ASL/DHL overrun LIME/BGY Italy

[OntimeexceptACARS]

Link here with photo (in French) :

Sortie de piste à l'atterrissage d'un avion de ASL Airlines (http://www.crash-aerien.aero/www/news/article.php?id=529401#)

That'll polish out...

[VJW]

LIME/BGY

http://i86.photobucket.com/albums/k86/vincent_watts/Mobile%20Uploads/image.jpeg (http://s86.photobucket.com/user/vincent_watts/media/Mobile%20Uploads/image.jpeg.html)

[Doors to Automatic]

10,000 feet to play with if memory serves - that will be an interesting read!

[cooperplace]

Link here with photo (in French) :

Sortie de piste à l'atterrissage d'un avion de ASL Airlines (http://www.crash-aerien.aero/www/news/article.php?id=529401#)

That'll polish out...

that'll polish out: especially the left wing, which seems to be sans engine and maybe a bit shorter......

[timmermc]

According to ASN:

ASL Airlines Hungary flight QY7332 suffered a runway excursion accident after landing at Bergamo-Orio Al Serio Airport (BGY), Italy.
The aircraft, a Boeing 737-400 cargo plane, departed Paris-Charles de Gaulle Airport, France at 02:54 hours local time. The aircraft landed on runway 28 at Bergamo-Orio Al Serio Airport at 04:07 but failed to stop on the runway. It continued until coming to rest at the side of a highway.

The runway length starting at the runway 28 threshold is 9209 ft (2807m). Failing to stop at the end of the runway, the aircraft travelled 300 m across two roads, a parking lot and a highway lane before coming to rest with the nose across another highway lane.

Looks like a hell of a ride.

[RexBanner]

Used to fly into Bergamo at least every week. Due to the lack of an instrument approach on RWY 10 aircraft would regularly accept some pretty hefty tailwinds coupled with a wet runway on 28 instead of circling to 10. I personally witnessed a Ryanair 737 come dangerously close to an excursion under those conditions. I'm not suggesting that the crew were landing out of limits in this case or that weather/tailwinds has been a factor but that kind of incident (runway excursion) has been waiting to happen at Bergamo for a long time now.

[737 Speedbrakes]

http://i228.photobucket.com/albums/ee228/dmdrewitt/C_2_fotogallery_3004007_12_image.jpg (http://s228.photobucket.com/user/dmdrewitt/media/C_2_fotogallery_3004007_12_image.jpg.html)


http://i228.photobucket.com/albums/ee228/dmdrewitt/C_2_fotogallery_3004007_13_image.jpg (http://s228.photobucket.com/user/dmdrewitt/media/C_2_fotogallery_3004007_13_image.jpg.html)


http://i228.photobucket.com/albums/ee228/dmdrewitt/C_2_fotogallery_3004007_10_image.jpg (http://s228.photobucket.com/user/dmdrewitt/media/C_2_fotogallery_3004007_10_image.jpg.html)


http://i228.photobucket.com/albums/ee228/dmdrewitt/C_2_fotogallery_3004007_8_image.jpg (http://s228.photobucket.com/user/dmdrewitt/media/C_2_fotogallery_3004007_8_image.jpg.html)


http://i228.photobucket.com/albums/ee228/dmdrewitt/C_2_fotogallery_3004007_9_image.jpg (http://s228.photobucket.com/user/dmdrewitt/media/C_2_fotogallery_3004007_9_image.jpg.html)

Orio al Serio, l'aereo finisce sulla strada - Tgcom24 (http://www.tgcom24.mediaset.it/cronaca/foto/orio-al-serio-l-aereo-finisce-sulla-strada_3004007-2016.shtml)

[TBSC]

METARs before and after the occurence shows wind from 260 and 340 therefore tailwind was not a factor here. Obviously (nearly) anything can happen in a TSRA...

[RexBanner]

Including a rapid shift in wind direction.

[dusk2dawn]

Accident: ASL Hungary B734 at Milan on Aug 5th 2016, overran runway (http://avherald.com/h?article=49c27d0c)

[weatherdude]

The landing time at 2.07 UTC was the worst moment imaginable with the core of a line of heavy thunderstorms OHD the AD (see radar)

https://kachelmannwetter.com/ch/regenradar/bergamo/20160805-0205z.html

There was also frequent lightning in the area, for details and timing click on the lightning icons.

https://kachelmannwetter.com/ch/blitze/bergamo/20160805-0210z.html

[blue up]

A 737 over-run. Now there is something you don't see every day! (Maybe every OTHER day)

[RAT 5]

This doesn't look like a quick & easy job to remove the a/c. What has happened to the LLZ aerial? What is the status of the airport? I can imagine huge disruption to RYR's schedules and other operators including all the night freight flights. What is in fact going on?

[D Bru]

This is certainly an original attempt to get parcels "on the road" quickly.


The A/C seems to have had still quite some fwd energy on exiting the paved RWY end, despite the deployed speedbrakes.


A quick ckeck on streetview shows it went through:
1. the localiser antenna;
2. the perimeter fence;
3. a steel railing/fence along the perimeter road;
4. a concrete low wall + fence on top btwn the perimeter road and the parking lot;
5. another fence btwn the parking and the northbound inroad;
6. a double safety railing btwn the inroad and the main northbound lanes;
7. a double concrete blocks separation holding an earthen wall of a few meters wide; and
8. a double safety railing btwn the main southbound lanes and the southbound exit.......

[D Bru]

https://www.youtube.com/watch?v=4hD8zZfDHS0


Pretty much on the centreline though....

[weatherdude]

With the radar echo posted above it's safe to say there was at least 2-4 cm of water on the RWY, you flying people will know about the braking action then.

[RAT 5]

One wonders what ATC told the crew about runway conditions. The a/c would have been light, I assume. Parcels weighting less than pax + baggage. What landing flap & autobrake did they use? Did they use TR's on a night arrival - noise abate? Where was the touchdown point? What was the Metar? I suspect, being dark, the touchdown point might not be assessable by ATC. However, the crew can answer the other questions.

[Two's in]

10,000 feet to play with if memory serves - that will be an interesting read!

Only if you start at the beginning...

[weatherdude]

That's the last Metar before the event:

LIME 050150Z 26011G23KT 220V310 9999 VCTS FEW040CB BKN080 23/16 Q1010=

The one after the event looks unexciting:

LIME 050220Z 34011KT 9999 SHRA TS FEW015 SCT030CB BKN050 18/17 Q1011=

The difference in temperature shows the passage of the severe thunderstorm line in between of those, there was definitely at least a 30-40 KN gust which is not being shown since no SPECI message was issued. Only looking at the Metars one could have been inclined to give it a shot, but with the impressive fireworks in the sky maybe not and ATC could have seen this and should have told them to wait:

https://kachelmannwetter.com/ch/regenradar/bergamo/20160805-0205z.html

The storm was registered by the stormtracker

https://kachelmannwetter.com/ch/stormtracking/bergamo/20160805-0205z.html

And the analysis says (if you click into the storm center) that it moves with 61KPH and gusts to 70 KPH are expected - there will be now way with a storm moving with 60+ KPH gusts would be slower than than - rather faster.

https://kachelmannwetter.com/ch/stormtracking/bergamo/201608050205z-1-731-8ee9f50.html

[Icelanta]

Rat5,

Your assumption that parcels and containers weigh less is not correct.

Very often, the B73F lands at or near MLW.

[framer]

Weather dude,
I've often wondered how heavy rain has to be before you get more than 3mm of surface water on a grooved runway as we are not supposed to land while that is the case at my outfit. Do you know what visibility in RA equates to 3mm deep of water on a grooved runway? 1500m? 1000m? 800m?
What about on a non grooved runway?

[Metro man]

Almost certainly a write off as an old B734 won't be worth repairing.

[weatherdude]

Weather dude,
I've often wondered how heavy rain has to be before you get more than 3mm of surface water on a grooved runway as we are not supposed to land while that is the case at my outfit. Do you know what visibility in RA equates to 3mm deep of water on a grooved runway? 1500m? 1000m? 800m?
What about on a non grooved runway?
Framer, with the intensity of rain during the event of at least 40 mm of rain/hour you'll get definitely more than 3 mm on the RWY. We have experience correlating German Highways and their layers of water on them with rain intensity suggesting the layer of water on the runway at LIME would have been thicker by far. If you drive 100 clicks with the car and tried to brake, you would have no traction under those conditions.

What I don't know what the weight of the airplane does and if you guys always get to the concrete and push all the liquid stuff aside...but for sure the water depth exceeded 3 mm by far.

I ask myself why there is no trend info on the METAR - a BECMNG 31025G35KT +TSRA at 1.50 UTC may have helped - and if ATC looked on the radar at all. And since the pics I posted are from the Swiss radar, question if they have that radar imagery at all.

[oceancrosser]

Looking at the video in post #15 it would seem they left the runway at a very high speed... must have been a heck of a ride. Amazing if uninjuired.

[FlyingStone]

The a/c would have been light, I assume. Parcels weighting less than pax + baggage.

While parcels are usually lighter and more volume-limited than general cargo, it is not 100% rule. Keep in mind that weight-wise, cargo-converted aircraft has much higher payload than pax aircraft: no seats, overhead bins, coffee heaters, ovens, magazines, less toilets, jump seats, etc.

[ericsson16]

Nothing to complicated here,04:00Hrs approx' Let's call it human factors,just to be gracious!

[flight_mode]

Apparently they touched down somewhere between taxiways D and G which would leave them with what, 300 metres of RWY?

[RedBullGaveMeWings]

That's not confirmed, just a rumour coming from someone in BGY.

[daelight]

Sure, a rumor but given the multiple impacts which are very evident in daylight, this a/c most likely touched down very, very late along the runway.

[RAT 5]

Thanks for those who commented about the Landing weight. I was wondering if a light weight might have lent itself to floating, especially with tailwind. However, both seem to be discounted, expect a gust/burst from the TS's might have caused a momentary tailwind.

Slightly off the direct topic, but relevant. It has been said many times, and also recently on the Emirates gear collapse in Dubai topic, that all engine G/A's are often the most messed up manoeuvre and the least practiced. Considering the number of overruns from long landings: it is possible in very a/c I've flown to execute a G/A from the runway until the TR's are selected. It is a scenario I have never practiced in 35 years of Boeing flying; yet many overruns could have been avoided by doing just that. Busting the gate at 500' is one thing, flaring and floating is another opportunity to G/A, even after touchdown it is possible to G/A BUT takes huge amounts of courage & awareness to change the mindset of landing. I'm certain that once experienced, in the sim, that doubt/fear would be reduced significantly. Yet, none of my airlines had seen fit to include it in an recurrency training. DAFT. There's a real world out there, but some of the 'training?' does not seem the most relevant.

[Double Back]

Rat5
Spot on. I could convince our training manager, long time ago, to include in one recurrent session a situation that necessitated a GA, well after the decision to land was taken. The results were rewarding, in that it needed to repeated in quite some sessions.
However after T/D it was a different ballgame, as our first action was to aggressively pull reverse. Once the REV handles were pulled back, a GA was not allowed any more. But counting in that the touchdown was anywhere near the TD point.

[Double Back]

Yes, having flown mostly long sectors, GA's were rare in my career. From the maybe three I made, only one was AS+ quality. The others soso. Mostly because ATC interfered and amended the published and briefed GA procedure, necessitating altitudes to be reset, headings to be changed. In a time that workload was high, as was the climb rate at light weight.

[Sidestick_n_Rudder]

https://postimg.org/image/i7j19bsn5/

Not sure if that's real or fake, but made me chuckle - apparently that's the post-accident statement of the driver that was hit by plane...

[RAT 5]

Double back: I have had the 'mandatory' wave off at 50'. It is a TR training item. It is briefed in advance, but not warned of. It was rarely repeated in training afterwards. In LVO training the 50' G/A using autopilot is a trained manoeuvre. The a/c may bounce but the automatics do not. That's the education.
What has never been done is a G/A after touchdown. That's the training I'm calling for. It's a possibility & reality, so why not trained for.

[CAT1]

Looks like the ILS was off.....


A5413/16 - INSTRUMENT LANDING SYSTEM (ILS) RWY28 UNSERVICEABLE. REF AIP AD 2 LIME 1-8. 05 AUG 05:26 2016 UNTIL 06 AUG 16:00 2016. CREATED: 05 AUG 05:25 2016

[Binder]

RAT

I would completely agree as well. I always brief it's one of the hardest manoeuvres we do. Why...because it can be unexpected and it's not sufficiently trained on sim details. It can be due to W/shear...baulked landing...or discontinued approach or a combination (each requiring different mindsets and rapid assimilation) and invariably a startle factor.

I can count the number of go arounds (non training) in my career on one hand.

One of those was recently in perfect flying conditions....

Was fatigue a factor..Yes. Was experience a factor....yes. Was the outcome of the manoeuvre ever in doubt....no.

But and it's a big but, the holes in the cheese are slowly lining up and I'm not alone in that viewpoint.

[bikeframe]

https://postimg.org/image/i7j19bsn5/

Not sure if that's real or fake, but made me chuckle - apparently that's the post-accident statement of the driver that was hit by plane...

Italian speaking SLF... It plays with some dialectal expressions of the Bergamo area... Can't be too explicit in translating the word "pota" down left...

[172_driver]

Looks like the ILS was off.....


A5413/16 - INSTRUMENT LANDING SYSTEM (ILS) RWY28 UNSERVICEABLE. REF AIP AD 2 LIME 1-8. 05 AUG 05:26 2016 UNTIL 06 AUG 16:00 2016. CREATED: 05 AUG 05:25 2016

Is it a joke or am I missing something? The NOTAM is created about an hour after the ILS was run over by an aircraft.

[TBSC]

Looks like the ILS was off.....
It was working until they destroyed the localizer antenna. The NOTAM was created after the accident (at 0525 UTC). Their fellow aviators will remember them fondly while diverting somewhere from BGY in the coming weeks (as no precision approach will be available).

[Double Back]

Rat5
I would disagree on training that. The most likely cause would be a long landing, but that would be the first mistake then. Landing long and THEN deciding to GA would be two mistakes in a row.
It gets into the field of aborting after V1, even on a long RWY.

[VJW]

Rex what you said was correct regarding RW28, but there has been a VOR approach to RW10 for a while now, and circle to lands are no longer required really. There is however a night curfew, where RW10 is used for take off and RW28 (even with a tailwind) are preferential for landing due to noise. Although I'm pretty sure a runoff is pretty noisy...

Here are a few pictures I took today.

http://i86.photobucket.com/albums/k86/vincent_watts/Mobile%20Uploads/image_1.jpeg (http://s86.photobucket.com/user/vincent_watts/media/Mobile%20Uploads/image_1.jpeg.html)

The one below shows what remains of the Localiser transmitter- probably the reason the ILS is NOW unserviceable......

http://i86.photobucket.com/albums/k86/vincent_watts/Mobile%20Uploads/image_7.jpeg (http://s86.photobucket.com/user/vincent_watts/media/Mobile%20Uploads/image_7.jpeg.html)

New temporary perimeter fence..

http://i86.photobucket.com/albums/k86/vincent_watts/Mobile%20Uploads/image_6.jpeg (http://s86.photobucket.com/user/vincent_watts/media/Mobile%20Uploads/image_6.jpeg.html)

This one is self explanatory

http://i86.photobucket.com/albums/k86/vincent_watts/Mobile%20Uploads/image_5.jpeg (http://s86.photobucket.com/user/vincent_watts/media/Mobile%20Uploads/image_5.jpeg.html)

[justcruizin]

Relieved the crew (and especially those on the ground) were uninjured. For those who might be viewing these posts who aren't freight dogs; the sobering photos depict the risks involved of multi-sector night freight operations, often at or close to a/c performance limits, tired (hanging in your straps) mixed with challenging weather conditions and minimum fuel. Very often, we push the boat out to get the job done (and it's sadly taken for granted). We're all thinking the same thing of course. I decided to go around a few months ago from just above the runway (20 ft) (somewhere else) due to control problems in v strong Xwinds. It was a surreal situation in that I could hardly believe I was actually doing the GA from such a low level. Took all my concentration - little or no spare capacity remaining. The decision was a no-brainer but even so, the temptation for me to continue with the landing and to try and resolve it in the flare was ENORMOUS. Can't quite state that enough. It would have ended badly if I'd have tried to remedy it throughout the flare - no doubt at all.

I hope this crew will be afforded some respect. They're having a very bad time.

[pkam]

https://postimg.org/image/i7j19bsn5/

Not sure if that's real or fake, but made me chuckle - apparently that's the post-accident statement of the driver that was hit by plane...
Fake Iwould say, the name John Holmes is, so Ive been told, a well remembered participant in alternative video entertainment in the 1970s.

[captplaystation]

Double Back,

with respect you either don't understand English, don't understand Boeing , or don't understand that any escape manoeuvre trumps an overrun any day.


"I would disagree on training that. The most likely cause would be a long landing, but that would be the first mistake then. Landing long and THEN deciding to GA would be two mistakes in a row.
It gets into the field of aborting after V1, even on a long RWY."


A go-around after landing (balked landing) is one of the few ways that you can save your sorry ass if you landed too deep/fast , Boeing acknowledges this in the FCTM, the only proviso being that this option is no longer viable/recommended if you have deployed TR's.
There are a few videos on youtube of the manoeuvre being performed shortly after touchdown in places like Funchal, admittedly, it is rarely done after aircraft have properly touched down, this mainly being due to our super sharp colleagues selecting reverse ASAP (as also demanded by Boeing)
In the right (or maybe better read "wrong") circumstances it is however a viable escape plan if you haven't opened reverser sleeves, but, I have never seen it trained in Sim in 27 years of B737 Ops.

[RAT 5]

In the right (or maybe better read "wrong") circumstances it is however a viable escape plan if you haven't opened reverser sleeves, but, I have never seen it trained in Sim in 27 years of B737 Ops.

Exactly my point. In a few over-run accidents the reports concluded that the a/c could have got airborne safely if full thrust had been applied immediately after touchdown. The a/c still had enough energy with the (short) remaining runway; but it never had a change of stopping in time. It would take a major change in mind-set and huge courage to do so. The lowest GA I've seen in the sim is the mandatory 'wave off' at 50' caused by ATC. i.e. you do not make the decision, it is commanded. Even a W/S GA is at a higher height and in new generation a/c is a command; but in severe conditions lower down it should be obvious. Watching the various youtube videos of very low GA's, due turbulence and instability, I am impressed by the decision making to do so, less impressed by some of the 'press-onitis' demo's. For the turbulent GA's it is pilots' decision and they must have felt falling over the edge in terms of being in control of the landing manoeuvre. Well done to them; but it is a totally different decision to make once the wheels touchdown and the end of the runway is looming. You know you've landed long, be it via a float, balloon or incorrect GP below 500'. Indeed you know you are going to land long well before touchdown. The manoeuvre is not difficult, it is the decision that is foreign. Surely much of our training is to experience situations which can surprise us and to teach us what it feels like to manage the scenario, including the decision making process. Given that over-runs due to long landings is an occurrence every year, somewhere in the world, why not teach what to do as a final resort? Most operators think that by having a rigid 500' gate policy they have done enough. Not so. There are plenty of airports where 'late landing clearance' is used and an ATC GA can be called very late.
A windshear GA at very low level is difficult to create in a sim and in the modern jets the WS warning kicks in. What needs to be added in training is the pure pilot generated feeling of "I don't like this, so let's get out of here." Not an SOP, not an auto command, just gut instinct followed by action. Surely that is what simulators are for.

[Icelanta]

We practiced baulked landings in the sim during last sim. training session.
Training dep. here does try to be innovative and give us the best training you can find on B744.
So some do train this very important manoeuvre.

Icelandic operator by the way.

[deltahotel]

Council Van

The reason the cargo door is closed is that the freight's already off and away!

[Double Back]

No matter how much You train, there will always be a scenario that is unique.

Sure, 98-99% of what can be expected is, or can be trained.
But training has it limits in view of cost, so EFFECTIVE training is something else as dragging students through all possible scenarios in an endless training program. You would create robots, that get lost if the reality does not fit their training experiences.

The best part of training should be honing the decision making process, because that is what keeps people alive.

Sure there have been cases where a GA after TD would have had a better outcome, as there are instances that aborting the T/O after V1 would have had saved lives. Easy in hindsight, reading the accident report.
But for me a touchdown is selecting reverse, no idea how one could train initiation a GA after TD without stomping this basic rule.
Training those one off scenarios would introduce a new set of risks and thus lives, IF a pilot elected to use them in circumstances that did not validate them.

O yes, I did make a few long landings. Good weather, a nice headwind, good braking coefficient, long RWY. Nobody getting nervous in the office. No issue, but when I would have ended with the nose gear past the THR lights, I would have had ran into serious trouble.

And please captplaystation, do not question my knowledge of the English language, I might not be as fluent as a native speaker, but apart from the fact I master four more, I consider it more than enough to take part in this discussion. As is my 22 years experience on B747 200-300 and 400 series. As is my comprehension of one off decisions that saved the day for one, but killed others.

[Yaw String]

After a long career in aviation,I have learned that I'm not the most clever of pilots,so need to avoid situations,that may require me to display extraordinary skills.
Looking at the weather radar image for the time of the incident,it would appear that the gust front of the storm would be just about smack bang over the field.
There would have been enough clues,....ATC actual tower reports of the deteriorating conditions,aircraft weather radar imagery( often cluttered due raindrop size,but in this casemost probably,a clear red line approaching the field)..wall to wall lightning,TAFs which most definitely forecast the storm..

All this scary stuff would not have gone un-noticed by the crew..

I can only imagine,they had run out of options,with no fuel left to divert,and therefore assessed the Bergamo landing as the least of all threats!....Otherwise...why would you!

[RAT 5]

The best part of training should be honing the decision making process, because that is what keeps people alive.

Excellent. Sadly not enough operators follow that philosophy; certainly not in the trained monkey world.

But for me a touchdown is selecting reverse, no idea how one could train initiation a GA after TD without stomping this basic rule.

Just as a discussion point, landing performance is calculated without TR's. I hated the technique I observed by many F/O's, especially on shorter runways with auto brakes set, where they would remove their hands from the correct position on the Thrust Levers to holding the REV T/L's during the flare with the a/c still in the air; waiting to snap them open ASAP. IMHO this is conditioning the mind that you WILL land. Their brain is in land mode and their hands are NOT is G/A mode. There is no rush. I preferred the philosophy of - land, speed brakes up, a/c brakes working, steer, "I want to stay on the ground", select Rev Thrust. On B738 the braking remains the same after TR's are deployed.
Training does have its costs and limitations, including time available and effectiveness; I agree. However, these type of events do happen perhaps more than we think. Training might imply repetition, while a one-off experience can be of enough value to remain with you. I know that my first low level GA in CAVOK in the a/c stayed with me for my whole career.

What I used to do, when I had the freedom to decide as a trainer, was to design scenarios to experience elements of recent accidents. i.e. learn from others mistakes/misfortune and avoid the accident. Isn't that a basis of eduction? I wonder how many airlines introduced double flameout ditching in their recurrency program after Sully; compared to how many had done so before? The same after the BA 777 flameout at LHR? Is that realistic training? Yes they did happen, but how many times in the last 30 years worldwide? You can't do everything, indeed, but you can be as realistically effective as possible in developing relevant skills. Some of these one-off bizarre scenarios are fun; very challenging, but would the time have been better spent improving skills in more likely and useful areas?
All engine GA's from various positions in a Circling. It has been said that normal all engine GA's are the most common mess-ups, and they are simple. Imagine in real life if the same manoeuvre was messed up during tight circling. There are many others we can think of, I'm sure.
I'm sure there will be a wide spectrum of opinions on the philosophy; no right or wrong.

[safetypee]

The importance of decision making, #49, #51; I agree.
However, decision making depends on good information. Airbus has been very proactive in generating new, more realistic landing performance; has Boeing done this yet (AC25.32 para 11)?
European operations (EASA) plan to used improved runway braking assessment and reporting; has this been implemented (also in AC 25.32 as guidance for US operations)?

Also sound decision making depends on judgement; not "can we land in these conditions" (book figures), "should we be landing, what if the runway conditions are worse than reported, what then is the distance safety margin and the last acceptable point of touchdown".

[The Ancient Geek]

There seems to be a feeling among the sky gods that a go around is a sign of failure rather than the preferred safety move.
If it doesnt feel right get the hell out of there and try again - simple.

[Fair_Weather_Flyer]

Thing is though, if there was a thunderstorm at the end of the runway, would you want to go around? It becomes a land or die trying scenario.

I suspect that the reason for this accident will lie in the decision to attempt the approach in the first place. Racing the storm as they say. Remember American Airlines, at Little Rock?

[VJW]

If there is no missed approach available there should be no approach :)

[Doors to Automatic]

Thing is though, if there was a thunderstorm at the end of the runway, would you want to go around? It becomes a land or die trying scenario

Call me a naive non-pilot but shouldn't it be a don't go there in the first place scenario?

[His dudeness]

The decision was a no-brainer but even so, the temptation for me to continue with the landing and to try and resolve it in the flare was ENORMOUS. Can't quite state that enough.

My PPL instructor drove this point home on almost every flight we did together:

"the decision to G/A is way harder than to continue the landing"

He would try to distract me in the flare or he would land the airplane halfway down the runway and then ask me "go or stay". Got my attention and although I had to G/A only maybe 5 times in the 26 years since my PPL I always thought that to be one of the most fundamental lessons I ever learned.

[justcruizin]

Call me a naive non-pilot but shouldn't it be a don't go there in the first place scenario?

Having already made a (seemingly wrong) decision to continue an approach into the mouth of a CB (sometimes painted inaccurately btw, by your weather radar) we now need another plan B. A thunderstorm could kill us but in all probably won't (but might severely damage the aeroplane). Compare that to an overrun at very high speed and it has very dire consequences. I'm no stranger to landing in Bergamo. The summer storms there can be aggressive in the extreme and when mixed with high terrain nearby are certainly not for the squeamish when they get going. An early decision to divert is "hindsight correct" but armchair philosophy after the event. No one will ever know the exact mindset of the PIC who decided to continue with a landing in such conditions - notwithstanding what they might recall for an ASR. Hopefully though, we'll all learn from it. Thank God it won't be for us to decipher the last seconds from the CVR.

[Derfred]

Rat5
I would disagree on training that. The most likely cause would be a long landing, but that would be the first mistake then. Landing long and THEN deciding to GA would be two mistakes in a row.
It gets into the field of aborting after V1, even on a long RWY.

"Landing long and THEN deciding NOT to GA would be two mistakes in a row."

There, fixed that for you.

I hated the technique I observed by many F/O's, especially on shorter runways with auto brakes set, where they would remove their hands from the correct position on the Thrust Levers to holding the REV T/L's during the flare with the a/c still in the air; waiting to snap them open ASAP. IMHO this is conditioning the mind that you WILL land. Their brain is in land mode and their hands are NOT is G/A mode. There is no rush. I preferred the philosophy of - land, speed brakes up, a/c brakes working, steer, "I want to stay on the ground", select Rev Thrust.

^^^ This.

[david1300]

Video of the removal operations - well,some of it:
1mJ6qt1hg-M

dmqVxcf8sAc

[david1300]

And all wrapped up for special delivery by DHL, no doubt
gZ2F_wBV3k4

[Alex Whittingham]

Regarding wet runways, there is an FAA SAFO number 15009 (https://www.nbaa.org/ops/safety/SAFO15009.pdf) from the end of last year arising from several overrun incidents in rain. It says that: "The data indicates that applying a 15% safety margin to wet runway time-of-arrival advisory data .... may be inadequate in certain wet runway conditions...The root cause of the wet runway stopping performance shortfall is not fully understood at this time; however issues that appear to be contributors are runway conditions such as texture (polished or rubber contaminated surfaces), drainage, puddling in wheel tracks and active precipitation. Analysis of this data indicates that 30 to 40 percent of additional stopping distance may be required in certain cases where the runway is very wet, but not flooded."

[Reverserbucket]

"Landing long and THEN deciding NOT to GA would be two mistakes in a row."
Or could equally lead to catastrophe under different circumstances.

[RAT 5]

Not quite Apples & Apples; unless we learn differently from EK.

[Reverserbucket]

In terms of attempting a two-engine go-around from a floater/long landing?Different environment yes, but a contaminated runway and variable w/v vs high temp and variable w/v are both limiting.

[Derfred]

Show me stats of runway overruns vs failed baulked landing manoeuvres. EK521 may be one, but we don't know that yet.

If you don't have enough runway remaining to go-around after touchdown, you sure as hell don't have enough runway to stop.

[Reverserbucket]

Quite, Derfred, I agree. Just observing that a go-around from a long landing (i.e. in principal, making the right decision) could result in a similar outcome - as you suggest, little evidence supports that however. And yes, we don't know about 521 - I'll delete my comment, although I was inferring a late go-around following floating beyond the FDM's; if the SOP's state touchdown within the blocks, it's a G/A regardless of LDA.

[captplaystation]

An Italian colleague has told me that a go-around from the touchdown was attempted but that the spoilers didn't retract automatically (as they should do with application of thrust ) nor were they retracted manually. Capt apparently has serious back injuries. All 3rd hand, but it is what I was told.

[Double Back]

Sucks, that is a bad one.

I failed to manually pop out the SBs after TD a few times in a sim session when I was PNF and the instructor failed the auto pop up.
A nasty one especially if the PF had difficulty to stay on the centreline due to N-1 and or Xwind and You as PNF needed monitoring/assisting the PF.
In this incident most likely the adverse WX conditions like tail/crosswind added a load to the PNF's workload, so that he missed the SBs.

BTW, another one I tended to do was after a GA to keep holding the throttles during a GA, after the initial push. I just wanted to feel the ATS take over and feel the throttles "firewall".
Not all the instructors would mark that as a S- however, some didn't really care. Others followed the book and made a negative remark about it.
Personally I did not like it at all to release them.
It stems from my other flying in GA aircraft which I kept on doing (about 5.500 hrs) besides my airline career.
Most of the Cessnas and the likes had a bad habit of throttles creeping back if the "friction nut" wasn't tightened enough.
I taught my students never to release it, even while a C172 has a dangerous pitch UP effect when adding full power with full flaps (in trimmed condition), let's say after a simulated force landing.
It needs quite some pitch down input, but that diminishes quickly after the flaps are retracted in stages.

There is now some discussion about this matter in the Emirates Gear collapse thread. When it will be established that the throttles did not or were not advanced (sufficiently), we might have to review worldwide how to handle the throttles during a GA.

After having seen the pics and videos from the path the 737 followed during its overrun, I was wondering there was initially no report about the condition of the crew. There must have been some serious vertical loads on their spine.
I hope all the best for the capt, more and more I think it is one of those crashes where I was glad not to have been there at that moment.
I ended after a scratch free career, I do contribute this however also to a load of luck, even the best crew cannot fight bad luck.


Richard

[Yaw String]

Double Back,
I understand, the Captain has some serious spinal injuries...Not certain about his colleague..

[timmcat]

Paxed into BGY late that afternoon. Although no suggestion of bad weather then the thunderstorms I saw a few hours later from the mountains surrounding were intense, spectacular and continued all night. Amazed any traffic was moving through any of Milan's airports.

[FullWings]

I’ve had recurrent training for baulked landings for some time. The thing that strikes me is that once you’ve made the (admittedly difficult) decision to throw it away close to or after touchdown, there is then no real rush.

As you are near to or at flying speed, there isn’t much acceleration required before you can get back into the air. The aircraft generally has performance in hand as you’re below MLW and as long as you rotate before you get into the reds it should work out. OK, if you’re touching down 2,500m into a 3,000m runway, then you need to be a bit snappier but if you haven’t chucked it away long before that point then you’ve got it coming, I’m afraid.

[RAT 5]

As you are near to or at flying speed, there isn’t much acceleration required before you can get back into the air.

On a B737 Vref landing = V2 GA flap. If the decision is made PDQ then the distance required to get airborne again is minimal. One would hope that the curly hairs on the back of the safety sensor have been twitching since 200'. Will we, won't we?? Then in the flare there should be lots of "Oops" and a OMG this is not good. Even after the wheels touch your mind could be halfway towards a GA and so it's not a suddens surprise, if you have been forewarned and if you have experienced, even just once in the sim, this decision making process and executed it.
What is required is some imaginative thinking to create this scenario in the sim. You don't want to allow the crew to enter the braking phase for more than 1 sec. It's similar to the decision at (just before) V1 and the delay to act with a Stop; in this case a Go. I'm sure that once experienced never forgotten.
It's like I drummed into my cadets: a takeoff is a stop until V1; an approach is a GA until TR's are selected. Hence my dislike of flaring with hands on TR's.

[FullWings]

The sim details I’ve done have been pre-briefed and more for getting people happy with the mechanics of a baulked landing and the lack of need for panic as opposed to throwing an unexpected scenario in there. I think it would be hard to manufacture something that wouldn’t get a competent crew to go-around before the event, or if the timing was out, lead to a “accident” in the sim, which is of dubious training value.

Overall, I think it’s better to get pilots familiar with a rejected landing so it holds no fear. Then it becomes just another tool in the box to be used when necessary.

[RAT 5]

The sim details I’ve done have been pre-briefed and more for getting people happy with the mechanics of a baulked landing and the lack of need for panic as opposed to throwing an unexpected scenario in there.

Fullwings: totally agree. It is pure training exercise and not done under surprise. It should be an eye-opener to show that is no stigma with it and how possible it is.

[Double Back]

RAT5
Indeed, the creeping hands towards the Rev levers during the flare (when the throttles were closed but no TD yet) was something a few people developed and it was sometimes difficult to retrain that "reflex". Totally agree that was unacceptable.
(me wonders how navy carrier pilots cope with the reflex tot slam the throttle(s) wide open upon touchdown when NOT making a carrier landing...)
OK, we are drifting away from the thread...

[RAT 5]

I just saw an Air Crash Investigation of B737 Garuda flight 200. It landed very fast at F5 and bounced twice and then tried to bury the nose gear. It was a sequence of errors, culminating the F/O PM calling GA x2 before touchdown and captain ignored the calls. It would appear there was still time for the F/O to have taken control, or the captain, and make a GA off the 1st bounce.

[DaveReidUK]

I’m reliably informed that you could indeed use reverse in the air on the HS121 in normal operations, which combined with the other drag devices made it fall out of the sky like a stone. The actual rates of descent have probably been exaggerated in telling over the years but I think they were substantial. I suppose the passengers got used to simulated re-entry manoeuvres when commuting on the Edinburgh shuttle...

To save repetition, there's a discussion on the use of Trident reverse in the flare, notably at EDI, towards the end of this thread:

http://www.pprune.org/aviation-history-nostalgia/577143-bea-trident-london-moscow-1971-a.html

[His dudeness]

Anybody in the airlineworld heard of RAAS ? If 'my' RAAS tells me 3000ft (remaining runway) and I´m still not really landed, let alone decelerating, I know what to do.

https://aerospace.honeywell.com/en/products/safety-and-connectivity/runway-awareness-and-advisory-system

Fitted to all airliners and crews trained, problem solved (mostly)

[FullWings]

RAAS is good, in fact excellent. Unfortunately, basic human factors tells us that the hearing sense is the first to suffer exclusion in times of high workload and/or stress.

IMHO RAAS probably isn’t strident enough to attract the attention of someone completely fixated on landing the aeroplane (which is probably a major causal factor in overruns) and “xxxx remaining” needs a bit of mental processing before the import is known, although it might work for the PM. In contrast, there’s a “whoop whoop” on the GPWS and it virtually shouts to get attention, windshear comes up big and red on the instruments and fire warnings are unmistakeable both audibly and visually.

Maybe we need a flashing runway overrun light in the windscreen or a buzzer in the seat or something...

[His dudeness]

Well, first of all the crew could commit to a certain amount of runway remaining after which there needs to be a G/A if not landed and secondly this "gate" could be easily programmable and given out with a synthetic command "G/A".

This would be no issue at all with todays computers. Even as a standalone machine if the avionic suite of older models wouldn´t be able to accommodate the required mods.

But then of course, this was a freighter and with no fatalities in "sufficient quantities" we can´t expect authorities to act. They rather let us fill in risk assessments, which for Bergamo surely finds nothing out of the ordinary....

[safetypee]

His dude, Full Wings, et al,
We, individually and the industry, tend to focus on 'last chance' defences; primarily because we are close to these operational scenarios, but also because of human - hindsight bias.
Greater safety benefits could be identified by working backwards along the timeline to consider other contributing factors and safety opportunities.

Overruns rarely have origins in a single factor; the much flaunted 'unstable approach' does not cause and accident, nor the failure to decide to go around; e.g. contributors; unstable approaches, tailwind (long landing), braking action, situation surprise, performance knowledge.

Many of these factors can be identified in advance - in the pre landing briefing, where weak or lacking information can be considered (braking action, wind speed), or safety boundaries tightened (last point of touchdown - first third on a long runway reduced to less than 1500ft on a short runway).

The objective is to reduce the burden of tactical decision-making in situations which could limit human performance, to the periods of strategic decision-making, before commencing the approach; briefing, thinking ahead, (weather CBs in the area, wet/ flooded runway, change of wind direction). Thus the decision-making process becomes 'should I be starting the approach', and for a continuing approach with the continuous comparison of the perceived situation with that in the plan (briefing).

"A briefing is a flight-plan for the mind"

His dude #81, freighters, fatalities, failure to act; regrettably I agree.
Again the industry needs to consider alternative views of safety - reducing the risk of harm in future operations. Every overrun has the potential for fatalities, many non fatal hull loss overrun accidents have been very close to a catastrophic outcome, e.g. A340 Toronto, 777 SFO, 777 DUB, 737 Jamaica.
Airbus provides a refreshing, alternative view, of safety statistics. (http://www.airbus.com/company/aircraft-manufacture/quality-and-safety-first/?eID=maglisting_push&tx_maglisting_pi1%5BdocID%5D=108528)
We need to change the way in which we think about safety, using statistics, training, operational guidance, and risk assessment.

[FullWings]

Overruns rarely have origins in a single factor; the much flaunted 'unstable approach' does not cause and accident, nor the failure to decide to go around; e.g. contributors; unstable approaches, tailwind (long landing), braking action, situation surprise, performance knowledge.

Many of these factors can be identified in advance - in the pre landing briefing, where weak or lacking information can be considered (braking action, wind speed), or safety boundaries tightened (last point of touchdown - first third on a long runway reduced to less than 1500ft on a short runway).
I very much agree with all that. The question is, with all these factors known, briefings done, etc. why do people still find it hard to throw it away when required?

It might be something to with briefing and mental rehearsal: they are really useful techniques and I use them all the time in professional and sporting aviation but they are incomplete insofar as the physical and mental environment is hard to emulate internally. What seems perfectly clear at briefing time can be confusing when it comes to actual execution. Which is another good reason for sim practice, of course.

We, individually and the industry, tend to focus on 'last chance' defences; primarily because we are close to these operational scenarios, but also because of human - hindsight bias.
True but normal operation in the commercial world is often not far from those last chance defences. It’s a credit to the vast majority of airline crews that they trigger those defences so rarely. The overall envelope is large but we generally hang out in a small bit near the edge where it’s more efficient. In the perfect world you’d have lots of contingency fuel, only use really long, dry into-wind runways, fly well below limiting weights and only during the daytime at that!

[safetypee]

FullWings, :ok:
'It’s a credit to the vast majority of airline crews ... etc, Oh so, so true.
However, if we expect pilots to work closer to the edge then the industry should consider making the edge conditions more visible, but in dynamic, high risk operations the edge is rarely stable even if visible. Thus everyone has to embrace the uncertainty of operations, minimise the risks, reduce the unknowns, buffer the safety margins (e.g. Airbus landing perf FOLD); a new way of thinking about safety.

Lemay - Review of Weick and Sutcliffe (2001) Managing the Unexpected | Raymond Lemay - Academia.edu (http://www.academia.edu/14179148/Lemay_-_Review_of_Weick_and_Sutcliffe_2001_Managing_the_Unexpected)

Or

http://www.mindtherisk.com/literature/42-managing-the-unexpected-assuring-high-performance-in-an-age-of-complexity-by-karl-e-weick-and-kathleen-m-sutcliffe-2001

[RAT 5]

RAAS: Maybe we need a flashing runway overrun light in the windscreen or a buzzer in the seat or something...

Hairs on the back of my neck have worked fine for a whole career, and still do in my paraglider flying; also in my car, and certainly when contemplating disagreeing with my wife.

[captplaystation]

"and certainly when contemplating disagreeing with my wife."


No-one has invented a warning system robust enough to provide effective protection for that scenario . . . . .


However, in most other cases, the old "hairs on the back of the neck" work just fine, but, I guess we are all prone to becoming goal fixated (the "goal " normally being to arrive . . . I.E. land at destination )

In these circumstances, a competent trustworthy colleague, who may be marginally less goal orientated , and, being younger hopefully has less "inhibitions" against speaking up, can be worth his weight in gold, but, he has to have the experience to realise too that it is all going South, and the industry "norm" is to increasingly fill the vacant seat on the right with low experience guys . . . . .

[Double Back]

You cannot solve all problems in aviation with yet another electronic device. There is just too much variables.
And if its starts generating false or superfluous warnings, it won't take long before nobody reacts anymore. See how long it took before "terrain, terrain, pull up". was accepted and people acted accordingly. Sadly, a few times it was the last audible part on the CVR...

One time we were saddled up with a (probably expensive) gadget in the DC10, a landing prediction display where more or less the touchdown was "predicted". I have seldom witnessed such a useless thinghy.

After a few Years a fresh technical pilot had them all yanked out.

[His dudeness]

And if its starts generating false or superfluous warnings, it won't take long before nobody reacts anymore.

We have it now for about 4 or 5 years and never had a false warning. Some airfields are not in the DB yet, but those are very few...Bergamo is in the DB, as I fly there regurlary I can tell you that....

How many have you had ?

Not saying every problem can be cured - BUT it gives you a clue in very rapidly developing scenario, in which humans "often" do have an issue.

Can it overcome the "desire to land" instead of "boltering" into a TS ? Not in every case, but provide with a FACT (e.g."3000ft remaining, Speed 130 KIAS, insufficient") might influence the decision making in a good way, I think.

I have not 'required' the input yet - luckily - and the type I fly lives on short fields.

Still I like having it. Would I fly a runway eatin' machine, I´d like it even more...

[Double Back]

Hd, nope, never had the opportunity to see the system in operation. I'm out of airline business for close to 10 Years. And flew mostly long haul with heavy jets on long RWY's. 2500m was a shorty for us.

If You feel it enhances Yr operation, fine and it is an addition.

I just wanted to state that not all decisions can be made by a computer, especially when ground comes into play.
As far as I know, complex military drones are fully controlled during flight, by far away operators, but shortly after landing a local controller takes it over manually.
Just too many things that can go wrong on the ground, as we all know.

That's why I am not charmed with the experiments with self driving cars in the current road structure. Even more than in aviation, weird situations can develop that go past the programming of the "auto"pilot. It recently cost the life of a driver that trusted the system too much.