Asiana flight crash at San Francisco

[james ozzie]

Capt Kremlins earlier comment on the approach lighting:

As far as I know, the approach lighting structures are arranged so the that the whole lighting array is coplanar with the runway surface. Hence if you hit the lighting, you are already at or below the runway surface level.

[junebug172]

Taildraggers are a fine alternative, but I was thinking of Asian carriers who might be looking for the cheapest possible way of developing and maintaining stick and rudder skills in a workforce that has no access to GA opportunities.

That's not their goal and its not what they want. They want pilots who fly profiles and nothing more.

[junebug172]

Then perhaps, if the airline has the route structure, "long haul" crew members should be given short haul assignments on a regular and continuing basis? 2 months long, one month short?

The aircraft they're on are long haul aircraft and moving to short haul means a different aircraft. You can't hop aircraft types and routes are bid on by seniority which you don't violate.

And before a debate on the complexities of such an approach (pun intended) begins, if the skill in visual approaches is perishable, but necessary, then a bit of effort overcoming "complexity" might be worthwhile. Otherwise, it's an exercise in "you can't get there from here", which solves nothing.

Does it cost more to accomplish? Yes? Not going to happen. Not unless its mandated.

In an occupational field where high flying hours is regularly touted as a badge of high skill and experience, isn't it a bit embarrassing to admit that the long haul folks, usually very high hour crew, have the least recent and refreshed skill in a very basic maneuver that is a requirement for even a Sport Pilot License - a visual approach?

Ironic, isn't it.

[ross_M]

As far as I know, the approach lighting structures are arranged so the that the whole lighting array is coplanar with the runway surface.


I'm no expert, but I doubt that.

[yarpos]

I guess if we have gone from why a 777 appears to have been flown into the ground to pointing out details of landing gear configs on GA aircraft and gliders, maybe the thread may have run its course until more real info becomes available.

[ross_M]

1. Hours are not a good measure of experience, thenumber of landings is.


I was thinking of that too!

Maybe, instead of 10,000 hour pilot we ought to be taking of 2000-landing-pilot etc.

[james ozzie]

Ross m:

The ICAO Annex 14 states "The system shall lie as nearly as practicable in the horizontal plane passing through the threshold..."

hence the reason for seeing approach lights on sometimes quite tall structures where the terrain (ocean) lies below the runway level.

[tilnextime]

Maybe, instead of 10,000 hour pilot we ought to be taking of 2000-landing-pilot etc.

Having flown with "high time" pilots who have exhibited the skill level of 500 hours experience simply repeated 10 or twenty times, yes, there is more than total hours logged in the equation.

Junebug:

The aircraft they're on are long haul aircraft and moving to short haul means a different aircraft. You can't hop aircraft types and routes are bid on by seniority which you don't violate.

Simply debating "complexity" to arrive at "you can't get there from here". Perhaps "seniority" is a causal factor? They don't have to fly PIC in the short haul aircraft, do they? They would be placed in them to maintain hands on skills. They weren't born qualified in the long haul bird, but typically flew the carrier's short haul aircraft to gain the seniority to get a posh slot that allows their skills to deteriorate.

In short, perhaps the current model doesn't work in more ways than one. Supplemental training is "too expensive" and "violating seniority" can't be done. Seems like the status quo is more important than raising skill levels.

[Schnowzer]

Hours and Landings might measure experience but so what, I guarantee you pretty much all pilots that have crashed airliners have hours, landings and experience.

What is needed is:
1. Aptitude!
2. Great Training!
3. A worthwhile check where the pilot demonstrates appropriate Capability and Skill!

On all checks a pass is a coat of paint from a failure and typically many airlines and regulators set the bar too low. In the present regulatory regime you can repeat pretty much everything and partial pass some items before retraining and retesting to get a minimal pass. How would you fancy being operated on by a surgeon with this sort of record.

Around the world pilots buy licenses, in some places more so than in others. It isn't in a Training Organisation's interests to fail their customers; they will just flee to their competitors. Some airlines don't allow their First Oficers to land the plane or Captains to do anything but an Autoland, yet they still count as recent. Until the industry wakes up and requires airlines to select pilots well and then pay the cash to train them/keep them current; these types of events will continue it is as simple as that.

The Industry views crashes as a cost of doing business but not paying for the training of pilots; how sad can that be?

[ross_M]

Hours and Landings might measure experience but so what, I guarantee you pretty much all pilots that have crashed airliners have hours, landings and experience.


Here's an empirical question: From past crash / accident / incident data or FAA / NTSB stats. (or equivalent foreign stats) is there any correlation between the number of hours flown versus likelihood of these events?

I don't know but I am indeed curious to find if anyone knows the answer.

[Old Carthusian]

A note to all those who believe that automation is somehow a serious factor in this accident. Go to the accident websites and research how many accidents there were in the 'good old days' when we didn't have automation - particularly undershoots. As others have stated there is a lot of misinformation floating around.

[framer]

Old Carthusian A note to all those who believe that automation is somehow a serious factor in this accident. Go to the accident websites and research how many accidents there were in the 'good old days' when we didn't have automation - particularly undershoots. As others have stated there is a lot of misinformation floating around.

Then do some research on the number of engine failures per 100,000 hrs flown, the likelihood of other technical difficulties, the accuracy of weather forecasts, the absence of airborne radar, TCAS, EGPWS, the limitations of communications at the time etc etc etc that existed in the good ole days.
It's not so much the existence of automation that pilots worldwide are pointing to as an issue, but the absence of the skills the automation automates.
Ie.....we need to practice flying airliners.

[glofish]

Hours and Landings might measure experience but so what, I guarantee you pretty much all pilots that have crashed airliners have hours, landings and experience.

What is needed is:
1. Aptitude!
2. Great Training!
3. A worthwhile check where the pilot demonstrates appropriate Capability and Skill!

On all checks a pass is a coat of paint from a failure and typically many airlines and regulators set the bar too low. In the present regulatory regime you can repeat pretty much everything and partial pass some items before retraining and retesting to get a minimal pass. How would you fancy being operated on by a surgeon with this sort of record.

Around the world pilots buy licenses, in some places more so than in others. It isn't in a Training Organisation's interests to fail their customers; they will just flee to their competitors. Some airlines don't allow their First Oficers to land the plane or Captains to do anything but an Autoland, yet they still count as recent. Until the industry wakes up and requires airlines to select pilots well and then pay the cash to train them/keep them current; these types of events will continue it is as simple as that.

The Industry views crashes as a cost of doing business but not paying for the training of pilots; how sad can that be?

Amen to that!

A quick halfway fix would also be to avoid rookies to fly together. As displayed here with Asiana, a rookie on the LHS and a rookie on the RHS as TRE, is a recipe for disaster, even if both can produce impressive records on other seats/types/functions, you can also add destinations/regions to this list.

I know it would take a few dollars more to implement a function in the rostering automations, but experience should always be paired with a trainee or a regional newcomer. But at the same time i guess these few bucks would give too many little grey, wobbling hairs to the bean counters that seem to be in charge of safety today, so even here we have to forget about common sense.

And by the way i would greatly appreciate a general freeze period for rookies to become trainers. It takes time to get used to a seat/function and a good trainer should be able to transmit experience, not only preach the sops and company bs.

[BOAC]

A quick halfway fix would also be to avoid rookies to fly together. - indeed, as already exists in many operators for 'new' Captains and line F/Os.

The whole training side, as I have previously said, needs a close inspection. Some airlines 'allow' an LTC to move to a new type and begin training straight-away. Do we know the LTC's experience on the 777 here? I agree the combination presented on 214 was bad.

Not-with-standing, of course, that as far as we know the LTC's 'omission' was a very basic one here, and not really type dependent.

[Fox3WheresMyBanana]

About 20 years ago, I left the RAF and got a job instructing baby airline pilots in the US. I was contemplating future career options, and discussed the airlines with a 747 Training Captain. He told me not to bother, as the airlines no longer cared about having good pilots. "They only want 'good enough', and that won't last long either". He reckoned the beancounters had figured that as long as the accident rate stayed below 1 per 10 million flight hours (which is about what it is now for commuter airlines), the increasing safety of the aircraft meant that money could be saved by hiring dumber pilots (and not training them, etc). The public/media seem to accept a an accident rate of 1 in 10 million, i.e. this rate does not cause people not to fly in significant numbers.
So events like AF447 and Asiana 214 will continue to happen.
There is no shortage of good pilots. There are thousands of guys like me could join the airlines with a six-month refresher, except I won't be leaving my current profession to be paid peanuts, get over-worked, given no stick time or get treated with no respect by the company.
The good guys are not as good as they could be if they had proper training and currency on manual flying, and there are an ever increasing number of bozos I wouldn't trust with a paper aeroplane.

[ross_M]

"They only want 'good enough', and that won't last long either". He reckoned the beancounters had figured that as long as the accident rate stayed below 1 per 10 million flight hours (which is about what it is now for commuter airlines), the increasing safety of the aircraft meant that money could be saved by hiring dumber pilots (and not training them, etc). The public/media seem to accept a an accident rate of 1 in 10 million, i.e. this rate does not cause people not to fly in significant numbers.

But an this incident like Asiana, does it not have a fairly lasting effect on the bottom line? Compensations apart, does it hurt operating revenues?

Or not? Maybe, the flying public is forgetful enough and price sensitive enough that a few $$ shaved off the ticket price will still get Asiana full planes?

Wonder how deep are the effects of a crash on an airlines revenues?

Beancounters may not fund safety for safety's sake, but they will respond to bleeding bottomlines like a hornet bit 'em. What gives?

[clayne]

As mentioned earlier (but in a different context) the airlines view training costs vs crashes in n number of flight hours akin to the Ford Pinto effect. The bean counters truly have won - but in the most insidious of ways. Sadly, Joe Public is too busy looking for his next 5$ flight to give a damn.

[framer]

But an this incident like Asiana, does it not have a fairly lasting effect on the bottom line? Compensations apart, does it hurt operating revenues?
It definitely hurts the airline involved but airline management take the risk that " it won't happen to me", just like some pilots do.

[Fox3WheresMyBanana]

It may affect an airline's revenue, but it won't affect airline revenue. The beancounters are prepared to take the gamble that it won't happen to their airline. The same is true of railroad operations - Lac Megantic being a prime example. The CEOs, etc take a gamble that it won't happen on their watch, but the monetary savings always boost their bonuses.
The principle operates almost everywhere these days. You won't get a road crossing installed until somebody dies. One cannot legally prove that any particular safety measure saves lives, so they won't happen.
Equally, vast numbers of unnecessary safety measures and banning happen where there is the risk of being sued, because that will cost money.

In summary, the two questions are:
Can I save money this financial year?
Will we get sued?
The solution to the second one is to get your cuts approved by the regulatory body. This can be achieved 3 ways.
Bribe the civil servants
Bribe the politicians to change the rules
Get the size of the regulatory body reduced so they can't effectively enforce the existing rules.

[grimmrad]

Not a pilot. After reading over several days this forum one thing struck me as rarely mentioned. Isn't it a systemic error of the airline to put a novice at the type (PF) for the first landing at a demanding airport (SFO) together with yet another novice in his job, the training captain? It was said that they were both experienced pilots but obviously that did t help them here, now did it. Isn't this the biggest mistake to put these two newcomers to type and job together?

In my profession that is not done. E.g. In surgery you will never find two experienced surgeons doing a procedure new to both of them together. There will be one experienced in the procedure training the other (unless it is so new and experimental but that equals in my comparison to landing on the moon). I have seen once a surgeon trying a new instrument (gastric stabler) nobody used before and it didn't bide well for him. He tried 40 minutes, didn't get it to work and then reverted to hand sewing.

[Sky Wave]

Isn't it a systemic error of the airline to put a novice at the type (PF) for the first landing at a demanding airport (SFO) together with yet another novice in his job, the training captain? It was said that they were both experienced pilots but obviously that did t help them here, now did it. Isn't this the biggest mistake to put these two newcomers to type and job together?

But how would a trainer ever train anybody. A new trainer will always be inexperienced at training until he's done some training. In all honesty training an experienced Captain should be much easier than training a new FO so this was probably considered a gentle way of breaking the trainer into his new job?

I'm assuming here that the trainer had previously done a number of sectors training under the supervision of an experienced trainer sat on the jump seat

[pax britanica]

Fox 3

I think your post sums up the problems of the modern world.
Too many accountants
Too many lawyers
Not enough ethics (or common sense)

[Flyer94]

grimmrad,

in my opinion there have been 4 pilots and all of them had lots of hours. Basic flying skills had to be there. Not checking speed and altitude and not to answer both are dropping is a huge failure of all of them. Even if one of the pilots, lets say the pilot flying (PF), did not recognize it, what's about the other gentlemen? Why didn't they respond?

Every student pilot gets drummed "Speed is life, altitude is life insurance", "Aviate - navigate - communicate", "First fly the aircraft" and "Never let an aircraft take you somewhere, your brain didn't get to 5 minutes earlier."

A lot of airlines require their pilots that the approach at certain points must be stable, for example at a 1000 ft gate - or to go around if not everything is in smooth condition at that point.

So I ask for the competence of the PF, the PNF and also the other crewmembers of that cockpit. Why didn't they recognize and prevent what happend?

Even if there are cultural circumstances, at some point a will to survive must kick in... And that's another very large site:

In the 1990's Korean Air lost many planes because crews did not work together in a proper way. The whole world introduced modern Crew resource management systems (CRM) in order to coordinate crew cooperation and to dismantle obstructive hierarchies. What about the Koreans?

They continue working under the old principles and continue to have bad accidents with it. Time is over to remain silent about that and to be political correct. These guys kill people with this behaviour. It is macabre, but seeing the Asiana wreckage and how it spinned around after impact, one must wonder that there are not 300+ dead. A little bit less height or speed and the aircraft would be completely crashed against the shore fortifications.

When the hell Korean aviation launches its renewal? How many deaths they still want to accept before they arrange with modern ways of crew coordination? Nothing against their culture, but if it does not fit into the cockpit, they must change it in the cockpit or should not fly.

[Fox3WheresMyBanana]

at some point a will to survive must kick insimply, no.
The point at which they realise they are in a survival situation is too late to do something about it.
In one sense, there is a real risk with people putting themselves into situations they know to be risky because they haven't been properly trained. This should apply to a lot of aircrew having read the AF447 report. Could I do any better with the training my company gives me?
However, the immediate survival risk of losing your job for making a stand overrides the more psychologically distant risk of being unable to cope if something unusual happens.
People rationalise. They tell themselves they'll cope, or "it'll never happen to me"; probably most do a bit of both.

Thus we end up with the situation we have in so many industries. The ones who make a stand get sacked. An increasing proportion of the remaining ones have either an inflated sense of their own skills, or too low a sense of self-esteem to complain,or they 'need the job'. With all of those, a management who only cares about their own bonuses will get away with anything they can. The only solution is an effective justice system to deal with unethical senior management. The ability to prosecute companies for corporate manslaughter in the UK has existed for nearly 50 years. There has been one successful prosecution, of the one-man company responsible for the Lyme Bay canoe tragedy. And there's an awful lot of bankers retired on nice pensions, with not one of them even accused.

[PPRuNeUser0172]

Asiana Airlines considering legal action after - CNN.com (http://us.cnn.com/2013/07/14/travel/asiana-offensive-names/index.html?hpt=hp_t3)

Really? Asiana trying to polarise support? Guess it might offset their huge insurance burden and counter suits for corporate manslaughter.
:mad:

[lomapaseo]

This thread seems to have split off into opinions about training or lack of.

Training costs money and airlines are not likely to freely add syllabus to their already approved programs.

Is the missing part simply a one time demonstration/learning of skill each time a move to a new model is made?

If we, as users could point out the pros of such training there is an opportunity for the regulator to step up to the plate with their cost benefits analysis and rewrite of their min training requirements.

[frankpgh]

SLF just reading up on FLCH on the 777 and found this old thread on PPRune for anyone interested:
http://www.pprune.org/tech-log/342579-777-flch-climb-t-going-into-hold-no-low-speed-prot.html

[Fox3WheresMyBanana]

Agreed, the problem is that clearly inadequate training programs are approved.

The problem is that no Government, via its regulator, is going to admit it's got things massively wrong, and that's where we are now.

Hasn't happened anywhere, ever.

[grimmrad]

"The reputation of the four pilots and of the company had been seriously damaged by this report." Really? But not by their pilots crashing the plane onto the runway? This is rediculous.

Flyer94 - thanks and couldn't agree more. Just saying that putting both together (new at type and new at instructing) didn't help the situation either. Might have been better to get the newbie on type together with an experienced I stricter and let the new instructer do a couple trips with someone more experienced already as a lead in.

[ross_M]

Asiana Airlines considering legal action after - CNN.com

Really? Asiana trying to polarise support? Guess it might offset their huge insurance burden and counter suits for corporate manslaughter.


Frankly, sounds like an overreaction. That joke / prank may have been silly but I didn't think it was horrendously out of place or offensive or anything (compared to the baseline on american TV). The racial / nationalistic angle was perhaps offensive to some, but it's not as if these pilots are blame free.

Every time some dude believes his GPS and drives himself onto railway tracks we make fun of them. Or people that do stupid stuff while yapping away on cellphones.

These Asiana pilots aren't exactly beyond reproach. I don't know why everyone wants to treat them so reverently.

In any case I don't know how they well make a legal case that the pilots' reputations were hurt, if all the TV station used were these silly pseudonyms.

[HotPants]

So i guess some feel it's ok to have a racist trip because the pilots have some blame. Says alot about the culture that is investigating this incident.

[ross_M]

in my opinion there have been 4 pilots and all of them had lots of hours. Basic flying skills had to be there. Not checking speed and altitude and not to answer both are dropping is a huge failure of all of them. Even if one of the pilots, lets say the pilot flying (PF), did not recognize it, what's about the other gentlemen? Why didn't they respond?


In some ways I think this crash is unique because

(1) We have a hull loss with fatalities.
(2) So far as we can guess right now, some degree of pilot error was involved. Perhaps gross error, or even negligence. Perhaps.
(3) Flight crew is alive
(4) Lots of forensics data: CVR, video, United crew that witnessed, relief pilots etc.

Asides of the NTSB investigation (which so far as I know does not assign blame) what's the chance of a criminal prosecution being filed? ( Almost certainly, civil suits will result. ) What's the dividing line between an accident and culpable negligence?

Historically, what precedents do we have for scheduled carrier flight crew being prosecuted for an incident? Do they enjoy any immunities? Have there been any successful prosecutions?

[kaokao]

What discussion have been ongoing are based on lack of information and facts.

NTSB reports at media show quite discrepency from Asiana pilots' statements during investigation.

Both pilots consistently urged that they have tried to put the throttle lever full back position in order to gain the thrust but it did not work, which took place much earlier than known in public.

They stated that discovered it too low when they noticed PAPI with 3 reds and 1 white and full back throttle at 500 feet altitude but failed to gain thrust for seconds.

After several trials, pushed TO/GA for final hope, then the flight regained power but late.

It seems strange to hear that all discussion and news are going on based on unfactual NTSB report without certain data that have to be analysed and summarized.

Anyway Korea goverment sent letter NTSB stop releasing unfactual inforamtion meanwhile Asiana preparing law case.

CP who experienced with 747, 320 for 16 years has been disgraced by ones-who-know-everything-from-CNN due to lack of facts and information.

We will see how premature information without thorough investigation have been released in public to make all focus on pilots' mistakesby NTSB. whatever reason is behind, truth is about to come.

[Pitch Up Authority]

The key point may be if Boeing is going to redesign the auto throttle system for the next plane they bring on the market.

A system that engages automatically even if switched off :D

[robertbartsch]

This complete transparency is new ground for the NSTB; right? Well, maybe this is not a good thing....

They should not spear anyone especially the crew immediately. They should wait until all the facts are in.

The NSTB is simply feeding the Internet frenzy for speculation on how and why this happened. Accidents are not cut and dry. The are caused by many factors.

I don't think suing the NTSB will go far in the USA.

[armchairpilot94116]

IIRC, when the SQ6 tragedy happened in Taiwan, the Taiwan authorities would not let the flight crew (all pilots survived) leave the country for a few weeks. They were allowed to remain in their hotels and free to move about but not leave the island, until Singapore's government protested and then the crew were allowed to leave upon the promise that they will return to answer questions. Under Taiwan's law they would have been liable for jail terms if found at fault.

Again the Singapore government defended them fiercely and the crew were not jailed.

SQ then quietly fired the Captain and CoPilot when they were found to be liable in the accident. While the Singapore government continued to protest deficiencies at the TPE airport. Their government's report on the accident differed substantially from the Taiwan government report on the same. With Singapore still insisting their crew were misled by missing runway lights, the fact that the partially closed runway 5R (the one they mistakenly took off from) should not have been partially open (part of it was being used as a taxi way during reconstruction) ,etc.

In all honestly the airport should have been closed as the typhoon was approaching. SQ6 was scheduled to be the last flight out that night as far as I can recall. But the winds were still within parameters and the flight crew wanted to leave ASAP. Perhaps they were fearful of what would happen to their jobs if they did not continue and they and their passengers suddenly needed hotel rooms for the next one to two days.

[wingview]

And where did you get your info from?

The NTSB published the last few seconds and just at the very (too late) moment they wanted to make a GA. Why would the NTSB lie?

Are you working for Asiana with your just 2 posts?

[Loose rivets]

I have to say this leaves me with a niggling doubt. Just the troubling thought of innocent people going to the slaughter always makes me want to look again, and again.

Is there telemetry from the levers themselves--or just the result of those movements?

We've all been stunned by the sink through the (ideal) glide-slope, but what if several small corrections had been applied, would they be recorded before the resultant parameters changed (same question, I know) as opposed to the time the TOGA command was given?

It just seems so impossible to believe these reasonably experienced pilots would fail to apply power under these circumstances - just sitting there waiting for a mechanism to do the job for them.

Who's right? Is there any chance their statement is true?

[green granite]

Surely the CVR would confirm/deny their story?

[RAT 5]

All the discussion about increasing manual flying hours sounds good, but there was the writer ho said he flies 8 sectors a month with 3 pilots. Each has to make a currency landing, then there is the autoland currency question etc. In some worlds it's not that practical and in the airports they use maybe not that useful anyway. LHR STARS are flown by ATC until G.S. capture.
In the short-haul world, very different. In the old days of Greek islands (and I wonder if it is still the same) the descending visual was the standard. Much beer was lost if you did not do a CDA or spooled up >1500'. It would be difficult for an XAA to impose a factor, as all licences are the same. It should be an airline culture thingie. Sadly that is going in the opposite direction.
One element of the attitude of the behaviour of the IP: not acting quick enough; should not have been rostered with a newbie in the first place; should not have been rostered into SFO knowing the lack of aids etc. One parameter I'll add is; given all these things were in place and did happen they he should not have given the sector to the newbie. A low experience on type pilot should be allowed to build confidence in a known and comfortable environment. Later you can pump up the volume.

[Anthony Supplebottom]

Bottom line - there is a minimum safe height which must be maintained before crossing the threshold and this height must not be compromised until the threshold has been crossed.

[Airbubba]

I have never had anyone take the airplane from me and in 30+ years of flying I have never initiated a "go around" because I was unable to land stabilized and safely.


While I congratulate you on your evident self-esteem, this type of 'Sky God' attitude may have contributed to the mishap in my opinion.

NTSB reports at media show quite discrepency from Asiana pilots' statements during investigation.

Both pilots consistently urged that they have tried to put the throttle lever full back position in order to gain the thrust but it did not work, which took place much earlier than known in public.

They stated that discovered it too low when they noticed PAPI with 3 reds and 1 white and full back throttle at 500 feet altitude but failed to gain thrust for seconds.

After several trials, pushed TO/GA for final hope, then the flight regained power but late.


Thanks for sharing this kaokao, I think the throttle being in the full back position is acknowledged as a possible cause of the continued sink rate below the visual glide slope.

[ross_M]

They stated that discovered it too low when they noticed PAPI with 3 reds and 1 white and full back throttle at 500 feet altitude but failed to gain thrust for seconds.


Enough said. :D

PS. I hope that effect didn't last for mere seconds.

[Etud_lAvia]

@loose_rivets:

It is mandatory for Flight Data Recorders to record throttle lever positions, as well as engine thrust and other engine operating parameters. See 14 CFR § 125.226.

I've as yet seen no information suggesting that the engines did not answer the throttles as they are supposed to do.

[Shutterbug]

@wingview

Korean media are spinning a story that the aircraft went hogwild and the pilots are courageous heroes for wrestling it down to the runway just in time to save the lives of more than 300 people on board. Much the same way the flight attendants were ordered to parade out in front of the media. Go look at that footage. You can see how screaming enthusiastic the FAs were about that move.

It's all part of the PR battle. Expect more to come.

[MPN11]

Is it not pertinent that the FD achieved something resembling a stabilised approach at c. one mile/300 FT from TD? After which they just carried in going down, with no escape possible?

How many aircraft captains would be content with an unstabilised approach at that stage?

It was too little, too late ... Am I wrong, gentlemen? (And ladies)

[ross_M]

Again the Singapore government defended them fiercely and the crew were not jailed.


I think pilots get off too easily sometimes.

If this hull loss were proven to be nothing but pilot error (speculatively , but not totally outside the realm of possibility) how is it very different from causing a road accident while texting or speeding or by exceeding work-hours etc.?

Most such mundane road offences, if resulting in fatalities, are dealt with quite seriously these days by prosecutors.

[Petercwelch]

Although I only fly a Piper Dakota with garmin 430 WAAS, i assume that the 777 has equipment that would allow them to fly the 28 L RNAV approach which would provide the pilot with a glideslope as good (or better) than the missing ILS. Was this available, and why would it not be standard procedure to use it as backup when the ILS is out?

[LASJayhawk]

I *think* it takes the throttle position, what the a/t wants and what the fadec sees.

With 1400 data points I wouldn't be too surprised if the FDC has a parameter to tell if the pilot had the ham and cheese or roast beef on rye for lunch. ;)

Should cycles be a metric pilots track along with hours to measure experience?

ETA: My guess would be the Asiana bird did not have WAAS

[Airbubba]

Korean media are spinning a story that the aircraft went hogwild and the pilots are courageous heroes for wrestling it down to the runway just in time to save the lives of more than 300 people on board.

This excerpt from a recent Korea Times article seems to me to contain some glaring inaccuracies (kinda like CNN, come to think of it):

Hersman said that when the plane came to a stop, pilots told passengers to stay seated for 90 seconds while they communicated with the tower as part of a safety procedure.

“What we saw here is that the first slides weren’t opened for about 90 seconds,” she said, hinting that the evacuation process was delayed.

However, her argument was rebuffed by Choi who said the pilots did not delay the evacuation process. “Pilots should communicate with the control tower first. I don’t think that they delayed it,” he said.

They also differ over the activation of the automatic speed control system called the auto-throttle during the crashed Asiana flight.

The NTSB confirmed that the auto-throttle was “armed”, but said that it does not necessarily mean it was activated.

However, the ministry said that “armed” is equal to “on” because there are only two modes in the system ― armed and off.

They also disagree over the paring [sic] and actions of the pilots at the time of the accident.

Lee Jeong-min was the pilot in command, sitting in the right seat and acting as an instructor to Lee Gang-guk, a veteran pilot but still in the process of becoming accustomed to the Boeing 777 was sitting in the left seat controlling the aircraft.

The NTSB has taken issue with the seat positioning of the pilots, arguing that the pilot in command should have been sitting in the left seat.

However, Choi said that as Lee Gang-guk was on a “familiarization flight,” he was customarily for him to take the left seat.


Korea, US clash over Asiana crash (http://www.koreatimes.co.kr/www/news/nation/2013/07/119_139103.html)

[Fox3WheresMyBanana]

It shouldn't be beyond the wit of man to provide the airline pilots of the world with some stick time. Convert a few light twins to variable stability a la Beagle Bassett of ETPS. Voila, you can now fly 777 flapless approaches, A310 single engine approaches, etc, to your heart's content.

[nigegilb]

The sooner the public base their decision making on safety rather than cost the better. If there really is a systemic problem concerning the training and experience of airline pilots within the aviation industry, safety will once again become the top priority when booking a flight. It would appear that the SFO crash has brought that day forward by some considerable amount.

Accountants are not stupid, they will respond.....

[A Squared]

Asides of the NTSB investigation (which so far as I know does not assign blame) what's the chance of a criminal prosecution being filed? ( Almost certainly, civil suits will result. ) What's the dividing line between an accident and culpable negligence?


Criminal prosecution for pilots involved in accidents are pretty rare in the US. I can't think of any of Airline pilots having had criminal prosecution for an accident. The only one I can think of was a few years ago a pilot was flying low over a river and hit a power line and his passenger died in the accident. This incident was reported in pilot magazines and was notable precisely because it is rare. Not a legal expert but I think that in the US there has to be a willful violation of the law resulting in the accident in order for criminal charges to apply.

edit: The case I mentioned was the first time a pilot in the us had ever faced criminal prosecution for an accident, according to the AOPA. That was in 2008. No idea if any have followed since.

[barit1]

pax britanica (responding to Fox 3):
I think your post sums up the problems of the modern world.
Too many accountants
Too many lawyers
Not enough ethics (or common sense)

And in the modern airline world, too much competition - resulting in too little training to overcome cultural gradients.

Competition is a good thing, but it can become cutthroat, resulting in cost cuts both visible and invisible to the unsavvy customer. :=

[Airbubba]

It takes amazing skill to control a plane that has lost its tail and to make it rotate without flipping while reducing the speed.

I agree with the Yonhap comment poster, it is very tough to control a plane that has lost its tail.

We would all like to believe that we as pilots are heroes and would not crash a perfectly functioning aircraft in good weather on a routine approach.

We should know more soon when the CVR transcript is released by the NTSB.

[Ditchdigger]

Quote:
Asiana Airlines considering legal action after - CNN.com


Really? Asiana trying to
polarise support? Guess it might offset their huge insurance burden and counter
suits for corporate manslaughter.
Frankly, sounds like an overreaction. That joke / prank may have been silly
but I didn't think it was horrendously out of place or offensive or anything
(compared to the baseline on american TV). The racial / nationalistic angle was
perhaps offensive to some, but it's not as if these pilots are blame free.


Every time some dude believes his GPS and drives himself onto railway
tracks we make fun of them. Or people that do stupid stuff while yapping away on
cellphones.

These Asiana pilots aren't exactly beyond reproach. I don't
know why everyone wants to treat them so reverently.

In any case I
don't know how they well make a legal case that the pilots' reputations were
hurt, if all the TV station used were these silly pseudonyms.


I wonder if this isn't a brilliant tactical move by the airline's attorneys.

Now, if the NTSB's finding of probable cause is nothing more than Pilot Error, the groundwork has been laid to dispute the impartiality of the finding: The NTSB can't possibly be impartial, because they made fun of (especially of the ethnicity of), our pilots' names...

Edit to add: The ethnic angle might also impugn the board's credibility with respect to any findings critical of the contributory effect of Korean culture to the conduct of the crew.

[RunSick]

Regardless of what the NTSB finally says, the thruth is: not much is going to change, at least not for the better for us pilots.

Do not expect your training sylabus to change in order to include xx amount of extra hours for us to do visuals etc. The ACCOUNTANTS of the world will not allow it.:=

Do not expect your next OM-A revision to come with explicit encouragment to let go of the automation. The LAWYERS of the world will not allow it. (if anything it will all just become more retrictive).:=

That being the reality of our modern corporate world: Do not expect SOMEBODY ELSE to fix our issue.

It is up to us to keep the last thing we have, and that is our professionalism, intact. So next time you shoot an approach (conditions permitting): disconnect early. If you are a captain, next time your FO briefs for the approach (conditions permitting): offer him to disconnect early. It is only up to US INSIDE THE COCKPIT to keep the standard of our profession, and more importantly, to give ourselves the chance to keep IMPROVING as pilots as our careers go by. And not, as it is happenning, getting each time worse and worse until we finally become the laughing stock of all the professionals around the world: pilots who cannot fly a plane. What a disgrace.

Good luck to all.

p.d.
(and please people that know :mad: about this job refrain from asking/suggesting :mad: , there is another area of this forum for that)

[PPRuNeUser0172]

[According to witnesses, the plane’s tail broke off first as it was landing and the pilot chose the nearest runway instead of the scheduled runway. It looks like the pilot’s judgement and skills prevented a big disaster. It takes amazing skill to control a plane that has lost its tail and to make it rotate without flipping while reducing the speed. If it flipped once, they would’ve all died. Imagine how hard it is to stop a tumbling car moving at 150 kilometers per hour all within a short distance. As shown in the emergency landing in Murmansk, Korean airline pilots’ skills are among the top in the world because most of them are from the air force.[QUOTE]

ASSUMING the translation stands up, it seems there is very little point investigating as the airline and wider Korean society will not be interested in the finding. Such denial and propaganda are reminiscent of ridiculous regimes over the last few decades...

The fact that the airline are trying to detract from the issue by threatening law suits over an ill conceived gag, is frankly appalling. If they took a closer look at why their "pilots" drove a perfectly serviceable jet into a sea-wall, killing 3 kids in the process, they might learn something.

Disgraceful.

[220mph]

I believe he said that was in a 'comment' to the Korean news story - not part of the story itself. But it seems to show the mentality of some.

[wheels up]

Is it not pertinent that the FD achieved something resembling a stabilised approach at c. one mile/300 FT from TD? After which they just carried in going down, with no escape possible?

By definition, that is not a stabilised approach. With the engines at idle and the airspeed rapidly decreasing? Not even remotely stable..

[Teldorserious]

Seriously, this is beyond sad when the airline apologists drop the standard of pilot performance down to the point where landing on big open runways on sunny days is 'dangerous'.

Yes, from now on, you abort any hand flown approach, nothing but coupled, autothrottle, and two pilots babysitting you all the way down. Beyond sad.

[techgeek]

I just listened to Chairman Hersman's final briefing in which she mentioned they have sent the GPWS to Wash. D.C. for analysis.

Q: Is the GPWS inhibited below some altitude on approach (similar to the A/T below 100' RA)?

[brak]

Asiana PR clearly working overtime in this thread, and using every dirty trick in the book too. I wish they spend some of the PR budget on pilot training instead.

[junebug172]

It takes amazing skill to control a plane that has lost its tail and to make it rotate without flipping while reducing the speed.

Nice try Asian PR people. That has got to be one of the stupidest statements I've read so far regarding this accident.

Those guys were along for the ride once the aircraft impacted the sea wall. The only thing their "skill" did was **** up the approach.

[cynar]

sound asleep,

My post was about misperceptions and the media echo chamber, and my alternate-theory story was a speculation on the sort of patched-together alternate narrative that might be believed by those who do not trust the NTSB, and believe there is bias against the pilots and a cover-up rather than a real investigation.

I was saying that things like the snafus with the first responders and the pilot-name story, both of which did, factually happen, can feed into mistrust and can undermine belief in an objective investigation.

For example, the "30-second" tidbit -- that is from an actual question fielded by the NTSB chair after a briefing. A reporter said, "The Korean media is reporting that the air traffic controllers changed shifts 30 seconds before the accident."

NTSB chair neither confirmed nor denied, but reiterated that the exchanges with the crew were uneventful and clearance was given. It seems, reading between the lines, that the Korean media was implying ATC dropped the ball because they did not reply promptly enough to one of the aircraft's transmissions.

But just from that question, as well as the translated news article someone posted above, you can see how different countries emphasize different things, which means that readers end up being *absolutely sure* that stories like the yarn I spun are the "real truth."

Just to be clear: it's not what I believe, nor is it a prediction of what the eventual conspiracy theory will actually be. But surely there will be one.

And, speaking now for myself, I do have a level of mistrust of the veracity of the fire department's statements. I will trust the NTSB's findings on the rescue operation far more than the interim statements coming from the SF department.

Why? Because the day of the accident, it was the SF Fire Chief who made statement after statement that was premature and wrong. She said everyone was alive. Then she said 60 people were unaccounted for (letting everyone believe they might still be on the burning plane.) Then she said that weird thing about some passengers coming up from the water line, sort of hinting that they had gone down for a dip in the water. I am betting very strongly that those people near the water line were the critically injured flight attendants and passenger, and the other passengers who had found them and were calling for help. It just has not inspired confidence.

And, given that the pushback for findings of pilot error can be nationalist in tone, all of these details could be twisted and presented as deliberate, malicious, inept, etc on the part of Americans, who messed up but want to blame the pilots.

[Kiwiconehead]

Q: Is the GPWS inhibited below some altitude on approach (similar to the A/T below 100' RA)?

Normal GPWS modes aren't inhibited

I would hazard a guess that their profile descent rates were not enough to trigger either Mode 1 or 2. They were configured so Mode 4 not applicable and no glideslope so no Mode 5.

The EGPWS does have an onboard memory so they could just be sending it to the manufacturer to have the data extracted as an additional source of information.

[kaokao]

I am not working at Asiana nor flight industry.

Several Korea media deliverately reported the pieces of statements from pilots but mented early come to conclusion until blackbox investigation done.

It was fair and common sense to cross check all information when we deal with events and accidents.

According to pilots there were plenty times to try recover speed and altitude but failed to gain thrust. This is testimony during investigation which they cannot fake. If they did make story to cover their mistake or tell lies they would be sent to jail.

Well. what are you going to do in flight if the engine does not listen to your manuver? Just you gonna be a sitting duck waiting until all dead.

Still they saved hundreds lives.


They are over experienced pilots who have 10000 hours flying time at commercial planes as well as legacy fighter jet during military service.

I do not believe NTSB reports that pilots are untrained, undisciplined and unprepared for critical situation.

From NTSB recent media reports, a number of evidence shown that they already drew public's attentions to pilots faults. Now we see a certain evidence that even a racial discrimination might have been involved from recent incidents showing bizarre names disgracing pilots.

Boeing is encountering harsh conditions these days due to many troubles such as 787 issues. However their loss cannot be compensated by innocent's head.

Full throttle did not work. why?

Did the pilots really not know how to gain the thrust?

or

Did something happen which should never happen?

[Lost in Saigon]

Maybe the answer to all of this is to have pilot training "on type" conducted separately from passenger aviation, I would envisage planes shuttling from location to location continuously with all the prospective trainees housed in hotels at either end, a team of trainers, and everyone on the one aircraft with no passengers, then if something like this happens, the casualty count is very small. It would be a selling point for aviation in general, as one has to assume some prospective passengers are probably a bit nervous about booking onto flights after these sorts of incidents. I suppose with the lack of incidents on major North American and European carriers that problem is less pointed. It might also be good for both confidence building and skill development if training pilots and trainees were from different airlines..............

The pilot flying Asiana 214 was not a "Trainee". He was FULLY qualified to fly the B777 due to the intensive training he had already received in Groundschool and in the Simulator. A Simulator so advanced and so realistic that there is no requirement to fly an actual B777 in order to be certified.

What he was doing was Line Indoctrination Training which all airlines do for a new Captain or First Officer only because the Airline Industry takes safety very seriously and leaves nothing to chance.

The accident was not caused because a new B777 Captain was at the controls. The accident happened because of a very complicated set of circumstances which is rampant in many(but not all) airlines outside of Europe and North America.

[Old Carthusian]

Farmer - you miss the point. Air travel has gotten safer since the good old days primarily due to automation which allows a lot of the pilots who might be tempted to hand fly badly to land and conduct flights safely. The message behind this accident is that it was a bad crew who lacked CRM and a scan. In a word it's called 'professionalism' which I would define as an attitude that you will do the correct thing and ensure that you know how to do the correct thing no matter what the environment you operate in. Others have postulated a cultural dimension which could indeed have played a role - living in the region I constantly see examples of where professionalism is lacking due to cultural aspects but I would hesitate to assign that explanation to this accident. I have included a lot of negatively loaded words in my comments here but I feel that it is justified - the accident was due to a poor crew and this can happen with any airline in the world. There will always be poor pilots who slip through the net as it were.

[rottenray]

kaokao writes:
I do not believe NTSB reports that pilots are untrained, undisciplined and unprepared for critical situation. First, welcome to Pprune.

That said, it's a shame your first few posts are, well, shameful.

NOWHERE in any media I've read has the NTSB said anything derogatory about the pilots of AS214.

From NTSB recent media reports, a number of evidence shown that they already drew public's attentions to pilots faults. Now we see a certain evidence that even a racial discrimination might have been involved from recent incidents showing bizarre names disgracing pilots.The NTSB have merely been communicating what has been retrieved from the CVR, the DFDR, and interviews with involved persons - like the pilots.

Also, the NTSB did not provide those hoax names to KTVU. I would guess someone probably faxed them in to the news desk, and the less-than-bright person who received that fax checked with another less-than-bright person at the NTSB who then improperly "confirmed" them.

It was a bad joke put forth by someone who has not yet been identified, and as soon as it was learned to be a hoax, everyone responsible apologized.

What more can you ask for?

[Lost in Saigon]

..........................................

Full throttle did not work. why?

Did the pilots really not know how to gain the thrust?

or

Did something happen which should never happen?

Full Throttle did not work because the pilots were relying on automation to do it for them. All the facts are not known at this time but a properly trained pilot monitors the airspeed and keeps their hand on the thrust levers at all times during the final phases of the approach. All that was needed was to simply physically push on the thrust levers and the engines would have responded.

All three pilots in that flight deck were negligent in their duties and allowed the airspeed to decay to a dangerous level without the appropriate response. The reason for this was an over reliance on automation that can effect pilots from every part of the world.

In view of the fact that the rest of the world has for many years held poor opinions of the flying abilities of Korean aircrew, I would have thought they would have worked hard to enforce practices to prove the world wrong.

In this case it looks like they didn't try hard enough.

[Indarra]

Suggest experienced posters take Kao Kao (and by extension a whole lot of other Korean readers) through the technicalities gently and clearly, without the little barb about Korean flying abilities at the end.

[neville_nobody]

And, given that the pushback for findings of pilot error can be nationalist in tone, all of these details could be twisted and presented as deliberate, malicious, inept, etc on the part of Americans, who messed up but want to blame the pilots.

Well given that they (including the CEO) have said there was no mechanical problem with the aircraft how can it not be a pilot problem?

If pilots can't fly a visual approach they should not be there. Don't try divert the issue away from the real issue which is why these guys struggled to fly a visual approach in good conditions and something that everyone else in the world seems to do perfectly safely 24/7/365.

its bound to happen... it will only be a matter of time... the days of the human flight crew is nearing its end... with automation taking its place.

Except automation can't do what humans can do in a aeroplane.

[Metro man]

Based on earlier posts about stable approach procedures, why not add an EGPWS mode offering a "GO AROUND" alert when the following conditions are met:

I believe AIRBUS have something in the pipeline to alert to an unstabilised approach. At the moment there is an arc displayed on the ND as a guide to energy management in the descent, if the arc crosses the runway threshold you are fine, if it's miles beyond that then it's time for speed brakes.

[junebug172]

Full throttle did not work. why?

When speaking about jets, we refer to "thrust" or "power". Throttles are for recip engines.

The crew did initiate a go around, but gave the aircraft very little time to respond. You have to consider two things here:

1. Engine spool-up time which, even at flight idle, takes a few seconds to come to full thrust.

2. Momentum - you simply cannot take any mass traveling in a particular direction and expect to change its vector instantaneously. It takes time, once the engines are to TOGA, for the airplane to start responding.

The crew gave the 777 about 1.5s to do the above two. You'd be hard pressed to get any aircraft to perform in the time frame.

Its important for a pilot to be a few seconds ahead of the aircraft at all times. Being proactive instead of reactive is the key. Once you get behind the aircraft, you're pretty much screwed.

[Etud_lAvia]

@techgeek, Metro_man:

Perhaps you will take a look at my post #1977, reachable by this link:

http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-99.html#post7938954

I'm curious what some ATPs may think of the concept.

PS It won't satisfy in the least, those who are appalled by the loss of stick-and-rudder skills. But maybe, once in a while, even a Pretty Good Pilot forgets something ... but is saved by a configuration warning horn.

[galaxy flyer]

Etud

It's being considered, I think Honeywell and its EGPWS gurus have designed it. Not released to service.

[techgeek]

@Etud_lAvia

It appears that we are in agreement!

My idea is an enhanced EGPWS mode (2?) that would address the short landing CFIT scenario exemplified by this accident.

[NSEU]

Q: Is the GPWS inhibited below some altitude on approach (similar to the A/T below 100' RA)?

Normal GPWS modes aren't inhibited

How do you define normal? If you look at detailed notes on the GPWS system, there are inhibits. For some modes, the inhibit is 30 feet. Inhibits can vary depending on closure rates and configuration and can vary enormously (e.g. up to 1000').

There is an AIRSPEED LOW caution (or advisory) fitted to Boeings. However, these are options. I'm assuming Asiana has not opted for an AIRSPEED LOW caution (beeper and message), otherwise it wouldn't only be the Second Officer alerting the flying pilot of his speed error.

[Etud_lAvia]

@techgeek:

EGPWS may have gotten a lot smarter than I remember it to be... but I think that the concept I proposed is a good deal "stronger" in the technical sense: that is, more restrictive.

If I understand correctly, EGWPS would not inherently warn of a "hot" landing coming in too high/fast (again, I may not understand how the systems work these days).

The "strong" warning system (which could be realized in the EGPWS, or any other convenient site in the avionics) could evaluate the full stabilized approach criteria selected by the appropriate authority (airline, certifying agency, etc.), including vertical and lateral deviations from ideal approach path, airspeed, and perhaps engine power range.

This would, of course, be more complex than a "too low/slow" warning.

@TWT: It'd be designed to be "always on" like the gear warning ;)

[AtoBsafely]

Kaokao,

From the information released by the NTSB and confirmed by Asiana CEO, the aircraft was working normally. From the data released, the aircraft was below normal speed for 30 seconds or more and the low airspeed warning and stick shaker activated appropriately. During the final seconds a go round was called and initiated and the aircraft responded normally with the engines spooling up as the impact occurred.

The pilots' account as reported in Korea bears little semblance to the facts as recorded by the FDR and CVR. This is exactly the cultural problem that western pilots who have worked in Korea and some other asian countries complain about. There is a cultural tendency to create an alternate reality rather than admit a shortcoming and learn from it or prevent it from recurring.

A critical part of the investigation will be to determine if any of the three pilots in the cockpit actually understood the state of the aircraft. Did they totally miss the indications and warnings they were getting? That is hard to believe. If they observed the approach becoming unstable and the speed decaying, why did they not act (PF) or say something (pilots not flying). It seems at this point that there was very little communication happening in the flight deck, and a go round was not considered.

The fact that it took so long after the crash to initiate evacuation is also indicative of the pilots state of mind.

The NTSB has a good history of sound conclusions, and in this accident there is a lot of data available. I agree that we should wait for the final report, but I also think that report will not praise these pilots.

[Photonic]

Given the recent posts from Korean sources, is anyone here still questioning the "too much information, released too soon" stance taken by the NTSB?

What are the options, after all? Should they hold all the info that's immediately verified, and let a thousand ugly rumors and wrong assumptions bloom on the Internet for a few months? Or release what they have that's verified information, and won't change in later reports?

I don't have any personal agenda here (other than hoping that the next flight my daughter-in-law takes from Seattle to Japan is a safe one). But I commend the NTSB for understanding the current media climate, which now means much more than the "official" media and extends through every corner of the Web.

[Indarra]

Photonic

One result of the faster media cycle is the implications for corporate bottom lines. In the old days, everyone could say we have to wait for the offical report in 18 months' or so time. By then the story had vanished from media attention and possibly a majority of prospective pax would not even learn about the final report when it came out. The airline concerned received a commercial advantage or "breather" from this buffer.

However, the situation now seems different. Perhaps this is the first time in a heavy crash that the responsibilities seem so clearly attributed, so early on. This must be very worrying for Asiana, and hence their imploring NTSB to be more discreet with releases, and calling for everyone to wait until the final report is out. NTSB will need to weigh the hurt to airline bottom lines from the fast news cycle from just one bad flight, versus the advantages of the faster and freer media such as in forcing airlines to quickly undertake necessary (and perhaps other, cosmetic) system reforms in order to retain the confidence of the flying public.

[kaokao]

Maybe I better make it short.

When they, cp especially, watched PAPI 3 reds and 1 white, he already knew the flight too low, which was at 500 feet, 34 secs before collision.

(Do I need to explain what PAPI is and what 3R1W means?)


He engaged the autothrottle ON and put the throttle lever back fully in order to gain the thrust. Then NO power increase at engine.


After GA engaged, the engine power revived, which was about 3 secs before collision.

We have to notice that what pilots say - they tried to regain engine power for 20 secs.


What missing from NTSB report is that the pilots were dumb for 20 seconds. However I could see that engine were dumb for 20 secs.

This is quite similiar case with crash at Heathrow airport 2008.

Similarities

- After engage autothrottle for the landing, engine went idle.
- throttle lever didnt help to gain thrust
- Crash just before runaway


Differences

- BA pilot called Mayday
- Asiana pilots tried to gain speed and altitude but no call
- Engine makers


When BA038 accident took place, initially the autothrottle function was suspected but concluded engine fuelling issue.

[twentyyearstoolate]

Kaokao ;

You mean to tell us that he pushed the throttle forward and got no response? But on the CVR he said absolutely nothing?? Then when the CVR has them calling for a GoAround, miraculously the Engines recover!

Oh it must be Boeings fault then, and also ATC for not telling them they were too low. Couldn't possibly be the Asiana crew :mad:

[nitpicker330]

Kaokao---we can understand how you want to defend your fellow Koreans BUT please stick to topics you understand. Obviously flying ( in particular large transport catagory Jets ) isn't your area of expertise....:{

[junebug172]

Man he's all over the place.

You need to give it up - your pilots screwed the pooch on this one and they did it badly.

Any airline pilot looking at this on what's be presented alone can see it was pilot error.

The CVR and FDs will more than put this to bed.

[No Fly Zone]

""Its important for a pilot to be a few seconds ahead of the aircraft at all times. Being proactive instead of reactive is the key. Once you get behind the aircraft, you're pretty much screwed.""

I think you got it about right. Those fellows from Asaina were Riding, not Flying their airplane.

[Thai Pom]

Mr. Metro Man,

Honeywell has developed a system called RAAS which is a "Runway Awareness and Advisory System". This would have told they were doing something wrong and they maybe would of reacted a bit quicker. I am not sure if A or B have it certified yet (or if they will), but there are STC's out there for the system on some aircraft types.

[dba7]

Dirty Sanchez

ASSUMING the translation stands up, it seems there is very little point investigating as the airline and wider Korean society will not be interested in the finding. Such denial and propaganda are reminiscent of ridiculous regimes over the last few decades...

The fact that the airline are trying to detract from the issue by threatening law suits over an ill conceived gag, is frankly appalling. If they took a closer look at why their "pilots" drove a perfectly serviceable jet into a sea-wall, killing 3 kids in the process, they might learn something.

Disgraceful.

Some nice stereotyping going on there.

S Korea has 50 million people. That's a lot of people to put into 1 category.

[caneworm]

Augmented crew operations.
Volumes have already been written on the two front seat guys, but what of the relief Capt & F/O?
Based on media reports this flight had an augmented crew (4 pilots). So, in respect to the other 2 pilots, who was where & who did what?
The relief Capt.
The media reported that the relief Capt was seated in the cabin for the approach & landing. This has been almost been glossed-over as being inconsequential.
Whenever I am operating as a member of an augmented crew we split into 2 ('A' and 'B') teams for the cruise, however all, repeat ALL crew members are required to be on the deck for take-off AND landing.
Why was the relief capt not on the deck? It could be that Asiana SOP's have provision for this and happy to be set straight if this is the case.
But assuming he was required to be on the deck for landing, it could be argued that he is at very least negligent or in worst case culpable in that another pair of 'trained' eyes may have prevented this accident.
The relief F/O.
How could a former 'nuck' quietly sit there and watch this happen without saying anything? Yet another example of Asian culture trumping CRM culture and sadly why this had no place in airline operations.

I hope when the investigators are done with the 2 drivers that they turn their blowtorch on the relief crew.

[RatherBeFlying]

If I understand kaokao correctly, the pilots did something to the AT to get more thrust.

KK, when you're thousands of feet up, you have the altitude to sort out any MCP confusions as long as you don't bust your clearance.

But when you are only a few hundred feet up with a serious descent rate, it's time to move the TLs yourself.

[HotDog]

Full throttle did not work. why?
They were 34 knots below Vref, with stick shaker active. They were definitely on the back side of the power curve and no amount of thrust would have been enough to get them out of this situation without increasing airspeed at this altitude.

[Machinbird]

He engaged the autothrottle ON and put the throttle lever back fully in order to gain the thrust. Then NO power increase at engine.

kaokao
I know English is not your first language, however, the sentence you have provided, if true, would explain the cause of the accident.

In English, "back" can also mean aft or toward the tail of the aircraft. This is the go-slow (idle thrust) throttle position.

The FDR data includes throttle position data. It should not be a long wait before you can actually see what happened with the throttles in a preliminary NTSB report.
I do not believe that these pilots had a reversed throttle reflex.

But do not expect these pilots to come out heroes.

[1a sound asleep]

How simple is it. :ugh: No airspeed and No altitude = MORE power needed. Take control of any automation and put your hand on the throttles and apply max power. Sorry to sound harsh but I am really tired of this automation culture. I know many airlines mandate the sue of automation as it potentially saves costs but this is basic abinitio training stuff

[lakedude]

4. Also - unless there was some other flammable material in the top of the fuselage amidships - where the fire flared up considerably about 5 minutes into the 2nd video - it would appear that composite fuselages flammability might be a concern.

Excellent post overall.

Not sure what you mean but I'm pretty sure that the trip-7 does not have a composite fuse. Composites are said to be used in the tails (h/v) and the floor beams.

Boeing: The Boeing 777 Family: Preferred by Passengers and Airlines Around the World (http://www.boeing.com/boeing/commercial/777family/background/back5.page)


Even the upcoming 777X is going to have a metal fuselage:

Boeing Defends 777X Aluminum Hull as Plastic A350 Flies - Bloomberg (http://www.bloomberg.com/news/2013-06-16/boeing-defends-777x-aluminum-hull-as-plastic-a350-flies.html)

[twentyyearstoolate]

All four pilots arrived back in Seoul on the 13th July.

[A4]

Did the NTSB not state in one of their briefs that the engines responded normally to all inputs by the pilots? This info can only have come from the FDR.

So, how about levers in IDLE as they capture from above, as they descend through the profile the levers are moved forward (as claimed by the crew) but even though they're at (approach) idle the response time is still relatively slow. The crew think (erroneously) they're not responding and close the levers to "try again". Repeat several times with the thrust barely going above idle and the perception is that the system has "failed" - only when they TOGA does the system "work".

What's the spool time from idle on 777 compared to the A320? Does the 777 have "approach idle"?

I offer this purely as a theory as to why the crew believed the thrust was not available.

[Vasco dePilot]

Stator Vane.
Thanks for your excellent post that every PPruner should digest.
1, SFO is a challenging approach environment where recovery from ATC imposed high and fast positioning on finals to visual approaches is common.
2, Reducing speed and descending from above the glideslope in a 777 requires assertive handing. That's what they were trying to do but failed.
3, Blend into the complex mix the inexperienced Training Captain and ex Airbus trainee, and the recipe has been disastrous.
Those self-aware and honest pilots among us will remember times when they've been in close shave scenarios where they needed all the skills available among their crew to avoid a catastrophe. Let us humbly acknowledge that "There but for the grace of God go many of us". :=
It is now the time to wait for the preliminary NTSB report with keen anticipation.

[kaokao]

Well, I already told not a pilot nor at flight industry.

However I have been working with complicating systems runnig with automatic control containing embedded sw for decades years.

When I heard what happened during Asiana 777 crash, I instinctly started survey the relevant information such as technical documents and incident cases showing what autothrottle was and whether similiar event ever happened.

Actually it is quite shocking that many people have strong beliefs on sw. Most of people started put their blames on pilots but almost none paid attention to the possible sw/hw defect.

80~90% of detects/incidents what we have encountered was software plus hardware problem, which might be a algorithm fault, coding mistakes and CPU system down.

I can just guess why many people expect is - boeing 777 has such a renown record of safety during a decade's her flights.

However in my professional perspective, it does not mean system is perfect. If conditions put together, the system will collapse.


I do not put blame on boeing yet nor pilots.

Just I am trying to collect information as many as possible to understand what problem have happened.


So far one thing is clear.

NTSB reports do not contain all information enough to judge whether it is system defect or pilots mistakes. However most people believe they are responsible for accident.


As NTSB claimed, whatever the flight has problems, it is pilots' responsibility to maintain speed and altitude.

But I would like to say

whoever manuver the flight at the cockpit, none can save thier lives if engine is not working as intended.

[LeadSled]

Throttles are for recip engines.
Junebug172,
Now I know what the problem was, with B747-200/300 I flew for about 5000h, and fitted with autothrottles --- Boeing fitted the wrong engines.

In another case of "anyone can make a mistake", I note that Asiana is suing NTSB and KTVU Channel 2 in Oakland for confirming incorrect names for the four flight crew.
Look up the cause of action for the incorrect names, as reported on the AFP wire service.
Tootle pip!!

[777boeings]

Stator Vane,
Your post is all very 'touch feely' and politically correct. Unfortunately though your post fails to address the primary issue here.
Flying a modern airliner is a grown up job. The flight deck is no place for people who can't perform at least to the basic standard required.
Technical knowledge, adherence to SOP, situational awareness, the list goes on....are an essential set of skills in an airline pilot. Preliminary facts show that the crew lacked any of these. Whether one knew them or not is neither here nor there.
Yes it is speculation at this point but that's what this forum is all about.

[ross_M]

Whenever I am operating as a member of an augmented crew we split into 2 ('A' and 'B') teams for the cruise, however all, repeat ALL crew members are required to be on the deck for take-off AND landing.
Why was the relief capt not on the deck? .

I hope when the investigators are done with the 2 drivers that they turn their blowtorch on the relief crew.

Is there a mandatory requirement to that effect (relief crews on flight deck for landings)? I am curious.

How many airlines' internal SOP's mandate it?

[Running_In]

Stator Vane, thank you for your post. I couldn't agree more.

I have personally made plenty of mistakes, I have tried to learn from each one and hopefully it has made me a better & safer pilot.

777Boeing

You say the crew had non of the below..

''Technical knowledge, adherence to SOP, situational awareness''

Do you really mean that? Or do you mean the crew had all of these to a degree but on this occasion maybe a reduced level of one of them led to an accident.

The RAF has red and white checkered caravans at the end of all of it's airfields that operate fighter or training aircraft - the idea is for them to act as an extra level of safety, checking for aircraft approaching with the gear up. So, it is accepted that even the best of the best will every so often make a mistake and try to put one on the deck with no wheels.

By your logic anyone who tried that and has to go around because of a red flare from the caravan has no situation awareness and has no place in a cockpit, despite the potential to have thousands of hours of flying experience. They have just been found out for the frauds they are and are simply not up to the job.

By Stator Vanes logic they are people who are put in a demanding environment and every so often, because only the pope is infallible, they fail to get everything right. That is part of the job and they hopefully live to tell the tail and learn to go on to be better aviators.

Now the RAF went for Stator Vanes logic - I guess they are just a bunch of PC touchy feely mummy's boys!

[clayne]

speculation is one thing. statements that imply that the writer of various responses could never make a similar mistake is not.

All the previous examples you listed were situations of adverse conditions. Can we get some examples of perfect sunny day visual approaches gone wrong at the list minute due to pilot error?

[koreafan]

Finally been drawn into this because it's getting silly and had to comment.

@ KaoKao

"We have to notice that what pilots say - they tried to regain engine power for 20 secs."

Sorry, I don't buy this at all. At this stage I personally believe what the NTSB have briefed on when TOGA was requested...which was not 20 odd seconds before impact.

[Momoe]

'Inexperienced training captain'??????

WTF is that then other than an oxymoron?

I'll wait for the NTSB report which I don't believe will have many technical issues.

[aviatorhi]

BBK, not a "large", but "mediums" count too right? I do about 75% of my sim training into that airport as well and feel familiar enough with the approaches to comment, and if a 5 mile straight in to an 11,000+ foot runway, which is 200 feet wide is considered difficult I'm just going to laugh.

[The Blu Riband]

75% of your training is at SFO?

What about the rest of the world? In any single month I go to asia, india, us, africa etc

I have 22, 000 hours (8,000 on 777s) and have landed at SFO abour 20 time over the last 15 years but have never practised approaches at SFO in the sim.

I am told many us pilots fly limited routes which makes them extremely familiar , but then perhaps atc expect too much of other, less familiar, operators.

Obviously I'm not excusing incompetence, but visiting an airfield twice a year is not the same as flying in and out daily.

[HazelNuts39]

What's the spool time from idle on 777 compared to the A320? Does the 777 have "approach idle"?
The regulation is the same for all Transport Category airplanes. FAR 25.119 Landing Climb: all-engines-operating specifies "The engines at the power or thrust that is available 8 seconds after initiation of movement of he power or thrust controls from the minimum flight idle to the go-around power or thrust setting", The airplane manufacturer selects the flight idle setting so that it meets that requirement.

Typically on high bypass-ratio engines during the first 3 or 4 seconds the acceleration is mostly in the high-pressure part of the engine with little increase in thrust.

[BBK]

Aviatorhi

Fair enough, but aren't you and the others who make the "guilty" call just a little bit curious about why this accident happened? Doesn't it seem odd that you have an experienced crew with about 27,000 hours between the three of them and no one noticed they were way below Vref?

In a way I envy people who can be so certain of their views when, in reality, they have no more data than the rest of us who have a natural curiousity and reticence to call the facts when they are not yet established.

For example, early on in this thread folks of your persuasion said well they're Korean so it must have been a meek FO too scared to stand up to the Captain....except it soon became clear it was a Captain, new to type, on his conversion course. Instantly their theory starts to unravel but don't let a few facts spoil your speculation frenzy. Anyway, if I have any sense I'll stop trying to preach my view. It's clear some people will drink from the fountain of knowledge and others just like to gargle.:E

[Tomescu]

It was mentioned numerous time here about the ATHR being on hold mode and that's something that I am curious to find out from the DFDR. Unfortunately, no matter how good is your training, human error take its toll sometimes.

[Vasco dePilot]

Momoe
'oxymoron'? Perhaps I should expand: inexperienced as a training captain on the 777 because this was his first flight as a trainer on this type.

[BuzzBox]

I do about 75% of my sim training into that airport as well and feel familiar enough with the approaches to comment

Yes, but how many times have you operated an unfamiliar 'heavy' widebody into an unfamiliar airport after a 12 hour ULH flight, at the back of your body-clock, without an ILS? A visual approach into SFO on a CAVOK day should be a non-event for a pilot who routinely makes such approaches, but I would suggest it's a very different story for the average ULH pilot who is new on the aircraft, tired and not particularly current. It's very easy to sit back and s***-can the guys involved in this accident - try putting yourself in their shoes.

[FERetd]

caneworm, Quote:- "Whenever I am operating as a member of an augmented crew we split into 2 ('A' and 'B') teams for the cruise, however all, repeat ALL crew members are required to be on the deck for take-off AND landing.
Why was the relief capt not on the deck?"

Probably because the B777 is certificated for a two crew operation - unless your Company is suggesting that it should't be.

If your Company accepts that this SOP enhances safety, does it accept a lower level of safety for short or medium haul operations? If so, why?

An extra pair of eyes when in the terminal area can't be a bad thing, but they need to be looking. An extra pair of hands when things are going wrong is also useful. However, sometimes the flight deck can become too crowded - you've probably experienced a 747 Classic with all the flight deck seats occupied.

When an augmented crew is operating in a normal crew environment, reponsibilities need to be clearly defined lest too many cooks.....

[aviatorhi]

75% of your training is at SFO?

What about the rest of the world?

It's a simulator from the 1980s, you can only put so much in. In any month I bounce around the Pacific as well. Now I'm not saying they need to blaze in at full speed like I do into the airports I go into and pick up all the landmarks I have memorized, but they need to (at the very least) not say that a long wide runway with a 5 mile final is a "challenge".

Fair enough, but aren't you and the others who make the "guilty" call just a little bit curious about why this accident happened? Doesn't it seem odd that you have an experienced crew with about 27,000 hours between the three of them and no one noticed they were way below Vref?

Tells me they were counting on the A/T to hold speed for them, and apparently it wasn't. The other option is that the ASI isn't part of their scan in the first place since they've become so dependent on the A/T to do the work for them. You would imagine the AF stall into the ocean wouldn't have happened either since there were enough hours of experience in the cockpit to keep from stalling an aircraft. Now, if we look at the most recent aviation accidents involving major passenger airlines in the western world we have:

Asiana B777
Air France A340
Colgan Q400

At the base level, all a result of not adding power when it was needed. I know that we should wait for the report on Asiana, but the one paramount FACT which the NTSB did put out was that the aircraft systems were functioning normally during the approach, all the way to impact. Which leaves only operator error, the report we are in fact waiting for is only a descriptor of the operator error and what the NTSB will recommend to prevent future occurrences (to my dismay this will probably be more automation).

Now, you can go back and look at my remarks on the subject and I've never suggested it was an Asian cultural issue, etc. I think this issue is applicable to all airlines which preach, and all pilots who accept, the mandatory use of automatics for as many phases of flight as possible.

...try putting yourself in their shoes.

They're probably better rested than I am after a 14 hour duty day with no relief pilots.

[220mph]

BBK - aren't you ... just a little bit curious about why this accident happened? Doesn't it seem odd that you have an experienced crew with about 27,000 hours between the three of them and no one noticed they were way below Vref?

BBK - that is my question exactly. I've tried to understand how this could occur ... how absent mechanical failure, which does not so far seem likely from the data provided, these experienced pilots could get into the position they did.

It is seemingly beyond comprehension this could occur in today's world with all the resources (and here experience) available.

It shouldn't be about guilt or necessarily blame - but moreso learning and understanding why and how this could have occurred - in order to help prevent from happening again.

[A4]

Typically on high bypass-ratio engines during the first 3 or 4 seconds the acceleration is mostly in the high-pressure part of the engine with little increase in thrust.

Thanks HazelNuts.....so that lends some credibility to pushing the levers, thinking nothing is happening, closing them to "try" again etc etc

Could be BS (particularly with the experience level in the flight deck) but I see no other way how the crew could try several times with no response....but TOGA worked, albeit too late.

[glofish]

Yes, but how many times have you operated an unfamiliar 'heavy' widebody into an unfamiliar airport after a 12 hour ULH flight, at the back of your body-clock, without an ILS? A visual approach into SFO on a CAVOK day should be a non-event for a pilot who routinely makes such approaches, but I would suggest it's a very different story for the average ULH pilot who is new on the aircraft, tired and not particularly current. It's very easy to sit back and s***-can the guys involved in this accident - try putting yourself in their shoes.

The only thing i can concur that might be a tiny little help to excuse the inexcusable, is the first, namely operating an unfamiliar heavy. But that is exactly the point where the trainer steps in and by that i mean a trainer with experience on it. What Asiana did here, and many other inconsiderate airlines do, is pairing two pilots unfamiliar with their seat. That is almost a set-up for a problem.
I truly hope that the NTSB will point that out very clearly and some regulators will implement correction in that respect.

Everything else you pointed out is bullocks, sorry.

There is a reason we are still in the cockpit and a cavok day visual approach should in almost any case be a no-event with even a AT malfunction into SFO.

Otherwise please hand in your wings and enjoy airline flying as a passenger.

I respect the trying to keep up some camaraderie as to not convict these pilots too early, but there is a limit to that, please.

[BuzzBox]

There is a reason we are still in the cockpit and a cavok day visual approach should in almost any case be a no-event with even a AT malfunction into SFO.

With the greatest respect, I disagree. The typical 'slam-dunk' approach into SFO can be a challenge at the end of an ULH flight, even with a functioning ILS. Take away the ILS, put an 'inexperienced' crew in the seat and it's not hard to see how a break down in situational awareness could occur. Throw in some cultural factors on top of that and the rest is history.

[ross_M]

I respect the trying to keep up some camaraderie as to not convict these pilots too early, but there is a limit to that, please.


+1

For those who want to stop discussing this till the official report is out: Fine. But if any system changes are going to result, the sooner the better.

The media, policy-makers and general flying public have fairly short memories. Once this disaster fades into the background no one will want to do anything about it. Those who want status quo, and unexamined dirty details need exactly this haze of time.

So if there is got to be any lobbying for change it better be soon. Personally, I'll fully agree that a full conclusion about the causes of this disaster, we don't have yet. But I'm a Bayesian, and based on past data and whatever details have been confirmed so far it is fairly clear what the likely causative factors are here. Not with 100% certainty of course, but that doesn't mean we ought to ignore the obvious and pretend we have no clue as to what went wrong.

To sum, whatever flavor be your reccomendations for change, the sooner they are lobbied for, the greater the chance that they will stick. The more you wait, the greater the likelihood this will be yet another disaster only remaining in the memory of technical forums like this one.

[edmundronald]

These are the holes of the cheese that lined up:

1. Disabled landing aids at SFO requiring visual approach from tired long haul crew.

2. PF unfamiliarity with type, and PIC unfamiliarity with training role, not a standard crew distribution, leading to loss of situational awareness of airspeed and CFIT.

3. Passenger ejection during hard landing as result of CFIT.

4. Ground crew driving over passengers.


I really think that (1.) deserves looking at, because otherwise it is just a question of waiting for the next incident, as aircrew training and fatigue will clearly not improve substantially in the next few years. As for (4) ...

[Indarra]

edmundronald

While early reports said passengers were ejected from rear, NTSB later stated this wasn't the case.

[glofish]

The typical 'slam-dunk' approach into SFO can be a challenge at the end of an ULH flight

It was not a slam-dunk approach, it was a very usual "visual" with the distance to height at a normal rate. If for the respective pilot this seems too high and close, say it and go around.
If either call is a challenge, then you belong to the children of the magenta, or there is definitely a problem with CRM/culture.

A visual in SFO should be a treat and not a threat.

You should not continue flying such equipment if you deem that a potential threat, as simple as that.
A T7 is ETOPS qualified and i don't know if you know, but most ULH sectors are ETOPS today and ETOPS is defined by "able to descend to resp. level, with resp. speed, proceed to the ETOPS Alt, 15 min hold at 1500ft, shoot an instrument appr. and GA, then land with a visual circuit". So there is a regulatory need to be able to do a visual at a most probably unknown airfield with a low ceiling!
I expect every ULH/heavy pilot to be able to do that, daily experience makes me doubt that, however. I have repeatedly pointed out the lack of skill of todays pilots. Now that some proof materialises, i hate the watering down of the obvious.

Disabled landing aids at SFO requiring visual approach from tired long haul crew.

This is not a hole in the Swiss cheese! They were augmented, thus fatigue is a small contributing factor. And spare us that "a visual is a hole lining up" bs, please.

[RHKAAF]

I was based in Hongkong during the 80's and 90's when KaiTak was considered one of the more difficult airports to carry out a visual approach. Often , including during the Typhoon season, the ILS or IGS would be switched off for "maintenance" Then it could not be switched on again until it had been flightchecked--sometimes for weeks on end. Why cannot a backup ILS be on hand to cover outages?. The Military even have portable systems to call on. Are GPS approaches now permitted ?

When on visual approaches, the only need to look inside at the instruments is to check AIRSPEED. All other parameters are covered by eye ,especially at a field with VASI's, VGPI's or any other glideslope indicaters.

[Lonewolf_50]

oldbob (http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-97.html#post7938191)@

It was a clear, a no-wind day and the airplane was doing everything that it
should have.
The target that was the end of the runway was in sight, if the target moved
up you add power. If it moves down, you retard power.
You concentrate on where you want to land and act accordingly...but then,
that is if you are a pilot.
That reflex/pattern/habit is apparently being trained out of long haul line pilots via neglect. That's the problem a lot of pilots have mentioned in the course of this discussion.

See, for example, the comments by the following gentleman:
HPSOV_L (http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-97.html#post7938191)

The system is setting pilots up for failure. Does the industry care?
Fox3 suggests not (http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-102.html#post7940226), when it comes to cost benefit analysis.

How likely is it that the public will be receptive to the point Fox 3 makes?

I don't know.

Basic flying skills proficiency seems to have been a root cause of AF 447. A pilot could not fly straight and level in cruise while non flying pilot trouble shot a systems malfunction. Basic pilot skills, not in evidence.

Two captains flew an approach that got low and slow at the back end of the power curve. Flew an approach that was not stable. Dropped 30 kts below VREF without making a decisive correction. Basic piloting skills not in evidence. Go around not initiated in a timely fashion.

Lion Air: unstable approach, landed short, thank God nobody died on that crash . (And that one had Wx as an element. ) Go around not initiated in a timely fashion.

Are these isolated incidents, or are they symptoms of an industry with a disease?

"The pilots are to blame" is an easier sound byte to swallow. It also means less effort on getting systemic fixes put into place.

How costly has it been to implement and embed in the culture CRM? Bloody expensive, but it was done (thank God) in order to make flying better and safer. (I am

What is it going to take to resolve the issues like A330 flown by Air Afrique into the ground?

How many more body bags?

[BuzzBox]

It was not a slam-dunk approach, it was a very usual "visual" with the distance to height at a normal rate.

I don't know for sure, but previous posts on this thread would seem to refute your assertion that the distance to height was 'normal'. In my experience, long-haul flights coming in from the Pacific are typically held high (10,000-12,000ft over PYE), followed by a steep descent over the Bay area to join right base for 28L/R. It's certainly not impossible, but it can be a challenge to get down, configured and stabilised on the final approach.

A visual in SFO should be a treat and not a threat.

Yes, it should, but unfortunately that's not the reality for most long-haul pilots. The typical long-haul pilot does not get many handling sectors these days; captains might get four a month, while some FOs are lucky to get one. The simple fact is that most long haul-pilots are not as sharp as their short-haul colleagues, particularly when they are operating at the back of their body clock.

By the way, I was a 777 skipper, I have more than a few thousand hours on the aircraft and have operated into SFO on many occasions. I am well aware of the ETOPS requirements and I must say that your take on things is simplistic in the extreme.

[misd-agin]

All the drama about SFO being tricky. Please tell me what's so tricky about it?

At the end of a long haul segment? That happens hundreds or thousands of times a day across the world.

Transition pilot getting IOE? Happens every day, hundreds or thousands of times daily.

New TRI/LTCA/CKA? Happens monthly, and maybe weekly, at major airlines.

At the end of the descent is an approach. In this case a visual approach and an FMC could be used for basic(distance to touchdown...300' per mile calculation) or more advanced guidance (RNAV, VNAV, etc). And the approach ands at pavement.

Let's not make SFO into something it hasn't. The hardest part of flying into SFO is trying to take the entire view in, it's that beautiful.

[Fox3WheresMyBanana]

Especially if the experienced hands reckon an SFO approach is hard, shouldn't the decision to go around have been made a lot earlier from such an obviously unstable approach? Judging from the radar plot of the glideslope flown, they hit the g/s about twice as close as I ever did flying run-&-breaks in the RAF.

[BOAC]

Buzzbox - I do not agree with your analysis of Glofish's post - what seems to be filtering out here, and hinted at by you, is that given the understandable lack of 'handling' by long-haul crews an ETOPS diversion on near min fuel plus a subsequent g/a, all flown under a stressful situation, carries a high probability of an accident in the ensuing visual circuit and that it seems to be agreed that at the end of a long flight, a visual is not the desired approach as it is really not safe to expect a 'tired' crew to execute one. So be it, if true.

Surely then the regulations need to change to require

a) Extra ETOPS div fuel to allow a second coupled approach at the alternate

b) A mandatory coupled approach on arrival at dest (or div if required to achieve) on a long-haul sector as defined by over xxxx hours or by circadian factors

If that is what we need, that is what we need. Let's not just pussy-foot around talking about the bunnies being 'tired' and having body clock problems and 'slam-dunking' around the sky - adjust the ops to cope?

[flyingchanges]

They were 34 knots below Vref, with stick shaker active. They were definitely on the back side of the power curve and no amount of thrust would have been enough to get them out of this situation without increasing airspeed at this altitude.

At landing weight, TOGA power would have flown them cleanly out of this.

[ross_M]

These are the holes of the cheese that lined up:

1. Disabled landing aids at SFO requiring visual approach from tired long haul crew.

2. PF unfamiliarity with type, and PIC unfamiliarity with training role, not a standard crew distribution, leading to loss of situational awareness of airspeed and CFIT.

3. Passenger ejection during hard landing as result of CFIT.

4. Ground crew driving over passengers.

Edmund

Nice list! :ok:

I'll add some, perhaps less important, points:

5. General sense of unease in Flight Crew about visual ops. (Speculative, but should be tested. Perhaps by throwing visual approaches at this or other Asiana crew in the Sim or check flights. )

6. Failure of relief crew in drawing attention to the impending disaster forcibly enough or failure of flight crew to take notice of relief crew's warning calls. Bad CRM?

7. Failure of the other relief crew member to remain present on flight deck during landing. (Who can say if that one extra set of eyes might have caused an earlier go around)

8. PF mixing manual and automated landing modes without realizing the precise nature of control logic.

9. Boeing allowing combinations in control logic that are potentially dangerous or easily misunderstood or not widely understood.

[palm47]

one cannot say how many, simply do not fly commercially and so perhaps, understandably, shout "pilot error" as a reflex. It could turn out to be a far more complex situation than we realise. I've said this before but watch Captain Sullenberger's interview for an eloquent rebuttal of why it is wrong to start screamimg "pilot error". In fact he calls the very term outdated and talks about human factors.We have arrived at a certain point of automation and "intelligent a/c" where I (as a passenger) will not longer accept "pilot error" as the cause of catastrophic events (and we can be lucky there were "only" 3 fatalities in this case).

Numerous pilots here have pointed out how fundamental errors where made in the simple observation of speed and altitude. And I as a passanger do not want to depend on captains, who may have an hangover, long haul, being from the wrong non-CRM "culture" or simply a bad day and being in the danger of making similar mistakes.

This event has tragically shown that a whole crew can make these kind of mistakes. The question is to the solution.
It could be a better pilot training/qualifications. But sorry, I as a passenger do not know who is flying the a/c. Is it the experienced one or are they basically training newbies in the cockpit and have additional divertion on top of all other problems of human factors?

The a/c had a vector into the ground (short of the runway) which could not be recovered when the stick-shacker went of. It was too late already (and it only warned of the approaching stall).
Yes, the pilots did let that happen. But the plane did, too. And I say the plane should have prevented that or at least warned the crew. The pilots here can say all they want about how simple it is to view airspeed and alt and act accordingly. The fact is: Some pilots didn't.

[PaperTiger]

However I could see that engine were dumb* for 20 secs.Where's this coming from? If it was in one of the NTSB briefings then I missed it. If the Asiana pilots have spoken publicly then I missed that too.

Simple revisionism/PR methinks.

* in reponse to power inputs that is

[BuzzBox]

BOAC:

an ETOPS diversion on near min fuel plus a subsequent g/a, all flown under a stressful situation, carries a high probability of an accident in the ensuing visual circuit

I have no doubt that such a scenario would be extremely stressful and carry with it a high degree of risk. I understand that the ETOPS minimum fuel reserves are based on such a scenario, but I have to ask what are the chances of it happening in the real world? Would changing the ETOPS requirements actually do anything to improve safety outcomes and prevent the type of accident that occurred in SFO? I doubt it.

[SMT Member]

Lifted from aviation week dot com:

NTSB Chairman Deborah Hersman said July 10 that during the final 2.5 min. of flight, the flight data recorder shows transition to “multiple autopilot modes and multiple autothrottle modes.”

Uncertainty hangs over whether the mode changes were pilot induced, or commanded by the auto-flight system. In any case, does point to a crew busying themselves trying to make the autoflight system do as they want when, perhaps, they should have gone 'click-click', 'click-click' and simply hand flown the aircraft to a safe arrival. In this context a lack of currency induced by long-haul flights, restrictive SOPs and an institutional opposition to manual flight should play a major role in the investigation.

Perhaps this accident, along with the more unfortunate ones involving Continental and Air France, may finally motivate the regulators to impose more hands-on practice, both during initial and recurrent training, as well as an examination regime ensuring they boys and girls up front demonstrates their ability to pole the damn thing around the skies.

[BOAC]

Would changing the ETOPS requirements actually do anything to improve safety outcomes and prevent the type of accident that occurred in SFO? I doubt it. - I am not following your question. Item b) would in theory HELP to "prevent the type of accident that occurred in SFO", not a)

a) would hopefully HELP to prevent an SFO Asiana event at an ETOPS div.

[Machaca]

Reuters reports (http://www.reuters.com/article/2013/07/15/us-usa-crash-asiana-idUSBRE96E07I20130715):


Asiana Airlines said on Monday that it would enhance training for pilots seeking to convert to flying new aircraft, part of a series of measures it is undertaking after the fatal crash of an Boeing 777 plane in San Francisco.


"We will bolster our training program...when a pilot converts to a jet from a different manufacturer," Asiana said in a presentation to the government, which was shown to reporters.



The new measures will include enhancing training for visual approach and automated flight and conducting flight inspection on airports which are "vulnerable to safety."


The pilots aboard the Boeing 777 made a visual approach to San Francisco airport, and relied on automatic equipment to maintain airspeed.

Asiana said it will also seek to improve communications skills among crew members, and introduce a system to manage "fatigue risk."

Other measures include setting up separate maintenance teams for Boeing and Airbus planes, and enhancing safety management systems.

[ssites]

"With the greatest respect, I disagree. The typical 'slam-dunk' approach into SFO can be a challenge at the end of an ULH flight, even with a functioning ILS. Take away the ILS, put an 'inexperienced' crew in the seat and it's not hard to see how a break down in situational awareness could occur. Throw in some cultural factors on top of that and the rest is history."

And an inexperienced crew should not be flying 300 people around

[A Squared]

With the greatest respect, I disagree. The typical 'slam-dunk' approach into SFO can be a challenge at the end of an ULH flight,

And

I don't know for sure, but previous posts on this thread would seem to refute your assertion that the distance to height was 'normal'. In my experience, long-haul flights coming in from the Pacific are typically held high (10,000-12,000ft over PYE), followed by a steep descent over the Bay area to join right base for 28L/R. It's certainly not impossible, but it can be a challenge to get down, configured and stabilised on the final approach.


This is an interesting phenomenon in this thread. It was established very early on, within a day or so of the accident that there was nothing "slam dunk" about this approach. That is very clear from the flight track data available on Flight Aware, almost immediately and has been confirmed repeatedly by all actual sources of real data released.

Once again: Asiana flight 214 was aligned on final by 14 NM from the runway threshold at 4300 ft.

This has information been posted repeatedly in this thread, yet still people insist that ATC gave them a "slam dunk" and somehow, without a scrap of supporting information, this becomes "truth"

[Machaca]

kaokao

On July 11 NTSB Chairwoman Deborah Hersman stated:

"There is no anomalous behavior of the autopilot, of the flight director, and of the auto-throttles, based on the FDR (flight data recorder) data reviewed to date."

With over one thousand 777's in operation, the investigators would have immediately informed the operators if a fault were posing a significant risk.

And as several have explained, it is the pilots job to override the automation if needed and fly the plane.

[7478ti]

Concur, ....but I specify "QUALIFICATION", as distinguished from a "License" per se (e.g., some European state's notion of a T/R's purpose) because QUALIFICATION is meant to include Training, Checking (evaluation), and Recency (currency). In addition Qualification addresses the full range of Knowledge, Skills, and Abilities for operation of a specific vehicle and mission for that specific flight (unlike many "Licenses", or a degree such as an M.D. degree, which may not necessarily even "Qualify" a person to perform a particular medical procedure).

I say "virtually" regarding the pilot intent issue, only because of the "outlier" cases of a few historic unfortunate deliberate acts that have in fact been attributed to seasoned commercial pilots (intending harm) over the decades (I can cite specific examples).

[suninmyeyes]

For those who have not flown a 777 and have expressed incredulity and lack of understanding of what could have happened at SFO I would like to explain a few things. I have seen it demonstrated in the simulator and it all happens very quickly.

Being high and fast at 1000 feet led to idle thrust. This led to a decelerating speed.

If you take a snapshot at 500 feet the height and airspeed looked about right. From having been high and fast the crew would have a sense that things were back on track. The biggest clue that things were about to go wrong was most likely the word "HOLD " at the top left of the primary flight display that indicates to those in the know that the autothrottle although engaged will not increase the thrust. Had the word at the top left been SPD (Speed) the accident would not have happened.

From 500 feet the plane starts to go slightly low on the visual profile. As all the private aircraft pilots on this thread have told us if you are low on a light aircraft you add power. That is not the case in a commercial airliner. If you are low you raise the nose and the autothrottle adjusts thrust to control the speed unless it is in hold mode.

If you have gear down flap 30 and idle power and are decelerating below Vref and you raise the nose then the rate of speed decay happens extremely quickly. At this stage if you are not aligned with the runway you inevitably spend more time looking forward and turns involve both ailerons and spoilers and invoke more drag. Apart from practice in the simulator this was probably the first approach either Captain had done where the autothrottle did not maintain the Vref speed. The landing checklist was not completed until 500 feet. The landing checklist in the 777 is electronic and normal airline practice is that when the checklist is complete the non-handling pilot announces it and the handling pilot would then have to look inside the flight deck below 500 feet at a critical time to confirm the checklist was complete. It's a bit like checking your text messages in a car while overtaking. Had this checklist been completed earlier it would have been one less distraction.

So to recap, although at 500 feet height and speed were ok the thrust levers were at idle, the alignment was not right and the nose was then raised with the speed decaying rapidly. It was probably only about 20 seconds after things looked OK at 500 feet that the the aircraft was below 200 feet and the situation was non recoverable due descent rate and lack of speed and low thrust setting. Jet lag does inevitably slow down the recognition process.

I am not in any way excusing what happened, I am just pointing out that it can happen extremely quickly with distractions which is why most 777 operators employ standard operating procedures that involve being stabilised at the right position and speed at 1000 feet with thrust levers back up and speed at vref controlled by the autothrottle and landing checklist complete. None of these happened in the above case which led to a lot of distraction and regrettably in that very busy period it looked like the crew became overloaded and missed the rapidly decreasing airspeed.

As regards changing procedures at SFO. I do not think it is necessary. Thousands of approaches were flown before this without accidents and thousands of approaches will be flown after this without accident. I'd also like to venture that in the unlikely event that the same crew were allowed to fly an airliner again they would never make the same mistake again. An accident is a painful learning experience.

[Lonewolf_50]

Tom: thanks for the reply, not sure why my post was deleted. Maybe it was too long. :(
suninmyeyes:
If you are low you raise the nose and the autothrottle adjusts thrust to control the speed unless it is in hold mode.
That seems to be the problem. Either the pilot adds power, or the A/T adds power (an automated feature, type dependent) but when low and slow there is a need for power to correct. Retired F4 named this pages ago: it is an energy management matter. Pilot (or an auto feature) adds energy via power (engines). Merely changing pitch does not add energy, it trades energy. If pilots are taught to fly the nose and the plane will take care of the power (because it seems that frequently, it is set up to do just that) then the root cause of an automation induced (assisted?) trap seems to be staring us in the face. (Granted, one can get low and slow in an aircraft without a bit of automation as well ... particularly if distracted ... )

In this respect, flying a visual approach in a heavy is no different than flying a King Air, with the major exception of response time. The pilot in a heavy has to be further ahead of the aircraft than the King Air pilot due to how long it takes to overcome inertia in landing configuration, at approach speeds, in the case that a correction is needed or a Go Around is required.

A similar comparison: driving a PT boat versus driving a Navy Destroyer. Response time / inertia: big difference.
If you have gear down flap 30 and idle power and are decelerating below Vref and you raise the nose then the rate of speed decay happens extremely quickly
From behind the power curve to further behind the power curve ... energy deficit.
Apart from practice in the simulator this was probably the first approach either Captain had done where the autothrottle did not maintain the Vref speed.
Aviation Week asks (July 15 2013 issue) Automation Paralysis?
The landing checklist was not completed until 500 feet.
Do you think this was due to accepting the 180/5 call from ATC?
Someone made a point on that early on in the thread.

[suninmyeyes]

Lonewolf

I do agree that 180 knots to 5 DME was a contributory factor to not being stabilised if they conformed to that. I personally would have either said " unable" or reduced speed at least two miles earlier as has been suggested earlier.

[PEI_3721]

suninmyeyes, thanks for an excellent and thoughtful explanation.

I would add / ask that the differences between previous A320 experience and the B777 may also have had influence, e.g. A320 autothrust when engaged will maintain speed without thrust lever movement, as in this accident.
What are the equivalent correct/incorrect A320 autothrust annunciations?
Does type training pay enough attention to these differences?

Also, the flight technique – raising the nose, should be based on the ‘normal’ picture, the attitude with respect to the real world for the aircraft type; had this pilot sufficient experience on this type to establish a normal picture?

Would the crew have any additional cue of speed error from the control force, assuming it deviated from the trim condition; or does the B777 have an auto trim follow-up system in manual flight?

I would disagree about not changing SFO procedures; previous success is not evidence of safe – acceptable risk operations. Accidents are a combination of factors – “the unforeseen and often unforeseeable concatenation (linking) of diverse events, each one necessary, but singularly insufficient.” (James Reason).

“The landing checklist was not completed until …” We often ‘kill time’, but lack of it can be a real killer; how many occasions did your post refer to time.

[phil gollin]

There is a majority (but not universal) feeling that the ATC advisory "180 kts to 5nm"/4-degree approach was a possible contributory factor.

I am sure that ATC did not impose this as a whim, in fact a couple of people have indicated that it is a common call for noise abatement reasons.

Well, where does that policy come from ?

Is it an airport operating requirement ? Is it just something that they would prefer ?

[Chronus]

Here is a link to a little piece written by Perry Thomas.

The Visual Trap (http://asrs.arc.nasa.gov/publications/directline/dl3_visual.htm)

I just wonder in accepting a visual approach whether the crew breached company SOP, were prepared for it in their landing brief or had been admiring the maginificent scenery which has been commented upon by another contributor to this forum.

It is of course the great Summer season over here in Europe and many charter operators are busy hauling our sun worshippers to wall to wall sunshine destinations, where the likes of PAPI`s may be difficult to read. For those heavy drivers Mr. Thomas` article may be worthy of a quick read.

[Bill Bader]

As regards changing procedures at SFO. I do not think it is necessary. Thousands of approaches were flown before this without accidents and thousands of approaches will be flown after this without accident. And as several have explained, it is the pilots job to override the automation if needed and fly the plane. And an inexperienced crew should not be flying 300 people around I've followed this entire thread, and I've read every post. These three points become painfully clear.

So many people have disagreed, usually allowing for pilot fatigue or a lack of hands-on skill. But, when I buy a ticket to fly, what I DON'T see in the fine print is the following:

"The ticket purchaser agrees that flying an airplane is demanding work, and crews may be fatigued or may lack the ability to manage the aircraft without anticipated computer assistance. Therefore our passengers are reminded that, from time to time, aircraft may stall and crash into the Atlantic Ocean or smash up whilst landing on a bright sunny day in San Fransisco. Should you be on such a flight, and should you thusly be killed or mangled, or should your spouse, parents, or children thusly be killed or mangled, we ask you to bear with us. Thank you for your understanding in this matter."

I think apologists should ask themselves whether such a caveat would seem quite okay and reasonable. Maybe in bright red, on their ticket.

Similarly, other professionals, from your friendly brake-repairman to your surgeon, might also like you to be so understanding. They, too, might be tired or new at the job.

[BuzzBox]

This is an interesting phenomenon in this thread. It was established very early on, within a day or so of the accident that there was nothing "slam dunk" about this approach.

A Squared: I was merely trying to point out that approaches into SFO are not always as 'easy' as some of the jocks on this forum seem to allege.

Having now had the time to trawl back through over 1,000 posts, it seems the flight in question was vectored in down the coast to join left base for 28L. That brings its own difficulties due to the high terrain to the south of the airport. The aircraft might have been 'aligned on final by 14 NM from the runway threshold at 4300 ft', but what speed was it doing? The Flight Aware data seems to suggest it still had a ground speed of around 230 knots. That's not an impossible situation to be in, but nevertheless it presents a challenge in achieving a stabilised approach if not handled correctly. Again, a reasonably fresh crew at the top of their game might not have a problem, but it's a different story altogether for a tired long-haul crew.

Why they didn't recognise the situation earlier and do something about it (ie go around) will no doubt be a focus of the investigation.

I think apologists should ask themselves whether such a caveat would seem quite okay and reasonable.

Bill: Nobody, including me, is 'apologising'. Most of us are merely trying to understand how this happened in a bid to find ways to prevent it happening again.

[Dolfin]

I would add / ask that the differences between previous A320 experience and the B777 may also have had influence, e.g. A320 autothrust when engaged will maintain speed without thrust lever movement, as in this accident.
What are the equivalent correct/incorrect A320 autothrust annunciations?
Does type training pay enough attention to these differences?


The really big difference between Boeing and Airbus is that the Boeing gives a tactile feedback by moving the controls and thrust levers, while the Airbus does not give any tactile feedback.

Thus, flying an Airbus, it is required to check always visually, what the bird does => change a parameter, then see on the instruments what the bird does, even (especially) on a visual approach.

That in turn means, as a former Airbus driver, at least this pilot should have been used to checked more often the instruments and so he should have detected the airspeed / N1 / EPR disagreement very soon, just by checking his instruments. Basic jet flying.

Regarding the training issue, see my post #1794 (http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-90.html#post7935876).

Just my 2 cents.

[jack11111]

Something is bothering me terribly: is there going to be an internal investigation of the run over girl...or is it this going to be sweeped under the "FOAM"?

[Dolfin]

Being high and fast at 1000 feet led to idle thrust. This led to a decelerating speed.


Well, and what should have happened at 1,000ft if the aircraft was too high and too fast?

Most operaters I know call this an unstabilized approach and require the crew to GO AROUND!

The landing checklist was not completed until 500 feet.
...
So to recap, although at 500 feet height and speed were ok the thrust levers were at idle, the alignment was not right and the nose was then raised with the speed decaying rapidly.


The aircraft was not stabilized at 500 ft either, another chance for a GO AROUND missed, not even the checklist was read at 500 ft nor adequate power set!

That has nothing at all to do with not understanding automatics or changing to a new type or having two guys in a new role or on a new seat or lack of a bloody glideslope.
That is nothing less than (multiple) disregarding SOP by not performing a GO AROUND at well predefined points for an unstabilized approach.

And, btw, the Airbus has an electronic landing checklist as well, so the trainee was familar with that.

[galaxy flyer]

Jack11111,

I'm sure there will be, the fire service debriefed any event like. The NTSB will probably include some of the findings in its report. But, by then, it will be page 3 news.

[fire wall]

Enough bullsh1t from general public and 100 hr private pilots
I have flown into KSFO numerous times with 21 years flying Boeing a/c, stated only to advise that this is not ill informed comment. Whilst the traveling public and pvt pilots are entitled to their opinion, this wild speculation does nothing to get to the crux of the accident.

1. The a/c was NOT given a slam dunk approach. Aligned on final at 4000 odd feet at 14 miles is not a slam dunk.
2. 230 kts at 14 miles is NOT a challenge.
3. Stabilised approach criteria was NON existant.
4. The a/c was on profile at 400 ft..... but with a ROD at close to double the stabilised equivalent, way outside the ballpark.
5. The 3 muppets up front said NOTHING. (I won't honour them with the term pilots)
6. A/T hold is a normal A/T sub mode. It only becomes a "trap" when you don't know what you are &^%#& doing.
7. It is preferable that the guys up the pointy end know what they are *&$^ doing !
8. All ULH operations have a fatigue element. It is a professional's responsibility to mitigate that fatigue element by inflight rest, professional competence and knowing your game. The last two items were NON existent.

These morons masquerading as pilots deserve jail time, the charge professional incompetence.

[misd-agin]

14 DME, 4300', 230kts, or even 250kts, is now being presented as some sort of tricky arrival? :{

It isn't. Period. Routinue arrival trying to save time is 250kts to 10 DME @3000'.

And every long haul crew is tired. Most are lucky if they get 2 hrs of sleep during a long haul overnight flight. Three hours of sleep, unless on a four man crew, is rare.

Four man crews are the most rested. Asiana was a four man crew.

[RoyHudd]

Try 2-crew long haul ops, and you'll know what tiredness is. UK charter companies are specialists in this exquisite form of cost-saving torture. Cheap tickets, exhausted pilots, no rest areas for 3-crew when they happen.

[Punchespilot]

Firewall ,Good post ! True indeed.


On another note , regarding speed brakes , i am wondering what is the likely hood the approach was flown with the speed brakes up ?

[despegue]

Manual flight with autothrottle/ thrust is not a good idea, and I do not practice it, neither does my company. either all ON or all OFF. combining makes things jot only more complex, it confuses both the aircraft and the crew.
It seems more and more likely that this is one of the contributing factors.

Over and over, I see Captains and FO's blindly relying on the autothrottles, never putting their hands on the thrust levers to feel their reaction ( Boeing here) or at least monitoring the thrust trend and value ( on AB).

[A Squared]

The Flight Aware data seems to suggest it still had a ground speed of around 230 knots. That's not an impossible situation to be in, but nevertheless it presents a challenge

Yeah, that's about what I see on Flight Aware also. Now I don't fly the 777, but a little googling leads me to believe that 230 knots is slow enough to extend the first two increments of flaps and extend the landing gear.

So, you're saying that being lined up on final 14 mile out, on a 3 degree glide, and slow enough to a) throw out the gear, and b) start throwing out flaps, is a "challenge"?

Maybe I'm missing something, but I'm not seeing the challenge. If you're not high, and you're slow enough to start configuring, and you've got 14 NM to go, it seems like easy money to me.

[boofhead]

I don't know the 777 but in the 737/757/747 manual flying an approach with the A/T on worked well for me. It took a little while to get used to the effect on pitch, but I always held on to the throttles so I got advanced notice of the changes as the throttles moved before the actual thrust changed.
I was very easy and not confusing at all.
Very comforting in fact, knowing that the airplane was responding to the changes and maintaining the selected speed to a very close tolerance..
What was the benefit? It gave me very good speed control, especially in gusty conditions, and allowed me to use Vref+5 as the target speed vice Vref +5 +gusts. Especially on short runways it was a bonus.
Not of much use in calm conditions, so I did not use it all the time and some airlines I worked with banned it as a practice although I don't remember if Boeing did allow it.

[BuzzBox]

So, you're saying that being lined up on final 14 mile out, on a 3 degree glide, and slow enough to a) throw out the gear, and b) start throwing out flaps, is a "challenge"?

That's exactly what I'm saying, in this case. It probably wouldn't be a challenge for a 737, but a new 777 pilot doing it in an aircraft weighing 200-odd tonnes probably would find it a challenge, especially without strong direction from the training captain, and if a breakdown in situational awareness got them to that point in the first place.

I'm not saying this was the cause of the accident, simply that it COULD have been a contributing factor. It's fairly obvious they should have been monitoring the speed and thrust more closely, and gone around much earlier in the approach when it was obvious they were unstable. I guess we'll have to wait for the NTSB report to find out why that didn't happen.

[Bob Zuruncle]

phil gollin

[QUOTE]There is a majority (but not universal) feeling that the ATC advisory "180 kts to 5nm"/4-degree approach was a possible contributory factor./QUOTE]

I'm not sure where you get the 4-degree approach thing from..... that wasn't in the instructions they were given and wouldn't be a normal thing anyway.

But I believe the 180 to 5 miles instruction might have contributed to an unstable approach, but it was not insurmountable. Ms. Hersman indicated that the speed limit for a 777 to select full flap was 160 kts. If you comply with the 180 till 5 instruction then you are accepting that you will not be in the landing configuration until quite late. In other words, you fly to 5 miles at 180 kts, then slow to below 160, then select full flap, then slow to target speed (in this case 137 kts). Only then, with the engines spooled up, and maintaining a stable target speed, on a stable glidepath to the touchdown zone with a rate of descent less than 1000fpm, can you consider the approach to be stabilized....my words are approximate, each company's SOPs will be very specific, but they are all similar.

But different companies specify differences in WHEN this must be achieved by. Some have a blanket "stabilized by 1000 ft" for ALL approaches, some say "by 1000ft in IMC, and by 500 ft in VMC." I don't know what Asiana's rules are, no doubt it will come out in the investigation.

Here are some standard references that pretty much ANY commercial pilot will know and rely on..... if you are on the desired 3-degree nominal glidepath, at 5 miles you will be passing 1500 ft, you pass 1000ft just outside 3 miles, and 500ft at just under 2 miles.

So, to comply with 180 to 5 and be stable by 1000ft in this case would require losing 43kts while continuing a steady descent and configuring in the middle of it, all in less than 2 miles and less than a minute (180 kts is 3 miles a minute). This would require some pretty aggressive handling by someone very familiar with his plane, not someone still trying to get a feel for his new plane. Stable by 500ft would be a lot more do-able but still a challenge for a new-on-type pilot. In any case, some of the plots I've seen, if accurate, show that at 5 miles they were faster than 180kts and higher than 1500ft so it may have been nigh on impossible to be be stable at either gate. The question will be, why did the flying pilot elect to continue, and why did the instructor allow it to continue?

As many have said, saying "unable" might have helped although if they were already too high and too fast it wouldn't have made any difference and this is all moot anyway.

In the past when given a "180 kts to 5 miles" instruction I have said, "Unable, but I can give you 180 to 7 miles and 160 to 5," or similar and the controller has accepted that, but that might not be quite so easy for a non-fluent English speaker to do.

[QUOTE]I am sure that ATC did not impose this as a whim, in fact a couple of people have indicated that it is a common call for noise abatement reasons.
Well, where does that policy come from ?
Is it an airport operating requirement ? Is it just something that they would prefer ?/QUOTE]

It's not noise abatement. It's because there is following traffic that is catching you up. If they get too close, they will have to go around adding one extra plane to an already busy arrival pattern. This is probably not intuitive to non-pilots, but on approach the planes behind you are always catching you up. Why?..... because you always get the the point where you have to slow down before they get to their point where they have to slow down. Why doesn't ATC slow them all down at the same time?... Sounds like it might work, but it doesn't. You end up with a massively long conga line of planes flying slowly, wasting gas, and causing more delays. It's ATC's job to try and manage the problem efficiently, sometimes it doesn't quite work out for all sorts of reasons, hence the requests to keep the speed up. But ATC doesn't know the particulars of your plane's limitations and capabilities, that's the pilot's job and it's up to him to say "unable" when it's just not practical.

[nitpicker330]

You've obviously never flown a 777 or a A330 then.:D
250 kts at 3000' at 10 DME IS A PROBLEM. ( yes the 777 is a lot better than the 330 but even it would be a handful trying to fly a 3 deg slope and slow down at the same time from 210 kts back to VRef and stabilized by 1000' )

180 kts to 5 DME IS A PROBLEM.

In my outfit we would say "negative cannot..." To such a request. We could not lose 45 kts AND be configured and spun up in only 2 nm ( by a minimum of 1000' which is 3 nm ) IMPOSSIBLE.

[galaxy flyer]

It's been mentioned earlier, just start slowing 2 miles before the slow down fix. ATC knows what you are doing and why.

[nitpicker330]

Yes that's what would most likely happen in reality. :ok:

We could hold 160 to 5 just.....

[tdracer]

Hey Firewall - stop mincing words and tell us how you really feel :ok::mad:

Question for you Airbus drivers:
I'm somewhat familiar with their non-moving throttles - so what do you do in 'manual thrust' mode (or is there such a thing). Do you have to manipulate those little throttle nubs to control thrust? Does type A have something equivalent to throttle 'hold'?

Just wondering if the pilot flying was sufficiently tired/stressed and reverted back to what he was used to rather than flying what he was in.

Still wouldn't explain why the 'pilot monitoring' didn't notice that the throttles were at the idle stop while airspeed was decaying :rolleyes:

BTW, I've never talked to a pilot that 'liked' the non-moving throttles (and had several tell me that's the only thing they dislike about the Airbus flight deck). Lots of pilots on this list - any of you actually like the non-moving throttle?

[nitpicker330]

In manual thrust you have to move the thrust levers just like a Boeing.

Yes I don't like the fact they don't move when you are using A/T. I don't like there is no feedback in the Sidesticks either.......

But the table is good :ok:

[junebug172]

Manual flight with autothrottle/ thrust is not a good idea, and I do not practice it, neither does my company. either all ON or all OFF. combining makes things jot only more complex, it confuses both the aircraft and the crew.
It seems more and more likely that this is one of the contributing factors.

Over and over, I see Captains and FO's blindly relying on the autothrottles, never putting their hands on the thrust levers to feel their reaction ( Boeing here) or at least monitoring the thrust trend and value ( on AB).

We do it all the time at my airline with no issues.

So what do you do prior to landing? Turn it all off? We click off the AP at 500ft on a visual and pull back power on RETARD. That goes against your line on thinking.

[Ollie Onion]

Gee if only there was something we could do when we find ourselves in an unstable approach situation........................ :ugh::ugh::ugh::ugh::ugh:

These incidents will keep on happening until someone can come up with some sort of procedure that allows us to 'throw' away an approach and start again. :rolleyes:

[junebug172]

Now we're back to the culture thing again.

[bubbers44]

Usually a normal pilot not all caught up with which button to push will realize at 1,000 ft if he has to fix it now or go around. At 500 ft you better have your STG or go around. At 100 ft a half mile out go around because you don't have your STG. Quite simple actually. Aviating 101. Ask an old timer if you can't find the issue.

[despegue]

Junebug1972,

We often put it all OFF at TOD:ok:

Either all ON or all OFF.

KISS principle, When Confused, or unsure, lower your level of automation!!!

[West Coast]

"lower your level of automation!!!"


So simple yet so hard to implement. It's getting a little long in the tooth, but the youtube flick children of the magenta should be required viewing.

[ross_M]

All four pilots arrived back in Seoul on the 13th July.


I think they got off too easy.

Compare this to the shipping accident where Cosco Busan crashed into SFO Bay Bridge in 2007. That crew was held on US soil, without charges, for more than six months, I recall.

If it's too early to conclude in the Asiana investigation, surely it is also too early to absolve the pilots too?

What if there is proven gross negligence? Will prosecutors extradite?

[junebug172]

despegue

We have the option as well and I usually do at 10K. My point is that AP off and AT on is not uncommon nor is it dangerous or confusing. If KISS is an issue, wouldn't you think leaving one on to focus on the other would be simpler to manage?

[galaxy flyer]

If autopilot OFF, A/T ON is so complicated, how come that's how USN pilots do a lot of traps that way? It's not a problem; except I would submit on an Airbus where the throttles don't move.

All of this is an argument for HUDs, btw.

[bubbers44]

TOD was my descent too because it saved fuel. Spool up was 1,000 ft not early because of profile descent. We could do it better than the computers.

[fire wall]

Interesting response BBL.
My points are fact and are beyond dispute (apart from one of the muppets saying we are too low at 4 sec before impact.... big &^$% deal ! Where was he in the loop for the previous 14 miles of divergent flight path)
You choose to counter with a guess at my TV viewing habits.
Infantile response. Tell me you have more to offer ?
Do you really need to be reminded that three innocent people have lost their lives as a result of this incompetence?

[junebug172]

Enough bullsh1t from general public and 100 hr private pilots
I have flown into KSFO numerous times with 21 years flying Boeing a/c, stated only to advise that this is not ill informed comment. Whilst the traveling public and pvt pilots are entitled to their opinion, this wild speculation does nothing to get to the crux of the accident.

1. The a/c was NOT given a slam dunk approach. Aligned on final at 4000 odd feet at 14 miles is not a slam dunk.
2. 230 kts at 14 miles is NOT a challenge.
3. Stabilised approach criteria was NON existant.
4. The a/c was on profile at 400 ft..... but with a ROD at close to double the stabilised equivalent, way outside the ballpark.
5. The 3 muppets up front said NOTHING. (I won't honour them with the term pilots)
6. A/T hold is a normal A/T sub mode. It only becomes a "trap" when you don't know what you are :mad: doing.
7. It is preferable that the guys up the pointy end know what they are *&$^ doing !
8. All ULH operations have a fatigue element. It is a professional's responsibility to mitigate that fatigue element by inflight rest, professional competence and knowing your game. The last two items were NON existent.

These morons masquerading as pilots deserve jail time, the charge professional incompetence.
Last edited by fire wall; 15th Jul 2013 at 14:39.

Thank you. One of the better posts to date.

[SMOC]

Likewise, fireball, spot on!

[220mph]

There is a majority (but not universal) feeling that the ATC advisory "180 kts to 5nm"/4-degree approach was a possible contributory factor.

I am sure that ATC did not impose this as a whim, in fact a couple of people have indicated that it is a common call for noise abatement reasons.

Seems to me that "noise abatement" and other non-aviation issues need to be discussed. If we start putting folks on the ground at a higher priority than aircraft I personally think there is an issue.

In Mpls the FAA has been trying to enact a new set of approach and departure routes they claim will improve safety. This will shift some noise to different neighborhoods. There has been a significant public backlash, including from the affluent community of Edina who complained pretty strongly.

That effort has successfully delayed implementation and spawned a bunch of neighborhood meetings etc.

I can't tell you about the pro's and con's of the new routing, but I do think if any ATC procedure has an appreciable potential effect on flight safety the decision should be easy.

[kaokao]

Maybe there is a million miles gap understanding the culture as well as the pilots skill.

Within months the investigation result will show whether it is really somthing from pilots mistakes or other causes since Korean goverment organzied special TFT to look into this issue.

Already I realized that information released by NTSB is far from whole story but just a bunch of bags containing contraversial situation unawareness, drawing ones attentions pilots faults.

Somehow most people who are experienced at Boeing jets seem to bring disccussion onto single stream that I cannot buy. Because I see the most speculations are based on unfactual and missing information from NTSB.

I will wait for investigation report from Korean government.

If investigation results would weigh pilots fault, I would suggest stop Airlines and pilots converting planes from Airbus to Boeing. I would rather suggest them switch from Boeing to Airbus.

The pilots are operators and customers. I dont think we have to push them such a danger by running incompetent products being unable to secure lives.

[Intruder]

If autopilot OFF, A/T ON is so complicated, how come that's how USN pilots do a lot of traps that way? It's not a problem; except I would submit on an Airbus where the throttles don't move.
They do it because (1) the airplanes are designed for it; and (2) they practice it a lot.

Flying an autothrottle approach to the carrier is a LOT different than a manual approach. It requires a finesse with the stick in pitch that is different than a manual approach. While the newest airplanes (F-18x) may have the differences ironed out in FBW software, the older (A-6, A-7) airplanes required distinctly different techniques.

[paulftw]

Now that the 4 pilots are back on Korean soil, if they are found guilty of breaking the aircraft, are they required to go back to the US and defend their actions, or will the Airline put them back to flying status to make a point that they are good pilots?, or will they go on long term holiday leave, or end up behind bars?. I was just thinking about this and hearing about the Korean Mindset Culture as to what they might do.

[Intruder]

4. The a/c was on profile at 400 ft..... but with a ROD at close to double the stabilised equivalent, way outside the ballpark.
I can't even begin to agree with the "on profile" assessment when thrust, airspeed, and ROD were not even close to nominal. Just because you cross a point, doesn't mean that you are "on profile"...

[junebug172]

If investigation results would weigh pilots fault, I would suggest stop Airlines and pilots converting planes from Boeing to Airbus. I would rather suggest them switch from Airbus to Boeing.

Give me a break. We have transitions both ways with no issues. There's no reason for such a stupid rule as that.

[junebug172]

They do it because (1) the airplanes are designed for it; and (2) they practice it a lot.

News flash.

We land that Airbus with AP off and AT on all the time unless you're doing an autoland.

THERE IS NOTHING ABNORMAL OR HARD ABOUT FLYING MIXED AUTOMATION.

[break_break]

Enough bullsh1t from general public and 100 hr private pilots
I have flown into KSFO numerous times with 21 years flying Boeing a/c, stated only to advise that this is not ill informed comment. Whilst the traveling public and pvt pilots are entitled to their opinion, this wild speculation does nothing to get to the crux of the accident.

1. The a/c was NOT given a slam dunk approach. Aligned on final at 4000 odd feet at 14 miles is not a slam dunk.
2. 230 kts at 14 miles is NOT a challenge.
3. Stabilised approach criteria was NON existant.
4. The a/c was on profile at 400 ft..... but with a ROD at close to double the stabilised equivalent, way outside the ballpark.
5. The 3 muppets up front said NOTHING. (I won't honour them with the term pilots)
6. A/T hold is a normal A/T sub mode. It only becomes a "trap" when you don't know what you are :mad: doing.
7. It is preferable that the guys up the pointy end know what they are *&$^ doing !
8. All ULH operations have a fatigue element. It is a professional's responsibility to mitigate that fatigue element by inflight rest, professional competence and knowing your game. The last two items were NON existent.

These morons masquerading as pilots deserve jail time, the charge professional incompetence.
Last edited by fire wall; 15th Jul 2013 at 14:39.

Usually it's more appropriate to wait for the outcome of NTSB's investigation, and thank goodness in this case it happened on US soil and we all can expect most probably a full transparent outcome.

However, in view of the blindly defensive Korean attitude after reading some of the most ridiculous and childish Korean news, nationally in Korea, or in US, or for that matter idiot coming on to Pprune in trying to convince the professional pilots' world of failure of automation or "bright light" at 500ft, they can all refer to probably the best written posting in this thread by Fire Wall.

[TOGA!]

180/5 is possible, just not ideal. You can configure gear and flaps 30 at 180 knots. The airplane will slow nicely from 5 miles/1500' agl to reach stabilized approach by 1000' agl. Maybe I missed it somewhere in this string, but flaps 30 could have been selected long before 160 knots.

Lifted from 777 FCOM:

[-200LR, 777F, -300ER, -300ER/ULR]
1 Flap Limit Placard
Flaps extended speed limits.
Normal Flap Position Indication
Displays combined flap and slat positions when all surfaces are operating
normally and control is in the primary (hydraulic) mode. The indicator shows
continuous motion.
The indication is no longer displayed 10 seconds after slat retraction.
FLAP LIMIT
1 - 255K
5 - 235K
15 - 215K
20 - 200K
25 - 190K
30 - 180K

[autoflight]

I understand that all non-Koreans wish they were Korean and it is simply an accident of birth that we are not.
Obviously the same thing applies to those born with increased juniority. When you generally think like this, all types of weird seniority problems can exist on the flight deck.

[ross_M]

All ULH operations have a fatigue element. It is a professional's responsibility to mitigate that fatigue element by inflight rest, professional competence and knowing your game. The last two items were NON existent.

Exactly! Well said.

Many professions have shifts where end-of-shift fatigue's an issue. But professionals handle this every day. We don't let a trucker excuse a crash because it was "end of shift". We don't let an ER doctor away with negligence because it was late at night. A process-plant operator that causes an accident cannot get away saying "it was a long day"

Professions have shift-lengths that were chosen to reflect the degree of fatigue. Ship watch-keeping is 6-hours-on 6-hours-off. Swimming pool life guards are supposed to rotate every 20 minutes.

If long haul flights are too long and the profession thinks it needs 3 sets of pilots that'd be a separate argument. I don't think we do.

Long Haul Fatigue might be a contributing factor but it surely isn't a mitigating factor or an excuse. That's only apologetics.

[fire wall]

Intruder, you are correct. Should read "The a/c crossed the 3 deg profile at 400ft."
My bad.

[BBK]

Firewall

Firstly, I note that your original post has been edited. The part about "commie pinkos" etc has gone. If you removed that yourself then well done.

Here, briefly, is my take on the accident. IMHO it is far too simplistic to say that the crew are guilty of pilot error and that is all there is to it. The questions remain of WHAT, HOW and WHY this accident occurred. If we adopt your methodology then there in no need for an investigation. What a number of us have tried to argue on this forum is that a visual approach, especially at SFO, may not be as simple as it appears.

Factors that may be relevant are: fatigue, mode confusion, inexperience on type, inexperience as trainer, vectors on final, language, CRM/HF aspects etc. There are far more of course which is why the report will take at least a year to be completed.

When you talk about the "facts" are you saying that you, personally, have seen the FDR data? Have you listened to the CVR? If not then how do you justify your position of absolute certainty.

I have flown into SFO enough to know that it can be very challenging ie landing a large jet when being given inappropriate speed/height constraints. The speed one learns to ignore otherwise you will not make your stabilised approach criteria. As far as the vertical profile I prefer taking all the automatics out and switching the FD off as it just gets too messy otherwise. Not an ideal situation I would argue when (a) you are tired and (b) as a long haul pilot you never get that many landings especially as an FO.

[767__FO]

"whoever manuver the flight at the cockpit, none can save thier lives if engine is not working as intended."


Are you nuts?

If they pushed the throttles up at 1000' or 500' when the approach was unstable, you might have a case, but they did not.

[ross_M]

What a number of us have tried to argue on this forum is that a visual approach, especially at SFO, may not be as simple as it appears.

They were not forced into accepting it, were they? They could have refused the visual. Knowing your limitations is fundamental to any critical Maneuver.

Obviously, a visual into SFO, is not something that a majority of crew thinks is unreasonably dangerous. If that was the case, fine.

It is up to the crews that are not comfortable pulling it off to refuse ATC's offer.

Besides, it's not as if accepting the visual was their last chance to correct this disaster. As things kept getting worse, the Asiana crew demonstrated a lack of corrective measures at several different points.

This wasn't a one-off error. This was a series of blunders.

Factors that may be relevant are: fatigue, mode confusion, inexperience on type, inexperience as trainer, vectors on final, language, CRM/HF aspects etc.

Pilot error may not be the only thing here, yes. But even in this list a lot of the problems can be directly or indirectly attributed to pilot incompetence.

[West Coast]

Maybe SOME SFO visual approaches are slam dunks or provide a challenge on some days.That's a differing argument if as been widely quoted the crew was on profile quite a few miles out.

[fox niner]

Let's cut the BS.

Fatigue can, in general, play a role during long haul flying. But it is still a pilot's responsibility to handle it accordingly.
About a year ago two guys up front were fatigued when making a landing in Munich. They DEMANDED enough separation on the ILS to perform an autoland.
See this thread:

http://www.pprune.org/rumours-news/488291-fatigued-crew-call-pan-pan-into-muc.html

This is how fatigue should be handled if it occurs.:D Probably was not the case here.
Besides, for an augmented crew composition:

"The longer the flight, the longer your rest period will be."

[cessnapete]

We seem to be loosing the plot with a lot of technical jargon in this incident.
On a visual approach look out of the window, which you should already be doing, and if the piano keys on the runway end are about to end up in your 777 flight deck, there are only two things to decide, either push the thrust levers forward which you should already have in your hands during a visual approach, and go around. Or crash.
Don't wait for the Automatics to save you, you can work out afterwards what went wrong, either crew errors with AP/AT mode confusion, or a technical fault.

[Vasco dePilot]

TOGA!:=
The Asiana plane was a 777-200ER which has a different wing and different flap limit speeds. 30 flap at 180 knots was not an option to the Asiana 214 crew.Your post has the flap speed limits for the heavier and longer winged -300ER/200LR

"Lifted from 777 FCOM:

[-200LR, 777F, -300ER, -300ER/ULR]
1 Flap Limit Placard
Flaps extended speed limits.
Normal Flap Position Indication"

[tilnextime]

What a number of us have tried to argue on this forum is that a visual approach, especially at SFO, may not be as simple as it appears.

I have flown into SFO enough to know that it can be very challenging ie landing a large jet when being given inappropriate speed/height constraints.

Obviously, a visual into SFO, is not something that a majority of crew thinks is unreasonably dangerous. If that was the case, fine.

If the NTSB does a proper investigation, it will make their determinations based on standards, not how things "appear", level of "challenge" or what a "majority" think. It's not a matter of trying to identify possible pieces of cheese to line up in the manner most supportive of making it look as if the mishap was inevitable. If a given "piece of cheese" was in the pilot's hands to begin with (i.e. - prior knowledge of a having to perform a given approach) then it is how the pilot places that cheese in the stack that is the contributing factor, not the mere existence of the cheese.

An approach is either executable within in the established standards for the aircraft and crew or it isn't. A mishap investigation does not deal in "near the limits", but within published limits. If "near the limits" is unsafe, then the limit needs to be corrected. If a given limit hasn't been established taking normal operator frailty into account, then both the operator standards and the aircraft/maneuver limits need to be revisited. As my late uncle would say, "There is no such thing as almost pregnant". The flight was either assigned an approach that was within the standards for the type aircraft and crew, or it wasn't. That determination has to be made on sound technical info, not feelings or personal opinion. Otherwise, it would be impossible to determine what is a safe maneuver.

You can't ascribe causative or contributing factors until you establish the standards the aircraft and crew are held to, and the standards they failed to meet. In my investigating experience, there were no end of maneuvers that were based upon proper standards that were only challenged when a crew member failed to perform, or failed to admit that he couldn't perform, until after the mishap.

And yes, I investigated mishaps where the commander should not have assigned a given mission profile to a given crew or crewmember. However, the crew has mouths, and are not absolved unless they spoke up. Embarking on a mission or maneuver that is beyond what you think is your ability level cannot be absolved, unless there is a real, loaded gun at your head. "Job security" is not a real, loaded gun when the lives of others are at risk. It is simply the same concern for your pocket as that which drives the "management" you condemn.

I said it before and will say it again, until pilots' unions take job actions for higher standards, to include more hands on time, the existence of these safety threats are not the sole sin of management. In effect, while the trend in "management" thinking may be cutting costs, there is a trend in pilot thinking is cutting workload and responsibility - and thus, wanting simpler or mandatory automated approaches, for example, to make up for lesser hands on capabilities.

The thing is that you can't have it both ways. Without standards, there is chaos.

[John Farley]

Well said sir.

[nitefiter]

Brilliant, I hope the training depts are reading that one.

[BBK]

As you have quoted me may I respond. Firstly, I think your post is thought provoking and intelligently argued. I merely posted to give an operator's perspective. I don't have an agenda and I am not suggesting a methodology for conducting the accident investigation. That is not an area I have any experience in.

I hear what you are saying about standards etc and you may have a good point there. However, is it wrong to ask whether some of the manoeuvres pilots are asked to perform are "sensible". Perhaps I am seeing shades of grey where you are seeing rules as black and white. I will give you an example. My company, based on flight data monitoring, has sent representatives to ATC at some of the airports where there is a clear trend towards unstable approaches. Of course the buck stops with the commander and if he sees an unstable approach then whether PF/PNF he MUST ensure a go around is flown. However, is it really a good idea to have been given vectors that made such an event all but inevitable in the first place. Note these are not approaches that are illegal in any way. I believe not many companies have taken the initiative in this respect and it has been welcomed by the ATC departments concerned. Sadly, I can't take any credit here personally.

As for the unions taking a proactive approach, no pun intended, then I wish them well. In the UK BALPA are doing exactly that with respect to Flight Time Limitations or at least trying to. Regarding training syllabi I am not sure whether they can influence them that much. It is, I agree, an excellent idea. Apologies, to all, for the thread drift.

[bobcat4]

If SOP in VMC says ”stable at 500 ft”, and assuming ”stable” includes ”landing checklist complete”, that seems a bit on the edge of being stable. Although we know they weren’t stable, they obviously thought they were (otherwise they would go around for a second attempt).

So at 500ft they completed the landing checklist and concluded they were stable. I guess they missed the point “engines spooled up” probably because they trusted the A/T.

Now, in VMC with the required “stable at 500”, the landing checklist MUST be completed at (or rather before) 500. If flaps cannot be fully extended (or flap 30 selected) at 180 knots, and they had to maintain 180 to 5, the workload seems to pile up. Landing configuration and landing checklist to be completed in less than 90 seconds. Looking at the data from FlightAware, the Asiana pilots delayed the slow-down from 180 at 5, shrinking the time to get stable. :confused:

[BOAC]

An approach is either executable within in the established standards for the aircraft and crew or it isn't. - first we need to establish these. Who does that? Manufacturer? PPrune? Regulator? Accident/incident records?

Example: Earlier someone somewhere said "250kts at 10,000' at 30 miles is on 'on the profile'. Which profile? Yes, I know it is fine, but who decides?

Regarding SFO/ATC - if, as it appears, they 'expect' and accept a speed reduction at 7 miles from 180 as posted here. why not say "180 to 7"?

[tilnextime]

BBK

If the standards are not appropriate for getting the job done safely, then by all means, correct the standards. However, before one reaches a conclusion that all airports must have instrumented G/S facilities, one has to ask why. If the answer is to compensate for low proficiency crews, or to compensate for possible crew inattention, then the question is whether or not it is "sensible" to continue increasing automation reliance to address a crew problem arising from automation reliance. Now, that's a question I pose, not an answer.

One significant human factors problem I have dealt with as a safety officer, flight instructor, crew member, mishap investigator and unit commander is that pilots do not want to be measured "pass/fail" on set flying standards. We want the "system" to rate us based on what my first CO called the "Ace Factor" - the guy who is smoothest on the controls is the best, or the guy with the most hours, etc, etc. But for 99.9% of the flying that is done, we don't need "best", we need "fully competent", not just in stick and rudder wiggling, but planning and judgement. It's not a contest. Every maneuver has parameters - the "plus and minus" factor. Keeping it all in 'the green arc" is competency, everything else is testerone driven overkill.

[MPN11]

Regarding SFO/ATC - if, as it appears, they 'expect' and accept a speed reduction at 7 miles from 180 as posted here. why not say "180 to 7"?

It appears from earlier posts that is "accepted" that an early speed reduction from 180/5 to 180/7 is OK. Would the Asiana crew have that perspective? Especially when the PF is 'under training'? What would be the IP's opinion if the deceleration started 2 miles earlier than instructed? Would the PF not try to comply with 180/5?

[tilnextime]

BOAC:

- first we need to establish these. Who does that? Manufacturer? PPRuNe? Regulator? Accident/incident records?

With the exception of PPRuNe each of the entities you mention, along with others, has a specific role. I exclude PPRuNe, simply because it has no formal accountability. Rather, I would suggest that formal, accountable, pilot input is needed.

I read post after post about pilot fatigue, yet not one post about ATC controller fatigue. A crew of 4 flew from point A to point B, knowing before takeoff that they would most likely have to make a visual approach. Meanwhile, the controller handling them was dealing with a long string of aircraft with no idea of whether any one of them had lifted a single finger to prepare for the PUBLISHED peculiarities of the airport.

Pilots are not the final word on what an aircraft can safely do. I have seen and or investigated far too many mishaps where well intentioned pilots made maneuver parameter or operating procedure decisions based on their cockpit view, and not the engineering principles used in the design and manufacture of the aircraft, for example. In one case, a "home brew" operating procedure that made the operation of a given helo "easier" for the pilots caused structural stresses that were, after repeated conduct, catastrophic.

Aviation is not just about flying. If it were, it would be so much simpler.

[BOAC]

All valid questions, MPN, and it is to be hoped the NTSB might look at this. I recall LGW accepting an early decel from "160 to 4", but I feel it would be much easier if firm gates were imposed ie 180 to7/160 to 5 etc, and promulgated and not 'nudge nudge wink wink' as it appears at the moment.

[Alexander de Meerkat]

In a sea of woeful ignorance in the last 112 pages, there have been one or two nuggets of gold - principally from 777 drivers who actually know what they are talking about. No doubt much will be made as to how the crew got into the situation they did and that will be a debate for another time. The key thing that stands out to any professional pilot is that the crew in question ignored the stabilised approach criteria and were allegedly descending at nearly twice the normal rate of descent below 500'. For any professional pilot that would necessitate an immediate go-around and living to fight another day. In any normal airline it would be a non-event and the most the crew could expect would be a question as to why they waited so long to initiate the go-around. Sadly in this case the worst excesses of Korean culture (and there are many very positive elements to this great nation) may have come into play. At the exact moment a regular western First Officer would have been shouting his head off to go-around, it may be that an over-polite and deferential group of three other pilots chose to watch a dangerously decaying situation become irrecoverable before the call was made to go-around.

How you defeat such a cultural problem, whereby it is rude and unacceptable to question someone in authority, is hard to say. Perhaps the answer lies with the Koreans themselves who surely must begin to question why they have had so many accidents over the years despite being such highly educated and intelligent people. The two other questions I would be asking is what happens to someone who does question authority in a decaying situation, and do military pilots receive preferential treatment in terms of advancing up the seniority list? Do pilots who have questioned authority get 'sorted' at some later stage in sim checks or experience general rejection by the rest of the pilot community? The sub-question I would then ask would be how the ex-military pilots conduct themselves in terms of CRM (I am ex-military myself by the way). To an extent these are all taboo areas in a cultural sense but they are so critical to understanding what went wrong here.

[BBK]

I'm not sure that your comments regarding the ace factor reflect a typical civilian airline. Maybe on a squadron perhaps? In fact it sounds like a lot of what you are describing might be more applicable to military aviation.

If I have given the impression that SFO ATC are acting unprofessionally then I certainly did not mean to. It is a very busy airport but I cannot help thinking whether some of the procedures are just pushing things in a direction that is not conducive to flight safety.

BOAC/MPN

I do hope that the local procedures are looked at in detail. It is a grey area I accept that but if Human Factors are an issue then by definition it is complex. I asked an HF psychologist why the stats were so rigorous in her field of work. She replied that because we are so "woolly" you need to some serious number crunching to try and distil the real effects being observed.

[Fox3WheresMyBanana]

There is an extradition treaty between S. Korea and the USA.

[TOGA!]

Here you go Vasco. Happy? Same argument stands. Flaps 25, 180/5. Flaps 30, slow to ref + 5 from 14-1500', easy.

from 777 Ops Manual:

[-200ER]
FLAP LIMIT
1 - 240K
5 - 220K
15 - 200K
20 - 190K
25 - 180K
30 - 170K
CENTER FORWARD PANEL

[pax britanica]

After 112 often interesting sometimes bizarre pages on this topic I thought what does this incident mean to me as a user of the product that aviation serves up-i.e. a passenger .
It seems reasonable that in exchange for my ticket money airlines are supposed to offer me fast, safe transportation from A to B. Implicit in that contractual arrangement, to my mind, is that they should make every possible effort to ensure the flight is safe by :-
1 Having properly maintained and equipped aircraft for the role.
2 Having properly trained flight crew capable of maintain safe operation in all reasonable circumstances.
3 Not fly to any airfield that they think is beyond the capabilities of 1 or 2.
Clearly in this case Asiana dropped the ball, they must know all about SFO and its ATC peculiarities (on one trip there I was astonished to find ATC allowed us to take off ‘the wrong way-i.e. against the landing stream. No doubt all coordinated etc but something I could never imagine happening at LHR or FRA). Asiana must have been aware that visual approaches are far from unknown at SFO and that as the ILS was inoperative and had been for some time so why didn’t they plan for it.
Leaving aside all the speculation about converting from Airbus to Boeing ( surely even a stressed tired pilot can remember what kind of plane he was flying (not like it was A321 vs an A319 was it) , tiredness. Fast speaking US ATC, A/T Modes, and a score of other rather thin excuses it comes back to the fact when assessing those three elements that concern me as passenger
1- Nothing was wrong with the aircraft other than a few tricky issues with the Auto throttle modes
2- A lot was wrong with the crews overall competence for the task- I just cannot readily accept most of the ‘excuses or reasons’. To me as a customer a crew having to fly a visual approach on a CAVOK day because the navaids are inoperative is surely a fundamental, realistic and reasonable expectation of a competent crew
3- A few quirks for the airport approach process that can distract or hurry the crew .
It looks to me like an absolute field day for US lawyers and for Asiana a massive legal and compensation bill , insurance complications and horrendous negative publicity in one of their major markets.

And personally I would not fly Asiana any time soon even if some people would suggest that made me racist.

[tilnextime]

BBK

I'm not sure that your comments regarding the ace factor reflect a typical civilian airline. Maybe on a squadron perhaps? In fact it sounds like a lot of what you are describing might be more applicable to military aviation.

Then why all the discussion of hours, hours in type, hours as a check pilot, "I can handle SFO, but a lot of pilots can't", etc.

You are either qualified to and perform to the standard or you are not. There is a task to do, there are the conditions within which the task is done, and you either do it to standards or you don't. Just as there is no such state as "almost pregnant", there is no state of "more pregnant".

If the procedure at SFO are unsafe, then the response from the pilot community would be "WE can't handle it safely". Saying "SOME can't" is Ace factor.

[nitpicker330]

TOGA ----the prudent Airline professional wouldn't (doesn't ) fly at the limit speeds for each flap setting so holding 180 kts F25 wouldn't be done.....most of us hold about 10 kts margin to allow for speed variations. Limits are limits..

Besides flap limits if you are going to hold 180 kts to 5 nm's then in Asiana's case they needed to lose 43 kts, configure final flap and then spool up. ALL IN ABOUT 2 nm and around 50 seconds. A little de stabilizing I would think and totally unnecessary. The fact the PM was new to the 777 and hand flying a visual approach made it harder to do. No excuses for the TC in the right seat though:sad:

[CONF iture]

The biggest clue that things were about to go wrong was most likely the word "HOLD " at the top left of the primary flight display that indicates to those in the know that the autothrottle although engaged will not increase the thrust. Had the word at the top left been SPD (Speed) the accident would not have happened.
In this eventuality, would it be enough or necessary to deselect the second FD to get back to SPD ?

[bobcat4]

Besides flap limits if you are going to hold 180 kts to 5 nm's then in Asiana's case they needed to lose 43 kts, configure final flap and then spool up. ALL IN ABOUT 2 nm and around 50 seconds.

nitpicker330, do you say ATC put them unstable?

I also wonder why ATC want to rush approaches (and possibly make them unstable) when it can lead to a go-around which adds another aircraft to the queue…

[nitpicker330]

ATC did require 180 kts to 5 nm. It's up to the Pilots whether or not they accept this in the prevailing conditions and taking into account their own experience levels etc.

[BOAC]

tilnextime - the reference to PPRune was, I hope you realise, a red herring, meant to highlight the vast range of wildly differing opinions from those qualified and those not:)

My post was in fact to support your post, but to point out the difficulty of finding the right basis for 'normal' and 'acceptable' - and this is the major task as you can see on PPRune.

Returning to this SFO "180 to 5" - I consider that if flown EXACTLY that way it is un-doable (I await the 'aces' cries). Most manufacturers' FCOM do not encourage using flaps as 'speedbrakes' which is what is necessary here.

I would guess that if the Asiana crew had KNOWN they were 'expected' by ATC to begin slowing at 7, a lot of the pressure would have been removed. Hence my call for some sort of clarity in speed control.

nitpicker - no - it transpires that ATC 'wanted' 180 to 7 with a tolerance of 2 miles to reduce speed (based on an earlier post). I feel Asiana were totally unaware of this aspect (too).

[Trackdiamond]

Am new here so please bear with me if I come across naively as I have read some quite robust and even philosophical posts on this wonderful thread..very inspiring I should add.

I feel the onus was on the TC to accept the potentially unstabilising approach clearance they accepted, however multi pilot cockpit golden rules:back each other up, if you don't like what the automation is doing..take over manually(and that applies to auto throttle too ).In any case if visual and unstabilized by 500ft ..Go Around!

Visual approach does mean beyond flying with the naked eye and seat of the pants in my humble opinion. PAPI was operational at the time was it not?were the PAPIS fully operational?3 rows for high cockpit jets (if first two rows followed would bring the touchdown much closer than the normal glideslope and undershoot with lowered gear clearance height).CNN NTSB report on the handling pilot interview that he was temprarily blinded during approach might be related to Papi visualization??

How about CDFA method of approaching visually?

CDFA was designed to replace the old dive and drive NPA profiles common in old USA culture..but not limited to just NPA but could be also utilised in visual approach ezpecially with VNAV assistance calculated or FMC assisted.

Visual approach doesn't mean both crew heads up and ignore all flight and nav instrument indications and alerts..the pre stall threshold hash marks on the PFD for instance!

Finally when you hear whoop whoop pull up..you usually have less than 10 seconds to get out of the hell hole.as most accident CVRs have miserably demonstrated.

[JW411]

I did a lot of flying in the USA (including being based at JFK for three years). There only ever seemed to be three speeds to remember:

250 Knots below 10,000 ft.

210 Knots intermediate approach and,

180 Knots to the marker/5 nms.

That's what everybody did and it was certainly not difficult in a DC-10 (mind you, we could put 35 Flap down at 185 Knots).

So what has changed since I hung my boots up to make it so bl**dy difficult to do nowadays?

[Dolfin]

It appears from earlier posts that is "accepted" that an early speed reduction from 180/5 to 180/7 is OK. Would the Asiana crew have that perspective? Especially when the PF is 'under training'? What would be the IP's opinion if the deceleration started 2 miles earlier than instructed? Would the PF not try to comply with 180/5?

I call it CRM:

ATC:"Maintain 180 to 5 miles"
Crew:"Wilco."
Captain to IP:"I don't think I can maintain the speed restriction, I will start reducing at 7NM, inform ATC."
Crew:"Radar, we are unable to maintain 180 to 5NM, we start reducing at 7NM."

Where is the problem?
The problem is not to communicate when a situation develops in a way, a pilot does not like it.
It seems as if there was no communication inside the crew about the unstable approach, and there was definately no communication to ATC about that or about being unable to comply to the speed restriction.

[bobcat4]

BOAC wrote:

yes, we know that - you are not reading the posts!


The only thing that might be unusual is that “180 to 5” means “180 to 5, but if you want to slow down at 7, that’s fine”. That is, unusual to Korean pilots who might be interpreting “180 to 5” as “do not go slower than 180 knots until 5 nm, that’s an order!”

They seemed to maintain 180 to 5 (DME) more or less exactly. Oh, and "180 to 5 DME" means 180 to 4 nm from threshold in SFO. Correct me if I'm wrong. But that means you have 2 nm to get stable, and that is 45 seconds at 160 knots.

[Dolfin]

So what has changed since I hung my boots up to make it so bl**dy difficult to do nowadays?

Let me take a guess: Nothing has really changed at all! The physics of flight is still the same as with the Wilbur bro's.
If one knows what to do and can fly the ship, it's a piece of cake, but if not, it's kinda mystic magic and things start falling out of the sky.

[aterpster]

JW411:

I did a lot of flying in the USA (including being based at JFK for three years). There only ever seemed to be three speeds to remember:

250 Knots below 10,000 ft.

210 Knots intermediate approach and,

180 Knots to the marker/5 nms.

That's what everybody did and it was certainly not difficult in a DC-10 (mind you, we could put 35 Flap down at 185 Knots).

So what has changed since I hung my boots up to make it so bl**dy difficult to do nowadays?

I probably go back further than you. I don't recall speed assignments being quite that simple. I do know asking someone to do 180 knots to the FAF, or similar point, is sacrificing a staple final approach for the sake of "moving the medal."

Fairly early in my career, probably 1969 or perhaps 1970, I clearly recall the Airman's Information Manual in those days stated that ATC speed assignments would be discontinued not later than 3 miles prior to the outer marker. One day a Los Angeles controller was adamant that I give him 170 to the outer marker. I refused whereupon he got quite huffy. The frequency wasn't that busy so I told him I was based there and suggest he discuss it with my chief pilot.

Well, they did call him and a note was waiting for me to see him. We chatted about it, and I showed him the AIM passage. His response was sort of like Rodney King; i.e., "We've all got to get along."

In the years after that ATC continued to just get ever more aggressive.

I suspect the 180 knot assignment to Asiana until 5 miles is going to result in the FAA picking up part of the bill for the accident.

[RAT 5]

When ATC asked for 'silly' speeds to be flown, so as to help out their traffic flow, even when there was no traffic, I used to suggest having the gear down 1nm early so that when you reduced thrust to configure and slow down the drag was immediate. That was a medium/heavy. These large/heavy a/c might have more trouble. If you start the complete slowing down 1nm early the inertia will likely allow you to slip through the hoop un-noticed. Understanding your a/c & engines' behaviour is always primary. A little more drag earlier means you don't have to go to idle in a bums rush to slow & configure.Might this be true of these heavier slippery types? The engines are bigger than my old CF-6's

[ExecClubPax]

Never run out of altitude, speed and ideas at the same time. On the face of the evidence to date, it appears this crew did just that. It doesn't create much confidence in those, like myself, who pay pilots to get them from A to B safely. When all you professionals have done swapping your pet theories, please remember the folks in the paying seats have a vested interest in ensuring appropriate skills and standards are maintained.

[JW411]

Aterpster:

I thank you for your response. I've just had a look in my old Jepps for JFK and LAX and I cannot find any strict laid down speed limitations apart from the 250 Knots at 10,000 feet.

However, I did find in the Introduction section under Speed Adjustment that ATC expect aircraft to maintain +/- 10 knots of any speed restriction given.

Therefore, 180 to 5 could be 170 to 5 or 190 to 5 as I read it?

[BOAC]

However, I did find in the Introduction section under Speed Adjustment that ATC expect aircraft to maintain +/- 10 knots of any speed restriction given. - I have a feeling that is ICAO?

[JW411]

You might well be right. I gave nearly all of my FAA stuff including the AIM and How to Pass the ATPL exams to a young man who was making his way in American aviation a long time ago, so I don't have that many references left to hand in my seriously retired state!

[suninmyeyes]

Conf iture

You quoted me as saying


The biggest clue that things were about to go wrong was most likely the word "HOLD " at the top left of the primary flight display that indicates to those in the know that the autothrottle although engaged will not increase the thrust. Had the word at the top left been SPD (Speed) the accident would not have happened.


You asked In this eventuality, would it be enough or necessary to deselect the second FD to get back to SPD ?

The answer is yes. If the second flight director had been switched off the autothrottle would have engaged in speed mode and the accident would not have happened.

Like someone else I wondered if the speedbrake had been pulled out earlier. The 777 is extremely slippery and frequently needs use of speedbrake on approach. If the speedbrake is left out for more than about 20 seconds without someone's hand on it it is extremely easy to forget it. The 777 warns you if you have left the speedbrake out but only when the power comes back up from idle, in this case the power did not come back up from idle until too late so there would not have been a warning. If the speedbrake had been left extended below 1000 feet the speed reduction would have happened even more quickly and it would have been one more unstabilised approach criteria item that had not been complied with.

[tilnextime]

BOAC

My post was in fact to support your post, but to point out the difficulty of finding the right basis for 'normal' and 'acceptable' - and this is the major task as you can see on PPRuNe.

Sorry I missed that.

It's a major task, and if referred to a "committee of the whole", it ain't gonna get done right. It's going to take some serious leadership, and the results are still not going to please everybody. But the objective is not pleasing everyone, but establishing sound, safe standards covering all of aviation, not just one aircraft, one crew. Flying is only one part of commercial aviation. Many of the other integral part:, maintenance, ATC, logistics, POL, crash rescue, etc are all essential elements to getting the job done in a safe, orderly and expeditious manner, and these elements are not rooted in flying skill. Few, pilots have a clue as to how to get fuel from the distributor to the wing tanks, nor the quality assurance involved. Without that uncontaminated fuel, flying would be seriously less safe.

While commanding an airfield, I overheard my operations officer tell a transient pilot who was a flight school classmate, "You know, up until now, I considered things like ATC, POL, crash rescue, restricted airspace management and the like PFM (Pure F--ing Magic). Now I find that I am Mandrake the Magician, and a simple wave of a wand does not provide those services at all. I'm learning what Aviation is all about, and it ain't just flying."

[wingview]

After I read so many things about a "challenging" (visual) approach for 28L at SFO I wanted to know when the last incident/accident was:
It was in 1968! with an JAL DC-8 on the ILS and hit the water 2,5 mls before the TH (quite similair to the Asiana) but without ILS.

So this was 45 years ago and I would think that in the mean time a lot of visuals were flown with an ILS out. Nothing happend in this period, not even an incident.

I don't know what Asiana's SOP is to be stable but this looks very much to the THY crash at Amsterdam. As a result, PNF didn't monitor anything, not being stable, checklist not finished and at least a 3 men cockpit crew running out of speed and CFIT.

Asiana already said that the plane was perfectly Ok and that they'll change theire training to prevent this happening again in the future. All this leads to pilot error said by Asiana.

Those who are saying they would fly with these guy's because they've learnt there lesson are out of wack. :ugh::ugh::ugh: This was a totally avoidable crash which cost 3 young girls their life!

[FO Cokebottle]

Bobcat4 has said it all. The culture of rote learning and nil questioning.

In countries with this education system combined with no general aviation sector where by national pilots learn to fly with the absolute minimum of required practical flight hours and the remainder is done in a box to strict company procedures and blind obedience to the written word before finding themselves in the right seat of a heavy jet, has to be questioned.

These questions should be asked of the State regulator for it is they that approve Airline Training Manuals

Combine this with the apect of the fast paced economic growth in formally autocratic countries/cultures with extreme nationalistic tendencies which had these guys on the ropes. Not excusing them at all.

This is my opinion thats all - having seen it and operated in it.

The once Chief of Standards of the Airline I was with, quietly said to me once, "some of our check airman don't even have airmanship". he was resigned to the this fact. That pretty well summed it up for me.

Further to my previous comment re: "180 to 5", it has always been taken to be referenced to the touch down point.

In addition, I have also had the following instruction, many times, from SFO ATC, "XXXX heavy see the jetstream31 at your x o'clock - x miles?" after the affirmative...."do not pass that aircraft!"

Knowing your aircraft and its limits, knowing about energy management and being prepared for any "normal" ATC instruction is required from the professional air transport pilot. In this case "normal" for SFO.

ATC also know your aircraft's limits and instruct accordingly, however, they also assume you have the required handling skills for that aircraft.

As one poster has previously remarked, " never take the aircraft were your brain hasn't been five minutes beforehand" or words to that effect.

[Cows getting bigger]

An interesting read from a couple of years back.

http://www2.icao.int/en/RunwaySafety/Toolkits/Unstable%20Approaches-ATC%20Considerations.pdf

[ross_M]

After I read so many things about a "challenging" (visual) approach for 28L at SFO I wanted to know when the last incident/accident was:
It was in 1968! with an JAL DC-8 on the ILS and hit the water 2,5 mls before the TH (quite similair to the Asiana) but without ILS.


Interesting. An uncanny similarity (Wiki excerpted):

(1) Captain Asoh was a veteran pilot with roughly 10,000 hours of flight time

(2) His first officer, Captain Joseph Hazen, had similar flight time, but little DC-8 experience.

(3) Captain Asoh attempted an automatic-coupled Instrument Landing System (ILS) approach

They were mighty lucky though (unlike our Asiana): "None of the 96 passengers or 11 crew were injured in the landing."

I only hope Asiana and the flight crew have the moral courage to use the "Asoh defence": Asoh, when asked by the NTSB about the landing, reportedly replied, "As you Americans say, I fu_ck_ed up."

[BBK]

CBE

Thanks for that link. Interesting stuff such as: "Visual approaches can be associated with more pilot errors including performing unstable approaches...."

[MPN11]

ATC also know your aircraft's limits and instruct accordingly, however, they also assume you have the required handling skills for that aircraft.


Really? In 30 years I had a vague idea about pilot/aircraft limits, but never EVER presumed to know. That is not, and never has been, an ATCO's responsibility. Local procedures, evolved in consultation with aircraft operating authorities, might result in a procedure that (at a certain distance from t/d, above the notional glideslope, at a speed inconsistent with a stabilised approach in a 777 or whatever). However, they are not imposed by ATC, surely? It is the airport operating authority, though promulgated procedures, that tells ATC what to do and to convey those instructions to the pilot. If that places a pilot at the margins of establishing a stabilised approach, please don't blame ATC - we actually do as we are told.

I know my place, as a former ATCO. I did NOT devise terminal procedures in isolation. I did NOT tell pilots how to fly aircraft. And I certainly didn't issue instructions (like 180 to 5) in the expectation that they would be ignored and turned into 180/7 if the pilot chose.

Peripheral to the main arguments? No idea, but the problem started somewhere, and from my professional perspective the 180/5 at 1800 is a hole in the cheese, as you folks like to say. After that, it's your call … and i do understand much of what has been said about automation, switch positions, monitoring, culture, etc etc.

IMO it starts with a badly designed approach plate which is evidently inappropriate, sets the aircraft up at 1800' (i.e. above the notional glideslope), and only works because those in the know ignore 180/5 and play 180/7.

Who authorised that approach plate? The rest is up to you sky-gods.

[James7]

Suninmyeyes Like someone else I wondered if the speedbrake had been pulled out earlier

Very good point, many times this has happened to me, the LG is selected down and speed brakes then armed as part of the sequence, then the PF uses the speedbrake and just stows them without re-arming them. Fortunately this is picked up on the ECAM landing checklist -Speedbrake .... and armed then selected. This usually happens in the Sim following multiple failures and me sitting in the right seat, not my usual seat. It has also happened a few times on the line, sitting in the right seat as PNF. I wonder if this was only picked up at 500' when the landing checks were done. I imagine the ECAM landing checklist is similar to the bus. This would explain the rapid drop in airspeed.

I believe the Autothrottle mode should also be displayed on the ECAM checklist. I know in the Bus the first line of the LDG checklist is Autothrust and the answer is Speed. However this is often missed ie just saying something that is not actually there. Also a common occurrence.

It would be a very simple thing to have -Autothrust ..... Speed. As a line on the ECAM. I am sure this would have saved a few embarrassing moments and in this case a crash.

[rudderrudderrat]

Hi MPN11,
IMO it starts with a badly designed approach plate which is evidently inappropriate, sets the aircraft up at 1800' (i.e. above the notional glideslope), and only works because those in the know ignore 180/5 and play 180/7.
Really?
The Jepp plates for the RNAV RW28L (3 deg slope)
http://yurik.flightgear.ru/KSFO.pdf show crossing the bridge at AXMUL at 1800 ft.
The quiet bridge visual shows crossing the bridge at 1900 ft (recommended).
Are you seriously saying that 100 ft higher is inappropriate?
The time taken to travel 2 nm at 180 kts is 40 secs.
By slowing down from 180kts to 160kts (average 170) takes 42.35 secs.
Are you seriously saying that taking an extra 2 seconds to reach the runway is significant for aircraft spacing?

I don't see why so many posters believe the visual approach / ATC were in some way to blame.
It was all down to the crew.

[Bob Zuruncle]

Cows getting bigger

[QUOTE]An interesting read from a couple of years back.

http://www2.icao.int/en/RunwaySafety...iderations.pdf/QUOTE]

Excellent link! Vey pertinent to the current discussion.

[MPN11]

With respect, rudderrudderrat ... The relevant plate is the visual to 28L, not RNAV.

No evidence that I recall that they were doing an RNAV.


Not that I would ever argue with a pilot. :cool:

[OK465]

(14:55) OBSERVATIONS FROM FLIGHT CREW (Not yet corroborated by CVR)


Approach asked them to maintain 180 knots until they were about 5 miles out.

In this entire thread, the above is the first reference I can find to '180 at 5' and is from Post #1353 (page 68 currently), an NTSB briefing summary by Knot Apilot.

It is, as is stated, evidently from the Flight Crew comments and is, at that point in time, also as stated, "Not yet corroborated by CVR".

The FCrew comment, as quoted, doesn't reference 5 DME or even just (180 at) 5 miles, but is quoted as an apparently TLAR (?) 'about 5 miles out'.

Shortly after this post, the comment was latched on to by posters and run with as '180 at 5' or variously '180 at 5 DME'. edit: or above just now '180 to 5'.

Not wanting to read every post between then and now, has this been confirmed by the CVR? Has the CVR info even been released?

(additional edit: the referenced poster does use the term 'paraphrased'.)

[junebug172]

Some new pics of Asiana being hauled away. Amazing more people weren't killed.

https://docs.google.com/file/d/0B08e-zZVr6ncVEI0SHdaTndjZlU/edit?usp=sharing

[Lonewolf_50]

From CGB's nice link. (:ok: good stuff)
VMC stable by 500ft VMC (The aircraft should aim to be stable by 1,000 ft even in VMC conditions. If the crew fail to achieve this then the gate can be reset to 500 ft, but only if the crew anticipate that the aircraft will be stable by 500 ft, if not a missed approach has to be carried out).
Note: The altitude at which the gates are set and by which the approach is
judged to be stable, varies depending on airline SOPs and can range from
1500ft-500ft
Note: you have to be ahead of the aircraft to make that judgment call. Asiana's SOP's will hopefully be included in the NSTB report.
EC Law now states:
• Without Visual Ground Reference:
It is recommended that stabilisation be achieved at the latest when
passing 1,000ft above runway threshold elevation. If ATC procedures require higher speeds and is allowed in the OM, the above gate may not be met, in this case stabilisation should be achieved by 500ft.
• With Visual Ground Reference: Stabilisation should be achieved by 500ft
(however it is still recommended that pilots use the 1000ft gate as
above). If the above gates are not met pilots should consider initiating a
go-around maneuver.

Additionally, note the use of the words “recommended” and “should”.

[JPJP]

rudderrudderrat - The quiet bridge visual shows crossing the bridge at 1900 ft (recommended).
Are you seriously saying that 100 ft higher is inappropriate?
The time taken to travel 2 nm at 180 kts is 40 secs.
By slowing down from 180kts to 160kts (average 170) takes 42.35 secs.
Are you seriously saying that taking an extra 2 seconds to reach the runway is significant for aircraft spacing?


1. They were on the TipToe Visual. The recommended ("should cross") altitude at the bridge is 1900 feet. The bridge is 5nm from the runway (6DME SFO). Therefore: at 1900 feet, the aircraft is 400 feet high, 5 miles from the runway.

2. If they were asked to maintain 180 knots to either a 5 or 7 mile final, they would still be slowing and configuring as they approached the bridge.

The above two factors may have combined to create what was obviously an unstable approach.

http://155.178.201.160/d-tpp/1307/00375TIPPTOE_VIS28L.PDF

[Lord Spandex Masher]

They weren't 400 feet high. They were 400 feet above a 3 degree profile. There's a difference.

[olasek]

Therefore: at 1900 feet, the aircraft is 400 feet highNo, it is about 280 ft higher above the 3 deg. slope.

Clearly, whatever the numbers, the overwhelming number of flights have no problem with this approach. Also '1900' is only 'recommended', it is not a mandatory requirement.