NTSB says Delta Pilot Error

[AmericanFlyer]

NTSB blames pilot error for Delta plane that skidded off snowy LaGuardia Airport runway | abc7ny.com (http://abc7ny.com/news/ntsb-blames-pilot-error-for-jet-that-skidded-off-snowy-lga-runway/1509556/)

[Capn Bloggs]

Passengers were told to exit over the broken right wing because the door out the back was too close to the water.
I could have sworn the pointy bit was at the front.

NTSB Summary: http://www.ntsb.gov/news/press-releases/Pages/pr20160913b.aspx

Synopsis: http://www.ntsb.gov/news/events/Documents/2016_laguardia_BMG_Abstract.pdf

How can two crews report "good" braking, then this?

[Jet Jockey A4]

I'd like to know what type of aircraft reported the "good braking".

Also looking at that short video, it seems there is a lot of snow on the ground.

[Never Fretter]

There is a well illustrated summary here: Delta MD-88 Accident at La Guardia 5 March 2015 - Aerossurance (http://aerossurance.com/safety-management/runway-excursion-evacuation/)

ALPA are furious with the probable cause only mentioning the Captain

Pax snap of runway
http://aerossurance.com/wp-content/uploads/2016/09/md88-pax-photo.jpg

Nose over the berm
http://aerossurance.com/wp-content/uploads/2016/09/md88-n909dl-fdny.jpg

[RAT 5]

The application of excessive reverse thrust during a landing at LaGuardia Airport, New York, March, 5, 2015, led to a loss of directional control and the passenger jet’s departure from the snow covered runway, according to findings of the National Transportation Safety Board

There is another topic on Prune where it is mentioned that in 1 EU major airline, of which a good mate of mine is a captain and has, as yet, had no problems with their SOP, where PM selects Reverse Thrust. I wonder what the debate would be in the event of such an accident in their fleet.

[RAT 5]

Just a point of information. At my employer, PF does NOT operate reversers! That is a job for PM. That simple fact allows me to pre-brief that PF does not remove their hand from the thrust levers unless they are happy we can stop, AND PM does not select reverse unless they are also happy we can safely stop. Either pilot can call go-around. We both have a very immediate investment, and clear responsibility, in the landing! ONLY when reverse is selected, are we committed to completing the landing! Not before.

Quote from the B777 Emirates crash topic.

[Check Airman]

Just a point of information. At my employer, PF does NOT operate reversers! That is a job for PM. That simple fact allows me to pre-brief that PF does not remove their hand from the thrust levers unless they are happy we can stop, AND PM does not select reverse unless they are also happy we can safely stop. Either pilot can call go-around. We both have a very immediate investment, and clear responsibility, in the landing! ONLY when reverse is selected, are we committed to completing the landing! Not before.

That certainly brings CRM to the next level.

[vapilot2004]

PF does not operate the thrust levers? That is astonishing.

[Airbubba]

Just a point of information. At my employer, PF does NOT operate reversers! That is a job for PM.

PF does not operate the thrust levers? That is astonishing.

Reminds me of that wacko 'monitored approach' some carriers were using a while back for low viz operations. One pilot would fly the plane to minimums and then hand over control to the other pilot to do the landing. :eek:

Sounds like an urban legend but I think it was actually an operational fad at one time, kinda like not using reverse to save the engines. Steel brakes versus carbon brakes or something like that. I realize that you still can't use above idle reverse with some noise curfews.

American Airlines was famous in years past for doing things their own way. At one time their boarding doors were on the other side of the aircraft and they still used QFE long after it was abandoned by other U.S. carriers. I'm told that the PM still guards the throttles after V1 on takeoff because of an engine rollback years ago. Or is someone pulling my leg on this one? :confused:

Anyway, at Delta I'm guessing that the pilot flying handles the throttles and reversers on landing. And going off the end at LGA is unfortunately a time-honored tradition, seems like USAir did it twice on takeoff three years apart.

This widely-circulated item from the 1990's is probably parody but after reading some recent flight ops bulletins, I'm not so sure:

*** British Airways Flight Operations Department Notice ***

There appears to be some confusion over the new pilot role titles. This notice will hopefully clear up any misunderstandings.

The titles P1, P2 and Co-Pilot will now cease to have any meaning, within the BA operations manuals. They are to be replaced by Handling Pilot, Non-handling Pilot, Handling Landing Pilot, Non-Handling Landing Pilot, Handling Non-Landing Pilot, and Non Handling Non-Landing Pilot.

The Landing Pilot, is initially the Handling Pilot and will handle the take-off and landing except in role reversal when he is the Non-Handling Pilot for taxi until the Handling Non-Landing Pilot, hands the Handling to the Landing Pilot at eighty knots.

The Non-Landing (Non-Handling, since the Landing Pilot is Handling) Pilot reads the checklist to the Handling Pilot until after the Before Descent Checklist completion, when the Handling Landing Pilot hands the handling to the Non-Handling Non-Landing Pilot who then becomes the Handling Non-Landing Pilot.

The Landing Pilot is the Non-Handling Pilot until the "decision altitude" call, when the Handling Non-Landing Pilot hands the handling to the Non-Handling Landing Pilot, unless the latter calls "go-around", in which case the Handling Non-Landing Pilot, continues Handling and the Non-Handling Landing Pilot continues non-handling until the next call of "land" or "go-around", as appropriate.

In view of the recent confusion over these rules, it was deemed necessary to restate them clearly.

[Capn Bloggs]

Originally Posted by RAT 5 View Post
Just a point of information. At my employer, PF does NOT operate reversers! That is a job for PM.
For clarification, Rat5's employer did not have such a policy. The statement came from Pruner 4468.

[peekay4]

Reminds me of that wacko 'monitored approach' some carriers were using a while back for low viz operations. One pilot would fly the plane to minimums and then hand over control to the other pilot to do the landing.

Sounds like an urban legend but I think it was actually an operational fad at one time, kinda like not using reverse to save the engines.
That's still SOP for many carriers, I believe (in Europe, and U.S. regionals). Monitored approaches isn't inherently good/bad; there's pros and cons to everything.

[Airbubba]

For clarification, Rat5's employer did not have such a policy. The statement came from Pruner 4468.

Thanks for catching that :ok:, I've corrected the earlier post.

[ExSp33db1rd]

Waiting in Idlewild - yes, Idlewild - Customs hall one day, a Pan Am ( Ahh ! ) Captain approached my Captain and asked if "You's guys did that monitored approach stuff ?" ( BEA, the airline that was experimenting with monitored approach was the other airline that merged with BOAC to form the present British Airways

My Captain said No. Well, said the Clipper Skipper, PanAm has used the monitored approach system since day one. Really ? we replied. Yes, said the Clipper Skipper, pointing to his First Officer - I fly, he monitors.

QED.

[Vessbot]

I'm at a regional in the US and use the monitored approach for Cat II ILS. Autopilot mandatory, FO acts as PF until he calls Minimums at which point the Captain takes control and lands if he sees the runway. (I say CA and FO because the roles are not reversible for Cat II)

I didn't know how to feel about this when I first learned about it and was a bit skeptical of the last-minute monkey motion, but I see the rationale, which is that the Captain has more reaction time once going visual if he's already outside looking for the runway, than he would if transitioning from instruments to outside.

[neville_nobody]

I think a fairer outcome would be 'the Captain failed to sufficiently compensate for a poor aircraft design whilst under high cognitive work load.'

[PEI_3721]

Is this accident indicative of the US system?
The crew appeared to be under some HF pressure, a desire to land. And even with some doubt about landing performance the approach was continued. "If there is doubt, ... then there is no doubt, don't do it."

The crew had poor information about the runway condition and braking action; yet the FAA has issued endless guidance (ACs) after TALPA on how and what to report, the role (and danger) of PIREPS, and for the industry to reconsider landing performance.

Has anything changed?
Dependence on PIREPS, dependance on reverse thrust, friction measurement (not universally accepted as accurate), and the use of 'actual' landing performance - with minimum additional factors (was this Boeing or third party data?).
Assuming that the landing performance included credit for reverse, was this using max reverse or the recommended lower value to be used on a contaminated runway?

http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC_25-32_Final.pdf

http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC_91_79.pdf

P.S. neville, a good craftsman works with the tools s/he is given. Don't blame the aircraft; consider the conditions of how and where it was used

[RAT 5]

*** British Airways Flight Operations Department Notice ***

There appears to be some confusion over the new pilot role titles. This notice will hopefully clear up any misunderstandings.

The titles P1, P2 and Co-Pilot will now cease to have any meaning, within the BA operations manuals. They are to be replaced by Handling Pilot, Non-handling Pilot, Handling Landing Pilot, Non-Handling Landing Pilot, Handling Non-Landing Pilot, and Non Handling Non-Landing Pilot.

The Landing Pilot, is initially the Handling Pilot and will handle the take-off and landing except in role reversal when he is the Non-Handling Pilot for taxi until the Handling Non-Landing Pilot, hands the Handling to the Landing Pilot at eighty knots.

The Non-Landing (Non-Handling, since the Landing Pilot is Handling) Pilot reads the checklist to the Handling Pilot until after the Before Descent Checklist completion, when the Handling Landing Pilot hands the handling to the Non-Handling Non-Landing Pilot who then becomes the Handling Non-Landing Pilot.

The Landing Pilot is the Non-Handling Pilot until the "decision altitude" call, when the Handling Non-Landing Pilot hands the handling to the Non-Handling Landing Pilot, unless the latter calls "go-around", in which case the Handling Non-Landing Pilot, continues Handling and the Non-Handling Landing Pilot continues non-handling until the next call of "land" or "go-around", as appropriate.

In view of the recent confusion over these rules, it was deemed necessary to restate them clearly.

I checked; it is not April 1st. Is this for real? Please. This is straight out of a Ronnie Barker sketch or a tongue tripping soliloquy by Sir Humphrey from Yes Minister. If it is true it woud question the sanity and education of the writer, and also of the Flt Ops manager who signed off on it to be published. Please say it ain't so.

[Basil]

I've flown mil and several airlines; monitored approach, one man band etc etc.
Remember: Your last company is history; just do what the ops manual for your present company says.
The people who used to piss me off were those who'd arrive and then bitch about the existing SOP.

JDI! :ok:


p.s. *** British Airways Flight Operations Department Notice *** is :mad:

[Herod]

Both my last two companies used the monitored approach technique for all low-vis ops. The FO flew the approach/monitored the A/P, up until DH, at which point the captain, who has been looking out as well as monitoring the FO/AP combination, takes over for landing. Makes a lot of sense, since the captain has an easier job transitioning to the visual at a critical moment.

[slast]

The so-called "British Airways Flight Operations Department Notice" is a fabrication from the mid 1970s created by a BOAC pilot, who circulated it in a slightly different format as part of an unsuccessful campaign against the merger of BOAC, BEA and several other smaller carriers into British Airways. I have all the original files from that period.

Rather than "wacko", a balanced and more comprehensive description can be found on the respected Eurocontrol / ICAO / Flight Safety Foundation Skybrary site, Monitored Approach - SKYbrary Aviation Safety (http://www.skybrary.aero/index.php/Monitored_Approach).

The NTSB said in a 2000 accident report that "the monitored approach method provides for more effective monitoring by the non-flying pilot because captains are more likely to be comfortable offering corrections or challenges to first officers than the reverse situation. ............ Monitored approaches decrease the workload of the flying pilot and increase flight crew interaction, especially when experienced captains monitor and prompt first officers during the execution of approaches."

It's also likely that for example UPS 1354 pilots Capt. Cerea Beal and F/O Shanda Fanning would still be alive if they had been using this procedure. It is specifically designed to protect against many of the contributory factors in that accident, particularly having both pilots "head-up" seeking visual cues as the aircraft approaches DH. This weakness in traditional procedures was recognised in NTSB studies going back as far as 1976. There's much more about these issues on the picma.org.uk website.

However, can I suggest that since the IFR approach procedures used probably did not greatly affect this particular accident, this thread would benefit from concentrating on the issues of contaminated runways, braking action reporting, and aircraft design/handling issues that were actually involved?

[413X3]

Capt landing in low vis sounds like an insurance thing.

[eckhard]

The so-called "British Airways Flight Operations Department Notice" is a fabrication from the mid 1970s created by a BOAC pilot, who circulated it in a slightly different format as part of an unsuccessful campaign against the merger of BOAC, BEA and several other smaller carriers into British Airways. I have all the original files from that period.

The same notice was 're-issued' by some joker in the late 1990s. At that time, the 747 Classic fleet was the only remaining* BA unit that didn't routinely fly monitored approaches. (I think they did for weather worse than Cat1 *and I don't know about CCDE.) When the Classic fleet did eventually 'catch up', someone posted the notice as a tongue-in-cheek riposte.

Having flown for different airlines and experienced both approach methods, I would agree with most of the others that the monitored approach unloads the Landing Pilot and informs him/her at an earlier stage as to the likelihood of a landing or go-around. The other crew member will be locked on to the instruments and will perform a go-around if there is no clear communication or any ambiguity at minima.

As far as reverse thrust lever handling is concerned, giving control of the TRs to the PM enables the Landing Pilot to concentrate on steering and braking. The PM will monitor the Speedbrake/Spoiler and TR deployment, N1/EPR, and give the PF the amount of reverse required. He/she will also monitor autobrake disconnection and call the speeds. That list shows that the PF is relieved of quite a few duties and can look outside all of the time. The PF can also ask for 'reverse idle' or 'forward idle' if any steering difficulties arise. The same SOP is used for an RTO.

Having said all that, my understanding is that the BA A380 fleet is about to change the SOP and have the PF operate the TRs!

[sudden twang]

It was rewritten in '89 or 90 I was said jokers Co and saw him typing it.

[Check Airman]

Having flown for different airlines and experienced both approach methods, I would agree with most of the others that the monitored approach unloads the Landing Pilot and informs him/her at an earlier stage as to the likelihood of a landing or go-around. The other crew member will be locked on to the instruments and will perform a go-around if there is no clear communication or any ambiguity at minima.

As far as reverse thrust lever handling is concerned, giving control of the TRs to the PM enables the Landing Pilot to concentrate on steering and braking. The PM will monitor the Speedbrake/Spoiler and TR deployment, N1/EPR, and give the PF the amount of reverse required. He/she will also monitor autobrake disconnection and call the speeds. That list shows that the PF is relieved of quite a few duties and can look outside all of the time. The PF can also ask for 'reverse idle' or 'forward idle' if any steering difficulties arise. The same SOP is used for an RTO.

Having said all that, my understanding is that the BA A380 fleet is about to change the SOP and have the PF operate the TRs! I see the benefit of a monitored approach in dodgy weather, but I think it'd be quite a pain in the rear to do every approach that way.

As to the PM using the thrust reversers...:rolleyes:

Does the PM also control thrust on approach?

[Pontius]

I see the benefit of a monitored approach in dodgy weather, but I think it'd be quite a pain in the rear to do every approach that way.

It's not a pain in the rear at all. Hand over control just before TOD, take over control either around 1000' when visual and all is stable or at minimums (if applicable). It's really very, very easy and takes just a few minutes to get used to. I much prefer it to the 'whole sector'-type flight that you're used to. Horses, courses etc etc.

As to the PM using the thrust reversers...

Why the stupid emoticon? The procedure works very well and it does offload the PF, who can concentrate on doing other things is strong crosswinds etc. Just because the PF is no longer an all-conquering hero who single-handedly fought the bucking beast onto the runway does not mean the procedure is flawed. You brief what you want, if you want more or less you just say. It's not rocket science, it works very well and has advantages over the PF using the TRs. In fact, I'm hard pressed to think of any reason why the PF needs to handle the TRs apart from that's the way they did it on the 707 and we can't possibly use our intelligence to imagine a more effective use of resources. The Captain is no longer a one-man band who has to do everything........unless he's a control freak.

Does the PM also control thrust on approach?

No need to be facetious just because it's not the way you do things.

[startall4]

I wonder how often, if PF is selecting reverse, the reverse selection is "fumbled" because the PF "misses" the reverser levers because he is (hopefully) looking out the window.
Also on a type (like wot I fly), where reverse is available and normally used on all four engines, and, say, one reverser doesn't unlock, that certainly would be less of a distraction to the PF if the the PM is selecting reverse.
In my airline PM selects reverse.

[Capn Bloggs]

I wonder how often, if PF is selecting reverse, the reverse selection is "fumbled" because the PF "misses" the reverser levers because he is (hopefully) looking out the window.
Are you serious?

[BEagle]

However do military fighter pilots cope with 200 ft decision heights when flying single seat jets....:confused:

Perhaps because they don't have any of this headshrinker horse$hit to worry about and are fully capable of 'going visual' after an IMC approach?

[4Greens]

No such thing as pilot error. All accidents are a function of human error in numerous ways _ training, instructors, manuals, weather conditions etc etc.

[Basil]

However do military fighter pilots cope with 200 ft decision heights when flying single seat jets....:confused:

Perhaps because they don't have any of this headshrinker horse$hit to worry about and are fully capable of 'going visual' after an IMC approach?
Entirely different sort of operation however, as I said before: 'JDI!'

[Check Airman]

It's not a pain in the rear at all. Hand over control just before TOD, take over control either around 1000' when visual and all is stable or at minimums (if applicable). It's really very, very easy and takes just a few minutes to get used to. I much prefer it to the 'whole sector'-type flight that you're used to. Horses, courses etc etc.Point taken, but if the CA does the approach until all is stable, when does a new FO (or CA) on type get to learn from his mistakes? Getting burned is part of the learning process, and if you get the plane handed to you on a silver platter, so to speak, when do you learn how NOT to set up for an approach, and how to fix it when you've done it incorrectly?

No need to be facetious just because it's not the way you do things. I'm not being facetious (ok, maybe just a little), but it's a serious question. On my type, to select reverse, I slide my hand forward a bit and pull back. That requires far fewer brain cells than managing thrust in flight, particularly on a windy approach.

If managing thrust is so difficult during the rollout, it should follow that the PM should manage the thrust while in flight, so the PF can concentrate on doing other things. That seems to be the logical extension to that line of reasoning.

PS. You're absolutely right- the whole thing seems foreign to me, as I've never heard of that procedure before. From the outside, it seems like an unnecessarily complicated procedure.

[Basil]

I was FO on an aircraft following a very big merger.
We operated the monitored approach system. My captain came from a company where they did not.
C: "D'you mind if I fly my own approach?"
FO: (In warning tone) "Well, YOU'RE the Captain."
FO: (on short finals) "YOU'RE HIGH AND FAST ON A SHORT WET RUNWAY!"

Despite warning, Capt lands and bursts all maingear tyres. I thought we were going off the end.
Funny old thing; I never heard another word about it.

JFDI!

[Pontius]

Point taken, but if the CA does the approach until all is stable, when does a new FO (or CA) on type get to learn from his mistakes? Getting burned is part of the learning process, and if you get the plane handed to you on a silver platter, so to speak, when do you learn how NOT to set up for an approach, and how to fix it when you've done it incorrectly?

Normally if the captain was PF on the first sector then the FO would do the approach for the captain's landing. On the next sector (all things being equal, weather etc) the FO would be the PF and the captain would do the approach for the FO's landing. The nice thing about this procedure is you get to have a 'play' on every sector and the FO's still get to practice all the things they'd practice in a non-'monitored' approach i.e. they still get to learn from their mistakes.

If managing thrust is so difficult during the rollout

I don't think anyone is suggesting it's difficult but there may be better ways of using the two pairs of hands available, rather than just one pair doing everything. It was certainly 'different' when I first came across this procedure but it is easy to get used to very quickly and I found I had more capacity to better manage other dynamic events with the help of the guy/guyess in the other seat.

However do military fighter pilots cope with 200 ft decision heights when flying single seat jets....

Perhaps because they don't have any of this headshrinker horse$hit to worry about and are fully capable of 'going visual' after an IMC approach?

Ahh, the dinosaur arrives. Having done both I can assure you that the colleagues with whom I fly are just as capable of 'going visual' after an IMC as I was when I flew single-seat fighter jets. They have to contend with other issues that are not applicable to nimble, agile fighter aircraft and yet they seem to get it done really quite satisfactorily. The fact that you refer to effective management of crew resources as "headshrinker horse$hit" is ample indication of your luddite and old-fashioned views which have little place in modern aviation.

[Capn Bloggs]

Having said all that, my understanding is that the BA A380 fleet is about to change the SOP and have the PF operate the TRs!
Headshrinking Horse:mad:, I say!! :)

[Check Airman]

Normally if the captain was PF on the first sector then the FO would do the approach for the captain's landing. On the next sector (all things being equal, weather etc) the FO would be the PF and the captain would do the approach for the FO's landing. The nice thing about this procedure is you get to have a 'play' on every sector and the FO's still get to practice all the things they'd practice in a non-'monitored' approach i.e. they still get to learn from their mistakes.

Fair enough. On the west coast of the Atlantic, the prevailing theory is "your leg, your controls"- up to and including the next approach after you've messed up the first one. Obviously, the PM is will speak up if he's not comfortable, but it's not atypical for a CA to sit back and watch the FO mess up (within reason), and use it as a teaching moment.

[tdracer]

I wonder how often, if PF is selecting reverse, the reverse selection is "fumbled" because the PF "misses" the reverser levers because he is (hopefully) looking out the window. Are you serious? Bloggs, I know of at least two 747 runway excursions when the pilot only grabbed three T/R levers, then managed to nudge the fourth throttle forward while working the T/R levers. Both resulted in the 747 doing basically a 270 deg spin as it left the runway :eek:.
Fortunately, no serious damage or injuries resulted, although I suspect there were some soiled undergarments :uhoh:

[Capn Bloggs]

I know of at least two 747 runway excursions when the pilot only grabbed three T/R levers, then managed to nudge the fourth throttle forward while working the T/R levers. Both resulted in the 747 doing basically a 270 deg spin as it left the runway
Holy cr@p! :ouch: What does the manufacturer recommend re use of the reversers?

[tdracer]

To the best of my knowledge, Boeing does not recommend someone other than the PF working the throttles. I know that whenever I've been on the flight deck for landing during flight testing, the PF always works the throttles and T/Rs.
I was just pointing out the concept of someone else doing it isn't completely crazy...

[exeng]

All quite easy really,

The PM selects reverse as soon as main wheel touch down. The PF then continues or cancels reverse if directional control becomes an issue.

The introduction of this SOP caused a few initial problems when I was flying for Big Airways, (like nobody selected reverse at all !!!) but then everybody settled down to it.

Observing from the car park adjacent to 26L at LGW it was always the Big Airways planes that had reverse selected before the 'others'.

Leaving Big I flew for two other operators who both insisted the PF pulled reverse. (one of these a large West African carrier). Handling a landing in a xwind on a wet and poorly drained runway meant I was a couple of seconds late with reverse.

[exeng]

I did not like the introduction of monitored approaches in Big. For low vis it was correct and was trained for every six months. For all ops - quite bonkers in my opinion. Good vis in howling winds and I fly the aircraft to about 500 ft where the F/O takes over to land - well it may not have the best possible outcome will it - some F/O's or Captains will do well and some won't.

[LittleMo]

I was FO on an aircraft following a very big merger.
We operated the monitored approach system. My captain came from a company where they did not.
C: "D'you mind if I fly my own approach?"
FO: (In warning tone) "Well, YOU'RE the Captain."
FO: (on short finals) "YOU'RE HIGH AND FAST ON A SHORT WET RUNWAY!"

Despite warning, Capt lands and bursts all maingear tyres. I thought we were going off the end.
Funny old thing; I never heard another word about it.

JFDI!
Maybe better and safer CRM should have been applied?
'Do you mind if I do my own approach?' - 'Well captain the RVR/wind/etc is xxx and SOP states that we should rather do a monitored'
'YOU'RE' HIGH AND FAST ON A SHORT WET RUNWAY' - ' Speed is Vref plus twenty, slope 1 dot fly down'...'Go Around'

The burst tires and almost over running the runway are as much your fault for not calling the go aroud

[RAT 5]

Good vis in howling winds and I fly the aircraft to about 500 ft where the F/O takes over to land

Monitored approaches: I knew of these, but was flying for an airline (B737 family) where they were not in use. F/O was PF single channel ILS. Procedure was for PM to search for lights <500'. At +100 nothing seen, nothing said; at "minimums" PF looked up, sawing nothing and went around. However, as PM, I had been looking out all the time and seen the whole situation. Our 2nd approach was a briefed monitored approach, like our LVO ILS, except a man land by me. It worked a treat.
Many years later, for various reasons, but primarily a safety & success aspect, the monitored approach for precision & NPA's was introduced; but with bad weather parameters. i.e. only when necessary due weather. In that case PF would use AP. It was very relaxed, more so than the previous PF all the way to landing in limiting weather technique. The head-down to head up close to the ground can cause some delay in 'deciding'.
Using a monitored approach for all approaches seems over kill, and especially in the scenario quoted; last minute switch for PF in strong winds. In a couple of runway excursions, in strong x-winds & gusts, one of the contributory factors in the accident report was that PF disconnected the AP too late in the approach; they were not feeling the air during the approach, and how the a/c was behaving came as a surprise too late it be in tune with the environment.
One size fits all may not be the best.

[Pontius]

Good vis in howling winds and I fly the aircraft to about 500 ft where the F/O takes over to land

I humbly suggest that if the winds were howling that much then the FO probably would not be doing the landing and this would have been discussed beforehand. If the weather is okay then the take-over would normally be around 1000', with plenty of time to get a feel for it. If the weather is at or close to limits then it will be the FO flying the approach for the captain's landing. As you say, plenty of opportunity for captains to cock it up but I suppose it has to be assumed, when designing these procedures, that someone is allegedly more capable and it seems reasonable to assume the captain will reach those lofty expectations.

[slast]

Re: However do military fighter pilots cope with 200 ft decision heights when flying single seat jets....

DH has an RVR associated with it: typically 200ft may be 550m or 1800ft RVR. Sure, transition from a defined cloudbase isn't much of a problem but most other conditions are, since the RVR values you're given aren't necessarily or even usually the "real" RVR that represents what you can actually see. The illustration below with different touchdown, midpoint and rollout RVRs (700/400/900m) shows why RVR readings don't tell you the actual RVR: definition "the distance over which a pilot of an aircraft on the centreline of the runway can see the runway surface markings delineating the runway or identifying its centre line." Anyone like to give an answer to the question at the bottom of the picture?

http://picma.org.uk/sites/default/files/images/rationale/transition/RVR%20fallacy.png

At DH you are required to to decide, based on what you can see, whether the aircraft trajectory - position and rate of change of position - is satisfactory to continue. The USAF Instrument Pilots School and other research organisations showed decades ago that (1) you need to assess whatever visual cues you can see for 3 seconds before you can make a judgement of where the aircraft is actually going, and (2) to tell whether its vertical path is correct you need to be able to see the touchdown zone.

So when it really matters, with minimum legal RVR, you have no chance of seeing touchdown zone lights at DH. Even if the atmosphere has a uniform 1800ft RVR, when your wheels are at 200ft, your eyes are going to be at least 4000 ft from the touchdown point so you can only see a few approach lights. 3 seconds earlier, when you really need to start the assessment you'll see even less.

So even if you are right on the glideslope at DH, if your vertical trajectory isn't also 100% right, you won't be able to detect it until you get a lot lower - by which time it may be too late to correct it. Illustrated below.
http://picma.org.uk/sites/default/files/Angle_vertical%20increased_1.jpg

This is the major cause of poor visibility accidents recognised decades ago and was one of the driving factors behind the development of autoland systems.

[Capn Bloggs]

The PM selects reverse as soon as main wheel touch down.
Real smart when the PF decided to Go Round ala EK521.

[slast]

Since this thread seems to be drifting anyway.....
There's often muddled thinking about lots of issues regarding "monitored approaches". I use the term Skybrary term "PicMA", partly because just "monitored approach" can be taken to imply that the "traditional" PF/PM flying doesn't include monitoring, which obviously it does.

The case for using PicMA for all routine IFR approaches, not just "when needed", is the same as preparing for an engine failure on every takeoff - you just can't tell in advance when it will be needed. If you've only prepared for a nice sunny day and reality turns sour, s**t happens. Many accident reports prove this, and they ALWAYS blame the crew. UPS 1354 crew for example "expected to be visual at 1000ft aal". But if you're prepared for the worst and it turns out to be a lovely day, nothing's lost.

Similarly there are lots of accidents in "good" conditions where monitoring has broken down - the PM has recognised that the situation is unsatisfactory (e.g. high / fast ) but been unable to convince the PF, who has the higher effective authority, and got caught between the need to help the PF who believes the problem can be resolved, and his/her own judgment that in fact it won't be solved in time. Either could be correct, but the PM's view is fail-safe (safe if wrong), the PF's is fail-dangerous. In a PicMA the PM definitely has the authority to impose the safer option. See post 33 this thread! It's very easy and facile to be smug and say "should have applied better CRM, it wouldn't have happened to me". OK, congratulations, but most of us are a bit more fallible.

The smart way to look at this issue is that you want to standardise on a default operation for the worst risks (which relate to visual transition) and build in flexibility to deal with other real world factors. PicMA operations optimise the IFR approaches which are where public transport risks are highest. So a "best practice" application would start by assuming it's going to be a worst case - rubbish visibility to DH, F/O flying to DH and G/A if needed, Captain takes control when satisfied landing is safe.

The worst case won't actually occur most of the time, so the intelligent way is then to allow your crews (especially Captains) to be professionals and allow the control change at a higher altitude when appropriate. That may well apply with the "strong crosswind but good visibility scenario. For example the following would cover the "good vis but howling gusty crosswind scenario: "At the Captain's discretion, he/she may resume control above DH/MDA provided
a) the aircraft is established on final approach in stable landing configuration,
b) the probability of a go-around due to inadequate visual reference is nil (e.g. touchdown point is visible), and
c) the probability of a go-around due to other factors is low (e.g. runway clear etc).

Another muddled issue is "F/Os won't get experience/ role reversal" etc. There's absolutely no logical reason why using PicMA as your standard everyday procedure should inhibit this in any way. The distribution of T/Os and landings etc. can be identical to that using traditional PM/PF flying. Many traditional operators write the PF duties under the title "Captain" and the PM duties under "First Officer" or "co-pilot", and no-one says that means F/Os can't do takeoffs and landings there. What certainly does happen in PicMA based operation is that if you have Captains who don't give legs away, their F/Os may not get landings but they do get pretty good at shooting approaches because they get to do a lot of them!

[RAT 5]

So there you are on a CAVOK day drifting down into quiet skies for a downwind visual join CDA to a spool up at 1000' in the slot intercepting finals. Lovely & Rewarding. You've been thinking ahead and planning what to do after VNAV has placed you where you want to be at 10,000 even as low as 5000'. Perhaps you wanted to hand fly from 10,000. In the case where the other chappie is going to takeover and kiss the ground where is the point of handover? Surely it should then be TOD. IT also makes for an interesting brief. The GA could be made by either pilot, but executed by only 1. Who briefs it?
Monitored approaches on dodgy days could be better & appropriate; depends on the dogdiness. Monitored approaches on clear days does seem open to discussion. I can well understand some will that it allows for early correction of hot/high approaches as the other chap is not going to out the a/c where you want it to make your greaser on the white patches; shades of B737 off the end in india, and TSL, & glide medium fall landing in Sweden come to mind where PM (F/O) was not assertive enough to stop the prang & near prang, all occurring in good weather.
I suspect there will remain 2 camps; reason being only the minority will have sampled both options.

[Pontius]

In the case where the other chappie is going to takeover and kiss the ground where is the point of handover?

If the weather is okay then the take-over would normally be around 1000', with plenty of time to get a feel for it.

I suspect there will remain 2 camps; reason being only the minority will have sampled both options.

I'm now doing a job where, as PF, I fly the whole thing and I handle the TRs. I still much prefer the system alluded to above i.e. 'monitored approach' on every sector and PM wiggles the TRs.

[Max Angle]

Well the thread seems to have well and truly drifted SO, as someone who moved to Big A some years ago from an airline that operated "conventionally" I agree with Exeng, monitored approach for all ops is bonkers as is PM doing the reverse.

[Jet Jockey A4]

... And IMHO if you fly an aircraft with a HUD, or HUD/EVS this should negate the use of monitored approaches.

But now we are so far off thread...

[safetypee]

Although the thread title cites 'Pilot Error', the NTSB did not state that, neither as a conclusion or probable cause.
However, their discussion did identify several decisions that, with hindsight were less than optimal. Several contributing factors were considered, but most aspects focused on the evolving event and reactive safety solutions.

Is it standard for US operators to use calculated landing distances up to the limiting value. And then being dependent on the accuracy of the reported runway condition, touchdown position and speed, and the availability of reverse. Also would this consider if the landing data provided sufficient margins, crew additives, or even if it considerd the lower EPR thrust reverse.
Many (non US) operators are believed to consider the next lower runway condition and the use of manual brake which provides 'a bit more' than autobrake; this may alleviate some of the PIREP bias and a changed, or inadequately reported runway condition.
The crew having identified an unexpected runway state and knowing that performance was inadequate, continued the landing. The lack of GA puts this accident in the HF area.

Yet the NTSB recommendations consider more/enhanced piloting actions on the runway as a defence, checking, and calls (automated). But in this accident the errant high EPR was identified, called, and corrected, yet control was still lost. Will new procedures change this?

Ref requiring on-board equipment to determine real time braking action may be of limited value. The 'first aircraft' to land may still be at risk of an overrun. Furthermore if every aircraft retarding device was already in use, then what more could the crew could do in the event of an alert. Any device could only generate a reactive safety warning, still relying on pilots' predictive abilities.

Has the NTSB missed the point, or have I overlooked something.

[Aluminium shuffler]

TALPA tables were specifically created in the US to get over the subjective nature of runway assessments and to prevent these accidents, but they continue at a similar rate, the pilots taking verbally reported braking actions in violation of the explicit instructions that TALPA braking actions may only be downgraded, not upgraded, by ATC or pilot reports. The guys are simply not bothering to do the calculations. It is complacency, nothing else.

[Basil]

Maybe better and safer CRM should have been applied?
'Do you mind if I do my own approach?' - 'Well captain the RVR/wind/etc is xxx and SOP states that we should rather do a monitored'
'YOU'RE' HIGH AND FAST ON A SHORT WET RUNWAY' - ' Speed is Vref plus twenty, slope 1 dot fly down'...'Go Around'

The burst tires and almost over running the runway are as much your fault for not calling the go aroud
Ah, yes, all very well to say sitting quietly on the ground; rather different in the situation.
Suppose ol' skip doesn't go-around: should I fight him for control? Up until then, I hadn't realised that the tvat couldn't fly.

I may say that was a period during which I preferred to fly with check/training captains because I knew they would follow SOPs.
Our company was bending over backwards to accommodate some difficult and barely competent people.*

* If any of you read this, you know who you are and some of you were a dangerous PITA.

[West Coast]

TALPA tables were specifically created in the US to get over the subjective nature of runway assessments and to prevent these accidents, but they continue at a similar rate, the pilots taking verbally reported braking actions in violation of the explicit instructions that TALPA braking actions may only be downgraded, not upgraded, by ATC or pilot reports. The guys are simply not bothering to do the calculations. It is complacency, nothing else.

To be fair, TALPA doesn't start in the US till 10/1/16, a few days from now. In the aftermath of the SWA overrun at MDW, a safety alert for operators (SAFO) has asked operators to calculate landing distance when they differ from planned. While a voluntary program, my company and many others have made it mandatory to complete a SAFO assessment.

[silverstrata]

The so-called "British Airways Flight Operations Department Notice" is a fabrication from the mid 1970s created by a BOAC pilot, who circulated it in a slightly different format as part of an unsuccessful campaign against the merger of BOAC, BEA and several other smaller carriers into British Airways. I have all the original files from that period.

The 'spoof' BA handling SOP can hardly be described as a complete fabrication. Having been forced to adopt this SOP many years ago, it quite accurately describes the monitored approach procedure, albeit in a deliberately convoluted tongue-twisting fashion. And yes, the wording was indeed based upon a typical Ronnie Barker sketch.

[Basil]

Having been forced to adopt this SOP many years ago, it quite accurately describes the monitored approach procedure
Sorry, silverstrata, I have to disagree there. The spoof made a functional system look like madness.
Correctly used in appropriate circumstances, it worked very well. We used it flying an aircraft without autoland into airfields, some of which only had a VOR or NDB approach and, even on a man-land ILS, it was very useful.
Was it useful for an autoland? Probably less so.

[UK019]

Well I look at it this way: The important thing about SOPs is that everyone is doing the same thing, and unless an SOP is clearly ill-designed or unsafe (and one would hope the regulator would have something to say about that) then they usually work well – whatever they are - because they are familiar, ingrained in the airline’s culture and understood by all. As far as I can see, more accidents are caused by a failure to follow the SOPs – again, whatever they are - than by the SOPs themselves.

Some years ago, I was sent for line training on a new type with another operator which used BA SOPs. We were asked to stay on for a month or two after we’d checked out (our aircraft had yet to be delivered) so I got a good exposure. It was just fine thank you very much, and yes, PM selected reverse. Yeah, it was a bit odd at first but I soon became accustomed to it. And although SOPs are not designed for pilots' enjoyment, I did rather like the fact that you got to handle the aircraft on every sector. When I returned to my own airline we adopted our own company SOPs, and that was fine too. As long as everyone is doing the same, whatever the particular protocols and philosophy are, then you know what to expect.

[LittleMo]

Ah, yes, all very well to say sitting quietly on the ground; rather different in the situation.
Suppose ol' skip doesn't go-around: should I fight him for control? Up until then, I hadn't realised that the tvat couldn't fly.

I may say that was a period during which I preferred to fly with check/training captains because I knew they would follow SOPs.
Our company was bending over backwards to accommodate some difficult and barely competent people.*

* If any of you read this, you know who you are and some of you were a dangerous PITA.

Perhaps it is easier to say sitting on the ground but the fact remains, CRM is about your actions to manage this situation. I feel for you, it couldn't have been nice flying for a company with that kind of culture.

However, If he didn't go around on your call, maybe transmitting on TWR frequency "xxx is going around" would get some response, but if still none then, "xxx please note for the record that the captain refused to go around from this unstable approach should anything happen"

I've actually heard that radio call in real life and guess what, the guy went around. Sure you'll have a bun fight on your hands when you land but rather sort it then that land and blow tires and endanger pax.

[Alpine Flyer]

The advantage/disadvantage of thrust reverser handling by PF/PM IMHO depends on the technology employed as well.

On earlier jets there probably was some danger of overboosting the engine or exceeding some parameters, making it wise for the PM to look at the engine gauges while the PF stayed outside.

On more modern engines having devices (FADEC, EEC, etc.) limiting this danger to almost nil, the PF might be better off handling the reversers himself, thus having a little less delay when deselecting them for control problems, whatever.

As for monitored approaches, they work great although I don't see a necessity to use them in fair weather.

[slast]

The "monitored approach" aspects of this thread have little to do with the original topic. If people want to continue it I'd be happy to copy the relevant comments to a new one in the "Tech Log" forum which would be more appropriate than "Rumours and News" and leave this one for the actual subject of the NTSB report in question. But only if there are a few indications of agreement that it would meet with approval.
Steve

[Basil]

Steve, as you know very well, in certain company, when the subject of "monitored approach" is raised it's like a red rag to a bull. Aah, happy daze :E

[slast]

Basil, that's why I suggested moving it - let those who want to talk about slippery runways etc. do so in peace!;)
BTW see your PMs...

[vapilot2004]

I think this would be a very interesting discussion in Tech Log - with many of the participants potentially gaining some insight (such as myself) from it.

[AKAAB]

A320 - PF operates throttles and T/Rs. We have enough guys that are terrified of using more than idle reverse because the company says it costs money. The resultant unexpected consequence is a number of RTOs where idle thrust reverse was so ingrained that full reverse was never selected.

[Basil]

The "monitored approach" aspects of this thread have little to do with the original topic. If people want to continue it I'd be happy to copy the relevant comments to a new one in the "Tech Log" forum which would be more appropriate than "Rumours and News" and leave this one for the actual subject of the NTSB report in question. But only if there are a few indications of agreement that it would meet with approval.
Steve
I'd agree. Whether or not in favour of the 'Monitored Approach', the discussion of MA raises CRM aspects of advocacy and assertion on the flight deck which, no matter the particular SOP followed, are an important part of flight safety.
I still replay events where I should have, could have but didn't.
A separate thread in Tech would, I think, be a good move.

p.s. I know all multi-crew approaches are monitored. In this case "monitored approach" is just shorthand for a particular SOP.

[safetypee]

Back to the subject, re complacency #53.
Complacency, without elaboration does not identify any issues for improving safety or avoiding similar accidents.
Although this was a side excursion, there are many similarities with overruns, which the FAA are well aware of and hence TALPA. However, the FAA do not proposed to mandate TALPA recommendations, leaving the safety responsibility with operators and in turn with the crew.
Were previous efforts to improve landing distance calculation overruled by operators?

In comparison with Europe, US operations might appear to be complacent given the frequency of encountering similar operating conditions. EASA provides extensive advice on contaminated operations, the performance calculation (1) is one of a few sections of part 25 not copied by FAA; this AMC also has extensive operational advice and cautions (although not the best document for operational awareness).
EASA also supports the implementation of OLD - Operational Landing Distance, which is more relevant on contaminated runways than the 'actual' + factor distances favoured by Boeing.
Another significant difference is that European operators are advised to consider contaminated operations as 'non normal' requiring additional risk mitigation - larger performance margins, crew training/awareness; whereas (complacent) US operators appear to treat contamination as an everyday operation.

(1) CS 25 AMC1591

[slast]

New thread started in Tech Log: "Pilot-in-charge "monitored approach" with all the original comments added - pick up where you left off if you wish!:ok:

[PEI_3721]

The most recent FAA documents (six) on TALPA and avoiding an overrun, @
http://www.skybrary.aero/bookshelf/content/index.php?summarySearch=&categorySearch=&authorSearch=&titleSearch=&dateSort=desc