Senate Inquiry, Hearing Program 4th Nov 2011
I am grimly amused by those who presume to know the precise terms of the weather information actually heard by the crew in flight. Not the words transmitted from the ground: the words actually heard by the crew in flight.
Someone said someone transmitted some words. Therefore all of those words were heard by the crew. Therefore the crew failed to correctly assimilate the information they had.
Now that’s solid gold “hearsay and tautological rubbish”.
Someone said someone transmitted some words. Therefore all of those words were heard by the crew. Therefore the crew failed to correctly assimilate the information they had.
Now that’s solid gold “hearsay and tautological rubbish”.
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Well, Oh dear.
Ne pensez-vous pas Aristotle's "Reductio ad absurdum" un peu recherché.
To do is Voltaire, to be is Hamlet and to Do Be Do is Sinatra. "K".
Cribbed from Wiki – to assist, or not as the case may be.
PS + What Creampuff said.
To do is Voltaire, to be is Hamlet and to Do Be Do is Sinatra. "K".
Cribbed from Wiki – to assist, or not as the case may be.
The primary motivation for paraconsistent logic is the conviction that it ought to be possible to reason with inconsistent information in a controlled and discriminating way. The principle of explosion precludes this, and so must be abandoned. In non-paraconsistent logics, there is only one inconsistent theory: the trivial theory that has every sentence as a theorem. Paraconsistent logic makes it possible to distinguish between inconsistent theories and to reason with them.
Research into paraconsistent logic has also led to the establishment of the philosophical school of dialetheism (most notably advocated by Graham Priest), which asserts that true contradictions exist in reality, for example groups of people holding opposing views on various moral issues.
Being a dialetheist rationally commits one to some form of paraconsistent logic, on pain of otherwise embracing trivialism, i.e. accepting that all contradictions (and equivalently all statements) are true. However, the study of paraconsistent logics, does not necessarily entail a dialetheist viewpoint. For example, one need not commit to either the existence of true theories or true contradictions, but would rather prefer a weaker standard like empirical adequacy, as proposed by Bas van Fraassen.
Research into paraconsistent logic has also led to the establishment of the philosophical school of dialetheism (most notably advocated by Graham Priest), which asserts that true contradictions exist in reality, for example groups of people holding opposing views on various moral issues.
Being a dialetheist rationally commits one to some form of paraconsistent logic, on pain of otherwise embracing trivialism, i.e. accepting that all contradictions (and equivalently all statements) are true. However, the study of paraconsistent logics, does not necessarily entail a dialetheist viewpoint. For example, one need not commit to either the existence of true theories or true contradictions, but would rather prefer a weaker standard like empirical adequacy, as proposed by Bas van Fraassen.
Last edited by Kharon; 21st Nov 2012 at 20:02. Reason: French grammar and French Grandmama's being the fundemental issue
Depends on what court we’re in and for what purpose the transcript is being adduced.
But let’s apply Occam’s Razor and assume it’s admissible and incontrovertible evidence that the precise words in the transcript were transmitted, at the time and on the frequency stated in the transcript.
It does not follow that those precise words were heard by the crew. Anybody with any experience in radio voice communications – especially HF voice communications – knows how easy it is to misunderstand, or not hear at all, some of those communications.
That’s why there’s a phonetic alphabet. That’s why there are standard transmission formats and phrases.
That’s why the standard phrases include: “say again”, “speak slower” and “words twice”.
There is only one person who can give first hand evidence of what the PIC heard. And the 'blame the pilot' crowd might want to entertain the possibility that what the pilot actually heard supported his decision, and he didn't know what he didn't know.
But let’s apply Occam’s Razor and assume it’s admissible and incontrovertible evidence that the precise words in the transcript were transmitted, at the time and on the frequency stated in the transcript.
It does not follow that those precise words were heard by the crew. Anybody with any experience in radio voice communications – especially HF voice communications – knows how easy it is to misunderstand, or not hear at all, some of those communications.
That’s why there’s a phonetic alphabet. That’s why there are standard transmission formats and phrases.
That’s why the standard phrases include: “say again”, “speak slower” and “words twice”.
There is only one person who can give first hand evidence of what the PIC heard. And the 'blame the pilot' crowd might want to entertain the possibility that what the pilot actually heard supported his decision, and he didn't know what he didn't know.
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Frank, if I understand Creampuff, the CVR would not be enough. The recording of the conversation about the SPECI received and aknowledged already exists and was transcribed into the ATSB report and tabled at the hearing. What would be needed, I geuss, is sworn evidence from both the PIC and FO.
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Or evidence under privelege in The Senate which most "givers" are prior warned of contempt;
Is evidence thus assumed to be sworn because of the contempt provisions?
The principal immunity is the freedom of parliamentary debates and proceedings from question and impeachment in the courts, the most significant effect of which is that members of Parliament cannot be sued or prosecuted for anything they say in debate in the houses. The principal powers are the power to compel the attendance of witnesses, the giving of evidence and the production of documents, and to adjudge and punish contempts of the house.
Is this what you are after:
Some of you are still banging on about fault and who was most at fault for this accident, please remember that currently the ATSB Final Report puts the blame solely at the feet of Dominic James.
The Senate inquiry isn't about whose fault this accident was it is more about what appears to be an extremely substandard Final Report put out by the ATSB some three years after the event. The 'blame game' and, as ferris clearly highlights below, those that are trying to escape scrutiny or ownership of any blame has come about as a consequence of the inquiry:
You can continue to play the 'blame game' or you can question how it is that such an important safety agency (the ATSB) can deem that this flawed, deficient final report is an acceptable "safety document" to publish and be disseminated worldwide.
I remind you that these are the terms of reference:
Time UTC
From
To
Transmission
0756:34
VH-NGA
Nadi
Nadi radio victor hotel november golf alpha request
0756:46
Nadi
VH-NGA
Victor november golf alpha nadi
0756:48
VH-NGA
Nadi
Is it possible to obtain a METAR for yankee sierra november foxtrot please
0757:01
Nadi
VH-NGA
Victor november golf alpha nadi standby
0801:15
Nadi
VH-NGA
Victor hotel november golf alpha nadi
0801:20
VH-NGA
Nadi
Nadi go ahead victor golf alpha
0801:24
Nadi
VH-NGA
Roger ready to copy METAR Norfolk?
0801:27
Go ahead victor golf alpha
0801:31
Nadi
VH-NGA
METAR Norfolk at 0630 Zulu wind 300 09 knots 9999, few 6,000 broken 2400 temperature 21 dewpoint 19 QNH norfolk 1011 remarks closed till 1930 UTC go ahead
0802:08
VH-NGA
Nadi
Ahhh ...copy... just say again the issue time for the METAR
0802:14
Nadi
VH-NGA
Issue time for the METAR this is the latest 0630 Zulu
0802:22
VH-NGA
Nadi
Victor golf alpha thank you
0802:26
Nadi
VH-NGA
Victor november golf alpha nadi
0802:29
VH-NGA
Nadi
Go ahead nadi victor golf alpha
0802:32
Nadi
VH-NGA
Roger this the latest weather for Norfolk...SPECI... I say again special weather Norfolk at 0800 Zulu... auto I say again auto, alpha uniform tango oscar, wind 290 08 knots, 999 november delta victor, overcast one thousand one hundred , temperature 21, dew point 19, QNH Norfolk 1012...remarks... romeo foxtrot zero zero decimal zero oblique zero zero zero decimal zero go ahead
0803:21
VH-NGA
Nadi
Thank you nadi... much appreciated november golf alpha
0803:24
Nadi
VH-NGA
November golf alpha...DOLSI, DOLSI contact Auckland thank you
0803:24
VH-NGA
Nadi
Auckland at DOLSI victor golf alpha
(End of Transcript)
From
To
Transmission
0756:34
VH-NGA
Nadi
Nadi radio victor hotel november golf alpha request
0756:46
Nadi
VH-NGA
Victor november golf alpha nadi
0756:48
VH-NGA
Nadi
Is it possible to obtain a METAR for yankee sierra november foxtrot please
0757:01
Nadi
VH-NGA
Victor november golf alpha nadi standby
0801:15
Nadi
VH-NGA
Victor hotel november golf alpha nadi
0801:20
VH-NGA
Nadi
Nadi go ahead victor golf alpha
0801:24
Nadi
VH-NGA
Roger ready to copy METAR Norfolk?
0801:27
Go ahead victor golf alpha
0801:31
Nadi
VH-NGA
METAR Norfolk at 0630 Zulu wind 300 09 knots 9999, few 6,000 broken 2400 temperature 21 dewpoint 19 QNH norfolk 1011 remarks closed till 1930 UTC go ahead
0802:08
VH-NGA
Nadi
Ahhh ...copy... just say again the issue time for the METAR
0802:14
Nadi
VH-NGA
Issue time for the METAR this is the latest 0630 Zulu
0802:22
VH-NGA
Nadi
Victor golf alpha thank you
0802:26
Nadi
VH-NGA
Victor november golf alpha nadi
0802:29
VH-NGA
Nadi
Go ahead nadi victor golf alpha
0802:32
Nadi
VH-NGA
Roger this the latest weather for Norfolk...SPECI... I say again special weather Norfolk at 0800 Zulu... auto I say again auto, alpha uniform tango oscar, wind 290 08 knots, 999 november delta victor, overcast one thousand one hundred , temperature 21, dew point 19, QNH Norfolk 1012...remarks... romeo foxtrot zero zero decimal zero oblique zero zero zero decimal zero go ahead
0803:21
VH-NGA
Nadi
Thank you nadi... much appreciated november golf alpha
0803:24
Nadi
VH-NGA
November golf alpha...DOLSI, DOLSI contact Auckland thank you
0803:24
VH-NGA
Nadi
Auckland at DOLSI victor golf alpha
(End of Transcript)
The Senate inquiry isn't about whose fault this accident was it is more about what appears to be an extremely substandard Final Report put out by the ATSB some three years after the event. The 'blame game' and, as ferris clearly highlights below, those that are trying to escape scrutiny or ownership of any blame has come about as a consequence of the inquiry:
ferris: My point has been that Heffernan appears to be having a go at Harfield in this latest hearing, not about what the rules were or who was responsible for what, he is having a go at him for having done absolutely nothing to fix it. To the good senators, it looks like CASA hasn't done their job, the ATSB - god knows what they are doing- they seem a bit lost about what their job is, AsA is saying "it isn't our responsibility" and the senators are getting a bit frustrated/exasperated.
All these bureaucrats sitting around going "it's not our fault" and conveniently running lines that end with it being no-ones fault (except the pilots, of course), and them not having to actually do anything differently in future.
All these bureaucrats sitting around going "it's not our fault" and conveniently running lines that end with it being no-ones fault (except the pilots, of course), and them not having to actually do anything differently in future.
I remind you that these are the terms of reference:
Terms of Reference
On 13 September 2012, the Senate agreed that the following matters be referred to the Rural and Regional Affairs and Transport References Committee for inquiry and report by 29 November 2012:
(a) the findings of the Australian Transport Safety Bureau into the ditching of VH-NGA Westwind II, operated by
Pel-Air Aviation Pty Ltd, in the ocean near Norfolk Island airport on 18 November 2009;
(b) the nature of, and protocols involved in, communications between agencies and directly interested parties in an
aviation accident investigation and the reporting process;
(c) the mechanisms in place to ensure recommendations from aviation accident investigations are implemented in
a timely manner; and
(d) any related matters.
On 13 September 2012, the Senate agreed that the following matters be referred to the Rural and Regional Affairs and Transport References Committee for inquiry and report by 29 November 2012:
(a) the findings of the Australian Transport Safety Bureau into the ditching of VH-NGA Westwind II, operated by
Pel-Air Aviation Pty Ltd, in the ocean near Norfolk Island airport on 18 November 2009;
(b) the nature of, and protocols involved in, communications between agencies and directly interested parties in an
aviation accident investigation and the reporting process;
(c) the mechanisms in place to ensure recommendations from aviation accident investigations are implemented in
a timely manner; and
(d) any related matters.
Gaunty:
Not so fast, we have heard this before and it isn't necessarily true.
The problem is known as The double bind problem" and it is well known and frequently deadly, as it almost was in this case.
A double bind exists for a person when the formal rules and regulations they are expected to work to are totally at variance with the informal rules and regulations of an organization. That leaves the employee, like James, totally exposed when there is an accident because they have not complied with the formal rules but the informal rules.
CASA and ATSB have dutifully ignored the informal culture of Pel Air and instead hung the pilot out to dry.
As has been stated elsewhere I believe, strict application of relevant fuel planning principles by a competent chief pilot would have meant that it was impossible to use the Westwind for this mission. But the Westwind was used, so we have to ask the question that the ATSB and CASA studiously ignored: are the operations manuals for Pel Air adequate? Apparently not according to the secret CASA audit.
So now we get to the question, assuming James followed Pel Airs manuals to the letter, would he have been safe? apparently not.
That begs the question: what would have happened to James had he got up on his hind legs and told the CP that he was in error as evidenced by the less than stellar Pel Air documentation? whAt would have happened if James had then lectured the cp on the correct fuel planning technique and announced that he would ignore the manual and employ a better and correct procedure instead?
What would have happened to James if he had decided to bring the manuals shortcomings to the attention of CaSA?
What would have happened to James if he told the CP that this flight was just too dangerous in the aircraft concerned?
That's right Gaunty, every single one of those courses of action finishes with D. James out on the street and another dumb schmuck at the controls of the Westwind. Pilots are just like everyone else, if they aren't supported in the pursuit of safety, let alone undermined, they can and do make mistakes.
The PIC is the PIC and carries the considerable responsibilities of the privileges of his/her license. Whether Private, Aerial Work, Charter, RPT notwithstanding regulation is not relevant. The passengers and the crew deserve the same duty of care.
The problem is known as The double bind problem" and it is well known and frequently deadly, as it almost was in this case.
A double bind exists for a person when the formal rules and regulations they are expected to work to are totally at variance with the informal rules and regulations of an organization. That leaves the employee, like James, totally exposed when there is an accident because they have not complied with the formal rules but the informal rules.
CASA and ATSB have dutifully ignored the informal culture of Pel Air and instead hung the pilot out to dry.
As has been stated elsewhere I believe, strict application of relevant fuel planning principles by a competent chief pilot would have meant that it was impossible to use the Westwind for this mission. But the Westwind was used, so we have to ask the question that the ATSB and CASA studiously ignored: are the operations manuals for Pel Air adequate? Apparently not according to the secret CASA audit.
So now we get to the question, assuming James followed Pel Airs manuals to the letter, would he have been safe? apparently not.
That begs the question: what would have happened to James had he got up on his hind legs and told the CP that he was in error as evidenced by the less than stellar Pel Air documentation? whAt would have happened if James had then lectured the cp on the correct fuel planning technique and announced that he would ignore the manual and employ a better and correct procedure instead?
What would have happened to James if he had decided to bring the manuals shortcomings to the attention of CaSA?
What would have happened to James if he told the CP that this flight was just too dangerous in the aircraft concerned?
That's right Gaunty, every single one of those courses of action finishes with D. James out on the street and another dumb schmuck at the controls of the Westwind. Pilots are just like everyone else, if they aren't supported in the pursuit of safety, let alone undermined, they can and do make mistakes.
The CVR would provide very strong evidence of what sounds were actually in the intercom system, with a corresponding strong inference that those sounds were actually heard by the crew. But only the human listening can give first hand evidence of what s/he heard and what s/he interpreted what s/he heard to mean.
True story from someone close to me (I spell the words phonetically to make the point):
Heard in the cockpit: ABC tern rite too wun zero.
ABC: ABC tern right too wun zero.
[ABC’s pilot ‘heard’ an instruction to “turn right, two one zero”. ABC takes up a heading of 210 degrees magnetic. In fact, a second zero was clipped from the instruction to ABC. The words out of ATC’s mouth were: Turn right to one zero zero.]
Heard in cockpit: ABC is your heading wun zero zero?
ABC: Negative, heading too wun zero.
Is that outcome really just the fault of the pilot of ABC?
Rugby League fans may be aware of an hilariously funny song, by Denis Carnahan, about the selection process for the Queensland State of Origin team. The song’s called “That’s in Queensland”, and the first verse goes like this (copyright Denis Carnahan):
And so it goes. It’s worth a view on youtube.
It struck me that a similar concept applies to the Pel Air ditching matter. I call this song: “Symptomatic Of Other Ills In Society”. It’s in ‘C minor’.
Could somebody please help me?
I’m a little bit surprised
When I’m in a commercial aircraft
Who’s keeping me alive?
The system’s there to protect me: surely that’s my safety net
So could somebody please tell me, who’s helping my Pie-let …
Phone unanswered? Blame the pilot!
Mistake in METAR? Blame the pilot!
Outsourced to NZ? Blame the pilot!
Ops manual deficient? Blame the pilot!
That it’s aerial work? Blame the pilot!
Not RSVM certified? Blame the pilot!
Rules unclear? Blame the pilot!
Hopeless lifevests? Blame the pilot!
Liferaft lost? Blame the pilot!
Audit outcomes? Blame the pilot!
Pel-Air breaches? Blame the pilot!
Lessons learned? Blame the pilot!
Systemic problems? No way! The pilot’s everything!
True story from someone close to me (I spell the words phonetically to make the point):
Heard in the cockpit: ABC tern rite too wun zero.
ABC: ABC tern right too wun zero.
[ABC’s pilot ‘heard’ an instruction to “turn right, two one zero”. ABC takes up a heading of 210 degrees magnetic. In fact, a second zero was clipped from the instruction to ABC. The words out of ATC’s mouth were: Turn right to one zero zero.]
Heard in cockpit: ABC is your heading wun zero zero?
ABC: Negative, heading too wun zero.
Is that outcome really just the fault of the pilot of ABC?
Rugby League fans may be aware of an hilariously funny song, by Denis Carnahan, about the selection process for the Queensland State of Origin team. The song’s called “That’s in Queensland”, and the first verse goes like this (copyright Denis Carnahan):
Could somebody please help me?
I’m a little bit confused.
When selectors choose for Queensland
Could you tell what map they use?
Where you’re born and where you come from, surely that’s your origin
So could somebody please tell me, what States these towns are in …
Where is Sydney? That’s in Queensland!
Suva Fiji? That’s in Queensland!
Where is Nowraville? That’s in Queensland!
Queensland’s everywhere!
I’m a little bit confused.
When selectors choose for Queensland
Could you tell what map they use?
Where you’re born and where you come from, surely that’s your origin
So could somebody please tell me, what States these towns are in …
Where is Sydney? That’s in Queensland!
Suva Fiji? That’s in Queensland!
Where is Nowraville? That’s in Queensland!
Queensland’s everywhere!
It struck me that a similar concept applies to the Pel Air ditching matter. I call this song: “Symptomatic Of Other Ills In Society”. It’s in ‘C minor’.
Could somebody please help me?
I’m a little bit surprised
When I’m in a commercial aircraft
Who’s keeping me alive?
The system’s there to protect me: surely that’s my safety net
So could somebody please tell me, who’s helping my Pie-let …
Phone unanswered? Blame the pilot!
Mistake in METAR? Blame the pilot!
Outsourced to NZ? Blame the pilot!
Ops manual deficient? Blame the pilot!
That it’s aerial work? Blame the pilot!
Not RSVM certified? Blame the pilot!
Rules unclear? Blame the pilot!
Hopeless lifevests? Blame the pilot!
Liferaft lost? Blame the pilot!
Audit outcomes? Blame the pilot!
Pel-Air breaches? Blame the pilot!
Lessons learned? Blame the pilot!
Systemic problems? No way! The pilot’s everything!
Top post Creamy...laughed so hard nearly fell off the chair!
Dangly Bits are you for real or did you just want to get in the action? I suppose if you really wanted to know you could put in an FOI (if they have them in NZED??) with Airways NZ for the HF transcript for that particular night...although I wish you luck with that as it appears the ATSB weren't successful in obtaining one!
Dangly Bits are you for real or did you just want to get in the action? I suppose if you really wanted to know you could put in an FOI (if they have them in NZED??) with Airways NZ for the HF transcript for that particular night...although I wish you luck with that as it appears the ATSB weren't successful in obtaining one!
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The CVR would provide very strong evidence of what sounds were actually in the intercom system, with a corresponding strong inference that those sounds were actually heard by the crew. But only the human listening can give first hand evidence of what s/he heard and what s/he interpreted what s/he heard to mean.
"the whole truth, nothing but the truth, (insert affirmation /or Diety swearing here). The cockpit sounds are NOT insignificant.
So help me God!
You may call it theatre
Given Creamy's perfect summary in 'C minor' or "K's" 'D major' makes you wonder how the bureau continue's to stand by the report, see here page 6 of yesterday's Hansard:
Almost totally farcical except in this case it is 'obscene' because this is coming from the 'Australian Transport Safety Bureau'! Or as Senator X mentions on page 4..." A number of pilots have approached me and said that concerns them, because if it goes off to the regulator, to CASA, that may inhibit their willingness to report issues of safety to the ATSB, as the primary safety body for aviation in this country."
Professor McMillan although an obvious expert in the law could best be described as a layman in regards to aviation highlighted perfectly these issues on reviewing the October 22 Hansard:
MD said:We undertook the investigation of the Norfolk Island accident and published an investigation report under those functions and conditions. A number of claims have been made about the inaccuracy of the investigation report or about omissions in the report.
As I indicated, we have provided a range of submissions to the committee addressing the points raised. The latest was yesterday, addressing some assertions that had been made about the fuel planning and management of the accident flight. The ATSB remains satisfied that there is no material error of fact in the report.
We have also satisfied ourselves that, at this stage, no significant new information has been brought to light that requires a formal reopening of the investigation.
I would like to make it clear that the ATSB stands by its report.
As I indicated, we have provided a range of submissions to the committee addressing the points raised. The latest was yesterday, addressing some assertions that had been made about the fuel planning and management of the accident flight. The ATSB remains satisfied that there is no material error of fact in the report.
We have also satisfied ourselves that, at this stage, no significant new information has been brought to light that requires a formal reopening of the investigation.
I would like to make it clear that the ATSB stands by its report.
Almost totally farcical except in this case it is 'obscene' because this is coming from the 'Australian Transport Safety Bureau'! Or as Senator X mentions on page 4..." A number of pilots have approached me and said that concerns them, because if it goes off to the regulator, to CASA, that may inhibit their willingness to report issues of safety to the ATSB, as the primary safety body for aviation in this country."
Professor McMillan although an obvious expert in the law could best be described as a layman in regards to aviation highlighted perfectly these issues on reviewing the October 22 Hansard:
Prof. McMillan: I am interested that the secrecy provision does not apply to the information-gathering powers of the parliament. This committee has requested information that would otherwise be protected against release under the FOI Act. Clearly that is one way in which a balance has been struck in the legislation.
The other comment that I would make, and this is just an observation from reading the earlier transcript, is that I note the comment of the Chief Commissioner, Mr Dolan, that with hindsight the report could have been a more fulsome report that discussed lines of inquiry that were decided not to be relevant and arguments that were not accepted. Generally speaking, that is by far the better way of ensuring that information gets on the public record in a better form.
FOI is certainly a valuable legal means but it can operate in a fairly random way because of its interaction with exemption provisions and because of the range of documents that are released. (my bolding)[/
The other comment that I would make, and this is just an observation from reading the earlier transcript, is that I note the comment of the Chief Commissioner, Mr Dolan, that with hindsight the report could have been a more fulsome report that discussed lines of inquiry that were decided not to be relevant and arguments that were not accepted. Generally speaking, that is by far the better way of ensuring that information gets on the public record in a better form.
FOI is certainly a valuable legal means but it can operate in a fairly random way because of its interaction with exemption provisions and because of the range of documents that are released. (my bolding)[/
Last edited by Sarcs; 22nd Nov 2012 at 07:07.
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Sunfish,
Thank you and I do know about the double bind, having had to compete, and succesfully, over the years gainst operators who continue to operate as such and under the benign supervision of our CASA friends, and I agree with every single syllable and letter of your post.
Just some context around my remarks for you.
I have fairly recently completed a task which involved the building from a blank piece of paper a transport category only AOC with unrestricted worldwide operation and with the highest international SMS, best practise and management accreditations available. It is not BARS which does not even get close. However! Fleet now Citation, Phenom, Challenger and Gulfstream.
100 days between application and grant. This could not have been possible without the proactive support of CASA and a team around me with a great deal of experience and all of four us in "good standing", the COM written from scratch alongside the CASA guide and an internationally accepted template that would ubsequently be used for application to the aforementioned. I hold an further iteration of that in which CASA are particularly interested.
Fairly senior pilot applicant for a job and with the view that he didnt expect us to have one for "at least 18 months, but I can probably help you there", mistakenly asked with a straight face yet "whose Ops Manual did you steal/plagiarise to achieve that then". Your case rests.
Frank Arouet
Your namesake as a well known and oft quoted author had some very insightful comments in that direction and I have experienced it first hand. Usually with Leadsled and T28 as principal actors.
Creampuff,
Indeed, your legal interpretation of the HF content may well be correct, we shall see, and, we should also be agitating for the recovery of the recorders.
As you aver they may or may not shed any further light, but, shouldn't we, if only for the cause of natural justice, make them available. Or does the age old legal principle of letting sleeping dogs lie or in political terms "don't ask a question to which you do not know the answer."
Sarcs
I am sure we must have been watching the same broadcast but I came away even more confident than less with the ATSB and Dolans calm but fearless handling of the whole thing.
Are you suggesting that we reduce the level of inquiry to the "are you still beating your wife" category.
IMHO they got it right, the first AND last time.
They were IMHO prescient in recognising the hornets nest it would inevitably stir up, and the consequences that would follow, they had been there before.
They were going to be on a hiding to nothing as the messenger.
They were not the cause of the accident merely the reporters.
The fairly lengthy exchange surrounding the ATSB changing of an important safety factor from Critical to Less on the same evidence revealed to me the tight rope performance required by the ATSB in maintaining a difficult balance of fairness.
This is the time for more not less calm and reasoned dialogue.
Thank you and I do know about the double bind, having had to compete, and succesfully, over the years gainst operators who continue to operate as such and under the benign supervision of our CASA friends, and I agree with every single syllable and letter of your post.
Just some context around my remarks for you.
I have fairly recently completed a task which involved the building from a blank piece of paper a transport category only AOC with unrestricted worldwide operation and with the highest international SMS, best practise and management accreditations available. It is not BARS which does not even get close. However! Fleet now Citation, Phenom, Challenger and Gulfstream.
100 days between application and grant. This could not have been possible without the proactive support of CASA and a team around me with a great deal of experience and all of four us in "good standing", the COM written from scratch alongside the CASA guide and an internationally accepted template that would ubsequently be used for application to the aforementioned. I hold an further iteration of that in which CASA are particularly interested.
Fairly senior pilot applicant for a job and with the view that he didnt expect us to have one for "at least 18 months, but I can probably help you there", mistakenly asked with a straight face yet "whose Ops Manual did you steal/plagiarise to achieve that then". Your case rests.
Frank Arouet
Your namesake as a well known and oft quoted author had some very insightful comments in that direction and I have experienced it first hand. Usually with Leadsled and T28 as principal actors.
Creampuff,
Indeed, your legal interpretation of the HF content may well be correct, we shall see, and, we should also be agitating for the recovery of the recorders.
As you aver they may or may not shed any further light, but, shouldn't we, if only for the cause of natural justice, make them available. Or does the age old legal principle of letting sleeping dogs lie or in political terms "don't ask a question to which you do not know the answer."
Sarcs
I am sure we must have been watching the same broadcast but I came away even more confident than less with the ATSB and Dolans calm but fearless handling of the whole thing.
Are you suggesting that we reduce the level of inquiry to the "are you still beating your wife" category.
IMHO they got it right, the first AND last time.
They were IMHO prescient in recognising the hornets nest it would inevitably stir up, and the consequences that would follow, they had been there before.
They were going to be on a hiding to nothing as the messenger.
They were not the cause of the accident merely the reporters.
The fairly lengthy exchange surrounding the ATSB changing of an important safety factor from Critical to Less on the same evidence revealed to me the tight rope performance required by the ATSB in maintaining a difficult balance of fairness.
This is the time for more not less calm and reasoned dialogue.
Don Quixote Impersonator
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Sarcs.
Oh and BTW I missed your comments re McMillan at the bottom of the page.
Good point.
I agree with him.
But that process was not then available to the ATSB or if it was then it was not clear, lets hope McMillan clears the way on this so the ATSB or any department in this situation does not have to argue with both hands tied behind their backs and wearing snorkel and goggles.
Oh and BTW I missed your comments re McMillan at the bottom of the page.
Good point.
I agree with him.
But that process was not then available to the ATSB or if it was then it was not clear, lets hope McMillan clears the way on this so the ATSB or any department in this situation does not have to argue with both hands tied behind their backs and wearing snorkel and goggles.
If:
- the upshot of all of this is that CASA and the ATSB stick to the line that the only cause of this incident was bad airmanship on the part of the PIC, and
- the basis of that conclusion is that the PIC failed properly to assimilate and make the correct decision in the context of information given to the PIC,
the right thing to do would be get the CVR (if its duration of recording goes back to point at which ‘CASA’ says the information was given to the PIC) to find out the quality and content of the transmissions received.
(I note that even if the proximate cause of the ditching was bad airmanship, it does not excuse the ATSB or CASA from doing nothing about the lifevest and liferaft issue. The silence and inaction on that stuff really makes me sick to the stomach.)
But on the question of the information available to the PIC, let’s continue with the assumption that the PIC received and understood, verbatim, what’s in the transcript.
My reading is that at 0801:31 Nadi makes a transmission addressed to NGA, in these terms:
The transcript says that the response from NGA was:
I note that there are no other “Ahhh”s in the transcript quoted above.
Now I’m only a wheelchair-bound geek from Hicksville, and this may be pure speculation, but maybe the crew member who was on the radio felt compelled to respond, so that Nadi knew the transmission had been received, but the “Ahhh” was a verbal ‘head-scratch’ about the “few 6,000 broken 2400” bit. I know that if I were in an aircraft in which that transmission were received by the people with whom I’m fortunate enough to fly, the phrase “few 6,000 broken 2400” in a METAR would produce a ‘WTF?’ moment.
Irrespective of what caused the “Ahhh” and what was going on in the cockpit, at 0802:32 according to the transcript – that’s just one minute after the METAR quoted above - another transmission was sent to and acknowledged by NGA:
So – again assuming all of this has been received word-for-word – on what basis does the pilot get crucified for deciding to continue?
Let’s assume the crew aren’t idiots, and their mutual head scratching resulted in them concluding that the “few 6,000 broken 2400” information may be erroneous, and perhaps instead should be “few 600 broken 2,400”. However, before they ask the question, the SPECI comes through. The SPECI says “overcast one thousand one hundred”.
Is that really the basis on which this entire mess gets pinned on the PIC? Has ‘CASA’ really decided that that piece of information should have resulted in a diversion?
- the upshot of all of this is that CASA and the ATSB stick to the line that the only cause of this incident was bad airmanship on the part of the PIC, and
- the basis of that conclusion is that the PIC failed properly to assimilate and make the correct decision in the context of information given to the PIC,
the right thing to do would be get the CVR (if its duration of recording goes back to point at which ‘CASA’ says the information was given to the PIC) to find out the quality and content of the transmissions received.
(I note that even if the proximate cause of the ditching was bad airmanship, it does not excuse the ATSB or CASA from doing nothing about the lifevest and liferaft issue. The silence and inaction on that stuff really makes me sick to the stomach.)
But on the question of the information available to the PIC, let’s continue with the assumption that the PIC received and understood, verbatim, what’s in the transcript.
My reading is that at 0801:31 Nadi makes a transmission addressed to NGA, in these terms:
METAR Norfolk at 0630 Zulu wind 300 09 knots 9999, few 6,000 broken 2400 temperature 21 dewpoint 19 QNH norfolk 1011 remarks closed till 1930 UTC go ahead.
Ahhh ...copy... just say again the issue time for the METAR.
Now I’m only a wheelchair-bound geek from Hicksville, and this may be pure speculation, but maybe the crew member who was on the radio felt compelled to respond, so that Nadi knew the transmission had been received, but the “Ahhh” was a verbal ‘head-scratch’ about the “few 6,000 broken 2400” bit. I know that if I were in an aircraft in which that transmission were received by the people with whom I’m fortunate enough to fly, the phrase “few 6,000 broken 2400” in a METAR would produce a ‘WTF?’ moment.
Irrespective of what caused the “Ahhh” and what was going on in the cockpit, at 0802:32 according to the transcript – that’s just one minute after the METAR quoted above - another transmission was sent to and acknowledged by NGA:
Roger this the latest weather for Norfolk...SPECI... I say again special weather Norfolk at 0800 Zulu... auto I say again auto, alpha uniform tango oscar, wind 290 08 knots, 999 november delta victor, overcast one thousand one hundred , temperature 21, dew point 19, QNH Norfolk 1012...remarks... romeo foxtrot zero zero decimal zero oblique zero zero zero decimal zero go ahead.
Let’s assume the crew aren’t idiots, and their mutual head scratching resulted in them concluding that the “few 6,000 broken 2400” information may be erroneous, and perhaps instead should be “few 600 broken 2,400”. However, before they ask the question, the SPECI comes through. The SPECI says “overcast one thousand one hundred”.
Is that really the basis on which this entire mess gets pinned on the PIC? Has ‘CASA’ really decided that that piece of information should have resulted in a diversion?
Last edited by Creampuff; 22nd Nov 2012 at 08:33.
gaunty
So that'd be this mob then: A First for Australian Business Aviation | International Standard for Business Aircraft Operations (IS-BAO) | NBAA - National Business Aviation Association
I see the good Senator X has caught onto the tautological comment from the DAS that gobbles had in his last post on this thread: http://www.pprune.org/7528218-post825.html
(my bold)
Onya Nick!
Sorry Creamy almost missed your post, which is extremely relevant because for some reason the ATSB initially missed the erroneous 0630 METAR that was relayed at 0801 UTC (giving few at 6,000') and subsequently due to the 4C program had to correct their report.
Something that is equally troubling is that in the CASA Accident Investigation Report 09/3 on page 7 there is this statement for the 0801 UTC NADI communication:
Which besides leaving out several parts of the true transcript also totally leaves out the details for the 0630 UTC METAR and the pilot asking for the issue time to be repeated.
So my question would be was the CASA truncated version the one that was originally given to the ATSB and hence the reason why they missed the erroneous "few at 6,000 ft" message??
I have fairly recently completed a task which involved the building from a blank piece of paper a transport category only AOC with unrestricted worldwide operation and with the highest international SMS, best practise and management accreditations available. It is not BARS which does not even get close. However! Fleet now Citation, Phenom, Challenger and Gulfstream.
I see the good Senator X has caught onto the tautological comment from the DAS that gobbles had in his last post on this thread: http://www.pprune.org/7528218-post825.html
Senator XENOPHON: Just finally from me—again, possibly on notice—can you advise whether CASA has any right to access an operator's internal investigations? What about internal disciplinary proceedings? If Mr McCormick reads this I hope he does not consider this a 'tautological rubbish' question.
Onya Nick!
Sorry Creamy almost missed your post, which is extremely relevant because for some reason the ATSB initially missed the erroneous 0630 METAR that was relayed at 0801 UTC (giving few at 6,000') and subsequently due to the 4C program had to correct their report.
Something that is equally troubling is that in the CASA Accident Investigation Report 09/3 on page 7 there is this statement for the 0801 UTC NADI communication:
0801 UTC NADI ATC provides the aircraft with the METAR for YSNF issued at 0630 ZULU. This was then updated with an Auto SPECI for Norfolk issued at 0800 ZULU. Wind 290 at 08 Knots cloud (OVC) at one thousand one hundred ft AGL, 21°C and the dew point was 19°C and QNH Norfolk 1012.
So my question would be was the CASA truncated version the one that was originally given to the ATSB and hence the reason why they missed the erroneous "few at 6,000 ft" message??
Last edited by Sarcs; 22nd Nov 2012 at 10:25.