Go Back  PPRuNe Forums > PPRuNe Worldwide > Australia, New Zealand & the Pacific
Reload this Page >

Qantas B744 stick shaker event near Hong Kong

Australia, New Zealand & the Pacific Airline and RPT Rumours & News in Australia, enZed and the Pacific

Qantas B744 stick shaker event near Hong Kong

Old 27th Mar 2019, 06:51
  #1 (permalink)  
Thread Starter
 
Join Date: Nov 2017
Location: Low in the weed or getting high at levels
Posts: 27
Likes: 0
Received 0 Likes on 0 Posts
Qantas B744 stick shaker event near Hong Kong

Australian Aviation - Qantas B744 stick shaker event near Hong Kong

markfelt is offline  
Old 27th Mar 2019, 07:20
  #2 (permalink)  
 
Join Date: Mar 2002
Location: Seat 1A
Posts: 8,532
Received 72 Likes on 41 Posts
Originally Posted by ATSB
While descending towards BETTY, the aircraft’s speed reduced below both the target speed of 225 kt and the minimum manoeuvring speed
Why was this? No mention of autothrottle modes...
Capn Bloggs is online now  
Old 27th Mar 2019, 07:51
  #3 (permalink)  
 
Join Date: Sep 2006
Location: Inside the Industry
Posts: 876
Received 0 Likes on 0 Posts
Regrettably, this is another incident which highlights the need to fly and monitor the aircraft. This crew was obviously some way mentally behind the aircraft and its automation having little idea what it was going to do in response to FMS input.

Last edited by industry insider; 27th Mar 2019 at 08:30. Reason: Typo
industry insider is offline  
Old 27th Mar 2019, 12:51
  #4 (permalink)  
 
Join Date: Aug 2001
Location: The wrong time zone...
Posts: 839
Received 48 Likes on 21 Posts
From The Age
Pilots flying a Qantas plane that experienced a roller-coaster descent into Hong Kong two years ago struggled to respond to the incident because of a lack of training, an investigation has found.

The in-flight "upset" left four cabin crew and two passengers with minor injuries, and has prompted Qantas to retrain all of its Boeing 747 pilots and update training for its other Boeing pilots.

The Australian Transport Safety Bureau's final report into the incident, released on Wednesday, found the pilots at the controls of the 747-400 from Melbourne manually over-rode the flight computer's flight speed when preparing to enter a holding pattern around Hong Kong International Airport on April 7, 2017.

The pilots then failed to increase their speed when directed to enter the holding pattern at a higher altitude than expected. The ATSB said the aircraft slowed to below the necessary speed while descending but the flight crew did not notice because they were busy reading flight documents and looking out the window for other air traffic.

Shortly after, the aircraft started experiencing pre-stall buffeting. The pilot took recovery action to stop the buffeting, but failed to complete the full stall-recovery procedure.

This led to further "stick shaker" stall warnings – indicating the aircraft could be about to lose altitude. That prompted the pilot to force the plane's nose down several times, resulting in the violent oscillations that saw several crew and passengers hit the cabin's roof.

The ATSB found that while the pilots had been trained in stall recovery in low altitudes, they had not had instructions on how to handle the problem at higher altitudes.

"The opportunity for flight crew to practice their high altitude manual handling skills was limited," the report says.

As a result, the flight crew did not adequately respond to the initial buffet and probable stick shaker activation, leading to the in-flight upset."

Qantas has since updated its training for pilots across its fleet of 747s, Boeing 787 Dreamliners and Boeing 737s.

“We take these incidents very seriously and use them as an opportunity to reinforce procedures
and improve safety," a Qantas spokesman said.

"In correcting the aircraft’s path, the crew was very conscious they were operating in congested airspace and had limited room to manoeuvre, which added to the sense of turbulence in the cabin.“
josephfeatherweight is offline  
Old 27th Mar 2019, 15:31
  #5 (permalink)  
 
Join Date: Feb 2000
Location: 500 miles from Chaikhosi, Yogistan
Posts: 4,282
Received 131 Likes on 59 Posts
How about you lot reference the report not the journos' interpretations.

https://www.atsb.gov.au/media/577579...-044_final.pdf
compressor stall is offline  
Old 27th Mar 2019, 20:25
  #6 (permalink)  
 
Join Date: Jun 2001
Location: sierra village
Posts: 656
Received 102 Likes on 51 Posts
This is a rumour network! We simply cannot allow facts to get in the way of a good story.
lucille is offline  
Old 27th Mar 2019, 21:17
  #7 (permalink)  
 
Join Date: Aug 2001
Location: The wrong time zone...
Posts: 839
Received 48 Likes on 21 Posts
How about you lot reference the report not the journos' interpretations.
How about we pool together the collective information, which includes articles from the media, which also includes classic comments from Qantas PR such as this:
"In correcting the aircraft’s path, the crew was very conscious they were operating in congested airspace and had limited room to manoeuvre, which added to the sense of turbulence in the cabin.“
This was also "behind the paywall" that so many of you get upset with, hence my posting of The Age article here.

Reference:
We simply cannot allow facts to get in the way of a good story.
Having read the report the following appears to be FACT:
- the crew were not aware of the required holding speed above FL200
- the aircraft was allowed to slow below minimum maneuvering speed
- in the "stall recovery" the wings were not leveled in order to "remain within the protected airspace of the hold" - @ FL220??
- following the minimalist "stall recovery", the captain "pulled back on the control column to increase the pitch angle to prevent further descent." ??
- when the stick shaker was again (predictably) activated the captain "again pushed forward on the control column to reduce the aircraft’s pitch angle and increased thrust slightly." Slightly!?!?

This appears to have been written off as a "but we weren't trained how to do high altitude stalls." but the airmanship and handling skills displayed by the crew was pretty lackluster...
josephfeatherweight is offline  
Old 27th Mar 2019, 21:33
  #8 (permalink)  
 
Join Date: Aug 2016
Location: Sydney
Posts: 57
Likes: 0
Received 0 Likes on 0 Posts
And CASA allows this crowd to fly in Australia...? Oh wait
downdata is offline  
Old 27th Mar 2019, 22:47
  #9 (permalink)  
 
Join Date: Aug 2009
Posts: 509
Likes: 0
Received 0 Likes on 0 Posts
A pairing of 24,000 and 16,000 hours and a mistake like this. Who was flying the aircraft?... Pretty concerning. Everyone is fallible.
PPRuNeUser0198 is offline  
Old 27th Mar 2019, 23:04
  #10 (permalink)  
 
Join Date: Sep 2018
Location: Melbourne
Posts: 2
Likes: 0
Received 0 Likes on 0 Posts
"..........."Qantas never crash"..........the SkyGods are a protected species remember, the general public will believe the QF PR machine watered down version of events & justification of their actions, contrary to actual industry standards! This event reminds me of Kendell incident some years ago when the drivers lost control whilst in a holding pattern, who was minding the shop in both cases?
Hopefully something positive can come out of this but at the very least it's a wake up call that we pilots can F**k it up at any time,
machtuk is offline  
Old 28th Mar 2019, 01:47
  #11 (permalink)  
 
Join Date: Sep 2009
Location: space
Posts: 389
Likes: 0
Received 1 Like on 1 Post
Remember QF1? Captain allowed the crash. Captain is responsible for EVERYTHING that happens on his/her aircraft. QF should have written the hull off as uneconomical to repair but were so bloody minded about their reputation they spent more than a new aircraft to fix it. Shame Skygods Shame!This is the truth, QF and Little Gay Al will do anything to safeguard their reputation rather than admit fault.
zanthrus is offline  
Old 28th Mar 2019, 01:59
  #12 (permalink)  
 
Join Date: Jun 2001
Location: FNQ ... It's Permanent!
Posts: 4,281
Received 162 Likes on 83 Posts
Remember QF1?
How could anyone forget it?
Capt Fathom is online now  
Old 28th Mar 2019, 03:23
  #13 (permalink)  
 
Join Date: Apr 2007
Location: BackofBourke
Posts: 346
Likes: 0
Received 0 Likes on 0 Posts
The investigation states on Page 2, a 'glass ceiling' contributed to the event.
tio540 is offline  
Old 28th Mar 2019, 05:18
  #14 (permalink)  
 
Join Date: Apr 2001
Location: overthere
Posts: 3,037
Received 17 Likes on 9 Posts
Originally Posted by T-Vasis
A pairing of 24,000 and 16,000 hours and a mistake like this. Who was flying the aircraft?... Pretty concerning. Everyone is fallible.
On checking, I have found both crew members were human . It would seem it's a human trait that allows them to make an error . Add the startle of something happening, when nothing has ever happened in the previous 20k hours, the decision making and handling skills you believe you have when reading a report, are sometimes different to those you have when starring in a report .

It is rare to find someone that has manoeuvred an aircraft without autopilot about 10000 feet these days . And no, following FDs in a climb is not manoeuvring. it is even more rare to have such a large aircraft at so low a speed .Procedures are designed to prevent this right? So when it does happen on your watch, it takes a while to understand why? What is happening? Did I do it? Have I lost my job? Etc etc . So when recovery commences, you are already at a high state of anxiety, much much more than you have had during SIM training (nothing goes wrong in aeroplanes anymore right?), so things aren't going to be as pretty as they are in the SIM . During the recovery, you will rationalise that it's only a stall warning, not a stall, so does that procedure really apply .You will not want ATC asking why you are deviating from ALT etc .

Lots to learn from reports like this .
donpizmeov is offline  
Old 28th Mar 2019, 06:07
  #15 (permalink)  
 
Join Date: Jun 2005
Location: in denial
Posts: 293
Received 0 Likes on 0 Posts
Well said Don.
Veruka Salt is offline  
Old 28th Mar 2019, 06:23
  #16 (permalink)  
 
Join Date: Jul 2013
Location: Doomadgee
Posts: 279
Received 47 Likes on 25 Posts
Great post Don.

Have people forgotten that the sim isn’t fitted with an adrenaline drip, nor does negative g too well.

Ive seen first hand in the aircraft how the startle affect, and fear of job loss, degrades performance.

Capn Rex Havoc is offline  
Old 28th Mar 2019, 07:02
  #17 (permalink)  
 
Join Date: Aug 2011
Location: NDB
Age: 53
Posts: 152
Likes: 0
Received 0 Likes on 0 Posts
Thumbs up

Well said Don.

Shame there are so many Monday morning quarterbacks and plane spotters with expert analysis.

Best advice is to just read the report and learn from it.
OnceBitten is offline  
Old 28th Mar 2019, 12:58
  #18 (permalink)  
 
Join Date: Jun 2000
Location: Australia
Posts: 4,186
Likes: 0
Received 6 Likes on 4 Posts
Thumbs up

:
Add the startle of something happening
Ah! Yes!. The dreaded "startle factor" is the new get out of jail free card.
Centaurus is offline  
Old 28th Mar 2019, 14:42
  #19 (permalink)  
 
Join Date: Apr 2001
Location: overthere
Posts: 3,037
Received 17 Likes on 9 Posts
Originally Posted by Centaurus
:

Ah! Yes!. The dreaded "startle factor" is the new get out of jail free card.
No centaurus, it's not a get out of jail free card .it's the name of a condition which prevents people from acting in an optimal manner . In WW1 troops who suffered startle were shot for cowardice. Luckily we have moved on .It's the reason why I can always make the perfect decision of what someone should have done, and how they should have done it when I read an incident report . And also why I might not always walk the walk if in the operating seat. No-one goes to work wanting to have an incident . Nor had this crew until it happened .
As I said, there is lots to learn from reports like this . But to learn from them you need to read them in a “How could this have occurred” mindset . To just say no-one was minding the shop is missing the whole point .
Anyone, good or bad can have a bad day. Learning from others having a bad day out is far better than learning first hand.
donpizmeov is offline  
Old 28th Mar 2019, 16:51
  #20 (permalink)  
 
Join Date: Feb 2006
Location: Bottom of the Harbour
Posts: 415
Likes: 0
Received 4 Likes on 2 Posts
.No centaurus, it's not a get out of jail free card .it's the name of a condition which prevents people from acting in an optimal manner
Acting at less than 'optimal performance' in a situation that is non normal due to poor pilot input I think sums this up. This event occurred due to poor airmanship and the recovery demonstrates this.

Placing an aircraft in an unstable state and recovering like this crew did raises multiple questions on automation management and disciplined recovery techniques. Aviate, navigate, communicate is still a valid concept on modern airliners.

Pilot training was Boeings first defence in the MAX accidents, Airbus was the same following Air France. Airbus thankfully only suffered one unreliable airspeed that led to deaths, a second would have seen the same outcome as Boeing. It was only through pilot training, experience and correct recovery that prevented a second significant loss of life.

I am sickened by the Qantas PR spin that the FO had their head looking out at other traffic in the holding pattern to ensure separation , shame I can't do that in IMC.

There is no sugar coating what is effectively a loos of control by three pilots on the flight deck. Three pilots having a bad day leads to a lot of questions, drawing WW1 parallels is a long bow.

Last edited by KABOY; 28th Mar 2019 at 17:27.
KABOY is online now  

Thread Tools
Search this Thread

Contact Us - Archive - Advertising - Cookie Policy - Privacy Statement - Terms of Service

Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.