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Hawk incident near Culdrose

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Hawk incident near Culdrose

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Old 11th May 2021, 20:52
  #101 (permalink)  
 
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Is there any real info regarding the cause of the Hawk incident? There has been nothing concrete at all, just the speculation of the good members of Pprune. Will there be any info? or will the powers that be sort out the cause for themselves and then make it classified info?

Just curious.

Rans6.......
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Old 11th May 2021, 22:14
  #102 (permalink)  
 
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Originally Posted by rans6andrew
Is there any real info regarding the cause of the Hawk incident? There has been nothing concrete at all, just the speculation of the good members of Pprune. Will there be any info? or will the powers that be sort out the cause for themselves and then make it classified info?

Just curious.

Rans6.......
Why do you need to know? If you are a current military pilot, or involved in Hawk operations, then you already know the high points of the accident.

No, it won't be covered up either - a Service Inquiry takes time to be published.
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Old 12th May 2021, 08:46
  #103 (permalink)  

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Originally Posted by [email protected]
As I understand, the hawk pilot initially positioned for a PFL to Culdrose but the engine problem appeared to correct itself - he changed plan and was then caught out when the problem came back in spades.

Probably carburettor icing.
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Old 12th May 2021, 19:14
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Heard a strong rumour that the engine failed due to a lack of oil pressure!
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Old 30th Jul 2022, 09:17
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Originally Posted by H Peacock
Heard a strong rumour that the engine failed due to a lack of oil pressure!
So it seems.

https://www.cornwalllive.com/news/co...-crash-7399276
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Old 30th Jul 2022, 09:39
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Engine failure has been blamed for a Royal Navy jet crashing into a remote Cornish woodland on the Lizard Peninsula.

A report by the Defence Safety Authority which took almost a year to complete has now revealed that the jet from RNAS Culdrose crashed in a woodland area outside St Martin near Helston in March 2021 after losing its engine oil when a plug was incorrectly fitted and popped out when the pilot and co-pilot fired the engine during their training exercise last year.

In its conclusion the report found that the crash was due to the loss of engine oil after an incorrectly fitted Magnetic Chip Detection (MCD) plug was ejected from its housing on engine start by the oil system working pressure. Furthermore, there was a failure of the self-sealing valve situated within the missing MCD housing, the purpose of which is to prevent oil from leaking when the MCD is not present.

The report also revealed the pilot’s lifejacket had burst on ejection and was a vital piece of survival equipment if they’d landed in water. The report concluded it had been incorrectly packed. The immediate actions of the post-crash emergency team were also commended in the report.
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Old 30th Jul 2022, 10:37
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Originally Posted by Asturias56
Engine failure has been blamed for a Royal Navy jet crashing into a remote Cornish woodland on the Lizard Peninsula.

A report by the Defence Safety Authority which took almost a year to complete has now revealed that the jet from RNAS Culdrose crashed in a woodland area outside St Martin near Helston in March 2021 after losing its engine oil when a plug was incorrectly fitted and popped out when the pilot and co-pilot fired the engine during their training exercise last year.

In its conclusion the report found that the crash was due to the loss of engine oil after an incorrectly fitted Magnetic Chip Detection (MCD) plug was ejected from its housing on engine start by the oil system working pressure. Furthermore, there was a failure of the self-sealing valve situated within the missing MCD housing, the purpose of which is to prevent oil from leaking when the MCD is not present.

The report also revealed the pilot’s lifejacket had burst on ejection and was a vital piece of survival equipment if they’d landed in water. The report concluded it had been incorrectly packed. The immediate actions of the post-crash emergency team were also commended in the report.
The full report is here:

Service Inquiry into the Loss of Hawk T Mk1 XX189 from 736 Naval Air Squadron, RNAS Culdrose - GOV.UK (www.gov.uk)
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Old 30th Jul 2022, 11:05
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Hawk incident near Culdrose

The report indicates that engine ground runs to test a disturbed system were discontinued in 2012, since this incident they have been reinstated; problem solved?
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Old 30th Jul 2022, 16:24
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Originally Posted by lefty loose
The report indicates that engine ground runs to test a disturbed system were discontinued in 2012, since this incident they have been reinstated; problem solved?
Shortly after failure to conduct disturbed systems testing had killed Flt Lt Sean Cunningham. Not errors of omission. On both occasions a conscious policy decision was made not to do it. A repair is not complete until verified.

Even the briefest glance at the recommendations tells you most would be unnecessary if mandates were met in the first place.

Surely the Convening Authority should be asking 'How are you getting on with implementing the same recommendations from.....?' (Insert almost any accident, but Hawk XX204 and Hawk XX177 for a start). But then, that would bring matters too close to home.

You can't make this stuff up.
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Old 30th Jul 2022, 16:39
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Did not a 146 from Northolt run out of oil some time ago when work was not done properly?
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Old 30th Jul 2022, 18:56
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Turned over a lot of `stones` there.....
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Old 30th Jul 2022, 20:29
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I get that most are horrified by the MCD error, but I think it is worth highlighting the errors with regard to the provision of maintenance of AEA.

Once leaving any incident aircraft there is an assumption that the AAES and AEA will all work as advertised. In my 25 years of working alongside RAF SE personnel, I am surprised and disturbed that RN SES personnel are not operating to a similar standard and particularly in this case, not provisioned with adequate staff and facilities to undertake their work correctly.
For the SI to state that 736 NAS made no use of the main SE Bay is a little disingenuous, given the geography at CU, or the practicality of moving this kit around what is a huge piece of real estate at all times of the day.
Possibly a ‘one off’ given the operating circumstances at CU and hopefully the Joint environment will help to address any differences (I consider myself as being ‘purple’ and work in the Joint environment).
Or then again, maybe RAF SE personnel are being similarly ‘leaned’ to save money by those that removed the requirement to conduct an engine Ground Run post MCD removal. There is plenty of anecdotal evidence of not, or poorly fitted MCDs bringing down aircraft.
Anyone can know the cost of something, but only the SQEP few know the value and there but for the grace of God there were no funerals from this event, it could have clearly had a different outcome.
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Old 31st Jul 2022, 00:00
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Isn't the installation of a Mag Chip detector a duplicate inspection item? On my days working on airliners I seem to remember it was.
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Old 31st Jul 2022, 05:24
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Originally Posted by Mortmeister
Or then again, maybe RAF SE personnel are being similarly ‘leaned’ to save money by those that removed the requirement to conduct an engine Ground Run post MCD removal. There is plenty of anecdotal evidence of not, or poorly fitted MCDs bringing down aircraft.
Anyone can know the cost of something, but only the SQEP few know the value and there but for the grace of God there were no funerals from this event, it could have clearly had a different outcome.
The reports from the Cunningham and Bayliss deaths (Hawks XX177 and 204) spell this out in excruciating detail. In the latter case, lack of SQEP was a common complaint. AOC 22 Group said he'd bags of staff, but they weren't SQEP; although others said they lacked any kind of staff. In the former, the Reds had armourers with no seat experience, they were directed to ignore mandates, and had/were allowed to use the wrong tools. But that is no excuse for so many above them agreeing to omit testing; especially, as 8674planes says, when double-checking is mandated.

That they were RAF, and the current one RN, simply highlights that these are core activities. The Panel's report, at 1.6.11, rightly touches on this, pointing out there is a single Type Airworthiness Authority. (I thought it a good report). But previous occurrences have demonstrated the weakness caused by TAAs not having the necessary authority, and the dearth of support afforded them. It's rather like giving a chippie a bag of nails and telling him to build a house.

If this is happening time and time again, and the subject of hundreds of recommendations in accident reports, then the Safety Management System isn't working and is unfit for purpose.

Here, DGDSA says there are 'valuable lessons', and then lists many that came up in the Jon Bayliss case, where only last November the Coroner found MoD negligent because it repeated breaches from 2011 and 2007. That damning indictment was on his desk when he took up post, and his predecessor knew throughout her tenure. I conclude the DG, also, doesn't actually have the necessary authority, and we already know that neither do the Delivery and Operating Duty Holders. Once again the current Duty Holder construct is proven a complete crock. There's plenty of people who say they're in charge, but there's apparently no-one in control.
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Old 31st Jul 2022, 06:55
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On my last Hawk Unit (not military) if the mag plug change was carried out on a turn round or (say) if an engine runner was not available after an evening mag plug change - we did the mag plug leak check on the next sortie start up as we always had a 1st line tool box with us.
One of those vital little jobs.
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Old 31st Jul 2022, 08:13
  #116 (permalink)  
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Originally Posted by 8674planes
Isn't the installation of a Mag Chip detector a duplicate inspection item? On my days working on airliners I seem to remember it was.
Certainly is for obvious reasons.

The reference to EFDC is alarming. EFDC's are worth their weight in gold to any organisation....they have the expertise to analyse any debris after all....and it was a golden rule, never remove debris from a plug before sending it to the EFDC. If I've read the report correctly, the mention of "on condition" seals being inspected is also concerning.

Once a seal has been removed from its seating, irrespective of the location, it gets replaced NO exceptions ...remember, its been under compression and subject to varying px and temps...and you can't tell its condition just by looking at it.
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Old 31st Jul 2022, 09:12
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Krystal

SQEP+.
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Old 31st Jul 2022, 09:39
  #118 (permalink)  
 
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Notwithstanding the plethora of maintenance and organisational failures involved, I find it rather surprising that a pilot flying through the overhead at 8000ft, with a surface W/V of 220/11G18 for RW29, 29km vis. and few (less than 2 oktas) of cloud below 6000ft didn't fly a simple spiral descent to High Key?

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Old 31st Jul 2022, 10:18
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Originally Posted by BEagle
Notwithstanding the plethora of maintenance and organisational failures involved, I find it rather surprising that a pilot flying through the overhead at 8000ft, with a surface W/V of 220/11G18 for RW29, 29km vis. and few (less than 2 oktas) of cloud below 6000ft didn't fly a simple spiral descent to High Key?
Probably because a spiral FL isn't as simple as you insinuate and quite easy to mess up with serious consequences, especially so with some of the immediate area built up - Helston to N and families quarters to S. If the engine is running smoothly with an oil caption (no other symptoms) the teaching has been, for the last decade or so, to fly a straight in fixed power approach, ideally over an unpopulated area. As such, pilot did 100% the right thing.
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Old 31st Jul 2022, 11:46
  #120 (permalink)  
 
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BEagle

I know exactly what you’re saying. I’m not about to throw spears since I wasn’t in the cockpit but my 3000+ Hawk hours did lead me to question it.

By way of mitigation though I have come to realise that our teaching of how we handle OIL captions and engine malfunctions could be slightly erroneous.

If you have an OIL caption the drill is to set 78-87% RPM (note that the ACM says 80-85%) and land ASAP. We teach and practice flying a straight in approach maintaining a constant RPM. If at any stage you were to suspect engine damage or an impending mechanical failure then you would probably consider a forced landing. Here is where the confusion may set in though.

A fixed power of 78-87% is not going to allow you to gain much height if you were low and slow since it is quite low. It also won’t work if you try to fly a glide profile since it is too high to allow a sensible glide (some guys in Canada tried to practice powered forced landings for this reason and they weren’t pretty). We also know that the engine should keep running if we maintain a constant RPM.

So, the pilot in this case did everything right and set up for a straight in approach in accordance with the teaching. Once the engine started to vibrate he was too low and too slow to really be able to get onto a glide profile quickly and land ASAP.

I think it’s easy for us to look with hindsight and say they should have gone for an AFL profile sooner but that would involve bringing a faulty engine back to idle and risking a complete failure. Therefore giving yourself one shot at glory versus the supposed safer option of maintaining powered flight.

What should perhaps come out of this accident is a rethink of some of our teaching for OIL captions. If you’re at height, and can successfully glide maybe throttle to idle and forced landing is the best option. Bear in mind though that the T1 would have had zero avionics with the engine shut down. If you’re low and slow the fixed power option would seem more sensible.

As an example I was on base leg for a RAD-PAR in a T2 at Valley a few years back when the OIL caption illuminated. Since the power was already set in the correct range I simply declared a PAN and continued my PAR to land. If I had been descending at high speed out of the local medium level airspace though maybe a precautionary forced landing might have been more sensible. It turned out to be an erroneous caption by the way!

So, in summary, I think the pilot did what he was taught and just got very unlucky. But I bet he is kicking himself at how close he came to winning an AFC for landing successfully!

BV
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