Computer Disasters

[NEUMANN at SRI-AI.ARPA]

From:  Peter G. Neumann <NEUMANN at SRI-AI.ARPA>

Review of Computer Problems -- Catastrophes and Otherwise

As a warmup for an appearance on a SOFTFAIR panel on computers and
human safety (28 July 1983, Crystal City, VA), and for a new editorial
on the need for high-quality systems, I decided to look back over
previous issues of the ACM SIGSOFT SOFTWARE ENGINEERING NOTES [SEN]
and itemize some of the most interesting computer problems recorded.
The list of what I found, plus a few others from the top of the head,
may be of interest to many of you.  Except for the Garman and Rosen
articles, most of the references to SEN [given in the form (SEN Vol
No)] are to my editorials.

SYSTEM -- 
SF Bay Area Rapid Transit (BART) disaster [Oct 72] 
Three Mile Island (SEN 4 2) 
SAC: 50 false alerts in 1979 (SEN 5 3);
  simulated attack triggered a live scramble [9 Nov 79] (SEN 5 3);
  WWMCCS false alarms triggered scrambles [3-6 Jun 80] (SEN 5 3)
Microwave therapy killed arthritic patient by racing pacemaker (SEN 5 1) 
Credit/debit card copying despite encryption (Metro, BART, etc.)
Remote (portable) phones (lots of free calls) 

SOFTWARE -- 
First Space Shuttle launch: backup computer synchronization (SEN 6 5 [Garman])
Second Space Shuttle operational simulation: tight loop on cancellation
  of early abort required manual intervention (SEN 7 1) 
F16 simulation: plane flipped over crossing equator (SEN 5 2) 
Mariner 18: abort due to missing NOT (SEN 5 2) 
F18: crash due to missing exception condition (SEN 6 2) 
El Dorado: brake computer bug causing recall (SEN 4 4) 
Nuclear reactor design: bug in Shock II model/program (SEN 4 2)
Various system intrusions ...

HARDWARE/SOFTWARE -- 
ARPAnet: collapse [27 Oct 1980] (SEN 6 5 [Rosen], 6 1) 
FAA Air Traffic Control: many outages (e.g., SEN 5 3) 
SF Muni Metro: Ghost Train (SEN 8 3)

COMPUTER AS CATALYST -- 
Air New Zealand: crash; pilots not told of new course data (SEN 6 3 & 6 5) 
Human frailties:
  Embezzlements, e.g., Muhammed Ali swindle [$23.2 Million],
    Security Pacific [$10.2 Million],
    City National, Beverly Hills CA [$1.1 Million, 23 Mar 1979]
  Wizards altering software or critical data (various cases)

SEE ALSO A COLLECTION OF COMPUTER ANECDOTES SUBMITTED FOR the 7th SOSP
  (SEN 5 1 and SEN 7 1) for some of your favorite operating system
  and other problems...

As you may by now know, I am always very interested in hearing about
problems involving computers (not just software) and human well being,
both for SOFTWARE ENGINEERING NOTES and generally.  John Shore
(Shore at NRL-CSS) is also compiling a list (and has circulated a prior
BBOARD notice to some of your BBOARDS), and I will forward anything
you send me to him.  If you wish, we will try to keep you informed as
well...

Peter G. Neumann, NEUMANN at SRI-CSL or NEUMANN at SRI-AI.
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