NTSB CAROL · Event
Event CHI93IA248
Registry · N158US
FAA Aircraft Registry record.
Make / Model
ASCENDING TECHNOLOGIES GMBH FIREFLY
ADS-B equipped
Yes — Mode-S A0E9BA
Registrant of record
UNIVERSITY OF NEBRASKA-LINCOLN
Source: FAA Aircraft Registry (releasable master file).
Aircraft involved
Probable cause & findings
the failure of a navigation system (#1 INS) for reason or reasons undetermined.
Factual narrative
On July 10, 1993, about 1900 eastern daylight time, a McDonnell Douglas DC-10-40, N158US, registered to and operated by Northwest Airlines, Inc., as Flight 48, experienced an uncommanded rudder oscillation while climbing through 20,000 feet (mean sea level). The anomaly was corrected when the crew disconnected the number one inertial navigation system (INS). The airplane returned to Detroit, Michigan, where it landed without incident. The flight crew of three, cabin crew of eight, and 92 passengers reported no injuries. The airplane sustained no damage. The 14 CFR Part 121 flight was a domestic flight operating between Detroit, Michigan, and Boston, Massachusetts. The flight was on an IFR flight plan; however, VFR conditions existed at Detroit, Michigan. The flight departed at 1842 and returned at 1930. The airplane was examined by the NTSB, FAA, and Northwest Airlines personnel in Detroit on July 11, 1993. The #1 INS display unit and the Captain's attitude indicator were replaced. The cockpit voice recorder (CVR) and flight data recorder (FDR) were removed and taken to the NTSB laboratories in Washington, DC for readout. A review of the airplane's design indicated that the #1 INS provides bank angle information to the yaw flight guidance computer through the attitude monitoring and switching unit. The bank angle information is then transmitted from the yaw flight guidance computer to the lower rudder hydraulic actuator to move the rudder. On July 11, 1993, while the airplane was at Northwest maintenance facilities in Detroit, MI, the examination of the #1 INS began with a cockpit test to identify fault codes recorded in the INS. Fault codes were recorded consistent with a #1 INS failure. The #2 INS and standby INS were examined and both appeared to be operational. The airplane's hydraulic systems were powered via the APU. All flight controls were operated with no anomalies. The yaw damper system self-test was completed with no anomalies. Following the tests and examinations, the #1 INS and controller were removed along with the Captain's ADI. These components were sent to Northwest Airlines facilities for further evaluation. Following a preflight inspection, the airplane was flight tested by Northwest Airlines flight crew. The flight test involved extensive maneuvering of the airplane and a thorough operation of all flight control systems and INS operations. The flight was accomplished successfully. On or about July 16, 1993, bench testing of the #1 INS, by Northwest personnel, indicated that the internal gyro generating bank-axis (lateral) reference information had failed. The gyro output varied as the gyro tumbled, which produced a bank angle signal. The INS warning light that illuminated on the unit during the incident event correctly identified a failure of the unit. Northwest Airlines personnel reported that testing verified there were no anomalies with the Captain's ADI. The Digital Flight Data Recorder Factual Report is attached as an addendum to this report. WHILE CLIMBING THROUGH 20,000 FEET THE #1 INS FAILED. THE GYRO OUTPUT VARIED AS THE GYRO TUMBLED, WHICH PRODUCED A BANK ANGLE SIGNAL. THE FAILURE MODE ALLOWED THE BANK ANGLE INFORMATION TO BE TRANSMITTED TO THE YAW FLIGHT GUIDANCE COMPUTER, ALLOWING THE ATTITUDE MONITORING AND SWITCHING UNIT TO MOVE THE LOWER RUDDER HYDRAULIC ACTUATOR, CAUSING THE LOWER RUDDER TO MOVE. Source: NTSB Aviation Accident Database (Pre-2008 Archive) Retrieved: 2026-02-12
Verbatim from NTSB's published report. Source file
NTSB_1993_CHI93IA248.txt.
Findings + structured fields enriched from FAA avall.mdb.
Full investigation docket on
data.ntsb.gov ↗.
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Related research
What the literature says.
Academic papers and agency reports matching this event's aircraft type or causal vocabulary (maintenance). Sourced from NASA NTRS, NTSB Safety Studies, FAA CAMI, AOPA Air Safety Institute, Embry-Riddle Scholarly Commons, arXiv, and the Semantic Scholar academic graph.
- Embry-Riddle Scholarly Commons 2026 · Journal article (IJAAA)
From Reactive to Predictive: A hybrid Trust-Mediated Adoption Framework for Data-Driven Maintenance in Distributed-Authority Aviation Environments
Modern aviation maintenance operates within increasingly data-intensive technological environments, yet the operational integration of predictive maintenance into routine decision-making remains incon…
- Semantic Scholar 2025 · Article (Applied Sciences)
Decision-Making Framework for Aviation Safety in Predictive Maintenance Strategies
The implementation of predictive maintenance (PM) in aviation presents unique challenges due to strict safety requirements, complex operational environments, and regulatory constraints.
- Embry-Riddle Scholarly Commons 2024 · Journal article (JAAER)
Low-Resource Automatic Speech Recognition Domain Adaptation – A Case-Study in Aviation Maintenance
With timeliness and efficiency being critical in the aviation maintenance industry, the need has been growing for smart technological solutions that optimize and streamline the different underlying ta…
- Embry-Riddle Scholarly Commons 2024 · Journal article (JAAER)
A New Trajectory in UAV Safety: Leveraging Reinforcement Learning for Distance Maintenance Under Wind Variations
In the field of aviation, safety is a critical cornerstone, and the operation of Unmanned Aerial Vehicle (UAV) systems is deeply connected with this principle.
- Embry-Riddle Scholarly Commons 2024 · Journal article (IJAAA)
Just Culture in Aviation: A Metaphorical Study on Aircraft Maintenance Students
Just Culture, a sub-dimension of safety culture, has been a prominent and debated topic in aviation safety in recent years.
- Embry-Riddle Scholarly Commons 2024 · Journal article (IJAAA)
Performance PRISM: A Comprehensive Framework For Performance Measurement In Aircraft Maintenance
Aircraft maintenance is governed by rigorous safety requirements and high operational complexity, demanding robust performance measurement frameworks to ensure optimal maintenance practices.
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