United Airlines Flight 2528
Boeing 737-322 · Accident: on ground/water collision with object during pushback
From Los Angeles International Airport (LAX) to Oakland San Francisco Bay Airport (OAK)
Event
- NTSB case
- LAX99LA302
- Event typeAccident: someone killed or seriously injured, or the aircraft substantially damaged (NTSB definition). Incident: an occurrence that affected or could have affected safety, short of that. Glossary
- Accident
- InvestigationHow far the investigation had got when the record was published: preliminary, ongoing, final or completed. Unknown where the source does not say. Glossary
- Completed
- API-reported fatalities
- 0 · all aircraft and ground
- Ground fatalities
- 0
- OperationWhat kind of flying it was, grouped by the rules it flew under: airline (US Part 121), air taxi and commuter (Part 135), general aviation (Part 91 and similar), military or government. Glossary
- Airline
- WeatherVisual meteorological conditions (VMC): good enough to fly by looking outside. Instrument conditions (IMC): cloud or low visibility, flying by instruments. Glossary
- Visual Meteorological Cond
Boeing 737-322
- Aircraft type
- Boeing 737
- Category
- Airplane
- RegistrationThe aircraft's tail number, such as N12345 or G-ABCD. Registrations are reissued, so the same one years apart can be a different aircraft. Glossary
- N388UA
- Operator
- United Airlines
- Onboard fatalities
- Unknown
- Route
- From Los Angeles International Airport (LAX)To Oakland San Francisco Bay Airport (OAK), Oakland, CA
- Aircraft age
- Not recorded
- Flight rulesThe regulations the flight operated under: in the US, Part 91 (general aviation), Part 121 (airlines), Part 135 (air taxi and commuter) and others; for flights abroad, the NTSB's coarser commercial or non-commercial code. Glossary
- Part 121: Air Carrier
- Phase of flightThe stage of the flight when things started to go wrong: standing, taxi, takeoff, initial climb, en route, maneuvering, approach or landing. Glossary
- Pushback/towing
- First occurrenceThe single coded event the NTSB judges best describes what happened (records from 2008 on). Older records name the first occurrence in the sequence instead. Glossary
- On ground/water collision with object
- DamageDestroyed: beyond practical repair. Substantial: damage that affects the structure, performance or handling and normally needs major repair. Minor: less than that. Glossary
- Substantial
Cause areas
- Ground personnel › Procedures/directives, not followed
Approximate · Coordinates as recorded by the NTSB; no uncertainty radius is established.
NTSB narrative
The flight was being pushed back by a tug when it contacted a lavatory service truck, which had pulled up at the rear of the airplane to service the lavatories. The airline uses one person pushback operations at this station for B737's. Under the procedure, the ground handler will walk around the airplane just before the pushback to ensure that the airplane's path is clear. Once the flight crew gives the clearance, the pushback commences without the aid of wing walkers or other safety observers. The handler assigned to this flight did his walk around after the jetway bridge had been moved back. Once he was cleared by the flight crew he leaned over the tow bar for one last look and then mounted the tractor to start the push. He did not see the lavatory service truck at any time and the lavatory driver did not verbally communicate his presence or intentions. The flight crew turned on the rotating beacon just before the aircraft started to move. During the push the handler felt resistance and stopped just as the lavatory service driver ran to the front of the airplane shouting for him to stop. Three calls had been made for lavatory service on this airplane, the last one 10 minutes prior to departure. The lavatory service driver originally assigned to handle this flight was busy. Another lavatory service driver heard the service request on the radio and responded to the airplane, arriving about 7 minutes prior to departure. When he arrived, the rotating beacon was not on, which signified to him that the pushback was not imminent. He parked his service truck under the tail of the airplane and proceeded to service the aft lavatory just as the airplane began to move and it contacted his truck. The airline's ramp operations manual states, 'Before approaching aircraft to perform last-minute servicing, at or near departure time, always establish positive verbal communication with the pushback tractor driver.'
Probable cause
The lavatory service driver's failure to follow established company procedures and directives. A factor in the accident was the airline's use of a one person pushback procedure.
Verbatim NTSB analysis and probable cause from the NTSB dataset
Sources
NTSB record LAX99LA302
- Event ID
- 20001212X19804
- Case number
- LAX99LA302
- Dataset
- historical-pre2008
- Source SHA-256
- 89e2df6d848e7ab3b42e7d7c7a03ff403303057a26ca04c95b3ea67201c3ce74
Source notes (4)
- Unreviewed is an editorial label, not an investigation status. API-sourced is not report-checked or human-reviewed. Explicit event totals are used without summing aircraft injury tables; onboard allocation is withheld. Unknown values remain unknown. The operation category is mapped from the NTSB-reported FAR part and has not been reviewed.
- Filled from the NTSB case API where the bulk record had no value: investigation status. Values present in the bulk record are kept.
- The date is the local date, which is the same as the UTC date the NTSB stores.
- API snapshot SHA-256: 1114f2be5002fd774e6862ca70dfc06acdabe98c36109b589f6f9ade9a466b54; retrieved 2026-09-18T16:53:08.996Z.