Air NZ crash ruling 'superficial'
Air NZ crash ruling 'superficial' | Stuff.co.nz
By MICHAEL FIELD - Stuff
A ruling by French prosecutors that an Air New Zealand crash was pilot error, is superficial and unreasonable, one of New Zealand's leading forensic engineers and independent air accident investigators says.
Seven people died when the Air New Zealand Airbus A320, in the process of being handed over from a charter to German carrier XL Air, crashed into the Mediterranean off Canet-en-Roussillon in the South of France on November 27, 2008, killing five New Zealanders and two Germans.
Private accident investigator Andrew McGregor of Auckland based Prosolve Ltd, says the French investigations to date are alarming for what they missed.
"It is easy to blame the pilot, but I would delve a bit deeper and suggest that humans often get the blame over a machine," he said, adding that the human error could be the result of a systemic issue in the Airbus operating system rather than with the crews of individual planes.
A criminal manslaughter investigation has been underway in France along with a formal crash investigation by the Paris-based Bureau d'Enquetes et d'Analyses (BEA).
Yesterday a French deputy prosecutor, Dominique Alzeari, told a press conference in Perpignan that based on their assessment of the BEA's preliminary report the Airbus had performed "an inappropriate test, in unsuitable conditions, with a manoeuvre carried out in an unprepared manner, which made it all the more perilous."
A decision by German pilots Norbert Kaeppel, 51, and co-pilot Theodor Ketzer, 58, monitored by Air New Zealand Captain Brian Horrell, 52, was termed "human error".
The French judicial report, written by aviation legal expert and pilot Claudine Oosterlinck, said that when the plane was at 600 metres and stalling, the pilots opened the throttle.
The plane remained unstable and climbed almost vertically 300 metres before diving over 1000 metres and hit the sea at about 500kmh 20 seconds later.
Mr Alzeari said the accident was not due to the aircraft design, nor to the regular maintenance which was overseen by the Airbus company.
"It was an aircraft that was working properly and was correctly maintained and its design was not called into question by the investigators."
He noted that the aircraft had been repainted just before the flight by Perpignan's Europe Aero Services Industries (EAS).
When it left EAS two of three external sensors essential for the plane's computerised flying system might also be partly to blame for the crash.
Two of the three sensors were not working and thus the excessive pitching "could not be corrected by the electronic brain of the aircraft," he said.
That could be "linked to cleaning operations" on the plane the day before the crash, but he said that "the accident is not due to a maintenance or design problem of the aircraft."
Aviation industry insiders, some with senior Air New Zealand connections but who wished to remain nameless, have suggested that French investigators were always anxious to blame foreign crews while clearing the French manufactured Airbus and the French maintenance firm.
Mr McGregor said the preliminary BEA report was superficial and did not address many aspects which normally feature in a comprehensive international air accident report. Often such accidents can be caused by a whole series of defense breaches and it is not always possible to determine a primary cause.
Despite implicating the pilot and the low flying, there was no evidence in the judicial or BEA statements as to why the plane had failed and crashed.
"There appears to be a lot of criticism about the pilots not conducting the flight tests at 10,000 feet instead of 3000 feet, and this may be a fair criticism," he said.
"But what we don't know is that if they had conducted it at 10,000 feet, whether or not the crash would still have occurred, because we don't have sufficient information.
"We don't know whether an extra 7000 feet would have been enough for them to recover if the same problem occurred."
He said he would want to understand what caused the loss of control because the information available suggested it was not simply a case of being at low level.
"I am not convinced that that was the cause of the loss of control. We don't know why the pilots lost control. It is unlikely to be a lack of skill; they were quite experienced."
He said it was clear the pilots were all highly experienced.
"It is pretty hard to blame the pilots and give credit to the machine with that kind of experience onboard."
Airbus has a highly computer-controlled aircraft and Mr McGregor said investigators should be looking at the man-machine interface.
He said there was no evidence the French had used the FDR and CVR to simulate the accident flight on an Airbus simulator.
"What I would do in the simulator is put myself in the shoes of the pilot and try and replicate what he did and note the problems and issues he experienced along the way, without benefit of hindsight," The preliminary BEA report does not mention this being addressed.
Mr McGregor said his views on superficiality of the preliminary BEA report was shared among many in the aviation and investigation community.
Human error may rest not with the pilot, but with others such as those who designed the aircraft.
"It may be a systemic error, something deeper than an individual pilot making a mistake.
"There maybe a systemic problem affecting all these machines."
Mr McGregor said the question of possible faulty sensors had not been properly considered by the French BEA preliminary report.
"We need to hold judgment. It is unfortunate that the preliminary report isn't more comprehensive than it is," he said.
"We don't know very much at the moment."