PPRuNe Forums - View Single Post - NYT: How Boeing’s Responsibility in a Deadly Crash ‘Got Buried’
Old 25th Jan 2020, 00:12
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MechEngr
 
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Originally Posted by OldnGrounded
This is drifting way off-topic. This thread is supposed to be about alleged whitewashing of Boeing's share of responsibility in the cited 2009 AMS crash.

Also, we're in the deja-vu-all-over-again realm where some folks simply insist that the MAX crashes were substantially due to pilot error. It's fine for those who want to believe that to do so, of course -- everyone is entitled to her or his own opinion. However, it should be recognized that virtually everyone and every entity responsible for aircraft certification, around the world, has agreed for nearly a year that the MAX, as it was introduced and initially flown, had engineering/design defects sufficiently serious to justify its grounding, for many months. And grounded is where it is now. The blame-the-pilots narrative has been overwhelmingly rejected.
You will note that I've started the blame for the pilot side with the airline, the relevant CAA, and finally with the pilots who rejected training for the Ethiopian crash. I just remain puzzled and saddened that in the case of Lion Air, one pilot repeatedly responded to adverse trim by eliminating the trim problem and keeping the plane on speed and altitude while the other pilot seems to have been transfixed with the idea that making the ever increasing amount of trim stop was sufficient. As if he didn't notice the trim position was changing and instead just wanted to keep the trim wheel from moving all while the control loads were going up.

As to whitewashing, that is a bad thing. OTOH airlines failing to perform due diligence is also a bad thing. They had access to all 737 accident reports and could certainly quiz the maker about their approach to avoiding similar accidents.

So why did the Dutch Safety board give in? They are independent of the FAA and the US NTSB and not obligated to Boeing. In no way does the NY Times article explain how the Dekker report got buried.

The human factors concept for alerting pilots or training them, in this case, is flawed. Had either system gone with dual sensors or some other scheme to prevent an adverse result there would have been zero benefit to a distracting alert of the pilots to the discrepancy and therefore no human factor to be considered. It's far better to avoid involving humans in performance decisions. This appears to be what Boeing's software changes did and there were no more RA failure related crashes. LIke MCAS, the manufacturer problem isn't failing to train or alert pilots, it's not recognizing the potential combination leading to a bad outcome.

Let's face it - there are human factors engineers at Boeing. Bunches of them. Yet not a peep from them complaining that MCAS ran on a single sensor and that pilots would certainly crash the plane if that sensor misreported. At least so far - maybe there are more emails, but my experience with human factors engineers is they are outspoken on all sorts of things.

What it really was was a failure of Systems Architects, a relatively new and somewhat toxic addition to engineering. This bunch of hand wavers sit between management and promises made to customers and the actual engineers and are responsible for creating the performance specifications for the hardware and software. Which is exactly where flawed software like MCAS gets born. The good SAs are great - Kelly Johnson of the Skunk Works was one. Anyone living in PowerPoint land? View with great skepticism.
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