Mid-air collision over Brasil [Archive] - Page 5

A310driver

12th Dec 2006, 21:22

caos

13th Dec 2006, 00:02

There is a popular TV program in the US where the moderator refers to the fact that "this is a no-spin zone" meaning that guests are not allowed to "spin" the facts so that they appear to be something other than what they really are. Methinks that we have some of this going on in this thread including your last post where you imply that the fact that the Legacy pilots did not request a different altitude was one of the factors in a series of factors that caused the accident.
I did not say this, what I said as a first point is related to a bad communication of the SBSJ ATC toward the Legacy, a wrong phrase used by SBSJ ATC (recognized by several Brazilian authorities), wrong words, wrong languaje, clearing the Legacy at same level up to Manaus.

You apparently are neither an ATC person nor a pilot nor have you read my previous posts or those of others.
I'm not ATC, I'm not a pilot, I'm not fool, I'm an investigator that has read all the posts from the beginning and want to know exactly what happened.

The Legacy was cleared by ATC to maintain FL 370 prior to crossing and beyond BRS and this was operative until such time as changed by ATC or the provisions of lost comm rules took effect (which appears to be a time well after the collision by application the rules).

The Legacy was under no obligation to request a lower altitude(or different altitude complying with the normal hemispheric plan) passing BRS nor should ATC have expected it to request a change.

The Legacy was maintaining its last cleared altitude and was required to do so
until it was changed by ATC(which by your own quotation it never did).
I get your point perfectly.

The listing of the fact that the Legacy did not request an altitude change as factor in a series of events causal to the accident is spinning.

This is a no spin zone.
I was talking about SBSJ Controller attitude when he first cleared FL370 to Manaus (note 1) and not to BRS.

From Preliminary Report (not my words)
http://www.ntsb.gov/pressrel/2006/061122a.htm
" After takeoff, N600XL was issued a number of interim altitudes during climb, all of which were read back. The flight was cleared to proceed direct to Araxa VOR (on airway UW2), and at 3:11 pm was cleared to climb to FL370 (note 1). At 3:33 pm, the airplane leveled at FL370.

At 3:51 pm, an air traffic controller in the Brasilia ACC (CINDACTA 1) instructed N600XL to change frequencies to the next controller's sector. The crew of N600XL reported in on the assigned frequency that the flight was level at FL370. ATC acknowledged and instructed the crew to "ident" (flash their transponder). Radar indicates that the ident was observed. This was the last two-way communication between N600XL and ATC. At this time the airplane was approximately 40 nautical miles south of BRS. "

(note 1)
To be more clear, It was recognized by several Brazilian authorities that there was possibly an error in the language used by the controller of SBSJ, the one that would have authorized the level 370 until Manaus.

Btw, my first reply was to answer what was posted by RatherBeFlying "There is a deeper software problem.
How is it that when the Legacy was cleared to Manaus at FL370, the flight plan was not amended with FL370 to Manaus? "

In the mind of any controller was the idea of having authorized the level 370, what happens later is a succession of errors that only will be known when the recordings are published.

caos

13th Dec 2006, 01:01

12/12/2006
EXAM DOESN'T POINT FLAW IN TRANSPONDER OF LEGACY
Jet that beat Gol Boeing had two antennas of radars.
Technicians believe that pilots would have turned off apparel.

The initial evaluation done by Honeywell, manufacturer of the transponder of the jet Legacy, didn't indicate significant alterations in the equipments of the airplane that it was collided on September 29 with a Gol Boeing. As a source of the Aeronautics, the jet counted with two apparels, and no one. One of the antennas perfectly worked. The second, however, it presented rocking registrations, that were not considered relevant to elucidate the causes of the disconnection.

The jet Legacy beat Gol Boeing on September 29. The airplane of the Brazilian aerial company fell in the North of Mato Grosso and the 154 people that were on board died. Preliminary report of the specialists' commission that investigates the causes of the accident pointed that the transponder of Legacy was turned off and, for that, it was not possible to check the altitude of the jet.

Up to now there is not a plausible explanation on what took the equipment to stop working. It is also unknown why the transponder emitted signs again after the collision. That reinforces the lifted up suspicions soon after the tragedy that the apparel would have been turned off by the American pilots, although unaware, for inobservance of procedures or for 'to test' the jet, making maneuvers.

The military say that the breakdown in a transponder is acceptable. For technicians of the Aeronautics, the disconnection of the transponder is still the cause number one of the collision.

After a trip to the United States, where he accompanied the expertise in the transponder of the jet, colonel Rufino Ferreira, responsible for the investigations, disembarked in Brasília and he sought the controllers that were on duty in the moment of the collision for a first conversation.
http://g1.globo.com/Noticias/Brasil/0,,AA1384009-5598-295,00.html

A310driver

13th Dec 2006, 02:25

Halfnut

13th Dec 2006, 03:24

http://www.upi.com/NewsTrack/view.php?StoryID=20061212-072307-7549r

NewsTrack - Top News

Airlines issue airspace warning for Brazil

SAO PAULO, Dec. 12 (UPI) -- Two foreign airlines are warning their pilots about the dangers of flying in Brazilian airspace following the deadliest accident on record in the country.

The airlines, both European and unnamed in a story in leading Brazilian newspaper Folha de Sao Paulo, are instructing their pilots to fly defensively in Brazilian airspace and remain on the outside of flying lanes until it is absolutely necessary to enter a landing pattern.

The warning followed the September mid-air sideswipe of two planes in Brazilian airspace that killed more than 150 people aboard a commercial airliner that crashed.

United Press International, Inc.

London Mil

13th Dec 2006, 06:45

Having read the past 50 pages or so, I thought I would offer my tuppence-worth. Whatever the reason for the lost SSR/comms, it would appear to me that a major causal factor was the lack of robust ATM procedures. This accident occured with CAS, a known environment. If ATC did not know what the Legacy was doing, they were no longer able to provide IFR separation. It appears to me that somewhere along the line, ATC has assumed instead of knowing.

mm_flynn

13th Dec 2006, 08:50

12/12/2006
EXAM DOESN'T POINT FLAW IN TRANSPONDER OF LEGACY
...reinforces the lifted up suspicions soon after the tragedy that the apparel would have been turned off by the American pilots, although unaware, for inobservance of procedures or for 'to test' the jet, making maneuvers.

The military say that the breakdown in a transponder is acceptable. For technicians of the Aeronautics, the disconnection of the transponder is still the cause number one of the collision.

I think this is a good clip of what the 'US pilot support contingent' are concerned about.

To raise up again the demonstrated false (via FDR and CVR data) allegation that the Legacy was maneuvering or 'testing performance' is unbelievable.

The fact that this and a series of other demonstrated false acusations were made by Brazilian officials speaks to poor investigative practice. It also probably kicked off the whole criminalisation thing.

If the NTSB or AAIB said "Pilot A was performing unauthorised maneuvers in contravention to his clearance prior to (collision, crash, some other bad thing)", I would expect a crimianal investigation to be launched and charges to be brought. It is a disappointment (and hopefully only releated to the specific individuals involved rather than the Brazilian Government in general) that just such serious allegations were made without any substance - in a situation where a few weeks of investigation would have demonstrated the lack of fact surounding these allegations.

It is also very worrying if the "technicians of the Aeronautics" believe that the failure of the transponder is the primary cause of the accident - This would indicate that Brazilian ATC is a fail dangerous system! And one that doesn't appear to be reliable in detecting this critical failure!

agusaleale

13th Dec 2006, 09:37

Nice article. This clears everthing up and adds a reasoned, unbiased, technically accurate perspective to the events leading up to the beating of the Gol Boeing by the jet with two antennas of radar.

I get it now.

Up from this moment it´s play time.... the money game began....

The thing is to find someone to blame and someone to pay......

Who was?, me sir?, not sir! ...who was then?

agusaleale

13th Dec 2006, 10:08

http://www1.folha.uol.com.br/folha/cotidiano/ult95u129291.shtml

Federal Police also makes responsible to three operators for the air accident
by LEONARDO SOUZA
In the partial report that will be delivered to Federal Justice tomorrow, the Federal Policy points that, of the 13 controllers of air traffic heard in the inquiry on the accident with the Goal, three had bigger responsibility. One of them is the one of the tower of control of Sao Jose dos Caomposs (SP) and two are of the tower of Brasilia. The commission agent of the PF Ramon Da Silva Almeida will ask for time extension of the inquiry, that he finishes tomorrow. As the majority of the flight controllers are from Aeronautic Force, but they carry on a considered civil activity, the PF will consult the Justice the way to treat them in the inquiry: if as common people, able to be accused, or if only must point the identified irregularities, suggesting the accusation, but leaving the decision to military court.
In the partial report, the Federal Policy will relate the committed errors per eachcontroller, but without associating them with eventual crimes. As the Folha anticipated last week, the final report will not point an only guilty group for the accident, but tos a conjunction of failures and responsibilities.
...
The three factors
In summary, in the vision of the PF, the accident would have not occurred if: 1 - The members of the Legacy crew had respected the plan of flight or insisted on the contact with the center of Brasilia; 2 - The flight controllers had detected that the Legacy flied at not foreseen altitude. Therefore, even without getting in contact with the Legacy, they could have informed the Gol´s crew to deviate from the route; 3 - If there where not "blind areas" between the radars, the flight controllers could have detected easily that the executive jet did not meet the altitude foreseen in its plan.

London Mil

13th Dec 2006, 10:09

Oh, and it also appears to me that any concept of Flight Safety principles and lessons to be identified has rapidly faded into the background.:ugh:

A310driver

13th Dec 2006, 12:59

Based on this last report just posted it is clear where the mind-set is in this "investigation"........the Legacy pilots should have realized that the ATC system was not doing its job and , perhaps that its equipment had failed, so that it could have "insisted" on contacting ATC to let them know that they were not doing their job. It's all perfectly clear and should be listed as the number one "cause" as it in fact was above. Claire Voyant is my co-pilot.

What really needs to happen now is that the Brazilian government(civil) should bring in a recognized Accident Investigation team from another country(not the USA NTSB, for obvious reasons) such as the UK, Australia, or Canada to take over this matter and provide an unbiased report which will be accepted by the rest of the world. If Brazil thinks this is an internal matter now it is badly mistaken.

barit1

13th Dec 2006, 14:08

That's an excellent point.

A US-made jet with Brazilian pilots, a Brazilian-made jet with US pilots, Brazilian controllers operating foreign-made systems - lots of potential for finger pointing even in the best of circumstances.

The best way to get an objective accident report with objective recommendations is to call on an objective third party. It won't make those closest to the event happy, but it can bring about a restoration of public confidence. (Which, judging from Brazilian traffic figures, is sorely needed.)

BTW, the impoundment of the Legacy should have given the opportunity for an outside electronics forensics expert to determine whether an intermittent wiring fault silenced the Comm and/or transponder. I hope the systems have not been disturbed to prevent this determination.

bubbers44

13th Dec 2006, 18:00

Having flown into these countries and seeing how the controllers don't seem to understand the basics of ATC I finally after several events insisted on staying above the clouds in visual conditions before initiating the approach to minimize my exposure to a conflict. One of my last ones was being put in holding 100 ft above the clouds at 10,000 feet to notice my TCAS showed another aircraft approaching my holding fix at the same altitude. When I questioned the controller I heard a lot of Spanish back and forth and he climbed to 10,500 and I was told he was at 11,000 in english. The next turn in holding he was back at 10,000 and 2 miles in front of me so I disengaged the autopilot and made an evasive maneuver asking why was he there. His answer was to clear me for the approach and spoke in spanish to the other plane to hold. My 757 crew if we had collided I am sure would have been blamed for the conflict. This is not rocket science. Why do they not understand the basics of ATC?

bubbers44

13th Dec 2006, 19:15

Another time we were cleared to the same IAF to 10,000 feet. Cloud tops were 11,000 feet. TCAS showed oposite direction traffic at 10,000 feet so we leveled at 11,000. The C130 went right underneath us in a break in the clouds. Amazing. The Brazilian police would have a very hard time getting me back there to answer their charges with their rules.

Richard_Brazil

14th Dec 2006, 00:22

http://g1.globo.com/Noticias/Brasil/0,,AA1386360-5598,00.html (http://g1.globo.com/Noticias/Brasil/0,,5598,00.html)

13/12/2006 - 16:49 - updated 13/12/2006 - 21:13
"There is evidence that the pilots contributed to the accident", says Federal Police

Federal Police deliver report to court this Wednesday.
Report points to negligence during flight.

Leandro Colon, special envoy of G1 to Cuiabá
(http://g1.globo.com/Noticias/0,,F0-5597-2109890-3042,00.html)
[Photo of Jan and Joe at welcome reception, Joe holding 3-year-old]

Photo legend: Pilots arrive in USA after being formally accused

The superintendent of the Federal Police in Mato Grosso, Daniel Lorenz Azevedo, said this Wednesday (13) that the Federal Police have evidence that the pilots of the Legacy were partially responsible for the accident with the plane making Gol flight 1907 on September 29 which killed 154 people. "There is evidence and indications that the pilots had conduct that contributed to the accident", he said. The partial report of the Federal Police was delivered to Federal Court in Sinop (Mato Grosso) this Wednesday.

According to the superintendent, the dialogues on the jet's black box endanger Joe Lepore and Jan Paladino. "When the dialogues are compared with the technical data from the air traffic control center you can reach the conclusion that induced us to accuse the pilots", he affirmed.

The pilots were formally accused last Friday, December 8, under article 261 of the Criminal Code, which covers risk to air traffic. The penalty is from two to five years of prison, and can be increased by a third because of the deaths in the tragedy. For the Federal Police, the pilots were negligent in not perceiving that the transponder (the equipment that sends data from the airplane to the control tower and to other aircraft) of the jet was turned off for at least 50 minutes before the collision. According to the report, it is not possible to affirm if the equipment was turned off voluntarily, but there is proof that it was turned back on only two minutes after the collision.

The accusation of the pilots is in the partial report that police chief Ramon Almeida, who is in charge of the investigation, delivered this Wednesday to the court. The report, besides accusing the pilots, summarizes the 17 depositions given up to now, raises suspicions against the flight controllers, but still does not call them responsible for the accident. For the Federal Police, the negligence of the pilots, the failures of communication with the tower, and, possibly, the errors by controllers contributed to the tragedy.

New accusations

Lorenz Azevedo confirmed, without giving names, that additional persons may be accused if the court concedes the 30-day extension requested by the Federal Police. "The chances are great of new accusations against persons with vehement indications against them", he said. G1 learned that these "persons" are controllers in the São José dos Campos and Brasília towers.

Two factors have prevented the police from accusing the controllers up to now. The first is the Federal Police's jurisdiction to take this measure. The police fear their control being questioned by the Military Courts, since the controllers are military. That doubt should be settled for the police chief by the court in Sinop in the next few days.

Another point is that the police would like to hear the controller of the Manus tower, also in relation to the two flights, and conclude their examination of the dialogues on the black boxes of the jet and the Boeing, and of the graphical representation of the flights. By comparing this information, the Federal Police agree, it should be possible to show where the flight controllers are to blame.

The Federal Police does not give names in the report, but the heaviest suspicions weigh against one controller from São José dos Campos and two from Brasília. The first supposedly told the Legacy to take off to 37.000 feet and stay at that altitude to Manaus, when, in reality, it should have descended to 36.000 feet after Brasília and, at a given spot, ascended to 38,000.

As to Brasília, one of the controllers is said to not have perceived that the Legacy stayed at 37.000 feet, the same altitude at which the Gol Boeing was travelling, in the region of the accident. This controller, the police investigation says, did not pass this information to his relief at the shift change. This last, for his part, could have advised the Legacy on detecting the altitude error.

It is at this point, however, that the technical examination enters, that the police expect to complete in the next thirty days to know what the communication error was between the towers and the Legacy. The Federal Police consider the dialogues fundamental to clear up what happened in the accident.

While the inquiry is not sealed, the Federal Police will attempt to prevent the leaking of the dialogues, because a document from the Air Force prohibits divulging this type of information.

bubbers44

14th Dec 2006, 22:43

Today on the news the Brazilian police said the pilots should have known that their transponder wasn't working. I guess when they were making those 12 attempts to make radio contact they should have been monitoring their transponder to see if it was still functioning. I never stare at the transponder during flight to see if it keeps working. If they can't talk to anybody it is amazing that the transponder would still work. Hummmmmmm?

broadreach

14th Dec 2006, 22:52

What's been played out in Brazil over the last few months is the worst combination possible, a newly democratic country, separation of powers, the last residues of an opaque military dictatorship, a too green civil administration, personalities seeking fame, an ingrained societal tendency to blame others for inhouse failings.

The inhouse failings are multiple but the main one is a lack of infrastructure planning. I see it up close in my own little sphere, maritime transport, and peripherally in road transport, both areas where “normal” equals “problematical”. Air transport was never publicily perceived as a problem; we the traveling pubic became accustomed to the ease, regularity and, when Gol set up their Southwest lookalike, low cost of zipping around for afternoon meetings a thousand miles away, then zipping back. Quietly rather self-satisfied, perhaps, of this emerging democracy’s boasting the world’s second- or third-largest regular airline network and a very good safety record.

The Gol/Legacy collision has brought the entire house of cards down and, shown up the fragility of, not just ATC, but infrastructure planning in general. Nothing like the drama of thousands of people stranded, sleeping on granite airport floors, babies missing their heart transplants and congressment missing the meetings the lobbyists paid them to vote at, to get the country’s attention. The comlete shutdown of Brasilia ATC served to reveal that there was nobody in Brazil competent to diagnose what appears to have been a minor hardware fault; the manufacturers had to send someone from Italy to resolve it.

Mega-incompetence on a national scale isn’t the exclusive domain of Brazil, though, is it. Perhaps worth noting is how much real information on the collision and its aftermath has actually come through the work of journalists; much of it just passing on BS but, if you’ve followed the story, maturing into sensible, unbiased reporting. Learning curve.

In all of this the Legacy crews’ detention was, with respect, a sideshow. Unjust and, in realpolitik terms, stupid; an ambitious DA equivalent compromising the entire judicial system as well as the country’s image. Had it not been for that intervention, the Legacy crew would have been home very shortly after the collision. It unwittingly served to avoid the real issue of mismanagement of infrastructure, just not very effectively. It also served as a(nother) wakeup call against criminalisation of aviation accidents; the Brazilian commercial pilots’s union have addressed the recent congressional hearing on that subject.

As for what the future holds, as mentioned above a few European airlines have recommended offsetting when overflying Brazil; holiday season (mid-Dec through end Feb) hotel reservations are down ±50% vs last year; anyone who would like to travel is hedging; Brazil’s president Lula says ATC problems are solved but ANAC says they’ll continue for the next two to three months; ATC themselves say too little, too late. We will see. What seems increasingly likely is gradual transference of ATC to civilian management, although the mechanics of such a transfer are miles away from being designed.

Last comment: don't waste time on what the Federal Police say.

bubbers44

14th Dec 2006, 23:17

Having spent a lot of my life troubleshooting electronic systems I have found that new equipment is more likely to fail than one in service for a while. The Legacy plane was on it's initial real flight after the maintenance test flight so the transponder had never been exposed to the colder temperatures at altitude for a duration of time so hopefully when it is repaired the next crew will see if the transponder duplicates it's failure again when exposed to the same environment. If it fails again we will know why it quit working, if it works it could be an intermittent problem and not conclusive. The transponder started working again when they descended into warmer air so hopefully someone will look at that possibility. I could be wrong but I hope someone looks into this as a probable cause of the transponder failing.

Graybeard

15th Dec 2006, 00:23

I'm not familiar with Embraers, but I seriously doubt the transponders are in a location to be affected by altitude and cold. They should be inside the pressure vessel. The antennas, otoh, are exposed to the elements. However if one antenna or coax failed, the other will do the job for collision avoidance in a TCAS encounter, even if not line of sight to an ATC antenna.

GB

Richard_Brazil

15th Dec 2006, 01:02

And now the news.

Brazilian air workers union (http://www.aeronautas.org.br (http://www.aeronautas.org.br/)) objects to criminalization of Flight 1907 and impounding of pilots' passports, while Minister Pires washes hands of passport impounding; pilots' lawyers respond to Federal Police report claiming pilots failed to note transponder was off.

http://g1.globo.com/Noticias/Brasil/0,,AA1387161-5598,00.html

14/12/2006 – 09:03 – Updated 14/12/2006 – 09:32
Commandant rejects criminalization of air accidents
Union leader criticizes apprehension of passports of Legacy pilots
Jet collided with Gol Boeing; 154 people died

By G1, in São Paulo, with information from Agência Estado

In the committee of the Chamber of Deputies that is analyzing the air travel crisis, representatives of the sector asked for the beginning of a discussion at various level about the need to avoid the criminalization of air accidents. Commandant Célio Eugênio, flight security aide of the Aviation Workers' Union (Sindicáto dos Aeronautas) condemned the decision by the courts to impound the passports of the Legacy pilots, which collided with the Gol Boeing on September 29, for more than two months. Last week, the pilots were heard by the Federal Police and accused of placing at risk air security. Soon afterward, they left the country. If convicted, they could be sentenced to from one to three years of prison.

After the collision between the two aircraft, the Brazilian airline company's plane fell in the north of the state of Mato Grosso and the 154 people who were aboard died. It was Brazilian aviation's worst tragedy.

On warning that "the non-criminalization of the pilots is not a procedure to protect criminals", Célio Eugênio explained that accident investigations are undertaken to avoid other accidents occurring for the same reasons. "If we were to have hanging over us being accused of crimes we did not commit, we pilots could stop contributing toward improving the system", he declared.

Congressman Luiz Antônio Fleury Filho (PMDB-SP), however, contested the union leader's theory, alleging that "no one can be above the law". "It isn't possible that someone who's involved himself in a accident like this remain unpunished", he responded.

The Minister of Defense, Waldir Pires, made a point of emphasizing that the Government did not interfere in the case. "No one, strictly speaking, commits a crime [when piloting], unless he's a terrorist or a suicide. At no time did we interfere in the question of the passports. But a judicial decision must be complied with."

http://g1.globo.com/Noticias/Brasil/0,,AA1388013-5598,00.html

14/12/2006 - 18:04 - Updated 14/12/2006 - 18:11
Legacy pilots' lawyers respond to Federal Police report

Defense alleges that analyses of aviation rules are incorrect
According to lawyers, transponder was never turned off.

By G1, in São Paulo

Lawyers José Carlos Dias and Theo Dias, who are defending the pilots of the Legacy that collided with the Gol plane on September 29, issued a note, this Thursday (14), responding to the report that the Federal Police delivered Wednesday to the Federal Court in Sinop, in Mato Grosso.

For the superintendent of the Federal Police in Mato Grosso, Daniel Lorenz Azevedo, there is evidence that pilots Joe Lepore and Jan Paladino were partly responsible for the accident.

Here is the complete text of the note:

"In a highly complex investigation, as in an air accident, it is worrying to see a police chief, who has taken over the case only a few days before, make accusations based on incorrect analyses of the rules and procedures of aviation, as well as of the conduct of the pilots.

"The transponder was never turned off by the pilots, and, at the present moment, it is not possible to affirm if it was or was not working. The fact is that, for reasons that aren't known, the ground radar did not receive the signal emitted by the aircraft's transponder.

The pilots did not have any way to access that information. In accordance with IMA 100-12 (Rules of Air and Air Traffic Services of the Ministry of Aeronautics), it is the controller who should inform the pilot, or inform the next control position, when the aircraft's transponder is not operating or is operating inadequately.

"The police chief adventured into a technical universe with which he is unfamiliar, rushed to conclusions ahead of specialist, which has contributed only to throw into tumult the process of investigating the accident, which should be professional, cautious, and impartial.

"José Carlos Dias e Theo Dias"

bubbers44

15th Dec 2006, 02:25

TCAS does not need any line of sight with ground equipment. It only looks at other Mode C transponders and gives climb or descent commands in coordination with the other TCAS. My question was if they lost Mode C with Legacy and also VHF com maybe they were in one of their blind spots because of line of sight not allowing either to work. As far as the temperature of the transponder equipment I agree most equipment would probably be in the pressurized climate controlled part of the aircraft but skin temperatures and coax to antennas have to be eventually routed to an external antenna which may be affected by cold temperatures. If on their next flight they had the same problem then we would know what caused the failure. If it didn't happen it could be just the conditions not being the same.

DingerX

15th Dec 2006, 06:50

Okay, let's assume for the sake of argument the "Worst Case" scenario for everyone involved, based on the evidence "leaked". This is far from factual -- just what the "best possible case" the FP would have:

Rookie FO on his first flight with the company, and with his bosses in back, fumbles when told to ident, and somehow shuts off the transponder.
ATC is watching the football match, and doesn't notice the transponder problem.
Both sides make a halfhearted attempt to establish radio contact.

After impact, when the Legacy crew turns to squawk 7700, one of them says "Oh ****, the transponder's in standby", and turns it back on.

So, if this were the case they had, who would get what out of it?
In any reasonable country, even this scenario wouldn't result in criminal charges, except perhaps to whoever setup the policies by which ATCs operate (and even in reasonable countries, those guys are well protected): there's no clear reason why the transponder was turned off, and no other evidence to suggest this was a conscious error, or one that occurred through willful incompetence.

Aviation Safety is severely damaged in Brazil: if you're gonna make a mistake and turn something off, better start with the CVR; and with a couple of controllers in jail, you think any future ATC tapes are going to survive without damage?

On the other hand, the provincial FP running the case becomes a nationally known figure. Perhaps noting how Tsolakis flight, catapulted to regional fame as the head of the Greek investigatory board inquiring into the Helios tragedy, the Brazilian Federal Police are making sure they be the focus of attention, not the investigators.

And that's the "Best Case" scenario, assuming the absolute worst of the pilots and controllers.
In short, it's a political game with very few winners, and millions of losers.

KC135777

15th Dec 2006, 16:52

http://video.msn.com/v/us/fv/msnbc/fv.htm??f=00&g=c2f91c3b-bfd9-4839-afe0-a15ebcef414e&p=source_today%20show&t=m5&rf=http://www.msnbc.msn.com/id/3032633/&fg=

8 minute, 42 second interview on the "Today Show" of both Joe & Jan (and their lawyer), by Matt Lauer. Very interesting. It's in English.

Tarq57

15th Dec 2006, 23:16

Can't play the clip. Once past the ads, robot woman announces that "the clip is being prepared in a format that will be compatible with your system..."

jondc9

16th Dec 2006, 00:37

regarding the transponder.

if you had made 12 attempts to contact atc via vhf radio and didn't get hold of anyone, wouldn't you at least think about selecting 7600 in the transponder...mind you I am not saying to do it just yet, but at least think of it?

honestly, if I hadn't had any radio transmissions in a certain amount of time, I would look at my tcas to see if there were any other planes nearby for a relay or at least a radio check.

and when looking at my tcas display ( unless it is one of the real small cheap ones) I would certainly see any warning that it wasn't working because my transponder was off...

just questions and not judgements yet.

pilots do have to think and question and consider situations.

ATC Watcher

16th Dec 2006, 09:57

jondc9, the issue for me is not really about humans failing to notice their Xponder was off or on SBY for so long, , but the sofware trap that caused the system to shut down that way, and the HMI design that prevented the crew from noticing it.
Because it happened before ( in Switserland and France recently, both involving E145 with Primus ), and so, most probably, it will happen again .
The idiocy of this is that by switching itself off, it also disable ( ACAS) as well.
So the end result of this is depriving you in one go of your 2 main anticollison systems : ATC and ACAS.

This is half of the cause of this collision. The other half is on the ground and there apparently, also caused by 2 software traps that led the controllers to beleive the aircrfat was not at the altitude he actually was .

I think we should far more focus on HMI and computers/man decisions processes integration than about blaming their operators .
But this is far less popular.

bubbers44

16th Dec 2006, 11:00

Making numerous attempts at communications down there isn't uncommon so squacking 7600 never occured to me because usually the radar wasn't available either. I routinely found that places as close as Kingston seemed to make it a game to see how many times you would call them without them answering. I finally would just make two calls then one in the blind giving my position and ETA. This always got a response because it was treating them like a 3rd world country.

visibility3miles

16th Dec 2006, 12:15

Pilots Say They Flew Assigned Altitude Before Crash (Update1)

By John Hughes

Dec. 15 (Bloomberg) -- Two U.S. pilots said they were flying at their assigned altitude of 37,000 feet when their small jet collided with a Brazilian airliner in September, killing 154 people in that country's worst aviation accident.

``We cannot leave our altitude without instructions from air-traffic control,'' pilot Jan Paladino said on the ``Today Show'' on NBC-TV. ``We were doing exactly what we were supposed to be doing.''

I don't see how having the transponder on or off would have caused the crash if they were flying at the assigned altitude. Yes, it may have helped the collision avoidance system, but there wasn't much time to react given the closing speeds involved.

The accident was a tragedy, but it is a miracle that one plane landed safely.

I'm probably naively repeating much of what has been said already, but my best wishes go out to everyone involved.

caos

16th Dec 2006, 12:23

Can't play the clip. Once past the ads, robot woman announces that "the clip is being prepared in a format that will be compatible with your system..."
Try with http://www.msnbc.msn.com/default.cdnx/id/16219142/displaymode/1157
Be sure you have Windows Media Player version 9 or later.

HowlingWind

16th Dec 2006, 13:11

A generally good interview on Today, but does anybody know where that animation came from? It seems more than a bit sloppy to portray the Legacy losing the entire port side of the horizontal stab and entire winglet when the still photo clearly showed the damage was not that severe. One could overlook the winglet, but if they had lost that much of the stab one might conclude they would have suffered the same unfortunate fate as the Gol 737.

It was also interesting to hear that due to translation issues the reports that made it appear they were formally "charged" just before their release also seem to have been somewhat exaggerated.

Best of luck to you, guys, we're pulling for you. :ok:

A310driver

16th Dec 2006, 16:03

ATC

I do not believe you should lump together "ATC and (T)ACAS" as the two primary anti-collision systems. This , of course, is not true. They are not co-equals. ATC is the primary collision avoidance system ....that is its primary role, ie, separation.... other than eyeballs (which is interesting since there has been no discussion of looking out the window...have we given this up because of closure rates or other factors for all aircraft at flight levels above 180 ?)

what is becoming more and more obvious......

ATC cleared both aircraft to the same level without proper coordination between adjoining sectors. Through inadvertence, complicated by possible flaws in its procedures, equipment performance or design, ATC was neither able to recognize the nature of the situation that was unfolding and communicate this to other sectors nor communicate with the Legacy to issue an appropriate clearance or confirm its level. Contributing factors were poor communictions coverage and failure or improper operation of the transponder aboard the Legacy.

jondc9

your characterization of the twelve calls as being sufficient cause to select
7600 does not consider that those calls occurred in 4 minute period(not very long in this environment) followed by what probably appeared to them as a response from ATC to their calls (which, in fact, appears to have been a blind call from ATC) requesting that they change frequency. I suggest that the lost-comm situation began following the crew's subsequent unsuccessful attempts to contact ATC....just two minutes or so before impact. At this point the ATC controller should have been on the horn to the next sector controller (who was in contact with GOL) advising of the NORDO Legacy at an unconfirmed FL360. Since the collision occurred at or near the sector boundary, it will be interesting to learn whether the Brasilia controller had the GOL flight on his display and for how long.

jondc9

16th Dec 2006, 19:20

but thinking about 7600 on the transponder MIGHT, key word MIGHT, have made the legacy pilots look at the transponder and see if there was a reply light illuminating at regular intervals.

if you have charts for brazil, does the airway/jet route show "communications gap" for the area involved?

also, did the legacy pilots attempt contact on all comm radios? some comm radios are wired to the top antenna, some to the bottom and sometimes (not always) this might make a difference.

ATC Watcher

16th Dec 2006, 19:32

You read my post too fast I think , look again : I did not say that ATC and ACAS were " primary" means of separation, but " main" means. Because I agree with you, in IFR , the primary means of anti-collision is ATC, and ACAS is the ultimate last minute one. (In between there is visual aquisition) .

The rest of your post is fully correct, except that the communication problems were not between adjacent sectors, ( i.e sectors within a same unit, seing teh same radar picure ) but adjacent centres , i.e 3 different ATC units located hunderds of miles appart and using diferent ATC systems and radars.

From what it transpires now, Manaus expected the legacy a 360 and since they never saw it coming as the Xponder was not on, and it did not call already , they had little reason to " move" the 737 out of the airway . What happened in Campos and Brasilia is less clear.The transcript of the coordination between the two will probably shed some light when we see it.
The Brasilia ATC system showed the legacy at 360 ( while it was in fact at 370) that we know, and we know why.
I do not think Brasilia had the 737 on radar nor on R/T contact. Again the radar recording of Brasilia will show this when it will become public.
( and check your PM)

bubbers44

16th Dec 2006, 20:44

If Brazil has a radar facility that receives Mode C transponder data why wouldn't they have a VHF transceiver at the same site so they could talk to them since they both operate with line of sight frequencies? Are they sure the transponder failed on Legacy when ATC lost it or were they out of range in one of their blind areas. Since ATC didn't question the loss of Mode C they must have experienced it routinely so didn't question them. Why would software in their radar room automatically display them at their flight planned altitude because they lost Mode C? The shift change might have contributed to why them reporting in at FL370 and later displaying FL360 didn't get picked up.

I think Brazil has to fix their ATC problems quickly because blaming the American pilots isn't going to bail them out.

jondc9

16th Dec 2006, 20:59

way back when...

in the US atc was required to point out jet traffic to other traffic as a matter of course...

even if seperated by altitude or heading.

and if brazil atc had done this just as a matter of course, eg: GOL AIR, JET TRAFFIC 12 o'clock, radar shows at FL360

at least GOL could have been looking...might have then mentioned not seen on TCAS (we mention that here in the states all the time)

the more technology becomes involved and the more good people become less involved you will get problems.

caos

17th Dec 2006, 00:49

I do not think Brasilia had the 737 on radar nor on R/T contact. Again the radar recording of Brasilia will show this when it will become public.
( and check your PM)
This is right and was confirmed by the Brasilia Controller in an interview, he never got the Gol in his radar, he said he was waiting for the Gol to appear.
Collision was inside Manaus (Cindacta 4) covering.
(this should answer the question of A310driver).

In another news was said that Gol received radio transmisions from Brasilia ATC to the Legacy, and the captain Decio Chaves listened them.
http://g1.globo.com/Noticias/Brasil/0,,AA1388605-5598-295,00.html

A310driver

17th Dec 2006, 07:53

Regarding your post above, you are technically correct regarding center/sector boundaries.

However,there is no functional difference between a sector boundary and a center boundary within the same country in a modern ATC system even though the physical facilities of the centers may be hundreds of miles apart. When I transit the Cleveland Center / New York Center boundary or the Cleveland / Chicago or the NY/Washington Center boundary yes the controllers are hundreds of miles apart but the radar and communications systems are integrated such that there is no practical difference from being handed off to a controller working another sector within a center boundary. What you imply may be true crossing an international center boundary, like Cleveland/Toronto or Miami/Havana but has no relevance in this discussion as it occurred wholly within the Brazil domestic system.

Richard_Brazil

17th Dec 2006, 15:40

There is a long interview with Lepore and Paladino (and their lawyer, Torricella) in the Sunday Folha. The online version is more complete than the printed version, and can be found (in Portuguese translation) at
http://www1.folha.uol.com.br/folha/cotidiano/ult95u129463.shtml

Principal items of interest here are:

1) The radio was functioning just fine. Paladino says, "We received transmissions in Portuguese from Brasilia during the whole flight." He also says that when he did talk to the controller in Brasilia, [IIRC, a few minutes before the collision], to get the frequency in Manaus, there was "no urgency" in the controller's voice.

2) Asked about why they didn't set the transponder to code 7600 [ATC has said they should have], registering communications difficulties, Paladino again says, "7600 isn't for difficulty in talking to the control center, it's for equipment failure. That wasn't the case. The radio was perfectly fine. What we we have to do, in these cases, is search for another frequency, more appropriate for the route, which is what I did."

3) Police have claimed there's a dialogue between the pilots recognizing that transponder was turned off. Lawyer (who reporter describes as being like "a lioness defending her cubs") wouldn't let them answer that.

4) Lepore claimed that "It happens all the time, that you have a flight plan at one altitude and you are authorized to fly at another. Let's say it happens 99% of the time."

5) Something online, not in the printed newspaper, is about the Legacy not descending to 360 over Brasilia. Paladino says, "We're not expected to contract the control tower on flying over Brasilia". The lawyer, Torricella, says, "The regulation for when you're under radar vigilance is that the control tower is who defines the rules and altitudes is the contol center. The law is clear."

6) The pilots indicated they were quite familiar with the Legacy; Lepore had 20 hours of simulator and a lot of time in very similar aircraft; Paladino had flown a lot as commandant of an Embraer 145, an exact copy of the Legacy.

----

It's an honest interview. The reporter, Eliane Cantanhêde, asks the tough questions and they answer, except that the lawyer won't let them reproduce dialogues for which the police are withholding the transcripts. This was in contrast to the travesty of the interview with the controllers in Época magazine, in which they didn't even give their names, and got only soft questions, with Época tiptoeing around the real issues.

Note that the interview was taped in English, transcribed to Portuguese, and the taped destroyed, presumably to keep lawyers from playing the word games they so love. Quotes above are my own translations back to English, and certainly vary from what was actually said.

They are only unconvincing when Cantanhêde asks what they think of the Brazilian press coverage, and all three respond diplomatically. Though the less Portuguese one speaks, the better the coverage appears. The accusations against the pilots have been compared by others to the worst excesses of the Brazilian media.

ATC Watcher

17th Dec 2006, 20:16

...the radar and communications systems are integrated such that there is no practical difference from being handed off to a controller working another sector within a center boundary. What you imply ..... has no relevance in this discussion as it occurred wholly within the Brazil domestic system.

Yes the US ATC system is wholly integrated ( radars and comm, between major airports, TRACONs and Centers ) , but this is rather an exception and not the case in many , if not most, other countries, which bought their systems a different periods from often different manufacturers .

I do not think this whole integration apply for Brazil, but you can correct me if you have the facts of course.

jondc9

17th Dec 2006, 20:42

well, the feeling and meaning is odd in the above interview.

IF the radios were working "just fine" then why couldn't they talk to anyone? even if given the wrong frequency, you go back to the good one, or look at your chart and find the nearest ATC facility and call them and when in doubt, 121.5mhz.

and according to the US AIM, check out sections 6-4-1 (2,3), : if an aircraft with a coded radar beacon transponder experiences a loss of two-way radio capability, the pilot should adjust the transponder to reply on Mode A/3 , Code 7600.

this does not say: equipment faliure.

it goes on to encourge use of 121.5mhz and ARINC and listening on VOR's.

KC135777

18th Dec 2006, 01:51

jondc9

18th Dec 2006, 07:18

as I mentioned in previous post, I chose the domestic usa and canada as my routes of choice after reading about the swissair/athens thing along time ago.

if legacy could hear brazilia (airport and not the plane type) and didn't try calling them, I would be concerned, wouldn't you?

A310driver

18th Dec 2006, 14:29

My thoughts exactly

jondc9

18th Dec 2006, 15:29

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j

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Chris200

18th Dec 2006, 22:11

Hi, I'm new to this forum and I read MOST of this thread.
I'm personally still missing some informations about this accident, or better more fundamental information about the accident's region and RVSM...

I NEVER read anything about the fact (not in this forum, neither in Press or elsewhere), that the Brazilian controller should have assured a 2.000ft separation between the GOL B737 and the Legacy.
The only thing I always read and hear is that the Legacy should have been at FL360 and the Boeing at FL370. But since the Legacy had no transponder readout (for whatever reason), this appeared as a clear fact that the RVSM ability of the aircraft was not assured (since the transponder is an mandatory for RVSM).
In such a case, the aircraft is either denied to enter RVSM airspace (since was impossible due to R/T failure), or has to treated as a non-RVSM aircraft in none RVSM airspace.
So logically the ATC should have provided a 2.000ft separation at these levels. This means that even if the Legacy would have been at FL360, the 2.000ft level separation should have been the minimum, so that the GOL would have had to climb to FL380 in any case (at least, FL390 would have been better since FL380 is a pair level) or descend to FL340 or FL330.

The controller said in his interviews that he considered the Legacy at FL360 and did not see any conflict with the Boeing at FL370.
So I consider this as a clear fact of a lack in training in Brazilian ATC.

Another question arrises to me: How can an airspace that has a clear lack in Radar surveillance over its territory, and 'maybe' even an important lack in its computer software (due to the erroneous altitude readouts the controllers had), be authorized in establishing an RVSM airspace??
Have the RVSM operations been canceled in Brazilian airspace or not after the accident? Maybe is this the reason for the delays in Brazil? And if not, why doesn't the ICAO react? Or they reacted without informing the press?

Bedder believeit

20th Dec 2006, 07:06

Not wishing to be gouhlish, but have any of the readers seen the two digital photos making the rounds on the web, purpoted to have been taken by one of the pax inside the GOL B737 immediately after the midair? Quite amazing if they are for real! According to the story attached to the photo's, the owner of the digital camera has been identified as a pax on the aircraft. It doesn't surprise me that this has come about as everyone, everywhere are snapping digital pics, hardly an event goes by that isn't captured either on video or digital camera and the memory sticks must be pretty hardy, able to survive just about anything but fire.

westhawk

20th Dec 2006, 07:31

Not wishing to be gouhlish, but have any of the readers seen the two digital photos making the rounds on the web, purported to have been taken by one of the pax inside the GOL B737 immediately after the midair?

This fraud has been debunked! The photos were taken from scenes from the pilot episode of the popular US television show Lost. The fraud was perpetrated by a Brazilian national who says he wanted prove that people don't really pay attention to what they see. Guess he proved his point! See the full story HERE (http://www.snopes.com/photos/accident/brazil737.asp).

Best,

ATC Watcher

20th Dec 2006, 08:02

.....since the Legacy had no transponder readout (for whatever reason), this appeared as a clear fact that the RVSM ability of the aircraft was not assured (since the transponder is an mandatory for RVSM).
In such a case, the aircraft .........has to treated as a non-RVSM aircraft in none RVSM airspace.

Good point but I believe the anwser of it lies in the fact that the controller said ( declared to the press at least ) he beleived the aircraft was at 360 since the label on the radar showed 360 . So I think he did not suspect transponder failure. ( Although they probably was a clue in the label like a symbol or a letter ). When he lost both radar returns later, they asumed it was because the aircraft entered the so called "blind area " ... a well know everyday occurrence I beleive.
The RVSM training the controllers received is of course the key issue.And that will come out (I hope) . I also think this " blind area" existed before RVSM was introduced.

The other way to alert the controller was for the pilot to report the failure of one of the RVSM MEL component, but there also the pilots declared to the press that for them everything was working well. Perceptions as opposed to facts perhaps , but perceptions are more important as you know.

Lack of adequate radar coverage and foremost bad VHF communications complicated the issue

Which brings us to your second remark :

Another question arrises to me: How can an airspace that has a clear lack in Radar surveillance over its territory, and 'maybe' even an important lack in its computer software (due to the erroneous altitude readouts the controllers had), be authorized in establishing an RVSM airspace??

That is a very, very good question.The answer they will probably give you is that you do not need radar to have RVSM . True. But applying radar procedures in KNOWN non-radar airspace is something else, and there I beleive the Brazilian Air Force has some serious answers to prepare.

broadreach

20th Dec 2006, 22:21

As predicted by many but denied by Defense Ministry, ANAC, Lula, FAB, the holiday delays are building up. Jornal Nacional, the leading evening news channel, today showed check-in queues at CGH snaking outside the terminal, 40% of flights delayed country-wide. ANAC blaming it on yesterday's weather. It's rumoured elsewhere that controllers intend to apply 10-minute separation between takeoffs/landings at BSB on 31 Dec and 1 Jan to disrupt the presidential inauguration ceremonies.

ATC Watcher, how long do you reckon, off the top of your hat and, that it might take to reorganise/integrate ATC in Brazil? Assuming that financial and administrative control were to pass from 100% airforce to a civilian organisation (but probably govt owned as are the airports). When and if you reply, consider whether it might not be worthwhile starting a separate thread.

caos

21st Dec 2006, 01:33

Merry Christmas And Happy New Year...to you all.

(sorry Mod) :)

ATC Watcher

21st Dec 2006, 08:14

Quote from Broadreach :
ATC Watcher, how long do you reckon, off the top of your hat and, that it might take to reorganise/integrate ATC in Brazil? Assuming that financial and administrative control were to pass from 100% airforce to a civilian organisation (but probably govt owned as are the airports). When and if you reply, consider whether it might not be worthwhile starting a separate thread.

Out of my hat as you say, I woud guess 3 to 5 years if done properly.

Of course if one wants to change the names and the uniforms and keep the same people/structures/procedures it can be done faster : For instance the DFS in Germany integrated their military controllers into the civil structure in roughly one year , but the civil strucure already existed and the prime body was civil and only about 15% military were to be integrated.
But I do not think that is the aim.
In Brazil the whole en-route ATC is military and I understand that no civil entity (e.g Airports ) has en-route ATC experience, which is quite a different business.

What is happening in Argentina , who has pledge to do the same would be interesting to watch.

Lost in Saigon

21st Dec 2006, 13:32

Graybeard

21st Dec 2006, 14:44

Reply lights were eliminated in the design of Mode S, in about 1987.

Regarding the old ATCRBS transponders, the lack of a reply light is not the best in human factors to draw attention.

GB

ironbutt57

21st Dec 2006, 20:19

not to sound too simplistic...but wouldnt any lost com procedure existing have taken precedence over the atc clearance???

caos

22nd Dec 2006, 01:36

but thinking about 7600 on the transponder MIGHT, key word MIGHT, have made the legacy pilots look at the transponder and see if there was a reply light illuminating at regular intervals.

Airliner transponders don't have a reply light. (Not the ones that I fly)

Can anyone confirm whether or not the Legacy would have a reply light on their transponder?
"
7. The Embraer Legacy cockpit can be a dangerous trap for pilots. The Legacy with its Honeywell custom-built avionics panel can be a hazard in the air. To inadvertently switch off the safety-essential transponder (or to put it on stand-by) in this aircraft is very easy. This, despite the fact that doing so in any aircraft in flight is a most unlikely and an exceptional
event. There may be moments where there is a wrong altitude indication (Mode C), requiring a de-activation of certain parts of the transponder (altitude for instance), but to de-activate it completely, or to put it on stand-by (switch it off and let it heat up) is not at all common practice. Incredibly IFATCA has learned that with one accidental or wrong touch of a button on the panel, a pilot can actually inhibit all transponder transmissions in a Legacy cockpit! This would mean it is possible, even probable, that pilots (in particular pilots that are not very experienced Legacy pilots) could accidentally switch off the transponder in flight, not “on purpose”, but accidentally. This vital piece of equipment that permits aircraft to be “seen” by ATC, and which forms the basis of anti-collision systems such as TCAS (a last-ditch anticollision system) could be rendered completely useless by an accidental and involuntary action.

What is even worse is that the indications on the panels after an accidental transponder (and TCAS) switch-off are not very prominent and cannot be clearly seen by the pilots. Examples are:

- TCAS OFF is written in small white letters on the Primary Flight Display (PFD), and not in red warning colours!
- a similar white message is put on the Navigation display (very small)
- on the transponder display where the 4 numbers are set, a small yellow message appears saying STAND BY
- the TCAS needle, displaying vertical escape movements to the crew when a TCAS Resolution Advisory is triggered, remains green despite the fact that the equipment is turned off and not functioning (in aviation green means on and functioning!!) "
Source: http://www.ifatca.org/press/251106.pdf

threemiles

22nd Dec 2006, 11:49

Where's the point?

If a conventional transponders is accidentally turned to standby on the single turn of a button there is no sign at all but "TCAS off" somewhere.

ATC taking up the mike and saying "recycle transponder" is the usual thing to follow.

Where's the point?

RatherBeFlying

22nd Dec 2006, 14:13

broadreach

22nd Dec 2006, 14:57

Thanks for your thoughts. Any decision in Brazil regarding a changeover from military to civil control is likely to take a very long time. Unless of course the process is accelerated politically in reaction to the present chaos.

Current Brazilian air traffic difficulties pale in comparison to those in the UK and US. But at least ATC in England and Colorado can point out the window at the fog and snow.

Here there have been a few instances this week of closing CGH due to wind and rain but nothing to justify the countrywide delays of over 40% of flights - yesterday it was 44% not counting cancellations. Queues this morning reported at over 1km.

ANAC have blamed the weather. FAB are blaming TAM who apparently had six of their fleet go tech yesterday. Unimaginable confusion. In Brasilia, politicians enter and leave the boarding lounges via side doors so they don't have to face the public; congressmen have had the audacity to request the airforce for transport home for Christmas so they can avoid the delays.

Chris200

22nd Dec 2006, 16:23

Hi,

I read quite a lot of this this tread (ok, I admit not everything), and I'm missing some important facts...

In RVSM airspace, every aircraft that has a failure of one of its mandatory RSVM equipments, has to be considered as a NON-RVSM aircraft.
The transponder is without any doubt a mandatory equipment, so the Legacy should have been treated as a non-RVSM aircraft in RSVM airspace.

This means that the vertical separation with all other aircraft has to be 2000ft (!) and not 1000 like if it was RVSM approved.

Consequently the controller should have taken every action to assure a 2000ft separation with the GOL. So in any case (Legacy at FL360 or FL370), the GOL should have been cleared to FL390 or FL330 (FL350 in case the controller supposed the Legacy at FL370, which was not the case)!

Could this not be a big lack of training in Brazilian ATC, since the controller did not even seem to be aware of this?
In case it is, I want just to be clear that the responsability for training is not the worker, but the boss!

And a more general question..

Overhead the ocean the airspace is not RVSM because there is no Radar coverage and bad radio transmission. And in the same way that every aircraft need special equipment to enter RVSM airpace, every center also needs special equipment to operate as RVSM airspace.

So how is it possible, that the Amazon region, that was well known to have problems with the radar coverage, can be approved nationally and internationally (by ICAO) to operate as RVSM airspace?

And in case it was not known, why was operation as RVSM not immediately stopped after this fact got clear???

agusaleale

22nd Dec 2006, 19:26

In Argentina air traffic controllers are civilians, but they operate under the management of Air Force.
This year, the Argentine Government decided to retire to the Air Force this competence over the air traffic.
It was required to ICAO to assist in preparing the transference of competence, missions and functions of civil aviation.

In Argentina, since 2003, there is a system interconecting 6 radars, 5 in Argentina and 1 in Uruguay (Carrasco). The system has been provided by Lockheed Martin, Rhode & Schwarz and Frequentis. The system is able to follow an airplane entering Argentina from the North bound. This system, named Skyline, processes the information received from the 6 radars and integrates it in a platform.

Tarq57

23rd Dec 2006, 00:03

FreeJoe&Jan

23rd Dec 2006, 01:19

Chris2000, It seems likely, from what's reported here, that the controller/s weren't aware the transponder had failed. Seems likely the pilots weren't aware of that, either. Have a look at the IFATCA link in the post by caos a few up, goes a long way to explaining why this could be overlooked.
I have no idea how an area well known for radar and communications "holes" could be approved for RVSM.
Hopefully this, and the many other questions, will be answered by the investigation. We'll see.

In last weekend's Epoca Magazine story on the controllers, one of the controllers is quoted as saying that he noticed that the transponder wasn't working, but wasn't alarmed because primary radar provided all of the necessary information, though it is less accurate.

caos

23rd Dec 2006, 03:53

In last weekend's Epoca Magazine story on the controllers, one of the controllers is quoted as saying that he noticed that the transponder wasn't working, but wasn't alarmed because primary radar provided all of the necessary information, though it is less accurate.
Maybe it is very common for controllers to lose radar in that region.

What take my atention is just there you can find the Cachimbo Air Force base for "air training" (Campo de Treinamento Aéreo Brigadeiro Velloso), but was used to test weapons and missiles. Also under suspect was build to do underground nuclear tests.
Watch it at 9º 20' S 54º 58' W in Google Earth.

bobusse

23rd Dec 2006, 11:24

The point seems to be the xpdr went to standby and the ATC radar displays showed that, but nobody in ATC caught the obscure symbology and let the Legacy pilots know that their xpdr was not replying:confused:

According to the pilots' interview, they were hearing ATC talking to everybody else in Portugese; so, had no reason to suspect ATC had a problem with them.

The need for a STAND-BY position on the switch is/was needed to keep the filament of the transmitting vacuum valve hot in case of immediate need(filaments could take up to a minut to be ready).
In the nowadays all solid state technology, is it still the case,if not,why to keep this position,rather confusing.
Since this equipment is essential for security,how about a condition to allow ,in flight of course,only momentary OFF push button which would restore itself to ON after a timed delay.

BizJetJock

23rd Dec 2006, 12:48

Chris 2000
I don't know who told you that oceans weren't RVSM; the North Atlantic was the first place in the world to have it!

ATC Watcher

23rd Dec 2006, 13:10

This means that the vertical separation with all other aircraft has to be 2000ft (!) and not 1000 like if it was RVSM approved.

the GOL should have been cleared to FL390 or FL330 (FL350 in case the controller supposed the Legacy at FL370, which was not the case)!

In your first post/question I asumed you knew about ATC and RVSM procedures, I was obvously wrong.

RVSM is about Height keeping accuracy . You do not need radar for RVSM. The mandatory transponder operation is to verify heigh reported/ by height measured and broadcast, and to provide ACAS protection.
If the controller would have noticed the loss of SSR of the Legacy and could not reach it on VHF ( which was apparently the case) then it is not 2000 ft but lateral separation that was needed with the Gol.

This is not an RVSM accident. Same would have happened if the Legacy had been coordinated at 350 instead of 36. The problem was that he was still at 37 UNDETECTED and the ATC Technical system in Brasilia showed the aircraft at the coordinated level , not his actual level.

Overhead the ocean the airspace is not RVSM because there is no Radar coverage and bad radio transmission. And in the same way that every aircraft need special equipment to enter RVSM airpace, every center also needs special equipment to operate as RVSM airspace.

Totally wrong : the first RVSM airspace was the North Atlantic, and many States Operating RVSM todat do not have 100% radar coverage.
You do not need any " special equipment" in ATC centres to operate RVSM, it is is just an extension of what you have been doing for years below FL285.

Proper training and procedures are definitively another matter.

jondc9

23rd Dec 2006, 14:50

fellow pilots and other aviation lovers:

I think this thread has been a very useful one. While we all seem to fly planes, each cockpit is different. I have never been in a Legacy ( sorry, Brazilian planes just don't do IT for me) and didn't know how confusing some of the displays can be.

In the last 2 jets I flew, the TCAS display was right on the wx radar either as a dedicated display or overlayed to the wx radar when in use. We could select ranges just like the WX radar. When the TCAS went out of service, the display would go blank except for a TCAS operational status readout.

There are other TCAS systems that are the minimum required installations and have so little data, I can't imagine a pilot enjoying it (just on VSI with max range 6 miles or so)

Our old planes did have reply lights on the transponders/tcas . These were so called "steam gauge" instrumented planes.

I think we are seeing what many of us have worried about for years...that the engineers and designers have taken over and the pilot/machine interface leaves us vulnerable in new ways.

Graybeard

23rd Dec 2006, 15:04

The need for a STAND-BY position on the switch is/was needed to keep the filament of the transmitting vacuum valve hot in case of immediate need(filaments could take up to a minut to be ready).
In the nowadays all solid state technology, is it still the case,if not,why to keep this position,rather confusing.
Since this equipment is essential for security,how about a condition to allow ,in flight of course,only momentary OFF push button which would restore itself to ON after a timed delay.
Good thought, Bobusse. Standby (or off) mode is needed while the aircraft is at the gate, at least. It has been pretty much agreed there was a failure in the Legacy transponder or its control. Would a self-reverting mode change remove a potential failure, or just add one more layer of confusion? Pilots are not comfortable with uncommanded mode selections or reversions.

Another option would be to trip the Master Caution system when transponder goes to Standby in flight. Whatever, this accident may well cause some change in all flight decks.
GB

songbird29

23rd Dec 2006, 16:04

Broadreach and ATC Watcher :

Some ten or fifteen years ago Italian ATC was changed from a military organisation into a civil one, which is called ENAV. I don't think this operation brought many difficulties. Staff remained the same, no uniforms anymore. Management was changed. But for the details we would need an Italian contribution. I'll try to find something on the web.

While I am on line on this thread I'd like to thank the Brazilian and other members who master the Portuguese language for their input to keep us updated on progress (or lack of, if one prefers). Please continue, really appreciated.

broadreach

23rd Dec 2006, 20:28

For anyone who’s been stuck for hours waiting for a flight in Brazil during the last few months and thought things couldn’t possibly get worse, it seems they are.

Tam, Gol and Varig operate, respectively, 96 (Airbus and F-100s), 96 (Boeing 73*) and (5-10 Boeing 73*, not sure). From Jan through Nov their collective share of domestic passenger miles carried was 92%. Gol, modelled on Southwest, may get better overall utilisation than the other two. Both Tam and Gol are said to be hard taskmasters and what I have heard is that pay is not fantastic. That’s not too surprising given the numbers Varig shed during its prolonged collapse, and the numbers of aspirants from a large GA fleet.

Up until the Gol/Legacy collision at the end of September, Brazil had an ATC system that, to all outward appearances, worked just the way it was supposed to, quietly and invisibly.

Enough has been said on this thread as to how it all came to pieces after the collision. This week’s chaos, though, has the airforce and ANAC and the president saying “this time it’s not our fault, it’s the airlines’” while pointing at TAM who removed six aircraft from service ostensibly for tech reasons.

I won’t say there’s a gleeful tone in the accusations, just “isn’t it great to be back on the offensive”.
On Friday ANAC ordered TAM to suspend ticket sales until Monday because of overbooking, and made a big show of putting the air force’s two 707s and two 732s (respectively nicknamed “Big Scrapheap” and “Little Scrapheap”) and four smaller Embraer jets at the disposal of the airlines. TAM reportedly spot-chartered the two 707s. Cynics say that all they’re really doing is providing a cover to get politicians out of Brasilia for the holidays. Others might observe that the capacity of all these aircraft together is less than 1% of the Brazil’s scheduled fleet and that Gol took delivery of two more 737s this week, with one more due next week.

One does wonder whether “tech reasons” is strictly true or if taking a larger number of aircraft out of service than usual might not be the payoff for three months of stretching duty times and cutting planned maintenance times to cope with the crisis.

How long a tail would the recent/current US/UK weather-related disruption leave after operational conditions returned to normal? A week? Presumably, when all those flights are cancelled, crews are stood down; they don’t just hang around the aircraft waiting for the weather to improve. Weather permitting, would everything not return to normal with a fortnight at most?

Picture the situation in Brazil. For nearly three months now it’s not been the weather but ATC holding things back. So, for all that time, crews have been standing by, waiting and inevitably going over the limit, but almost always continuing, i.e. better to get home while we can than wait a day or more downline for another crew who are probably stuck somewhere on the line themselves. How long can that be held together? Can any of you who were flying in the US during the Reagan/ATC faceoff relate?

JimR

24th Dec 2006, 13:48

First post, and maybe the last, because I’m no longer flying and as a “layman” don’t have any technically constructive comments that haven’t already been addressed.
I have been reading this thread with great interest, particularly because it is constructive and devoid of the garbage found in other non-aviation forums regarding this unfortunate accident. I have seen many interesting points raised that can only improve aviation safety.
I am wondering if there is any member of the official investigation team reading this forum; certainly I haven’t seen any posts to that effect.
As with any professional activity, sometimes points are overlooked that are important but not necessarily apparent to those closest to the problem.
Is there anyone out there that can at least provide a summary of the salient features raised in this forum as an input to the official investigation? I unfortunately, don’t have any contacts.:ugh:
Keep up the good work guys for the sake of us all, pax included.

broadreach

24th Dec 2006, 14:18

Very likely they are JimR, just unlikely they'd reveal themselves! It'd be interesting to see Pprune's access stats by country over the last six months.

caos

24th Dec 2006, 15:45

Very likely they are JimR, just unlikely they'd reveal themselves! It'd be interesting to see Pprune's access stats by country over the last six months.
http://www.big-boards.com/img/graphs/nc569.png

Period is not clear.
Source: http://www.big-boards.com/board/569/

FreeJoe&Jan

26th Dec 2006, 22:59

I have been reading this thread with great interest, particularly because it is constructive and devoid of the garbage found in other non-aviation forums regarding this unfortunate accident. I have seen many interesting points raised that can only improve aviation safety.

Great observation. A lot of experienced people, both pilots and ATC folks (and me not being one of them) have brought great insight to this thread. Congrats to all of them.

broadreach

26th Dec 2006, 22:59

Thanks Caos,

How much attention Pprune's received over the last few months as a result of the collision is hidden in the "others" of that pie chart. In any case I'm sure the balanced posts and hypotheses suggested in this long thread will have been noted.

Flight delays in Brazil pretty much evaporated on the 25th. Most of this week should be quiet. TAM are allowed to sell tickets again. Another test of the system will come this weekend: people returning home and presidential swearing-in in Brasilia. Highways are overloaded now and, pretty much as expected, accident rates are up.

After 1 Jan there should be time for more balanced damage assessment; whether same is accomplished may be open to question: Brazil still tends to slow down between Jan and Carnival (week 8, 19 Feb) and politicians take holidays too.

caos

26th Dec 2006, 23:56

You can find daily stats from Ads here
http://www.pprune.org/demoAdStats.php
At least here you can see South America.

FreeJoe&Jan

27th Dec 2006, 22:36

In any case I'm sure the balanced posts and hypotheses suggested in this long thread will have been noted.

No doubt. The vast majority of those dealt with technical issues related to the flight.

What would be interesting is for the pilot and ATC folks on here to make recommendations on how to improve things, based upon their knowledge of the incident.

I also wonder how people feel about the bigger questions raised by the events, such as the criminal investigation, the detention of the pilots, the military control of ATC, the government officials making public statements blaming the pilots, possible criminal charges for allegedly not noticing a transponder isn't working, etc.

One can only hope that this tragedy serves as a lesson in a lot of ways.

broadreach

29th Dec 2006, 23:54

FJ&J

You raise several points.

Regarding recommendations, it would seem that the broad causal factors are now well known and that those involved in the investigation have all the detail. I doubt suggestions from "outside" would be welcomed.

Re “how people feel”, I can only give you an approximate idea of local, i.e. Brazilian, feelings regarding the official statements, criminalisation and ATC under military control. Last first: re military control, nobody except the ATC staff themselves really gives a damn as long as it works. Right now it’s a tremendously emotional and political issue so I don’t think we’re likely to see which direction it’s headed for another few months.

Official statements have served only to expose the officials spouting them to ridicule.

Criminalisation. O Globo, a newspaper, ran a web survey in which it asked whether readers thought the Legacy crew should or should not have been allowed to leave the country. 52% said yes they should. That is presumably the uninformed public so better not to read too much into it. Anybody I’ve spoken with thinks retaining their passports was a cheap, ridiculous gesture. Anybody connected with aviation is horrified.

Yes, many lessons are being learnt - and again, I can only speak "locally". Whether it’s the airforce or a civil organisation in charge of ATC in the future, they won’t be as subservient to the treasury as they have been. Just short of US$ 300 million’s just been granted to close that stable door. The airlines will have learned that when the reservations system is disrupted by external factors like ATC they can’t just go on relying on their standard overbooking algorithms. Airlines might also take a more pro-active stance right from the start rather than keeping their heads down, as they have done, and hoping that most passenger fury would be directed at the government.

vapilot2004

23rd Jan 2007, 06:48

From AP and other sources:

Air traffic controllers as well as two American pilots are likely to share the blame for Brazil's worst aviation disaster when the country's criminal probe of the September collision wraps up in about a month, a spokeswoman for the federal police said Monday.

The statement by Tamares Carvalho, spokeswoman for lead investigator Renato Sayao, was the first time anyone connected with the criminal investigation has said the controllers would be held responsible for the collision of a Gol airlines Boeing 737 and Embraer Legacy 600 executive jet owned by Ronkonkoma-based ExcelAire and flown by Joseph Lepore, 42, of Bay Shore, and Jan Paladino, 34, of Westhampton Beach. Other Brazilian officials have blamed the pilots and, more recently, the controllers as lapses in the air traffic system have come to light since the Sept. 29 crash that killed 154 people when Gol Flight 1907 crashed. None of the seven people aboard the Legacy were injured.

The controllers could face up to 12 years in prison on homicide charges and exposing an aircraft to danger because they failed to divert the Boeing after the Legacy disappeared from their radar, Carvalho said.

Carvalho said she did not know whether authorities would prosecute the American pilots, who were formally accused by police with exposing an aircraft to danger before their passports were returned last month and they were allowed to leave the country after 71 days.

Because the controllers are military personnel, the police can only submit their findings to the Defense Department, which would decide whether to prosecute, Carvalho said.

Brazilian officials continue to insist that the American pilots should have noticed that their jet's transponder, which transmits the plane's altitude and is a key component of the anti-collision or TCAS system, was not working before the collision.

In a statement released Monday, ExcelAire said it "again affirms that its pilots did not intentionally or inadvertently disengage the Legacy's transponder or TCAS and that there was no indication in the cockpit at any time during the flight that the transponder or TCAS system were not operational. The accident investigators continue to analyze the Legacy's transponder and other avionics systems to determine whether those units suffered from defects or faults that compromised their operation."

Besides the criminal investigation, a civil investigation is being conducted by the Brazilian government aided by the U.S. National Transportation Board and Federal Aviation Administration. That probe on what caused the collision will be completed in the fall.

Crossunder

23rd Jan 2007, 10:10

Brazilian officials continue to insist that the American pilots should have noticed that their jet's transponder
How?
And how professional of the investigators to blame the pilots BEFORE they've finished their report. Typical of these countries (cultures) to have a strong need of finding someone to blame. Pilots fly at their assigned Flight Level. ATC informs the pilots when the XPDR doesn't reply.
Pilot error, my @$$ :mad:

bomarc

23rd Jan 2007, 15:24

crossunder and others:

very few of us have flown that particular model of airplane with its unique avionics.

if there is nothing that tells a pilot if the transponder is not working properly, then something is wrong.

I do ask those who know this type of avionics to tells us:

Would the TCAS onboard the Legacy indicate a failure mode if the transponder were not "on"?

would that failure mode be visible to the pilots?

if it would, then there is some blame to be shared by the pilots...

if not, more blame for an avionics system that isn't "fail safe" (also a nod to the movie and book)

I don't want to see these pilots in jail. but I do want the truth, so we can avoid another MidAir like this or any other.

TCAS came about, partially, due to a midair over cerittos california, near los angeles...among others.

Richard_Brazil

26th Jan 2007, 15:33

There are some misstatements in the "AP and other sources" report.

The policeman, Renato Sayão, says that the Military Prosecutors must decide if the controllers should be charged, because they're in the Armed Forces.Because the controllers are military personnel, the police can only submit their findings to the Defense Department, which would decide whether to prosecute, Carvalho said.The Military Prosecutors are subordinate to the Federal Prosecutor-General, and quite independent of the Defense Department.

In December the Military Prosecutor-General said "but in case the participation of military flight controllers in the accident is verified, they may be accused by the Federal Police, if it is shown that the crime is of a civilian nature." You can listen to her interview (in Portuguese, of course) here: http://www.bandnewsfm.com.br/audio/BOECHAT_1312_MARIAESTER.mp3

I don't know where Sayão gets the 12 years from. The Military Code of Justice defines the "placing an aircraft in danger" crime differently than the common penal code; it would seem to apply only to craft "under military administration, guard or protection." There are other aspects I'm wary of commenting on because I'm not a lawyer and anything I say may contribute more heat than light.

The reason Sayão is commenting is that the Brazil's leading news magazine, Veja, last weekend printed a supposed extract from the Legacy's black-box dialogs. One line is, literally retranslated:

"All right. We're descending. Declaring an emergency. Sit."

"Sit?" I'd bet what was originally said was "Sit tight". But there are other phrases where I can't guess what the original English was, and so it's impossible to guess the meaning of what was said.

The translation was produced by a certified public translator, which doesn't mean that it's any good.

As to the timetable on this, last week the police were granted an additional thirty days for their investigation. They'd asked for that extension on December 13. Today's papers say that Sayão will be asking for at least another sixty days after this. if this were an ocean liner's daily mileage pool, I'd advise putting your money on the high range.

Of the fifteen controllers, the police still haven't talked to the two who were on duty in Manaus.

barit1

4th Feb 2007, 15:30

By coincidence I'm sure - but I've never heard it called SLOP (http://www.pprune.org/forums/showthread.php?t=262739)

brain fade

4th Feb 2007, 16:05

'TCAS fail' presented on both pilolts PFD in the event of.......

Graybeard

5th Feb 2007, 01:52

The data busses out of the TCAS processor, digital altitude source, and the transponder report one of three conditions: Valid, Fail, or No Computed Data.

If the transponder is in standby mode, its output label is NCD. The TCAS processor then indicates "TCAS OFF," which is an advisory level, and not an alert or warning. Depending on the aircraft, it may not be all that obvious. There should also be a transponder indication of "TPR SBY," or similar. It assumes Standby was selected intentionally.

"TCAS FAIL" indicates a failure within the TCAS processor or transponder, or aircraft identification source.

GB

Graybeard

5th Feb 2007, 02:55

Here's some pure speculation: Maybe neither pilot had flown the Legacy beyond radar range, and upon seeing "TCAS OFF" and "TPR SBY," they erroneously concluded this was normal for this airplane in non-radar environment.

GB

TheShadow

18th Feb 2007, 16:44

The way that I'm reading a few news releases (Folha) and posts on other forums and blogs, the Legacy pilots' use of a laptop might have both:
.
a. Turned off the transponder (inadvertently with the laptop's opening lid) and thereafter
.
b. Obscured the transponder panel (and any advisories thereon) whilst open and in front of it during their repeated attempts to re-establish comms (19 attempts in 8 minutes I think it was).
.
The laptop I'd imagine might hold some charts, freqs, CxLists or suchlike? Can anybody familiar with the aircraft's center console panels (and pushbuttons down their sides), endorse or deny any such theory? The IFATCA paper has already pointed out that it's possible to finger-mash buttons and put the TxPDR to STBY inadvertently. I guess the lid of a laptop tool (BLT) might be able to do similar if it was being manipulated clumsily (juggled whilst also consulting unfolded paper charts for sector freqs).
45. ... On information and belief, the line key that puts the transponder into “standby” mode is located in close proximity to line keys that are commonly used by pilots in flight for other purposes. If the pilot’s finger slips slightly, the standby line key will be depressed also or instead, deactivating the transponder and the TCAS.
...
49. Honeywell did not provide adequate warnings regarding the danger posed by the foreseeable pilot uses above. On information and belief, the only notice regarding the loss of the TCAS provided by the Honeywell transponder on the ExcelAire Aircraft upon its transponder being switched to “standby” mode is a white light that reads “TCAS off.” There is no voice warning, and no amber or red light of the type pilots are trained to look for as a sign of a safety problem. An amber “TCAS fail” light is only activated when there is a technical malfunction of the transponder, but the effect is no different when the transponder is in “standby” mode—in either circumstance, the TCAS is not performing its critical lifesaving function.
Eliane Cantanhede, a lead journalist from Folha newspaper got access to 290 pages of transcripts of the cockpit and ATC conversations. According to Eliane the transcripts "clearly show that the difficulty in communication between the Legacy pilots and the controller prevented them, for three times, from clarifying if they were supposed to proceed at FL370".
In addition, according to Eliane, the investigators are working with the possibility that either Joseph Lepore or Jan Paladino had a laptop opened in front of the transponder display panel.
Folha is releasing the full article only on news-stands, the internet has only a summary. http://www1.folha.uol.com.br/folha/cotidiano/ult95u131896.shtml.
Note: Picapau (a journalist himself) has noted that Eliane is a highly regarded, well-connected and informed journalist working out of Brasília city.
On FAB's site ( http://www.fab.mil.br/imprensa/enotimp/enotimp_capa.htm) there is more from Eliane's text than in Folha's non-premium version.
Brazzil mag has commented on some parts of this: http://www.brazzilmag.com/content/view/7911/54/

Austrian Simon

19th Feb 2007, 09:36

The way that I'm reading a few news releases (Folha) and posts on other forums and blogs, the Legacy pilots' use of a laptop might have both:

So far, that notebook is pure speculation, not backed by any evidence as even this journalist needed to write in her article. The only hint towards that notebook, as stated in that article, is that the crew was talking about a DVD according to the transcript. There is no mention of a notebook in the transcript at all.

But since when does talking about a DVD require to actually view the DVD at the same time?

It would be extremely bad, if indeed the investigators would base their investigation on that notebook, as this journalist suggests in her article.

The main question is still burning, to which we still haven't seen the tiniest attempt of an answer by investigators, officials or press people so far (this journalist actually raises the same question in her article, again without an answer):

Why were the two planes at the same altitude?

If there is any attempt to answer this question, then it can be found in this article: the controller was convinced, the Legacy was on FL360 and never realised, that the label on his screen was a "fiction" and not the true transponder return! That's why he never concluded, it would be prudent to turn the GOL around the Legacy ...

But if that report holds water, then what does this tell about the system, that produces "fictious" labels and obviously doesn't train the operators accordingly, and what does this tell about that system's operators, who don't know their displays?

It is quite interesting to notice, how the military now tries to change their story (e.g. introducing that notebook, dropping a lot of earlier accusations that already got disproven, introducing the same accusations again with different reasoning and different unproven "facts", ...) while still trying to turn attention away from ATC and the ATC system and attempting to solely blame the Legacy pilots. Isn't it also highly revealing, that especially the website of the Military quotes most of her article?

The blame game trying to mislead the Brasilian public goes into another round, but it doesn't get any more credible. I believe, Brasilian public is more clever than what those "authorities" believe.

Pity, the article appears to contain quite some good leads, that due to the obvious bias in the article were not followed up, however. It might be interesting, actually necessary, to read the article in its entirety to really form an opinion about how far that journalist got indeed and whether the bias, that appears in those parts published on the Internet so far, gets confirmed or disproven. I would be grateful to receive a link to a full copy of that article on the Internet ...

Servus, Simon

broadreach

19th Feb 2007, 11:13

There are said to be 300 pages of transcripts, covering Cindacta, Sao Jose dos Campos, Manaus, the Legacy and, presumably, the Gol 737.

It would be naive to think that anyone could condense that into a single newspaper article without appearing to show bias, distorting the context or strewing red herrings about. Frankly, I don't see how the reporter could have avoided it.

All the article does is heighten the drama with a few excerpts of real language in Cindacta and in the Legacy cockpit, even if they lose (or gain)something in the translation.

As for FAB putting the article in their press clippings page, like many other clipping services they put in everything that relates to their area, good or bad; hardly "highly revealing".

ATC Watcher

19th Feb 2007, 22:01

The laptop story is just a smoke screen . Even if partially correct, this is not interesting for us.
The real reasons behind this collision are emerging now, and it looks like combination of 3 factors : (very) poor HMI of a transponder, even poorer ATC sofware system on the ground and a well know area on non VHF and radar coverage in between.

The rest are details .

Interestingly enough , Thales ( the French radar manufacturer ) has just announced the modernisation of Brazil radar system , with the Brazilian Air Force ordering 26 new radars ( 17 S and 9 L bands ) for 80 Millions USD.

That should probably take care of one of the above problems.

georgecrock

20th Feb 2007, 19:33

Captain
written by George Rock, 2007-02-19 21:14:16

There are many misunderstanding and TECHNICAL bad translations in Eliane Cantanhêde's newspaper article published on Sunday, FEV 18, 2007, Folha de São Paulo newspaper.

For example:

She said the pilots had trouble with the aircraft radio equipment because of transcripted phrase:

In portuguese, as published in newspaper:
"Céu a 2.500. Eu não sei o que TX 35 significa... TN 25. Eu preciso aprender essa porra internacional. *****."

In english:
Ceiling 2500. I don't know TX 35 ... TN 25 meanings. I need to learn that international f**king. ****."

The pilots were talking about Terminal Aerodrome Forecast - TAF. There was no relation to aircraft Radio Equipment. TX means Forecast Maximum Temperature and TN means Forecast Minimum Temperature.

Other supposed phrase said by the pilot was about aircraft Weight and Balance calculation for landing after collision.

In portuguese, as published in newspaper:
Hot 2 - 1.600. Mil menos, uh... 8.800. Sim, devemos estar pousando em torno de 7.200.

In english:
Hot 2 - 1600. Minus 1000, uh... 8800. Yes, we should be landing around 7200.
***Hot 2 - Nickname for second pilot in that dialogue

Both pilots were very upset about the collision and they were calculating MLW = Maximum Landing Weight, Runway length for that Weight, Fuel Consumption, Heading, etc..

Another bad interpreted phrase by journalist Eliane Cantanhêde as an irrefutable proof that both Legacy's pilots had difficulties how to operate the aircraft:

In portuguese, as published in newspaper:
- Não sei como funciona o Satfone.
- Se você soubesse, seria maravilhoso.

In english:
- I don't know how Satphone works.
- If you knew, it would be wonderful.

They were talking about Satellite Phone.

Other insidious translated phrase that irritated Brazilian people:

Journalist Eliane Cantanhêde said insidiously in her newspaper article that pilots called injuriously Brazilian Air Traffic Controllers as "fudidos" ( pronounce 'foo-did-oo' ).

A bad translation for "f**k" word , an english interjection that express extreme irritation and disgust. In Brazilian aviation jargon, "big f**ck" is an idiomatic expression that many pilots say it in reference to situation when an Air Traffic Controller abandon the aircraft without radio communications for a long period of time.

We always say:
Those "Big F**ck"" abandoned us".

"Big F**ck" means in portuguese "FODÃO", so we say:

Those "FODÃO" abandoned us.

"Fodão" ( pronounce like that 'Fó-dun' ) this word means a person who has behavior to think He or She is "the best" Air Traffic Controler on Earth, He or She is a "Know-it-all", He or She is "Powerful", but He or She, in fact, has made many mistakes.

So the correct translation to portuguese for "f**k" in situation like that is "FODÃO", not "FUDIDOS".

"fudidos" is a very strong offensive word for Brazilian people. It means as a put-down. It express contempt feelings.

All Cockpit Voice Recorder and Flight Data Recorder transcripted phrases published by Eliane Cantanhêde were picked up from transcriptions without the correct sequence for flight phases. Not even the correct phrases timetable was published in GMT time ( = Greenwich Mean Time ) which is suitable for aviation time recording.

The article did citation to Washington Time like that:

In portuguese, as published in newspaper:
1 Joe não pode saber
18:37:12
(horário de Washington )

In english:
1 Joe cann't know ( ...they were talking about Center of Gravity - CG of the aircraft. The plane had not took off yet )
18:37:12
(Washington Time )

The official Take off time was 14:51 Local Time = 17:51 GMT Time = 12:51 in Washington Time.

But that Time ( 18:37:12 ) in Washington, it should be 20:37:12 in Brasilia ( capital City ) and it should be 23:37:12 in Greenwich ( London ), on September 29, 2006.

The official collision time was 16:56:54 Local Time = 19:56:54 GMT or = 14:56:54 in Washington, as published in Preliminary Investigation Report.

What did 18:37:12 Flight Phase Time refer to?

That newspaper article does NOT deserve any TECHNICAL credibility.

George Rock
Airline Transport Pilot
Rio de Janeiro
Copacabana
Brazil

atakacs

20th Feb 2007, 20:52

In english:
- I don't know how Satphone works.
- If you knew, it would be wonderful.

They were talking about Satellite Phone.

Just wondering... what use did they foresee for those sat phones ?

Was that before or after the collision ?

alex

@George Rock: Thanks for your insight

georgecrock

21st Feb 2007, 11:06

Alex,

It was AFTER collision.

When both pilots were trying to keep radio contact with Manaus Area Control Center - ACC Amazonia without success and they finally got radio contact with Polar 71 crew.

Polar 71 aircraft was flying nearby and its crew passed Lagacy's distress on Manaus ACC.

Lagacy's crew called Polar 71 at 17:01:22 Local Time = 20:01:22 GMT.

At 17:13:16 Local Time = 20:13:16 GMT after many unsuccessful calls of both aircrafts to Amazonia Center ( Manaus ) and to Brasilia Center, Polar 71's crew finally got to pass Legacy distress on Manaus ACC.

varigflier

23rd Feb 2007, 00:48

For those of you who are going to be flying to Brazil, be careful when in Brazilian airspace. Ever since the accident last year things are chaotic at best and it gets worse near national holidays. What the controllers are doing to us is a joke. Flights going to Europe are put on hold 30 minutes after departure, people are holding till declaring low fuel, 10 minute separation with for no reasons plus the usual loss of communication, radar coverage, ATC forgetting you are there etc........ Watch out!!!

atakacs

11th Mar 2007, 23:37

Folks

did try to read the whole thread - honest !

I don't seem to find much information about the fate of the GOL 737. From the few pictures I have seen it seems fairly intact with no obvious reason for it's crash. I understand the CVR/FDR were eventually recovered. Anything official about them ? Any other info ?

Regards

alex

forget

11th Mar 2007, 23:46

Folks, did try to read the whole thread - honest !

atakacs. Reading this thread is a waste of your time. Read first about the basics of flight - or 'How Aeroplanes Work'. :*

Tarq57

11th Mar 2007, 23:57

From the few pictures I have seen it seems fairly intact with no obvious reason for it's crash.

The outer half of its left wing was torn off in the collision, making controlled flight impossible.
What's so difficult to understand about that?
As for the orange boxes, I don't know.

barit1

12th Mar 2007, 00:48

atakacs: Post #359 has a link to an animation that likely will be very close to the final report:

http://g1.globo.com/Noticias/0,,IIF661-5598,00.html

atakacs

13th Mar 2007, 19:34

Thanks for the link to #359... Didn't follow it...

alex

lomapaseo

13th Mar 2007, 21:35

atakacs: Post #359 has a link to an animation that likely will be very close to the final report:

http://g1.globo.com/Noticias/0,,IIF661-5598,00.html

I have about as much faith in pure graphics as I do in the similar graphics produced outside the investigation for the TWA800 hearing.

Unless the graphics are supported by analysis and facts they are worthless imaginations to me.

barit1

14th Mar 2007, 00:21

lomapaseo: Point well taken.

atakacs: Is it the assymetric lift that you don't get? Or what?

atakacs

14th Mar 2007, 09:29

Well I didn't get to see the animation. IF it depicts what happened then I am perfectly clear about it... just wondering what was the basis for this scenario.

ATC Watcher

22nd Mar 2007, 07:52

Very interesting serie of articles about the collision in the latest March issue of The Controller http://www.the-controller.net depicting both the ATC ground systems and the transponder HMI features .

The inside view on the actual ATC situation in Brasil is also quite interesting.

Zeffy

22nd Mar 2007, 10:42

Very interesting serie of articles about the collision in the latest March issue of The Controller http://www.the-controller.net (http://www.the-controller.net/) depicting both the ATC ground systems and the transponder HMI features .

The inside view on the actual ATC situation in Brasil is also quite interesting.

The link to the archived 1981 piece worked, but no luck with the rest. Is it possible to read the entire series on line?

preta

23rd Mar 2007, 16:13

dear iomapaseo
the upper wing surface have compression stresses.
but, the under wing suffers very high tensile stress(traction).
the things are so severe ,that a minimal crack or scratch in de under wing,starts a catastrophic rupture.Try at home to separate a celophane
sheet. you have a certain difficult to do it.
but insert a little cut and........you will feel the greatest engineering problem
which is:fine grooving efect;could be caused by fadigue or a fine cut or scratch..... and them BY BY WING
condolences to the victims
best regards
preta:sad:

lomapaseo

24th Mar 2007, 18:55

Preta

Sorry, I don't buy into it. If it were that simple, any impact from tyre failures or engine debris would be snapping wings off right and left.

Over simplifications don't fail wings. I'll only be satisfied when all the layers of swiss cheese are revealed. So far they are outstandingly quiet about this. But I guess we'll just revisit all this after another inflight breakup.

barit1

24th Mar 2007, 20:54

preta's is not a good analogy.

Without actually seeing the impact area, I'd hazard an educated guess that the 738 lower wing skin was nearly completely sliced into inboard and outboard halves by the legacy winglet (with a closure speed of 1500 ft/sec).

This means the upper skin, designed to carry chiefly compression loads (or minor tensile load if negative G), is now carrying a bending load from the lift of the outer wing. Being ralitively thin, it won't endure long. Ergo the lift load bends the outer section upwards, hinging on the upper skin in line with the cut in the lower skin.

Although I haven't seen the debris field pattern I wouldn't be at all surprised if the outboard wing didn't separate completely in the highspeed descent.

broadreach

25th Mar 2007, 01:48

Lomapaseo, it may be an oversimplification but the hypothesis of the Legacy's port winglet slicing through the under skin of the Boeing's port wing, and the Boeing's wing failing as a result, is as close as anyone's got. Somewhere along the line, months back, there was a confused report in a local newspaper that either the Legacy had hit the Boeing's stabilizer or that the Boeing's wing had; I don't remember where I saw it but I expect when the accident report is finally published the debris pattern will show, as Barit suggests, the Boeing's port wing well behind the main wreckage site.

Graybeard

25th Mar 2007, 03:54

You are saying the skin carries enough wing load that the spars can't hold the wing on if the lower skin fails? I doubt that. Else, why have spars?
GB

RatherBeFlying

25th Mar 2007, 04:55

I doubt the Legacy winglet stayed attached more than a foot or so; so, likely would not slice the entire span of lower wing skin. If it got that far it would likely have remained attached.

We are talking a 1000 kt impact which can do damage in a number of ways including: sever hydraulic and electric lines airloads pulling off wingskin and making controllability issues fuel tank rupture and ignition of contents at the moment of collision.

GlueBall

25th Mar 2007, 06:03

lomapaseo... . . .Unless the graphics are supported by analysis and facts they are worthless imaginations to me.

But you have seen a photo of the missing left winglet, and associated damage to the left vertical stabilizer of the Embraer jet. . . no? If you have seen the post crash photo of this jet, what other conceivable collision scenario could produce such "facts?"

lomapaseo

25th Mar 2007, 10:56

I doubt the Legacy winglet stayed attached more than a foot or so; so, likely would not slice the entire span of lower wing skin. If it got that far it would likely have remained attached.

We are talking a 1000 kt impact which can do damage in a number of ways including:
sever hydraulic and electric lines
airloads pulling off wingskin and making controllability issues
fuel tank rupture and ignition of contents at the moment of collision.

agreed now what else to add and which layers of cheese?

barit1

25th Mar 2007, 12:44

Greybeard asks: You are saying the skin carries enough wing load that the spars can't hold the wing on if the lower skin fails? I doubt that. Else, why have spars?

I found this drawing of a typical wing box (http://www.ame.arizona.edu/courses/ame422a/labs/lab2.doc) (see fig. 5). Note that there is little that you could call a "spar" in this mid-span section of the wing - the major spar sections are around cutouts like the MLG wells. Further out in the wing, the upper and lower wing skins are carrying all the load.

As I mentioned several months ago, this very efficient design was introduced by Jack Northrop in his "Alpha" (1930), and has become industry standard since the DC-3.

See also here: (http://www.pprune.org/forums/showthread.php?p=2894248#post2894248)

GlueBall

25th Mar 2007, 13:25

It's like insulation foam coming unglued from the space shuttle tank; . . . at first everybody said that a chunk of foam couldn't open the leading edge of the wing; but a chunk of foam impacting at 160+mph could; and it did.

broadreach

30th Mar 2007, 23:49

A black Friday for air commuters, crews and airlines in Brazil. Patience of the mixed airforce/civil ATC staff seems to have ended and Brasilia, Manaus, Rio and Salvador shut down for takeoffs early this evening. A few hours later Infraero, the airports authority, announced that all airports in Brazil were closed.

This may turn out to be just a skirmish. If you understand Portuguese and are interested, check out the Brazilian ATC site with the latest manifesto:
http://www.abcta.org.br/default.php?ABCTAID=c57d2eda7e4691ff684060bbd7280928=IPacess o=201.1.1.174=ID=c57d2eda7e4691ff684060bbd7280928=PHPSESSID= c57d2eda7e4691ff684060bbd7280928c57d2eda7e4691ff684060bbd728 0928

alemaobaiano

31st Mar 2007, 00:01

It is now being reported that 18 controllers from Brasilia have been arrested, and warrants for all other striking controllers have been issued. A couple of flights have left Congonhas for Rio, but all movement in and around Brasilia is suspended.

Have a great weekend

broadreach

31st Mar 2007, 13:12

Agreement between the government and ATC leaders was reached around midnight. Text published in Folha de Sao Paulo at

http://www1.folha.uol.com.br/folha/cotidiano/ult95u133574.shtml

Basically:
1) No punishment for yesterday's strike and a "review" (assume this means reversal) of disciplinary measures such as transfers, suspensions etc taken against perceived leaders over last six months.
2) Negotiations as from 3 April with civil and military ATC staff with a view to gradual transfer of ATC to civilian control.
3) Negotiations as from 3 April with civil and military ATC staff over pay and conditions.

All in all, quite a breakthrough and ATC people have achieved their goal. The government's officially agreeing to negotiate transfer to civil control is an unfortunate humiliation for the airforce who, with some foresight, could have turned the problem created back in October into an opportunity but chose, instead, an attempt to maintain the status quo ante.

jet_noseover

31st Mar 2007, 13:57

It was only a matter of time:

Two Long Island pilots were named in a series of lawsuits filed Friday in federal court seeking millions of dollars in damages for alleged negligence stemming from an aircraft collision that led to Brazil's worst air disaster.
.....
The lawsuits name the Embraer's owner, Ronkonkoma, N.Y.-based ExcelAire, and the two pilots who survived, Joseph Lepore and Jan Paladino — both Long Island residents. The jet's pilots failed to maintain proper altitude, didn't maintain proper communication with Brazilian air traffic controllers and didn't operate the aircraft properly, the lawsuit contends.
....
Brazilian investigators have also said that air traffic controllers bear some responsibility for the crash.

The lawsuits filed in Miami also level negligence and products liability claims against the maker of the transponder, Honeywell International Inc. Officials at that corporation declined comment because they had not yet seen the lawsuits.

"Honeywell, however is unaware of any evidence that its equipment was defective or had malfunctioned in any way. The company will vigorously defend itself in this matter," according to a statement e-mailed by a spokesman.

In addition, the lawsuits contend that a factor in the crash were defects in an air traffic control system known as the System for the Vigilance of the Amazon, or SIVAM. The lawsuits name as defendants Bethesda, Md.-based Lockheed Martin Corp. and two other companies that developed and maintained that system.

more at:

http://www.silive.com/newsflash/metro/index.ssf?/base/news-24/1175299808136320.xml&storylist=simetro

Halfnut

31st Mar 2007, 19:42

No URL but from another board:

An unprecedented rebellion by Brazil's air traffic controllers, most of them military, paralyzed this Friday, March 30, all 49 commercial airports in the country. According to Infraero, Brazil's airport authority, no plane was being allowed to take off. The air control towers were only letting incoming air traffic.

The rebellious flight controllers told the Cindacta-1 (Brazilian capital Brasília central control tower) brass that their strike would continue and all incoming and outgoing traffic would stop entirely until the authorities negotiated with them. The work stoppage started at 6:44 pm in Brasília.

Cindacta-1 is an important control center, which monitors flights for the most important air hubs in the country in the states of São Paulo, Rio de Janeiro, Minas Gerais, Goiás, Espírito Santo, among others. The controllers' action left thousands of passengers stranded in airports.

With President Luiz Inácio Lula da Silva out of the country for a meeting with Bush this weekend in Camp David, acting president José Alencar, rushed back from Belo Horizonte to Brasília. He only was able to fly after getting special clearance from the Air Force leadership.

Still on the air on his way to Washington, Lula intervened in the crisis to avoid that some air controllers be taken to jail as was the Air Force top command's wish.

The Military Public Prosecutor's Office had already issued arrest orders against 18 flight controllers, who were charged with mutiny. The Justice Military prosecutor, Ione de Souza Cruz, was on her way to make the arrests when came word that Lula had decided that they should negotiate with the insubordinate controllers.

It was already Saturday, when the Brazilian government announced that it had reached an agreement with the controllers. Apparently they won all their main demands including no punishment for the rebels and a demilitarization - at least partial - of the sector. The government also promised to raise their salaries.

Brazilian Planning Minister, Paulo Bernardo, arrived at the Cindacta-1's headquarters to negotiate with the controllers and try to get them back to work at about 11 pm. He was accompanied by brigadier Ramon Cardoso, the Air Force's Air Space Control Department director.

Besides the Air Force Commander, Juniti Saito, other ministers got involved in the negotiations including Social Communication's Minister, Franklin Martins; Institutional Security Minister, Jorge Armando Félix and the presidency's Chief of Staff, Gilberto Carvalho.

Among the controllers' demands were better working conditions, higher wages and the category's demilitarization. About 80% of the country's air controllers are military men today.

The rebellion started Friday morning, as a response to the transfer of sergeant Edleuzo Souza Cavalcanti, an air-controller leader, from Brasília to Santa Maria in the southern state of Rio Grande do Sul. To protest this relocation over 100 of his colleagues at Cindacta -1, Brasília's air control center, went into a hunger strike. In Mato Grosso state a group of air controllers soon joined the movement staging a work to rule campaign.

Flying in Brazil has been problematic since September 29 when a Boeing 737 collided with a Legacy executive jet killing all 154 passengers and crew aboard the Boeing over the Amazon rainforest. Since then Brazil has faced several chaotic situations in the airports during times of increased air traffic like All Souls Day holiday, Christmas and Carnaval.

Defense Minister, Waldir Pires, said Friday afternoon that a democratic state could not become hostage of anybody. "There is no negotiation with the controllers," he stated at the time, while saying that he recognized that their demands were "legitimate." It just took a few hours before his no-negotiation warning was trampled by the facts.

broadreach

1st Apr 2007, 02:00

Did someone say "gradual transfer" to civilian control?

The Brazilian airforce high command have released a statement to the effect that the transfer should take place post-haste. And which makes plain their irritation at having been overruled by the president when in the process of arresting mutinous military ATCers.

On Tuesday 4 April Lula is expected to sign a bill transferring 1,500 of the 2,400 military controllers to a new body, the "Controle da Circulação Aérea Geral" which will still be under Defense department control but a step removed from the airforce. How this is actually going to function remains to be seen. There will probably be some confusion in the early stages but it shouldn't be seen as just a cover for continued military control, rather as a transitional stage while the government decides what the next step should be, e.g. an Infraero (airports authority, 100% government) subsidiary; another parastatal alongside Infraero; a PPP (unlikely), etc.

rotornut

1st Apr 2007, 11:33

Brazil air chaos follows strike

There have been chaotic scenes at most of Brazil's airports as airlines tried to find flights for thousands of passengers caught up in a strike.
Airports resumed flights after air traffic controllers suspended a strike to protest about working conditions.

The strike briefly halted all flights out of the country's airports.

The action spread across Brazil after air traffic controllers went on hunger strike in the capital, Brasilia, leaving thousands stranded.

For several hours, Brazil's huge air traffic network was at a total standstill as controllers refused to authorise any take-offs or landings.

Long queues snaked outside airport halls, particularly in Rio de Janeiro and Sao Paulo, after nearly 100 domestic and international flights were cancelled and many more were delayed.

"The situation will not return to normal before three days," the head of the state airport authority Infraero, Jose Carlos Pereira, said.

Police were called to the main airports to help deal with passengers furious at the delays, reports say.

In Brasilia, a group of passengers invaded the tarmac when their plane for the south-eastern city of Belo Horizonte was rerouted to a different city, the Associated Press news agency reports.

Brasilia is the main traffic control centre for all flights through central Brazil.

Ongoing crisis

It was the culmination of a crisis in the system that has created major delays across the country for several months.

In the early hours of Saturday, the controllers agreed to resume work after the government agreed to begin negotiations on increasing the salaries of the controllers and to discuss removing at least part of the system from the control of the military - a key demand of the unions.

The striking controllers had said they had lost all confidence in their commanders and the equipment at their disposal.

Air traffic controllers in Brazil have staged similar protests since last September, when 154 people were killed in the country's worst air disaster.

The BBC's Tim Hirsch in Sao Paulo says internal flights have been in a state of chaos since the crash.

Air traffic control in Brazil is under the control of the air force, and most controllers are military and non-unionised.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/americas/6514999.stm

lomapaseo

1st Apr 2007, 11:52

I can't seem to fathom a controller on a hunger strike. All sorts of visions come to mind in conflict with each other.

wench007

4th Apr 2007, 12:17

Does a controller on a hunger strike still get a 40 minute meal break? ;)

broadreach

4th Apr 2007, 12:28

Under pressure from the airforce and the rest of the military, Lula has "de-authorised" the agreement his Planning minister, on his behalf, signed with the striking ATCers last Friday night.

The airforce want to court-martial the sergeants who stopped work and had already begun arresting them when Lula, enroute to the US, ordered negotiations.

broadreach

9th Apr 2007, 00:51

From today’s Estado de Sao Paulo after an interview with a line pilot on the Rio-Sao Paulo shuttle. Liberal translation; apologies for any inaccuracies
Pilots and controllers disagree on procedures; mid-air arguments
Captains reveal: some ATC instructions against air safety
Mariana Barbosa (O Estado de Sao Paulo)
A happy pilot, at ease with life, is all passengers could ask for when entering an aircraft. And for the majority of pilots, flying has always been a great source of pleasure. That’s how it had been throughout the 28 year career of the Rio-Sao Paulo pilot of a large Brazilian airline. For the last six months, though, the job’s become stress itself. “I was always happy to go to work. But now, three hours before I leave home, I’m worried about how I’m going to handle the situations that arise, how I’m going to end the day, what time I’ll get home. My relationship with the job has changed entirely”, says the pilot, who prefers not to be named.
So-called safety procedures adopted by ATC after the Gol accident on 29th September and which have resulted in widespread delays and cancellations throughout Brazilian commercial aviation, have altered a longstanding relationship of trust between pilots and controllers. “We’ve always had a good relationship, controllers were our guardian angels”, says the captain, “and they still are, despite the crisis. But much of the trust is gone. You just don’t know whether what he’s asking for is really for the sake of safety or just to screw us up”.
These situations are now frequently winding up in heated arguments. And, since stronger language tends to generate infringement reports, pilots and controllers are going heavy on the irony and sarcasm, with pilots swearing only when there’s no risk of identification. Phrases like “that’s a lie”, “bull****”, “son of a bitch” tend to come from other aircraft on the frequency and who can’t be identified. When it reaches that level controllers are left with no option but to try to recover control with “let’s keep to standard phraseology”.
Pilots are complaining that some ATC instructions are unjustifiable and, often, run contrary to flight safety. For example, ATC authorize a departure but then order the aircraft to orbit for thirty minutes at low altitude until the requested airway is free or until the single controller has less than fourteen aircraft to handle.
The heavier the aircraft and the lower the flight level, the greater the fuel consumption. That generates cost for the airline; fuel is at least 30% of operating cost. But not just that; safety demands that an aircraft take off with sufficient fuel to reach its destination with sufficient reserves to land at an alternate, plus fuel for a further 30 minutes. “Circling for thirty minutes while heavy, at low altitudes, has a direct impact on flight safety”, says the captain.
According to him, instructions to circle at low levels right after takeoff were more commonplace early on in the crisis. “We explained to them how this procedure affected safety and that it was not the proper way to go about applying pressure. They no longer do that; now they ask us to circle nearer the destination. It’s not as bad but it’s still costly”.
Often, when the landing delay is too long, airlines opt to deviate flights to another airport. “Planes are deviating too often and there are too many landing at the limit in terms of fuel remaining”, the pilot says. The result is angry passengers who have to complete their journeys by bus. For crews it often means another day away from home. “My roster’s become an abstraction. We’ve been living in a state of emergency for six months now”.
According to the captain, these situations now occur more frequently on Fridays, at peak hours or when ATC is working to rule.
He also questions the veracity of some information transmitted by controllers to justify holdups: “Many times you might be approaching Congonhas and they ask you to hold over Santos because the apron’s full. When we check with our own ground staff they say it’s not true. The controller then says he got that information from the tower and that there are x aircraft in the hold ahead of us. That happens every day and it gets to a point that would try the patience of a Buddhist monk.”
Ends.
Comment:
Since the Gol accident pilots have been very quiet on the ATC subject. Less so now, nudged, perhaps, by the IFALPA release and by flight crew strike threats in Argentina, also related to ATC deficiencies.
Articles like the one above are appearing more frequently in the dailies and in weekly newsmagazines. Some, like this one, fairly straightforward, others a good deal more sensational. All of them bombarding the traveling public and, to some extent, "the other side"; this one critical of ATC which may, in turn, require someone in ATC to criticize pilots etc.
ATC staff, military and civil, don’t know which way to turn. Different factions have different objectives and they’ve now become pawns in a political struggle between the military – with their own internal differences of opinion – and the executive who, at first, signaled privatization but now dither.
There’s a phrase in Brazil, “Empurrar com a barriga”, literally translated as “To push with the belly”, i.e. nudge things along in the expectation that the opposition has no knives on his person – or in the hope they won’t be used. It’s a euphemism for lack of leadership or planning. The executive – and the military – have been doing that since well prior to the Gol accident. When knives do appear, though, it’s not always from the expected quarters; some rather large ones can be wielded by individual players – in ATC or on the flight deck.

F4F

3rd May 2007, 07:00

From FSI:

GOL 737 crash update -- NTSB report

The pilots of the business jet apparently were not aware that the jet's
transponder was set to STANDBY mode and in this mode it was not transmitting data. This meant the jet's collision avoidance system, TCAS, could not display vital information that would have alerted the pilots that the Gol 737 was headed their way.

Here is a link to the NTSB letter:
http://www.ntsb.gov/recs/letters/2007/A07_35_37.pdf

This is some of what the NTSB had to say about what was happening on the
private jet:

CVR data from the Legacy airplane indicate that, during the crew's emergency descent to Cachimbo Air Base, the crew made a series of comments related to whether or not the TCAS was on. ATC radar data indicate that the transponder return for the airplane was again visible to ATC radar less than 30 seconds after these comments. About 2 minutes later, the crew made a comment related to setting the transponder to the emergency code (7700); ATC radar subsequently indicated the emergency code.

broadreach

3rd May 2007, 23:43

Thanks F4F.
Brazilian media have picked it up but are, so far, handling it without sensationalism. The focus here has moved on to a congressional investigation into ATC, the airforce, Infraero etc. Govt trying to block/neutralize, opposition.. well you know...

varigflier

6th May 2007, 13:28

The bottom line is that flying down here sucks right now. I totally agree with the article posted above. It's total bull. Brazil does not have the amount of traffic to require gate hold procedures and sequencing. We don't have that many planes. ATC work sucks. They can't handle more than 3 planes at a time. Often we have to wait at the gate because the hold short area is too "crowded" with 4 planes waiting for take off. They give you a 7 mile separation and even then it's not "safe" enough to take off between landing traffic. It's pathetic. I've never seen anything worse.

fox niner

9th May 2007, 21:27

pilots of embraer blamed for crash:

http://news.bbc.co.uk/2/hi/americas/6640625.stm

so that clears ATC then I suppose?:(

Tarq57

9th May 2007, 21:58

It seems from the report linked to above that this is a police action, no mention of the initial findings of the accident investigation.
Allowing this level of ignorance of aviation procedures into the mix is ridiculous. Unfortunately, it's happened before, in my country too.
Hopefully the official accident investigation won't be affected by these charges.

broadreach

9th May 2007, 23:43

Right, Markjoy.

The Federal Police (PF) hands over to Justice and now it's up to them. Justice will presumably wait for the official report to emerge and may even wait until the congressional investigation that started this week presents its results.

FP don't investigate ATC because that's military jurisdiction.

The indictment has been covered in the media but without sensationalism. Globo News showed someone carrying the "report", all 24 inches of A4.

Ace Rimmer

10th May 2007, 15:33

Well IFALPA are not happy see below its Press Release:

IFALPA says Brazilian Polícia Federal recommendation that Legacy crew be prosecuted is fundamentally flawed

Chertsey 10 May: The International Federation of Air Line Pilots’ Associations (IFALPA) is outraged to learn that the Brazilian Polícia Federal have recommended prosecution of Joseph Lepore and Jan Paladino, the pilots of the Embraer Legacy that collided with a Gol Airlines 737-800 in September of 2006, under section 261 of the Brazilian Penal Code “for placing a vessel or aircraft in jeopardy”.

The Federation believes that this course of action is flawed on a number of levels:

1. IFALPA strongly insists that, as laid down in ICAO Annex 13, Attachment E, there can be no criminal liability without intent. Brazilian law should respect this fundamental principle in all cases. As there does not seem to be any factual support for a finding that there was any intent by the Legacy crew to place their aircraft in danger, there should be no basis for prosecution under Brazilian law.

2. The decision by the Polícia Federal to exclude the military from their investigation is a staggering oversight. In its own report, the Polícia Federal acknowledges that air traffic controller performance was flawed yet failed to investigate fully the role played by air traffic control, vital to establish the sequence of events that led to the tragedy, claiming the military controllers are outside its jurisdiction.

3. Finally, IFALPA believes that in any accident it is vital that an independent technical investigation carried out by experts in air accident investigation must be completed before any criminal or civil action is pursued. To pre-empt the results of a expert technical investigation with a judicial investigation which may not be technically competent is counter productive to improvement of air safety.

IFALPA calls on the Prosecutor’s Office of Brazilian Ministry of Justice to take the opportunity comply with the guidance of ICAO Annex 13 concerning post accident prosecution and to correct the premature action of the Polícia Federal by waiting until the findings of the technical investigation are reported by CINTRA.

bubbers44

11th May 2007, 01:40

ATC cleared both aircraft to fly at FL370. Legacy crew may or may not have bumped the transponder switch to standby. Last I heard ATC was responsible for separation and the TCAS was a last ditch device in case ATC failed and your aircraft had a conflict with another aircraft. Maybe we should rethink flying in Brazil if they feel other than that.

A310driver

11th May 2007, 14:52

Amen.

:D :D

ATC Watcher

11th May 2007, 20:30

The BBC article is not very accurate.:hmm: The crew is not responsible for the collision.With the info retreived so far, they should be cleared soon.

They are howhever part of a rather complex chain of events.The controllers are also a big part of that chain , and so is the ground ATC system sofware used, and the perticular transponder unit ( his history is being carefully investigated , as it turned out it was not a new unit ). ATC failed , yes, but why and how it failed is what is interesting to determine , not who should hang .

TCAS should not be part of the investigation ( it could perhaps have prevented the collision had the Legacy SSR been operational , but this is not a cause of this collision ) TCAS is not an ATC tool, not even part of ATC at all.

The Jolly Roger

11th May 2007, 20:51

Lads and Lassies,

NO ONE should be prosecuted for this. Controllers or Pilots. The stronger we get the message accross on NO BLAME POLICY the better.

llondel

11th May 2007, 22:03

I thought the whole point of the thorough investigations was to fix the system rather than apportion blame and prosecute individuals for a system failure - OK, a pilot (or crew) might have made a mistake but it's more important to understand why he made the mistake and why wasn't there something in place to warn him. In this instance it seems that the Legacy crew managed to switch off the TCAS without being aware of it, so is there something that could be done (big flashing light every few minutes while it's off when high up?) The rest of the problem appears to be ATC assigning both aircraft the same flight level, so something needs to be done there (given remarks on here about the quality of Brazilian ATC, quite a lot) to reduce the chance of it happening again.

Magoodotcom

11th May 2007, 22:11

If I'm not mistaken, this was the first hull loss of a 737NG? The second was the Kenya Airways jet last week. :sad:

Magoo

A310driver

12th May 2007, 01:25

You gotta be kidding..

Oh, by the way, it seems both aircraft were assigned the same altitude and if, mind you, we have the time, we ought to have a go at that once we get all the other problems solved!

Tarq57

12th May 2007, 01:42

llondel,
It appears to me that the primary cause of the accident was the failure of ATS to separate the aircraft. There will be many contributing factors to that, including communications coverage, the design of the radar system, and the display of same system, that presents flight planned level as opposed to last cleared level when mode c isn't available, triangulates the altitude crudely using a form of slant radar, and, when the mode c drops out, presents a tiny wee block of info to the controller concerning this. There also appear to be fairly widespread systemic problems within the structure and administration of the organisation.
The TCAS, as has been correctly pointed out, is a last-ditch, last chance technology, relatively new, designed to prevent a collision should the ATS fail, or the crew are at the incorrect level.
It's failure to work and the reasons for that, while extremely significant, should, I believe, be listed as contributory factors.

Richard_Brazil

30th May 2007, 03:18

From the official news agency of the Brazilian Chamber of Deputies, this evening. In paragraph four to end, the main focus is George Rock, a poster here. He seems to have successfully taken the fight from online to the real world.
-Richard

Consolidated - 28/05/2007 19:35

Internauts criticize thesis that transponder was turned off
Anna Izabel
[Photo, bearded Congressman in front of PC]

[Photo Caption:] Marco Maia: "Perhaps the American pilots could give us elements [showing] that the transponder was turned off involuntarily"

In a chat organized by Agência Câmara with the report referee of the Aviation Crisis CPI [Parliamentary Commission of Inquiry], congressman Marco Maia (PT-Rio Grande do Sul), air traffic controllers and aircraft pilots criticized the Federal Police investigations that point to the possibility that the Legacy jet's pilots had turned off the aircraft's transponder (http://www2.camara.gov.br/homeagencia/materias.html?pk=103144). The majority believe that for a pilot to intentionally turn off the equipment would be a suicidal act.

Internaut Márcio questioned why a pilot would turn off the transponder knowing that he would be risking his life. Marco Maia affirmed that he also did not understand the reason, but remembered that the investigation proved that the equipment was turned off. The Congressman explained that, on analyzing the data on the accident, he did not manage to identify how the transponder could have been turned off involuntarily. "That is why we are convoking the American pilots to testify to the CPI. Perhaps they can give us elements that permit us to believe is this affirmation that the transponder was turned off involuntarily."

The report referee explained that the CPI is analyzing all the information relative to the accident with the Gol plane. "Various factors contributed to the collision, since an accident like this does not occur only for one error, but rather because of a sequence of errors. In this sequence it is possible, yes, to identify responsibility by the American pilots."

Internaut George Rock asked the Congressman in which data he based his affirmation that the Legacy jet's transponder was turned off. Marco Maia affirmed that his declarations are based on the forensic examinations undertaken both by the companies and by the Federal Police. "The Legacy's transponder had no defect and, therefore, it was turned off."

Technical Problems
Georgerock remembered, during the chat, that the National Transportation Safety Board (NTSB) - an international entity in the area of flight security - emitted recommendations that there be a prominent warning in case of the transponder and TCAS (http://www2.camara.gov.br/homeagencia/materias.html?pk=103143)being turned off. Marco Maia affirmed that the internaut's concern is pertinent, because, up to the present, the transponder does not have an alarm in case of failure or disconnection. "This is a recommendation that is being given, including to the manufacturers, for them to include an audio alarm system in new transponders for these cases".

The internaut pointed out other problems such as breakdowns in TCAS, transponders and radios, which have been happening since 2005, the use of non-electricity-conducting silicone in the transponder's connecting terminals, which may interfere with the equipment's functioning; and incorrect information on onboard computers. Marco Maia affirmed that these are new pieces of information, which will be analyzed technically. "What I can affirm to you is that the technical conditions, of the Federal Police as much as the Air Force, are adequate for the analysis of this information. Many of these analysis are being done or were performed in the United States or in Canada. However, you can be certain that we will have very precise information about the functioning of the equipment and the condition of both aircraft at the time of the accident."
Read More:
Controllers and pilots criticize Air Force and ask for greater participation in CPI (http://www2.camara.gov.br/homeagencia/materias.html?pk=104091)

The Newsroom
Editing - Patricia Roedel

(Reproductino authorized as long as it contains the signature 'Agência Câmara')

Agência Câmara
Tel. (61) 3216.1851/3216.1852
Fax. (61) 3216.1856
E-mail:[email protected]

Thylakoid

30th May 2007, 09:09

Mr. Maia just stated that the causes were various and sequenced.
The xponder in question ... is the one that goes to standby mode after a few seconds, when a code is not set immediately? I've heard that from a pilot who flies an aircraft with one of those.

Obviously, the authorities have to find the people responsible for the accident, but the Federal Police or the Air Force are the least qualified, in my opinion, to make any findings in any air accident.
They need an independent entity, like the NTSB or the CTSB, composed of qualified accident investigators, to lead that type of analysis.

alph2z

4th Jun 2007, 00:21

Quoted from Richard_Brazil:
".....The internaut pointed out other problems such as breakdowns in TCAS, transponders and radios, which have been happening since 2005, the use of non-electricity-conducting silicone in the transponder's connecting terminals, which may interfere with the equipment's functioning; and incorrect information on onboard computers. Marco Maia affirmed that these are new pieces of information, which will be analyzed technically. "What I can affirm to you is that the technical conditions, of the Federal Police as much as the Air Force, are adequate for the analysis of this information. Many of these analysis are being done or were performed in the United States or in Canada....."

I have some experience with silicon (not) being used in circuits when I worked as an engineer at a major telecom company.

Because of serious problems with silicon very slowly migrating to contacts thus resulting in failures of mechanical contacts in switches and connectors due to detoriating contacts, we were forced in public telephone equipment to not used silicon based pastes.

It gave me major headaches then to find and confirm non-silicon replacements.

Major telephone companies had serious problems with silicon based products.
It is possible that the avionics industry has not caught-up to the telecom industry; or the newer designers have forgotten (or other) about the problems with silicon pastes.
.

UNCTUOUS

4th Jun 2007, 01:32

The possibility also exists that the Legacy 600 transponder "failure into STBY mode" may be one of the early manifestations of the increased incidences (and consequences) of lead-free solder (imposed by the EU's RoHS Directive)
see link (http://www.critical-embedded-systems.com/meecc/2005/presentations/anderson.pdf) and
link (http://smt.pennnet.com/Search/Search.cfm?Section=SERCH&Keywords=Lead%2Dfree%20Solders%3A%20Technology&MaxRows=10&searcharea=articles&ConID1=807884&ConID2=807885&StartRow=61&PubIDs=35)
and link (http://images.google.com.au/images?q=tin+whiskers&gbv=2&ndsp=20&svnum=10&hl=en&start=0&sa=N)
.
Problems noted thus far are:
a. Tin whiskering (hair-like protuberances that grow over time from-lead-free solder that are capable of shorting out surface-mount components on circuit-boards or introducing intermittencies that can be frustratingly "once off" due to individual whiskers completing a circuit but then melting or recoiling under the current flow, or possibly as a result of the changed magnetic field). The requirement to be lead-free has caused the percentage of tin in some solders to exceed 60%.
.
b. Brittle fracture surfaces in lead-free solders causing intermittencies (a greater incidence with some of the new formulations of lead-free solder - of which there are about 700 variants).
.
If the two Legacy pilots want their "get out of jail free" cards stamped, they'd do well to acquire some expert testimony on the new failure modes in PFD's and other sensitive transponder type avionics that are slowly being introduced as the avionics industry compulsorily transitions across to lead-free solder - with its attendant new suite of intermittency problems.
.
When considering the performance variations between pb-rich and pb-free solder, think the difference between a glue that has had it's binding agent removed and replaced by greater amounts of gelatin. Alternatively think of what super-glue used to be like when it first came out and how uselessly ineffectual the modern denatured super-glue is nowadays (after the safety wowsers forced its manufacturers to make it less lethally effective).
.
You can read an extensive array of articles on "tin whiskers" and the problems it causes in modern electronics (since the introduction of lead-free solder) at this
link (http://www.google.com.au/search?hl=en&q=tin+whiskers&btnG=Search&meta=)

georgecrock

4th Jun 2007, 09:44

Legacy Ground Speed as presented on Radar Data Tag on screen: 460 Knots

broadreach

3rd Jul 2007, 20:14

From today’s Folha de São Paulo. I’ve just translated the essence of the article; please forgive any technical inaccuracies on my part.

The airforce’s accident investigation committee concluded that the Legacy pilots mistakenly switched off the aircraft’s transponder when they mistook it for the radio. Both are located in the same box on the control panel.

Folha were informed that the pilots made two attempts to enter radio frequencies. The transponder did not recognize these and switched off. At that point the message “TCAS Off” immediately appeared on the FO’s panel but went unnoticed.

After the collision the pilot asked “hey have you got the TCAS switched off?” to which the FO replied “Yes, the TCAS is off”. Two minutes later it appears to have been reset as the aircraft reappeared on ATC screens.

The accident committee expect to bring forward their report in August or September.

A possible reason for releasing the above, and which the article itself alludes to, is that it may help to clarify one of the issues in the post-crash dispute between controllers and the airforce, namely the existence of a communications “black hole” in Amazon coverage.

Full text in Portuguese:

Folha de São Paulo
Pilotos desligaram transponder, diz FAB
Comissão de inquérito da Aeronáutica concluiu que americanos confundiram o aparelho anticolisão e o rádio do Legacy
Joe Lepore e Jan Paladino teriam digitado os códigos de freqüência do rádio no transponder, prejudicando o funcionamento de ambos
ELIANE CANTANHÊDE
COLUNISTA DA FOLHA
A comissão de inquérito da Aeronáutica que investiga as causas da queda do Boeing da Gol em 29 de setembro do ano passado concluiu que os pilotos americanos Joe Lepore e Jan Paladino desligaram involuntariamente o transponder do jato Legacy que se chocou com o avião, confundindo esse aparelho e o rádio. Os dois ficam dentro da mesma "caixa" do painel de controle.
Conforme a Folha apurou, os pilotos teriam digitado os códigos de freqüência do rádio no transponder e, assim, prejudicado o funcionamento de ambos. O erro apontado pode explicar por que tanto o transponder estava inoperante quanto o rádio não funcionava adequadamente quando ocorreu o choque entre os dois aviões, em pleno ar, resultando na morte de 154 pessoas.
Mais de 20 tentativas de comunicação com o controle em terra foram em vão, porque, segundo as investigações, a freqüência de rádio estava errada e o transponder desligou depois de duas tentativas de inserção de códigos não reconhecidos pelo aparelho.
A digitação equivocada pode ter sido possível porque os pilotos não estavam devidamente preparados para pilotar o Legacy em sua primeira viagem ao sair da fábrica da Embraer em São José dos Campos (SP). Além disso, o rádio e o transponder ficam na mesma "caixa" do painel, entre o piloto e o co-piloto, e são parecidos.
Com o erro, o transponder ficou inoperante e imediatamente apareceu ao lado direito, em frente à poltrona do co-piloto Paladino, sem que ele se desse conta, a mensagem "TCAS off", informando que o TCAS (Traffic Allert and Collision Avoidance System, ou sistema anticolisão) se encontrava desligado.
Acionado pelo transponder, o TCAS evita acidentes com alertas visuais e sonoros aos pilotos, acompanhados da indicação de como eles devem agir, desviando o avião na horizontal e na vertical.
Conforme a gravação das conversas entre Lepore e Paladino, na caixa-preta do Legacy, um deles reagiu com surpresa ao perceber, depois do choque com o Boeing, que o sistema anticolisão estava desligado.
"Cara, você está com o TCAS ligado?", pergunta. O outro admite: "É. O TCAS está desligado". Cerca de dois minutos depois, o aparelho voltou a funcionar, com o transponder enviando sinais normalmente para os centros de controle de tráfego aéreo em terra. Isso indica que foi religado.
Resolvido o último grande mistério do acidente, a comissão poderá antecipar de setembro para agosto o anúncio oficial do resultado das causas do choque, confirmando as informações sobre a seqüência de falhas humanas, tanto dos pilotos quanto dos controladores de vôo, especialmente do Cindacta-1, de Brasília, que resultaram no maior acidente da história da aviação comercial brasileira.
O Comando da Aeronáutica afirma que não influencia conclusões nem prazos para a finalização do inquérito, mas a Folha apurou que vê com bom grado a antecipação do anúncio. Acha que isso poderá tirar um dos focos de tensão dos controladores de vôo, que desde o acidente têm se rebelado contra o Comando e promovido uma série de operações-padrão e greves, na tentativa de denunciar falhas do sistema de controle aéreo.
Caso seja confirmada a apuração de que os pilotos digitaram erroneamente os códigos do rádio e do transponder, isso aliviará, por exemplo, a importância no acidente da existência apontada por controladores de vôo de um "buraco negro" na região onde ocorreu o choque, em Mato Grosso, na altura da serra do Cachimbo.
O relatório deverá mostrar que, apesar de não conseguir contato com o Legacy, os Cindactas tanto de Brasília quanto de Manaus tinham comunicação normal com outras aeronaves na mesma hora e no mesmo espaço, que é sujeito a interferências magnéticas.

Olindaguy

7th Jul 2007, 14:47

Comments to the posts of Broadreach:
You say "The airforce’s accident investigation committee concluded that the Legacy pilots mistakenly switched off the aircraft’s transponder when they mistook it for the radio. Both are located in the same box on the control panel."

I know that this is written in the article of Folha de São Paulo that you quote.
But I have strong doubts that this is the correct version, as the CVR of the Legacy doesn't even have a shadow of such a manipulation in the timeframe minus 5 and plus 5 minutes before/after the transponder went on stand-by at 19.02 UTC, about 30 miles North of BRS.

No remarks about radio manipulations (either Set 1 or Set 2) are present on the CVR. In fact the pilots talk continously about the landing in Manaus and the weather and the runway conditions up there at Eduardo Gomes.
I have strong doubts that this is the correct explanation.

You say further on: "A possible reason for releasing the above, and which the article itself alludes to, is that it may help to clarify one of the issues in the post-crash dispute between controllers and the airforce, namely the existence of a communications “black hole” in Amazon coverage".

You are correct to point this out as the current chief of ACC Brasilia, Commander Raulino, has now officially confirmed that there were black radar holes and blind spots at ACC Brasilia in September 2006, when the crash occured.

In the mean time these holes are "fixed" as a radar source from Manaus was brought in and is now fully available.

Once again it had to occur an accident before well identified safety issues got finally fixed.

All the best
Chris

Brian Abraham

8th Jul 2007, 03:23

Don't know what commonality there may be between the Legacy and ERJ 135 but this bit from post #63 at http://www.pprune.org/forums/showthread.php?t=281098&page=4 perhaps raises some interesting questions.

I can remember some small glitches that popped up when the airplane was initially introduced in the U.S. but nothing big....well sort of. I can still remember being cautioned about the problem with the transponder, how if you start to change the code and then don't touch the knob for more than so many seconds the transponder would switch off. That's right, no warning or a default to the last code inputted, it would just switch off. Remember the crash in Brazil of the 737 after colliding with a Legacy?

broadreach

11th Jul 2007, 00:53

Olindaguy, thanks for the comments. The investigation committee must be under a tremendous amount of pressure from many sides and the interpretation of anything that comes out can be expected to have some bias.

For what it's worth, and I would guess it's about zero, the congressional investigation committee have said they've seen enough evidence to lay blame for the collision on the Legacy pilots. One might suspect that other scandals and other congressional investigation committees are getting more of the limelight these days, so that was the easiest way out. At least that's one distraction out of the way, and the Federal Police investigation also seems to have come to an end as it didn't include cross-examination of the airforce controllers.

The entire issue of civil vs military control now having been thrown back to the airforce, and with a handful of the military ATC people suspended and facing courts-martial/jail, the ATC front has gone very quiet.

Brian Abraham

13th Jul 2007, 01:56

From http://www.faa.gov/other_visit/aviation_industry/airline_operators/airline_safety/safo/all_safos/media/2007/SAFO07005.pdf

Subject: Embraer Legacy/EMB-135, -140, -145 — Be Careful Where You Put Your Foot

Purpose: This SAFO calls attention to the possibility that a pilot of an Embraer Legacy, EMB-135 or -145 (sometimes called EMB-140 in marketing literature) might inadvertently change VHF radio frequencies or place the ATC transponder into standby mode during flight.

Background: During an investigation the FAA discovered that crewmembers who had the simple habit of placing their shoe on the footrest just below the instrument panel could inadvertently put the ATC transponder into standby mode, or change radio frequencies without the crew's awareness. Further, they found that pilots might not notice the corresponding indication on the Pilot Flight Display due to the white colored letters, which are not as noticeable as differently colored caution or warning indications.

Switching a transponder with a functioning traffic alert and collision avoidance system (TCAS) to standby mode renders the TCAS ineffective, and is therefore one of the most serious consequences of a pilot’s foot inadvertently contacting the radio management unit. Two airplanes equipped with TCAS would fail to see each other if they were on a collision course. Pilots could presume TCAS was operating normally if they failed to notice the subtle TCAS OFF indication on the Pilot Flight Display.

Recommended Action: Managers of part 142 training centers where pilot training on the Embraer Legacy, EMB-135, and EMB-145 is conducted should ensure that their trainers caution pilots of this latent hazard and emphasize the importance of being careful when using the footrests provided. Similarly, directors of safety, directors of operations, trainers, and check airmen for operators flying any of these Embraer models should immediately make this hazard known to their pilots and should make sure that it is addressed in their training programs, especially during flight training, supervised operating experience, and line checks.

Any questions regarding the content of this SAFO should be directed to the Air Transportation Division, AFS-200, at (202) 267-8116.

Slice of Swiss Cheese anyone?

arcniz

16th Jul 2007, 01:56

Background: During an investigation the FAA discovered that crewmembers who had the simple habit of placing their shoe on the footrest just below the instrument panel could inadvertently put the ATC transponder into standby mode, or change radio frequencies without the crew's awareness. Further, they found that pilots might not notice the corresponding indication on the Pilot Flight Display due to the white colored letters, which are not as noticeable as differently colored caution or warning indications.

One of the sub-plots in the drama ensuing from the Gol-Embraer collision is the possibility of direct criminal charges against the Embraer crew and the ensuing arguments about whether or not the pilots should return to Brazilian jurisdiction to provide further testimony, or to submit to trial as criminal defendants.

The post-accident investigative process in Brazil has been marred by conspicuous public confusion of political, military, corporate and personal interests in 'spinning' facts, coloring details, broadcasting unsubstantiated accusations and meddling with the methods of investigation. Few serious observers - with access to information made public - would imagine the investigations have been either fair or thorough.

Under such circumstances, one can see some reason for concern on the part of the pilots that they might be caught in the middle of a political show trial, with objectives other than fairness and fact-finding.

One can also note that the referenced FAA advisory circular, inconspicuous as it is, creates an official standard of plausible deniability for the Embraer crew, in regard to the primary allegation floated about in Brazil - that the crew intentionally disabled the transponder for unspecified reasons. Presumably the FAA kept good notes on the instances and sources indicating the inadvertent shutoff problem they describe in their official circular, so the net effect is to create a strong affirmative defence for any and all claims related to the Embraer crew responsibility for the transponder outage that may have been a factor in the aerial collision.

Certain facts clarified, plot thickens.

bubbers44

16th Jul 2007, 02:53

I do not think the pilots should ever return to Brazil because they can not expect a fair trial. We all know they followed the rules and did nothing to cause this accident. Maybe design flaws in their aircraft caused the transponder to go to standby but they didn't design the aircraft. Going back there would be a big mistake. When ATC puts two aircraft on the same airway at the same altitude with GPS accuracy in opposite directions bad things happen. TCAS was not designed for separation of normal traffic, it was designed to avoid a mid air if ATC screwed up. If it quit working it does not take the responsibility off of ATC.

green granite

16th Jul 2007, 12:34

I do not think the pilots should ever return to Brazil because they can not expect a fair trial.

The problem is of course if they don't return, then the next time something like this happens, the people involved will not be allowed to return home until after the trial which may be years.

barit1

16th Jul 2007, 15:50

If Brazil won't adhere to ICAO norms re impartial safety-oriented accident investigation, why isn't an international boycott by all aircrew a good response?

A310driver

16th Jul 2007, 16:04

Spot on!

:D:D

bubbers44

16th Jul 2007, 20:32

Absolutely. No one should be put at risk down there if a mishap puts you on trial as a criminal. Boycot Brazilian airspace if necessary.

lomapaseo

16th Jul 2007, 20:33

If Brazil won't adhere to ICAO norms re impartial safety-oriented accident investigation, why isn't an international boycott by all aircrew a good response?

Simple solution but it never works in a free society.

Where do you draw the line?

Lots of countries besides Brazil have not adopted in full the recommendations of ICAO Annex 13. I take it that you are really paring down the concen only to the criminal part of the investigation and threat of punishment to the flight crew. Else we could add in any criminal investigation leading to punishment of any person including the countries own citizens.

Individual actions by a crew member to refuse to fly a route to such a country are sure to result in unwanted results. So how do you take this up several notches to include all international pilots?

The only way that I am aware, is IFALPA and they were already a non-voting party to the latest ICAO Annex 13 deliberations.

A310driver

18th Jul 2007, 16:29

Unfortunately, this no longer can claim to be the worst air disaster in Brazilian history .

Brian Abraham

19th Jul 2007, 00:34

Just off the press from Avweb

Brazilian Congress Blames Legacy Pilots For Midair

An inquiry conducted by the lower house in Brazil's Congress just concluded U.S. pilots Jean Paul Paladino and Joseph Lepore, who were flying the Embraer Legacy operated by U.S.-based ExcelAire during a midair collision last September with a Gol Transportes Aereos Boeing 737-800, are partially to blame for the fatal accident. Meanwhile, another congressional inquiry, along with an investigation by Brazil's accident investigation team, continues. The completed report found Paladino and Lepore were insufficiently trained in operating the Legacy and negligently disregarded ICAO and Brazilian aviation regulations, engaged in "imprudent handling of the aircraft" and had "poor situational awareness." The inquiry concluded the two pilots should be charged with involuntary manslaughter by having placed an aircraft or vessel at risk. Additionally, the inquiry determined three air traffic controllers had committed the same crime, while one controller should be indicted on voluntary manslaughter. The two pilots and three controllers could face sentences of up to 12 years; the lone controller faces up to 20 years.

Yet the Brazilian Congress' report -- established to look into existing problems with the country's ATC system and corruption, as well as the midair collision -- has come under fire, especially from the body's opposition party. Critics of the filed report point to a lack of technical expertise on the part of those supposedly elected officials lacking an industry background and conducting the inquiry. No timetable was set for the Brazilian Senate to complete its inquiry; the third investigation, being conducted by Brazil's Centre for Investigation of Aeronautical Accidents (CENIPA), is expected to be finished by late August or early September.

A310driver

19th Jul 2007, 01:58

All pilots plying the Brazilian airspace should heed the advice of Barit1 in the post of 16 July above. Mere mortals should not venture where angels fear to tread.

9k2

19th Jul 2007, 21:41

Reckless endangerment charges recommended for LI pilots (http://www.newsday.com/news/local/longisland/ny-liair0714,0,630203.story?coll=ny-opinion-print)

But the recommendation is likely to have little or no impact because the Brazilian Congress has no authority to charge anyone with a crime and the pilots and traffic controllers have already been indicted by a federal court on lesser charges.

A310driver

21st Jul 2007, 14:14

So, who wants to volunteer to test the authority of the legislative body that writes the laws?
Part of the pre-flight briefing for operation in Brazil in addition to WX and NOTAM's should include the current laws/policies in effect at ETD, the forecast for changes in laws at ETA, and the trend for ETA+24h.

A310driver

25th Jul 2007, 14:44

Didn't mean to stifle comments on this thread...no posts in a week???
Sorry!.......:confused:

broadreach

25th Jul 2007, 15:29

A310, you'd never be suspected of THAT!
The recommendation the Legacy pilots be charged is part of the political process. Now that the Gol crash has been superceded by the TAM one all eyes focuss elsewhere; other witches to hunt and the congressional investigation committee have to allow everyone his or her five minutes of limelight.
Just for the record, a CENIPA colonel at a press conference yesterday was very incisive in saying "We are not interested in establishing blame, we are here to establish facts and help to ensure that accidents do not repeat themselves. And we do NOT release tapes or data prior to publishing the full report; in the case of the GOL accident we were specifically ordered to and had no option but to obey". He said more along those lines and there was a not inconsiderable dose of bitterness in his tone, at all the political meddling and second-guessing.

punkalouver

27th Jul 2007, 13:25

The Brazilians have said that the Gol captain HIMSELF remained calm throughout the ordeal trying to figure out how to regain control of the aircraft but sadly there was no possibility of recovery with the aircraft rolling uncontrollably. Excessive G-forces broke it apart at about 6,000 feet.

bomarc

7th Aug 2007, 20:54

has the cvr been released from the GOL 737? (in english transcript)?

In the final analysis, we can learn from the film "fate is the hunter" (coffee)

if a foot on a foot rest can screw up the radio stack...ouch

PBL

21st Aug 2007, 10:17

This thread seems to have gotten little traffic recently. As some might be aware, we have been following public developments quite closely. My colleague Jörn Stuphorn has performed a (very) preliminary Why-Because Analysis of the accident from the publically-available information. The Why-Because Graph of the accident is discussed in a presentation at the Ninth Bieleschweig Workshop in Hamburg in May 2007:
http://www.rvs.uni-bielefeld.de/Bieleschweig/ninth/StuphornB9Slides.pdf

I would particularly like to know:
* Who is investigating the accident now? (CENIPA, a Policia Federal, CIP, who else?)
* Who can bring criminal charges? Who has jurisdiction over criminal proceedings? And who not?
* Who can bring civil charges? Against whom? For what?

I would be grateful for any information. If this info isn't of general interest, maybe private message would be appropriate.

PBL

ATC Watcher

21st Aug 2007, 14:06

Dear Professor ,
Always nice to hear from you. The questions you asked are best answered by someone in Brazil, but most of the answers can be found already in this thread , these are however remarks made by individuals on internet and might not be the real picture . As far as we are aware CENIPA is conducting the Accident Investigation as per ICAO Annex 13,. Nothing else. The police investigation is another matter, and law in Brazil is particular. For instance a Judge in a very small community in Mato Grosso seem to want to make a name for himself.

The journal of IFATCA (the controller magazine at http://www.the-controller.net) had a good series or articles in its last March issue, and I am told that another series of articles on the legal issues of this accident is due in their September edition.
Good luck,

marciovp

22nd Aug 2007, 05:10

Almost one year now after the Boeing/Legacy accident. Someone from the press said to me that the final report is coming out soon, from CENIPA the Air Force Agency that deals with investigation and prevention. CENIPA officers have said more that one time that they are not going after blamming people. Just learn in order to prevent. NTSB is helping.

But, sorry to say, in Brazil everyone got into the act of deciding who is to blame: Federal Police (already issues their final report blamming four controllers from Cyndacta-Brasilia and the two Legacy pilots). the State Police (the same), the House of Representatives Committee (the same), the Senate Committee, just to mention the more importante ones.

As far as I know the Legacy pilots had originally a written plan for the flight from Sao Jose to Manaus. Sao Jose-Brasilia 370, Brasilia to somewhere on the way to Manaus 360, then climb to 380 to end the trip in Manaus. But after leaving Sao Jose the controller there said to them to go to Manaus at 370. Of course they changed their plan.

They came close to Brasilia, spoke with the controllers saying that they were at 370. Nothing else was said and they kept 370. The software at Cyndacta in Brasilia showed 370:360 on the radar screen for seven minutes. The 360 was there because the original flight plan called for 360...not for anything else. The 370 was the real altitude. The controllers did not do anything.

Then the transponder from the Legacy went off, and the screen showed this clearly. A primary radar from the airforce took over and read wrongly 360. The screen showed 360Z360 but the icon in the screen showed clearly that the transponder was not sending info. Actually showed the + was not circled as it shoud if info was coming from the transponder. This was there for about one hour and the Cyndacta people did not try to tell the pilots that their transpoder was off. Close to the end the Legacy and the Cyndacat in Brasilia tried to talk by radio with each other many times to no avail. Then the disaster.

The controllers said from the beginning that yes they had problems because of the equipments and the software in Brasilia and Manaus. The Air Force, that administers Air Traffic in Brazil, from the beginning said that there was nothing wrong with the equipments and software. The International Association of controllers supported them and denounced faulty software and equipments in Brazil. The Air Force denies it to this date. The Controllers in fact became so upset when they felt that they were going to be blamed that they started operation slow down and at one point even went into strike. As they are military of the Air Force (low rank) some of them are now being prosecuted for the crime of "motim" by the Air Force.

One problem in Brasil is that the investigation agency CENIPA belongs to the Air Force who is also one of the players in this game (they administer Air Traffic in Brazil).

Yes there was a tendency from the beginning to blame the north american pilots. Their passports were retained and they had to stay in Rio for many days before finally they were allowed to go. I remember seeing the Minister of Defense from Brazil in TV, shortly after the disaster, blaming the northamerican pilots. Saying crazy things like they disconnected the transponder because they wanted to do stunts to test the new plane...and did not want to be seen.

For long time there was indeed the question of why the transponder was disconnected such a long time until the FAA came with the recommendation about the resting foot below the panel of the Legacy.

The Legacy is still at Cachimbo where it landed because a judge somewhere confiscated it from Excelair to pay compensation for the families if they were judged gulty. It is there with the damage in the wing tip and back.

As a Brazilian I feel somewhat embarassed by all this comotion and hasty judgements. I wonder if we can have the same thing in other parts of the world. I am very curious now how the final report from CENIPA is going to say.

Brian Abraham

27th Aug 2007, 08:12

From Avweb
Brazilian Judge Wants U.S. Pilots in His Court

CNN say a judge in Brazil has turned down a request from Long Island bizjet pilots Joe Lepore and Jan Paladino to use a U.S. court to testify about their role in a collision between their Embraer 600 and a GOL Boeing 737 that resulted in the deaths of all 154 aboard the airliner last year. The pilots have a date in front of Judge Murilo Mendes on Monday but their lawyer Joel Weiss says they don't mind telling their story under oath but they'd rather do it within sight of the Statue of Liberty. Weiss says the U.S. and Brazil have a treaty that allows this type of long-distance testimony. Ironically, it's the Brazilians who fear they won't get a fair shake from the process. A court spokesman said Mendes is afraid a U.S. judge will filter his questions.

The pilots are charged with endangering an aircraft. The Brazilians say they either turned off their transponder or failed to notice it wasn't working and that prevented the TCAS on the 737 from alerting its pilots to the fact that controllers had cleared both aircraft to the same altitude, on the same airway going in opposite directions. The controllers are being dealt with by the Brazilian military, which runs air traffic control there. Mendes hasn't said what he'll do if the pilots don't show.

barit1

27th Aug 2007, 11:56

The Legacy pilots have an interesting choice:

1) Never again go near Brazilian territory, thus enduring the scorn of that nation's system of justice; or

2) Return to Brazil, and face worldwide suspicion regarding their sanity.

RobertS975

27th Aug 2007, 15:06

What is the status of the American pilots with regard to the Brazilian legal system? Are they under arrest? Have they been charged with a crime?

The only way I would set foot in Brazil if I were them is under a grant of immunity.

There was a very well written editorial in a recent Aviation Week and Space Technology pointing out the severe dangers to aviation safety when accident investigations are thrown into the legal arena.

PBL

27th Aug 2007, 17:37

There was a very well written editorial in a recent Aviation Week and Space Technology pointing out the severe dangers to aviation safety when accident investigations are thrown into the legal arena.

There was a series of one-page columns in his series "A European Perspective" by Pierre Sparaco in Aviation Week in 2006 which addressed exactly this: 22.05.2006, "Investigative Errors"; 03.07.2006 "Missed Opportunity"; and 13.11.2006, "Unwanted Crimininalisation". Sparaco was AvWeek's European editor and now writes the column every other week.

This is not only a problem in aviation. See the talk "Negotiating Accidents" at http://www.rvs.uni-bielefeld.de/Bieleschweig/ninth/LadkinB9Slides.pdf
for some examples from the rail industry.

PBL

marciovp

27th Aug 2007, 17:53

It seems that the Judge from a small town in Mato Grosso decided to go on with the trial without the deposition of the US pilots. I saw in TV tonight the judge saying that he will go on with the trial withour listening to the pilots. The lawyers for the pilots saying that they want to make a deposition in the USA, but the judge will go on without them.

As I said before, I am not sure how things are in other countries but as a Brazilian I am a little embarassed. After all the official report from CENIPA is not out and all kinds of people (mostly who know nothing about aviation) have decided who is to blame for the disaster. Let me say a few: this federal judge, the federal police, the president of the investigative committee of the house, the same for the senate.

The only thing I think they have on the US pilots is that their transponder was not operating. FAA had said that this could be caused by their putting their feet at the foot rest below the dash. They flew without the transponder for almost one hour and this was not noticed by Cyndacta in Brasilia.

I hate to admit this but I am not sure that these two pilots will have a fair trial in Brazil, and I understand why they did not show up.

Some say that the final report from CENIPA is coming out soon. Let´s wait and see.

galaxy flyer

28th Aug 2007, 03:08

This was probably covered here, but recent Honeywell refresher-if selecting a new code and delayed in doing so, it might go into standby.

My understanding is that they, the pilots, signed an agreement to appear at any hearings or trials. Could not the judge try to get an American court to enforce the agreement and, thus, bypass extradition which does not exist between US and Brazil.

GF

marciovp

28th Aug 2007, 03:50

The US pilots are willing to make a deposition in the USA and I believe thay have reasons to be afraid to come personally to Brazil. I am not sure and I don´t want to conclude about their guilt in the disaster, but I am afraid that that they are being scapegoated and that there is a lot of prejudice against them. So they ought to be careful.

From what I saw in TV the judge is going to try them without listening to them. I just want to know where this will lead us.

CENIPA has said that this criminalization of the disaster has made it much difficult for them to investigate it, aiming at prevention. I feel the same way.

PBL

28th Aug 2007, 11:27

CENIPA has said that this criminalization of the disaster has made it much difficult for them to investigate it, aiming at prevention

This is a universal, and well-known, issue wherever accidents are criminalised. It is mentioned in Sparaco's columns which I referenced; it is mentioned in the RAeS/FSF/CANSO statement on the accident; it is mentioned with regard to rail accidents in the slide set which I referenced above; it is mentioned above all by investigators who have had to deal with judicial interference. That is why ICAO Annex 13 reads as it does.

Brazil is an ICAO signatory. If Brazilian law is inconsistent with ICAO Annex 13 requirements, as flyingnewbie suggests it might be, then it follows that either the law should be changed or Brazil should withdraw from ICAO. That is what such international agreements mean.

PBL

bomarc

28th Aug 2007, 23:20

Radar Contact (radar identified) or the like is usually issued early on in the process of an IFR flight.

At some point the embraer was surely told it was in RADAR CONTACT/IDENTIFIED.

When it no long was in radar contact, isn't it the responsibility of ATC to advise them?

Brian Abraham

29th Aug 2007, 00:05

From AIN

Brazilian Aviation Agency Losing More Leaders
The leadership of Brazil’s Agência Nacional de Aviação Civil (ANAC) is collapsing under the pressure of international criticism. ANAC director Jorge Brito Velozo, formerly of the Departamento de Aviação Civil, will resign today, and president Milton Zuanazzi is expected to resign by the end of the week, according to Adalberto Febeliano, executive vice president of the Associacão Brasileira de Aviacão Geral (Brazilian Association of General Aviation). The two resignations follow last Friday’s resignation by ANAC director Denise Abreu. The agency has been under intense scrutiny, Febeliano said, following the 2005 bankruptcy of Varig Airlines, last year’s Gol 737/ExcelAire Legacy 600 midair, the air traffic controller strike early this year and the TAM crash at Congonhas Airport in July. “Everyone was under criticism after those four large events,” Febeliano told AIN. “The public, especially the large media, wanted them to be guilty. They pointed their fingers at the agency the same way they pointed their fingers to the Legacy pilots last September. It is really more a matter of public pressure than of real mismanagement.”

punkalouver

29th Aug 2007, 04:08

"Just imagine 154 american citizens dead... Do you think that in a similar accident, a brazilian crew would just be allowed to go away immediatelly ? Of course not...

Now I would like to know why this same concern about the reputation of the Legacy's pilots is not being shown with the crew of the TAM 3054...

Could you explain that ?"

Could you explain why your accident rate is almost twice as high as the civilized world. Look in the mirror perhaps or at your posts or just at this link as one of many reasons.

http://www.iht.com/articles/2006/03/19/news/safe.php

Why don't you try listening and learning from those who have successfully lowered their accident rate to near zero. I know....you won't, because your pride is more important than aviation safety. You are not alone.

marciovp

29th Aug 2007, 06:39

I am a little embarassed with the way Brazil is handling air disasters. Let´s start from the beginning... in both the GOL and the TAM disasters we don´t have any evidence of criminal action coming from anybody. Of course if there were such an evidence, by all means, let´s criminalize the investigation.

Then there is the case that Brazil has an agency ran by experts in aviation that is investigating the disasters. They did not publish their final report. Should the criminal agencies wait for this report before deciding to sue someone?

Now, please tell me what do federal judges, federal police, members of the senate and house of representatives know about aviation? What expertise do they have to decide whose fault caused the disasters? I have read incredible conclusions from these people in deciding whom to bleme. It is a shame! They translated the tapes wrongly, took wrong conclusions, etc, etc. In the beginning the Minister of Defense used to say that the US Pilots put themselves the transponder off because they wanted to do stunts to test the new plane. What a crazy statement ,yet it was in all papers and TV.

Then there is the question that in the moment there us a criminal investigation the process is justly what we don´t want: people will shoot their mouths, of course, for fear of being prosecuted. There goes prevention out...

To make this short. The tendency all over the world when there is a disaster, unless there is a clear indication of criminal behavior (drunkness, the New York Towers, etc) ie to allow the proper agency to investigate the disaster aiming at learning what happened and proposing ways to prevent other disasters like the one being studied, Of course if in the course of this investigation it becomes clear that anyone showed a criminal behavior, I guess a criminal investigation is in order.

In the case of TAM and GOL so far I don´t see any evidence of criminal behavior on the part of anyone. Of course in the case of GOL, everyone knows that the Excel Air that bought the Legacy has a big insurance in case of being sued and of course the lawyers will go where the money is. Did you know that a judge already confiscated the Legacy at the Cachimbo Air Force Base and the plane is there idle, not being fixed, ready to be sold to pay for indenizations? The lawyers don´t want to go to an endless battle with the Brazilian government (Air Force) or the flight controlers (Air Force too). So it seems important to blame the pilots of the Legacy because there is were the money seem to be.

Well these are thoughts from someone who has been following these things very closely ,and have been appaled how totally ignorant people have come to decisions on who to blame way before the experts, the people from aviation, came to any conclusions on what happened. I doubt if this goes on around the world like is happening in Brazil.

And, I am not sure what would happen to a Brazilian crew if this disaster had hapened in the US. We are assuming that they would be blamed without due judgement, would be arrested? I really am not sure. But I am sure that there wouldn´t be so many investigative agencies with people who knows nothing about aviation deciding that they were at fault.

I got carried way... Sorry. Let me go back to my Cherokees...

punkalouver

29th Aug 2007, 12:28

"Why so much international care with the american pilots in the Gol 1907 accident and all this jump-to-conclusions with the TAM 3054 crew ?"

I believe you will find jump to conclusions in the case of the "American pilots". Remember all the aerobatic type manouvers they did with the intentionally turned off transponder? I suspect you are letting nationalism obscure your impartialness which is a great threat to aviation safety.

lomapaseo

29th Aug 2007, 21:37

If you want to discuss that subject then do it in the proper thread - don't try to stir up unrest in threads that are unrelated.
Agree, but we need some guidelines on the dividing point.
For me it is the criminalization aspect rather than the jump to conclusions within the press and discussion boards.

DozyWannabe

29th Aug 2007, 22:04

Agreed.

But flyingnewbie10's modus operandi seems to be pushing the idea that the big, bad multinational corporations are trying to blame Brazilian pilots for something that may be down to their faulty equipment, against most of the (admittedly circumstantial) evidence that has come to light so far. I'm not disputing it's possible that he may be right, but it seems to me unlikely.
The problem with nationalised (or in the case of Brazilian ATC, militarised) institutions is that things tend to become political very quickly. It's hard to say what other countries may have done in the same situation, because there haven't been many situations like this in recent memory (JAL123 had a similar problem where the Japanese authorities were very sceptical of Boeing's involvement - and the net result of that was Boeing taking full responsibility for the faulty repair that brought the aircraft down).

Air safety isn't a question of powerful countries and their corporations strong-arming less-powerful nations. Tenerife proved that the most senior, experienced pilots of the oldest, most respected airlines are still capable of making mistakes that lead to tragedy. To err is human and there's no shame in admitting to making a mistake. All we can do is work to the best of our abilities to make sure that these mistakes are rectified.

marciovp

30th Aug 2007, 02:06

I don't disagree with you on the fact that in the GOL and TAM cases there is no evidence of criminal behaviour. But you can't generically forbid hipothetical lawsuits just because investigators think (or simply say) it would make their job more complicated.

Flyingnewbie 10. We are both from Brazil but I lived and worked in the US for thirty years. Actually I learned to be pilot of Tripacers and Cherokees there. Thirty years is a good experience in terms of learning about a Country. Especially is someone is a psychiatrist/psychoanalyst as I am.
Contrary to all prejudices I see in Brazil (there are in the US also about south americans...) I have a lot of respect for the USA.

It seems that you did not quite understand how different it is a criminal investigation from a expert investigation trying to know what went wrong in a disaster and above all what can be done to prevent it. Once the investigative agency publishes the final report, of course anyone is free to sue anyone else in a free country.

But when you have criminal investigation running ahead of the proper investigation by people who know about aviation you can imagine that this will make it very difficult for collecting data that could help in the understanding of the disaster.

I doubt if you will agree with what Brazil has done: start immediately several criminal investigations by local police, federal police, house of representatives, senate (people who have no expertise on aviation matters). Not to speak of the Defense Minister who knows nothing about aviation making declarations in TV on who should be blamed.
This indeed complicated for CENIPA to investigate the disaster.

Of course CENIPA also has a problem. It belongs to the Air Force and it is ackward to have it investigating a disaster where the Air Force could have played a part (Air Traffic Control).

About the US pilots and the Brazilian pilots from TAM. The ideal situation would be for everyone to wait the final reports from CENIPA (NTSB is also involved). But no...everyone gets into the act and I do feel that the US pilots could easily be scapegoated not only in terms of prejudice but also because they represent Excel Air that has a big insurance and an expensive Legacy that has been confiscated at the Cachimbo Air Base. Insofar as the TAM pilots there are some evidences that show that perhaps they indeed made a mistake but this has not been decided as far as I know the way it was decided by the local, federal police and house committee that the Legacy pilots were the cause of the GOL disaster.

Let´s try to be fair and just. I appreciate your participation and views.

Finally I really am not sure if Brazilian pilots would be held in the USA in a similar disaster. This is a conjecture.

My greetings and best wishes.

PBL

30th Aug 2007, 12:35

1. Does anyone here believes ATC put them on FL 370 in UZ6?

FL 370 was their last cleared and confirmed altitude before communications were lost. Check out the lost-communication procedures under IFR to see what both pilots and controllers should do in this circumstance. If you believe that pilots should fly the last cleared altitude you will answer "yes" to the question. If you believe, for example, that pilots should revert to flight plan at the next waypoint, no matter what altitude they have been cleared to, you will answer "no" to the question.

2. Did the pilot engage in appropriate pre-flight planning?

What has pre-flight planning got to do with this?

They filed a flight plan, and followed their clearances until communication was lost. Any issues that have arisen concern what they or others should have done in those circumstances.

3. Did the pilots commit ‘gross negligence’ for a criminal prosecution not engaging appropriate pre-flight planning?

Exactly what should they have done during pre-flight planning that they didn't do?

We never know because they will never come back to Brazil to say it.

I think we know the answers to these questions already,
modulo our understanding of the appropriate IFR for question 1.

PBL

PBL

30th Aug 2007, 19:34

Sdruvss,

No problem. I'm glad we seem to have sorted out our communications. We seem both to be interested at getting at the heart of this matter.

You want to discuss it in detail. OK, let's try.

1. Legacy was leaving a point-to-point section -- I don't know the english word for that -- (S.José to Brasilia) to enter a RVSM airspace in UZ6. No one RVSM authorized aircraft flies from Brasilia to Manaus at FL 370. All pilots know that. If they were engaged in appropriate pre-flight planning, Legacy pilots would have known that. That is why their original flight plan informs to descend to FL360 at Brasilia.

The Legacy joined UZ6 at a waypoint. I would assume the pilots knew what the usual westbound/eastbound flight levels on UZ6 are, because they are worldwide the same.
And, as you correctly surmise, they filed an appropriate FL in the flight plan.

2. “[…] before communications were lost” – From 15:51, last contact, until 16:26, there was no contact attempt, when Brasilia begins trying to contact them.

Communications were lost.

3. 16:02 Brasilia looses Legacy transponder signal.

That's what I understand, but I haven't specifically checked the time.

4. Brasília assumed they were at right level FL 360,

Now, here begins a problem. Why would ATC assume that?

There has to be a two-sided understanding of how an aircraft is going to behave under lost communications.

According to the IFR of many countries in the world, including the U.S. (whose rules I know best), but also including Germany and the U.K., then when you are cleared by ATC for a particular FL or altitude, you remain at that cleared altitude until you receive and acknowledge an amended clearance.

Cleared altitudes by ATC always take priority over what is in the flight plan. I don't think I have ever flown my filed flight plan under IFR. ATC always says something different at some time, and then it's for them to direct the flight through further clearances (they may also say "proceed as filed" but that itself is a further clearance).

So, what are the Brazilian IFR under lost communications?

all pilots knows what authorized levels from Brasilia to Manaus are. They don’t need to be cleared and, if they want to fly another authorized level, they don’t need clearance because they are under radar surveillance.

*Yes they do* need to be cleared. Every minute of the time they are flying IFR they need to be cleared.

It occurs to me that you may not understand what a clearance is.

A clearance is a two-sided contract between ATC and pilot, in which ATC undertakes to keep a particular block of airspace free of other (IFR) traffic, and the pilot accepts this undertaking or rejects it. If heshe accepts, heshe undertakes to fly within that block of cleared airspace until it terminates, or until another clearance is received and accepted.

This is all pretty routine until one no longer has two-way communications. Then one needs conventions, understood by both sides, as to what the pilot is going to do, and the controller will then keep other traffic out of the way of the airspace that the pilot is anticipated to be using.

These conventions exist in most jurisdictions (including those with which I am familiar).

5. There was a turn shift meanwhile. New operator isn’t alerted by this issue, but is not a big issue for him, the pilots should be at correct level.

What is the "correct level" depends in this case on convention. Legacy was last cleared to FL 370. He was not flying his flight plan, but following ATC clearances. This should be on the flight strip that the new controller took over.

6. Pilots should check transponder before entering RVSM airspace. If fails they should tell ATC “RVSM NEGATIVE”. ATC would take care of them.

Exactly what here does a transponder check consist in?

7. Last Legacy/Brasília dialog upsets me. It should be (but it isn’t):....

Are you aware of how often pilot-controller communications fit the precise standards, and how often they do not?

I don't buy your suggestion of how the communications "should" have proceeded. There is too much there that is not ICAO-standard terminology.

It is expected that they should descend!!! They shouldn’t confirm that.

Well, now, that is the crucial point, isn't it. If you are a U.S., or British, or German pilot and you are flying under ATC clearances, you fly your last cleared level, unless ATC clears you to "proceed as filed", in which case you then follow your flight plan.

And if it is so simple as that the Legacy pilots failed to follow Brazilian procedures, why are four controllers being charged with manslaughter (including "voluntary manslaughter" in one case)?

PBL

ATC Watcher

30th Aug 2007, 20:04

Sdruvss, what you say , or at least what I understand from your previous post, is not correct.
This might be due to , as you say, you "English lack of proficiency." but
Let me correct a few points, from a European ATC view of course .

FL370 is a normal RVSM level. Under radar controlled airspace , it is up to ATC to assign FLs , regardless of Flight Plan REQUESTED FLs , and of Level allocation scheme ( direction )
Again , under positive radar control, ATC overrides Flight Plan.

Changing headings without clearance is not authorized, ATC always clear an aircraft to fly A to B either via heading, track , point to go, etc.. or via Flight plan route. Therefore the turns that subsequently follow along the cleared route are authorized. In the vertical plane, the last FL cleared is the one to follow, regardless of Requested FLs , UNLESS IN RADIO FAILURE.
In radio failure a relatively new ICAO procedure applies ( see among the first pages of this thread for the details, no time to check for you ) in which after a certain time the pilot in command should disregard previous clearances and follow strictly the filed flight plan.
Now the big discussion and heavy debate we had a year ago, is : were they in radio failure , and if yes , which procedure did they follow, or were they intending to follow ? There was apparently a large discrepancy between the USA FAA "NORDO procedures" and the ICAO recommended ones. Which ones Brazil had published in their AIP at the time of the accident would be interesting to have. We had no reply on that question. But I am sure CENIPA , will look into this.

Your invented " ideal" R/T exchange that should have taken place makes no sense to me at all.

Finally , back to a previous post of yours : while lecturing Prof Ladkin, you said that the Brazilian RVSM bible ,called NABR-2, is only in Portuguese. I doubt this very much.

If , as i suspect, NABR-2 is only a translation of the ICAO RVSM introduction book, then RVSM as no bearing whatsoever in this accident.

marciovp

31st Aug 2007, 03:33

I am not a pro. Just love aviation and have been following closely this GOL X Legacy disaster. Used to fly Tripacers and Cherokees...Small guy. I also like justice and hate scapegoating and prejudices.

The two Legacy pilots did have an initial written flight plan. Go to Brasilia 370, descend to 360 and somewhare along the line back to 380 (kind of funny plan...but this is besides the point). After leaving São Jose the ATC changed the plan for them to fly 370 to Manaus (it is recorded, no way to deny it). Of course the last ATC plan is always what counts.

Arriving in Brasilia the pilots told ATC in Brasilia they were at 370. ATC greetd them, wished a good trip and nothing else was said.

They passed Brasilia and for seven minutes the screen at ATC showed 370:360 and + inside a circle (that is the transponder was ON). Why the 370? Came from the Legacy transponder. The 360? From a software in Cyndacta que was just spelling out the original flight plan (without expecting that ATC and the Pilots to confirm this. For seven minutes ATC did not question the discrepancy with the Legacy pilots.

Then the transponder went OFF. This showed in the screen. The + was not circled by a circle. As there was no imput from the transponder a primary radar from the Air Force framed the Legacy but this radar was not turstworthy for altitude. It read 360. Then in the screen at traffic control
there was 360Z360 (The Z means not reliable, not coming from the transponder). For almost one hour or so this showed up and ATC did not try to get in touch with the Legacy to ask or tell that the transponder was off.

In the Legacy the transponder went into stand by or so, probrably because the pilots rested their feet in the feet rest below the dash.
The warning sign that the transponder was OFF was a small sign in yellow letters easily not seen. (See FAA and NTSB)

The pilots thought they were in the right place and the ATC control the same way without realizing that the data they were getting were not reliable.

Yes, at one point they tried to talk with each other many times but I doubt if either side was concerned about altitude.

Then the disaster. When it happened the radar showed up in Manaus but the ATC was done by Brasilia...

Now, I will listen...

A310driver

31st Aug 2007, 04:39

It's not an ATC "plan"....it's an ATC CLEARANCE and, yes, you are correct.. it's what counts.

The legacy pilots were proceeding as CLEARED and the flight plan has no significance other than they were also cleared via the route they had filed(planned). The altitude listed in a flight plan is a request; the altitude/level to be flown is the one assigned in a clearance.

PBL

31st Aug 2007, 06:54

Sdruvss,

The posts by ATC Watcher, marciovp and A310driver say a lot of what I would have said in reply. I will not repeat here points they have made; I supplement them.

It seems to me that your concern has a number of components. Firstly, if I may say so, you don't seem to understand the contract between airspace users (pilots) and air traffic control under Instrument Flight Rules: what a clearance is and means, what a flight plan is and means, what takes priority over what and when. This is not trivial stuff. And, for example, it forms a large part of training for instrument flight. But it is stuff that IFR-rated pilots and controllers deal with every day, so if you are new to all this, please bear in mind that you are discussing with people with considerable expertise, and please don't take it badly if people flatly contradict you on some matters.

But it is also unfortunately not unambiguous. International misunderstandings over the roles and abilities of pilots and controllers have arguably contributed to two recent crashes: the 2002 Überlingen midair collision, and the 2006 Sochi CFIT, so international agreements play a role also. The Überlingen report in particular went into great detail over the differing guidance that may or may not have been in force or have played a role in that midair. That section of the report makes very sobering reading. I recommend it.

Furthermore, even in cases in which guidance is not unambiguous, it may be obscure. I give examples of three jurisdictions.

In the U.S., the Federal Aviation Regulations are published and readable. Indeed, you can get them on the WWW, and they are in a widely-used international language, namely English.

Move to the U.K. The corresponding law is called the Air Order; it will fill an entire bookshelf; it is written in language, some of which has a precise meaning which is only understood by professionals conversant with English law. The CAA provides some readable guidance booklets, called CAPs, and what is in the CAPs is used as a basis for what a pilot should know about the U.K. aviation law and rules. Now, suppose you wanted to fly to the U.K. in your bizjet, and you wanted to know about the rules. What would you do? Try to order a CAP? Which? Where do you find the list? How do you find out which CAP has the information you want?

Move to Germany. You can get the law on the WWW, It is called the LBO. But reading and interpreting legal German is something that most Germans cannot do, let alone people who do not speak or read German. It has taken me years of being here, and participating in legal proceedings, to gain an understanding of what specific meaning certain legal phraseology has. The LBO is no different. And I can assure you that there are plenty of German pilots who do not understand quite what the LBO says. So if you consider an incident in which some Russian under control of a Swiss hits a Belgian plane in German airspace, it is a fair bet that none of the participants actually understood the law governing their unfortunate interaction.

With this rather long-winded discursion, I simply hope to have indicated that it is simply not humanly reasonable to expect foreign pilots to understand all aspects of local aviation law, in most places except possibly the U.S.
That is why ICAO, and ICAO procedures, play such an important role. But in some cases (Überlingen), having ICAO procedures could be seen, not as cutting through the darkness with light, but as adding *yet another* layer of mutually partially contradictory guidance.

So how might this apply to the Amazonas midair collision?

If ATC Watcher and his organisation are unable to get an answer from the Brazilian authorities after nearly a year as to which procedures for lost communications actually applied at the time of the accident, how can anyone reasonably have expected two pilots on a delivery flight to know what those regulations may have been, other than those to which they were accustomed? And until that is determined, how could one even begin any kind of legal categorisation of the actions of the pilots or controllers? Yet, as I understand it, one criminal trial has formally begun already.

Second, you appear to be under the impression that when the Legacy pilots joined UZ6, they should have communicated with controllers about the heading change but didn't. I take it that marciovp's comment suffices to answer that.

Third, you ask me to define "lost communications". Communications are taken to be lost by one participant when they (repeatedly) attempt to communicate over the mutually established or conventional channel and do not succeed. A state of lost communications can only be established, as you say, when attempted but failed. The important point to note here, and which must be taken into account by IFR procedures for lost communications, is that one party will likely establish that communications are lost before the other.

Fourth, you say, concerning the FL at which the Legacy pilots flew UZ6, that
if you are in Brazil, as hundreds of pilots of Delta, AA, Fedex, United, Lufthansa, Air France, Air Portugal, Iberia, Alitalia, British Airways, …, it’s what they do each day
as if they "know" what is "right" and the Legacy pilots did it "wrong". Do you realise that you are conversing with some of these "hundreds" of pilots of established airlines in this forum? And that none of those whom I know personally have any idea at this point what it is that the Legacy crew are supposed to have done "wrong"?

As to your suggestion why the controllers are facing military tribunals,
Because Joe Lepore, Joe Sharkey, a lot of Brazilians and, a lot of foreigners are accusing them
you are, please, aware of the fact that the only people who seem to be taking a genuine interest and making a genuine effort to ensure that the inquiry into the behavior of these controllers proceeds appropriately are "a lot of foreigners", specifically, Swiss, French and Portuguese? With some of whom you are now conversing.

PBL

agusaleale

31st Aug 2007, 17:59

I´d like to contribute to this thread if possible.
I´d like to know if a german, spanish, usa flight enters brazilian airspace, just to cross it...Do they have a filed flight plan that is approved by brazilians, or they simply enter the airspace and take contact with ATC´s ?
I think the answer of this question would clarify a lot.

marciovp

31st Aug 2007, 18:35

OK, we are doing this for the love of aviation. I am hoping that CENIPA will clarify all these questions.

ATC never wanted to clear Legacy, or any other plane, to FL 370 at UZ6 from Brasilia to Manaus. They never want to do that with any plane. What was ATC mistake? What was their exact word that was misunderstood? When? What makes Legacy understood to keep FL 370 after Brasilia VOR until Manaus? I suppose that was their last words to Legacy, right? What they said, we know, but what they should have said them? There is not any value judgment in this question. It is only a simple question.
My point-of-view is that communications lost was a minor issue in this case. Why? My answer: Last two-way contact was 15:51, 40 miles far from Brasilia. ATC should have said something, which I don’t know what, but I would like that you tell me, that when they have reached Brasilia VOR they would have descended to FL 360.
Then 16:02, at same time, Legacy don’t descend, and transponder has no signal. ATC thinks it is only a transponder issue and assume they are at FL 360. This (16:02) is the beginning of the incident.

ATC from São Jose, did clear the Legacy to fly 370 until Manaus. This is recorded. I have listened to it. Of course - and it couldn´t be otherwise - pilots must follow the last clearance from ATC. And this frequently happens as you can imagine. The ATC in Sao Jose could have said what the original flight plan said. But he didn´t.

The ATC in Brasilia saw in the screen that the Legacy icon was showing 370:360 and of course could have asked the pilots about this discrepancy. The transponder was ON and this lasted for 7 minutes. Why there was that secong 360? Because the original flight plan was entered in the system and called for 360. The International Association of Air Traffic Controllers questioned the software that entered 360 WITHOUT REQUIRING AN AGREEMENT BETWEEN PILOTS AND ATC (automatically). They claim that this doesn´t work like that in the rest of the word and that for that 360 to be there PILOTS AND ATC should have talked and agreed. Not in Brazil. (The Air Force denies that and defends the software)

ATC could not think that it was just a transponder issue. There was clearly in the screen that the transponder was not working and the 360Z360 reading was not reliable (that is what th Z means). The first 360 was coming from a military radar that ATC new was not reliable in terms of altitude, and the second was entered automatically by the software without requiring that ATC and PILOTS talk. So by looking at the scree for almost one hour ATC saw that the transponder was not working, that the 360Z360 was not reliable and, as you said, felt that this was the altitude... Couldn´t they have -way before communication was impaired- talked to the pilots and ask why the transponder was off and in what altitude they were flying?...

As for the pilots, yes they could have seen in their screen in small letters that the transponder was off. But they were small letters in yellow, not even red. The NTSB has issued directives for this to be changed and for the pilots to have more clear warnings when the transponder goes off. And the FAA has said that in the Legacy, placing the feet on the feet rests altered the transponder to stand-by and altered the radio frequency.

This is how I see, but of course waiting for the final report from CENIPA (the only problem with CENIPA is that it belongs to the Air Force who administers Traffic Control in Brazil in terms of softwares and equipments).

Sarava!

ATC Watcher

31st Aug 2007, 19:22

marciovp : You make a lot of unverified assumptions in your reasoning . Just to take one :
ATC could not think that it was just a transponder issue. There was clearly in the screen that the transponder was not working and the 360Z360 reading was not reliable (that is what th Z means).
The " clearly" is what is most probably lacking in this ATC system. . How often a normal lack of Mode C interrogation return will provide a Z ? 10 times a day ? 100 times a day ? Is it a bright flashing letter coming on the screen if the Z remains for more than let's say , 3 returns , or 3 minutes...?
Is the radar coverage over Brasilia 100% ? , how does the ATC system behaves when the aircraft enters a zone of bad radar detection ?, puts another Z ?
Replacing Mode C/S altitude by the average altitude of a Military height finder is also something unheard of . All these are contributing factors.
The Brazilian ATC system has unique features that no one else in the world is using .Some are softly saying they are , " prone to Human errors" , some other are bluntly saying they are " dangerous" .If you combine this to poorly trained and poorly paid operators, ( compared to the rest of the world gain ) you might have a different perspective .
On the cockpit side, the same reasoning can apply.For instance a small difficult to spot TCAS OFF in white on a corner of a display while keeping the TCAS map/display unchanged is not what you would normally expect from a modern avionic suite .

PBL

31st Aug 2007, 19:41

Sdruvss,

I think we are getting somewhere with this discussion. It is important to reach agreement on known facts. It is important to know what is known, and also to know what is unknown.

S.José to Brasilia, but is not from Brasilia to Manaus, since they would be entering a RSVM airspace, right?

In any jurisdiction with which I am familiar, ATC has the authority to clear any aircraft to any flight level they wish in any airspace they control. They may be limited in their offers by their own internal procedures, but that is not apparent to their contract partners (the pilots of aircraft using their airspace under IFR).

You keep bringing up this issue of RVSM. I don't think either ATC Watcher or marciovp think it is relevant, and I
certainly don't. Why do *you* think it is relevant?

PBL

PBL

31st Aug 2007, 19:48

For instance a small difficult to spot TCAS OFF in white on a corner of a display while keeping the TCAS map/display unchanged is not what you would normally expect from a modern avionic suite

Especially in light of the extensive discussion of the disadvantages of such minimal displays after the Strasbourg/Mt. Ste-Odile accident in 1992.

PBL

agusaleale

31st Aug 2007, 19:58

ATC Watcher to agusaleale : this forum and its discussions are possibly not the right place for you.
Quick answer nevertheless: A flight plan submitted in advance is necessary for every international border crossing , not only for Brazil.

Sorry for my ignorance. I didn´t know that every person in this forum is an expert.

Just one more thing and thanks for clarifying, specially me.

I don´t find in this post many comments made by the great majority of pilots here present, many of them who surely fly across Brasil.
I think it would be very helpful to hear their past experiencies in situations like what is being discussed in this forum, i.e pilots who follow ICAO or not, FL, etc.
I´m afraid that if these situation happen regularly, it surely´d be more accidents, as all I´ve read in this forum is a continuous confusion between those who pretend to fly and those who controll the airspace. It should be simply; if not, why don´t accidents happen regularly in Brasil, given the discordance in procedures seen here?

PBL

31st Aug 2007, 20:59

Clearable levels are 300, 320, 340, 360, 380, 400. Right?

To an airspace user, IFR-clearable levels are any levels which end in "0", so you are missing a great many.

I think I just said this, didn't I?

PBL

bomarc

31st Aug 2007, 22:56

I think we covered this all at the top of the thread...ATC can give you an altitude not consistent with the above hemispheric rules.

they are called, "WAFDOFS" for wrong altitude/direction of flight

sometimes it just works out that way...sharp pilots usually verify it with atc...at least in america.

con-pilot

31st Aug 2007, 22:57

Maybe I am misunderstanding NABR-2. It says:

"RUMO MAGNETICO (what is english word for that?):
000º A 179º - FL290, FL310, FL330, FL350, FL370, FL390, FL410
180º A 359º - FL300, FL320, FL340, FL360, FL380, FL400

Brasilia to Manaus is NW, aprox. 300º, i guess. So only even levels, correct?
Remember, S.José to Brasilia is not RSVM.

Sdruvss, that is correct. That the reason the requested altitude of FL 360 was on the flight plan. Please remember that the altitude filed on a flight plan is only a requested Flight Level. Just because a Flight Level is requested does not mean that you will receive that Flight Level. Often crossing the North Atlantic I do not recieve the Flight Level I have requested.

ATC can assign any Flight Level in its airspace regardless of magnetic heading for various reasons.

This happens all over the world everyday.

I hope this helps you.

bomarc

31st Aug 2007, 23:27

just for the record ... isn't it magnetic course and not magnetic heading?

one could make good a course of 350 degrees by flying heading 001degrees...depending on the wind

con-pilot

31st Aug 2007, 23:34

That is the question. Why ATC would assign them FL 370? That is why this accident happened. Some one put them in an unappropriated level. Result: mid-air collision.

Yes, that is the question. The only people that can answer that question are the ATC controllers and staff on duty at the time of the accident. The crew of both aircraft had no choice of the Flight Level that they were at.

When they assigned FL370 from Brasilia to Manaus? When this level was assigned?

I really cannot tell you the answer to that, I do know that the information you are asking about is somewhere in this thread.

What you must understand is that ATC assigned the Legacy FL 370. The crew of the Legacy cannot leave the last assignined Flight Level in normal circumstances, which both crews had no reason believe that they were not in normal operations, without permission of ATC.

The requested Flight Level is immaterial to this accident. The Flight Level assignined by ATC has everything to do with this accident.

marciovp

1st Sep 2007, 04:34

The recording of the clearance from ATC in São Jose shows the conversation between the ATC and the pilots, after taking off. The recording is there at the Traffic Control Center. I will try to find it somewhere.

I found it. This was at Folha de São Paulo describing how the Air Force acknowledged that the ATC in São Jose cleared the Legacy pilots to fly to Manaus at 370 (in Brazilian Portuguese):

http://www1.folha.uol.com.br/folha/cotidiano/ult95u127785.shtml

The " clearly" is what is most probably lacking in this ATC system. . How often a normal lack of Mode C interrogation return will provide a Z ? 10 times a day ? 100 times a day ? Is it a bright flashing letter coming on the screen if the Z remains for more than let's say , 3 returns , or 3 minutes...?

Insofar as I know, no. No big warning. An Air Force officer has suggested this, that when a transponder is OFF as it was the case, an alarm would be heard loud and clear. But not only was the Z there (360Z360) but also there was indication that the transponder was off (+ nor surrounded by a circle). For almost one hour!

Yes, the Air Traffic Control in Brazil needs to be investigated in all levels: equipment, software and personal. I hope this is going to happen as Brazil is trying to fix this problems. Slowly they are changing things and I am sure that they will succeed.

arcniz

1st Sep 2007, 07:08

At jet speeds and under IFR conditions, it simply is not possible for aircraft by themselves to maintain enroute or terminal area separation without some outside agency or method providing guidance or rules that affirmatively enforce separation.

An expectation in IFR navigation, throughout the world, is that the air traffic control system acting through the various enroute and terminal area control facilities will take 'reasonable and prudent care' to provide separation between the various aircraft in the system at every point in time.

Surely the crews of the GOL 737 and the Embraer Legacy (who each knew nothing about existence, plans, intentions or position of the other) both had a belief that Brazil ATC was paying attention to their positions and progress via flight plans, radar surveillance, and controller oversight.

Perhaps I missed it somewhere in this long thread, but I do not recall that Brazil ATC made any effort to reposition the GOL airliner on the airway prior to the collision.

The record is becoming clearer in regard to "who knew what when". Clearly Brazil ATC had numerous indications that communications with the Embraer were 'irregular', with no reliable transponder data, no 2-way radio communication, and ambiguous indications in regard to the Embraer cruise altitude. The Legacy position on the airway seems to have been continuously available, however, from the long-range surveillance radar data serving the region.

Is it not true that Cindacta had normal and continuous 3-dimensional position information and voice communications with the GOL 737? Why did ATC not provide some guidance to the GOL flight to change course slightly as the two aircraft neared each other, so as to sidestep the passenger airliner from the airway when another aircraft was known to be coming from the opposite direction at approximately the same altitude and not in communication with ATC.

A couple of gentle turns given to the 737 to position it well clear of the airway center during the time of convergence would have protected both aircraft from the events that followed. This kind of precautionary separation is a common practice everywhere I have flown. Why did Brazil ATC do nothing to inform GOL regarding the traffic and to provide positive separation for the two aircraft as their paths crossed?

PBL

1st Sep 2007, 07:48

Sdruvss,

I have explained to you the protocols on clearances; so has ATC Watcher, and so has con-pilot. I cannot understand why you seem to have difficulty with this information.

I’ve read all I could, everywhere, all newspapers and magazines and, controllers interview at TV, and didn't read it.

We need to be working from the same information. Maybe you could read the NTSB publications on this. They were published on request of CENIPA. They contain much of the pertinent information. Here is a citation from the Factual Report, released last October, if I remember rightly.

After takeoff, N600XL was issued a number of interim altitudes during climb, all of which were read back. The flight was cleared to proceed direct to Araxa VOR (on airway UW2), and at 3:11 pm was cleared to climb to FL 370. At 3:33 pm, the aircraft levelled at FL 370.

........[Stuff about GOL 1907]..........

At 3:51 pm, an air traffic controller in the Brasilia ATC (CINDACTA 1) instructed N600XL to change frequencies to the next controller's sector. The crew of N600XL reported in on the assigned frequency that the flight was level at FL 370. ATC acknowledged and instructed the crew to "ident" (flash their transponder). Radar indicates that the ident was observed. This was the last two-way communication between N600XL and ATC. At this time the airplane was approximately 40 nautical miles south of BRS.

At 3:56 pm the Legacy N600XL passed BRS level at FL 370. There is no record of a request from N600XL to the control agencies to conduct a change of altitude, after reaching flight level 370. The crew made calls, but there is no communication in which they requested a change of flight level. There is also no record of any instruction from air traffic controllers at Brasilia Center to the aircraft, directing a change of altitude.

Is that clear enough? They were cleared to and confirmed FL 370, and on the check in with the next controller they reported level at FL 370. They requested no new flight level; ATC gave them no instruction for a change of flight level.
And that is the state of the clearance when the collision took place. That is fact.

This is, to most IF-rated pilots and controllers all over the world, unambiguous. The aircraft was cleared to FL 370 by the usual procedures; no further altitude clearance was issued by ATC.

The question is, then, what N600XL should have done. This is, to most IF-rated pilots and controllers all over the world, also clear. He stays at FL 370 until he is cleared to another flight level. ATC Watcher has pointed out, though, that new ICAO procedures contain provisions which may say something else. I understand that IFATCA has requested from the Brazilian authorities to say whether those new ICAO procedures were in force in Brasil at the time of the accident, and have until now received no reply. As I said, if an official request for clarification cannot be answered in the space of months, then even if these new ICAO procedures did happen to have been in force, how can these two pilots be expected to have known?

This is all just a repetition of stuff which has already been said, but with more words and lengthier citations. The discussion would be much more efficient if we could all read the canonical documents, and all accept certain basic facts about procedures under IFR.

PBL

marciovp

1st Sep 2007, 14:20

PS: Clearance from Brasilia to Manaus (UZ6, FL370) shouldn’t be explicid confirmed by pilots? I’ve read it somewhere. (Don’t mind, don’t answer it, I took so much of your time. Remember PBL: biased scientific overconfidence)

Yes in the dialog the pilots - I believe - confirmed twice the clearance to Manaus. When they approached Brasilia they also said 370. ATC wished then a good trip.

Their transponder sent 370 and the software 360 (without requiring that this be confirmed by direct talk). This lasted seven minutes and ATC for some reason did not ask about the discrepancy...

But, enough is enough...let´s wait for the final report.

regards

barit1

1st Sep 2007, 14:20

Sdruvss - please re-read my Post #432 (http://www.pprune.org/forums/showpost.php?p=2896518&postcount=432)

A310driver

1st Sep 2007, 16:34

sdruvss just doesn't get it and clearly has no/limited knowledge of the "system".

Why bother with all this diatribe trying to answer the inane comments/remarks?

His only qualification is "location Sao Paulo". Given this particular subject and the history of how the matter has been handled in Brazil,that might also be a disqualifier unless there are some professional qualifications to offset.

PBL

1st Sep 2007, 16:39

Now it becomes clear to me that Cindacta didn’t clear them from Brasilia to Manaus FL 370, wouldn’t clear if requested, but since Cindacta didn’t say it, this was assumed that they did.

Looks like we are not yet over the hump.

N600XL was cleared to FL 370 at 3:11 pm by whomever he was then talking to (Sao Joao dos Campos?). Before he was told to contact Brasilia Center, the controller would have contacted Brasilia Center to perform the hand-off. This hand-off information contains the info that aircraft N600XL is level at FL 370, and when Brasilia accepts the hand-off, he accepts the obligation to keep the airspace at FL 370 on the route of flight clear for this aircraft (or to keep some other airspace clear and issue an amended clearance).

So, contrary to what you say, Brasilia Center had accepted the obligation to clear them at FL 370.

if I were the pilots I would be very worried

If you were an experienced instrument rated pilot, none of this would have worried you as procedure (until September 2006, that is :( ). It is routine procedure, practiced tens of thousands of times a day by thousands of pilots and controllers.

PBL

poorwanderingwun

1st Sep 2007, 17:29

If you were an experienced instrument rated pilot, none of this would have worried you as procedure (until September 2006, that is ). It is routine procedure, practiced tens of thousands of times a day by thousands of pilots and controllers.

PBL

Like many on Pprune I've been following this thread with interest.. mid-airs have to be amongst the most feared of accidents... but not having any involvment I've had no reason to 'contribute'... however that statement by PBL does leave me feeling a bit uncomfortable...

Yes I am an experienced instrument rated pilot... and on a truly world-wide basis.. but when cleared to a non-standard FL, although not 'worried'.. I am conscious of being non-std and always include the 'non-std' phrase when reading back the clearance.. and again include it on hand-over or in the event of joining another A/W at an intersection... required ?? No... maybe not... but unless you believe controllers are incapable of making errors it would seem good sense.. I would do this when working the London TMA ... arguably the best controllers on the planet... I would most certainly do it anywhere where either the language or comms are less than perfect... No reflection on any of the crews involved in this accident...we still don't know the full story...just a comment on PBLs post.

PBL

1st Sep 2007, 17:59

I am an experienced instrument rated pilot... but when cleared to a non-standard FL, although not 'worried'.. I am conscious of being non-std and always include the 'non-std' phrase when reading back the clearance.. and again include it on hand-over or in the event of joining another A/W at an intersection.

Thanks for the clarification, pww.

I was responding to the word "worried", and you confirm what I said. We were also discussing the flight of N600XL with a neophyte who seems to be trying to find things procedurally incorrect with the way the pilots of N600XL executed IFR clearances.

I think people who fly all over the world learn certain techniques to improve their chances of not getting broadsided (in the general meaning of the word), and yours is one that people after GOL/Legacy might do well to emulate. After AA in Cali, many no longer took the word "Affirmative" to mean "Affirmative" when used by controllers in some S.Am. countries. And many are now taking seriously the thought of flying airways slightly offset; something that my instrument instructor suggested to me almost a quarter century ago.

PBL

mumbo jumbo

2nd Sep 2007, 15:01

Well, I can't understand Portugese but I'd bet a penny to a dollar that it just repeats that same old bit of air law that the neophites can't seem to get their heads around... namely that if an airway has direction of flow between 000º and 179º then a/c should fly at an odd altitude, eg. 310, 330, 350 etc. and if between 180º and 359º then it should be even, eg. 320, 340, 360 etc.

Sadly, what the neophites seem unable to grasp is that whilst the above is true, it only applies strictly when in a non-radar environent. If, as has already been explained much more clearly than I am able to, the a/c is under positive radar control then those rules can be overuled by ATC.

As has been stated on here already, the flight was cleared by ATC to maintain FL370 and that overrides the air law being quoted above. Even if they knowingly suffered radio or comms failure, they should continue at the last assigned clearance. Only if they reach the limit of their clearance and they have lost comms should they revert to whatever is in their flight plan.

Now, I don't know why the neophites seem to be having so much trouble with this but I suspect that it is due to their total lack of experience of what the job is about. Add to that fact that we are dealing with a lawyer who probably is trying to make a literal interpretation without understanding the day to day operational requirements of ATC.

I suppose that patience is required, even though it is sometimes difficult, especially when so many neophites are trying to tell us how we should operate our a/c according to their very narrow and limited understanding of air law and 'the job'. :ugh:

mumbo jumbo

2nd Sep 2007, 15:12

OK. But whose "text" are you quoting? Who has made that interpretation of the radio calls between the a/c and ATC?

marciovp

2nd Sep 2007, 16:17

João Batista da Silva Controlador de Tráfego Aéreo
November seis zero zero x-ray lima, ATC permissão para Eduardo Gomes, nível de vôo três sete zero direção Poços de Caldas,

Sdruvss is quoting the "final report" of the House of Representatives Commission to Investigate the disaster (CPI), whose chair belongs to the government party, and know nothing of aviation. A shame. How come a "commission" like this without anyone acquainted with aviation come to conclusions to blame anyone for the disaster? Only in Brazil. I say again, let´s wait for CENIPA/NTSB. At least those people know better about aviation (although CENIPA belongs to the Air Force, who also is responsible for Air Traffic Control in Brazil).

The quote above is clear: "João Batista da SIlva ATC: November six zero zero x-ray lima, ATC permission for Eduardo Gomes (Manaus) flight level three seven zero direction Poços de Caldas."

I heard the dialogue between the pilots and ATC and if I am not mistaken they asked twice about the clearance.

The rest of the document from the CPI is again holding the pilots to follow the initial written flight plan and saying that they did not follow it. This has become the common criticism here: the original flight plan was not followed... little is said about the dialogue between the pilots and ATC in Sâo Jose. I hope they don´t erase this tape...

When they approached Brasilia they again told ATC that they were at 370. Brasilia wished them a good trip. Then their transponder showed for seven minutes that they were at 370 after passing Brasilia...etc, etc... I am not going to repeat myself.

Yes, I find that maybe the pilots could take the initiative in Brasilia and after to make sure they were flying in the proper altitude 370 and perhaps insist to know if this was the proper altitude. In hindsight everything is easy. But yes, maybe they could have done this... even though they knew that their altitude was being sent by their transponder (seven minutes) and they were in the radar of Cyndacta.

Well, let me admit that I got involved on this when I saw this prejudiced movement to blame the US pilots. I dislike prejudices of any kind. I was appaled whem in the first week after the accident the Minister of Defense in Brazil was in TV saying the the american pilots disconnected their transponder because they wanted to make stunts to test the new plane...
At that moment I decided to get involved.

But I am flexible and will change my present views when I see evidences for it. As for the dialogue between São Jose and the Pilots I will have to hear, myself, the tape before going for interpretations of what happened.

I am becoming found of Sdruvss (a Brazilian like me) andI am sorry we all can´t listen together to the tape with the conversation between TC in São Jose and Legacy. Perhaps someday...

marciovp

2nd Sep 2007, 16:25

Sdruvss asked me to translate this conversation between himself and a Brazilian pilot:

Eu: O que você acha deste acidente?
Piloto: É, o Legacy fez m....
Eu: Por que?
Piloto: Ele entrou no nível impar para Manaus
Eu: Mas o Legacy disse que os controladores que estabeleceram esta altitude.
Piloto: Nunca, todo mundo sabe que é par para Manaus e impar para Brasília, foi o Legacy que não entendeu o Cindacta e f... Eu nunca soube do Cindacta botar alguém em impar para Manaus.

I: WHat do you think about this accident?
Pilot: Yes, the Legacy messed up
I: Why?
Pilot: He entered in an odd level for Manaus
I: But the Legacy said that the controllers cleared this altitude
Pilot: Never. everyone knows that it is even for Manaus, and odd for Brasilia. it was the Legacy that did not understood the Cindacta and screw up. I never knew that Cindacta place anyone on odd to Manaus.

con-pilot

2nd Sep 2007, 19:36

You missed the most important part of the clearance Sdruvss.

FL 370,

That was their assigned altitude and ATC NEVER CHANGED THAT ASSIGNED LEVEL. You cannot change altitude any time without expressed permission from ATC.

No matter how many times you ask the question you are not going to get the answer you are obviously looking for. The pilot you were talking to shortly after the accident was wrong. Or did not understand the circumstances.

ATC Watcher

2nd Sep 2007, 20:29

Sdruvss : I fully support what con pilot just wrote. this is the way things works, not like your " pilot friend" said.
Also do not mix up a ' pre-departure clearance " that is a contract before take off that can be amended at any time once airborne by the controllers en route depending on other traffic.

To help you understand how things work, everywhere in the world , , let me try a small basic lecture if you allow me :

To stay in your country and in this case : Remember Brasilia VOR is an intersection of many airways. Therefore all kind of odds and even FLs are crossing there.(e.g. If 2 airways are facing west they are both using same family of levels )
Imagine there was another aircraft coming at FL 360 in the vicinity, from another airway, also heading for Brasilia VOR. Do you think that just because the airway direction changes for the Legacy, the controller is going to descent it and put it in conflict with that one ? Of course not. If nobody else is at FL370 ,he is going to wait some minutes before doing so. In the same manner , it is inconceivable for any pilot to just descend on his own to any level, when he overfly a VOR , just because its flight plan says so, as there might be other traffic in his vicinity at this level that is unaware of.

Under positive radar control, it is the controller that assign and determines the altitudes, not the pilot, and not the flight plan. The Flight plan is made of REQUESTED levels , as in " would like to have if available " levels. Those requested FLs have to be in line with what the AIP says, and for this route ( BRS-Manaus) it was even levels.
Therefore the flight plan said BRS FL360 and the controller last instruction was maintain FL370. both are perfectly correct in their own ways. The causes of the collision are not there, over BRS. They lie tens of minutes later.

marciovp

2nd Sep 2007, 22:03

It seems to me that sdruvss is coming from a legal perspective and he wants the Legacy pilots to be held reponsible for the disaster. He is a fellow Brazilian that of course I respect.

But, let´s say that we agree with him: the Legacy pilots misunderstood ATC in São Jose and later did not notice that their transponder was off. So, in a situation like this Brazilian Traffic Controll allows a plane to fly in the wrong altitude, in a coliding route, for about ONE HOUR without trying to communicate with the pilots?...

I guess everyone flying in Brazil should then know that: if you are in a colision route, you are in your own...

Is this what Traffic Control is for?...

bubbers44

3rd Sep 2007, 00:11

I think reporting in at FL370 and an acknowledgement of such is a confirmation that ATC accepts you at that altitude and therefore it is their responsibility to protect your altitude for your next segment of your flight.

Tarq57

3rd Sep 2007, 01:06

No it was not. It was, I don't know the word in english, like a handshake. Controller was confirming that transponder was ok, confirming his altitude. This not mean that Brasilia to Manaus was cleared. This should be confirmed because it would be a flight plan change.
Yes, it was. It is everywhere. Tactical changes to flight plans occur all the time.
Others have tried (very capably in my opinion) to explain this.
A flight plan is just that. A booking, if you like, stating the requested routes and levels, among other things. At submission it is loaded in to the database.
It is nothing more (or less) than a tool for the controllers to use and refer to.
It should be considered as a strategic (planning) request, and as such, the levels (and other data entered) should comply with the rules for the route/s flown. This includes quadrantal altitude selection.
The actual business of controlling a flight will take all requests on the plan into account. In the initial clearance issued to the pilot, the clearance is to destination, via a particular route (usually flight planned route, but this can be changed according to traffic requirements and other reasons, such as a temporary restricted area) at the altitude requested initially on the plan. There is more to the clearance than just that, but those are the salient features.
Subsequent requests for altitude change, planned or not, for any reason, are handled by the controller/s handling the flight at the time the change is requested. This is the way it happens everywhere. And it is common. For example, many long distance flights file an initial cruise level somewhat below the level the pilot wishes to cruise at later, when fuel weight has been reduced, and a higher (and more efficient) level is planned for and requested, maybe 2 - 5 hours into the flight. This sort of request, planned or not, is handled at the time.
Ditto requests for direct routing, for which it is often not possible to file in the plan because of the route structure, but it is possible (sometimes) for the controller to approve at the time as workload and traffic and agreement of the subsequent sector/s allow.
Ditto requests to go around weather, which are (or should be) always approved, and the controller may take further steps (requesting a particular compass heading or altitude) if there are other aircraft in the way wanting to avoid the same weather. (Often the case.)
Sdruvss, if you wish to learn from this discussion, you need to understand the differences talked about here, between strategic planning (eg, a flight plan) and actual "hands on" tactical controlling (eg, making sure that flights are separated.)
If there were none of the former (flight plans) the system would not work because no controller would know who was entering the airspace next. If there was no tactical controlling, and instead, reliance was placed on every pilot exactly following their flight plans, a computer would have to calculate - before every takeoff - that those flights were all going to miss, and controllers wouldn't be required. (Technology is heading this way. At least for area control. Give it a few years.)
Nobody changes altitude just because that is what the flight plan has said, all things being normal, without a specific clearance to do so. Clearances are amended and modified all the time, throughout the course of a flight, according to the requirements of the flight crew, and ATC.
Get this, then you can start to talk about comm failure procedures, poor equipment design, poor displays of critical failures etc.
(To save you having to ask, or look it up, I am an ATCO, currently with a Tower (aerodrome) rating, with past area and radar ratings, and an approach rating. About 31 years service.)
(Some of us here may be prepared to accord you the respect you keep mentioning, if you were to state your occupation/experience/interest, etc, but quite frankly a great amount of respect has already been accorded. I'm quite impressed and a little humbled at the patience shown by many posters here.)

[Edit] (cross posted.) and Legacy didn't know it was at level not cleared
Incorrect. The legacy crew had received no altitude change clearance. They were cruising at their cleared level.
That it appears ATC thought they were at another level is a very large part of the reason for the collision, probably the primary cause. I would expect the investigation to examine in detail the reasons as to why ATC thought they were at FL360, but their last cleared level was, I say again, FL370.

Tarq57

3rd Sep 2007, 01:39

This is not "theoretically"; this is how it works.
The Legacy crew were at their cleared level. The Gol crew were at their cleared level.
Clearly, ATC thought the Legacy was at a different level.
"WHY?" will be the focus of the investigation. I hope. And as part of that investigation, the flight plans, communication difficulties, transponder failures, poor design of software and displays, and quite a few other things will come under the spotlight. I hope.

I would not want to work as a controller with equipment that gave such a poor indication that an element had failed, and as part of that, defaulted its display to a level I had not deliberately entered myself. (In this case, FL360.)

That it failed to work, in this case, is not a problem with the way aircraft are cleared, it is a problem with this particular combination of ATC, software, and probably a few other things, such as organization, training etc.

Given what I have read in this thread, the route and expected altitude change at a certain point wasn't the issue, here, it was a contributing factor. A big one, for sure, but still contributory. It could have happened anywhere there were two aircraft converging at the same level, one with a transponder out. I am sure there are places in Brazil where routes cross and aircraft at 89 degrees to each other can be at the same level, according to the quadrantal rule. (There sure are here.) In these cases the job of ATC is to ensure they will miss.
Of course, the chance of collision is greatly increased if they are both on the same or reciprocal tracks that are defined by GPS.

There is nothing in the clearance delivery or flight planning areas that authorizes a change to level, without direct communication with ATC at the time (or near the time) the change is requested.

marciovp

3rd Sep 2007, 03:34

Sorry to see you go Sdruvss. But it indeed seems that we all have gone as far as we can go on this discussion. And we are now just repeating ourselves.

I would love to hear the tapes of the talk between São José and the Legacy (I hope someone is keeping them intact). The tapes will not lie.

Of course when approaching Brasilia the Legacy pilots said were they were and their altitute (they thought they were following the last flight plan cleared by ATC in São José). ATC in Brasilia wished them a nice trip and that is all. Yes, they were before Brasilia.

But when they were after Brasilia with the transponder ON the screen in Brasilia showed 370:360, that is, they were flying at 370 (the first number is the transponder data). Let me repeat the 360 entered there automatically without requiring that ATC talked to the pilots to confirm this. The International Association of Controllers in their report felt that this software was kind of odd, with such a data entering in the screen automatically. ATC said that the Legacy was being followed in their radar... This of course calmed the pilots of any aprehension they could have abou what they were doing.

Then the transponder went OFF and for almost one hour the radar screen showed that the transponder was off and that the data was not reliable: 360Z360, the first 360 coming from the automatic entrance of the original flight plane and the second coming from a military radar that everyone knew was unreliable for altitude. ATC did nothing and even when finally they talked with the Legacy, close to the disaster time, it was to tell them the frequency they should speak to Manaus.

Even if the pilots misunderstood the clearance from ATC in São José and thought they could fly 370 until Eduardo Gomes Airport (Manaus) there was plenty of time and opportunity for ATC to correct what proved to be a colision route.

But I guess I will become quiet too on this issues from now on until we have new data.

Regards to all.

pa.000.blo

3rd Sep 2007, 12:11

Like many others I am following thread interested, because many times I flew, as a tourist and working in Brazil, and I am very well impressed with that country, airports and people. And I just registered to say one thing. Someone said americans is cleared to FL 370 at 3:11 pm by Sao José dos Campos, and he showed clearly that american plane was not and showed that american plane did not understand names of the cities and airport. Legacy were unable to acknowledge and confirm Pozos de Caldas, and I know that it is a difficult city name to pronounce. American plane also didn’t understand the name of Manaus airport.
Why is difficult for people here to understand that Americans misunderstood clearance? Why PPrune member repeat clearance rules that all understand. OK, americans thought they had a clearance but he had not, this is a fact, planes collided, what more must said? Let’s go on, stop repeating the same rules, because I like to reach the end of this history.

pa.000.blo

3rd Sep 2007, 13:57

poorwanderingwun,

Let's go ahead. Everybody said all, and every one makes their mind. It's not necessary that all agree. Let's talk about other stuff, as the transponder stuff for instance. And I can tell you, Brazil is not what you think. If you know it you didn't use those words.

A310driver

3rd Sep 2007, 14:49

I, for one, will take my leave of this forum as so much time, energy , vitriol and hand holding is spent dealing with the SLF, lawyers and other clowns who know nothing about a technical subject and are allowed to clutter-up the space with non-sense such as exhibited in the past few days of posts, to say nothing of the past six months, so be it.:ugh::ugh:

73's, au revoir, over and out.

pa.000.blo

3rd Sep 2007, 15:29

A310driver,

I like very much yours comments, and it would be a shame if you do not participate. It is not important if we agree or not each other. All contributions seems very important. Do not be upset if people do not understand you, and do not agree with you, it is a language problem, I am sure. This is democracy.

attlaw

3rd Sep 2007, 16:55

I had to register to answer that:

[...] spent dealing with the SLF, lawyers and other clowns

If I were you, I would take care with those words. One of this clowns can put in jail if you are not able to explain yourself when you kill 154 innocent people, as Joe Lepore and Jan Paul Paladino.

attlaw

3rd Sep 2007, 17:47

you are claiming that Lepore and Paladino killed people. That is a criminal charge. Please give your legal reasons for publically making such a charge.
I take it you are aware that there is no evidence in the official investigative documents that will support such a charge, and plenty of evidence that will refute it categorically?

The evidences are in this thread and in the way people here try to cover and distort evidences of the official investigative documents. If I had any doubt about Legacy pilots guilty before, you and other pilots here convinced me that they are.

RobertS975

3rd Sep 2007, 17:58

I have read every post on this thread from the date of the accident. If anyone was negligent here, it was the Air Force employed ATC people with a contribution from obsolete equipment and software. The Legacy pilots, for the millionth time, adhered to the altitude to which ATC had cleared them , an altitude clearance which was never amended or changed.

attlaw, you are embarassing your presumably great nation with such remarks.
Your government, your nation has a system problem which caused this horrific collision.

attlaw

3rd Sep 2007, 20:02

PBL,
All that should be said already was. People who read this thread will make their own judgment. This is not a court. And you may not judge us. No one needs to accept or deny evidences. No one needs to give any evidence that you ask. People are here because wants to understand what happened with this tragedy. People aren’t here to accept your judgment, but just know your respectably expert opinion. People here would like to make their minds by themselves, but you and a group of experts here insist that all folks agree with you. Anyone may make their own interpretation of the evidences. If some questions bother you and this group of experts, just don’t answer. It’s simple as that. You are the owner of this site, so delete what you want, delete the questions you don’t want to answer, delete opinions that are contrary of yours. You may do all you want with this forum. But if you keep it open, you will hear what you don’t want. Don’t pretend with this kind of forum that your technical view is shared by all the word. It is not. I suggest you to make a blog instead, then you publish your articles, and accept the comments you approve. What upsets me is that there is no one Brazilian expert participating in this forum. I think they have their reasons. I thought you are an ethical person but you are not, I was naïve. You are the kind that calls descent people like me of clowns, and some of them could be judging Legacy pilots very soon. It's better to convince them not calling them clowns.
Shame on you.

RobertS975

3rd Sep 2007, 20:10

attlaw, if your kind of judgement of the facts is what the Legacy pilots can expect from the Brazilian legal system, perhaps it would be best if they chose not to attend your party. And if Sdruvss is an example of how well a lay person in Brazil understands technical detail and facts despite having things repeatedly explained, then even more reason for the Legacy pilots to send an RSVP in the negative. If I were them, I would not attend any proceedings unless granted complete immunity from prosecution.

A question: is the Brazilian ATC system/software/personnel any better today than it was a year ago?

con-pilot

3rd Sep 2007, 20:43

After reading the responses of attlaw and Sdruvss I have come to the conclusion that for Lepore and Paladino to return to Brazil would be suicide.

Sr. Sdruvss has repeatedly ask the same question repeatedly insinuating that the Legacy crew purposely flew at the wrong Flight Level. He offers no reason of logic for this accusation, he offers no proof that the Legacy ignored ATC, he has not offered any evidence that ATC ever ordered a Flight Level change from 370 to 360. Instead he keeps insisting that the Legacy crew should have either changed their assigned Flight Level without ATC clearance just because the flight plan filed had 360 for the requested flight level.

Every professional pilot and experience Air Traffic Controller in this thread has answered Sr. Sdruvss calmly, professionally and politely informing him that his premise totally incorrect and is against ICAO and all rules of aviation Air Traffic Control. However, in spite of and in the face of all the the accurate, valid information provided to Sr. Sdruvss he still indicates that we are all wrong. Still he offers no evidence of his assertions.

Now, just as soon as Sr. Sdruvss signs off from Pprune we have Sr. attlaw sign on and blatantly accuse Lepore and Paladino of murder. Then his response after being challenged he posts the following all but accusing us of lying.

The evidences are in this thread and in the way people here try to cover and distort evidences of the official investigative documents. If I had any doubt about Legacy pilots guilty before, you and other pilots here convinced me that they are.

Therefore Sr. attlaw I would ask you to please supply that myself or any one else in this thread The evidences are in this thread and in the way people here try to cover and distort evidences of the official investigative documents. Just in case you are unaware of this fact a 'official investigative document' is just that, not the rule of law.

As for Sr. pa.000.blo, just another non-professional giving opinions that he has no background, education or experience to qualify him as a knowledgeable person in aviation matters. To wit:

Like many others I am following thread interested, because many times I flew, as a tourist and working in Brazil, and I am very well impressed with that country, airports and people. And I just registered to say one thing. Someone said americans is cleared to FL 370 at 3:11 pm by Sao José dos Campos, and he showed clearly that american plane was not and showed that american plane did not understand names of the cities and airport. Legacy were unable to acknowledge and confirm Pozos de Caldas, and I know that it is a difficult city name to pronounce. American plane also didn’t understand the name of Manaus airport.
Why is difficult for people here to understand that Americans misunderstood clearance? Why PPrune member repeat clearance rules that all understand. OK, americans thought they had a clearance but he had not, this is a fact, planes collided, what more must said? Let’s go on, stop repeating the same rules, because I like to reach the end of this history.

Okay, I'm done.

RobertS975

3rd Sep 2007, 20:43

I see you ignored the last question: Is the Brazilian ATC system/software/personnel any better today than it was a year ago?

And one more question for the group as a whole... what does Mr. attlaw have to do to violate his probationary period here? Seems to me that he has stepped way over that line!

Rippa

3rd Sep 2007, 20:46

No Robert, it is not. Acctually it is safe enough to say that it is way worse it was a year ago...that is why I am trying to get the hell out of here :sad:(I am Brazilian, but I am not blind).:=
Rgds

ATC Watcher

3rd Sep 2007, 20:46

Atlaw, do not shoot at the wrong target, it is not PBL who mentioned “ self loading cargo , Lawyers and other clowns “ , it was A310 driver.

You seem upset to be associated with clowns, I can understand that but I can understand as well what A310 was trying to say. Neophytes in aviation have a tendency, when confronted with an accident, to see conspiracies everywhere and deny simple basic facts. . This is human nature I guess.

Nobody here is trying to make up your mind for you or to mislead you away from the truth. Some of us have knowledge you do not have and are trying to educate persons like you, that unfortunately, as you rightly said, can send us to jail for a long time because they had formed a wrong impression. The Linate trial after the Ground collision there is a prime example of this.

You are at least honest and put in your profile who you really are : an attorney in Brazil involved with that case .
This is for this reason that I am still here, talking to you. Some could say wasting my time, but I have been there before.

I am glad you are here talking to us, because maybe I can convince you of something : Nobody , not any pilot, not any controller that I know of would willingly put the life of others at risk. Circumstances, are putting people in a position to do great harm, but the conditions leading to those actions are never simple , because multiple.

Focusing on the Flight level issue, or on the 2 Americans pilots , is, in my opinion totally wrong, but perhaps this is where the FAB wants you to look at. Blame 2 foreign pilots and 4 low rank controllers , so that 154 people died because of single human errors, so that the whole system is safe. Humans errors is like people not doing their jobs. Send them to jail and Brazil is safe. End of the story.

Never look at how the ATC system is programmed, what it shows to controllers when something is odd, what is the real, actual radar coverage above the area in question, and what is the quality of the radar returns,. Do not question the authorities that put a transfer of communications between 2 major ATC centers in a zone of known lack of VHF coverage, and of radar coverage ( at least from Brasilia ) .
Never ask how your national manufacturer, Embraer put a PRIMUS avionic suite in their aircraft so badly programmed, that a foot rest or a wrong input can switch the transponder off, make it invisible to TCAS and do not warn the pilots about it.

I could continue the list, but I thing you got my point by now.

If your aim is to learn the truth, then ask those questions, BEFORE, there is plenty of time afterwards to determine the percentage of responsibility for each player.
But for us here, the professionals in this forum , the aim is not to see people blamed. The aim is to make sure the Brazilian authorities understand what is wrong , change the procedures and the systems accordingly , in order that a collision like this one never happens again in Brazil.

I rest my case.

bubbers44

3rd Sep 2007, 21:09

Until anything new comes out of this investigation on why two airplanes at the same altitude flew into each other on the same route in opposite directions in controlled airspace we should stop repeating ourselves. Wait until something not already discussed is revealed to continue with this thread.

pa.000.blo

3rd Sep 2007, 23:51

PBL said:
please let's keep this thread factual and on-topic.

bubbers44 said:

Until anything new comes out of this investigation on why two airplanes at the same altitude flew into each other on the same route in opposite directions in controlled airspace we should stop repeating ourselves

poorwanderingwun, a310driver,
That is what I did mean. I will keep my mouth shut.:uhoh:

PBL

4th Sep 2007, 06:31

Folks,

I restarted (reprovoked?) this thread on 21 August (post #1177) after a couple weeks silence (since 7 August) and a longer silence (essentially since 21 July).

I posted on 21 August because we have done some analysis of the accident from public information, and because I am concerned about the legal difficulties of 2 U.S. pilots and 4 Brazilian controllers. And I said so.

What then transpired has been eye-opening. We have been joined by three declared Brazilian non-pilots (indeed, two who are self-declared attorneys and one who is married to an attorney).

Of these three, just one engaged in technical discussion. But his repeated denial of the facts of air traffic control, and his attempted questioning of material in the Factual Statement of last October from NTSB/CENIPA, as well as his ad hominem comments, left little apparent room for genuine discussion. I suspect that he had an agenda that he was not sharing with us; Marciovp suggested what this agenda might be in his post #1253.

But he did introduce some important text (unfortunately without attribution). Marciovp told us this text came from the report of the CIP. The reason the text is important is not that is is fault-free, but precisely *that it contains reasoning that is alien to people familiar with air traffic control*. This is an governmental legal document which is making public the way that the Brazilian government sees ATC and aviation, and its reasoning appears to be at variance with international standards on ATC procedures. This is *hugely important*.

Does anybody have a copy of the entire document that they could share? I am e-mailable, and I do read portuguese.

One Brazilian amateur pilot has joined us and has contributed to technical discussion, and has made some decisive interventions (for example, identifying the source of the document above). One Venezuelan and one Spanish contributor have joined us but not yet contributed to the technical discussion.

There have been a large number of posts explaining the basics of air traffic control, and the contract between pilots and controllers. Since this is repetitive, and to many of us stuff that we have known for many years, some of the more technically-minded, aviation-experienced people are signing off.

This is a difficult discussion for a number of reasons. One reason is that there appear to be differences in what is acceptable in discussion protocol amongst various contributors. A second is that the difficulties that, on the one hand, pilots and air traffic controllers and, on the other hand, the Brazilian legal establishment seem to be having with each other are coming to the surface.

I propose that that is a good thing. Let's think of this discussion as an experiment in testing the persuasive strength of arguments. (In places in which the word does not have a perjorative meaning, this is known as rhetoric. Yes, logic is a part.)

The pilots of N600XL are in difficulties; the controllers are in difficulties; the first thing that possible helpers have to know is, in detail, what sort of reasoning is putting them in those difficulties. This kind of inquiry is not for everyone - I can quite understand if some people sign off - but I can assure people from personal experience that the best legal arguments are constructed on the basis of knowing *exactly what the other side is claiming*. That is why the CIP document, in portuguese, is so important.

I don't see any way that discussion can be easy. One first task for those concerned with the fate of the 6 participants is to understand where Sdruvss was coming from. His stance appeared irrational and stubborn to those familiar with the procedures of air traffic control, since he seemed to be comfortable denying established fact, but he was assuring us that many thought like him, and he is, obviously, not without legal experience. So let's simply believe him when he says he represents the many.

The question is, then, how is one to prevail with argument in a milieu in which everyone thinks and argues as he did. Now, he gave up and went away. Why? Is it because he finally could not answer the arguments presented to him (which is what I suspect), or is it simply because he felt outnumbered? If the latter, then we haven't necessarily found out what arguments would prevail in a forum consisting of all the people that think like him.

But it is crucial to helping the 6 participants to know that.

So, how to move forward? I am going back and deleting all my posts since 21 August that did not contribute persistent, pertinent information. I invite all serious discussants to do similarly with theirs.

Somebody with access please send me the CIP documents.

PBL

lomapaseo

4th Sep 2007, 08:51

PBL
I applaud your willingness to help streamline this discussion to pertinent points supported by facts.

I wonder if it might be a lot quicker if a mod would simply delete all posts in the last two months.

PBL

4th Sep 2007, 09:14

I wonder if it might be a lot quicker if a mod would simply delete all posts in the last two months.

Assuming you are half-serious:-

No, because then we would lose some crucial information on how this situation is being handled in Brazil.

PBL

ATC Watcher

4th Sep 2007, 09:41

I will also be against removing all posts, because it would be depriving us of the opportunity to discuss with persons like Attlaw or Sdruvss, and of the information they give us : the attitude of the judiciary and perhaps of the public in Brazil.
It is for me interesting to see how prosecutors , judges and lawyers are making up their minds on sometimes rubbish information they received from local " experts" , Some are ready to start a trial ( like this judge in Mato Grosso last week , see below a newswire extract ) and this BEFORE the official technical investigation is even completed and published.

----------------------------------------------------------------
MATTO GROSSO STATE, Brazil - A Brazilian air traffic controller accused of making errors that led to that country's most deadly plane crash last fall refused to answer questions about the crash during his criminal trial Tuesday.

"I will use my right to stay quiet," he said repeatedly during more than 20 minutes of inquiry in front of federal Judge Murilo Mendes in Sinop court.

He is the only one of the four controllers on trial charged with intentionally exposing an aircraft to danger, which has a sentence of 34 years in prison.

The other three, were charged with unintentionally exposing an aircraft to danger, which carries a sentence of 1 to 3 years in prison. They are all officials with Brazilian Aeronautic, the military unit that runs the country's air traffic control system.

Testimony began around midafternoon yesterday and continued late last night
---------------------------------------------------------------

poorwanderingwun

4th Sep 2007, 10:48

Yet another classic example of why I have no patience with people who demand that this or that persons/countries' laws/customs/beliefs deserve 'respect'.... repect is not just given, it has to be earned and the proceedings following this tragic event are doing little except bringing shame and derision on Brazil and its mlitary and civil institutions.

marciovp

4th Sep 2007, 16:37

House CPI
http://www.gabeira.com.br/noticias/noticia.asp?id=4170

Senate CPI
http://portalamazonia.globo.com/noticias.php?idLingua=1&idN=53525

PBL

4th Sep 2007, 17:19

Marcio,

thanks for the news reports. Have you found the original CPI reports anywhere?

Our Brazilian lawyer/lawyer spouse colleagues have apparently gone back and deleted *all* their posts, including the contentful ones, including especially the one from Sdruvss which cited the CPI report, which I held to be important.

If anybody needed more evidence that more things were going on here than meet the eye, this provides it.

I recommend to everybody who posts here in future to cite carefully and fully the statements to which you respond. Then the posts which remain will show the development of the discussion through the citations.

PBL

Larry in TN

4th Sep 2007, 19:48

There seems to a be assumption from the non-pilot Brazilians in the forum that an altitude clearance applies to only a segment of a flight. i.e. until Brazilia. I'm not sure that this incorrect assumption has been clearly debunked.

Unless specific qualifiers are added, i.e. "Cross Brazilia at FL370, then descend and maintain FL360.", then an altitude assignment is in force until amended. It is completely normal to have a situation where your altitude assignment is planned, and expected, to change later in the flight. The flight, however, DOES NOT change altitude until told by ATC to do so.

It is also not unusual for non-standard altitude assignments to be used. They are used when factors such as traffic conflicts, aircraft performance limitations or weather conditions prevent using the standard altitude or make using it undesirable (i.e. turbulence). There are also areas of airspace where non-standard altitude assignments are, in fact, standard. The majority of the state of Florida in the US is one such example where they segregate altitudes based on North vs. South instead of East vs. West due to the geography of the state. A pilot who is not familiar with the area will not necessarily be aware of the local differences.

The bottom line is, you don't change altitude until told to do so by ATC.

mm_flynn

4th Sep 2007, 20:52

The Brazilian non-pilot position I think is slightly different.
to paraphrase their position:
1 - In Brazil the rules/expectation are that the flight will move to its flight planned altitude without communicating with ATC - contrary to what everyone else in the world seems to do.
2 - ATC are so ingrained in this expectation that even though the flight checks in at FL370 with a planned descent in the next few minutes, ATC wouldn't mention the expected descent while confirming current cleared level.
3 - ATC wouldn't look (or would expect a 'casual' descent) so the fact that 7 minutes after Brasilia the plane is still showing level at FL370 wouldn't cause ATC to contact the plane or to note anything on their strip.
4 - Compliance with this expectation is such that it is reasonable for the computer to updated the display of planned/(cleared?) level without any controller action or data from the transponder
While this may look like an absurd interpretation of how flights operate in real life (from my North American and European perspective) it might be possible that Brazil operates way outside ICAO norms in terms of ATC/Pilot interaction:confused: If so this would clearly be a big factor. If its just a bo**cks view of the non-professional, it just brings us back to the question of what was going on in the ATC processes that let this happen.