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How can this happen - controller partly blamed (merged)

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How can this happen - controller partly blamed (merged)

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Old 6th Feb 2006, 17:03
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How can this happen - controller partly blamed (merged)

http://news.bbc.co.uk/1/hi/scotland/4686602.stm

Surely if your not guilty at a court martial, then you arent to blame !!
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Old 6th Feb 2006, 17:21
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What utter nonsense.

Clearly the F-15 pilots were inadequately prepared to fly in the UK ATC environment - it was entirely up to their unit 'indoctrination' to ensure that they understood UK terminology and ATC service levels. That the lead pilot requested the 'minimum vectoring altitude' shows that he had no idea of UK terminology.....

The Court Martial which cleared the ATCO was told that the lead F-15 pilot was entirely to blame for his CFIT accident.

The ATCO in question should insist that it is made abundantly clear that no blame whatsoever should be attached to him.

This is worthy of another Chinook/Mull of Kintyre level of outrage from serving RAF personnel...
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Old 6th Feb 2006, 17:56
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The right way around

Surely this is a case of the horse going before the cart The Courts Mashall shouldn't have taken place until after the RAF Enquiry was complete. That way all the information would have been available.

The BBC report also seems to imply that the Courts Marshall cleared him of total blame; in other words that he wasn't solely to blame, but leaving the door open for the official RAF enquiry to find him partially to blame for giving an unsafe clearance.

Seems he had a 'lucky' escape at the CM, if it had come after the official enquiry he might now be facing very serious charges. Or does double jeopardy not come into play here?
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Old 6th Feb 2006, 18:35
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Beagle

I try hard to bite my tongue at the drivel you normally spout. However on this occasion...

This is worthy of nothing like the level of disgust felt around the service at the dreadful Mull of Kintyre saga.

Read some information on the case, read some information on the BoI and then see if your opinions are still the same.

Lots of people at fault, lots of issues raised. Blame? Not on any single person. And rightly so.

Sad facts: Two dead aircrew. RIP.

Last edited by rudekid; 6th Feb 2006 at 19:10.
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Old 6th Feb 2006, 18:42
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A spokesman for the Ministry of Defence said it was not the role of a Board of Inquiry to apportion blame, and it marked the closure of an unfortunate incident for the RAF
The purpose, surely is to estsablish facts and prevent it happening again?
Sadly the crews can't comment. Do F15s carry FDRs?

Please don't lambast me for lack of knowledge, I'm merely an interested civilian.
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Old 6th Feb 2006, 19:02
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If the RAF enquiry is in the standard format of an accident report, then it would not lay the blame with any one, it would instead list the various contributory factors which lead to the accident. This has been the case I believe ever since after the Mull of Kintyre accident report. This would tie in with the quote in the report:-

"A spokesman for the Ministry of Defence said it was not the role of a Board of Inquiry to apportion blame, and it marked the closure of an unfortunate incident for the RAF."

It would therefore seem that this is another piece of badly written reporting by the BBC, reopening wounds best left alone.

Edited because my grammar is appalling.

Last edited by JTIDS; 7th Feb 2006 at 12:17.
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Old 7th Feb 2006, 05:36
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Crash controller 'partly blamed'

http://news.bbc.co.uk/1/hi/scotland/4686602.stm

A crash which killed two fighter pilots in the Cairngorms has been partly blamed on a military air traffic controller, BBC Scotland has learned.
The official RAF inquiry reached its conclusion even though the controller was cleared of causing the deaths by an earlier RAF court martial.

Two US pilots from Suffolk died when their F-15 jets crashed into Ben Macdui on a low flying exercise in 2001.

The report concludes they accepted an unsafe air traffic control instruction.

The deaths of Lieutenant Colonel Kenneth Hyvonen and Captain Kirk Jones, who were based at RAF Lakenheath, have been scrutinised several times.

The original RAF Board of Inquiry was suspended pending the court martial of Malcolm Williams, the air traffic controller at RAF Leuchars who gave flight descent information to the two US planes shortly before they crashed.

The RAF court martial cleared Flt Lt Williams of causing the deaths of the two pilots.



A US Air Force inquiry then concluded the American pilots made the first mistake, following confusion about terminology with the RAF controller.

Now the findings of the reconvened RAF Board of Inquiry conclude the crash happened partly because the pilots accepted an air traffic control instruction that was clearly unsafe.

A spokesman for the Ministry of Defence said it was not the role of a Board of Inquiry to apportion blame, and it marked the closure of an unfortunate incident for the RAF.

The F-15 pilots were flying in variable cloud on a low altitude training mission and were lost from radar during an air traffic control handover on 26 March, 2001.

Lieutenant Colonel Hyvonen, 40, and Captain Jones, 27, were killed instantly when their aircraft crashed while on a low flying exercise from RAF Lakenheath.
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Old 7th Feb 2006, 06:57
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Is this bad reporting, or do the BoI really believe that he gave an INSTRUCTION when providiing RIS?
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Old 7th Feb 2006, 08:41
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A detailed account of the Courts Martial is at: http://www.pprune.org/forums/showthr...ight=F15+Court

The whole sad and sorry story seems to whiff of the foulest sort of politics. I wonder if the BoI ignored eyewitness accounts etc. in the same way as the Prosecution appeared to have done!
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Old 7th Feb 2006, 09:27
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Reporting

JTIDS are you suggesting that this shouldn't have been reported? Or are you suggesting that the report didn't say that the pilots accepted an unsafe clearance and that the media have got that wrong? There seems to be the suggestion of both, in your last posting.

Any of us who have been around avaiation for a while know that most accidents are caused by a catalogue of events. It seems that this is the case here. If the board state that the clearance was unsafe, then that is the conclusion of the board. The board isn't apportioning blame just stating the facts. This fact, was a contributary factor to the accident and must be recognised by all concerned.

In the interest of safety and to ensure that another tragic event like this does not happen again, it is necessary for all concerned to be aware, take this on board and ensure that any clearnce given and received is clearly understood by all parties.
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Old 7th Feb 2006, 10:14
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By flying below safety altitude in IMC without positive radar control, the flight leader displayed woeful situational awareness and, as a result, caused the controlled flight into terrain of both himself and his wingman.

This was not helped by his lack of understanding of UK ATC procedures, and the confusion he caused to the ATCO providing the Radar Information Service by his incorrect use of domestic US terminology.

All RAF pilots of my era were taught low level weather aborts during their basic Jet Provost low level navigation training. Quite why this experienced pilot was so unaware of the immediate terrain and yet pressed on with his exercise will probably never be fully established.

The CM cleared the ATCO of any blame and costs were awarded against the Crown. One hopes that the ATCO's QC will go into battle once more to demand both a retraction and an unequivocal apology.

Is the report available in the public domain yet? The US press are reporting: 'The report concluded that "the controller's actions were not the cause of the accident, though they made it very likely to occur." '
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Old 7th Feb 2006, 10:15
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Angry

In no way shape or form can this be equated with the Mull of Kintyre travesty!
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Old 7th Feb 2006, 10:27
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Gorilla,

I repect your right to an opinion. I just disagree with it.
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Old 7th Feb 2006, 12:15
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PAMACC, I am agreeing with pretty much what you say. What I was trying to say that the BBC report seemed to be trying to create controversy where there was none. However I have just re-read my posting and realised the possible area of confusion.
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Old 7th Feb 2006, 13:17
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they accepted an unsafe air traffic control instruction
Some have questioned this choice of words? From what I recall of the accident (not first-hand, but read on this forum and in other more "official" sources)... On request from the formation leader for descent, the Controller allocated a level that did not provide terrain clearance... the fact that the pilots, under RIS, had responsible for terrain clearance and that the allocated level was above the mountain top so could not have directly caused the death of the pilots... even the not guilty decision (which incidently I do support) does not diminish from the fact IMHO it was still an unsafe instruction?
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Old 7th Feb 2006, 14:31
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What phraseology was used?

JTIDS, the media always have a habit of trying to create controversy. Thank you for your reply though

I hope, that sensible people will think that the Board's report raises interesting saftey issues. I am curious to know why they say that the phraseology used by the ATCO was constributary to the accident. If, it was indeed, contributary, then we should all be asking this question and a resolution made to ensure that better phraseology is used in the future. This has got to be worthy of discussion on this thread.

Can anyone tell me what the exact phraseology was? Is there a transcript available anywhere?
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Old 7th Feb 2006, 15:57
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Had he "issued a clearance" (under a RIS i understand) to descend to an altitude below MSA for the area?

Presumably this is why we are now constantly reminded that we are responsible for our own terrain clearance when in reciept of such a service now...
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Old 7th Feb 2006, 16:07
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All RAF pilots of my era were taught low level weather aborts during their basic Jet Provost low level navigation training. Quite why this experienced pilot was so unaware of the immediate terrain and yet pressed on with his exercise will probably never be fully established.
Beags....has an RAF crew smacked rock since you were first trained on Boxkites in the RAF? Seems to me we have had a long ongoing discussion about at least one crew in a Chinook.

Try to answer your own question....why did the two pilots find themselves flying lower than the rock? Reckon they may have had some help in making that mistake? It does not have to be intentional help....it does not have to be direct help....but two good men died for some bad reason.

It seems very odd to hold a court martial while a BOI is on-going. They are two indepenent inquiries and have completely different purposes, however they are about the very same set of facts and thus cannot be separated.

My view would be the court martial was hurried up and the BOI was suspended so that political face could be saved. No one on the RAF side wanted to confronted with any responsibliity for two USAF aircraft and pilots being lost.....no matter how tangentially involved.

I see it as being a very transparant method of shielding the home team while leaving the visitors out on the limb.

That the USAF pilots made a mistake....or a series of mistakes but the bottom line....any vector given by radar to an aircraft has to take into account the minimum safe altitude for the area being flown. The terminology difference should not have rendered that mandate invalid.

The controller if confused...and aware of being confused...should have announced his uncertainty and suggested a climb to altitude while things got sorted out. I would suggest if the pilots had sensed any uncertainty, in all liklihood they would have asked for the climb clearance or one would hope anyway.

The thrust of the BOI should be to accurately layout the facts....assess them for factors that led to the disaster and fairly descibed what those factors were without regard to who winds up with egg on their face.

The inclusion of the court martial smacks of some self serving interest by the Airships in this matter and not a seeking of justice for either the pilots or the controller.

The Chinook thread is yet another indicator of how good men can be let down by the system.

Last edited by SASless; 7th Feb 2006 at 16:21.
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Old 7th Feb 2006, 19:33
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It is indeed SixDelta,

although I have to say that it took me a while to get used to!

"You are identified RIS blah blah. You are responsible for terrain avoidance."

No Sh*t..!
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Old 7th Feb 2006, 22:16
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Confusion and correct phraseology

Issues as to the ATCO being confused with respect to the terminology used, are, in my opinion exactly why the safety issues from the BoI should be being addressed. An ATCO of his apparent long standing and capability (and I'm going on what all his friends and collegues wrote on this forum leading up to the CM) should not have been confused. So why did this happen and why did he feel unable to advise the pilot that this was the case?

The results of the CM are known and unarguable.

However there are lessons to be learnt here. I have not had any replies as to the exact phraseology used. What happened to the good old phrase "at your discretion' or "unable to give descent below Minimum safe Altitude"? Were these phrases used or weren't they? If they were then how could the BoI have considered the phraseology used to be unsafe?

It also seems that the ATCO was well aware that the aircraft intended to descend to 4000ft and that the aircarft disappeared from radar, but that this was not due to the crash. I read from this, that this descent took the aircraft out of known radar coverage. Is that correct? If so what happened to that good old phrase "you are (going) out of radar coverage, Radar Information Service Terminated".

All of the above are little alert messages to the pilot that he is now doing entirely his own thing and if they had been used, would have absolutely and fully exonerated the ATCO.

So someone out there please tell me. Are military controllers no longer taught the above phraseology? Has it changed? Did they ever use it? Was it used in this case? From what we are learning from the BoI, it seems the latter is unlikely.

So I say once again. We all have a lot to learn on the issue of safety here. What is likely to be done about it? Has any of it already been addressed?
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