Wrong weight entry … again [Archive]

White Knight

8th Jul 2010, 18:09

At a former carrier we had a system where we sent runway and weather info via ACARS and we got a piece of paper back with the speeds on it. We entered the speeds in to the MCDU and away we went. That carrier has been operating FBW Airbus since they entered service in about 1988 and to my knowledge there has never ever been a single entry error for take-off weight. No laptops - they are bull**** imho. Somebody elses idea of a clever way to introduce a lot of work for very little return and the potential for huge errors with potential for catastrophe.

The VS incident was via ACARS and not laptop:hmm: - read the AAIB report

I've said it before and I'll say it again, why does the loadsheet not have V-Speeds on it, it would give an additonal cross-check. Seems simple really.

Loadsheet is from load control - they have bugg#r all to do with performance calculations.. And there are so many variables - it's not like a turboprop or small jet where you can just pull a booklet out and flip to the relevant take-off flap and weight page.. Performance calculations should be SOLELY up to the crew!!! Just be careful with your numbers and don't rush...

White Knight

8th Jul 2010, 18:11

Quote:
Originally Posted by fjordviking
Why the error? It´s called MFF(Mixed Fleet Flying). Virgin have both A340-600 and A330-300
[...]
When you sit in the cockpit they are very similar, hence the MFF.
Surely the number of donks on each wing would give just a small clue in this case ?

Or do you just walk down the airbridge into the cockpit without ever looking at the outside of the plane these days ?

See how easy a typo is? Fjordviking means VS fly 340-600 and 340-300 (not 330-300). Same number of 'donks' on each wing infrequentflyer789..

jimpy1979uk

8th Jul 2010, 19:05

Just a techy update on this, both Honeywell and Thales, the FMS suppliers for Airbus are working on versions of their FMS systems in which one of the improvements will be a feature that secures take off performance. It basically introduces a rough error check to prevent such large errors being entered into the FMS.

I think both are due for certification next year and whilst newer aircraft it will involve just software updates some slightly older FMS installations will require some hardware and the software changes and on the really old Airbus FMS systems a complete retrofit of the system will be required.

jackx123

8th Jul 2010, 19:36

Virgin have both A340-600
MTOW 368 tons, and A330-300 MTOW 275 tons

That's really troublesome that the Pilots in this case cannot tell the difference between 346 and 333 :}

jackieofalltrades

8th Jul 2010, 21:43

@Jackx123

@ fjordviking
Code:
Virgin have both A340-600 MTOW 368 tons, and A330-300 MTOW 275 tons
That's really troublesome that the Pilots in this case cannot tell the difference between 346 and 333 http://images.ibsrv.net/ibsrv/res/src:www.pprune.org/get/images/smilies/badteeth.gif

Like White Knight alluded to earlier, Virgin don't have A330s. It was a simple typo!

protectthehornet

8th Jul 2010, 21:51

FWIW:

we knew how much fuel (pounds), how many people (which we multiplied by 200 pounds) and the BOW (basic operating weight of the plane). So, in our humble minds we put them all together. Then we flipped our little vspeed FLIP BOOK to the weight we came up with. We set our tri to the green band...just guessing mind you and we waited.

Across the ACARS came the W&B calculations, v speeds, trim, optional reduced power and runways.

Our flip book was already set to the right weight...it was a nice little system...(the pax times 200 took care of belly luggage)

PT6A

8th Jul 2010, 22:00

Just to clarify, Virgin use an ACARS system to calculate the required speeds prior to takeoff. This system is provided to them as a partnership of SAS and Navtech.

It provides a few screens to input data on the MCDU and then it is transmitted to a server by ACARS and then the results are sent back.

The system is also available on the Internet for use in the event ACARS is U/S. It is not a laptop based system.

PT6A (below is a sample from the ACARS)

G-VFOX 08JUL10 22:04 V3.3.6
A340-642
EGLL/27RFULL

000/00 +15C 1013
DRY RUNWAY
RW 3884 CW 77 SW 0
AC-OFF A/I-OFF
SYST OK

CONF 2 FULL THRUST
CLIMB 400.0
OBSTACLE 400.0
FIELD 400.0
STRUCTURAL 368.0

ACT TOW 360.0
MAX FLEX T=48
V1 - 149
VR - 168
V2 - 179
ACCL ALT STD 1600FT

NOTE:

TODC END

chimbu warrior

8th Jul 2010, 22:36

I'm with TyroPicard.

This is not a computer problem. This is not an Airbus problem (it has happened on Boeing too; SQ B744 at Auckland in 2002).

I'd even go so far as to say it is not a mixed fleet flying problem.

This is a problem with crews not having a rule of thumb, or gross error check in their heads. To me, that shows a lack of awareness of your aircraft, and far too much reliance on automation (of all types).

Getting the figures done by someone else (load controllers, dispatchers etc) is not a solution, it is merely an attempt to shift the blame in the event of error (they are human too).

Get back to basics, and focus clearly on the task at hand.

Sqwak7700

9th Jul 2010, 00:38

This is a problem with crews not having a rule of thumb, or gross error check in their heads. To me, that shows a lack of awareness of your aircraft, and far too much reliance on automation (of all types).

Getting the figures done by someone else (load controllers, dispatchers etc) is not a solution, it is merely an attempt to shift the blame in the event of error (they are human too).

It is not that simple Chimbu. Have you considered that maybe the procedures are so complex and attention-grabbing that no-one has any extra capacity to catch gross errors. Have you ever seen the video with the people passing a basketball around and you have to count the bounces and passes? It is a really good example of task saturation and how you can miss the "elephant" in the room.

And I'm not suggesting to include others in order to apportion blame but merely to have someone else with different set of distractions as a safeguard.

I'm merely asking has this type of incident occurred at a carrier with a dispatcher system in place, or does it at least happen less frequently? Only trying to find a solution. "Just don't do it again" type solutions have been proven to not work - otherwise we would still be flying around with long memorized checklists, no GPWS, and no gear warning systems.

goldfish85

9th Jul 2010, 01:14

I dunno,

It happens once, I'll call it pilot error.
It happens two or three times, I'll squirm a little and still call it pilot error.
It happens five times, I'll start to question pilot error.
It's happened more than that. Maybe, just maybe there's a problem here.

Now you all understand, I've never made a mistake in an airplane.

The Goldfish

jackx123

9th Jul 2010, 06:32

So the question is: How does one become a captain? Hmmmm can it be experience :confused:

Well let's assume it is experience how the F**K can't you tell 100t difference.

Say the a/c burns 7-8t per hour and you should at least have a vague idea where you're flying to and the time it takes. Is it 2h or maybe 10h? Oh no just go ahead and blame it on some box in the middle - very amateurish that may cost human lives

stilton

9th Jul 2010, 06:50

Have to agree with M Rat,

These laptops and their use to compute take off performance in the cockpit under tight time constraints seems to be a consistent weak link and an accident waiting to happen.

Especially with Crews operating similar types with significant gross weight differences.

In the US, most Major Airlines including the one I work for have dedicated 'load planning' departments that compute the take off numbers then data link them to the FMC.

After double checking the numbers for reasonableness we then accept and load them into the FMC.

It's been a pretty good system with the advantage of using a dedicated department of load planning specialists (with double checks of their own) in a spacious environment working with a lot more than a laptop balanced on their knees with a few minutes to push..

It seems a little ironic, that with all of the emphasis on performance in the theoretical examinations for the UK and JAR licences that under that system most of these disastrous take off miscalculations have been made.

:ugh:

haejangkuk

9th Jul 2010, 06:56

Is this misinformation or disinformation? A Virgin crew succumbing to such mistakes? The way I hear from the expats over at KAL, it can never happen because they are such astute operators. It can only happen in KAL, Dynasty......Virgin, EK, CX? .........never!!! Must be some kind of sick joke or wind up.

wetbehindear

9th Jul 2010, 07:01

Understand weight of the airplane ascertained by calculations and checked against calculations. Nobody looking at the actual physical thing.

Actually undercarriage is a very large scale , isn't it?

Coat,hat and hanger . Hello Mr. Pierrepoint.

Heavy operator

9th Jul 2010, 07:17

Just look at some of the people posting on here! You've got the likes of jackx123 who is spouting off and quite obviously has no conception of operating a heavy type such as the A340 but takes it upon himself to preach about rules of thumb and gross error checks.

Obviously he is trying to relate his experience flying something older and much lighter without having read the AAIB report. What can we expect next? Advice on cross controlling the A340 for crosswind landings? :ugh:

Also, there is all this hand wringing and tut tutting from various posters who, again, show themselves to be inexperienced in the operation of modern heavy jets but are quite prepared to cast blame and unwanted advice to those of us who do operate these aircraft. There are even spotters who mistakenly think the crew operate the A340-600 and the A330-300 when it is the fact that they operate the A340-300 and then we are preached to about "counting the number of 'donks'" to avoid the kind of error we are supposedly discussing!

Why can't you read the article and AAIB report and then discuss without all this amateurish speculation based on some ignorant Muppets getting the facts wrong. For example, where does it state that they used laptops to calculate their performance figures? Well, it doesn't because they didn't and Virgin don't.

The report states that the crew did not stick to SOP and this lead to the error not being spotted. No matter how "robust" the procedures are, not sticking to SOP can lead to this situation. Additional factors were mixed fleet flying between the bigger and heavier A340-600 and the smaller and lighter A340-300 as well as distractions and other pressures during a rushed preparation.

Can we please have the amateurs and others inexperienced in the operation of heavy jets stick to 'informed' observation rather than their presumptions and criticisms based on their anonymity and wet dreams of being a heavy jet pilot. Gross error checks are part of the normal SOP but in this case they weren't followed which allowed a gross error to get into the system. No laptops were or are used at Virgin as it is an FMC/ACARS system and if you don't know what that is then you shouldn't be commenting on here as it just shows you to be a wannabe wet dreamer!
:rolleyes:

Jetjock330

9th Jul 2010, 07:29

We fly A332/A333/A345/A346 as MFF and there are a lot of weight differences and ranges, including speed and the cockpits look very much the same, including 500 and the 600. That being said, I know of a few cases where the correct weights have been calculated, but incorrect fuel has been uplifted which is also a problem. Example, pilots uplifted 43.8 tons instead of 48.3 tons, a difference of almost 5 tons (an hours flying in A330) short. Speeds were good, but fuel was wrong!

In another case pilots have uplifted trip fuel instead of flight plan fuel on the A320, only to have an embarrassing chat to ops about where to land enroute for a technical stop.

The list goes on and on and all the mistakes have slipped through the system design to catch it, but it didn't. Human Factor is a natural problem, which makes us infallible. We need to slow down and have time catchup with us!

Most companies require pilot to individually calculate the take-off figure and then compare the figures, including the green dot speed. But when chased for time, we work over the other guys shoulder, cross communicating the weights being used or weather and hence we are doubling up on the wrong information and will have a problem.

BOAC

9th Jul 2010, 07:46

The report for those who wish to read (http://www.aaib.gov.uk/cms_resources/Airbus%20A340-642,%20G-VYOU%2007-10.pdf)

fjordviking

9th Jul 2010, 07:52

Thanks for calling me spotter. Like whiteknight pointed out, typo on the A330-300, meant to write A340-300.
Having flown a meager 6000 hrs on the A320/A330-200/A330-300/A340-300/A340-500, having done the MFF/CCQ on all the variants I know it`s not that easy always to have that built in warning lamp in your head come on when an unusual number pops up for one type. That number was perfectly valid on the type you flew on your previous sector.
I`m human, I do make mistakes, but luckily most of them do get trapped.

Fjordviking

Capt Groper

9th Jul 2010, 07:57

springbok449

9th Jul 2010, 08:15

I believe that there is more to this incident that what is being told...

The VS SOPs for performance are pretty rigid and idiot proof if you follow them, strict adherence to them was highlighted after a couple of incidents in the past...

ExSp33db1rd

9th Jul 2010, 09:16

Just be careful with your numbers and don't rush...

Another thread has questioned whether we rely too much on computers, it doesn't matter if you call them FMC, ACARS etc. same problem.

One of my early Flt. Nav.instructors told me to stop trying to do a maths exam in a rattling steel cabinet, i.e. Big Numbers, Rule of Thumb, then refine as necessary, it's like using an old style Slide Rule ( remember them ? ) one had to know where to put the decimal point,i.e. have a pretty good idea of the answer before asking the question.

Think navigation has nothing to do with this ? same philosophy, check, then re-check, ( and on the Stratocruiser the navigator worked out the take-off calculations anyway ! )

It all comes down to the fact that Mr. Murphy is always with us.

Fatfish

9th Jul 2010, 09:19

These three stand out
1) Rushed for time
2) Sluggish, Lowered the nose. TOGA??
3) Airbus. Designed by engineers for engineers. :O

johan_jnb

9th Jul 2010, 10:04

and one more... fact that landing weight inserted into TOW field.

MoodyBlue

9th Jul 2010, 13:41

Answer to the problem = An automated Xcheck. We cannot go back to the RTOW paper charts so why not make the best usage of automation.

The computer system used, either a cockpit BLT/LPC/OIS or that used via ACARS needs to have a sub routine working in the back ground. This routine should know the usual average TOW for the airlines sectors (a simple summation program) and if there is a significant variation to that on the day then display a warning screen.

Such a system exists and is operational at the airline I work for. It's even better: it compares the TOW that's inserted into the (ACARS-based) performance system with the last known TOW in the loadsheet-system. If the difference exceeds certain thresholds, a warning is added to the message.
No system is gonna be foolproof, but this seems like a fairly straighforward way to catch this kind of error.

BusDriverLHR

9th Jul 2010, 15:14

jackx123
wrote:
So the question is: How does one become a captain? Hmmmm can it be experience

Well let's assume it is experience how the F**K can't you tell 100t difference.

I'm gonna go out on a limb here and guess that you don't fly commercial airliners. Am I right?

Discorde

9th Jul 2010, 15:45

Forty years ago, BEA (as it then was) converted some of their Vanguard 4-turboprop airliners into Merchantman freighters.

Part of the conversion refit included fitting mass transducers into the three landing gear legs. During pushback, a switch was operated which gave a read-out of TOM (masses summed) and CG position (main gear sensed masses compared to nose gear sensed mass).

On at least one occasion the system saved an embarrassment (or worse) when the pallets had been loaded in the reverse order compared to the load sheet, giving a CG outside the permitted envelope.

Could not mass transducers be fitted in today's aircraft, with the sensed total mass data inputted directly to the FMC? Gross errors would show up immediately.

safelife

9th Jul 2010, 16:59

Such sensors have been built in to modern aircraft as well, but have been deactivated as airlines found the sensed weight would often be considerably over the load sheet weight.......

pineridge

9th Jul 2010, 17:49

Safelife said.....................
"Such sensors have been built in to modern aircraft as well, but have been deactivated as airlines found the sensed weight would often be considerably over the load sheet weight......."

Surely you jest, Sir.

heavy.airbourne

9th Jul 2010, 18:01

No, he's not. There is no safest course of action anymore, but for management there always is a cost saving way. :eek:

BEA 71

9th Jul 2010, 19:10

Discord, I remember very well another occasion when STAN saved
us from embarrasment. A load-controller ( big-mouth ) had made a
considerable mistake which was discovered as soon as the Merchantman
moved. Although corrective action was taken immediately and there was a happy end, I wished for all my airline life that all aircraft were fitted with something like STAN.

BEA 71

Ex Cargo Clown

9th Jul 2010, 20:17

To reply to an above post, it would not be difficult to have a system where TOW, Rwy and Temp from automated METAR retrieval could then calculate V-speeds and put them on the loadsheet as one last, final gross error check.

Yes I know that MEL items, flap settings, anti-ice etc will alter take-off settings, but it would be better than this situation at the moment.

The technology should be there, it shouldn't be relied on, but would be a little like the third AI.

milsabords

9th Jul 2010, 21:18

As a naive observer, I'm amazed that these ac can take off when the weight has been so much underestimated.
It means to me that they may have large built in safety margins.

sunbird123

9th Jul 2010, 23:35

I think that there are too many distractions in the modern cockpit.
Too many people coming in with papers to sign which breaks the routine of the crew. They then try to do more than one item at once to get back on schedule.
Data entry has always been a problem not just with airlines.

Dairyground

9th Jul 2010, 23:45

I'm surprised that this thread has reached the third page before someone raises the idea of calculating the expected time to V1 (or ideally some lower speed) and rejecting the take off if you are not going that fast by that time. The idea was mentioned independently at least twice in the MEL incident thread.

Some people thought it a reasonable addition to the procedures, others implied that it was just another straw on an already overloaded camel at a particularly busy time.

As an afterthought, getting to the monitored speed (half V1?) too soon could also catch the case where half the fuel has been left behind.

Roger Greendeck

10th Jul 2010, 00:47

Just a thought. If the calculations are correct and the engines are working as advertised then the aircraft should accelerate at a certain rate. Would it not be possible for the FMS to provide the crew with a time to say 80 kts based on what they have entered. Start the stopwatch at breaks release and if there is a significant discrepancy then the take off can be aborted rather than have an 'oh sh@t!' moment after V1.

Whilst there are many that believe rules of thumb should be enough I think that the combination of significantly different: loads, fuel, ambient conditions, and runway lengths that exist for long haul ops combined with the comparitively small numbers of take offs per month per pilot, means it is unrealistic for the crews to detect an error based on the 'vibe and the Mabo'. As was mentioned above, once can be put down to pilot error, but this seems to be happening regularly enough to consider it a systemic problem.

Busbert

10th Jul 2010, 01:46

Essentially the issue is a matter of increasing complexity in an already complex system.
The FLEX/RTOW take offs are a means of safely borrowing from safety to increase system efficiency by saving fuel and engine life by only using as much as you need.

This is an effect of added technology, and it introduces a level of coupling such that the outputs in terms of V speeds and flex temperature are not necessarily obviously wrong, as the variables involved make it intractable to get a simple rule of thumb.

I was dismayed by the AAIB suggestion to use EVEN MORE automation and technology.

Ironically some airlines use a simple error trap in the RTOW calculations so that it will spit back an error message on ACARS if the TOW from the pilot is less than the MZFW. In this case it would have worked, as would the previous case in MEL.

As was the case of the BA B744 in JNB, the coupling is very tight on takeoff, so I admire and respect any pilot that can get the aircraft safely off the ground in these conditions.

If is easy to point the finger of blame to the unfortunate pilot who may have contributed the proximal failure in the 'chain of events', but this is a systems accident that has manifested itself repeatedly, and is a function of the system and the relentless trade off of throroughness for efficiency.

Discuss

Sqwak7700

10th Jul 2010, 02:49

Our freighters have the mass / balance sensing struts and it is a great backup to the load-sheet numbers. Our procedures say that we have to re-check the pallets if we are more than 3% off the computed TOW or CoG. This is rare, but occasionally happens. It is usually a ramp issue (not very level), I have never seen it be the loading.

I would imagine that with passengers the airlines don't want to scrap the standard weights because they would loose out on revenue. I ask you, how many American adult males weigh 180 lbs?

Obviously, a weight sensing system would have to go hand in hand with accurate loading (ie, weighing passengers) which is easily done - the technology is used for bags when it comes to making passengers pay for extra luggage weights.

Payscale

10th Jul 2010, 05:48

Sunbirb123
Thats what went wrong in MEL, to my understanding.

Too many engineers with techlogs, fuelers with fuel slips, cabin crew with sandwiches and coffee groundstaff with bloody walkie talkies, dispatchers with load sheets with LMCs. All wanting the Captain attention and wanting an on time deaprture..

EK has changed since then, but still not very sterile. Engineers can fill out the log in silence and dont talk on mobile while doing it..
Send the fuel slip with the engineer
CC should stay away until called for.
I dont need to see the ground staff.
Let me sign the load sheet electronically

Now let get down to the business of briefing.....

fo4ever

10th Jul 2010, 06:27

Payscale:

AMEN

PJ2

10th Jul 2010, 14:06

Sunbird123; (post #48)

I think that there are too many distractions in the modern cockpit.
Too many people coming in with papers to sign which breaks the routine of the crew. They then try to do more than one item at once to get back on schedule.
Data entry has always been a problem not just with airlines.
and,

Payscale; (post #53)
Thats what went wrong in MEL, to my understanding.

Too many engineers with techlogs, fuelers with fuel slips, cabin crew with sandwiches and coffee groundstaff with bloody walkie talkies, dispatchers with load sheets with LMCs. All wanting the Captain attention and wanting an on time deaprture..

EK has changed since then, but still not very sterile. Engineers can fill out the log in silence and dont talk on mobile while doing it..
Send the fuel slip with the engineer
CC should stay away until called for.
I dont need to see the ground staff.
Let me sign the load sheet electronically

Now let get down to the business of briefing.....
From the FARS:
(a) No certificate holder shall require, nor may any flight crew member perform any duties during a critical phase of flight except those duties required for the safe operation of the aircraft. Duties such as company required calls made for non-safety related purposes as ordering galley supplies and confirming passenger connections, announcements made to passengers promoting the air carrier or pointing out sights of interest and filling out company payroll and related records are not required for the safe operation of the aircraft.

(b) No flight crew member may engage in, nor may any pilot in command permit, any activity during a critical phase of flight which could distract any flight crew member from the performance of his or her duties or which could interfere in any way with the proper conduct of those duties. Activities such as eating meals, engaging in non-essential conversations within the cockpit and non-essential communications between the cabin and cockpit crews, and reading publications not related to the proper conduct of the flight are not required for the safe operation of the aircraft.

(c) For the purposes of this section, critical phase of flight involves all ground operations involving taxi, takeoff and landing, and all other flight operations conducted below 10,000 feet, except cruise flight.

Note: Taxi is defined as "movement of an airplane under its own power on the surface of an airport."

The decision to make the sterile cockpit on the ground a priority has already been partially made at some carriers. At a former company, it was policy that the F/A's did not interrupt the cockpit preparation until the time came for the briefing, which was signalled by the captain. Many times the briefing to the In-charge F/A took place in the cabin, prior to boarding the passengers and before cockpit preparation.

I don't think the same policy applied to maintenance, fueler, load-sheet acceptance, extra cockpit occupants such as regulatory (check) personnel, maintenance personnel (for test flights) etc. Each of these groups has their own time schedules and needs and usually have to be at other places quickly - those needs have been permitted to override the need for a undistracted cockpit preparation and have thus made our reaction to such interruptions almost automatically accomodating, - it is "part of the job of being an airline pilot to manage distraction", we are told. And to an extent, that is true. One key is necessity.

Most country's aviation regulations provide for some requirement for the sterile cockpit.

However, as indicated by the bolding Para (c), the rule does not apply in perhaps one of the most critical "phases" of flight, cockpit preparation for departure.

Here, the commercial priority of an on-time departure is privileged over the orderly preparation of the cockpit.

Constant interruptions such as MEL resolutions, F/A briefings/passenger issues) are permitted and supercede the need for the same sterility these regulations provide for in the air.

While the most important priority is the accurate preparation of the cockpit, commercial priorities are understandable as are the decisions from the captain on various dispatch matters which must be resolved prior to departure. The intent of any policy or regulatory provision and therefore future recurrent training regarding would be to provide for an orderly cockpit preparation without interruption, (from sitting down/adjusting seats and turning on the IRSs, to the completion of the takeoff briefing and including FMS entry of preliminary load data and the emergency briefing).

The objections and cited problems, and we can think of a number of them, will be based solely upon commercial and economic priorities, not flight safety priorities. Commercial priorities cannot be dismissed but must be instead accomodated. MEL items must be dealt with and sometimes they will even be a part of the cockpit preparation. Such issues must obviously be dealt with; the notion is "minimal distraction/interruption" - complete sterility is not likely possible.

At present, anyone with the need and who is not provided with at leasst some guidance regarding such cockpit interruptions, feels free to do so without further thought.

I doubt if some form of regulatory intervention would come about without strong airline lobbying but to my knowledge the issue has never been described or addressed in any formal way by any of the usual advocacy groups. Perhaps it is time?

PJ2

Old and Horrified

10th Jul 2010, 17:19

My guess is that the fact they were taking off from a very long runway at LHR with a lot of flat ground around may have had something to so with it. It could a been a very different result elsewhere.

Feeding in the wrong data is a very bad mistake and should have been caught. But the bit I find astonishing is that an experienced crew (Captain with over 16,000 hours) just watched the aircraft barely stagger into the air and didn't realise that something was (almost catastrophically) wrong. Why on earth did they not firewall (or TOGA or whatever it is called nowadays) the throttles? Are we in a situation that aircrew have so much trust or reliance or dependance on the computers that they are scared to over ride? As an ex pilot (DC-10, not Piper) and infrequent passenger I find that quite terrifying.

heavy.airbourne

10th Jul 2010, 23:05

Too many here do not know nowadays airline ops!

1. "time to V1" or alike: Airbus offers MFF as an integral part of the package. You can mix every type from A318 to A346, you derate/flex T/O power according to Wx and RWY (resulting in differing acceleration rates but similar weights), you even can flex a derated T/O, you fly maybe only 6-8 legs per month with approx. 1-2 legs as PF, and then somebody really expects the pilots flying to feel the correct acceleration or s.th.? Get real!

2. "sterile cockpit on ground": There's the rub! 40 minutes to prepare the a/c for the flight w/ 10 minutes before the SLF arrives, incl. outside check, tec log, booting the EFB and setting it to mode 2 and connecting and calibrating it, finding out why the wind data just won't load in the FMC, catching the bugs in the data bases (EFB/OFP/FMC), finding the difference between routing MUCCCU6 in the FMC and the routing MUCCCU6 in the OFP (or: hey, why is BGTL planned as an ETOPS alternate on Saturday), searching for the waypoint xyz13 from your flight plan to find that it has been renamed to zyx31 (on the 31st NOTAMs page) so you can find it in the FMC, now ordering missing meals from catering, a lavatory needs to be cleaned again, the flight control center wants to know why you stopped boarding so you have to call back (or have to decide not to) and explain that boarding while fueling with only one airstair is illegal (glad you caught that), now try to order a 2nd airstair, but the number is occupied (again), while you are listening in on the de-ice freq to catch the righ moment for your request (or reckon the right moment to ask for your airway clearance etc. etc.) - I give up. Does anybody who knows airline ops really wonder why pilots might miss s.th.? Really? :ugh:

PJ2

11th Jul 2010, 01:32

heavy.airborne;

If you read my post carefully, you will understand that I never stated that "sterile" on the ground would be easy or even doable - I said that it had never been addressed as it has while the aircraft is under way. I proposed some approaches because it is in this period that preparation errors can, as we have seen, lead to serious consequences and I acknowledged the problems with such solutions, which problems are primarily commercially driven as you have clearly demonstrated. "On time" is not a flight safety priority; "Ready" is. Commercial priorites are important and the balance between the two is achievable if it is managed well and supported with airline policy as I mentioned above. I am trying to open a dialogue here.

Why do you suppose this kind of error continues to occur and what's your proposal to resolve the issue?

I really don't know why I bother here anymore.

PJ2

ExSp33db1rd

11th Jul 2010, 06:16

heavy.airborne

Sounds like you need a Flight Engineer !

( glad I always had one )

Capt Groper

11th Jul 2010, 06:28

HEAVY.AIRBORNE has provided just an average workload situation. There are too many tasks to accomplish, with many added due to computerization and electronic documentation.

2. "sterile cockpit on gound": There's the rub! 40 minutes to prepare the a/c for the flight w/ 10 minutes before the SLF arrives, incl. outside check, tec log, booting the EFB and setting it to mode 2 and connecting and calibrating it, finding out why the wind data just won't load in the FMC, catching the bugs in the data bases (EFB/OFP/FMC), finding the difference between routing MUCCCU6 in the FMC and the routing MUCCCU6 in the OFP (or: hey, why is BGTL planned as an ETOPS alternate on Saturday), searching for the waypoint xyz13 from your flight plan to find that it has been renamed to zyx31 (on the 31st NOTAMs page) so you can find it in the FMC, now ordering missing meals from catering, a lavatory needs to be cleaned again, the flight control center wants to know why you stopped boarding so you have to call back (or have to decide not to) and explain that boarding while fueling with only one airstair is illegal (glad you caught that), now try to order a 2nd airstair, but the number is occupied (again), while you are listening in on the de-ice freq to catch the righ moment for your request (or reckon the right moment to ask for your airway clearance etc. etc.) - I give up. Does anybody who knows airline ops really wonder why pilots might miss s.th.? Really?

To achieve an ONTIME departure there has to be a certain degree of short cuts. Accomplishing the above in 40 mins is impossible! Unfortunately added to this is a checklist which many crews just pay lip service to, i.e. checked, checked, checked, but actually not Xchecking the parameters correctly.

The checklist read and challenge procedure needs to be modified to avoid this lip service. For example the replier should nominate or state a setting/number and the reader should then also state the setting/number too and then say Xchecked for each checklist item.
This is the last line of defence!

PJ2

11th Jul 2010, 07:00

Capt. Groper;
To achieve an ONTIME departure there has to be a certain degree of short cuts.
We complain at times about management's parsimony in terms of safety but here is an area where we can have direct effect on ensuring an appropriate level of safety commensurate with commercial considerations. I say again, "On time" is not a flight safety priority; "Ready" is. I am fully cognizant of all the issues, distractions, demands upon attention which are stated by heavy.airbourne. BTDT many, many times but it is not an excuse for error, it is a reason for error.

I am fully aware of the demands made upon us by all and sundry during departure preps and have had to deal with most if not all of the issues outlined in the post at one time or another in a 35-year career starting with the DC9 and ending eight types later on the A330/A340. I am fully aware of calls from one's superiors about a late departure and the pressure to push back from everyone. But that certainly isn't the point here - the captain is the captain and can manage and direct actions, resources and priorities.

The point is, a sterile cockpit is a legal requirement after pushback; what about considering such during another critical phase of flight, cockpit preparation?

The only resistance to this idea seems to come from those who still put up with all the demands made by others in their cockpit and who consider on-time performance a mandatory requirement, when in fact it is not - it is a commercial requirement.

That doesn't mean one beligerantly ignores one's commercial responsibilities towards one's employer, nothing of the sort - this is a rational call for an examination of the question, including the question about why FMS entries continue to be a source of potential takeoff accidents.

PJ2

BOAC

11th Jul 2010, 07:55

PJ - I think I know you well enough to know that while this is an admirable target, you, especially after your time 'in the business' must recognise that it is unachievable in the world in which we live - akin to asking someone to move Mount Everest 2135m to the south.

Heavy has summed it up precisely. We have a very experienced and no doubt extremely capable Captain, as F/O, experiencing the familiar snowball effect. We all know how feeble it is when asked why you were 10 minutes late on pushback when the dispatcher said 'all was ready' (don't forget his 'on-time' bonus), and you try to explain the small discrepancy on the fuel uplift, the late toilet truck (F/O on radio trying to sort it) c/crew with a drunken pax, not enough orange juice - and then a new load sheet after all the prep is done - and not one of your immediate managers can understand why you got a bit screwed up. Their actions after brakes off on the runway may well bear scrutiny by the company but to change the 'day in the life' of a crew before push-back requires a total re-write of the way commercial aviation is done. Even if we adopt the US style of dispatcher here and off-load ALL non-flight orientated stuff to them, who is going to make the command decisions that inevitably crop up and will affect the actual flight once you have left the tower of babel?

I think the only solution is to get a major shift away from this paranoia of 'on-time' departures (with all the ensuing problems for slots/stands etc) and lift some of the pressures. Back to Mount Everest?

Cee of Gee

11th Jul 2010, 09:17

Discorde,
Is this the kit you were referring to?

http://i47.photobucket.com/albums/f176/CeeofGee/th_DSC01073.jpg (http://s47.photobucket.com/albums/f176/CeeofGee/?action=view&current=DSC01073.jpg)

Should have carried Loadies - They never make mistakes!!;)

C o' G

Discorde

11th Jul 2010, 10:10

Similar, but more compact, consisting of the two readouts (mass & CG) & the operating switch between them. SOP was to check it during push-back, preferably orientated crosswind to minimise any aerodynamic biases. We knew the kit as STAN (as BEA 71 pointed out), but I can't remember what the acronym stood for. However, somewhere in my loft I've got the manuals for the Vanguard ground school . . .

heavy.airbourne

11th Jul 2010, 14:09

PJ2

:uhoh: Please, stick with us. You are absolutely right, and I just tried to show how bad it has become.

This industry has been moving in the wrong direction for 20 years. Overworked, untrained, incompetent, or missing personal everywhere. I did not complete one uninterrupted cockpit preparation in 10 years. The professionals here all know about it. I am glad to hear that I am not alone with my criticism, as sometimes it seems that I am the only one complaining where I am working now.

The dialogue needs to be taken to other places, but then the issue becomes a lot broader: competition is killing safety! And who should we talk to? "Our" companies? By speaking up I just got me an unofficial check ride. Authorities? Those agencies supposed to overlook and regulate this industry by allowing it to become what it is today? Come on, they will forfeit their chance for a well paid position on the board or a job as a consultant by stepping on an airline's toes. Politicians? :} Those people who think that confiscating a pilot's Leathermen is enhancing security? They still have not understood that pilots need sleep...

Willit Run

11th Jul 2010, 17:26

The companies I have worked for have made just about every mistake in the book; but we always try to learn from them and take corrective action in SOP's.
Why in the world would you show only 40 minutes before departure knowing full well that you will be rushed and interupted and knowing the result if you can't stuff ten pounds of crap into that 5 pound bag?? Thats why we show at the plane 1 1/2 hours before. I know its not possible everytime to do that, but for gods sake, at least an hour! If you're late, your late! So what, you won't get fired! Maybe management will get the messege!

We have our co-pilots read the ZFW to us, from the W&B sheet, while we enter it into the FMS. We compare the fms weights to the flight plan. I as a personal thingy, try and guess the V2 from the weight on the flightplan. A big discrepency will catch my eye. Crap into the computer , you know the answer. SLOW DOWN! There is only one guy who signs the flight release.

ExSp33db1rd

11th Jul 2010, 22:00

.....Why in the world would you show only 40 minutes before departure .....

because it's all part of the Flight Deck Duty period - or whatever it's called these days, and to arrive an hour and half earlier reduces the total sector length that can then be flown, some operators take advantage of that - believe it or not.

I once worked for an owner who wanted to fly a long trip, which was just outside the legally permitted Duty Period, so he asked me to roster 2 crews, one to arrive early and do all the aircraft checks,flight planning, Met, and loadsheet duties, then the second crew would arrive just as the aircraft was ready to close the door and start, they would slip into the seats and wind up the engines, only having been on duty for 5 minutes, which would make the long flight possible without an additional 'slip' crew halfway along the route.

No, I'm not going into more details, history now, and of course it didn't happen - unless it happened after I had resigned ! - and this wasn't in my ExS. days but comparatively recently, in what one had hoped were more enlightened times.

That company is no longer in business.

RevMan2

12th Jul 2010, 06:02

Why do procedures have to be "robust"? And why are processes always "in place"?

poldek77

12th Jul 2010, 07:40

To reply to an above post, it would not be difficult to have a system where TOW, Rwy and Temp from automated METAR retrieval could then calculate V-speeds and put them on the loadsheet as one last, final gross error check.

Yes I know that MEL items, flap settings, anti-ice etc will alter take-off settings, but it would be better than this situation at the moment.

Just wanted to come back to that idea - it looks that VFS speed is rather independent of these RWY and obstacle factors. What if we have it (VFS) printed on the loadsheet? Would that be enough to help us to catch such a discrepancy?

Meikleour

12th Jul 2010, 09:45

STAN = Sum Total And Nosewheel

justvisual

12th Jul 2010, 16:01

If it doesn't look right it probably isn't. Look at the engine instruments and make sure it's right....you don't wanna die...

PJ2

12th Jul 2010, 19:46

BOAC;

As always, thanks for a frank and thoughtful response. Yes, I know there's a bit of Don Quixote work here - I think the key, if any, is as you say, I think the only solution is to get a major shift away from this paranoia of 'on-time' departures (with all the ensuing problems for slots/stands etc) and lift some of the pressures. Back to Mount Everest?
We board an hour to 45minutes before departure and usually its just enough time.

Given that, I have more than once delayed departure due to distractions including some pretty fundamental MEL items which took the combined efforts of Dispatch, maintenance and a lot of my time to sort out the complex operational requirements. Thankfully that doesn't happen very often. That said, getting an overseas flight ready in less than an hour in the cockpit can be challenge and yes, the contractual/duty day provisions do have something to say about how early one is aboard.

Regarding the delays I decided I would take over the years, while respecting the job they had to do, in the end it did not matter to me what others on the ground wanted/demanded/needed for their own timings, reports or processes. One doesn't do this without very good cause, I will add! "Ready for flight" was my only criteria for releasing the park brake. I have happily taken responsibility for the delay (that's the captains' job) and when either he called or I did, I explained the problem to my superiors; My superior's support was not the issue nor was it important or needed; he would not be the one in the oak chair responding to the hard questions - I was not asking permission to do what I did but I was providing an explanation for the delay so that if necessary he could respond in turn to his superiors and perhaps address some of the issues which caused the original delay. I realize however that many distractions and resulting delays can't be avoided or sorted out and that it's just the way things are. The key point then, as stated, is managing distractions such that they don't cause errors in preparation. If a delay is needed to do that, so be it. Asking for a completely sterile cockpit during departure is, admittedly, asking to climb Everest... ;-) - PJ

Heavy.Airbourne;

Regarding how our industry has changed and how our profession has been allowed to atrophy under commercial pressures, de-regulation and now the disappearance of the regulator - your remarks are superbly stated.

In fact, in the broader scheme of things, it is because of these very issues that I stated the matter of sterility on departure so strongly - if we are to be responsible for the safety of flight, (and we are!), then the time has come for us to take back those actions which we have permitted to be taken away from us and that make our flights as safe as possible. The time has come for those who manage the books and dispense marketing promises to our customers without regard for the complexity of the tasks at hand, to realize that the only real fundamental is, within practical reason, the safety of flight. The two go hand-in-hand - perfectly safe means staying on the ground - perfect commercial responses, meaning profit at all cost, means flight safety is being compromised. I think as flight crews we have a great deal to offer in balancing those two objectives so that our employers can remain in business both by keeping realistic promises and by preventing accidents which can (and have) put airlines out of business.

Thanks for your response.

PJ2

Dairyground

12th Jul 2010, 23:50

perfect commercial responses, meaning profit at all cost

But those costs include paying insurers enough for them to provide you with a new aircraft from time to time and compensating grieving relatives.

Those last bits of the total cost seem to be ignored by many of those obsessed with counting beans.

JPJP

13th Jul 2010, 01:17

PJ2,

Thank you for your measured post. It is obvious that "this isn't your first rodeo" ...

The same concept applies to the 73NG. The door doesn't close until the briefing and checklist are complete. Prior to that the 'V Speeds' and weights are crosschecked between ACARS data and the flight release.

Indeed, this is easier said than done. However there is a certain satisfaction to it all; Ground crew radios squawking, gate agents hovering and tug drivers attempting to establish comms. Smile and meticulously complete the briefing and checklist.

Explaining the compliance with your companies procedures to your Chief pilot is remarkably simple. Depending on the company your results may vary ;)

PJ2

13th Jul 2010, 02:41

Dairyground;
Those last bits of the total cost seem to be ignored by many of those obsessed with counting beans.
Yes. That acknowledged, it is true that active safety programs are rewarded with reduced premiums. (This assumes that the underwriters are competent, or hire un-interested competency, to assess whether said safety programs are a box-tick or are actually resourced and used effectively by the carrier.)

I wonder if "ignored" really means "no time to understand xxx well"?

One of the mistakes I made in conveying safety information was assuming too much on the part of those to whom the information was addressed. I even sensed that, but it was difficult to convey a clear picture of a complex operational safety problem while at the same time ensuring understanding. Often "I'll see it when I believe it" got in the way of communication.

Getting senior management's attention for a sufficiently long period of time and sustaining interest long enough to deliver the message was definitely a challenge. Even some of the spreadsheets we made were claimed to be too complex to understand although to us they were very straightforward and clear, though financial spreadsheets seemed to fall to hand quite easily...

I don't think too many managers or beancounters intentionally ignore safety information. Rather, I think they don't understand it or its importance and, perhaps viewing the organization through "bureaucratic glasses", see the "safety department" as another impediment to "productivity, process and progress", (now, given the necessary tension between operations and safety, that's exactly what it is and it should never be cozy!). In an organization focussed on costs, it can be too easy to dismiss concerns expressed in various reports because, after all, where are the accidents?

Management positions in the safety department are sometimes viewed as backwaters with little possibility for advancement and so may not always be taken seriously. Depending however upon how strongly the organization's CEO feels about safety and its importance, mid-level managers may behave in a way that is contrary to the interests of SMS. Budgets and defending one's department's expenses is a far more powerful motivator than any safety information one gets on a monthly basis. If one can escape "flak" from one's boss, knowing that the CEO's priorities are costs and productivity, one will do so with little thought. If the CEO sends out the message that inappropriate risk and safety violations will not be tolerated, you may be sure that the organizations senior and mid-level management will make this their own priority because they know they have the support (and the job security) of their leader.

The actual ignoring of safety information, (knowing there is danger, but ignoring it), is rare, and implies what Diane Vaughan called, "amoral calculation" - an intentional dis-interest in safety information that will increase costs, cause delays or require re-design of processes or components. She also coined the term, 'normalizaion of deviance' which is the result of such "ignoring" - one just points to the lack of untoward outcomes when standards are reduced and declares that the new, lower standard is acceptable. I think there is ample indication that very few within an organization behave in this manner but instead feel as though what they are doing is exactly the right thing and do not see it as increasing risk. As discussed in Vaughan's book, this is what the normalization of deviance does within an organization.

This is quite a "black-and-white" description of a far more subtle and complex process, but the nature of the process is at least suggested here.

JPJP;
Explaining the compliance with your companies procedures to your Chief pilot is remarkably simple. Depending on the company your results may vary
Yes it is. There is essentially nothing further to say in the conversation when approached in this manner. Results may vary on the one side in terms of impatience, anger or harrassment but they are always the same on the crews' side - an airplane ready for departure.

PJ2

mustafagander

13th Jul 2010, 10:43

OK guys, I fly long haul and ultra long haul so we may have a bit more time to work it all out.

When flight planning we have an assumed TOW upon which the flight plan hangs. After ordering fuel we head for the aircraft and collect a provisional load sheet at the gate. We then calculate the T/O data from the manual.

The guts of it is that we do all our performance calcs based on this prov load sheet. After it's all buttoned up we get a final via ACARS.

Now, the final ACARS TOW MUST be close to the provisional. If not, why not?

That's how we work and it has yet to let us down. If the TOW at flight planning is very different from the final ACARS, why??? Sort it out!

Dan Winterland

13th Jul 2010, 19:40

In the world of safety, we had CRM which became TEM - which is all about trapping the threats as they arrive. The wrong weight in the T/O calcs is one which recurrs frequently. To my knowledge, it's only the MK crash at Halifax which has caused fatalities - mercifully, it was a freighter and the fatalities were small in number. It's now time the industry looks at a solution to the problem before a large number of passengers are killed.

There are problems with the current techniques. I have personally seen the 100 tonne error twice - both trapped at the planning stage. And in one of the companies, the SOPs were changed partly as a result of our ASR. But this company apparently still has problems. (VS!)

My current company uses ACARS performance, we input the figures into the FMGC in one format, then into the ACARS in a different format - and the two systems don't crosscheck each other. It takes a lot of concentration to make sure mistakes aren't made. And with all the usual distractions - it's difficult.

I'm actually suprised that there aren't more.

BEA 71

13th Jul 2010, 21:16

Apart from common sense the old " better safe than sorry " rule should
apply. It served me well. Taking shortcuts of any kind can be fatal.
When asked to " bend the rules " in a non-safety matter by my boss
I just told him to give that in writing. He never asked again. When I
read all this I wonder how we got flights out on time without having
calculators or whatever, doing " manual " loadsheets and trimsheets.
During peak-times three at a time. Excellent company training was
one of the reasons why we were able to achieve this. There was one
training course called " corrective procedures ", one of the most
valuable courses. Any trainee I had under my wings was not allowed
to use any of these " fancy " aids until I was satiesfied with their work.
Adding machines only to check the " grand total ". They hated me for
that, but they became good load controllers. Not that I condem the
new technology or say everything was better, but the basics have not
changed.

BEA 71

framer

14th Jul 2010, 01:07

But those costs include paying insurers enough for them to provide you with a new aircraft from time to time and compensating grieving relatives.

Those last bits of the total cost seem to be ignored by many of those obsessed with counting beans.
OK then, how about legislate that accidents involving only one aircraft are not insurable against. Would that shift the companies perspective on flight-safety? (I'm not sure if thats a really dumb idea or a really good one .)

411A

14th Jul 2010, 13:58

In our small company, on time departures are only achieved when one, and only one individual is completely satisfied that all required tasks have been completed to their satisfaction...and that one individual is the Commander.
Company management does not interfere in this arrangement...ever.

A simple and satisfactory solution.
NB.
Type, L1011

PJ2

14th Jul 2010, 15:13

411A;
on time departures are only achieved when one, and only one individual is completely satisfied that all required tasks have been completed to their satisfaction...and that one individual is the Commander.
Company management does not interfere in this arrangement...ever.
Yep. That is the only way to run it and reclaiming the commander's authority and responsibility is exactly what I meant by my first post on this - "On-time performance is not a flight-safety priority, 'ready-for-flight' is".

This doesn't mean that "on-time" isn't important. It's just less important than a satisfied captain who manages commercial pressures from everyone else and still departs with an aircraft ready for flight.

This approach legitimately deals with the commercial pressures and bureaucratic/administrative pressures, removing the tendency to rush or push-back "on-time" just to avoid the call or to keep a station's "flawless" record for the month.

It is a fact that crews have released (and continue to release) the park brake prematurely to get an ACARS time-out. This tactic to get an on-time departure while finishing the cockpit check is a direct response to the pressure to push-back "on-time" no matter what.

This "technique" has caused accidents, including door-removals, and injuries to ground personnel from aircraft rolling at the gate while the crew, who has released the park brake to send an ACARS "time-out" message assuming the chocks are still in, is distracted by the rest of the cockpit check and can't see the motion.

The inappropriate pressures for "on-time" extend to areas that passengers rarely contemplate. I have even had calls from the station after departure asking us to revise the departure time for them; (Who here hasn't had one of those calls?)

To put this "on-time" priority nonsense into perspective, most delays are shorter than a wait in a Starbuck's lineup for coffee, (or insert the name of your favourite coffee/pastry shop). People willingly wait 20 minutes in line for coffee!...or on the phone listening to elevator music while their favourite understaffed internet service provider or phone company tells us we are important and makes us wait. I doubt if any passengers let alone a significant number of our customers are looking at their watches and tapping their fingers/toes.

What IS needed when a bit more time is needed for cockpit preparation is a quick announcement from the cockpit at departure time, giving the necessary information about any short delay. Such an announcement is respectful of BOTH oneself/one's crew, and the customer's time and need for information.

In fact, most complaints I have heard are not because the customer's airplane hasn't left on-time; - it is because no one from the cockpit tells them anything after departure time has come and gone.

Silence is not golden here; a brief announcement manages one's time effectively while at the same time fulfilling the commercial responsibility of telling one's passengers what's going on - that's all people want - information, and safety.

This is a response we can all provide which does not interfere with the preparation of the cockpit. Of course 411A, your 'passengers' don't have watches! ;-)

A simple announcement is one more important key to managing the pressures from everyone who wants you to go "on-time" and it makes it easier, along with the other very good reasons offered by others here, when explaining a delay to your superior.

And if one's superior doesn't like the explanation and gives one grief, either take it higher in the food chain or take it to the air carrier's POI, or if you must, file an Air Safety Report, (which must be dealt with by SMS safety processes and of which the regulator gets a de-identified copy).

I know that in many countries this process does not work and has little support from ignorant bean-counters and/or an out-of-touch senior management with a skewed set of priorities. In these cases the incident/accident rate will remain the same or get worse.

PJ2

JW411

14th Jul 2010, 15:35

What on earth happened to 'ISH'?

For my non-English friends 'ISH' means "roughly, approximately, nearly or in the same ballpark". (EG: we will meet in the bar at 1800-ISH).

For example, a DC-10 would burn 9 tonnes (18,000 lbs) "ish" per hour. You could safely say (except in the case of a a very distant alternate) that the trip time from the computer plan multiplied by 9 should be the total fuel required including hold and diversion (because the burn at the beginning when you are heavy would be 18,000 PPH but, after 10 hours of cruising would be down to 14,500 pph).

The BAe146 was a 2 tonne aeroplane. You neede 2 tonnes per hour to cruise and needed 2 tonnes to take care of holding and diversion. Therefore, a two hour flight needed 6 tonnes of fuel.

So, 'ISH' prevents gross errors.

I personally do not even like using a calculator. (I would only ever use one to calculate the third decimal point).

We have all reached the checkout at Sears in Santa Monica to be challenged with a $2000 bill by the not-too-bright individual at the checkout and who cannot see the difference between a socket set and a sit-on tractor.

Awareness of TOW was a big deal when I joined Fred Laker's airline. We all wanted to get paid at the end of the month so we knew that we could just make it from LAX to LGW in a DC-10-10A at the moment that the 250th seat was sold ('ISH' give or take 10 seats depending on the wind) otherwise we were into dear old Bangor, Maine for a crew change.

So, we had a pretty finely honed conception of MTOW.

Then we got DC-10-30s.

Now this was quite a different beast. The DC-10-10 was a London -New York aeroplane whereas the DC-10-30 was a London - Los Angeles aeroplane. Fred Laker spent an absolute fortune (at the CAA's behest) making the cockpits as identical as was absolutely possible.

As best as I can remember, the only difference in the cockpit was 4 greens instaed of 3 greens.

Of course, there was a huge difference. The DC-10-10A (CF6-6-D1A) came out at a MTOW of 455,000 lbs (normal domestic DC10-10 was 440,000 lbs).

The Laker DC-10-30 (CF6-50-C2B) grossed out at 585,000 lbs MTOW.

(Historically, the original DC-10-30s had an MTOW of 558,000 lbs. This was not enough for some customers so a major redesign of the wing brought it up to 572,000 lbs. To me, it is particularly interesting to note that the redesign actually only added around 100 lbs or so extra to the structural weight).

The KC-10 started off at 595,000 lbs.

What point am I trying to make?

Well, just as VS operate vastly different A340-300s and A340-600s, we did exactly that with -10s and -30s.

I simply do not remember such a gross error happening to any of my colleagues.

Can I please invite us ALL to get back to 'ISH'.

JW411

14th Jul 2010, 16:06

Further to 'ISH':

I might have already related this story some years ago on pprune and so I apologise to those of you who have already heard the story but there are probably just as many young 'hi-tec' heroes out there just waiting to make a huge mistake that it is probably worth re-telling.

The crew assemble at JFK to fly to LGW. The captain has not been long in the left seat.

The computer plan calls for a fuel load of something like 137,000 lbs.

Good old flight engineer says "Doesn't sound enough to me". First officer agrees. Young hero gives his crew a lecture about how we are now into the era of computer flight plans and how they are generated through Continental in LAX and the UK Met Office in Bracknell so we are now talking exact science and not guesswork anymore.

Well, the F/O and the F/E decide that there is little point in arguing with God's gift to aviation and there isn't a flight safety problem, so off they go.

By the time the get north of Bangor, Maine the F/E shows the man the fuel howgozit and there is no way they are going to make it to LGW.

Now we get into some great decision making.

Having got himself into this situation, he could have redeclared Shannon as a destination. Who knows, he might have even got closer.

Anyway, he decided to divert to CYQX (Gander to those who have never been there) to pick up more fuel. As they went through 10,000 feet in the descent, the F/E pointed out that they are going to be 20 tonnes over MLW!

And so it was that they dumped 20 tonnes on the Grand Banks in order to pick up 30 tonnes of fresh fuel.

What a wonderful commercial decision.

So, what actually happened? What was the original cause?

It really was incredibly simple. At the point where young Lochinvar was regaling his 'ISH' crew with a lecture on the fantastic ability of a modern computer flight plan to get everything EXACTLY right, he completely missed Line 2 on the flight plan which stated:

B707

and not

DC-10

40&80

14th Jul 2010, 17:30

Murphy was pleased when they also killed off ISHs friend Airmanship and replaced him with Management Bull****.

ExSp33db1rd

16th Jul 2010, 23:16

I doubt if any passengers let alone a significant number of our customers are looking at their watches and tapping their fingers/toes.

Once announced a 30 min delay which spread to 60 mins.

In flight, pax complained that he had previously flown a well known European airline, the citizens of which Country were well known for precision and efficiency, and that Capt. had announced a 45 min delay, and precisely 45 mins later the engines started - what was wrong with me ?

I explained that the previous Capt. had probably been ready in only 20 mins, but would have waited the full 45 mins. to prove the National ( and his ) point !!

JW411 - currently in Santa Monica on hols. I'll have a beer in the Kings' Head for you. ( when I leave Sears, need to upgrade my tool kit ! )

BOAC

17th Jul 2010, 07:59

PJ - unfortunately the 'on-time' management/bonus-driven culture is wide-spread. A few years back at LGW I was 'preparing' for 'ready-for-flight' with pax still boarding when I heard the forward (737) door slam shut and seconds later a harrassed purser rushed in to tell me the dispatcher had 'pushed' the last few pax in, shut the door in her face and was removing the jetty (aka 'on-time' for him/aka 'delay now down to Captain'). I duly vacated my seat, opened the door and summoned him back for 'a chat' - but that is what we were up against - and it messed up his 'Christmas turkey' I think:).

Green Guard

18th Jul 2010, 11:35

After the war it is easy to be a Minister of war...
Anyway....

When we talk about wrong V1 Vr and V2, would it not be helpful to check The Actual Acceleration till 100 KTS or any other bellow V1
against Calculated Acceleration in seconds.

It is not only weight that can lead to underspeed at V1 Vr and V2, but also:
change of wind,
engines' thrust bellow expected,
brakes not exactly off for one reason or another, etc. etc.

(or check the Acceleration even by INS or GPS etc. g-Force
if available perhaps like in (411A) L1011s)
:suspect:

PJ2

18th Jul 2010, 15:41

BOAC;
unfortunately the 'on-time' management/bonus-driven culture is wide-spread.
I know you know all that I'm about to say but I would like to offer a thought as I think the continued public discussion of this is important.

Our industry sells "time" and nothing else. So the pressure is natural understandably needs to be managed - that's the key point for the commander.

In practise, managing commercial pressures is part of what we do, just like everyone else in the chain of command. It is the balance that is the key. Experienced commanders already quietly do this without fanfare. The discussion here is important for those coming up for or who have just begun their first command either in an aircraft or on-board ship.

As a testimony to how well the industry legitimately-without-compromise works under such pressures, in almost all cases the issue being discussed is not a problem for crews and no incidents/accidents occur.

There are times, like your example, when the captain's authority to keep the park-brake set while things get sorted out and pointed out, should be exercised and the pressure to depart on-time set aside until it's appropriate to push-back.

Sometimes a reminder from the captain of who is in command is a good thing - in my view, for far too long we have let far too many personnel who will never sit in the oak chair answering the tough questions, have their say in our cockpits and have an effect upon our operation. It is a good thing to regularly draw the line where the law provides and requires.

Would that the Spanair MD82 captain (or even the F/O) in Madrid had done so.

We know that there are parts of the world where cultural behaviours and priorities do not permit this to work, and instead captains are routinely pressured by forces well outside of the cockpit to compromise flight readiness for time, MEL issues and so on. The fatal accident rate reflects this priority.

It is the regulatory authority who licences us and permits us to fly passengers, not our employer.

In the end, we provide a service under licence which has nothing to do with corporate priorities and everything to do with keeping the operation as safe as reasonably possible.

PJ2

Gretchenfrage

19th Jul 2010, 08:26

It is the regulatory authority who licences us and permits us to fly passengers, not our employer.

Nice, but naive. You tend to forget that in a lot of places they report to the same bosses, or at least share the same bed.

PJ2

19th Jul 2010, 15:09

Gretchenfrage;
Nice, but naive. You tend to forget that in a lot of places they report to the same bosses, or at least share the same bed.
No, the view is not naive. Did you read the entire post? That very point is acknowledged as is the accident rate for those countries in which the relationships you describe obtain. From the post:
We know that there are parts of the world where cultural behaviours and priorities do not permit this to work, and instead captains are routinely pressured by forces well outside of the cockpit to compromise flight readiness for time, MEL issues and so on. The fatal accident rate reflects this priority.
The comments are addressed to those for whom a normal regulatory relationship applies, and to those who may be just beginning their command, (which I also stated in a previous post). I acknowledged in a reply to BOAC that a fully sterile cockpit during departure is probably like "trying to climb Everest", but that doesn't invalidate the original point which is made thoroughly enough in the other posts in the thread.

ExSp33db1rd

19th Jul 2010, 20:49

unfortunately the 'on-time' management/bonus-driven culture is wide-spread.

On the other hand ....... departing from an Asian location, longhaul night flight to Europe, all ready, no problem. Despatcher advised that the wife of a neighbouring State V.V.I.P. Potentate was missing, presumed in Duty Free, would I log a 10 min. Tech delay ? Nope, crew, and all other pax., were ready to go, if you want a 10 min. Traffic delay, be my guest. Slight wetting of pants from Traffic, and his delay agreed.

10 mins later, repeat performance.

10 mins later I'd had enough, long duty period, other pax to consider, etc. get off, close door pls. Go.

Can't go without Mrs. Potentate. Yes I can. Can't go with Mrs. Potenates bags on board - Yes I can, don't think Mr.or Mrs.Potentate are security risk, my decision ( long prior to 9/11 ) pls. close door as you leave, now, thank you.

More wetting of pants, and then 2 black Mercedes slid under the nose, problem solved.

Yes, culture comes into it, sadly. I'd probably have been sacked, but I was near the end anyway, and equally it would have been a wasted gesture, those sort of people are going to ignore them like us anyway, 'twas always, and always will be, thus.

Might have made me feel good tho' !!! Unfortunately it would only have been a Battle I'd won, not the War.

dozing4dollars

8th Aug 2010, 05:06

After pushback, sids, runways, winds and conditions change. The take-off data has to be reprogrammed. The Before Take-off Check is the last error trap in the chain. The item, "Takeoff Data" is responded to on the Airbus in our airline with "FCU, FMA, PFD, ND, set." The Captain's response is "Reviewed and Set."
It's very easy to parrot this during taxi without really checking.

If you can't see yourself making the mistakes, I think you are more likely to make them.

fdr

9th Aug 2010, 09:34

Hi.... FWIW...

PJ: "Management positions in the safety department are sometimes viewed as backwaters with little possibility for advancement and so may not always be taken seriously. Depending however upon how strongly the organization's CEO feels about safety and its importance, mid-level managers may behave in a way that is contrary to the interests of SMS. Budgets and defending one's department's expenses is a far more powerful motivator than any safety information one gets on a monthly basis. If one can escape "flak" from one's boss, knowing that the CEO's priorities are costs and productivity, one will do so with little thought. If the CEO sends out the message that inappropriate risk and safety violations will not be tolerated, you may be sure that the organizations senior and mid-level management will make this their own priority because they know they have the support (and the job security) of their leader.

The actual ignoring of safety information, (knowing there is danger, but ignoring it), is rare, and implies what Diane Vaughan called, "amoral calculation" - an intentional dis-interest in safety information that will increase costs, cause delays or require re-design of processes or components. She also coined the term, 'normalizaion of deviance' which is the result of such "ignoring" - one just points to the lack of untoward outcomes when standards are reduced and declares that the new, lower standard is acceptable. I think there is ample indication that very few within an organization behave in this manner but instead feel as though what they are doing is exactly the right thing and do not see it as increasing risk. As discussed in Vaughan's book, this is what the normalization of deviance does within an organization".

Good summation PJ.

"Everyone thinks of changing the world, but no one thinks of changing himself". L. N. Tolstoy, (1828-1910).

IMHO, Aerospace "safety Culture" is fundamentally a myth. Safety is paid lip service at all levels, including a number of investigative organisations, (which have been politicised to the point of irrelevance).

For commercial enterprises, including operators and manufacturers, the same applies.

The institutional "systems" safety leader should be NASA (+ one assumes ESA & FRS...), given their operation at the edge of known technology. The lip service paid to safety review is evident to the lack of critical evaluation of systems prior to Apollo 1, Challenger, & Columbia. Between the last events, where one assumes that the soul searching following the loss of Challenger and the tightening of safety oversight existed for a period until corporate memory dimmed leading to Columbia is belied by the events of Phase 1 ISS, the NASA crews on MIR. In that time, safety was continuously compromised by the politicising of the task, including under reporting of risks and criticality of events, denying event occurrences, while providing little support to the first 5 increment crews.

NASA has a history of normalising abnormal operations where no loss of life actually occurred, consider the O Ring erosion issue, well identified before 28th January 1986, MIR fire(s) before Phase 1 increment 3 Kvant-1 module fire, loss of power, depressurisation, comms losses etc. Trivialising of a near miss between Progress and MIR was followed a few months later with a direct hit and a decompression of the station, and the loss of the just added Spektr module. Notable throughout this history is the sad fact that Safety Officers did speak out about the situations that they were aware of, and for their proactive input ended up in obscurity. In some cases, the usual response from an organisation facing embarrassment, the tried and tested activity of "shooting the messenger" has been engaged in.

"trending away from Goodness..."

Civil aviation... recall the engineer that blew the whistle on falsification of a certain US carrier who had falsified maintenance reports on MD80 Stabiliser Trim actuators.... he is still in professional purgatory. Having followed the regulatory mandated processes.

The MIR safety dissenters ended up in professional obscurity, as did the Challenger M-T dissenters.

Politics trumps commerce, trumps safety.

We are taught to act responsibly and truthfully, and report safety deficiencies. Guess what... that may be the ideal, and desirable, it is inconsistent with the reality of the real world. The organisations do what they can get away with within reason, and generally what benefits the managements continued tenure in management, ie being able to obfuscate sufficiently to avoid direct blame for their complicity with continued disregard of safety standards and duty of care.

FMS design, load sheet processes, and robust performance crosschecks will occur once the pain to management has achieved adequately large magnitudes. Not before.

In the meantime, the poor operator usually will continue to be barraged by conflicting schedule demands in the pre departure period, where generalised (ball park) values would have been readily available with just a little bit of common sense.

Excuse the rant...

SMS...
CRM...
EMC...
HF...

great concepts; management invariably fails to implement any of them into their own processes. For the guys/girls flying the line? keep up your skills and any process that retains SA, or gives the hairs on the back of your neck a fair weighting. Flying is fundamentally safe, it just is unforgiving of loss of situational awareness. Don't expect any acronym, however well intentioned, stopping you becoming a statistic.

Crews: "In the name of God, stop a moment, cease your work, look around you". Tolstoy.

Managers: "A man is like a fraction whose numerator is what he is and whose denominator is what he thinks of himself. The larger the denominator, the smaller the fraction". Tolstoy.