. The area controller has an overview of the airspace for most areas in the southern parts of Pakistan for all types of air traffic.
Second phase
The second phase is from ATC's clearance to gear retraction. (From 09:15:06 To 09:33:10). Two major problems emerged during the second phase. The aircraft's speed and altitude were far above the required levels. Second, the pilots of the aircraft set the wrong radio frequency, which hampered communication.
After making first contact with the Karachi Area Controller, the aircraft was given access to the Karachi International Airport. At 09:15, the crew of the aircraft asked the air traffic controller for permission to land, which was granted. Remember, this was during the Covid-19 pandemic and air traffic was at a minimum.
After securing clearance, the aircraft started the landing process, which is called 'descent'. This was followed by repeated back and forth communication between the aircraft and the approach controller and area controller, with the controllers trying to convince the pilots that the aircraft was too high above the required altitude and that it would not be able descend easily. The pilots, however, were adamant that they could 'manage it' and that everything will go well and they will take the plane down easily.
To make the runway, the pilots began to bring the plane down very quickly. At one point, the plane was descending at a speed of 1,000 feet per minute. At a later point, this speed more than doubled to 2,400 feet per minute.
At this point Karachi area control called the aircraft and said "Pakistan 8303 contact Approach 125.5". meaning the pilots should contact approach control Karachi on the radio frequency 125.5. The call was not answered by the pilots. After that, Area Control tried to contact the aircraft crew three times but without success.
The report mentions that: "the flight crew probably mistook the approach control Karachi radio frequency, and several ATC calls went unanswered."
In simple words, the pilots flying the aircraft had not set the radio frequency correctly to speak to the air traffic control and area controller, which directed all air traffic around the plane. This was a big problem in itself, because after the area controller, the approach controller also contacted the aircraft but got no response, after which the approach controller contacted the pilots on the 'guard frequency' - which is a general frequency available to all planes.
On the third attempt, the aircraft finally answered the call, saying, "Confirmation of change to frequency 126.5". After that, contact was established between the aircraft and the Karachi approach.
At this point, the approach controller asked the flight crew, "Pakistan 8303 confirm track mile comfortable for descent?"
At this point, the controllers were asking the pilots to confirm if they could get in a position to land easily compared to the trajectory they were flying previously. The flight crew simply replied with "affirm". In other words, the pilots were told by the air traffic controllers that they were too high and that they should probably fly around the airport once or twice so that they could descend easily and safely. At the moment of this exchange, the plane was flying at an altitude of 9,000 feet and was about 15 nautical miles from the runway.
But at that moment, the captain can be heard saying in Urdu in the plane's CVR, "What has happened?", "Stop, Stop, Oh No! Take out the Hold, take out the Hold, take out the Hold, take out the Hold." To this, the flight officer responded, "Hold taken out, should we report this happening?" (in Urdu).
Basically what had happened was that the aircraft was flying a preprogrammed route. But since their trajectory upon approach had been altered, the pilots had forgotten to disengage from the pre-determined flight path and opt for changing the approach parametres, including the flight altitude and speed.
In response to the first officer's question whether the system had run into a glitch or they had made an error, the captain replied, "No, this could be due to Hold, tell Karachi Approach that established on localiser" (in Urdu).
This marked the beginning of the problems that the flight experienced thanks to the captain's obstinacy, unprofessional behaviour, and consideration of himself as an individual above the prevailing rules of the airline and civil aviation. The captain was apparently used to such behaviour and knew that neither the airline nor the civil aviation would do anything.
The captain had a history of poor behaviour. The captain had been issued show cause notices by the PCAA for violating flight duty time limits, and exceeding stipulated limits of flying hours within 30 / 365 days.
Second, when the captain had joined the airline, a psychologist at the time of induction noted in the official psychological evaluation that the captain was of a "bossy nature, firm, dominant and overbearing. He had a tendency to have little regard for the authority, low mechanical / space relation comprehension and inadequate level of stress tolerance."
Returning to the flight, at 09:31:13, the Karachi air tower controller contacted the Karachi approach controller on the hotline and shared its observation about the incoming flight PK8303. "Sir, it's too high" (in Urdu). To that, the approach controller responded, "Yes, it is too high, and I am observing it and will give orbit" (in Urdu). This meant that the air traffic controllers knew the plane was too high to make a safe landing and would ask the plane to go around so that it could lower its speed and altitude for a safe landing.
Later the approach controller at 09:31:41, called the flight PK8303, "Sir, orbit is available if you want". But the pilots had the same reply, "negative sir, we are comfortable we can make it Insha-Allah".
Inside the cockpit, however, chaos was starting to brew. Within seconds the captain's voice was recorded at 09:32:09 as saying, "Hold was stuck, this is automatically built-in, I forgot". (in Urdu). This means the plane was making adjustments given it was trying to come down at a faster pace and the auto pilot itself decided to hold the plane to accommodate or manage the descent as given to it through data input.
Then at 09:32:24, the captain uttered the ominous words, "He will be surprised what we have done" (in Urdu). That is, the captain tells the first officer that when they bring the plane down so fast from such a height, the approach controller giving them directions, would be amazed at what a miracle they had done.
And so began a back and forth that provides us insights into the mentality or psyche of the pilots and the way they operated affirming the observation of physiologist at the captain's induction.
A second later, the approach controller gave a decisive instruction to the pilot saying "Pakistan 8303 disregard turn left heading 180". Here the pilots are explicitly told to cancel their landing approach, turn left, circle and bring the plane down normally. But the pilots were still adamant and replied "Sir, we are comfortable now and we are out of 3,500 for 3,000 established ILS 25L".
The approach controller, however, put his foot down and said at 09:32:38, "Negative turn left heading 180". But the pilot, following on from his bravado, proceeded to show what he was capable of and told the controller, "Sir, we are established on ILS 25L". The pilots were informing the approach controller that they had established the plane on Instrument Landing System to land at runway 25 L. This was not true, as in the next few seconds, the pitch angle of the plane was at -12.6° and reached -13.7°. This manoeuvre was so crazy, and the pilots had pitched the plane's nose so much down that the plane's autopilot disengaged. At its peak, the aeroplane's descent rate reached 6,800 ft/min. The aircraft was still far above the required altitude, while the distance from the runway was rapidly decreasing with each passing second.
After the autopilot of the plane turned off, a series of warnings started to ring out in the cockpit. It ignited a storm that pushed the captain and first officer into tunnel vision, where their ability to understand and think became severely limited. These warnings ranged from those for top speed and master warnings. As the aircraft descended rapidly, a ground approach warning also started to blare. The aircraft was still well above the required altitude for a comfortable and safe landing, and now the plane was flying too fast. You can imagine how much trouble the captain was putting not only the aeroplane but also the 97 passengers and crew on board.
PIA records show that this was not the first time this captain had performed such a landing. In fact, some have suggested that this was more of a norm for the capital with records showing his flight history over the plast 12 months containing "several unstable approaches." Not only were they not stopped and rectified, but "they continued, and the operator (PIA) blamed the ineffective SMS (Safety Management System) and FDA (Flight Data Management) programme implementation," did not ensure its effective monitoring.
Simply put, Captain Sajjad Gul had been taking off and flying flights in an unstable manner for a year prior to the plane crash and perhaps even longer. Not only this, but PIA, its flight operations and airlines had not only ignored the prevailing laws and regulations but had either intentionally or unintentionally reinforced this practice.
At 9:32:52, the aircraft was issued with the first ground approach warning by the aircraft. This warning occurred three times during the flight. At the same time, the plane started to warn the pilots with a loud voice to pull the plane up, but there was such a storm in the cockpit that the pilots tuned it out as background noise.
The pilots then made the first fatal mistake which confirmed the fate of the plane. It was decided to raise the plane's landing gear and three seconds later the speed brakes were also retracted.
At that moment, the Karachi approach controller finally gave up. Observing that the pilot was not complying with their instructions, it finally gave the aircraft permission to land on runway 25L. Here, it seems that the first officer may have wanted to go around and retracted the landing gear, but he did not inform his captain about his actions or intentions, signalling poor communication between the captain and his first officer. Amid the chaos, the captain, who had been appointed as someone who was supposed to enforce flight standards for the A320 in the airline, did not realise what had happened, did not inquire nor issue instructions to the flight officer about the landing gear.
Phase three
The third phase is from gears being retracted to the first impact of the plane with the runway (Belly Landing) which damaged both engines and sealed the aircraft's fate. (From 09:33:10 To 09:34:28).
After going through the chaotic initial moments, the first officer did the only positive thing in this whole phase, ask a question. The flight officer was heard saying: "Should we do the Orbit?" (in Urdu), to which the captain replied dismissively: "No-No," followed by, "Leave it" (both in Urdu). The last comment was supposed to be an instruction to the first officer to hand over the controls of the plane to the captain for landing. From here on out, the captain took over the controls of the plane. Despite that, the first officer maintained his input through his set of flight controls. This question reaffirms the possibility that the first officer was still thinking that they should go around and could offer an explanation if he was the one who had retracted the landing gears in anticipation of a go-around. But, as observed, communication between the two was quite poor, and the first officer never mentioned to the captain that seconds before they landed, the plane's landing gears had been retracted.
The decision to go around was perfectly legitimate and had even been suggested, or rather instructed, by the air traffic controllers more than once.
A few seconds later, however, warning lights for the plane's landing gear not being down started going up in the cockpit. This warning is shown in the form of a red arrow sign below the landing gear lever.
The voice recorder in the cockpit of the plane, however, recorded no less than 13 warnings during this time. These are the warnings that were in the form of voice, besides other warnings in the form of beeps and flashing lights. Among the warnings, there were ten for "Too Low, Terrain", which warned the pilots that the aircraft was too close to the ground. There were at least two "Pull-up" warnings meant to tell the crew to fly the plane higher.
These warnings do not come up when the landing gear is down, and the plane is about to land normally. But there was nothing normal about the way this plane was flown.
Phase four
The fourth phase is from the first impact of the aircraft with the runway, dragging the engines on the runway to taking off again and the Go-Around. (From 09:34:28 To 09:34:42).
According to the CVR recording, a sound similar to an aircraft falling to the ground was recorded at 09:34:28, corresponding to a belly landing of the aircraft. This was verified through the vertical load factor and longitudinal deceleration recorded on the plane's instruments and data recorders, as well as cameras installed at the airport.
The nacelles of both engines of the aircraft, one slung under each wing, made contact with the runway and dragged for almost 4,500 feet down the runway 25L. Moreover, it is important to note that the engines made contact with the runway around 4,000 feet from where the runway started. A further five hundred feet on, the plane touched the ground for the first time with its landing gear still retracted. Over the next 18 seconds, the plane came in contact with the runway four times. As a result, friction marks appeared on the runway.
What is noteworthy here is that the aircraft's engine number two remained in contact with the runway for a longer time than engine number one. That is, engine number two continued to rub along the runway for a total of 583 feet, while the duration of engine number one was 2,194 feet. That is, engine number two suffered four times more runway friction and ended up in worse shape as a result. The report states that the aircraft's engine number two may have been destroyed during this period as it issued a fire warning while engine number one continued to power the entire flight after that stage. However, as a result of this friction, the engine began to leak oil, as the warnings in the aircraft's cockpit indicated.
From 09:34:28 to 09:34:46, the aircraft remained in intermittent contact with the runway's surface. Both flight crew, the captain and the first officer, gave opposing sidestick inputs. The captain's sidestick inputs reached up to full nose down, meaning he was trying to put the plane down. At the same time, the first officer, who should have let the captain take care of the plane as he had handed over the aircraft to him, applied up to two-thirds of full-back sidestick input. Meaning he was trying to pull up the plane and take off. The resultant elevator positions were, on average, mainly to nose down with pitch attitude reaching -4º within two seconds of making contact with the runway. Both Engines' N1 vibrations started to increase.
In the Airbus A320, the plane's system manages the sidestick input and applies an aggregate or appropriate action to the inputs it is receiving.
Once again, the first officer, who had so far shown us that he was always late to the party, indecisive and poor at communicating on time, asked the captain, who was controlling the plane at that time, to "Take off, sir, take off (in Urdu)."
Here, according to the analysis and my conversations with experts, the flight crew made a second fatal mistake. Many pilots and first officers whom I spoke to believe that the captain at this stage should have let the plane slide down the runway on its belly. It was possible that the plane would have gone over the runway and landed on the dirt, or maybe it would have collided with the hangers at the far end of the runway. In that case, the outcome could have been different. More importantly, there was a higher chance that the passengers and crew could have survived, something their subsequent actions eliminated as a possibility.
Meanwhile, the two pilots of the aircraft gave opposing side-stick inputs. Engine number one's speed increased to 94% while engine number two decreased to 16%, resulting in the engine changing its status to 'start' (i.e. the engine restarted) while the landing gear not down warning was turned off.
This is the first part of a two-part series. You can read the second part here