NTSB update on Asiana 214

[A Squared]

I'm aware of all that, of course, and you haven't got the gist of my question. If the ILS had been u/s on this aircraft in Seoul, no go. But why then go when the known landing runway at SFO had none.

Barit1 posted a very clear, simple, easily understood answer to that question. Why do you keep repeating a question that has already been answered?

[porterhouse]

I'm aware of all that,
I don't think so, with every minute your questions get more bizarre. :ugh:

[olasek]

why is dispatch with the ILS unserviceable on the anticipated landing runway allowedBy the way a good example is Ryanair providing a normal service from many European cities to Warsaw's Modlin airport. They were flying there for more than a year even though this airport offered nothing better than a measly VOR-DME approach, it just so happened in the last couple months that they finally installed a ILS.

[ExSp33db1rd]

Is the concept of a "sidestep" ILS approach still used in the USA ?

I recall being cleared for an ILS to Rwy 24L at LAX, but cleared to break off at my discretion, when visual and inside the Outer Marker ( I think - over 30 yrs ago ) so Shock ! Horror ! at fairly low level and close in, 'sidestep' to land MANUALLY and VISUALLY on 24R.

No 'Glass' cockpit of course, so no chance to go heads down pushing buttons to set up a mythical ILS Magenta Line for 24R, just fly the beast.

No problem, and I actually quite enjoyed it !

Therefore, couldn't Asiana have been cleared for a 'sidestep' ILS approach to 28R with a landing on 28L ? tho', seeing what they did with a straight in to 28L, one does wonder how they would have coped with a 'sidesep'!!

[glendalegoon]

WHBM:

In the world of flying, you must follow the rules. The rules say if you have something wrong on an etops twin you should fix it before you go. In your example, the ILS receiver OTS. What would happen if something went wrong and you had to land in Alaska, or Seattle and the weather was below other approach minimums. You would need the ILS. And if it failed enroute you would have to have an alternative course of action.

But the ILS on the runway isn't needed UNLESS YOU NEED IT because you can't do the expected approach. By virtue of preflight wx briefing and ATIS somewhere out near point reyes, you would know you have the choice of a visual approach or asking for something else.

Why did Asiana dispatch from Seoul to San Francisco knowing the ILS was ots on 28Left? Because every other airline in the world dispatched to San Francisco that day with the same knowledge. And none of them crashed.

Not airlines from China, or India, or Japan, or Australia, or France or Timbuktu.

Do you fly into SFO at all?

In the early 90's we dispatched into a domestic US airport that only had an NDB approach available. And we did it with onboard ADF. Part 121 major air carrier.

[bubbers44]

WHBM is a primary reason we should shut down this thread. He doesn't seem to understand what a legal dispatch is and we all do. He won't stop posting his nonsense but won't listen to us.

[A Squared]

Is the concept of a "sidestep" ILS approach still used in the USA ?

I've done it quite a few times on the parallels at Anchorage, for various reasons. Can't say for sure that it's still a currently approved procedure as it's been 4-5 years since I did one, but the again I don't fly into and out of ANC as frequently as I used to.

[bubbers44]

His latest stupid statement about needing his AC ILS operative at Seoul to take off but his known landing runway at SFO has one inop ILS shows he is not an airline pilot. We all know we need a take off alternate if IMC but SFO was clear with tons of alternates.

[olasek]

couldn't Asiana have been cleared for a 'sidestep' ILS approach to 28R with a landing on 28L ?Clearly they would have asked for it early enough and it is not clear whether they would have been accommodated (or what delay could have been), SFO likes to run parallel simultaneous approaches to both 28L/R for maximum airport landing capacity in VMC.

[bubbers44]

A teenager with a daddy that actually flies maybe but Daddy is flying while he is posting all day long?

[edmundronald]

Having done hundreds of approaches to 28L never felt I was giving up a will to live to do a simple visual approach with no glide slope. Amazingly we never got low once and always touched down beyond the threshold with no risk of life. No pilot I have ever met has either. Why did you say that?

Bubbers,
The press has reported NTSB was told by pilot he was "very concerned" *before* takeoff about the no-ILS landing he knew he needed to make. This shows the guy is neither an idiot nor a liar, and very conscious of limitations to his abilities.

Pilot who crashed at SFO worried about landing (http://bigstory.ap.org/article/ntsb-review-asiana-crash-hearing-wednesday)

As reported, it seems *he*, LEE KANG KUK could not request a change THAT DAY because of the check and cultural issues; however we would have a more realistic view of the real impact on safety of the lack of ILS on that runway at SFO if we knew whether this guy's colleagues -and others- had requested runway changes in the past.

Of course, political issues will probably intrude and impede such inquiries being made. No one likes telling their boss that they were the ones who lined up one of the holes in the cheese. It is less politically risky to say that a pilot crashed because he was not trained, than to say that one of a crowd of guys with low training was sooner or later not going to make it, and Asiana 714 was the one with the shortest straw.

[glendalegoon]

quoting from edmundronald:


this shows the guy is neither an idiot nor a liar, and very conscious of limitations to his abilities.

that you use this as any excuse or mitigation is astounding.

if he knew his limitations he would have called in sick that day. so he put his job above the safety of flight.

And this guy flew 747s into SFO before the 777.

I honestly believe I could put a 250 hour commercial multi engine pilot into the 777 without any preparation and tell him: LAND THIS PLANE AT THAT AIRPORT. DON"T GET SLOW

[edmundronald]

I'm sure you're right. But maybe people who are not skilled were requesting runway changes? What harm other than political can it do to ask the question?

[bubbers44]

Not skilled pilots should not fly people in airliners. Why don't you understand that?

[edmundronald]

Not only do I understand but I wholeheartedly agree.
:D

[A Squared]

Bubbers,
The press has reported NTSB was told by pilot he was "very concerned" *before* takeoff about the no-ILS landing he knew he needed to make. This shows the guy is neither an idiot nor a liar, and very conscious of limitations to his abilities.

Ok, he gets about half a point (out of a possible 100) for being aware he's grossly incompetent.

[bubbers44]

How did he know in Seoul that he would get 28L? He didn't of course because on approach to SFO we routinely got runway changes and accepted what we got because it did'nt matter. If he was that incompetent why did he pass a check ride?

[olasek]

I think he could have expected 28L even in Seoul. I think that most aircraft arriving on POINT REYES ONE or GOLDEN GATE SIX arrivals (far East or Europe) get assigned to 28L by default.

[bubbers44]

Then learn how to do a visual approach. It is quite easy.

[llondel]

I think he could have expected 28L even in Seoul. I think that most aircraft arriving on POINT REYES ONE or GOLDEN GATE SIX arrivals (far East or Europe) get assigned to 28L by default.

I was wondering whether there was a standard. I guess they're flying down the peninsula and then turning back up to the airport, so other traffic inbound from other directions can take 28R without paths crossing. I have recollection of crossing a runway after landing but that might have been a domestic flight.

[bubbers44]

It is not Rocket science. Line up with your runway and land as all pilots are trained to do. Crashing into rocks before the runway means no pilot was in control of the 777, it was just an uncontrolled crash to SFO because nobody knew how to fly an airplane but they thought they could push the right buttons. Kind of sad, isn't it?

[porterhouse]

I guess they're flying down the peninsula and then turning back up to the airport, so other traffic inbound from other directions can take 28R without paths crossingThat's generally how SFO channels its traffic on a typical good-weather summer day, there can always be exceptions to that rule. If you look at many summer photos of parallel approaches at SFO you will typically see a larger (foreign) widebody aircraft in the foreground (rwy 28L) and some smaller domestic aircraft on 28R in the background.

[glendalegoon]

I've read the whole thread.

Wondering, does anyone really think the pilots are victims here?

I don't.

Now, I don't know how all the people in the cockpit could let one of the most capable airliners of all time get low and slow in perfect flying weather, but I have a contrast to consider.

In the US and many other countries, airline pilots have either come up through the military ranks (and had pretty good training).

Or they came up the civilian ranks and managed to make all of their mistakes in little planes , corrected them and got on with airlines.


A tradition in flying that starts at the bottom and moves up. Not start at near the top and move sideways.

[jetpilot007]

glendalegoon (http://www.pprune.org/members/424060-glendalegoon)

Who says those pilots are victims here?

Everyone knows what happened with Asiana in SFO.
No one here is defending those two pilots.


So why don't you just be quiet and wait for the final report in Summer.


I know there are many pilots who think they are the best.
Good pilots come to this forum to not to criticize the pilots who had accidents.
Good pilots come to this forum to learn from other's mistakes.


You are the kind of pilot that we don't need in this forum.
And don't stir up again with this issue.

[glendalegoon]

jetpilot007


maybe you haven't read the thread closely enough. many have complained about the lack of ILS and other factors.

oh and jetpilot 007, there were three pilots in the cockpit that day, not two.

I'm sorry you don't understand the point I was trying to make.

[olasek]

I've read the whole thread.
If you did too bad you didn't realize that everything that could have been said had already been said over and over again. Your post contributes nothing new.

[Wizofoz]

Yes, the pilots are victims here.

Victims of poor training and a poor safety culture.

They didn't set out to crash the aircraft. They weren't negligent in the sense that they didn't deliberately flout regulations or have a "cowboy" attitude.

They did their best to deal with the situation with the tools they had been given, in the form of their training and company regulations (which includes a "maximum automation" policy)- those tools were manifestly inadequate.

Yes, the situation was there were two (probably three) pilots without the capability to use basic airmanship to correct an error and simply hand fly and visually land an aircraft.

But- HOW DID THEY GET THERE? WHY were they no able to?

I have first hand experience of Asiana and can say from personal experience it is because they would not only have never been trained in something so simple, it would have been actively discouraged.

Yes, the pilots didn't do their job.

The Airline, and the regulator behind that airline, put pilots not CAPABLE of doing the job in that cockpit.

[Cows getting bigger]

GDG, I sort of see where you are coming from but would suggest that 'experience fade' is far more prevalent than we may think. You just need to look at the various other cock-ups that have happened in the past year (SWA wrong airport, UPS Washington, wheelbarrowing 737 at JFK (?) and BA 747 at Jo'burg). All of these appear to have an airmanship issue.

[Passenger 389]

:confused: I thought this hamster wheel had mercifully been put to bed, by general agreement, pending any new and noteworthy developments.

Ordinarily, I'd bite my tongue and mind by own business, but this particular thread is one many monitor for new developments. Not sure another rehash qualifies (or benefits anyone).

[porterhouse]

Agreed, they should lock this thread pending new developments. The thread is becoming circular - you read now what had been said many times before.

[Piltdown Man]

I have a book, initially published in 1967 an on page 319 (Third edition, April 1990), there is this rather interesting paragraph which reads:

Finally, a word about basic flying training, instrument flying and recovery from unusual attitudes on limited panel. A number of airlines are now buying small executive jet type aircraft as trainers for their major transport fleets. In these, some attempt is made to make the instrument panel layout resemble the transport aircraft. This is probably the most significant step forward in training programmes for years. It provides a small, comparatively cheap aeroplane on which pilots can practice and exercise their flying skills.

This was written 46 years ago. It appears that exactly the same problem of lack of flying ability in wide-bodied pilots existed then as it does now. But nowadays we should have an advantage by using high fidelity, purpose built training simulators to do this training. But we don't. In 20 years of small aircraft operations (50-100 seater) I've only ever had one dedicated session to recovery from upsets and loss of control scenarios. Over the years I've obviously used odd bits of sim. time to mess about (touch and go on every runway, fastest circuit, low passes etc.), like every other pilot - but I really don't think that's enough. And I say that when I probably do 10 landings per week, many of which are both visual and hand-flown. We should all do more. Failing to do so results in accidents like this.

[olasek]

Failing to do so results in accidents like this.For "upset recovery" there are other standar examples like AF447 over North Atlantic or Colgan Air in Buffalo, I see little relevance in this accident with upset recovery techniques. Certainly by the time they realized they were "upset" they had already crashed. These guys need a primer in instrument scan.

[Gretchenfrage]

But nowadays we should have an advantage by using high fidelity, purpose built training simulators to do this training. But we don't.

I agree 100%. I have had the rare "privilege" to live through a (self induced) upset with subsequent successful recovery in an airliner some time ago. In spare time in a sim, i later duplicated the event, only to realise how far away from reality the machine simulated the event. At that time we blamed it on technology with the hope that newer generations would improve.
Lately i was planned on a brand new sim with state of the art programming. You guessed right, i tried again and realised that it was closer, but still too far away from what reality shoved down my spine as to be able to state, that a sim would be valuable enough to train upsets.

It still is not realistic enough, unfortunately.

The cost cutting by putting almost all the flying training into simulators still has its limits.

Upsets and close to the edge flying is still not covered satisfactorily in synthetic training.

[RAT 5]

Upsets and close to the edge flying is still not covered satisfactorily in synthetic training.

What creates this problem, if you see it that way, is that the vast % of training is to try and keep the crew well away from anything that might require this type of training. However, in our real world of a chain of humans of differing skill levels, mother nature, mechanical wear & tear and our good old friend Murphy, there are occasions where these skills are required. Sadly the financial guys have, perhaps, done their risk assessment and persuaded the powers that be, inside and outside their airlines that the costs of the skill training outweigh the resultant benefits. There are not, yet, enough smoking holes in the significant states who could bring influence to bear on this philosophy. A few crashes in the outer reaches of civilisation might to be expected in their eyes eyes. IMHO there have been enough on their own doorstep to cause some deep concern. Are the correct people asking the correct questions and demanding the correct answers? I wonder.

[awblain]

But isn't the intention of the synthetic training to make sure that the edge of the envelope always remains out of reach? That actions are taken so that stalls and upsets just don't happen?

If they do, then a simulator certainly can't wander beyond the edge of the gathered test flight data to reproduce them. If a large part of the aircraft falls off, or it enters a stall, then the simulator won't be able to reproduce the experience unless the model contains data as extreme as that event.

Aerobatic training might be very interesting, but would it have helped AF447 or Colgan whatever in Buffalo? I don't really think so. Wasn't it some exotic maneuvering training at American that could have contributed to the actions leading to the Queens NY Airbus crash in 2001?

[RAT 5]

But isn't the intention of the synthetic training to make sure that the edge of the envelope always remains out of reach?

I think you'll find that the modern airline pilot has absolutely no idea where the edge of the envelope is, or how close of far away from it they are at any given time. The box of most a/c is quite large. The SOP box of most airlines is extremely small. The buffer margin is enormous. This ignorance can cause problems when events conspire to move you out of your comfort zone. As a young F/O my comfort zone was small. It was experience/knowledge based. As I flew the line with the old farts in/out of old age low tech airports my experience/knowledge base grew and so my comfort zone expanded until I felt it large enough for me to cross over and feel comfortable with handling what the environment could throw at me.
Today that apprenticeship is no more. Commands are given away in half the time. Stringent trained monkey SOP's are a straight-jacket to knowledge of the a/c. Many captain's comfort zone is likely smaller than mine was 1/2 way through my F/O apprenticeship: and it will likely stay that way. Thus think what little knowledge is passed on, and then think how tiny the comfort zone will be of the following generation. Hardly the progression we might wish for. I am an advocate of SOP's, but when the SOP is maximum use of automatics at all times; full procedural approaches even in VMC etc. I wonder if there in lies the answer to having a tiny comfort zone.

[fireflybob]

When I did my B707 conversion training in 1971 we did dutch roll recovery, high mach "tuck" and emergency descent on the aircraft because the simulator didn't have the fidelity to do same.

That said, of course, we shouldn't forget that the odd accident happened on the real aircraft when practising the training which we now routinely conduct in the simulator.

[ThreeThreeMike]

That said, of course, we shouldn't forget that the odd accident happened on the real aircraft when practising the training which we now routinely conduct in the simulator.

The crash of Airborne Express N827AX is illustrative of this, and it also speaks to a failure of basic airmanship.

The National Transportation Safety Board determines that the probable causes of this accident were the inappropriate control inputs applied by the flying pilot during a stall recovery attempt, the failure of the nonflying pilot-in-command to recognize, address, and correct these inappropriate control inputs, and the failure of ABX to establish a formal functional evaluation flight program that included adequate program guidelines, requirements and pilot training for performance of these flights.

Contributing to the causes of the accident were the inoperative stick shaker stall warning system and the ABX DC-8 flight training simulator’s inadequate fidelity in reproducing the airplane’s stall characteristics.

http://www.ntsb.gov/doclib/reports/1997/aar9705.pdf

[Gretchenfrage]

RAT 5 :ok:

I fully agree. The problem starts with today's training syllabi, like Multi-Crew-Licence-shorttracks and national-pride-ab-initio-direct-to-widebody careers (arabic countries) are flawed from the beginning due to lack of training of simple and basic skills and basic experience.

When the earlier generation started training, they did many hours on single, then twin, then turboprops. As students and then as young CFIs, as low-paid night mailshifters or even cropdusters. During these hours we had the "opportunity" to "almost screw-up" many times, to get close to the limits, we flew alone or together in non-blackbox-surveyed small equipment.
Many of such close encounters sharpened our senses, developed our early warning instincts and showed us our own limits and weaknesses. Similar experience was achieved in the Air-forces.
Every now and then someone paid the price, yes, but it was rarely with SLF!

Todays typical airline cadet and new FO has gone through the loops and hoops in record time, many logging unrealistic hours and the genuine ones with tight sops and 99% on autopilot or assisting the skippers. They know maybe three types of aircraft (another 20 in the MFS). Never given the chance to get close to any limits, their instincts are non existent, their early warning system digitally imprinted on the magenta cross on the PFD.

That is simply not enough for Murphys law, for some badly designed airline philosophy or some cheap maintenance and training.

Basic training should be just that: Basic training and not synthetic shortcuts.
It will never be possible to regain any lack of airmen-ship in a synthetic trainer, they can never be programmed realistically enough and without sound basic skills no program in the world can install professional skill into a human pilot.

It's as simple as that.

[IcePack]

gretchenfrage, you are totally wrong. Well according to the accountants. Cheap labour is a risk worth taking.

Actually I agree with every word of your post. Well said:)

[Cool Guys]

Asiana Adopts New Pilot Training After US Crash (http://www.voanews.com/content/asiana-adopts-new-pilot-training/1851905.html)

[ExSp33db1rd]

Cheap labour is a risk worth taking.

When I did my Command training, we completed Huggy Fluffy Team building exercises, and my 'team' came up with a suggestion that we said would make our airline 10% better that the competition.

Not interested, said the Managment, we only need to be 1% better, the other 9% costs money.

[Capn Bloggs]

After a deadly crash landing last summer in San Francisco, Asiana Airlines is changing its training for pilots to encourage crews to talk more and change cockpit culture.
Good on them. :D

[Petercwelch]

Gretchenfrage's post is the best most succinct explanation of the why of a number of recent accidents. Would that airline management would all read it carefully!

[Old King Coal]

gretchenfrage - I salute you for a most succinct explanation of the truth and reality of the matter !! :D

[MrDK]

Although there is nothing "funny" about an accident, this statement had me nearly falling of the chair.

*** Kirstein said other airlines should take note of Asiana’s improvements
and understand the importance of open communication in the cockpit. ***

[Rwy in Sight]

MrDK,

I would be more concerned by the way an tryly independent and decent authority decides to add some political correcteness in their statement.

[mary meagher]

TTM, I think you are being rather unfair to the two pilots who died in the Airborne Express crash in 1997. They were both vastly experienced in many forms of flying, with aprox. 8,000 hours each. They were test flying a 30 year old rusty DC8 with an unserviceable stick shaker. To say they crashed because of a failure of basic airmanship implies to me only that you haven't read or understood the whole report.

Anyone who flies any airplane when it has just suffered major repairs is, in effect, a test pilot. Most of us know that.

[mary meagher]

Mods, forgive my double posts, but the subjects differ.

We have often flown experienced airline pilots at our gliding club. Aside from a tendency to round out (flare) at approx. twenty feet above the ground, they usually do well. Gliding training takes one back to basics, we cover stalls, spins, spiral dives, negative g, planning a SAFE circuit (pattern), we MONITOR the approach, we correct for UNDERSHOOTING - or the other extreme. And all of these exercises are done in real time in real aircraft and actual weather conditions (though seldom at night!).

So could I recommend gliding training as a prerequisite to becoming an airline pilot? (Sully was an experienced glider pilot).

[RAT 5]

All of the above could be covered in an aero's course followed by dead stick landing from downwind in a normally powered a/c. To learn gliders, specifically, is a whole new ball game and not logistically realistic.
The most simple of exercise in a big jet is to come over head the rwy at 90 degrees, 4000' clean speed, make a low drag CDA to either rwy, with or without PAPI. To my mind that should be in every 6 month check as a recurrency training. It was a common manoeuvre in my previous life, but is now frowned upon by the current crop of managers and so the crews have no idea how to do it. Simple basic a/c handling. Disappeared.

[RoyHudd]

Dead-stick landing....stable at 500 feet? Dead-stick practice could encourage unstable approaches, as happened with the Asiana SFO crash.

For normal airline ops, best to have the pilots demo a variety of visual landings in various conditions with 2 engines, (crosswinds, poor vis, both, neither) and the mandatory s/e approach and landings.

[MFgeo]

Mary:
Gliding training, like any hand flying experience, might help. However, it is no magic solution. Yes, Sully was a glider pilot -- but so was Bonin (PF of AF447).

[Centaurus]

Dead-stick landing....stable at 500 feet? Dead-stick practice could encourage unstable approaches

Come off the grass. That's like saying practice engine failures in the simulator could encourage cowboy pilots to pull an engine back on take off to keep current at engine failure technique. Dead stick landing practice in the simulator would quickly sort out skill deficiency in manual flying and basic judgement.

If student and private pilots are required to demonstrate proficiency in dead stick landings following an engine failure, then shouldn't we expect a jet transport pilot undergoing Loss of All Engines in the simulator and is unable to relight his engines, be also certified competent at the subsequent forced landing? After all, we practice putting airline simulators into unusual attitudes just in case it happens on a dark and stormy night.

Isn't that what simulators are for? In other words safe practices designed to improve piloting skills which have been shown to be sadly lacking judging by the number of spectacular crashes. A certain Boeing 777 operator comes to mind at SFO.

[punkalouver]

Someone at Korean was saying that they are now doing lots of visual approach practice in the sim. Since the past summer.

[SRS]

I know they have been doing visual approach practice in the sim, with 30 knot crosswinds for the last 10 years. Has not helped much.

[glendalegoon]

gliders:


gliders are designed without engines (motor assisted gliders aside). airliners are designed with engines.

the best practice would be in the type you are flying on a daily basis, not the use of dedicated gliders.

as to sully, I understand he took gliding lessons early in his flying career. that's nice. but the basic skills of airmanship are practiced every day in routine flying. they are called the four fundamentals of flight. and while he didn't shut down engines (to get rid of residual thrust) on a routine basis, i think the argument for flying gliders to help you fly airliners is pretty far fetched.

[bubbers44]

We always did a dead stick landing in the B737 once on each recurrent, usually from 10 miles out on a base leg. It wasn't hard but gave every pilot the training to not rely on engines if the day ever comes when you have none. I flew sailplanes too but it was a totally different type of flying and had very little to do with the sucess of dead sticking a 737.

[IcePack]

Some quoting the Hudson incident should read the report & ponder Alpha Prot.
BUT in no way do I wish to undervalue the skill of the PF, just to add balance to the glider pilot theory.

[Intruder]

the best practice would be in the type you are flying on a daily basis, not the use of dedicated gliders.

as to sully, I understand he took gliding lessons early in his flying career. that's nice. but the basic skills of airmanship are practiced every day in routine flying. they are called the four fundamentals of flight. and while he didn't shut down engines (to get rid of residual thrust) on a routine basis, i think the argument for flying gliders to help you fly airliners is pretty far fetched.
Unfortunately, we get WAY too little practice on a daily basis on the "basic skills of airmanship" in airplanes with autopilots, autothrottles, and FMS; and in a regulatory environment that forces us to couple up for 90% or more of each flight.

While I might agree that there is not a need for "dedicated" gliders or glider training for airline pilots, I am an advocate of encouraging EVERY pilot to get some training and time in gliders. Glider time is virtually 100% "basic skills of airmanship" time, and I still believe that I learned more about flying, per time spent, in gliders than any other aircraft. Some of those skills are not easily forgotten, and may come back at the most opportune times...

[Tee Emm]

The problem everywhere is that 95 percent of simulator recurrency training is on automatic pilot. Until simulator sessions are 50/50 automatics and manual raw data, no flight director, no autothrottle handling, then the current status quo will remain. In other words a low standard of manual flying skills.

[glendalegoon]

BASIC AIRMANSHIP can and should be practiced on every flight and every simulator session.

IF you can't "CLICK" off the autopilot and fly the takeoff, climbout and trim for cruise (autopilot if a long flight in cruise is ok, but click it off once in awhile and see if you can hand fly at altitude)and then click off the autopilot and hand fly the descent , approach, landing and rollout, then IT IS YOUR OWN FAULT.

AND if your company says you can't turn the autopilot OFF, then speak up and demand more proficiency training.

Gliders may offer something, but it is probably because I can't think of one that has an autopilot.

Bubbers is right, we always did a dead stick landing in the sim, maybe from different KEY positions and we did them way before sully splashed

[Linktrained]

Intruder #561


I mentioned that my glider training may have been of help for me with an engine problem on a low overshoot ( see 21 Dec 2013 #13 , 15 , 19).
I think that it enabled me to avoid stalling whilst getting the aircraft going the way that it should - trading loss of height for an increase in speed. My Chief Pilot said that I had reached Vmca ( or was it Vmcg ?)


Or it could have been my big left foot !

[Intruder]

IF you can't "CLICK" off the autopilot and fly the takeoff, climbout and trim for cruise (autopilot if a long flight in cruise is ok, but click it off once in awhile and see if you can hand fly at altitude)and then click off the autopilot and hand fly the descent , approach, landing and rollout, then IT IS YOUR OWN FAULT.
Sometimes yes; most times no...

Between the RNAV1 SIDs, RVSM cruise altitudes, and RNAV1 STARs in the US, it is difficult to find time where manual flight is allowed. While the FAA technically allows use of the Flight Director in lieu of autopilot on those SIDs and STARs, our company procedures do not. On many flights the only manual flight allowed is from takeoff roll to 1000' or so, and from the IAF to landing. Add Cat II weather, and the latter goes away, too...

[glendalegoon]

Intruder

and what have you done to change things? written your congressman? written a letter to the editor? flown lower?

[Intruder]

Writing to a congresscritter or editor would be a waste of time. All these rules are perceived by the public as making them safer, and the likelihood of rescinding these types of rules is VERY low. Flying lower is normally not an option, since fuel consumption would suffer significantly.

I fly non-RNAV SIDs and STARs when available, so I can hand-fly. I encourage my FOs to hand-fly whenever possible, and try to break them of their schoolhouse habits of keeping the automation on until short final.

[hec7or]

Long time since I've flown a glider, but I didn't see anything in the last one I flew that would help with an instrument scan, including of course the engine gauges.

Too much adverse yaw to help with basic handling and asymmetric handling practice not much in evidence either.


After Kegworth, it was found that prudent use of the automatics may have reduced the workload sufficiently to enable the crew to run through an effective decision making loop.

[mary meagher]

It is always interesting to read the comments of airline pilots, real or simulated pilots, to the prospect of flying an aircraft with engines U/S or never installed in the first place (gliders). You have to get the approach and landing right every time. From the moment that the instructor gets out of the back seat and tells you to get on with it, the only weapon to deal with an undershoot situation is to put away the Airbrakes (Spoilers). As did the Captain of the 777 at LHR when his engines declined to spool up at a critical moment.

Three times in my flying I have noticed completely unbelievable readings on the ASI. I followed the basic rule of flying number one, first of all, if the aircraft is still right side up, Do Nothing. Avoid panic. Think about it. Realising the problem (I had left the static ports covered with tape) the two options left were to fly by attitude, and the sound of the airflow. Being fortunate enough to have plenty of height, and experimenting gently with these remaining indications of airspeed, made presentable landings back at base.

A third problem that has occasionally brought down an airliner, was an inoperative control, namely my ailerons were frozen. Quite literally, as the tape on the wings got wet the previous night, and I was at 20,000 feet. (in wave, at Aboyne).
Same drill. Do Nothing, avoid panic, think about it. Solution, gentle turns with rudder alone, and descent to warmer air.

Its a shame that the beancounters and those dependent on engines don't realise how valuable the experience of basic flying in simple aircraft can prove. Of course sim training gets you accustomed to complex panels and alarm systems. Unfortunately in this training your butt is never truly in danger, only your coreer.....

[Aluminium shuffler]

Those advocating we opt to fly more manually in the sim must be working for exceptional companies. For the bulk of us, the sim is used more for checking than training, and with a career, house and family riding on the line, most simply can't put their neck on the block like that.

I have been fortunate that my employers have a checking day and a training day every other check, and previous employers had training days each check. Not all employers do this. Now, these training days are assessed too, so you still have to be careful during the sessions and that includes full, appropriate use of automatics, FMC and so on. However, these sessions over the years covered double engine failures, rudder hard-overs, ash clouds with erratic engine operation (including a flame out which self re-lit, but you lose the other which was running with no indication, and if you don't land within a very short time scale, a loss of the running engine too...), FMC failures, EFIS failure, manual reversion (all hydraulics) and lateral control failure, and more. So, all of our line pilots get to expand their experience. If we finish early, then it's play time, un-assessed - I had a go as a Sioux City/Baghdad scenario using just thrust to control a 737 from 400' on TO to landing, and it was all good stuff, but few get that opportunity and few feel they can take that chance on a "training" session that is recorded an assessed.

As for glider pilots' superiority - hogwash. I have flown with many, and while some are excellent, the majority are arrogant and cavalier. In the UK, it is commonplace for gliders to penetrate controlled airspace because they know they can't be seen on radar and they'll get away with it. That is their "airmanship". I fly with low hour cadets, experienced FOs and new FOs with GA instructor backgrounds. All I can say is that you have to judge each by their own merit - there is no pattern dictating which has better skill or judgement.

What can be done to improve things is for authorities to insist companies make clear in their manuals and training that raw data and manual flying practice are to be encouraged when circumstances permit, including unassessed periods in the sim, to increase our competence and confidence in flying the aircraft and not the manuals, and to stop harassing crews for petty SOP deviations that had good airmanship behind them. This is the bigger issue; SOP is now banded around as dogma, and anyone who uses airmanship is branded a heretic.

[Ian W]

BASIC AIRMANSHIP can and should be practiced on every flight and every simulator session.

IF you can't "CLICK" off the autopilot and fly the takeoff, climbout and trim for cruise (autopilot if a long flight in cruise is ok, but click it off once in awhile and see if you can hand fly at altitude)and then click off the autopilot and hand fly the descent , approach, landing and rollout, then IT IS YOUR OWN FAULT.

AND if your company says you can't turn the autopilot OFF, then speak up and demand more proficiency training.

Gliders may offer something, but it is probably because I can't think of one that has an autopilot.

Bubbers is right, we always did a dead stick landing in the sim, maybe from different KEY positions and we did them way before sully splashed

I have nothing against crews getting hands on manual flying and 'glider' flying training. But that is to miss the point of this incident and the AMS 737 incident. In both cases the crew thought that the automatics were looking after the speed so did not bother to maintain scan of the speed.

The FAA and Boeing response is to add yet another alert that speed is low but there right in the middle of the panel is an ASI showing that which the crew do not bother to monitor. When a human is in cognitive overload the first sense to be switched out is hearing, then vision tunnels onto what is deemed to be most important (it is called 'cognitive tunneling') and once in that state only haptic input (touch) has any effect - hence stick shakers.

But the real problem is failing to scan the instruments leading to lack of situational awareness. So perhaps sim runs ought not to drop you into 'dead stick' - more slowly decrease a value during a difficult approach to see when it is picked up, or even freeze and the instruments blank out and the instructor asks 'what was your speed? What was the altitude? what was the descent rate? etc. Simple checks that you were actually understanding what these values were rather than glancing and not taking in what the instruments were indicating.

[hec7or]

My experience of the approach configuration stall scenario is that the rate of decrease of airspeed is initially quite slow from 220kts down to 160kts, then as gear and flap are lowered, the airspeed drops off at a much higher rate and if the rate of airspeed reduction is not arrested before Vref, then everything happens very quickly.

Assuming that nothing has been done to arrest the rate of decrease of speed, then the question should be "why are the crew not monitoring the airspeed?".

Well there are plenty of distractions during the final few miles on the approach such as ATC transmissions, other traffic, configuring the aircraft, running the landing checklist, preceding aircraft separation, especially if the approach has an element of high energy, etc.

Poor situational awareness leads to overload and a breakdown in the scan, with possibly one crewmember running the landing checklist which may reduce the ability to monitor the pilot flying and the instruments.

Add in some presson-itis and life gets quite difficult.

It is difficult to recognise the onset of crew overload and there is no "pilot overload" warning lamp on the panel to alert us.

I was told by a very good TC that if you can't remember the wind direction and speed given with the landing clearance, then you're overloaded.

Manual handling is important, but it should be stressed that manual flying will not necessarily reduce overload and nor will it increase situational awareness since the workload on the pilot monitoring will normally increase.

Experience helps, since it will aid recognition of a crew overload situation developing and allow time to reduce the workload and regain situational awareness.

Gliding skills? Naaah.

[Lonewolf_50]

All ranting aside, dead stick landing skills won't be needed if the 777 crew had simply maintained the airspeed (137kts IIRC) on speed during the approach.
From a post before the bickering began ...

Those advocating we opt to fly more manually in the sim must be working for exceptional companies.
For the bulk of us, the sim is used more for checking than training, and with
a career, house and family riding on the line, most simply can't put their neck
on the block like that.
This seems a cogent point.

If one has passed a check ride, how does on stay both current and proficient in necessary skills until the next check ride? :confused:

[bubbers44]

The Asiana crew was probably never able to do a visual approach because of their training. Every thing was using automation.

[barit1]

Reminder - in case you haven't read it lately:
NTSB says Asiana captain worried about visual landing | Fox News (http://www.foxnews.com/us/2013/12/11/ntsb-to-review-asiana-crash-at-hearing/?cmpid=cmty_twitter_fn)

Very difficult? Really? On a CAVU day, no obstacles?

[bubbers44]

A Squared, I soloed at an airport where the runway was used as a drag strip one day a week. I doubt a drag race was happening when the AC 767 landed. Other than their fuel management they did one hell of a job that hopefully any qualified pilot could do.

But that was then and now it probably wouldn't happen. We have a different breed of pilots that prefer to push buttons than aviate.

[Centaurus]

it should be stressed that manual flying will not necessarily reduce overload and nor will it increase situational awareness since the workload on the pilot monitoring will normally increase.


I have heard that statement many times. Surely if the pilot has been certified as competent to fly a certain aircraft type this would necessarily mean he was competent at hand flying, automatics watching, monitoring the various instruments and operating the radio switches. So where does this claimed work-load increase come from?

Either way the PM will be keeping an eye on the flight path whether the other pilot is using the automatics or hand flying for the conditions. Let's face it, watching the other pilot pole the aircraft isn't exactly a life threatening job, so how on earth does this increase the work load on the PM?

After all even the youngest inexperienced flying instructor has a high workload concentrating on watching his student pilot trying to do cross wind landings. If an airline pilot workload is getting right up to his upper limit by watching the other bloke flying, then he will quickly blow a brain gasket if a simple generator failure or a fire warning occurs and he has to find the appropriate QRH page.:ok: Claims that watching manual flying increases the other pilots work load to an intolerable amount leading to a flight safety problem on the flight deck, is really laughable. IMHO:ok:

[iceman50]

Centaurus

You seem to forget that in a lot of the cases of "manual" flight the PF requires the FD's to be giving the required information. That is where the increased workload on the PM comes from, as well as performing his "normal" duties and MONITORING. If the PF is not using the FD's then yes there will be no corresponding large increase in workload. Some companies may also require the use of FD's for certain operations even when hand flying.

[glendalegoon]

Increased workload? INCREASED WORKLOAD!

Oh my, what if the autoflight system failed? Imagine the poor PM (prefer term NFP) actually having to do a number of things at the same time.

Sad.

A friend said: you aren't really an instrument rated pilot until you can hand fly an ILS to minimums on one engine while eating a hamburger.

somewhere being a lame pilot became acceptable. (lame in the teenager sense of the word)

[Yancey Slide]

Off-thread, but:

I doubt a drag race was happening when the AC 767 landed. Other than their fuel management they did one hell of a job that hopefully any qualified pilot could do.

http://cdn.damninteresting.com/wp-content/uploads/2007/11/gimlix.jpg

?Gimli Glider? pilot recalls heroic landing of 767 | National Post (http://news.nationalpost.com/2013/04/14/gimli-glider-pilot-recalls-heroic-landing-of-air-canada-767-as-famed-plane-put-up-for-sale/)

[RAT 5]

It was the case, a few years ago, and not that long, when an upgrade command check required an ILS on SBY instruments: those pokey little thingies no-one ever looks at. That is what they were there for, the final back up. If you knew the attitude and power settings, and could manipulate the controls in a manner akin to driving on ice rather than ploughing a field, it was quite possible. Even on B733 classics, B757/B767 with a Loss of AC it was necessary, but I wonder how many upgrade courses demanded it. Perhaps the XAA's should have done so. (Indeed, now there is a thread creep: how much input do they have into commander's upgrade syllabus, or do they just rubber stamp the airlines internal course?)
Back to the plot: along comes the B737NG and an option is a PFD + MAP on SBY. Great for safety, of course. So why still have the SBY's? except for analysing the rogue instrument when a disagree is seen, perhaps.
An occasional raw data ILS in the sim as a recurrency is all well and good, but it is not a pass/fail. Should it be? Should a captain be able to fly a mini-SBY ILS on 2 engines? Yes. It's basics. These manoeuvres are the crux of being in control. All this gliding dead-stick stuff is great for the bar, but as likely to happen as a pay rise/pension plan in a LoCo. However, training, testing, exhibiting basic skills which could and should be used every day is another matter. It would raise the bar back to somewhere whence it once was and put some fun back into for the dreamers. It'll make the pax feel better knowing there is a real pilot up front. As a CP it would also make me feel more comfortable knowing my guys could most likely get themselves out of whatever hole they had found themselves in without digging deeper first.

[Alycidon]

Interestingly, the current teaching at my Company for the ATPL upgrade, raw data ILS is to bring the ND into the scan in order to monitor tracking and reduce the tendency to needle chase.

So it's not really raw data is it?

[PEI_3721]

“Claims that watching manual flying increases the other pilots work load to an intolerable amount leading to a flight safety problem on the flight deck, is really laughable”.

Perhaps no so, either manual or auto flight, over a short but important timescales, and in specific situations; everything in context. There are good examples in the BEA AGASA study.
Note the similarities (not the speculative details) between Asiana and THY AMS. Training in a complex ATC/approach scenario, weaknesses in automation design; perhaps insufficient spare mental capacity to understand the developing hazardous situation, minds focussed elsewhere. Does industry have too high an expectation that monitoring / CRM will provide a safety defence in every situation.

These accidents involve aspects far greater than individual behaviour, we should consider all humans' behaviour in the more unusual / demanding ‘normal’ situations.

[bubbers44]

Obviously the new generation of pilots are not required to fly with automation failure as we were. We never got overloaded when it all went south but obviously that is not the case today reading these posts.

[llondel]

if there is automation aboard a plane, one has to be able to fly OK if it fails. but there is a new view that if automation fails, the flight crashes.

It's the media write-ups afterwards that go really overboard, about how the pilot (usually singular) managed to land safely after the computer that was supposed to do it all for him had failed. They totally miss the point that if he (or she) can't do that, he shouldn't be sitting there in the first place.

[tdracer]

I rather like the idea that someone posted a few pages back. During a sim session landing, suddenly freeze the sim and blank all the displays. Pilot has to repeat what the airspeed, altitude (above ground), where they were relative to glideslope, and any other parameters that might be considered relevant.
If the pilot can't immediately repeat - with reasonable accuracy - the parameters at the time the sim froze, they fail.

[RetiredF4]

“Claims that watching manual flying increases the other pilots work load to an intolerable amount leading to a flight safety problem on the flight deck, is really laughable”.

Perhaps no so, either manual or auto flight, over a short but important timescales, and in specific situations; everything in context. There are good examples in the BEA AGASA study.
Note the similarities (not the speculative details) between Asiana and THY AMS. Training in a complex ATC/approach scenario, weaknesses in automation design; perhaps insufficient spare mental capacity to understand the developing hazardous situation, minds focussed elsewhere. Does industry have too high an expectation that monitoring / CRM will provide a safety defence in every situation.

These accidents involve aspects far greater than individual behaviour, we should consider all humans' behaviour in the more unusual / demanding ‘normal’ situations.



In the context of this thread this statement reads like a notion for the future three man cockpit. The third guy/gal being a shrink to monitor the crew.

[RAT 5]

weaknesses in automation design;

Perhaps this should read "weakness in understanding the automation and how to use it properly in non-normal situations."

Obviously the new generation of pilots are not required to fly with automation failure as we were.

They should be able to do so if they switch it off and fly via Mk.1 eyeball and manual manipulation of the controls as the pax expect you to be able to do. Failing and switching off should be the same thing. Take a straw poll amongst the flying public and ask them what they'd expect the abilities of their crew should be. I doubt it will match up to the bi-annual test.

[hec7or]

Let's face it, watching the other pilot pole the aircraft isn't exactly a life threatening job,

If an airline pilot workload is getting right up to his upper limit by watching the other bloke flying,

now there speaks someone with no real understanding of the role of the PM.

While the ace of the base is flying manually, who do you suppose makes all the mode settings for the FD, continuously sets the HDG bug, sets the airspeed bug for every speed change, resets and confirms the altitude selector setting, makes the FMC entries, does the RT, runs the checklists, selects gear and flap, monitors the pressurisation system, addresses master caution alerts, monitors the position and altitude of the aircraft with reference to the departure/arrival, monitors terrain, monitors proximate traffic, talks to the cabin crew and if necessary runs the QRH?

That's what you call a workload.

"watching the other bloke fly"

are you having a laugh?

[Centaurus]

All this gliding dead-stick stuff is great for the bar, but as likely to happen as a pay rise/pension plan in a LoCo.

Must disagree on that point. An engine failure right on V1 could be said to be great for the bar, but as likely to happen as a pay rise plan etc etc. Same with a high dive depress from 40,000 ft. Same with loss of both gens simultaneously due to lighting strike. Same with an all flaps up landing on a limited length runway. Where do you want to stop?

We practice volcanic ash events where loss of both engines occurs. But always magically in the sim we get one engine going to save the day. I have never seen failure not to get one engine going in the sim which would logically lead to a forced landing like the Gimli glider and other examples of successful dead stick landings in transport jets.

What we do see in the simulator where I work, is the inevitable lack of basic flying skill displayed by even the most experienced pilots when confronted with a loss of all engines at 20,000 ft because they flew into a super size 63,000 ft storm and drowned both engines and couldn't get a restart. Never happens, you say? Try reading the Garuda 737 report where they finished up dead stick flapless ditching in a river. Sully did a good job too after losing both engines to bird strikes.

What I have seen in the simulator is not necessarily the direct fault of the captain when he crashes trying to dead stick. It is more the training department who do the ostrich head in the sand trick and think to themselves why practice something which is great for the bar, but as likely to happen as a pay plan pension etc etc?:ok:

Pilots spend hours in the simulator practicing ILS which they do every day of their career in real time. By then they know every facet of how to fly an ILS on one or two engines. However throw in a standby flight instrument ILS with manual stab trim and only a couple of flight instruments plus a baby ILS all in IMC and most are so far outside standard instrument rating flight tolerances they would fail the test. But they never do of course because the box must be ticked and sim time is limited... :sad:

If you accept that probably 95% of jet transport pilots have never practiced a dual engine failure followed logically by a dead stick landing, then what an indictment on training departments. But stick a MPL 200 hour pilot as second in command of a 300 passenger jet, then no flight safety problem at all; even if the captain keels over with food poisoning at 20,000 ft. The chances of an MPL pulling that off successfully is great stuff for the bar etc etc:ok:

[Capn Bloggs]

While the ace of the base is flying manually, who do you suppose makes all the mode settings for the FD, continuously sets the HDG bug, sets the airspeed bug for every speed change, resets and confirms the altitude selector setting, makes the FMC entries, does the RT, runs the checklists, selects gear and flap, monitors the pressurisation system, addresses master caution alerts, monitors the position and altitude of the aircraft with reference to the departure/arrival, monitors terrain, monitors proximate traffic, talks to the cabin crew and if necessary runs the QRH?

Drama alert! Sounds impressive but most of those don't happen at the same time. Monitors the pressuriation system? Ya joking? Runs the QRH whilst Ace does his handflying practice? Ya joking on that too? Handflying PF confirms Alt Sel setting...

[hec7or]

Monitors the pressuriation system? Ya joking?

clearly never done your after takeoff checks correctly have you?

[glendalegoon]

hec7or


wow. and the pilot flying is monitoring what the pilot monitoring is doing too. sheesh, you really don't have a clue do you?

tell me the pilot is listening to the "RT" (that's the radio for most of us)

tell me the pilot flying isn't making sure that the heading bug has been properly set (wow, I've even been hand flying and moved the heading bug myself, I must be superman huh?)

And while hand flying I"ve looked over to make sure the pilot monitoring hasn't fallen asleep, or made sure the cabin pressure was right.

oh, and I've done all of that while hand flying and watching my altimeter, airspeed, heading, course , and keeping situational awareness of nearby terrain, traffic and how cute the senior flight attendant is.


I can't believe some of the stuff I'm reading. Have we forgotten how to tie our shoe laces too?

[hec7or]

well glendale,

yes it's against SOP for the PF to set the HDG, ASI bugs or the ALT selector, this is what increases the workload for the PM.

And while hand flying I"ve looked over to make sure the pilot monitoring hasn't fallen asleep, or made sure the cabin pressure was right.

:D gosh you're good

meanwhile, you don't agree with the SOPs? fine, your choice, but not in my airline.

wow. and the pilot flying is monitoring what the pilot monitoring is doing too. sheesh, you really don't have a clue do you?

nice comment, thanks, but the CAA were very complimentary on my last examiner's revalidation

glendale...goon? yes you appear to have that one pegged

[Brian Abraham]

hec7or, a hint, read the red script at the bottom of the page, and of more importance is the bit in green immediately below.

[hec7or]

Sage advice Brian, thanks for your hint.

I'm a bit slow on the uptake sometimes!:rolleyes:

[flyingchanges]

Geez, how do all the commuters do it? Thousands of hours flown in solid IMC with no automation, no autopilot, no FD? Guess they were just overloaded all the time.

PM overloaded watching the other guy hand fly, give me a break.

[Alexander de Meerkat]

Centaurus - I work for easyJet and nearly every pilot in the company (2500 of us) will have practiced a dual engine failure followed by a dead stick landing at some stage. No all have been successful but they have certainly had a go!

[ExSp33db1rd]

[A friend said: you aren't really an instrument rated pilot until you can hand fly an ILS to minimums on one engine while eating a hamburger.]

and as my Nav instructor said - you'll never make a Navigator until you've been over Berlin with the shells coming through the cockpit as you make the pilot fly steadily on 3 headings 120 deg. apart as you try to work out the upper wind from readings you take through the drift sight !

I never had to.

One of our WWII Captains flew his last 707 flight to New York and back to London before retirement by hand flying the thing all the way. ( I guess he had to make some arrangement to drink his coffee and visit the toilet, but other than that ...... )

Not saying it was a good thing, just saying he did it ! ( I was told )

Once had to fly across the Atlantic with a u/s autopilot, the Captain and I took it in turns, 30 minutes each was about all we could manage before losing concentration.


I seem to recall that passing 10,000 - up or down - was a signal to engage autopilot, unless there was some problem that needed attention, in which case engaging the autopilot was a recommended practice, to release hand/brain resources to attend to the problem.


Wasn't it Eddie Rickenbacker, of Easten Airlines fame, who refused to instal auto-pilots in the '30's, he said "our pilots are paid to fly, let the b***ers fly" and it was only when the Sperry Autopilot of the day proved to help with fuel saving, i.e. money saving, that he relented ?

Such fun, sounds like it's all gone now. I blame Bill Gates.

[glendalegoon]

hec7or


tell me, what do you do when the pilot monitoring has to do two things at once like answer the radio and move the heading bug or altitude alerter?

or God Forbid, what if the pilot monitoring has been busy making a PA announcement while the pilot flying is hand flying and has to answer a radio call?

My airline has a similar SOP but it also allows for other methods to accomplish the tasks at hand. It specifically allows for the PF to set the altitude alerter, airspeed bug etc if the PNF (pilot monitoring) is busy doing something else. With a quick double check when back "ON".

I'm so sorry that an increased workload is so tough on you, but it also makes for the side benefit of increased hand flying skills for the other pilot.

I'm so happy that the CAA was so complimentary to you. Did you get a Victoria Cross for working the radio and setting the altitude alerter and heading bug all at the same time?

FOLKS, if automation is going to be so good for everyone, did anyone think it might replace the copilot? JOB SECURITY!


And hec7or. Is there any conceivable situation where autoflight and the pilot monitoring would all be inop at the same time?

Oh my, what would we all do?

[Centaurus]

clearly never done your after takeoff checks correctly have you?

Let's be realistic here, please. In a 737 it takes less than two seconds for either pilot to actually look up from the FMC or whatever he is doing, to glancing and noting that the pressurisation is either acting normally or abnormally. No increase in pilot loading with that surely?:D

[Brian Abraham]

You may well be right Centaurus - if the checks are actually done. The Helios Airways Flight 522 crew missed the settings on at least three occasions - during the pre-flight procedure, the after-start check, and the after take-off check. Six occasions the error might have been picked up, seven if you count when maintenance asked if it was set to"AUTO", or does that make nine occasions?

[Centaurus]

if the checks are actually done

Brian,
I take your point but you can't legislate for idiots like the Helios crew who made so many basic errors that it is hard to believe they were qualified pilots almost. Just because someone reads a checklist does not always mean the action concerned has been correctly completed. In the case of the pre-start checks for that 737 it was clear that neither pilot looked at the pressurisation panel otherwise they would have seen a green light signifying manual pressurisation. Likewise they must have never looked at the pressurisation instruments which would have shown them the aircraft was unpressurised. Or if either pilot in fact did look at the pressurisation instruments as part of the after take off checks, then what they would have seen obviously meant nothing to them.

Scanning the flight instruments during manual flying would need only a flick of the eyes for a qualified competent pilot. Two seconds maximum to take in the whole picture. Surely that is not a work-load problem? After all, newly graduated instrument rated pilots can do that flying single pilot IMC. I think the term "increased work-load" while flying an airliner is over-used when you look back when pilots flew Lancaster bombers in action at night, in cloud and icing and being shot at - and yet they coped with the increased "work-load".

I recall flying a 737-400 German registered aircraft on a typical IT charter in Europe. The weather was perfect and I decided to hand fly for 10 minutes or so during cruise at 35,000 ft. The flight plan tracks were via VOR's and so I told the local first officer (an inexperienced 1000 hour lad) that I was about disengage the autopilot and hand fly maintaining the required VOR track.

I was quite unprepared for his reaction which was to sit up rigidly in his seat and I swear his face went white. "In that case" he said in a trembling voice, "Wait until I put my shoulder harness on." I don't know about his workload going up, but I felt so sorry for him that in the end I only did five minutes of hand flying. Before all that he was a real chatter box in the cockpit which irritated me after a while. When I started to hand fly he lapsed into frightened silence. When I re-engaged the automatics the colour returned to his face and his babbling started up again. I was tempted to hand fly again just to shut him up.:ok:

[glendalegoon]

centaurus makes a fine point.

Wasn't the Lancaster actually a single pilot plane? While it had other crewmembers there was only one pilot wasn't there?

Like anything Centaurus, if you do it enough, you should be getting good at it. Either that or you are superman! ;-)

I recall in the early days of the 707 that Charles Lindbergh was a passenger on a jet operated by the airline he was on the board of directors for. He was invited to the cockpit and allowed to take the controls. He clicked off the autopilot, and hand trimmed in all three axis and the speed increased by five knots, no change in power.

In your above post, you hit the nail on the head. The copilot had only 1000 hours. He simply had never had the chance to really develop hand flying skills coupled with multitasking. AS you probably know, hand flying single pilot IFR is tough, until you get good at it. Indeed there are special allowances for military pilots in single seat fighter jets as things can be a handful.

As to the helios crew, we must all remember that they heard the warning of excessive cabin altitude, did not recognize it as such and called on the radio to their mx control for advice.

That alone is telling.


So you don't really have to be superman. What you have to do is practice and maintain proficiency. Sadly, the modern economics of airline flying don't seem to allow for that, esp with new multi crew requirements and the like.

[Brian Abraham]

Understood Centaurus. That was my point re the checks actually being done, in response to your requote "clearly never done your after takeoff checks correctly have you?". The recent 737 burning all the wing fuel but still having an untouched centre tank is another example of missed after take off checks. But we digress.

[iceman50]

Centaurus and Glendalegoon

What BOTH of you are failing to understand, because you keep harping back to your glory days, is that workload does increase if you are busy hand flying an SID or a STAR. If you are being "brave " and hand flying in the cruise at 35,000 then there will be NO increase in workload. We are talking here of the PM having to do his normal duties and manipulate the FCU so that "your" FD's are giving you what you want. If you CANNOT understand that then there is no hope for you and NOWHERE has anyone said that the increase would be impossible to cope with. So READ what is being said and get rid of your prejudices and WIWO stories, we all have them just don't brag about them.

PS I think the Lancaster had TWO pilots!

[bubbers44]

I 50, the Lancaster only had one pilot seat. Look it up.

See, sometimes you are not always right.

[Prober]

The recent posts re Check Lists re-awakens one of my bugbears as a contract training captain. I was brought up on the basis of "Who does it, reads it". Some companies' SOPs insisted on the other way round which, to my mind, is a recipe for mistakes (or even disasters). If you are on the fourth sector (or if you are just downright lazy and unprofessional), and someone asks you if you have done something or set something, the temptation could easily be to say "Check" without even bothering to look (because you are sure you have). I can only hope Check Lists are not read that way by any operators in this day and age.

[glendalegoon]

Iceman 50, we understand workload increases, but is it so hard to actually do? If it is, wow, that's all I can say.

Workload. It is almost always increased in the terminal environment. It is to be expected.

Gee bubbers, what did we do when we had to have the copilot set a heading bug and manipulate the wx radar?

we are lucky to be here.

And won't iceman 50 feel better when a Brit tells him about the Lancaster! Or he could go out and rent the film, "Dam Busters"

[Brian Abraham]

Gee bubbers, what did we do when we had to have the copilot set a heading bug and manipulate the wx radar?

we are lucky to be here.You ever make a mistake?

Most aviators I know have had their OMG moments, and came away realising how close they came to being terminal, and how lucky they were to be here (still).

I guess the only mistake you ever made was thinking you made a mistake.

Re Lancasters - only one qualified pilot, but crews usually made sure another crew member had the necessary skill to bring it home should the worse happen. Some Lancasters did have duals for training purposes, and those used for passenger transport (Lancastrian), so Iceman is only partially incorrect.

http://img40.imageshack.us/img40/8294/pa474cockpit.jpg

[MrSnuggles]

Why are you dissing each other so hard the screen starts to flicker?

In the early days of aviation planes fell from the sky because of poor aerodynamics and bad construction. Some pilots were surely too cocky and managed to faceplant their aircraft even then.

In the period after WW2 planes fell from the sky because those stickandrudder-guys got things wrong. Of course there were some really bad planes out there too.

In the jet era planes continues to fall from the sky due to weather, politics (DC10 anyone?), mixed aircraft failures and of course the guy behind the yoke messing up.

So, aircraft manufacturer gets tired of seeing perfectly fine planes smashing to pieces and introduces FBW. Now aircraft seems to fall out of the sky a little less often than in the "good old days" which some are referring to as superiour in some kind of way - but the FBW systems just introduced the opportunity for pilots to screw up in a different way than before.

All in all - accident rates per flown km has decreased. All good ol' stick-and-rudder-guys are not among us anymore... some of them may lie under a heap of scrambled metal because they didn't know how to react to a sudden downdraft (or any other peculiar thing - pick your choice).

Sure, I would LOVE to have an experienced and well trained stick-and-rudder pilot at the pointy end of my aircraft.. BUT the FBW can be a huge advantage if you're in an emergency. Sullenberger himself used the Airbus FBW very cleverly to his advantage when those geese decided to taste engine oil.

Please stop picking at eachother because nothing good can come of this. Hand flying IS important, and any GOOD pilot would be crazy to not try it as often as possible. But the computers are there for a reason. All "good ol' guys" from the "good ol' days" just screwed up too many times for aircraft manufacturers and flying public to be completely satisfied.

My personal opinion, if anyone cares, is that hand flying is a serious skill that should be trained regularly. Why don't YOU, Capt, let your FO get some hands-on experience next trip? If you are up to the challenge, I guess your FO wouldn't mind if he is a true pilot.
But while the hand flying is important as a last resort in case everything fails there is equal importance in knowing what the computers can do for you (like, not stall when trying to land on the Hudson). The two goes hand in hand.

Can you please remember what the thread is about, really?

[BBK]

Mr. Snuggles

Excellent post. This thread generates the same old macho posturing that doesn't, in my humble opinion, add anything to our understanding of the accident in question.

One of my trainers puts it very well. He says there's a time to be John Wayne ie hand fly and there's a time not to! It's knowing when to use the automation to free up your own mental resources and when it's better to get in there and point it where you want the aeroplane to go. I'm all for hand flying when I can but there's a time and a place eg the difference between making an approach to a Caribbean airfield in good weather compared to a miserable early morning into the UK winter when you've been awake all night.

Automation has undoubtedly made flying safer and as you say there never was a halcyon age when airliners didn't fall out of the sky. However, there's an industry wide realisation that perhaps training hasn't kept up with the challenges posed by a generation of pilots who have only flown highly reliable jets where failures are, thankfully, very rare. It's a man-machine interface problem I believe. The machine does a great job for 99.99% of the time so how easy is it for the pilot(s) to reengage if the systems fail or malfunction. I believe we are being reminded that when all is said and done we still have to "mind the ship" since that's what we're paid for. If you don't like what the automatics are doing then by all means take manual control or even revert to a lower level of automation eg level change as opposed to Vnav.

Lastly, in the context of this particular accident it comes back to what we learned in our first few hours ie speed is everything! Why a modern well equipped airliner crashed in such a way is what I'm interested in.

[mary meagher]

Almost never, only one single cause for an accident.

To my mind, the most important change in ensuring safe arrival of passenger jets is the emphasis on CRM. Those crusty old timers of vast experience may have seen it all before, but some have contempt for the newbies who tremble at the very thought of hand flying. Without doubt the old timers are more likely to suffer brain shutdown when everything goes tits up, if only because reflexes in the aged slow us down. I admit it, I have slowed down.

As long as you have two competent pilots in the front who have been trained to respect each other and to speak up forcefully when the airspeed decays, thats about as good as we will get these days. Captain, Airspeed! Captain, Go Around. Captain, I HAVE CONTROL!

[fireflybob]

Without doubt the old timers are more likely to suffer brain shutdown when everything goes tits up, if only because reflexes in the aged slow us down.

Sorry but I think this comment is absolute rubbish!

[MrSnuggles]

fireflybob - Please stop the nit picking.

marymeagher IS correct. There is scientifical evidence that older people generally DO have slower reaction times than younger people. (Equally, we have fewer taste buds and poorer eye sight, just to mention a few things that deteriorate as we grow older.)

Mind you, this is only GENERALLY speaking. And a slower reaction time might very well be compensated for by using the amount of aquired experience in order to react -correctly- to a given situation.

So please, again.... what is this thread REALLY about?

[mary meagher]

According to his post number 539 on this thread, Firefly Bob did his B707 conversion training, complete with aerobatics in the aircraft (well done, Bob!)
in the year 1971. That was, let me see, 44 years ago? Assuming he is now well experienced on many types of aircraft, he is now approaching 70, and still completely ready for any emergency.
I am no longer approaching 70, it is getting farther away all the time. I have alas had to recognise that my brain is not so agile as in former years.

And so I have had to step down from instructing and solo flying. As it is nearly impossible to say at what age this decay sets in, an arbitrary number of years must be the rule, when other people's lives are at risk.

[Piltdown Man]

We are missing the point here. Stalls don't just happen. So it is most unlikely that the lack of reflexes that caused this incident. Likely candidates are ridiculous company rules, poor standards and training and dreadful CRM (due to cultural attitudes). Evidence of the latter can be experienced first hand in any crew centre in the world. If it wasn't so lethal it would be funny.

Couple the above to an aircraft designed, in both technical and operational terms, by Westerners to be flown by Westerners and you have a disaster waiting to happen whenever people with differing cultural values get behind the controls.

[flyingchanges]

Without doubt the old timers are more likely to suffer brain shutdown when everything goes tits up, if only because reflexes in the aged slow us down.


Reaction time is irrelevant compared to being ahead of the airplane.

[Lonewolf_50]

All good ol' stick-and-rudder-guys are not among us anymore ...
Data points to consider ...
a certain Asiana flight ...
a 737 in Russia recently ...
AF 447 ...

You may be on to something here. :eek:

[roulishollandais]

Hand flying IS important, and any GOOD pilot would be crazy to not try it as often as possible. But the computers are there for a reason Good and bad pilots exist... Bad computers too

[fireflybob]

Assuming he is now well experienced on many types of aircraft, he is now approaching 70, and still completely ready for any emergency.

mary meagher, your maths is 7 years out in the wrong direction but like good wine we mature with age!

fireflybob - Please stop the nit picking.


MrSnuggles, nit picking? - You cannot be serious!

When someone makes such a sweeping generalisation, do you really think that should go unchallenged?

It all depends on the individual. I have flown with some pilots in their forties who were hardly in a physical condition to be ahead of their game. On the other hand I have flown with pilots in their sixties who would beat the forty year olds hands down!

[Bergerie1]

I agree with Mary. I no longer fly but I know my reflexes have slowed down. My appreciation of confusing situations when driving takes just a little longer and therefore I drive accordingly. Some of us are good right into old age, but most of do slow down around 70, if not a little earlier.

[mary meagher]

Mr. Snuggles of Sweden calls us back to the subject; with that charming phrase "faceplant" (trouble with ATPL's performing a faceplant is that so many people are sitting behind them)

What is this thread really about? It is neatly sumarised by Piltdown Man, who reminds us that modern jets are designed by westerners to be flown by westerners who speak English. We must not be too squeamish to recognise the problems set up by cultural values not shared. In Russia basic instruments read the other way round, so undertrained pilots on a basic go around thought the 737 instruments were telling them lies..... Korean and Turkish co-pilots saw the airspeed decay, but did not forcefully insist on a go-around....

We cannot say that unassertive junior pilots are exclusively a third world problem. Tenerife was initially blamed on Spanish ATC, but the Dutch Captain ignored the feeble protests of his first officer.

Was it in Indonesia where Adam's fond mother bought an airline for her son, equipping it with the latest shiny new airplanes? For nightmare bedtime reading, look up the story of Adam Air on Wickipedia!

We moan about the FAA and the CAA, but I for one am very glad that somebody is minding the industry in English speaking civilisations.

[hec7or]

Good points Mary, but I believe we've also had a UK reg stalling on the approach, fortunately the go round was called early enough to avoid the ground!

In fact IIRC the go round was called at the stickshaker and the aircraft stalled during the go round.

[MrSnuggles]

modern jets are designed by westerners to be flown by westerners who speak English

I would join myself to those who hold this belief. As marymeagher continues with examples from Russia, Turkey and the infamous Asiana, there are cultural values we Westerners must take into account when making aircraft safer. Just like we build Volvos with the steering wheel on the right hand side, to accomodate for British people, aircraft manufacturers might consider designing controls and flight decks that acknowledges the culture in which they are supposed to be used.

Russians use metric system and a different artificial horizon - so we see accidents when they are placed in a Western (Anglo-American) airplane where everything is strange to them (with feet, knots, inches and a reversed artificial horizon). It is known that in an emergency it is often the thing we are taught FIRST that kicks into action. So a Russian pilot facing a difficulty will probably revert to the old Russian logic built airplane.

This does not mean that the Russian pilot is worse. It does not mean that the Western plane is bad. It just means that a Western plane are built for another mindset than the Russian.

In the case of the Asian carriers and their accident rates I am thinking of a radical solution. Maybe you will flame me to death because of it, but here goes...

I believe that there is nothing wrong with Asian (in this context I am referring to Singapore, China, Korea, Taiwan, Indonesia) views on loss of life and airplane accidents. I truly believe that they are just as devastated as anyone. What we do know is that their culture is based on another logic than the Western. Any attempts to eradicate this would not just be immoral (in my belief it is not OK to remove anyone's culture and traditions) but also take a very long time.
The easier way to do this is to honour their culture and design the aircraft systems and CRMs to accommodate for the differences in culture. This would need an open mind from the aircraft manufacturers and a close collaboration with Asian carriers as to what their needs are and how their culture works and how to "work around" the things that have contributed to accidents in the past.

I remember reading about a Korean cargo B747 that nosedived into a field somewhere in the UK. Apparently the Capt's instrument had failed - or if he had vertigo, or both - so he didn't realise their dangerous attitude. But the FO had working instruments and didn't say a single word even though he knew he would die. I find this accident very tragic and indeed, Asiana 214 could have been a disastrous repeat of it.

Now, we Westerners found -our- way for CRM to reduce accidents. I firmly believe that it is easier to successfully adapt CRM to the culture, than to remodel the cultural way of thinking.

But these are just my own thoughts and ponders about this, apparently very sensitive, subject.

[ExSp33db1rd]

Yes, I agree, cultural differences affect what is now referred to as CRM.


As a Captain with an Asian airline employing many nationalites, a British co-pilot profusely apologised to me for disembarking and boarding the crew transport before me. I asked him what he meant ? He explained that on his last trip the "Local" Training Captain had torn into him with rage when he left the flight deck before the Captain, asking that if he treated a Training Captain with such disrespect, how did he treat a mere Line Captain ?


In the early days of "monitored approach" trials - whereby the "non-handling" pilot flies the instrument approach down to minima, where the "handling pilot" then takes over and completes a manual landing, a PanAm skipper walked over to us and said " Pan Am has practised monitored approach procedures since the dawn of aviation" Oh! Really ? " Yes, he said, I fly, he monitors " !


In my early days as a Second Officer / Navigator, I was roundly admonished for addressing the co-pilot by his Christian names. " We do NOT use Christian names on the flight deck, MR XXXX " and one of that Captains own colleagues was known for not talking to anyone but his co-pilot, he would order the co-pilot to ask the flight engineer to set take off power, and as Navigator I wasn't allowed to pass any information directly to him, I had to give it to the co-pilot for transmission across the centre pedestal ! - and that was in a British airline with only British crew. North Atlantic Barons we called that generation of Captains, maybe the British Class system was still alive and well in those days.


We are all subject to "culture" !!

[MrSnuggles]

Exsp33dbird

I see what you are writing. As I recall it, there were at least one spectacular accident in England attributed to, amongst other factors, poor CRM. (Staines Disaster.)

I really hope that the Asians can find -their- way to work around experience gradients in the cockpit. The Anglo-American sphere found its own way. This may not be the only way, though.

[fireflybob]

As I recall it, there were at least one spectacular accident in England attributed to, amongst other factors, poor CRM. (Staines Disaster.)

The Trident accident at Staines (which I remember well as both the First and Second Officer had trained at Hamble like myself) happened long before the concept of CRM had even appeared on the horizon.

[MrSnuggles]

fireflybob

You are right. There was no mention of CRM during that time. But one of many contributing factors was a hostile work environment, that much can be deduced from the report. Also, some people have shared their first hand knowledge of the workplace circumstances at that period. I'm sure you may be one of those.

But let's not drift from the thread here. There is a thread somewhere about Staines. Let's keep any more Staines discussions there. Sorry about this, mods.

[Prober]

Cultures certainly do differ but they also do change and we cannot afford to be PC in acknowledging the fact. I can confirm ExSp33db1rd’s narrated cockpit attitudes of the 60’s (at least). I had to position to SNN for some training details and the first available flight was on a different (but European) airline flying LHR-SNN-JFK. I was on the jump seat and I knew the F/O who had transferred from our company (but it was not, I hasten to add for the benefit of those who may jump to the conclusion that it was to BOAC). The weather was a stiff south westerly at LHR and at SNN. On T/O the F/O slid his seat back and folded his arms. “This is how I am supposed to behave at times like this!” And the same happened at SNN with the Capt literally battling the controls single-handedly like in some ridiculous movie whilst his F/O had to sit mute and inactive. My comment to him was that I thought it was seriously criminal.
Thank goodness those days have gone. Things will change.
I have also flown in the military with Asian pilots. The Command (C-in-C) view was that the Indian and Chinese pilots were neck and neck for first place in ability. There was nothing wrong in their flying. So maybe both A and B should examine their instrument presentation and we should all have a re-think.

[Gretchenfrage]

Interesting read, but i beg to differ.

To change aircraft design to adapt for cultural differences is saddling the horse beginning from the tail end. The modern (western) design has proven to be the most suited for civil aviation, with all its controversies (as you may remember, i am inclined to somewhat exclude the AB design here ...... but that's another thread).

Having started aviation with our own western old military heroes at the helm, i experienced the advent of CRM, due to the new awareness that the old ways lead to disaster. It was a pain first, but eventually worked quite well. I am sure it can work just as much for other cultures.

It all depends on the willingness of the regulators and company management.

And that is the problem, not aircraft design. If greed and wrong political or cultural correctness prevail, even a new design must fail.

As much as in the asian and arabic circles a change of culture is difficult, albeit necessary, i am afraid that the new greed and deregulation spectre works to annihilate the achievements we made in our latitudes!

We have to be convincing to the east and vigilant amongst our ranks.


One more thing:

It is known that in an emergency it is often the thing we are taught FIRST that kicks into action

Agreed, but it has to be taught first, and that is criminally neglected in many regions and companies.

[mary meagher]

Alas, another 777 down in Asia. The only possibly significant post on the thread mentions previous wing damage to that particular aircraft.

[blind pew]

It all depends on the willingness of the regulators and company management.
I couldn't agree more.
Last year I criticised my local authority...surprise surprise I receive a letter from the Revenue investigation department.
The Trident as did BEA's Tristar had an instrument panel more or less designed for single pilot. The Trident standby instruments were adjacent to the captains knee.
As to the Russian artificial horizon...I always thought it was more logical and less confusing than the western type...but it was more complex to manufacture. The Crossair accident at Rumlang was the result of confusion between the two.

Sadly I was a product of "keep your mouth shut" in my early days. 18 months ago I was given a ride by the owner of a smart single engine aircraft...he decided to put it into his mate's small strip in a vineyard in the south of France. Despite my saying the conditions were dodgy (I had flown a paraglider that morning and knew the area from gliding) he decided to continue...bounced due to tail wind gradient and pushed the stick forward. I didnt get my hand on the stick quickly enough. I could have stopped the accident if I had had my hand on the controls but I had spent 20 years NOT being allowed to do so.

I stopped instructing when I was 60 because I had slowed too much to be safe allowing a student to winch launch or fly with a wing tip feet from a mountain face but I have mates of my age still flying 747s, 737s and 787s.
One, who is back on the Jumbo now, threw the towel in a couple of years ago. Hadj flight returning to the Magreb...line squall..severe Turb..burnt the approach and when he subsequently landed he didn't remember anything that happened. Left the aircraft and caught a flight home after resigning by telephone. Company had to fly another crew in.
I have watched my performance go slowly down hill since I was in my 40s...yes experience made up for it and I was certainly safer at 50 than at 20 but at 60, tired, in the middle of the night and being kicked about in turbulence I shouldn't be flying a commercial aircraft. Which leads us back to the first line...line flying over 60 IMHO is wrong and the regulators should not condone it.

[MrSnuggles]

Gretchenfrage.

You are right in one thing. Aircraft aerodynamic and physical design should obviously not be altered.

But the interface between the aircraft and the pilots could very well be. Give those Russians what they are used to in terms of artificial horizons etc. It is comparably easy to replace a module in the cockpit, not so easy to replace human lives lost (blind pew gave one really good example in this regard).

CRM is another tool for aircraft safety that could easily be altered to accommodate for cultural differences. Give Asian FOs the tools to communicate to the Capt without loss of face but still within their social limits. Only the Asian carriers would know how to implement this, but I am sure they too want to reduce aircraft losses.

[ExSp33db1rd]

[......but I am sure they too want to reduce aircraft losses like the Malaysian 370 we are just learning about. ]


Big jump there ? "Cultural issues" ? Aircraft not even found yet. Possible of course, as is anything else at the moment.


Am reminded of the 747 that was rolled into the sea within around 50 secs of being airborne. Was assumed that the pilots' AH had stuck in a slight right bank as he captured the outbound course, so he applied progressively more left bank to level the wings, until at around 110 deg.bank he suggested that his AH had failed, at which point the co-pilot agreed that his had failed as well i.e. it was correctly indicating 110 bank ! Had he only just noticed, and also ignored a descent in excess of anything reasonable - when they should have been climbing and not yet cleaned up, and an increase in airspeed of unreasonable proportions ?


One has to ask what he had been doing, and not saying, prior to this point, had he not been properly "monitoring" or was he too culturally bound to not question his Lord and Master.


There is some suggestion that there might have been terrorist activity in the Malaysian mystery, but they would have been made to take their shoes and belts off before boarding, so we can discount that !

[ChrisVJ]

I would have thought that with today's glass cockpits you could have pretty well any instrument paradigm you wanted at the flick of a switch if the manufacturer's could only be bothered to program it.

[CaptainDrCook]

Air New Zealand has no plans to ground its Boeing 777s (http://www.smh.com.au/travel/travel-news/air-new-zealand-has-no-plans-to-ground-its-boeing-777s-20140309-34f9g.html)

Is the fourth paragraph accurate? "Three passengers died with the accident attributed to pilot error."

[hec7or]

you could have pretty well any instrument paradigm you wanted at the flick of a switch if the manufacturer's could only be bothered to program it.

...and of course if the airlines were prepared to pay for it.

[CaptainDrCook]

Air New Zealand has no plans to ground its Boeing 777s (http://www.smh.com.au/travel/travel-news/air-new-zealand-has-no-plans-to-ground-its-boeing-777s-20140309-34f9g.html)

Is the fourth paragraph accurate? "Three passengers died with the accident attributed to pilot error."

Edit: the newspaper has corrected this statement.

[Feathered]

In the news today regarding the Asiana crash last summer--Asiana is blaming Boeing and Air Traffic Control for the accident, in addition to their crew allowing the airspeed to decay.



Asiana Airlines admitted in regulatory filings released Monday that its Flight 214 was flying too slow in a crash last July at San Francisco International Airport, but said inadequate aircraft automation and warning systems contributed to the disaster in which three passengers died.
The airline's explanation of how its pilots landed a state of the art airliner short of the runway on a clear, sunny day is contained in documents released Monday by the National Transportation Safety Board.
While its pilots "did not insure minimum safe airspeed during final approach," the "highly trained and experienced" flight crew was beset by problems that "would have been difficult to predict." Asiana said in the documents.
It cited "inconsistencies in the aircraft's automation logic" that led to a surprise disabling of minimum airspeed "without warning to the flight crew."
Also, it said, a low airspeed alerting system "did not provide adequate time for recovery."
Finally, "air traffic control instructions and procedures led to an excessive pilot workload during the final approach."
"Asiana has flown into SFO uneventfully for over 20 years," the airline wrote in its submission to the NTSB. It said that "Asiana crews have successfully accomplished high-energy, visual approaches to the airport numerous times. The series of events that led to the accident, involving an advanced technology aircraft flown by a highly trained and experienced flight crew, would have been difficult to predict given the qualifications of the pilots and Asiana's premier flight safety program."



Asiana says Boeing 777's warning system inadequate in SFO crash - San Jose Mercury News (http://www.mercurynews.com/business/ci_25458868/asiana-says-boeing-777s-warning-system-inadequate-sfo)

[Jet Jockey A4]

Blah, blah, blah...

It must be already April fool's day somewhere on the planet.

The aircraft has been flying for how long without a crew crashing it?

Just because their pilots were incompetent in flying and monitoring the aircraft's systems doesn't mean it is a bad design.

Sure while we are at it might as well bring in SFO's ATC system into the act to deflect the blame off Asiana and their pilots.

Pretty sad situation.

[awblain]

"Well they would say that, wouldn't they?" Mandy Rice-Davies.

"Asiana has flown into SFO uneventfully for over 20 years," the airline wrote in its submission to the NTSB.

Owing to them not making it safely to 21 years, they need to make this submission to the NTSB.

Other airlines have avoided being out in this awkward situation for longer. Are we to assume that there's only so much total luck available, and that the more you need, the sooner you run out?

[Halfnut]

The NTSB files submitted today from Assiana, the Pilot's Union and Boeing are on pages 12 & 13 -

Accident ID DCA13MA120 Mode Aviation occurred on July 06, 2013 in San Francisco, CA United States Last Modified on March 31, 2014 13:03 Public Released on December 11, 2013 08:12 Total 183 document items (http://dms.ntsb.gov/pubdms/search/hitlist.cfm?docketID=55433&CurrentPage=12&EndRow=180&StartRow=166&order=1&sort=0&TXTSEARCHT=)


76 Mar 31, 2014 Air Cruisers Submission
177 Mar 31, 2014 Asiana Airlines Accident Investigation Submissions
178 Mar 31, 2014 Asiana Airlines Submission Appendix A
179 Mar 31, 2014 Asiana Airlines Submission Appendix B
180 Mar 31, 2014 Asiana Airlines Submission Appendix C
181 Mar 31, 2014 Asiana Pilots Union Submission
182 Mar 31, 2014 Boeing Submission
183 Mar 31, 2014 Letter from KARAIB

[ThreeThreeMike]

Finally, "air traffic control instructions and procedures led to an excessive pilot workload during the final approach."

The CVR transcript shows ATC communications were succinct and quite easy to understand...pretty much 'Reduce altitude, slow down, turn left a couple of times, cleared to land.'

A really weak assertion by Asiana.

[Mark in CA]

Here's the N Y Times report on this:

http://www.nytimes.com/2014/04/01/us/asiana-airlines-says-secondary-cause-of-san-francisco-crash-was-bad-software.html?ref=us


I think bottom line this is about money and the legal system, not about logic.

[Capn Bloggs]

http://www.nytimes.com/2014/04/01/us/asiana-airlines-says-secondary-cause-of-san-francisco-crash-was-bad-software.html?ref=us

Boeing's shirking. "Modern" jets cannot be crashed (via ever-reducing airpseed until the stall) in "normal law". It's about time Boeing modded the 777. And not having the feature in the 787 is just being bloody-minded. Cars have got every conceivable safety feature (and some); aeroplanes not. Why not?

The Asiana pilots stuffed it, but they weren't helped by the design.

[Lonewolf_50]

http://www.nytimes.com/2014/04/01/us/asiana-airlines-says-secondary-cause-of-san-francisco-crash-was-bad-software.html?ref=us

Boeing's shirking. "Modern" jets cannot be crashed (via ever-reducing airpseed until the stall) in "normal law". It's about time Boeing modded the 777. And not having the feature in the 787 is just being bloody-minded. Cars have got every conceivable safety feature (and some); aeroplanes not. Why not?

The Asiana pilots stuffed it, but they weren't helped by the design. What mod would have helped AF 447? Being 30+ knots slow on approach on a VFR/CAVU day isn't a design problem.

[Jet Jockey A4]

Totally agree with Lonewolf_50's post above.

It's not the aircraft's fault if 3 pilots in a cockpit cannot monitor the airspeed on an approach, especially in the conditions they were flying in that day.

[barit1]

Holy cow.

Trimmed for approach, engines stuck at idle, IAS decreasing...

...so nose-high the crew can't see PAPI...

...Yoke force approaching 100# >>>>

How many clues do you need? :ugh:

[flyboyike]

Gotta try and save face, no matter what, I guess. The same mentality that led to the crash in the first place.

[tdracer]

Crew miss-programs autothrottle such that it commands a climb. Crew doesn't want to climb and so overrides and disconnects the autothrottle. Crew then expects the disconnected autothrottle to maintain airspeed during final.

And somehow that's the fault of the autothrottle? :mad:

[sflaperons]

Crew miss-programs autothrottle such that it commands a climb. Crew doesn't want to climb and so overrides and disconnects the autothrottle. Crew then expects the disconnected autothrottle to maintain airspeed during final.

And somehow that's the fault of the autothrottle?

I think the crew is saying that they did not expect the autothrottle to disconnect when they disconnected the autopilot. In and of itself, that doesn't seem unreasonable, no?

[Mac the Knife]

I've has noticed that a large number of accidents recently have been caused by mis-assumptions about autotrim and autothrottle.

I'm sure these reduce pilot load but uncertainty about when these are active and what happens when they disconnect pervades these reports.

[Lonewolf_50]

sflaperons:

a. How well does one know one's aircraft?

b. What would you expect of a professional pilot, in terms of knowing his aircraft when other people's lives are on the line?

c. How many of us would have passed a check ride, in any aircraft, if we were 20 knots slow on final? (No less the 30+ in this case).

[TRF4EVR]

It doesn't seem unreasonable to you that they don't know how the throttles work? Or that uhm, they didn't notice that the airspeed thingamajig was going down? Surely I'm misreading this. April Fools, maybe? Which airline do you work for, anyway?

[Obama57]

I remember reading about a Korean cargo B747 that nosedived into a field somewhere in the UK. Apparently the Capt's instrument had failed - or if he had vertigo, or both - so he didn't realise their dangerous attitude. But the FO had working instruments and didn't say a single word even though he knew he would die. I find this accident very tragic[/COLOR] and indeed, Asiana 214 could have been a disastrous repeat of it.

1. Inbound, captain's ADI written up as U/S in normal mode - worked in STBY. Mechanic on board signed it off.
2. Outbound, same ADI problem. Captain did not switch to STBY.
3. Attitude monitor alerted 20+ times.
4. Heading changed 120 degrees.
5. Engineer actually verbalized, "Captain, bank angle" on two occasions.
6. F/O and STBY ADI both indicating 90 degrees of bank.

And this is a culture problem?

[sflaperons]

It doesn't seem unreasonable to you that they don't know how the throttles work?

I'm making a narrower statement than that.

To me at least, it is not instinctive that disconnecting the AP without turning off the autothrottle would cause you to lose airspeed protection. I think you would need to be trained on that point, which the crew claims it wasn't. It still doesn't excuse not monitoring airspeed, of course. But I wasn't trying to make excuses. Just to say that in an of itself the assumption does not strike me as unreasonable (leaving to the side the inevitable rejoinder than any assumptions are unreasonable by virtue of being assumptions).

[Lonewolf_50]

I think you would need to be trained on that point, which the crew claims it wasn't.
If that isn't in the upgrade syllabus, or the type qual syllabus, who is on the hook? The airline? What are the odds they'd admit that they didn't do a satisfactory systems course?
It still doesn't excuse not monitoring airspeed, of course Nor failing to correct airspeed so far out of limits. :cool:

[ironbutt57]

A point in time arrives where the pilot has to fly the aircraft first, and make sense of why it did, or did not do as expected at a more appropriate time..obviously Asiana doesn't understand this... so they blame Boeing...

[Lonewolf_50]

A guy I worked with used to have this sign over his desk:

"I didn't say it was your fault, I said I was going to blame you."

(This was in reference to an old boss, and a bit of an office inside joke).

Seems to be Asiana's position, at best.

[porterhouse]

I think you would need to be trained on that point, which the crew claims it wasn'tI am highly suspicious of such claim, sounds to me like ABC of systems knowledge in 777. But it would be very easy to check, they probably went through some standardized 777 training course when they were type rated.
But on the flip side did somebody train them that pulling 80 lbs on a yoke during the final stages of approach was OK?

[sflaperons]

If that isn't in the upgrade syllabus, or the type qual syllabus, who is on the hook? The airline? What are the odds they'd admit that they didn't do a satisfactory systems course?

I am highly suspicious of such claim, sounds to me like ABC of systems knowledge in 777. But it would be very easy to check, they probably went through some standardized 777 training course when they were type rated.

Well according to Asiana and the Union's NTSB submission, the crew's training, or at least it's sim-training, was conducted by a Boeing subsidiary. According to Boeing, meanwhile, the crew well knew or at least constructively knew that disconnecting the AP in FLCH puts the autothrottles to sleep (and airspeed protection ceases).

Submissions available here:

Accident ID DCA13MA120 Mode Aviation occurred on July 06, 2013 in San Francisco, CA United States Last Modified on March 31, 2014 13:03 Public Released on December 11, 2013 08:12 Total 183 document items (http://dms.ntsb.gov/pubdms/search/hitlist.cfm?docketID=55433&CFID=149111&CFTOKEN=59974082)

Just to be sure, I'm not seeking to defend what happened. And I'm certainly not criticizing Boeing's AP / AT logic.

I guess my thought is more that a professional crew with 20,000 hours appears to have assumed (with reasonable logic, I would say) something very basic about the autothrottle that is very much not true. From a safety recommendations perspective, how that happened seems worth talking about.

[olasek]

appears to have assumed (with reasonable logic, I would say) But that's inexcusable as well.
They are not paid to 'assume' anything but to know systems and fly as trained.
Also, apart from any A/T logic they had no business assuming that auto-throttle wouldn't fail. This A/T (even if engaged) could have simply malfunctioned or failed during this approach - they would still be expected to land this aircraft in one piece.

Also I am not even sure if their assumption was 'reasonable' to begin with. This A/T A/P logic was vetted during certification and they could very well be good reasons why it is supposed to work this way.

[ExSp33db1rd]

It doesn't seem unreasonable to you that they don't know how the throttles work?Not excusing anything, but don't forget that the handling pilot was fresh off flying an Airbus for some time, where the throttles don't move when the autothrottle is engaged - stupid in my opinion, the automatic "hunting" of the throttles on a Classic Boeing 747 ( no idea of the T7 ) was a visual clue (and tactile one 'cos we had our hands on the throttles anyway) that everything was doing what it should do - so 'thinking' that the autothrottle was engaged, as I believe he has stated (?) then he wouldn't be concerned that they were stationary. Old habits, new tricks etc.

Only one aspect of course, what was his thinking about the falling speed - if he was thinking about it at all ! - and what was the other pilot doing.

Life was easier before computers - in every walk of life !

We just flew the bl**dy aeroplane !

[ironbutt57]

Apparently they didn't know how FLC(H) works either

[CanadaKid]

I, too add my voice to ExSp33b1rd, olasek & a host of other pilots

Yes, the throttles move on the T7 just like the B747 when A/T is engaged, and agree it's a good idea to be hands on, the FMA reminder is HOLD, seems pretty clear to me. If you're holding them, expect to move them.

I also cannot comprehend the logic of waiting for / planning for / expecting an automatic feature like the Airbus' autothrottle alpha prot (or whatever it's called, it's been awhile) to make up for your shortcomings as a pilot.

As an example: planning an approach where you expect Load Relief to take care of any flap overspeed, or relying on a GPWS caution to remind you to perform some function would indicate to me that you're in the wrong business.

[GobonaStick]

To me at least, it is not instinctive that disconnecting the AP without turning off the autothrottle would cause you to lose airspeed protection.
It's not instinctive for me to know on which side of the car my petrol cap's fitted. Best to check before I park the wrong side of the pump.

Besides, surely the throttle is one of the first things you'd check if you were low on the approach? Four red PAPI, and all the other signs, would shout 'power', no?

[helen-damnation]

Having flown the 777 and Airbus, I prefer the moving TLs.

However, and my memory of 777 tech is sketchy, I believe that a system which doesn't warn the pilot that the AT is "disconnected" and has not received a direct disconnect physical action from the crew is flawed.

These are not the first crew to be caught out by this and won't be the last until there's an EICAS warning for the crew.

In the same vein, with a bit of thread creep, how is it that Boeing still produce a/c that won't auto retract the spoilers/speedbrake during a terrain avoidance manoeuvre? It's already killed people and so, now, has this AT issue.

Happy to be corrected on memory issues!

[Sir Richard]

There is an EICAS warning (caution) it says AIRSPEED LOW :ugh:

[ or at least it did on the 744, I cannot think the 777 would omit this ]

[helen-damnation]

Sir Richard,

What's with the :ugh: ? Stop acting like your abbreviation!

Yes, there is a low speed warning, but it is not triggered by the autothrottle being disconnected in FLCH. As you are well aware, it will come at a predetermined condition when the situation is already well developed.

If the crew are not cognisant that the autothrottle wake up mode is disabled, coupled with a high workload due to an unfamiliar approach/new type/tired etc etc then there is a killer trap and IMHO it's a design flaw.

[olasek]

If the crew are not cognisant that the autothrottle They should be, "A/T HOLD" is displaced right in front of their noses.

[Lonewolf_50]

IMHO it's a design flaw.
The other design flaw is the airspeed indicator that cannot reach out with a cricket bat and smack the pilots smartly about the head and shoulders when airspeed on final approach is 20 knots slow and decreasing ...

[Intruder]

Boeing wouldn't know anything about cricket bats... :8

[Capn Bloggs]

Yeh, well, let's permanently disable all those other safety aids like GPWS, TCAS, Windshear Avoidance systems... why on earth would pilots need it? They're supposed to be good enough at their job not to... :cool:

[Lonewolf_50]

Captain Bloggs: your zinger is appreciated, :) but I'd like to point out the following:

Airspeed is not a "safety aid," it is a primary performance instrument.
As above: when was the last check ride you passed where you were 20 knots slow on final?
I will predict that your answer will be "never!"

[Volume]

They are not paid to 'assume' anything but to know systems and fly as trained.Flight Engineers were paid to "know" the systems, Pilots are paid to know the standard procedured they need in normal life. The computers are designed to allow them to do so. So to "assume" everything is OK unless some alert goes off or some warning is shown is their daily business.
unfortunately...

[BraceBrace]

we are not paid to know all the systems. It is considered dangerous (logical considering the complexity modern jets have) by Boeing and the manuals only give you 1% of the technical background of the jet you are flying. If Boeing wanted you to know their 777 and 787 jets in detail, no pilot would pass his technical test. The flightdeck is only a USER INTERFACE, nothing more. We pilots learn to use the user interface. There is nothing wrong with that philosophy.

[jientho]

Quote:
If the crew are not cognisant that the autothrottleThey should be, "A/T HOLD" is displaced right in front of their noses. The Asiana Investigation document (Document 19 Other Pertinent Forms and Reports - 6120.1 Filing Date September 16, 2013 11 page(s) of Image (PDF or TIFF) 0 Photos (http://dms.ntsb.gov/pubdms/search/document.cfm?docID=410822&docketID=55433&mkey=87395)) makes a good case that cockpit warnings were not sufficient to the danger, especially with a busy crew. In particular, it repeatedly points out that the message you cite was in green color, with no accompanying audible warning when the automation entered that mode.

Another good point is that "low speed" is never upgraded (from caution to warning) depending on (radio) altitude. Obviously low speed is much more dangerous in some range like 5 to 500 feet than it is outside that range.

Also interesting in that document is an indirect reference to this forum (http://www.pprune.org/rumours-news/518568-asiana-flight-crash-san-francisco-16.html#post7926629) via the reference to Fallows's blog in footnote 138 (http://www.theatlantic.com/national/archive/2013/07/professional - pilots - on - the - san - francisco - crash/277563/) on the FLCH trap.

[ExSp33db1rd]

Boeing wouldn't know anything about cricket bats...

Baseball bats then ?

[Sir Richard]

helen-damnation

It is a tad unfortunate you took offence at the :ugh: which was aimed at the 3 pairs of eyes that seem to have been looking at the scenery instead of glancing at the ASI, EICAS or aircraft pitch attitude. I guess that any EICAS caution, without bells and whistles (or cricket bats), would have been ignored on that sunny day in SFO.

[WillowRun 6-3]

Link to article summarizing the airline's and manufacturer's NTSB submissions (free access):
Asiana And Boeing Spar Over Flight 214 Crash Cause (http://www.aviationweek.com/Article.aspx?id=%2Farticle-xml%2FAW_04_07_2014_p31-676678.xml)

[Hempy]

I've read all the arguments here, and I'm sorry, but...If the PIC of an aircraft, with all of the responsibilities designated to that role, does not know the operation of the basic systems of the aircraft (e.g the fkn autopilot!) he is in Command of, he has no right being there. And is fully responsible for any outcomes resulting from said failings..

[helen-damnation]

Sir Richard

I guess that any EICAS caution, without bells and whistles (or cricket bats), would have been ignored on that sunny day in SFO.

There we will have to disagree, my argument being that the absence of an EICAS warning contributed to this accident and other incidents as well.

Hempy

If the PIC of an aircraft, with all of the responsibilities designated to that role, does not know the operation of the basic systems of the aircraft (e.g the fkn autopilot!) he is in Command of, he has no right being there. And is fully responsible for any outcomes resulting from said failings..

I doubt anyone would disagree with you regarding the responsibilities of the PIC. However, the discussion here is about a design flaw, a know trap which has contributed to a fatal accident.

It would be interesting to know if the trap remains on the 787?

[Intruder]

Would a "FLCH TRAP" EICAS warning have been any better than the "AIRSPEED LOW" EICAS warning that they already ignored?!? :mad:

[helen-damnation]

If it contributed to the crew awareness and safety - YES.

[porterhouse]

However, the discussion here is about a design flaw, a know trap which has contributed to a fatal accident.You keep referring to the design "flaw" like a given thing. Clearly certification agencies have a different opinion. All aircraft/systems are full of "traps" for poorly qualified pilots. When I fly my Cirrus I don't have half of "safety features" that Boeing or Airbus pilot has at his/her disposal and when I screw up I can't say - why didn't you give me all the stuff the Boeing pilots have.

[olasek]

If it contributed to the crew awareness and safety - YES. They had absolutely zero reaction to the fact that they were pulling on the yoke by about 40 kg!!!! and you tell me that a lousy EICAS msg would change their awareness - you are in a dreamland. :ugh:

[safetypee]

FLCH No so much a design flaw, but a design weakness which can catch the unwary. Also, consider that this accident could represent a difference between what the regulators expected from pilots (acceptable for certification) and that which actually occurred, which reflects on the overall situation including high workload, training flight, demanding ATC scenario, etc.
Thus the weakness represents a series of assumptions, first by the manufacturer, then the regulator, and finally the operator and crew; all of whom had opportunity to consider the system, provide warnings or mitigations or just by understanding the assumptions.
Thus the safety message is that we need to identify the assumptions in operations, and if these have weaknesses take action;- don’t use FLCH during approach (why not use manual thrust), don’t remove all approach aids simultaneously or use ‘unnecessary’ noise / traffic restricted approach profiles, don’t train in these demanding circumstances (cf AMS 737 accident), and beware situations where there may be little spare mental capacity to cope with failures or system weaknesses.

How many other 777 pilots have been caught by this, how was the situation detected, and what is now done to avoid the weakness … and did anyone tell the manufacturer / regulator / operator so that they might reconsider the situation?

[Ian W]

FLCH No so much a design flaw, but a design weakness which can catch the unwary. Also, consider that this accident could represent a difference between what the regulators expected from pilots (acceptable for certification) and that which actually occurred, which reflects on the overall situation including high workload, training flight, demanding ATC scenario, etc.
Thus the weakness represents a series of assumptions, first by the manufacturer, then the regulator, and finally the operator and crew; all of whom had opportunity to consider the system, provide warnings or mitigations or just by understanding the assumptions.
Thus the safety message is that we need to identify the assumptions in operations, and if these have weaknesses take action;- don’t use FLCH during approach (why not use manual thrust), don’t remove all approach aids simultaneously or use ‘unnecessary’ noise / traffic restricted approach profiles, don’t train in these demanding circumstances (cf AMS 737 accident), and beware situations where there may be little spare mental capacity to cope with failures or system weaknesses.

How many other 777 pilots have been caught by this, how was the situation detected, and what is now done to avoid the weakness … and did anyone tell the manufacturer / regulator / operator so that they might reconsider the situation?

The clue is in the acronym. Flight Level CHange. This would provide the hint that its use to change altitude on approach is inappropriate. There are no doubt other functions that can be cleverly (mis)used just don't complain when the 'clever' crew is caught out. Otherwise, the manuals will be full of CYA language trying to cover every potential misuse of functions; like the hover-mower leaflet saying not to be used to trim hedges. That approach puts manufacturers in the untenable position that anything not specifically barred by their manuals by implication must be OK. It would probably be possible to implement software protections but they themselves then have complications and may introduce other misusable functionality. Or instead pilots could be trained to monitor speed and power on the approach like most good pilots already do :hmm:

[porterhouse]

Or instead pilots could be trained to monitor speed and power on the approach like most good pilots already do :hmm: Very true.
Actually remove absolutely all automation, make it a simple stick& rudder aircraft and all "weaknesses" are gone. Additional safeguards and other "warnings" only compound the problem by making pilot more dependent on them. More warnings, more audio sounds, more flashing lights don't necessarily make it safer, basic fact known to anybody who studied human factors in the cockpit. Therefore it has been recognized long time ago that absolutely nothing can replace monitoring such basic things like speed, power and attitude. These guys failed to monitor all 3 of them which is pretty astounding if you think about it.

[tdracer]

It's a well known human characteristic that, during high workload situations, aural inputs often get filtered out. In other words, when highly focused, we tend not to hear things or use 'selective hearing'. There was a documented case of a wheels up landing where both pilots swore the aural alert never sounded - until they listened to the CVR playback :ugh:

That's why the stall warning is a 'stick shaker', yoke forces go up, etc. An aural alert saying 'low airspeed' may not get through.

Perhaps the cricket/baseball bat isn't such a bad idea.:sad:

[safetypee]

In some very high workload situations the majority of perceptual inputs could degrade as might the mental ability to understand the situation, including monitoring and other alerts. A key aspect of safety is being able to identify these situations beforehand, as early as possible; thus manufacturer, regulator, and operator involvement – not leave it to the crew who might be overloaded. The industry must stop relying on the crew to detect everybody else’s lack of foresight; crews are human and they are the ones attempting to manage all of these factors at the critical moment.

Automation is very useful, but if misused then problems might occur. The skill in design, regulation, and operation is to foresee possible misuses and mitigate the effects. Documentation, SOPs and warnings are the least effective, as might be training; thus every effort should be made to ensure that the system is as tolerant to misuse as possible. Without knowing the 777 in detail, the AT system appears less resilient than other AT systems; it might be more capable, but is it as safe – you should not trade one for the other.

[olasek]

not leave it to the crew who might be overloaded. The industry must stop relying on the crew to detect everybody else’s lack of foresight; The more lofty words like "foresight" or "tolerant of misuse" the more meaningless they are. It's like a quote from some prayer book - let everyone be prosperous and happy. The industry does its part and pilot must do theirs I don't think in this case the crew did a scant fraction of what was expected of them, actually in my opinion they are guilty of serious dereliction of their basic duties.
I also claim that this crew was far from "overloaded", they had good weather and perfectly well functioning aircraft. They were not dealing with multiple emergencies, malfunctioning equipment, smoke in the cabin, etc. and/or substandard weather. It is really a travesty to call it an 'overload' considering that many rookie pilots shoot similar approaches in much less capable aircraft every day and they don't enjoy benefit of additional sets of eyes in the cockpit.

[Piltdown Man]

It sounds like Asiana won't be taking their medicine. Not until they modify their SOPs, training, standards & checking will they ever be a safe airline. Their face-saving, ignorant attitude will prove me right when they have their next crash.

[fox niner]

If the Koreans have such a face-saving predisposition embedded in their SOP's, then why did they end up having such a face-losing accident?

[barit1]

safetypee:In some very high workload situations the majority of perceptual inputs could degrade as might the mental ability to understand the situation, including monitoring and other alerts...

Very high workload ...

... such as a manual, day VFR approach to a long runway, good equipment, normal traffic and sequencing?

In a well-liked 20-year-old design type, proven by millions of landings?

Really?

[Capn Bloggs]

I wholeheartedly agree with the sentiments re "they should have done/known better" but why would somebody deliberately design an ATS that would not stop the speed reducing below the bottom foot/Vref, regardless of the mode it was in? I can't see any logical reason.

[MarcK]

Well, at some point they have to land. Or would you like them to run off the end of the runway at Vref?

[Capn Bloggs]

Well, at some point they have to land. Or would you like them to run off the end of the runway at Vref?
Twit. All ATS close the power to Idle at 50-30ft for the flare. What jet do you fly again :cool:

[ironbutt57]

Twit. All ATS close the power to Idle at 50-30ft for the flare. What jet do you fly again

Twit...not the 'Bus..it calls "retard" the pilots closes the thrust levers..

[Capn Bloggs]

Whatever. My point still stands. "Running off the end at Vref" is either supremely silly or supremely ignorant.

[barit1]

Capn Bloggs: why would somebody deliberately design an ATS that would not stop the speed reducing below the bottom foot/Vref, regardless of the mode it was in? I can't see any logical reason.

Very well - it's such an excellent idea let's petition to make it a universal cert requirement (like throttles fwd for TO, etc.). And write AD's for retrofit too.

[barit1]

"Running off the end at Vref" is either supremely silly or supremely ignorant.

See: TAM 3054, São Paulo/Congonhas, 17 July 2007, A320.

[WhatsaLizad?]

"Without knowing the 777 in detail,"

That pretty much covers your input to the FLCH discussion on the 777 or any Boeing for that matter. Thanks for playing.

Any pilot using FLCH in a 757/767/777/737 on final approach is an abject fool.

A trap? If that is a trap then so is walking into traffic and getting run over in front of the terminal. Some people need to find another line of work.

[Capn Bloggs]

Very well - it's such an excellent idea let's petition to make it a universal cert requirement (like throttles fwd for TO, etc.). And write AD's for retrofit too.
You (and lizard) can sledge all you like. But can you actually give any reason why speed protection, regardless of current ATS mode, should not be part of the design, or in fact why, in the 777, FLCH does not provide speed protection?

I didn't think so.

[tdracer]

Bloggs, to my simple airplane designing mind, it's pretty simple.


Asiana was high and hot. They then input a FLCH command that would have made the aircraft climb (no idea why they would have done that, but according to published reports that's exactly what they did) so the throttles started to advance. Since advancing throttles would be contrary to capturing glideslope when high and hot, the throttles were manually retarded and held at idle for several seconds which, by design, caused the A/T to disconnect (EICAS message and aural "beep beep beep" alert). Little more than a minute later they were caught unaware when that disconnected A/T, which they had programed for a climb, failed to maintain VREF airspeed for landing.


If you design an autothrottle such that it doesn't allow the pilot to override it if deemed necessary, why the :mad: do you even need the pilot?

[ExSp33db1rd]

...not the 'Bus..it calls "retard" the pilots closes the thrust levers..

Why do you need one of Bill Gates' Magic Boxes to tell you to close the throttles to complete the flare and landing ?

Amazes me that the Wright Brothers survived their first flight !

World's Gone Mad.

[safetypee]

‘The more lofty words like "foresight" or "tolerant of misuse" the more meaningless they are’.
This depends on your viewpoint; you can choose the ‘person view’ or the ‘system view’, both adequately described by James Reason et al.

With the person view, often biased by hindsight, blame is an easy solution but does little to provide deeper understanding of the safety issues. What value is there in concluding that you or your operation would not suffer the hazards of human / system / situational limitation; self-satisfaction does not equate to safety.

A system view might not provide a uniquely packaged primary cause, where new SOPs / training etc can be applied (but to what effect in scenarios differing from this accident); but such a view could provide generic indicators of weaknesses or opportunities for error in higher workload situations where crews are expected to manage unusual environments – monitoring when training, descending/decelerating without ILS, poorly identified system failures (737 AMS) or systems intolerant of misuse (777), - simultaneously.

Life is understood backwards, but it has to be lived forwards where foresight might help avoid the pitfalls which are so easy to identify with hindsight.

‘Without knowing the 777… …’; recognising individual limitations, knowledge, operation, might help avoid or resolve difficult situations, but labelling professionals who might have may have learnt from their mistakes, as fools, might suggest that it takes one to know one – FLCH that is.
How many 777 pilots have been caught out by Boeing FLCH … is the mode the same in all models?
How do operators train or guard against the differences between A or B when changing type; ‘first learnt best remembered’?
What avoidance strategies are used when flying types with particular ‘weaknesses’ (people also have weaknesses); … how have people adapted to crossing the road in the UK vice the USA? At least we might consider taking care and looking both ways – considering other people’s points of view.

[safetypee]

‘The more lofty words like "foresight" or "tolerant of misuse" the more meaningless they are’.
This depends on your viewpoint; you can choose the ‘person view’ or the ‘system view’, both adequately described by James Reason et al.

With the person view, often biased by hindsight, blame is an easy solution but does little to provide deeper understanding of the safety issues. What value is there in concluding that you or your operation would not suffer the hazards of human / system / situational limitation; self-satisfaction does not equate to safety.

A system view might not provide a uniquely packaged primary cause, where new SOPs / training etc can be applied (but to what effect in scenarios differing from this accident); but such a view could provide generic indicators of weaknesses or opportunities for error in higher workload situations where crews are expected to manage unusual environments – monitoring when training, descending/decelerating without ILS, poorly identified system failures (737 AMS) or systems intolerant of misuse (777), - simultaneously.

Life is understood backwards, but it has to be lived forwards where foresight might help avoid the pitfalls which are so easy to identify with hindsight.

‘Without knowing the 777… …’; recognising individual limitations, knowledge, operation, might help avoid or resolve difficult situations, but labelling professionals who might have may have learnt from their mistakes, as fools, might suggest that it takes one to know one – FLCH that is.
How many 777 pilots have been caught out by Boeing FLCH … is the mode the same in all models?
How do operators train or guard against the differences between A or B when changing type; ‘first learnt best remembered’?
What avoidance strategies are used when flying types with particular ‘weaknesses’ (people also have weaknesses); … how have people adapted to crossing the road in the UK vice the USA? At least we might consider taking care and looking both ways – considering other people’s points of view.

[barit1]

Recent reports on the Korean ferry ship disaster indicate an unwillingness of junior officers to take charge and call for evacuation when the captain was indisposed. Does anyone see a parallel with AZ214?

What does the Korean press have to say on the subject?

[Machinbird]

Recent reports on the Korean ferry ship disaster indicate an unwillingness of junior officers to take charge and call for evacuation when the captain was indisposed. Does anyone see a parallel with AZ214?Yes. I've been thinking the same thing.
When people have been trained by their culture to defer to authority, how do you get them to speak up when they really need to?

[RAT 5]

This 'culture' problem has been thrashed about for years. If memory is correct did not Delta's training & safety department go into Korean years ago to try and sort it out? I thought they had some modicum of success, at first.

[Lonewolf_50]

RAT 5, Aren't Korean Airlines and Asiana two different airlines? :confused:

[porterhouse]

How many 777 pilots have been caught out by Boeing FLCH … is the mode the same in all models? Probably quite a few, but as some pilot 777 admitted when he got "caught" a few times he very quickly recognized the problem and corrected it. We don't expect pilots to behave like programmed robots, mistakes do happen, we expect them to be vigilant enough to self-correct. In this particular case they had minutes (not seconds) to correct the situation, they never did.

[Mozella]

Recent reports on the Korean ferry ship disaster indicate an unwillingness of junior officers to take charge and call for evacuation when the captain was indisposed. Does anyone see a parallel with AZ214?

There are addition similarities. I have experience flying the 767 as well as operating yachts which have autopilots linked to a computerized navigation system. In both vehicles I have, on occasion, selected an incorrect mode which if left to it's own devices would result in disaster. For example, in the case of the yacht it's quite easy to accidentally direct the autopilot to make a sudden hard turn. I suspect that what the young woman operating the ferry did.

The key, of course, is to recognize your mistake (or for someone else to recognize it) and then take timely action to correct it. The two go hand-in-hand.

I wonder if there was anyone else on the bridge of the ferry who failed to speak up when they should have.

[Zapatas Blood]

"If memory is correct did not Delta's training & safety department go into Korean years ago to try and sort it out? I thought they had some modicum of success, at first."

They tried. A squillion years of socialization was never going to be fixed by a simple airline audit though.

[sflaperons]

If you design an autothrottle such that it doesn't allow the pilot to override it if deemed necessary, why the do you even need the pilot?

Yeah but I don't think @Capn Bloggs is disputing that. Bloggs is saying (I think), and I'm still wondering, why does airspeed protection specifically not exist in FLCH mode?

Why do you need one of Bill Gates' Magic Boxes to tell you to close the throttles to complete the flare and landing ?

Amazes me that the Wright Brothers survived their first flight !

haha.

[barit1]

In my very early days as a student, I had this drilled into me: "Stick controls airspeed, throttle controls altitude". Of course, the machine weighted about 15 pounds per horsepower.

Today's airliners are so overpowered, that the relationship can be reversed, and indeed the automatics do the opposite: Autothrottle controls airspeed, autopilot controls altitude.

And when you fly in this mode leg after leg, the basic principle in my first paragraph - if not completely forgotten - might not be readily called up from long-term cranial storage when it's really needed.

:uhoh:

[Big Pistons Forever]

In my very early days as a student, I had this drilled into me: "Stick controls airspeed, throttle controls altitude". Of course, the machine weighted about 15 pounds per horsepower.

Today's airliners are so overpowered, that the relationship can be reversed, and indeed the automatics do the opposite: Autothrottle controls airspeed, autopilot controls altitude.

And when you fly in this mode leg after leg, the basic principle in my first paragraph - if not completely forgotten - might not be readily called up from long-term cranial storage when it's really needed.

:uhoh:

So you are saying after a while the pilots forget the throttles work this way

Push to Go, Pull to Whoa

Really........... :ugh:

[Willit Run]

Automation was designed to make the competent pilots job easier; not be a replacement for incompetent pilots.

I am amazed at how many people are trying to make excuses for incompetence.

Let the fodder fly!

[barit1]

So you are saying after a while the pilots forget the throttles work this way

Push to Go, Pull to Whoa

Look at the current evidence.

[edmundronald]

Digital control is illusory and brittle.

Once something is totally digital eg. fly by wire, physics doesn't really hold anymore for the user where the computer is doing the work. Eg. the plane will go in any direction just by being pointed there.

And once you go off the edge of the world, the illusion collapses.

If you train people only inside the illusion, the first time they go off the edge into reality will quite possibly kill them - eg by a CFIT when the plane just doesn't have enough energy to clear an obstacle.

[Cool Guys]

This 'culture' problem has been thrashedabout for years. If memory is correct did not Delta's training & safetydepartment go into Korean years ago to try and sort it out? I thought they hadsome modicum of success, at first.


In this case it appears to be a CRM and intrument scan problem.

The Delta audit was with Korean Air, not Asiana. Since then Korean Air has had a good safety record - kind of detracts from the theory that it is a culture problem. Culture may be a contributory factor, like the FLCH "issue", but not the cause. It can be corrected with good training.

[barit1]

Once something is totally digital eg. fly by wire, physics doesn't really hold anymore for the user where the computer is doing the work. Eg. the plane will go in any direction just by being pointed there.

And once you go off the edge of the world, the illusion collapses.

If you train people only inside the illusion, the first time they go off the edge into reality will quite possibly kill them - eg by a CFIT when the plane just doesn't have enough energy to clear an obstacle.

Exactly; See Pinnacle 3701 (http://www.ntsb.gov/doclib/reports/2007/AAR0701.pdf)
Incidentally, the Pinnacle accident demonstrates that the problem is not unique to one nationality.

[Checkerboard 13]

SF fire chief backs down re: helmet cam reprimand:
Asiana crash: No reprimand for S.F. firefighter over filming - SFGate (http://www.sfgate.com/bayarea/article/Asiana-crash-No-reprimand-for-S-F-firefighter-5427996.php)

[MtSpeedDemon]

I just cannot imaging the agony of knowing your family member survived only to be run over. So much tragedy in the whole event. And what was the point of the helmet cam? I tried to read the article but the writing just couldn't hold my attention. I can't tolerate reporting that doesn't answer how and the five Ws. And if the helmet cams are becoming common, how or why are those images released. Seems very wrong to me to release those sorts of images. Sorry if that is getting off topic.

[JPJP]

Td Racer -
That's why the stall warning is a 'stick shaker', yoke forces go up, etc. An aural alert saying 'low airspeed' may not get through.


I strongly disagree. When the "Low airspeed" aural alert was added to the 737NG software, it then became the prompt to action the stall recovery maneuver. The pilots reaction is exactly as it would be at stick shaker.

If you say "low airspeed" into the ear of a sleeping NG pilot, he'll yell "set max thrust" and his right arm will move forward. Watch your head :E

[olasek]

it then became the prompt to action the stall recovery maneuver. Most of the time, by most pilot.
We are not taking about what happens "most" of the time but when signals/alerts are missed, clearly there are numerous examples when aural signals were completely missed by the crew (either the signal was missed or lack of sound was missed too), in this particular case the crew "missed" (or deemed as normal) that they had to pull the yoke with 80- lbs of force. If they missed that makes you wonder about their state of mind and whether sound would do any good. Also, just from the human factor point of view it is bad design to make pilots rely too much on all kinds of warning "signals" - signals themselves may fail for independent reasons (like this buzzer in the Detroit crash) and pilot not hearing any sound may think everything is OK and dangerous complacency sets in.

[barit1]

MtSpeedDemon: And what was the point of the helmet cam?

Indeed, what's the point of FDRs and CVRs?

[Volume]

If you say "low airspeed" into the ear of a sleeping NG pilot, he'll yell "set max thrust"Which everybody who has ever read "stick and rudder" or any other book on flight mechanics knows will have two effects: on climb rate and on noise level. For more speed you have to give a nose down input on the elevator...

[ImbracableCrunk]

Quote:
If you say "low airspeed" into the ear of a sleeping NG pilot, he'll yell "set max thrust"
Which everybody who has ever read "stick and rudder" or any other book on flight mechanics knows will have two effects: on climb rate and on noise level. For more speed you have to give a nose down input on the elevator...

The Asiana pilots should have pushed the nose forward! Why didn't we see that?:ugh:

(Haven't we done this before?)

[ExSp33db1rd]

.....bad design to make pilots rely too much on all kinds of warning "signals" Remember the Avianca crash in 1984 ?
Quote ... and the little voice said in English, “Pull up, pull up!”. Well it was a warning system, right? The pilot, (and the flight recorder had this on it), inexplicably snapped back, “Shut up Gringo . . . !” and flipped off the warning voice . Minutes later the plane smashed into the mountain and everybody was dead.

I was once on a training flight where the instructor was constantly closing the throttles to set up an approach to a stall, for the various trainees who were on that detail, so of course the gear warning horn sounded and was instantly silenced by another crew member. On setting up the final landing, but before "gear down" had been called, the pilot again retarded the throttles to adjust his approach, and again the horn sounded and was again quickly cancelled ... I wondered what might have happened if that horn had, correctly, sounded in the landing flare !!

Just sayin', familiarity breeds contempt.

[Capn Bloggs]

The Asiana pilots should have pushed the nose forward! Why didn't we see that?

(Haven't we done this before?)

We sure have!

http://www.pprune.org/tech-log/536616-thrust-during-flare-q-airbus-test-pilots.html

[autoflight]

They should have known better, but I still feel very sorry for both of these pilots.

A couple of years of pilot training, a heap of sim and CRM courses are insufficient to counteract thousands of years of culture. Asiana Airlines management in the past has failed to initiate counter culture cockpit management, which makes it the problem.

There have been isolated outcomes where cultural considerations have been put aside. However there are many more cases where management has been spoon fed safety solutions and for no valid reason, failed to act.

Last I heard, a retired Japanese pilot was engaged to manage safety matters. That must have been a major call and I hope he succeeds.

[Cool Guys]

Hi autoflight

This tells some more about the new safety Chief:

Asiana Airlines? new safety chief stresses preemptive action (http://www.koreaherald.com/view.php?ud=20131204000989)

The following article would seem to be a step in the right direction:

http://www.voanews.com/content/asiana-adopts-new-pilot-training/1851905.html

However punishments based on a set formula laid down by an authority without finding the root cause, such as the following article is proposing, is unlikly to produce good long lasting improvements (in my opinion):

http://www.koreaherald.com/view.php?ud=20131126000884

[fox niner]

That link is more than a year old....nothing new.

[JPJP]

Volume - Which everybody who has ever read "stick and rudder" or any other book on flight mechanics knows will have two effects: on climb rate and on noise level. For more speed you have to give a nose down input on the elevator...

Thanks Volume. I wondered what I'd been doing wrong all of these years. I'll make a note. :rolleyes:

[JPJP]

Olasek - Most of the time, by most pilot.
We are not taking about what happens "most" of the time but when signals/alerts are missed, clearly there are numerous examples when aural signals were completely missed by the crew (either the signal was missed or lack of sound was missed too), in this particular case the crew "missed" (or deemed as normal) that they had to pull the yoke with 80- lbs of force. If they missed that makes you wonder about their state of mind and whether sound would do any good. Also, just from the human factor point of view it is bad design to make pilots rely too much on all kinds of warning "signals" - signals themselves may fail for independent reasons (like this buzzer in the Detroit crash) and pilot not hearing any sound may think everything is OK and dangerous complacency sets in.

Agreed.

I prefer the "low airspeed" aural warning in addition to the stick shaker. As you intimated, this crew ignored many, many other cues. Who knows if another aural alert would have saved them from themselves.

[DaveReidUK]

NTSB Media Advisory May 8, 2014:

The National Transportation Safety Board will meet on Tuesday, June 24 at 9:30 a.m. (EDT) to determine the probable cause of the July 2013 crash of Asiana Airlines flight 214 in California.

[Sky Slug]

After a spate of "pilot error" crashes, and the founding of SkyTeam, Delta has sent tens of employees/crew over to Korean Air and China Airlines to institute a CRM program in both airlines. It seems to have worked as neither has had major "pilot error" incident since its inception.

Asiana was seen as a private airline and not a flag carrier like KE. They didn't face the same pressures to hire out of the Air Force like Korean. Asiana could look to United or Lufthansa for guidance on proper CRM.

I find it interesting that the major Chinese airlines haven't had a hull loss since the merger of airlines into Air China, China Southern, and China Eastern.

[Piltdown Man]

I find it interesting that the major Chinese airlines haven't had a hull loss since the merger of airlines into Air China, China Southern, and China Eastern.

Maybe they have a really good CRM programme in place. Or there again, maybe they do things very differently and we should start learning learning from them. After all, as a group they have an impressive record and they must have been doing lots of things right.

[barit1]

NTSB to release AZ214 report tomorrow 24 June.
Asiana crash: Who's to blame? - CNN.com (http://www.cnn.com/2014/06/23/us/asiana-ntsb/index.html?hpt=hp_t2)

If I may be so bold - Where is Asiana Flight Ops management in the link of events and evident misunderstandings leading up (down) to a 773 being so low and so slow?

[DaveReidUK]

NTSB to release AZ214 report tomorrow 24 June.Was it Alitalia's fault, then ... ?

[barit1]

Give an old, old guy a break. AZ, AY, OZ, Seen one you seen 'em all. :O

[BOAC]

barit - some of our correspondents are so sharp they are in danger of cutting themselves.......

[Obama57]

I can never remember ever using FLCH after the FAF on any aircraft type. Maybe I am confused, but I'm pretty sure FLCH is actually a pitch mode either with max climb thrust or idle; elevator controls the speed, yes? Throttles would then control your rate of climb or descent. So, with power at idle, if indeed one was in FLCH, wouldn't you be descending at a good rate to maintain that speed? As I understand it, the Asiana flight was not descending too fast, just too slow. What does this have to do with FLCH?

[dartman748]

FLCH adjusts thrust to give you a rate of climb (or descent, as the case may be) to reach the selected altitude / level in 2 minutes. i.e. If you are descending 2000 FT, it will give you approximatly 500 FPM. 1000 FT / 250FPM, etc. The AP will adjust the thrust up to CLB, or IDLE, as the case may be to try and achieve this.

[Capn Bloggs]

So, with power at idle, if indeed one was in FLCH, wouldn't you be descending at a good rate to maintain that speed?
Yes, but they weren't maintaining speed, they were continually decelerating when they were on final, I assume maintaining the slope (until of course they ran out of speed and started going low).

[underfire]

The National Transportation Safety Board is debating the extent to which Boeing’s automatic throttle contributed to the 777’s loss of speed before the jet slammed into a seawall in San Francisco last July 6, said three people with knowledge of the discussions.

WASHINGTON — U.S. investigators are debating whether to blame a Boeing jetliner’s design for helping cause a cascade of pilot mistakes in last year’s Asiana Airlines crash that killed three Chinese teenagers.

The sticking point within the National Transportation Safety Board (NTSB), in the days before its final decision is due, is over the extent to which Boeing’s automatic throttle contributed to the 777’s loss of speed before the jet slammed into a seawall in San Francisco on July 6, said three people with knowledge of the discussions. They asked not to be identified because they weren’t authorized to speak.

The safety board Tuesday will decide on the probable cause and other factors leading to Seoul-based Asiana’s crash, the first in the United States with passenger deaths in more than four years. While there’s little doubt the pilots made mistakes, a finding that equipment on the 777-200 jet confused them could open Boeing to greater liability in lawsuits and shade public opinion.

[msbbarratt]

Underfire reported:

While there’s little doubt the pilots made mistakes, a finding that equipment on the 777-200 jet confused them could open Boeing to greater liability in lawsuits and shade public opinion.An aircraft certified by the FAA is then criticised by the NTSB after an accident. What's an air-framer to do then?

On wonders exactly how Boeing are supposed to second guess the NTSB. It would seem that their first contact with the NTSB on a design issue is after an accident involving one of their aircraft flying with FAA certification.

If Boeing really are somehow dragged into it then surely there can be only one corporate response; no more automatics, other than a rudimentary autopilot. Same for Airbus too. If they are going to be liable in the US for a pilot's failure to fully understand these systems then they're not going to fit them in the first place.

Though surely the NTBS won't make such a finding, will they? I guess we'll find out in due course.

[BuzzBox]

Originally Posted by Dartman
FLCH adjusts thrust to give you a rate of climb (or descent, as the case may be) to reach the selected altitude / level in 2 minutes. i.e. If you are descending 2000 FT, it will give you approximatly 500 FPM. 1000 FT / 250FPM, etc. The AP will adjust the thrust up to CLB, or IDLE, as the case may be to try and achieve this.

I don't fly the 777 but I call "rubbish" on all of that.

Not rubbish at all. That's exactly how FLCH works in the 777, although I think you'll find that a 2,000 ft descent in 2 minutes equates to 1,000 ft/min not 500 ft/min, etc!

If the thrust comes back to IDLE, the autothrottle then transitions to HOLD. It doesn't 'wake up' again unless another vertical mode engages. Therein lies the problem.

[DaveReidUK]

I guess we'll find out in due course.In seven hours time, in fact: live webcast at National Transportation Safety Board (http://www.capitolconnection.net/capcon/ntsb/ntsb.htm)