Charlotte Douglas Internationa Airport
Aircraft Accident/Incident Report

Charlotte, North Carolina 28208
Sunday, March 31, 2002 19:45 EST

NTSB Narrative Summary Released at Completion of Accident

The captain stated he was the pilot flying and the takeoff and climb to the cruise altitude of 33,000 feet was conducted within normal parameters. After level off the relief pilot left the cockpit to begin his rest period. Within a few minutes he observed that the number 2 engine master warning light was illuminated, as well as a level 3 alert on the Engine and Alert Display and a red light on the number 2 fire handle and fuel shutoff lever. The fire bell did not activate. He and the first officer performed the memory and initial action items on the hard card checklists for an engine fire and shutdown the No. 2 engine. In addition, the captain discharged an engine fire bottle. The engine fire light continued to illuminate. The captain then fired a second engine fire bottle. The engine fire light continued to be illuminated. The captain requested that the relief pilot return to the cockpit. He then contacted Air Traffic Control (ATC) and told them that their No. 2 engine was on fire and that they intended to land at the nearest suitable field. ATC responded that Charlotte was 35 miles away with a 10,000 foot runway. He asked for radar vectors and an immediate descent into Charlotte. They were given a lower altitude. The first officer initiated fuel dumping. The relief pilot returned to the cockpit and he asked the relief pilot and the first officer to run the checklists. As they descended the aircraft encountered heavy rain, light hail, and moderate turbulence. In addition, they observed a bright flash to the left of the nose, which might have been a lightning strike. As they completed the descent and approach checklists he told the crew to expect an emergency evacuation upon landing and directed the first officer to so inform the flight attendants. The aircraft was configured for an engine out approach and they reviewed the loss of a second engine procedure. The remainder of the approach, touchdown and landing roll occurred within normal parameters. He brought the airplane to a stop on the runway. The engine fire indication remained illuminated. The relief pilot stated they did not terminate fuel dumping prior to landing. They completed the items on the evacuation checklist. He then ordered an evacuation of the airplane. According to Delta Air Lines representatives, examination of the No. 2 engine by company maintenance personnel found one fire loop chafed through an adjacent cable, an integrated drive generator (IDG) feeder cable, inside the No. 2 engine cowling This allowed a direct 115 volt AC connection between the IDG and the fire detection control unit. The result was an electrical short and complete failure of the detection control unit that was indicated in the cockpit as a fire warning. There was no evidence of fire in the No. 2 engine. Boeing Service Bullettin MD11-71-086 was issued on May 21, 1996. The subject of the service bulletin was "Power Plant - Electrical Harness - Replace/Modify Integrated Drive Generator (IDG) Wire Harness Support Brackets". On May 21, 2001, Boeing elevated the service bulletin to the "Alert" level. Boeing recommended that aircraft operators accomplish the service bulletin within 1 year. According to Delta Air Lines personnel, in November 2001, Delta Air Lines Aircraft Engineering issued a Engineering Order to comply with Alert Service Bulletin MD11-71A086. The Engineering Order stated that all engines should be inspected and modified by November 2002. All three engines on the accident aircraft were inspected and modified in accordance with the Engineering Order on March 3, 2002. On March 28, 2002, the No. 2 engine was changed and the engine installed had not been modified by the Engineering Order.The Delta Airlines descent, approach, and before landing checklists dated June 30, 2000, and which were in use at the time of the accident, required the pilots to check the Engine and Alert Display. When fuel dumping is activated, a message is displayed on the Engine and Alert Display.

NTSB Probable Cause Narrative

The failure of the aircraft operator to comply with, in a timely manner, on the No. 2 engine, Boeing Alert Service Bulletin MD11-71A086, resulting in the integrated drive generator feeder cable chaffing through a fire warning loop and failure of the fire warning system due to electrical damage. This resulted in a continuous indication in the cockpit of a No. 2 engine fire, an emergency descent and landing, and injuries to passengers during the subsequent emergency evacuation of the airplane.

Event Information

Type of Event Accident
Event Date 3/31/2002
Event Day of the Week Sunday
Time of Event 1945
Event Time Zone Eastern Standard Time
Event City Charlotte
Event State NORTH CAROLINA
Event Country --
Zipcode of the event site 28208
Event Date Year 2002
Event Date Month 3
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude 351251N
Event Location Longitude 0805635W
Event Location Airport Charlotte Douglas Internationa
Event Location Nearest Airport ID KCLT
Indicates whether the acc/inc occurred off or on an airport On Airport
Distance from airport in statute miles 0
Degrees magnetic from airport --
Airport Elevation 748
Weather Briefing Completeness Full
Investigator's weather source Weather Observation Facility
Time of the weather observation 1951 Eastern Standard Time
Direction of event from weather observation facility (degrees) --
Weather Observation Facility ID CLT
Elevation of weather observation facility 748
Distance of event from weather observation facility (units?) 0
Time Zone of the weather observation EST
Lighting Conditions Night
Lowest Ceiling Height 300
Lowest Non-Ceiling Height --
Sky/Lowest/Cloud Conditions --
Sky Condition for Lowest Ceiling Overcast
Visibility Runway Visual Range (Feet) --
Visibility Runway Visual Value (Statute Miles) --
Visibility (Statute Miles) 2
Air Temperature at event time (in degrees celsius) 12
Dew Point at event time (in degress fahrenheit) 12
Wind Direction (degrees magnetic) 360
Variable Wind Indicator Wind direction could be determined
Wind Speed (knots) 10
Wind Velocity Indicator --
Wind Gust Indicator Not Gusting
Wind Gust (knots) --
Altimeter Setting at event time (in. Hg) 29.85
Density Altitude (feet) 800
Intensity of Precipitation Light
METAR weather report --
Event Highest Injury Serious
On Ground, Fatal Injuries --
On Ground, Minor Injuries --
On Ground, Serious Injuries --
Injury Total Fatal --
Injury Total Minor 11
Injury Total None 229
Injury Total Serious 5
Injury Total All 16
Investigating Agency NTSB
NTSB Docket Number (internal use) 15328
NTSB Notification Source FAA Comm Ctr-SE
NTSB Notification Date Mar 31 2002 12:00AM
NTSB Notification Time 1958
Fiche Number and/or location -used to find docket information DMS
Date of most recent change to record Apr 28 2004 3:34PM
User who most recently changed record NTSB\MONR
Basic weather conditions Instrument Meteorological Cond
FAA District Office Charlotte

Aircraft Involved

Aircraft #1

Aircraft Registration Number N809DE
NTSB Number MIA02FA075
Missing Aircraft Indicator --
Federal Aviation Reg. Part Part 121: Air Carrier
Type of Flight Plan filed IFR
Flight plan Was Activated? Yes
Damage Minor
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name McDonnell Douglas
Aircraft Model MD-11
Aircraft Series Identifier --
Aircraft Serial Number 40480
Certified Max Gross Weight 628000
Aircraft Category Airplane
Aircraft Registration Class U.S. Registered/U.S. Soil
Aircraft is a homebuilt? No
Flight Crew Seats --
Cabin Crew Seats --
Passenger Seats --
Total number of seats on the aircraft 282
Number of Engines 3
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection AAIP
Date of Last Inspection Feb 28 2002 12:00AM
Airframe hours since last inspection 20
Airframe Hours 40531
ELT Installed No
ELT Activated No
ELT Aided Location of Event Site No
ELT Type --
Aircraft Owner Name Delta Air Lines, Inc.
Aircraft Owner Street Address Hartsfield Atlanta International Airport D595
Aircraft Owner City Atlanta
Aircraft Owner State GA
Aircraft Owner Country USA
Aircraft Owner Zipcode 30320
Operator is an individual? No
Operator Name --
Operator Same as Owner? Yes
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address --
Operator City --
Operator State --
Operator Country --
Operator Zip code --
Operator Code DALA
Owner has at least one certificate --
Other Operator of large aircraft? --
Certified for Part 133 or 137 Operation --
Operator Certificate Number --
Indicates whether an air carrier operation was scheduled or not Scheduled
Indicates Domestic or International Flight International
Operator carrying Pax/Cargo/Mail Passenger Only
Type of Flying (Per_Bus / Primary) --
Second Pilot on Board Yes
Departure Point Same as Event No
Departure Airport Code KATL
Departure City Atlanta
Departure State GA
Departure Country USA
Departure Time 1902
Departure Time Zone EST
Destination Same as Local Flt --
Destination Airport Code ELGW
Destination City London
Destination State --
Destination Country UK
Specific Phase of Flight Emergency landing
Report sent to ICAO? Yes
Evacuation occurred Yes
Date of most recent change to record Mar 2 2004 3:41PM
User who most recently changed record KENJ
Since inspection or accident Time of Accident
Event Location Runway Number and Location 18R
Runway Length 10000
Runway Width 150
Sight Seeing flight No
Air Medical Flight No
Medical Flight --