A twin-engine turboprop passenger airliner takes off for a short hop across part of Texas. Everything is normal until the airplane pitches nose down, exceeds maximum speed, loses a wing, and catches on fire. No one survives the crash. It must have been a horrible 12,000 foot descent, except that the G forces were such that everyone aboard may have been unconscious.
The investigators in this series are truly astonishing. They're all precise, methodical, fussbudgets. I'd hate to have had one as a roommate. The first task is to try to find all the parts of the airplane, which came apart during the fall. They're all there except for one part -- the leading edge of the left horizontal stabilizer, the flat part of the tail that sticks out on both sides of the fin. It wasn't with the rest of the wreckage. A lengthy search ensues in which, finally, the long thin sheet of aluminum is found lying against a board fence, parallel to the planks and almost impossible to identify.
Not to get into the weeds here, the investigators find that the leading edge of the left stabilizer was supposed to have been firmly screwed onto the rest of the stabilizer. But it's obvious that the bottom had been properly fixed but the screws were missing from the top side of the leading edge. Despite this, the leading edge held on long enough for most of the flight to be completed but was ripped off when the pilot increased speed while approach the landing field.
The error occurred during a change of shift at Continental Express. The mechanics were in a hurry to get the airplane out and the evening shift left the job of replacing leading edges on both sides of the tail unfinished, handing the completion of the job over to the night shift. But the paperwork detailing the job was sloppy and ambiguous. "Sometimes it takes longer to fill out the papers than it does to do the job." I, for one, am sympathetic but when lives are at stake, it's necessary to do the dull stuff too because, if you don't, someone will eventually die. Imagine a hospital in which a doc's shift is up and he leaves a note for the relieving physician that reads, "Helped patient."
The NTSB not only censured the three mechanics chiefly involved but Continental Express as well for allowing such a lax subculture to develop in their maintenance crews. One can only imagine what the mechanics felt like.