Among the review's findings are:
The possibility of a cause other than a collision or near collision with another airborne object being the initial cause of the upset to the St Phelim does not appear to have been adequately examined in the 1970 report.
Up to the end of 1995, 139 Viscount crashes have been reported, 66 of these accidents have involved fatalities with a total loss of 1,573 lives. Source: World Directory of Airliner Crashes.
Despite taking three months to locate the St Phelim on the seabed and the difficulties in establishing the flight path of the aircraft, the lack of communication between the St Phelim and any ATC [Air Traffic Control] station, and the difficulties in constructing the last movements of the aircraft, the report did not make any safety recommendation with regard to: search and rescue procedures in the Irish airspace; the fitting of the cockpit voice recorder to Viscount Aircraft (These were fitted by Aer Lingus to the remaining Viscounts after the Tuskar crash); the fitting of emergency locator beacons to Irish-registered aircraft; increased radar coverage in Irish airspace; the use of secondary surveillance radar in Irish airspace.
There were serious errors in the maintenance operating plan of EI-AOM [the aircraft] at the time of the accident. These errors originated within Aer Lingus.
The Department [of Transport and Power] failed in its role of approving and auditing the maintenance operating plan.
The omission, from the final report of details of the aircraft's maintenance history, except in the briefest of terms, is difficult to comprehend.
The total omission from the final report of details of the errors in EI-AOM's maintenance operating plan is difficult to comprehend.
While the maintenance history and Maintenance Operating Plan errors of EI-AOM contain many matters for concern, there is no evidence that any of these items had a bearing on the cause of the accident.
The structure of the Aeronautical section of the Department of Transport and Power, which led to the person responsible for the approval of the Certificate of Airworthiness being in charge of the investigation, posed a potential conflict of interest.
This also applied to the Department of Transport and Power personnel responsible for the regulation of the maintenance of the aircraft who were involved in the investigation of the accident.
The review's recommendations were:
This review recommends that all non-personal material be placed in the public domain through the National Archive and under the National Archive Act 1986, with the exception of files relating to post-mortem examinations. These excepted files should be retained by the Air Accident Investigation Unit
The Air Accident Investigation Unit should remain available to review any new evidence regarding this accident that may come to light in the future.