SQ286 return to AKL with tail strike damage. [Archive]

kavu

12th Mar 2003, 05:35

A Boeing 747 with nearly 400 people on board has been forced to make an emergency landing in Auckland after it caught fire.

The tail of the Singapore Airlines plane scraped the tarmac on take-off from Auckland International Airport on Wednesday afternoon.

The airline says the aircraft was forced to circle the airport and dump fuel while ground crews assessed the damage.

It then made an emergency landing.

About a dozen ambulances and fire trucks were on standby, but the airline says the plane landed safely and no one was hurt.

About 30 flights were distrupted as airport staff swept the runways clear of debris.

All those aboard were evacuated once it came to a stop, and no injuries have been reported.

(ONE News sourced from TVNZ, RNZ, Reuters and AAP)

Snowballs

12th Mar 2003, 06:45

The NZ Herald seems to have got it right which is rather refreshing considering the usual standard of avaition reporting.

It was a tail strike .... nothing more .... nothing less

The Singapore Airlines 747-400 with a damaged tail. Picture / Kenny Rodger

http://www.nzherald.co.nz/storydisplay.cfm?storyID=3200448&thesection=news&thesubsection=general

Airline denies fire caused emergency landing

12.03.2003
7.50pm
Despite eye-witness accounts of flames shooting from the back of a Singapore Airlines jet which made an emergency landing at Auckland International Airport today, the airline denies fire was involved.

The Boeing 747-400, carrying 368 passengers and 20 crew departed at 3.28pm this afternoon bound for Singapore, but apparently struck its tail on the runway on take-off.

In a statement released this afternoon, Singapore Airlines said it appeared the tail strike triggered a fire alarm in the cockpit.

However, there was "no information to suggest that the fire warning light was triggered by an actual fire", the statement said.

However, eye-witnesses interviewed by TV3 news this evening said they saw flames of up to 3m coming from the tail of the aircraft as it circled above the runway.

Singapore Airlines said the aircraft was in the air for about 20 minutes before it could land again.

The plane was then moved to a remote bay where passengers disembarked.

"No passengers or crew were injured in the incident or the landing."

The plane was under the command of an experienced crew, including a captain with 20 years' experience, the airline said.

The airline would "co-operate fully" with authorities investigating the incident.

Another aircraft was to be flown from Sydney to Auckland later tonight to operate the flight.

In a statement issued by the Transport Accident Investigation Commission, John Mockett, chief investigator of accidents, said an investigation would determine the causes and circumstances of the accident "for the purpose of preventing similar occurrences in future".

The investigation would include inspection of the aircraft and its cargo, interviews with flight and ground crews, and may take some months.

The investigator in charge, Ken Mathews, would travel to Auckland tomorrow morning.

About 20 flights out of Auckland were delayed because of the incident, which closed the runway for just over an hour.

Auckland International Airport CEO John Goulter said the runway was closed from about 4.50pm to 5.50pm to allow a full inspection to be carried out.

"We had to ensure that there was nothing on the runway, like pieces of debris, which could have posed a danger for other aircraft."

All flights had been rescheduled successfully, he said.

"It's not a big drama, it's just part of the business."

- NZPA

GAMAN

12th Mar 2003, 07:26

Well I didn't see the actual tail strike but I witnessed the aircraft from when it was downwind and the attempts to land.
The aircraft did not dump any fuel and so would have landed in the region of 100T over Max Landing weight. They did not evacuate the aircraft immediately as reported. Pax remained on board for around 25 - 30 minutes after landing and were off loaded at the layover stand by the international terminal.
The aircraft went well through the centreline on the two aborted attempts to land and was circling in the region of 500 - 700 feet AGL in my opinion.
Very scary that's for sure. I was fearing the worst for a while.

Kooka

12th Mar 2003, 07:59

I thought the orbit was at a very low altitude. Below the altitude for a normal visual circuit. No one was evacuated. The aircraft was asked to shut down to allow a tow in after the fire officers observed the damage.

the maori mobster

12th Mar 2003, 08:05

well cuz, the boy up da front will be an f/o now for sure.

i bet he was massey trained and that's why he pulled off the great landing. just don't mention the takeoff bit, aye.;)

kavu

12th Mar 2003, 08:10

GAMAN

Overweight landing are only permitted in an emergency.

An overweight landing does not present a safety hazard. The normal rate of descent is approx. 120ft/min. Aircraft are certified to 360ft/min for max structural takeoff weight and to 600ft/min ar max landing weight. It is therefore possible to perform an overweight landing with a rate of descent less than 360ft/min without risk of damage. An engineering inspection is required following any overweight landing.

(From study notes)

Cypher

12th Mar 2003, 08:37

OUCH!!

http://images.tvnz.co.nz/news/accidents_emergencies/singapore_plane_tail_plasma_120303.jpg

Skin Chimney

12th Mar 2003, 09:06

And the reporting has started!!

Channel 7 news reported, "the passengers on board witnessed flames 3 metres long coming from the tail!"

How the hell did they see that??

D.Lamination

12th Mar 2003, 10:03

Some thoughts:

That is one severe tailscrape

Possible causes (pure speculation - ouch!):

- Gross miss setting of the stab of the aircraft causing very light stick forces - unlikely becase the green band warning would come on. The B744 also has a bias in the elevator feel to account for forward Cof G.

- Gross miss loading of the aircraft - 20 to 30 tonnes heavier than the loadsheet or loaded outside of the C of G envelope (not reflected on the loadsheet).

-Gross error in entering performance data into the Flight management computer i.e. enetering a weight much lighter than the loadsheet.(see next point)

-Gross miscalculation or setting of Take off data i.e rotating 20 kts or so early- don't know if this data is uplinked to the a/c in SQ or worked out by the crew.

- Severe windshear recovery manouever - Boeing says if you encounter severe windshear on the takeoff roll (speed loss) rotate 2000' before the end of the runway scraping the tail if need be to achieve liftoff. Any clues on Auckland WX today?

- Overly rapid rotation say 4 degrees per second plus - You wouldn't think a twenty year Capt. would do that in the absence of any other factors. If VR was correct then lift off would still have been almost immediate with minimal damage - this thing looks like it has been dragged on the RWY for quite a distance.

- I f this happened in SIN you wouldn't have heard about it

I guess we'll have to wait for the NZCAA report in six months to find out what really happened.

:confused:

Capt Fathom

12th Mar 2003, 10:08

Very scary that's for sure. I was fearing the worst for a while.
It's all over now GAMAN, it's OK, you'll be fine. :rolleyes:

gaunty

12th Mar 2003, 10:54

There is a tad more than your "routine" tail scrape in this one.

Prof Reason et al where are you?

Minosavy Masta

12th Mar 2003, 11:08

Hey Dee............you forgot the most obvious one!!! Mis setting of the Take Off Flap...or perhaps not setting it at all??

Keg

12th Mar 2003, 11:38

This from the 'people in glass houses' file. ;)

Show us your LOSA results again!?!?! :E :}

D.Lamination

12th Mar 2003, 11:39

Minosavy:

Possibly, but if the flaps weren't at ten or twenty they would get a config warning as they advanced the thrust. Setting flap 10 with speeds set to flap 20 at heavy weight might just do it.:(

CT7

12th Mar 2003, 19:21

(For the Kiwi Boys)

Gee, Peter Clark must have been on board for it to return safely!

And the go-around I saw was with the 747 at 90 degrees to the runway!!! Go Figure!

Sid Departure

12th Mar 2003, 20:16

And listen to what the passengers had to say.....

" When we took off I instantly knew the plane was dragging.
I was on the side with the engine and I could hear it making
grunting noises like it was straining."

and

" There was no power, there wasn't enough thrust and I
think the pilot grounded the rear to get enough air under
the wings."

:eek: :eek: :eek: (sourse- NZ Herald)

Disco Stu

12th Mar 2003, 22:39

I eagerly await the report on this incident. I just hope it doesn't suffer the sanitising effect of the 'Singapore factor' that appeared to permeate the SQ006 at TPE report.

gaunty, Reason will need more than a kilo of cheese to demonstrate this one, my guess is he will need to buy a years production of 'your frund in the frudge'.

Disco Stu

Luke SkyToddler

13th Mar 2003, 04:42

I did watch the entire takeoff, from the vantage point of taxiway C1.

I don't think you'll find flap setting was a contributing factor, I'[m not a jet jockey but the amount of flap they had set, looked the same from the outside as any other 747.

Windshear wouldn't have had anything to do with it either, surface w/v at the time was a gentle southerly about 10 kts, not even any convection to bump things about.

In fact everything looked normal until the rotate, I thought they'd lost an engine because of the bloody great cloud of smoke that came up.

As previously pointed out, the first turn onto finals put them ridiculously through the centreline, probably a good half mile to the right at about a mile distance and stupidly high, they went around back towards Weymouth and came back for the second attempt, still right of centreline from the finals turn, high and bloody fast and obviously heavy, the wings were fully bowed upwards, and they landed just about abeam A3 with a almighty crunch of tyres. I wouldnt want to speculate on descent rates at touchdown etc, but they were definitely high crossing the threshold and it was far from the softest or sweetest landing I've ever seen.

Me thinks there'll be a couple of job vacancies at SQ this morning :(

Clearance Clarance

13th Mar 2003, 05:19

From what I have heard, Asian carriers are woefull at conducting Visual and Circling Approaches. An ILS would have been the safest approach for their return.

zulu kilo

13th Mar 2003, 05:33

(CT7) Good old Peter Clark - where will he crop up next?!!!:D :D :D

Dexter

13th Mar 2003, 05:57

the wings were fully bowed upwards :eek:
How did they do THAT??? :eek:

they were definitely high crossing the threshold
:confused: What is the crossing height of a Jumbo at the threshold Lukey?

From what I have heard, Asian carriers are woefull at conducting Visual and Circling Approaches
Thing is, a lot of NON-Asians fly for those carriers.

Their seems to be a lot of armchair experts hear who no nothing but are happy to speculat with rediculous theories.

How about it might just of been pilot error caused by too fast, or over-rotation like the scrape they had in Los Angels years back!

And who or wot is meant by peter Clark. He is a cook is'nt he?

Traffic

13th Mar 2003, 07:09

CC

===============================================
From what I have heard, Asian carriers are woefull at
conducting Visual and Circling Approaches. An ILS would
have been the safest approach for their return.
================================================

You mean woefull as in speling?

I think you will find that many Asian carriers have a highly developed skill level for circling approaches. Before making such a demeaning generalisation, may I suggest you visit Japan and watch 747's and 777s doing circling approaches at mimimums into 2,500m strips. Every second approach into these airports is a circling approach given the fact most domestic airports back into serious terrain.

Finally, I would be very interested to learn how to execute a stabilised ILS approach at 100t over MLW without re-calibrating the glideslope.

Capt Claret

13th Mar 2003, 07:52

Perhaps I'm having a vague day but I can't work out why the glide slope would have to be recalibrated to facilitate a stabilised approach, overweight landing. :confused:

Could you help me out please? :}

Dibble&Grub

13th Mar 2003, 09:06

I, like Claret, must be having a senior moment (I assume too much there I guess - sorry Claret). I cannot, for the life of me, figure out why the Glide Slope needs a recal for an overweight landing. Maybe I am just too old for this job and should go and fish or something.

Look this was a major problem that mercifully resulted in nothing more serious than a few ruined underpants (in the cockpit) and a badly damaged airplane. The investigation team has the crew and the aircraft and the recorders. All will become clear very soon. Why not wait and see ?

DG

Keg

13th Mar 2003, 09:53

I 'think' traffic may be referring to 1000' fpm as a 'stabilised approach' so yeah, a 330-350 tonne 744 would need greater than that to touchdown. However, I think most airlines have a caveat for a 'stabilised approach' that talks about speed, thrust, V/S 'appropriate' for the conditions. I'd say they'd just be accepting the rate of descent.

That said though, you'd reckon that you'd give yourself as long as possible to get it 'stable', not trying to turn final at 2-3 mile. I wasn't there but my gut suggest that we slow things down a tad and ask for at LEAST 5 miles and probably closer to 8-10!

Borneo Wild Man

13th Mar 2003, 10:32

Clearance,you've obviously"heard" crap!However I do have a couple of questions from the eye witnesses,what was his circuit height after the go-around and what distance did he turn finals?

Girt_bar

13th Mar 2003, 10:58

I reckon 1500ft and 3-4 miles. Pretty hard to tell from my position

BlueEagle

13th Mar 2003, 11:07

Keg He elected not to dump fuel, (we are told), because he had a fire warning and was,(we can assume), planning an expeditious return, so, possibly, a 'fully stabilized at 5 miles' may not have been part of his planning? We were not there.

Traffic

13th Mar 2003, 12:38

No it is me that is having the senior moment....guess what I was trying to say ( not very clearly) to CC who glibly suggested an ILS approach is that at that the higher speeds required and the urgency of the arrival, a textbook setup on the glideslope would be unlikely. My guess is that accepting the ROD you get from a very tight circuit at the speed and weight would be unlikely to give you 3 degrees unless you had practised it 10 times the day before in the sim.

The report should be interesting reading so I shall refrain from more senior moments and, in the pursuit of clarity, have some claret myself.

Capt Claret

13th Mar 2003, 13:33

I wasn't there, didn't see it, didn't have to make any of the decisions, don't know what facilities were available and in no way cast aspersions against the crew involved.

Having made the disclaimer, based only on the information in this thread, factual or not, it seems that one of the assumptions that can be made is that when in a hurry, don't.

Perhaps a wide circuit, followed by an ILS would have led to a landing on the first approach. Remember the old addage, more haste less speed

Now I just hope that when it all hits the fan for me, I remember my own assumptions! :}

Dibble&Grub, not assuming too mush at all old bean. One tries to become senior gracefully. ;)

Luke SkyToddler

13th Mar 2003, 17:58

Well Dexter I may only be a humble GA pilot but there's no need to get supercilious, I'm just reporting what I saw.

The wings were indeed noticeably bowed upwards as I imagine all 747's tend to be when they're full up. One of the air ambulance boys took a couple photos of it on short finals, I'll see if I can get him to post them perhaps.

Secondly, one would have to check the calibration of the VASIs but assuming they're set for 747 pilot eye height then they're supposed to be 47 or 48' crossing the threshold, I have spent enough time sitting about on the C1 apron to have a vague idea what that looks like from outside, and to me they were maybe 30 or 40' higher than they should have been at the threshold, they touched down maybe a couple of hundred yards past A3 which would confirm that supposition.

I don't see anything in that posting that renders me an 'armchair expert' but feel free to flame away at me if you wish :rolleyes:

Keg

13th Mar 2003, 20:40

Blueeagle, I would have thought that the extra couple of minutes to fly the extra few miles final would still have had them on the ground well before they were due to the shorter final and subsequent overshoot.

I'll back Clarrie's comments here 100%. Wasn't there and don't have all the info but when in doubt, slow down! It may actually SAVE you time in the long run!

Mr McGoo

13th Mar 2003, 21:39

Hear, hear,
I have had numerous instructors tell me that when required to land ASAP spending an extra minute to get set up on finals a little bit further out is a better percentage play than doing a tight rushed circuit and risking a go-around. This incident would surely lend weight to that line of thought.

BlueEagle

14th Mar 2003, 08:19

Yes, I would agree, take that extra two minutes if you can.

In this case we don't know what effect the fire warning had on the captain's decision making, if he actually thought he had a fire that wouldn't extinguish due the continuing red lights he may have tried to hurry things up a bit too much.

When doing the sim detail that involves engine separation the fire warning goes and won't go out even though there is no engine there!

crocodile redundee

14th Mar 2003, 08:34

I find it extremely hard to comprehend how a competent 747 400 pilot can possibly scrape the tail to that extent. There must be more to it than meets the eye.....

VH-UFO

14th Mar 2003, 09:48

Capt Claret
"it seems that one of the assumptions that can be made is that when in a hurry, don't."

BlueEagle
"because he had a fire warning".

Great in theory Capt Claret, but based on BlueEagle's comment, i would assume not.

The Concorde a few years ago is proof of that.

Capt Claret

14th Mar 2003, 16:14

I don't think the Concord(e) incident is a relevant comparison to this SQ incident.

I read a report, distributed by the Safety Dept of my employer I think, which was a real eye opener, and showed the Concord to be doomed from the start. A classic example of Reason's Swiss Cheese model.

From what I can remember the report alleged, in no particular order:
[list=1]
Aircraft planned to use one rwy with long taxi. Duty rwy changed short taxi, less fuel burn up to take off.
Change of runway meant aircraft was over RTOW BRW.
One bogie failed due maintenance error, causing directional control problems.
Aircraft rotated early to avoid leaving side of rwy and colliding with taxiing 747.
Flight Engineer shut down burning engine below accelleration altitude, without direction, thus leaving aircraft on only 2 engines.
[/list=1]

I stand by my opinion that based on the info in this thread it seems highly probable that the haste to return to the ground, quite understandable though it was assuming a fire indication, led to a go around and thus the need for another approach.

I also stand by my stated hope that when I'm in a similar situation, I have the presence of mind to not rush.

cribble

14th Mar 2003, 17:41

I'm waiting for Les Bloxham's take on this. We can't form a well balanced and informed view without hearing from Granny Herald's foremost aviation expert.. :rolleyes: :rolleyes:

Delta Whiskey

15th Mar 2003, 03:28

On the topic of passenger interviews I was tickled by quote from the young lady who spoke with authority about the event because she was "sitting on the side with the engine".

Ralph the Bong

15th Mar 2003, 10:22

Luke, the VASIS at most aerodromes gives an eye height at the threshold of around 50'. A variation on this was Rockhampton , which for a time had on on slope eye-height of 28' or thereabouts. An eye-height of 50' on a B747 means the body gear is crossing the threshold at ~4'; not good practice. For this reason, B747 crews fly 1 dot high and use an aimimg point at 450m. Using the "5 times GS" rule for rate of descent a GS of 200 knots would require 1000fpm. Clarrie, some Asians have been amongst the best stick and rudder guys I have seen.

Capt Claret

15th Mar 2003, 13:44

Ralph,

I'm a little confused. I've made no reference to any race or nationality, or their skills. :confused:

jtr

15th Mar 2003, 14:40

For this reason, B747 crews fly 1 dot high and use an aimimg point at 450m

Are you talking GS, or VASIS/PAPI

*Lancer*

16th Mar 2003, 02:23

1 Dot on the VASIs (relating to a more distant 'eye' touchdown point)

PAPI is the 'eye' approach angle so it's a normal 2/2.

The glideslope it relative to the ILS receiver antennae, which is much lower than the eyes, so it's on glideslope all the way.

Ralph the Bong

16th Mar 2003, 10:28

Sorry Capt Claret, I meant CLARENCE!! One dot high on VASIS, but on slope for PAPI. The reason being is that VASIS can provide a variable aim point with a constant glide slope. Whereas flying 3 reds or 3 whites on a PAPI changes the glide slope but gives a similar aim point. Personally, I think this is what makes VASIS the more usefull system. When gear is selected down on the B747, the GS is referenced from the antena on the nose gear, with gear up it is from the GS antena in the radome. Flying one dot high on the ILS GS will cause you to land long. Also not good practice!

Casper

16th Mar 2003, 20:06

Has anyone checked to see if the correct take-off speeds for the actual aircraft weight were used?

bonvol

16th Mar 2003, 22:41

Rumour round the traps is weight was 320T but was transposed to 230T in the box.

The_Cutest_of_Borg

17th Mar 2003, 01:34

Bonvol, you sure about that?...it is hard to see how such an error could occur unless they ignored the FMC weight presented after entering the ZFW, somehow electing to use a manual entered figure of 230T instead of 320T. Was there a fuel guage problem?

Either that or they entered a ZFW figure 90T lighter than the actual.

They would then have to use the FMC presented V speeds without question or crosscheck.

Then finally the error should have showed up with a check of the loadsheet.

That is a series of gross errors and/or non standard operation.

I am not saying this is what occurred, but if it is anything approximating the truth, the mind boggles.:eek:

bonvol

17th Mar 2003, 03:33

No, I'm not sure about anything. Just what my Singas mates have told me.

I guess the investigation will tell but in this game ones mind gets more and more boggled everyday. Nothing much surprises anymore.

BlueEagle

17th Mar 2003, 03:35

I really hope I am not proved wrong on this one but from my experience on the 744 with SIA when the load sheet arrives the captain reads out the ZFW and the TOW to the F/O who is usually doing the bug card. The bug card is then checked, the ZFW entered in the FMC and a cross check of the FMC and Loadsheet weights is done. As this would have been a two F/O flight they usually cross check each others book work also.
In ten years I certainly saw a few bug card errors but I can honestly say never gross, life threatening ones.

In addition one gets a certain'feel' for the ball-park TO speeds. If the ZFW was entered 90k below actual it would possibly be rejected by the FMC anyway? I would certainly expect the trim to be a very strange number, if in the green at all.

Just for what it is worth, the V speeds for 230K are about 25-27 kts less than for 320k and should stand out like a dogs..........

Feather #3

17th Mar 2003, 06:47

Since Casper raised the point..........

Bit of chat about this in the bar lately. Most appalled at the extent of the damage!

However, one chap pipes up that we had a potential for this when at MTOW, the guys loaded the V1 into the VR line and no-one noticed! :eek: [NB Normally V2 about 180 and VR 170. In this case V1 about 145 or so]

As PNF called Rotate , one of the S/O's shouted 'NO - too slow' and they held it till V2-10. The result would have been the same as this SIA incident, I guess.

So, there but for the grace of God go I, etc..................

We're ALL fallible!

G'day ;)

Far Canard

17th Mar 2003, 08:24

I heard the Captain had 20 years experience. I was wondering if it was 5 years as a S/O followed by 15 years as either a F/O or a Captain.

Now I figure they do about 800 hours per year, this equals 15x800=12000 Hours.

The average longhaul sector being say 8 hours gives the guy about 1500 sectors. Two pilot crew means he only flies half of them (750). The aircraft no doubt did a large number of autolands lowering his total further.

Then SQ revealed he has low 747-400 experience. I am not trying to say he was a bunny but the result was not good.

HotDog

17th Mar 2003, 09:04

Why does everybody still assume it was a pilot handling error? The facts will be revealed eventually, make your judgements then.:(

cyco

17th Mar 2003, 20:03

Not that it may have any bearing.............But.

I heard that the Captain even though he had 20 odd years experience had only recently converted to the Boeing from the AirBus with only a few hundred hours on the Boeing at the time of incident. That was one of the reasons he said that he was returning to CHC on the pax PA as the AirBus services CHC-SIN. When the **** hits the fan, you go back to what you know

From the talk of the takeoff weight, I did some checking at it was 385000kgs Brakes release weight. Makes for a pretty heavy landing doesnt it...

BlueEagle

19th Mar 2003, 10:32

This is a direct copy of a post from the reporting Points forum which may be of interest:

"Having returned from Singapore yesterday, word on the ground is that the aircraft had a large load sheet error, thus leading to the calculation of invalid takeoff data and V speeds insufficient to attain Vmu at a body angle of less than 12.5 deg.

Short of the flight crew supervising loading, you have to rely on the information provided by the Red Cap and load control."

The_Cutest_of_Borg

19th Mar 2003, 22:22

If that is correct then it goes a long way to exonerating the crew from committing a long list of errors.

As an aside, it does go to illuminate how vulnerable an aircraft commander is to the incompetence of others... so mnay of his responsibilities are delegated to people that won't bear the ultimate sanction to a gross error of this kind.

Yandros

20th Mar 2003, 06:53

I recall from a sim session a few years ago, 370t takeoff followed by uncontrollable engine fire at Vr, and an immediate return to a 600m rvr runway. An interesting exercise as what was so importantly stressed was DONT RUSH. The idea was to get back onto the ground on the first attemp, the few extra track miles also allows you to run all the checklists you need plus warning the cabin etc etc.

As I wasn't there I'm not going to comment on what the guys did or didn't do.

Should it come out that it was a load sheet stuff up then they probibly did well to get airborne as I have heard that the scrap mark diverges towards the right hand edge of the runway. :eek:

Just my 2 cents worth.

sausageman

28th Mar 2003, 10:23

Captain got load sheet.
Read out wrong figure to F/O (230t instead of 330t)
Captain was recently off airbus (used to lower weights)
Captain, F/O and third pilot in jump seat all missed this. (poor form I would hasten to say)

Result V speeds 20-30 knots slower than rqrd.

SIA fmc's don't give V speed predictions based on weight like Qf machines. They just have blank lines to be entered by crew. Thus a huge discrepancy of numbers didn't stand out.

F/O's tkoff. Basically re-created boeing's min unstick test.
Broke the fire loop in tail. Unresolved fire warning.
Hence the shenanigan's back on to terrafirma.

$$$$ ouch

Traffic

28th Mar 2003, 12:27

Straits Times reported that....

"The pilot, 49, is believed to have been with SIA for about two years but has about 20 years of flying experience. He and the first officer will continue to receive their base salary, but without any flight bonus."

So putting it all together the PIC has been at SQ for two years and has just come off the 340 onto the 744. We are also saying he is dyslexic and the other two missed the transposed figures.

Then noone noticed the low V numbers and the FMC doesn't have the idiot check installed.

They then failed to make haste slowly and missed the first approach.

Excuse my cynicism, but something doesn't quite gel.

G.Khan

28th Mar 2003, 16:26

Now I'm a bit confused. Flew the B744 for ten years with SIA.

Standard procedure when preparng the a/c: insert estimated ZFW into FMC, (taken from CFP), aircraft fuelled to required state, this would automatically give an estimatedTO weight, when the load sheet arrived verify and amend FMC as necessary, there must have been a massive discrepancy staring them in the face?
I have been away a while now but was always under the impression that the FMC did give estimated Vspeed numbers which would only blank when the de-rated (assumed) temperature was inserted?

Have heard from friends within SIA that it was indeed an error in the FMC, difficult to understand how it was missed though.:(

greybeard

28th Mar 2003, 23:10

The near tragedy of SQ286 has allowed us the privilege of learning from the unfortunate mistake of other professionals in our fragile industry.
The transposition of 2's and 3's in the culture, which surrounds us here, is not quite a daily event, but better than weekly in daily life and no less often in aviation which has so eventfully been demonstrated.
As a family we will get 2 instead of 3 or vv in shops, money amounts and floor levels just as examples.
English was NOT the first language of any of the crew involved just to add to the chances of an error.
Pressure, time constraints and the stress of the early days of a new type command all add to the scenario of 286.
Also the statistical gurus will also point to the graphs, which highlight that this crew fell into the so-called "high risk" exposure in hours of any new aircraft type.
The 3 Pilots and the rest of us will hopefully know the results of the Operational Investigation shortly and all will proceed with our lives, altered as well they may be.
Many previous and all current Pilots for SIA will watch, wait and pass judgement on the SIA decision on the fate of our unfortunate colleagues. Past events can cause us to have very firm opinions on the expectations and even the results in this matter.
SIA has, in spite of itself, has begun the process of metamorphosis in Flight Operations and in my own recent case, was seen to be fair and professional in its deliberations.
I dont exuse the past or predict the future, only call as happens to myself.
All that aside, it beholds us to be ABC ( Awfully Bloody Careful) out there and try to delay the next error in our own lives.
After all of 43 years in this Industry I still have to meet a pilot who hasn't made a mistake, even if it's to lie he never has!!!

C YA

rockarpee

29th Mar 2003, 06:24

Quite right Greybeard. It never ceases to amaze me how quick our fellow aviators are to "HANG EM HIGH".All I can say is "there by the grace of god.........".

Kaptin M

29th Mar 2003, 13:07

Yoy beat me by a whisker, Greybeard:D

The fact that none of the crew were native English speakers, but were communicating in that language is a only one factor that needs to be taken into consideration - I understand that each of the crew members on the flight deck that day were of different races.

As you have pointed out, something that seems very common in Asia, and not only Singapore, is the pronunciation (transposition) of 2 to 3, and 3 to 2.
It is an area that needs particular attention when native English speakers are dealing in these two numbers.

From my experience with SQ, I also would like to know the preceding crew patterns, the rest period in AKL (or CHC), and the reporting time in New Zealand.
New Zealand is 5 hours ahead of Singapore.
I recall one of the New Zealand trips for which I was rostered with SQ, had been preceded by an 8 day States trip, followed by 4 days "Off", and then the trip Down Under.
The circadian cycles are shot for a six - but crew scheduling apparently don`t give this consideration!

The_Cutest_of_Borg

30th Mar 2003, 05:52

Beats me why you guys are going so easy on SQ here. If this was a QF crew, the calls to lynch the offenders would be heard from all quaters of the Dunnuda forum.

Justifiably.

This is not one mistake leading to a commonly occuring error. This was at least three major errors that went unchecked. Where was the cross checking procedure? Where was the CRM? Where was the basic knowledge of the aeroplane?

Sorry, you guys can apologise for them all you want but the fact remains that these sorts of errors are what we are PAID to pick up, despite circadian disruptions and possible language problems. We do this by adherence to SOPS and crosschecking everything, particularly such vital and basic information as the aeroplanes weight.

From my knowledge of Singapore, to state that English was not the first language of the crew is a red -herring.

greybeard

30th Mar 2003, 11:06

C of B

Easy on SQ?

No not really, just making hopefully informed statements as to the on board circumstances which allowed this situation to develop to the near tragedy it was.

The language situation IS NOT A RED HERRING, in the day to day living in Asia as I and the Kaptin have said, the numbers are a major potential source of misunderstanding, not at all well understood by the locals and missed at times even by the long term Expats who have suffered by the error. See my post ref shopping.
As to who made this error and who didn't pick it up, the Flt Ops will sort that out from the data available.

Your "Profile" does not indicate your current fleet or experience, so at the risk of giving egg sucking lessons where possibly not needed,

Multi cultural, multi language and low total/type experience cockpits are quite normal operations of SIA and other Asian Airlines.
The subtle differences from other places are the traps.
Take the simple task of lowering/raising the undercarriage.
All the locals on my fleet will say "GEARS" UP/DOWN.
Which to me is a statement of fact not a request to lower or raise the wheels, as normal English is GEAR as is the Operations Manual.
Change them, I have tried, others have tried, no change as yet.
Normal ops all OK, under pressure, you can be caught.

You are right, we are paid and expected to do our professional duty and on average we do pretty well on a statistical basis, not becoming a statistic is the trick.
Try to be at the enquiry, not the subject is the next best we can all hope for.

In a group of 20 or so Pilots, we can have 150 years and 250,000 hrs total experiences in the room. Very rarely do we have anyone who has had an accident or even a major incident, so we do pretty well.
The after event flying skills of the unfortunate Captain of 286 turned a potential tragedy into what we have now able comment on. Hopefully we all could have done as well, I hope I never have to pass the test.

Ref QF, one language, one culture, lots of experience and off the end they went. That crew is still flying.

Kaptin M

30th Mar 2003, 11:52

The point that Greybeard and I are trying to impress on the majority of those who are reading this thread, in this forum, TCoB, is that certainly there are issues of SOPs that would involve checking and cross-checking that MIGHT (or might NOT)have been circumvented, however the readers MUST remember that there were at least TWO and most likely THREE versions of "English" involved that could be added to the list of probable root causes.

QF, does not have this factor on a day-to-day basis.

Again, as PILOTS, we should ALL be looking at trying to find out what factors caused these professional crew members of a major international airline to be led down a path that supposedly has many checks and balances built in to prevent such incidents/accidents.

"Pilot error" is NOT sufficient reason, and must not be accepted by any of us as the reason.
There are plenty of other non-pilots who are ready to crucify us, without other pilots jumping on to the bandwagon. It is not going to further any of YOUR careers by joining the uninformed baggers!!

Captain Gidday

30th Mar 2003, 22:25

With one big IF [which I'll get to in a moment] the 2s and 3s argument, while interesting must in this case be a red herring BECAUSE;
The ZFW, which G Khan says you enter from the Flight Plan when setting up the FMC, MUST be somewhere in the range from about 170,000 Kg, the aircraft's typical empty weight, to somewhere around 250,000 Kg, depending which Maximum ZFW your company has purchased from Boeing. Freighters of course have higher ZFWs, but self-evidently, this was not a freighter.
Now a reasonable ZFW with the passenger load ex AKL and with a typical freight uplift would indeed be about 230,000Kg. To make a gross error downwards, sufficient to cause a geometry limited strike, would require a ZFW value starting with the figure '1' to be entered, not '3', so there goes the '2s and 3s Proposition', right out the window. if you tried to enter a ZFW starting with '3' instead of '2', firstly I do not think the FMC would accept the input, and if it did you would end up with V1,VR,V2 speeds too high, not too low.
Now for the Big IF ;
The -400 FMC accepts entries into either the ZFW position on the Performance Initialisation Page, i.e. the third line down, or into the GR WT position, the top left key. IF it is SIA company policy for the pilots to update the weights when the Final is received by over-typing the finalised Gross Weight value into the top line, then that procedure is faulty and fraught with danger, as has just been shown in Auckland.
IF it is SIA company policy to update the weights by over-typing the final ZFW into the third line down on the FMC Performance Initialisation page, then that is much better. However, bear in mind that it remains possible for a pilot to enter a value, such as the ZFW for example, erroneously into the Gross Weight line of the FMC. This would produce a large error, of the order of magnitude which appears to have occurred in this case.

elektra

31st Mar 2003, 06:45

On our 777s they've inhibited the Gross Weight entry line on the Performance page to remove the potential for mis-entry. You can only type in the ZFW. Is that being done on any 400s?

Feather #3

31st Mar 2003, 08:20

Not too sure elektra , but if you read Boeing Bulletin 747-400-46 dated 31Mar00 you'll find a treatise on this very subject, to wit - "Inadvertant Enrty of Zero Fuel Weight (ZFW) into the gross Weight (GW) Line of the FMC".

Third last para gives a future option for inhibition.

Another quote -

"the following adverse effects are possible:
* tail strike"

A sense of deja vue ?

G'day ;)

Kaptin M

31st Mar 2003, 09:15

Good points, gents (and/or ladies) - it's good to see some REASONS being put forward, rather than outright crucifixions.
And IF "finger trouble" was one of the contributing factors in the chain of events, then I would be interested to know what OTHER links were involved that PREVENTED the crew from picking up on the error.

Were they tired? Was it a language problem. Were there other aircraft problems that may have distracted/diverted their attention? Was the FMC operative and reliable?

Assuming that an incorrect ZFW was entered, or that the ZFW was entered into the GWT boxes, this might also give a clue as to why the first approach ended up in a go-around, might it not? The (heavier) a/c would have been performing much differently to the one that was showing in the FMC.ie. the deceleration rate. So to say that they "rushed' the approach is possibly somewhat premature, because HAD the aircraft been at the weight which they THOUGHT (and which was reflected in the Vref from the FMC) then the circuit carried out most likely WOULD have been one that would have resulted in a landing first time.

I, for one, would like to know more about their scheduling and rest patterns immediately prior to this flight. How long did they have in AKL, and was it preceded by a CHC stopover?
Would someone be kind enough to please refresh us on the departure time of this flight, please?

Bankstown

31st Mar 2003, 10:39

The aircraft departed at around 1530 on the 12th of March.
http://www.rwy34.com/search/processed/thumbs/17032003SQ236.jpg
http://www.rwy34.com/search/bigpic.php?id=1236 (SQ286 photo.)

The_Cutest_of_Borg

31st Mar 2003, 12:39

Sorry Kaptin M and others, the errors committed by this crew simply do not add up. I am not saying we as aircrew do not commit errors, but basic adherence to SOP's catches most of them.

As seen below, someone made a two simple errors, the kind that anyone having a bad day might make. I cannot for the life of me however see why it went any further than that?

Lets have a quick review....

Crew errors..

Error 1. Transposing 230T into 320T

Error 2. Entering erroneous number on to GW line instead of ZFW line

Error 3. Not crosschecking Erroneous GW with correct Loadsheet figure in front of them.

Error 4. Not realising derived V speeds were 27-30 knots low for aircraft weight

Error 5. All three pilots committing errors 3 and 4.

All of these errors could have been nullified by ONE crosscheck by one of the pilots.

Possible SQ systemic errors.

1. Not requiring provisional ZFW to be entered on to FMC to allow for ball park figures to be derived and crosschecked before arrival of final loadsheet. (And if SQ do have this procedure then it becomes Error 6 for the crew)

2. Not requiring Load sheet GW figure to be cross-checked by all crew before calculation/validation of final takeoff figures. (And if they do require this then this crew broke SOP).

To add to all of this, as pointed out, the GW on the FMC would have been around 65 Tonnes too low on approach as well. How close was this aircraft to stalling over the threshold due to erroneous Vref on arrival... twice?

You may say their but for the grace of God go I...and I certainly hope there is more to the story than so far gleaned, but this has all the hallmarks of a signature screwup that purely by the grace of the design team at Boeing, ended happily.

What I mean by signature screwup is the sort of accident that people refer to simply by one word... Erebus.... Tenerife.... Fort Worth... you all know what I am referring to.

Once again, thanks to Boeing we are not now referring to the "Auckland" accident, sadly shaking our heads..

Feather #3

31st Mar 2003, 18:45

Easy to see how these errors are made if even Borg can confuse his own error chain numbers!!:eek:

G'day ;)

greybeard

1st Apr 2003, 08:08

Yes, just a little mistake with only the PPRuNe people to see, the 286 guys got front page.

The real trouble with all of this is that we are HUMAN, we will make mistakes,

I SAY AGAIN--WE WILL MAKE MISTAKES.

LOSA data from that area indicates we make an average of 2 errors per flight, up to 17 observed errors on one isolated flight.
A sucessful one we assume as the data from the observer survived.
So, even if "WE" think "WE" are twice as good as the average, "WE" will still make one so called error per flight.

It makes the hair on your neck stand up.

Be careful out there. (appol to Avweb)

C YA

The_Cutest_of_Borg

1st Apr 2003, 09:51

Actually, you just proved my point there feather...anyone can make a mistake, but simple crosschecking picked it up...:=

G.Khan

1st Apr 2003, 10:32

Ref points 1 and 2, SIA SOP requires it exactly as you say.

Possibly not in this case, but I too have said more than once,
"there, but for the Grace of God, go I".

Now, about your point 6!:}

Kaptin M

1st Apr 2003, 10:34

But what percentage did NOT, TCoB?
Additionally, your post was sitting there unchanged, whereas once the entry is made into the FMC and executed, more than likely another page is then selected.

"Yes", a mistake WAS made, and "yes" it was not caught in the safety net that SIA employs.
But the question that NEEDS answering is "Why wasn't it picked up?" by at least one of the the three crew members?

BTW, TCoB, Erebus was NOT a crew stuff up.
In the Teneriffe accident, the F/O in fact did voice his concern that KLM was not cleared for take-off, however the domineering personality and the rush to get going by the Captain were considered the overriding causes.
And your final point of "crew errors"...Error 5. All three pilots committing errors 3 and 4., begs the question once again.

What distraction prevented at least ONE crew member from picking up the error?

The_Cutest_of_Borg

1st Apr 2003, 11:55

I never said Erebus was a crew stuff-up. It was however one of those accidents that held lessons for all of us. That is what I meant by a signature accident.

Tenerife told us, inter alia, that we needed to rigidly enforce SOP's and employ the, as then unknown, CRM.

Fort Worth was the first time microbursts and their effects really became known. That wasn't a crew stuff-up then either... although any crew doing what they did now would certainly have some explaining to do. (If they survived).

I take your point Kaptin that this SQ error was probably due to some form of distraction on the flight deck. That doesn't excuse them though. Managing the inevitable distractions that occur during a pre-flight is one of the other things we get paid for.

Kaptin M

1st Apr 2003, 12:17

Thank you, TCoB. You come across (rightly or wrongly) on this forum, as one who does not tolerate any leeway with the crew (and yourself, I presume), with statements such as, "although any crew doing what they did now would certainly have some explaining to do." and, "That doesn't excuse them though.".
I wonder if this is how junior crew members would also see you, and whether it would affect their readiness to speak up, IF you were ever "guilty" of making a mistake? I`m sure your reply would be that you would EXPECT them to, and that you would chastise them if YOU subsequently discovered it yourself.

And so once again, we head down the CRM path.]

Personally I am not as interested in knowing WHAT mistake(s) was made, but WHY, and why it wasn`t caught in the airline`s Safety Net, because if it`s capable of happening once, it can recur countless times.

Just saying that ALL 3 crew members missed it, and that they should be hung high, is not - for me - any sort of answer.

The_Cutest_of_Borg

1st Apr 2003, 13:08

Well maybe I do come across as someone intolerant of error. I don't believe that I am.

Way back in my neophyte days I read something that someone wrote about this job that made an impression on me then and still resonates. The quote when something along the lines of, "Those pilots unwilling to take responsibility for their actions, should aggressively seek other employment."

Now I take this to mean that, yes mistakes do occur. But, when it comes down to it my basic responsibility is to get a large aeroplane from point A to point B as safely as possible. Emphasis on MY.

I may be tired, that does not excuse me from that responsibility. If I am tired I need to take extra care.

I may be 11 hours out of my time zone, that does not excuse me.

I may be distracted, that too does not excuse me.

We all miss things when we are tired, but the knowledge of the weight of your aircraft in all stages of flight is paramount. Therefore it requires careful checking and crosschecking, no matter how tired, distracted, horny or circadian challenged you may be.

I don't jump on crew members for making mistakes however, and when they pick up one of mine I thank them for their attention.

What concerns me these days is that I am starting to see a trend where pilots in particular see the holistic approach to accident investigation as mitigating their responsibilities and absolving them of blame when circumstances are not ideal.

So therefore I am critical of any attempt to find an excuse for a basic error such as this one, particularly one that could have easily been prevented by adherence to SOP's.

If that characterises me a hard man these days, so be it.

Woomera

1st Apr 2003, 13:43

Sounds like you two are actually in heated agreement.;)

sean1

1st Apr 2003, 13:51

I like your style Borg.Yes the buck stops in the cockpit.

Kooka

1st Apr 2003, 14:12

Yes, just a little mistake with only the PPRuNe people to see, the 286 guys got front page.
Did this really make the front page of the Singapore Straits Times? I'm very surprised if it did.

Traffic

1st Apr 2003, 14:23

This certainly is a warm and cuddly thread.

We have plausible explanations for what happened (finger trouble and transposition).

We have some explanations as to why it might have happened (lack of familiarity on type, rostering effects/circadian function, language and pronounciation).

What I simply cannot come to grips with is how three highly competent and qualified individuals could leave their commonsense checker back in the hotel.

In round figures the V numbers for the 400 and the 340 would be about the same for a 10 hour flight with a reasonable pax/cargo config.

When the a/c gave them 737 numbers back, they simply accepted them.

Surely this is comparable to believing a calculator when it tells you 2+2 equals 3. It is something that just doesn't happen.......

Avago

2nd Apr 2003, 06:35

I'm curious to know whether people blindly accept the FMC computed V speeds, or is there some kind of cross-check?

In my outfit the sequence of events goes like this (for both the B744 and B777):

An estimate of the zero fuel weight is used to calculate an estimated take-off weight, which is then used to calculate the take-off data using tabulated RTOW figures. This data is cross-checked by at least one other crew member. Nothing is entered in the FMC at this stage.

When the loadsheet arrives with the final figures, the actual zero fuel weight is entered in the FMC, and the FMC computed gross weight compared with the take-off weight shown on the loadsheet - ANY discrepancy must be investigated. The take-off weight shown on the loadsheet is also compared with that used to compute the take-off data, and if it is within certain limits, the calculated take-off data is then manually entered into the FMC. If the difference between the actual take-off weight and that used to calculate the take-off data is outside the limit, then the take-off data is recalculated from the tabulated RTOW figures and manually entered in the FMC.

What procedures do other airlines use?