We discussed it before, and this accident pisses off the judge big time because it had 3 very simple ways to be (likely) avoided. Any single one of this 3 things would've probably prevented it from happening:
-If the crew would've made sure the flaps and slats were out. But, as humans, we are all entitled to make a mistake once every 10 years. This would be the "fault" of the pilots, as they were trained and required by the SOP to do it. But then again, all it takes is a second of distraction to "skip" or "missunderstand" or "screw up" setting one item in the checklist.
-If the SOP demanded a TOWS test (and/or the crew actually performed a TOWS test). This would be the "fault" of the airline for not "insisting" on the test to be made. Hopefully, the crew wouldn't have made the additional mistake of "forgetting" this other item as well as the flaps.
-If the TOWS would've been working. But, like anything electrical (specially 30 years old designs), if it's not overly critical (otherwise the airplane couldn't physically fly), it's entitled to fail at any time. Hopefully, it can be re-designed to be more reliable or to be more easily diagnosed. This would be the manufacturer's "fault". But the manufacturer had already advised that the only way to be (somewhat) sure the system is operative ... is to test it right before its use.
So everybody is "at fault" yet nobody is "at fault" for doing something majorly wrong knowingly. Spanair claims they were never told about the change in SOPs recomendations, Boeing claims they told everybody to never trust the TOWS 100% and constanly check them and the pilots thought they had followed the checklist and thought they had actually set the flaps/slats. If they are proven not to have been overly distracted and to have performed the TOWS check in the previous flight from Barcelona, then it's a case of a single, "reasonable", unlucky, mistake.
Everybody thought they were doing the right thing yet none of them did 100%.
Seems that this cheese was small in size but had plenty of really tiny small holes aligned ...
Last edited by justme69; 14th Oct 2008 at 15:45.