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PakoSpain
31st May 2002, 17:50
As published on local press http://www.surinenglish.com/gnews.html#19

Copilot on Melilla flight stopped wrong engine

Examination of the black box from the Binter plane which plummeted to the ground just short of Malaga airport in August last year, killing four people and injuring 26, shows that immediately before the crash the pilot was recorded saying “What’s going on? Which engine have you cut? ****! Which engine have you cut? You’ve cut them both! Oh my God!” These were the last words of Mariano Hernández Ruano, who was one of the victims when the plane hit the ground, gouging out a track 100 metres long before coming to rest with its nose on the N340.
The copilot of the CN-235 plane, Luis Checa, stated at the time that neither of the men had shut down the engine which was still functioning. However this week the lawyer Manuel Temboury, acting in the private case being brought against Binter, said that human error was the cause of the accident after a fire alert. “The preliminary reports show that in fact there wasn’t a fire in the left engine but there was a fault in the fire warning system, which went off although there was no fire”. He explained that in the event of a fire alert, the engine affected is immediately shut down and then a lever mechanism is used to activate an extinguisher to prevent the fire reaching the fuel. From the recorded conversation Temboury deduces that instead of activating the extinguisher in the left engine, the copilot released the liquid in the right engine, effectively leaving the plane without power.

Info about this accident on
http://www.pprune.org/forums/showthread.php?s=&threadid=3856

TE RANGI
31st May 2002, 19:49
A bit reminiscent of BD 737-400 at EMA in Jan '89.

What was the copilot experience?

Pvt. Godfrey
31st May 2002, 21:05
My sister Dolly tells me the Spanish aviation community is aghast at the broadcasting of the actual CVR recording on Spanish television. It is alleged the tape may have come from the legal community and joins the New Zealand accident investigation in the continuing pressure negating the whole purpose of such records.

Simon Z
31st May 2002, 21:47
TE RANGI. Perhaps the quality of CREW training is the issue here rather than co pilot experience.

Or are you trying to make another point?

wallabie
1st Jun 2002, 07:40
Spot on Simon

fireflybob
1st Jun 2002, 08:26
I feel the circumstances surrounding this accident have little, if anything, to do with the Kegworth B737 accident.

All accidents are a combination of circumstances coming together at one time. Eliminate one of those circumstances and the outcome might have been quite different.

Shutting down the "wrong" engine is a classic error on twin engine a/c and has happened on many occasions in the past.

As has been so eruditely stated above, it is often the quality of the training which has a major impact on the safety of an airline (this comment is not intended to be a critisism in this case) although the "error chain" often starts elsewhere, eg the design of vibration indicators, certification (or lack of) the engine, etc etc.

Like all accidents we should not go jumping after what we think is the "instant" solution. It is so easy to say "How an earth did they do that?" when the reality is that we might have done exactly the same in the circumstances at the time.

TE RANGI
1st Jun 2002, 09:11
Simon Z,

You are correct. I should have chosen my words more carefully. Training quality is more the issue here. However, both training and experience are inextricably linked to pilot performance in an emergency. And both should be taken into account in the investigation.

fireflybob,

Well I agree with you. I only mentioned the similarity with the Kegworth case in that both aircraft hit a road embankment very short of the runway after the good engine had been shutdown and both aircraft would probably have made it had they had just a few more seconds of power available, but the similarity ends here. As you point out shutting down the good one is a classic scenario as sim instructors know. But I thought that confirming with the other pilot (in two pilot/two engine cockpits) before performing such critical actions was SOP everywhere. Of course checking this company SOPs and whether they had been adhered to is another point for the investigators.

I would also like to bring the attention to the fact that CVR trancripts have been leaked to the press and are being used by lawyers in their lawsuit against the airline. Obviously not the purpose CVRs were intended to serve. But that's the way it goes these days. Make one mistake and your own words -maybe your last- will be on the net overnight. Shouldn't something be done about it?

amos2
1st Jun 2002, 09:47
Unfortunately, confirming the failed/on fire engine prior to shutdown actions is not SOPs with many so called major airlines! Strange but true! :cool:

Few Cloudy
2nd Jun 2002, 06:56
Quite right - the title should have been "Crew stops wrong engine". The repeated question on the CVR shows that the guy was not in the loop during the fatal action. A lesson for us all - the fire warning does seem to stop us thinking for a while.

wallabie
2nd Jun 2002, 08:13
I remember a similar case some years ago with a french domestic 320. The guys forgot to retract the landing gear leading to airframe vibrations as they gained speed which they took for engine vibrations. The captain called for ??? engine shutt down which of course didn't do a thing and this is where things go completly crazy.........He then took it to shutt the second one to his F/O's greatest dismay !! The guy then completly lost the plot.
Somehow, the F/O manages to resart one engine and to turn around to land back in Orly. Do I need to say the Captain was immediatly toasted.
Now, one of the pax was the Bishop of Tarbes a town just nearby Lourdes which, as every dyed in the whool catholic knows, is a place of pilgrimage where miracles happen !!
This is a true story !