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Old 11th Feb 2008, 15:51
  #68 (permalink)  
alf5071h
 
Join Date: Jul 2003
Location: An Island Province
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This incident has many similarities with those described in the link below.
For those who believe that this was a minor incident, then consider if your biased perception might lead to a more hazardous position – “I know better, it’s not a real warning, no need to pull up etc, etc”. Of course you could share with us the secret of not suffering error in this type of operation.

Use of VNAV etc would overcome many of the problems (and open new opportunities for error), but this is not always an available solution – timescale and in some countries cost or ability to produce the procedure.
The crew can use defences; the use of the basic crosschecks, an altitude-range table, the required vertical speed, timing. All of these are on the chart – were they briefed, were they used? An NPA requires a good plan, a good briefing, and then an error tolerant operation involving crosschecking / monitoring. … are Captains good monitors?

The NPA and chart have opportunities for error. The use of overlapping range scales – the hazard of the DME displaced from the threshold. If GPS is used which range datum should be used? Will the threshold be visible at MDA in minimum visibility? Thus in addition to error in operating modern technology, crews are exposed to further opportunities for error during the procedure.

One critical issue is that MDA is not a safe altitude; it’s only a minimum altitude during the latter part of a correctly executed procedure; this strengthens the necessity to pull up even with an amber alert.
Although an operator’s procedure for an EGPWS ‘amber’ alert might only require ‘an adjustment to the flight path’ (certification terms to differentiate from a red pull up warning) the adjustment can and should be a climb. EGPWS alerts a situation where there an error has occurred (crew, ATC, procedure, etc), which has led to a reduced safety margin; the crew are unlikely to know why this has occurred, so climb and start again. Being visual with the runway does not guarantee safety particularly if you don’t start for a safe position – note the hazards of poorly defined obstacles or an illusion.

Ref EPGWS events and analysis.
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