Turkish Airlines Flight 1951

The Poldercrash

Turkish Airlines Flight 1951

According to Charles Perrow, interfaces, whether they be hardware or software, may enable unintentional sequences not immediately visible or comprehensible, presenting complex interactions. Much of the same can be said for tight system coupling where no buffers exist to prevent one input from having an immediate and direct impact on an entire system. Either of these situations present innate hazards; but combined, a catastrophic outcome can become expected, even normal. In the Feb. 25, 2009 crash of Turkish Airlines Flight 1951, complex interactions inherent in outdated automated flight controls were combined with yet another ingredient: social complexity. As Flight TK1951 approached the Polderbaan runway at Amsterdam-Schiphol International Airport that day, shifting interfaces met uncoordinated organizational policy. These effects manifested themselves with disastrous consequences, claiming the lives of nine people and the injuries of countless more aboard Flight 1951.