A United Air Lines flight is approaching Portland International Airport for a routine landing on a clear night with little traffic. The problem is that the landing gear, instead of descending gently, has fallen into place with a thump and the lights on the instrument panel do not show the gear as locked.
The pilot asks for a holding pattern while he tries to solve the problem. He circles the airport so long, despite the warnings of the other two crew members, that the DC8 runs out of fuel in all four engines. Luck and skill enable the pilot to land in a stretch of suburban woods that saves the lives of all but a few.
The pilot was distracted, so the responsibility for the crash rests with him. But blaming someone is not the responsibility of the ATSB. The question is not so much "who did it?" It's "how do we prevent this from happening again?" The problem was systemic at this point in time, some years ago. The pilot is the sole authority in on the flight deck. And the structure is rigid. The first officer and the flight engineer do not tell the pilot he's a cretinous fool. Instead, as in this case, they offer only tense prompts: "We're getting low on fuel, Captain." It's not enough when the pilot's attention is focused elsewhere.
So a training program is implemented that apparently has eased the problem of cockpit communication by making the control of the aircraft more democratic, so to speak. It appears to work, because this DC8 at Portland was only one of a string of terrific accidents that were the result of the authoritarian structure of the flight deck. And there haven't been any like this since.