In this episode Amir and Adam discuss three aviation accidents that parallel the Elaine Bromiley case.

• Human factors in medicine: As Captain Bromiley put it, this was not an individual failure. It was a system failure. It was a failure of human performance. In aviation, 75% of airline accidents are due to human factors rather than mechanical failure. 
• Eastern Airlines Flight 401 (1972)
  • Fixation-induced loss of situational awareness.
  • Troubleshooting a landing gear light indicator problem in the cockpit (one of the landing gear lights would not indicate the gear was down and locked).
  • The autopilot was engaged and the aircraft was flying over unlit terrain (the Florida everglades) at night.
  • One of the flight crew inadvertently bumped the control column which disengaged the autopilot.
  • Despite an altitude alert chime being audible on the Cockpit Voice Recorder (CVR), none of the crew responded to it.
  • The aircraft slowly descended and impacted terrain.
  • The landing gear was in fact down and locked and the failure of a single light bulb resulted in many fatalities.
• United Airlines Flight 173 (1978)
  • Fixation-induced loss of situational awareness leading to fuel exhaustion and crashing in Portland
  • Troubleshooting a landing gear light indication problem, similar to Eastern Airlines Flight 401
  • Again the light failed to indicate, but the gear was later found to be in a safe position
  • This time the Captain continued to circle to try to troubleshoot the problem and optimize the conditions for the emergency landing with a potentially unsafe landing gear.
  • Despite the First Officer (FO) and Flight Engineer (FE) attempting to tell the Captain that the aircraft was dangerously low on fuel, the Captain continued to take time to work the landing gear problem.
  • When the engines began to fail, the Captain was surprised that it was because of a lack of fuel.
• Air Florida Flight 90 (1982)
  • Poor crew coordination and lack of assertiveness / failure of leadership leading to a crash on departure in icing conditions.
  • The failure to engage the engine anti ice later led to a false indication in the cockpit instruments showing that the engines were developing sufficient thrust for takeoff when they weren’t.
  • The Captain ignored the First Officer’s repeated concerns about the amount of ice on the wings and whether the engines were developing sufficient power on takeoff.
• Just a Routine Operation (YouTube - 6 min)
• Just a Routine Operation (YouTube - 14 min)
• Martin Bromiley: A patient’s perspective (March 16, 2018 - YouTube - 23 min)
• Eastern Airline Flight 401  Mayday Fatal Distraction - S05E09 (YouTube)
• United Airlines Flight 173 - Mayday Focused on Failure  S12E08 (YouTube)
• Air Florida Flight 90 - Mayday Disaster on the Potomac - S13E04 (YouTube)
• ACCRAC Ep 325: The WISH Inventory and Well-Being in Anesthesiology with Drs. Higgins and Vinson (anesthesiologists take an outsized sense of responsibility for outcomes - at 5 min