Originally Posted by Underfire
Pretty damning article…
Editorial: Air Canada, FAA hindered probe of SFO near-miss
Editorial: Air Canada, FAA hindered investigation of SFO near-miss
The U.S. Federal Aviation Administration and Air Canada hindered the investigation of last month’s near-catastrophe at San Francisco Airport by dragging their feet in the aftermath.
As a result, key evidence from the cockpit voice recorder was erased and the pilots were never tested for drugs or alcohol. It’s a bureaucratic cover-up that conveniently protects the federal agency and the airline involved.
The fiasco highlights the need for new federal laws or regulations mandating immediate reporting of near-misses and the grounding of aircraft and pilots until after National Transportation Safety Board investigators are called in.
This could have been nearly the worst aviation disaster in history, second only to the two hijacked planes that plowed into the World Trade Center on September 11, 2001.
On July 7, pilots of an Air Canada plane landing minutes before midnight at SFO mistook a taxiway for the runway where they were supposed to land. The latest investigative findingsshow the plane dipped as low as 59 feet off the ground as the pilots aborted their landing, barely missing four fully-fueled aircraft with an estimated 1,000 passengers that were awaiting takeoff.
The FAA, which was responsible for having only one air controller working traffic in the tower at the time, took more than 24 hours to notify the NTSB. The delay allowed Air Canada to use the plane for three flights in which the cockpit recorder was taped over multiple times.
That recorder held potentially critical information about what the pilots were saying as they headed straight for the taxiway. The cockpit conversation between the pilots might have helped explain their confusion.
As for the pilots, a source familiar with the current NTSB investigation told reporter Matthias Gafni that they spent the night in the Bay Area and flew out the next morning on their normally scheduled flight.
It was business as usual, despicable behavior on the part of Air Canada, which refuses to answer questions during the investigation, including whether the pilots have since been grounded. United Airlines’ outrageous response after a passenger was dragged off a plane pales in comparison to this stonewalling.
Similarly, the FAA refuses to explain why it took more than a day to notify the NTSB. The NTSB, in turn, excuses all this by noting that federal rules did not require that it be notified because there was no collision.
That technical rationalization belies common sense. Air Canada Flight 759 came within a few dozen feet and a few seconds of creating an airport inferno the likes of which this nation has never seen.
Jim Hall, former NTSB chairman, told Gafni that those reporting guidelines should be addressed in the investigation. “This was probably the most significant near-miss we’ve had in this decade,” Hall said. “I think splitting hairs on this issue on an incident of this significance is a disservice to safety.”
He’s right. The investigation into this terrifying episode should have started immediately.
This article raises several questions:
- Is The Mercury News an authoritative source on air accident and investigation & safety?
- Do they have additional information that is generally not known the public?
The article makes no specific claim about additional sources that I could see, so I am going to assume that they have about as much information as PPRuNe has found.
Claim 1 AC and the FAA dragged their feet? Evidence, source? No it was based on the fact that the CVR was erased. Inferred in this statement is that this was a deliberate act. No mention that this is the default mode of operation for this device.
Active steps must be taken to avoid erasure.
Claim 2 New laws to protect the CVR are required in the case of a series near miss. The assumption is that either the crew or the tower were aware that the incident was as series as it actually turned out to be. It may not have been clear to the crew just how close it actually was. Unless the tower controller was watching the radar altitude and been aware of the offset, he also may have been unaware the seriousness.
Claim 3 Potentially the second worst disaster ever. True
Claim 4 AC pilots attempted to land on a taxiway. True
Claim 5 Single tower controller. Appears to be true
Claim 6 FAA took 24 hours to notify NTSB. True
Claim 7 CVR overwritten caused by notification delay. True
Claim 8 CVR held vital information about the event. True
Claim 9 Pilots operated out as per schedule. Appears to be true.
Claim 10 AC non assistance with investigation. Appears to be true
Claim 11 FAA has not explained reporting delay. True
Claim 12 No immediate reporting requirement as no collision had occurred. True
Claim 13 Most serious near miss in a decade. True
Most of the specific detail of the article are technically correct. However, the entire assumption of this article and its criticism & tone of malicious intent by the crew & FAA
rests on the assumption that there was the recognition of the seriousness of the event by either the crew or the tower controller. We have no way of knowing the state of mind of these three people, and what they believed about their perception of the seriousness of the event. There are only 3 people in the world who know.
Ten years ago, it is almost certain that this event would not have surfaced publicly, as the availability of the information from web based Flight Trackers and ATC recordings were just in their infancy without the widespread coverage and use by the public.
Would an NTSB investigation looked closely enough to also realise the seriousness of the event based on a crew or tower report? That is an unknowable answer.
The entire basis of the “damning” article appears to be about the judgement of how the crew & tower controller perceived the event. The inference from the article is the crew & tower would have been aware. On what basis could this view be formed? Pure assumption or actual knowledge?
To the general public reading this editorial, the crew & tower controller have been judged & convicted, case closed, throw away the key. To anybody with genuine insight, there are many more questions to be asked and information to gather. The truth is, we may never find the truth of this event. Likely this was true of many other near misses in the past that everyone in the system were unaware of.
Absence of evidence is not evidence of absence.
The system is being judged through a different lens than existed in the past with the explosion of information available for open source analysis.