Haraka,
This is only my recollection but I believe that in the Yeovilton case the SPH had not been inserted at all. When the pilot stood up on the seat he stood on the handle which pivoted around the QRB and fired the seat. In the train of events leading to Sean's accident of course the SPH had seemed to be inserted but wasn't in the right place.

Question for Viking, whom I assume is a Hawk QFI:

In my time in the RAF as a QFI, albeit 40 years ago, before we entered the jet the first thing we did was check all seat and canopy pins in place.
Then we kneeled on the seat facing aft and did a thorough seat check, including such vitals as the top latch alignment, attachments of sear pins etc. and correct harness alignment.

It was done on each and every flight, just as we did an external check of the airframe.

Have things changed ?

Retired BA/BY
 

You assume correctly regarding my profession.

Aside from the fact we no longer kneel on the seat to conduct our checks nothing has changed.

BV

Maybe not known about at the time. As I stated earlier in this thread, this was shown to my course in 1986 by the GS Sergeant instructor, on the seat in the classroom. I clearly remember the demo of the sear pulling out and used to check on every occasion. I subsequently flew Tornado and then Hawk again as an instructor and continued to check. Somewhere along the line the corporate knowledge was lost.

Maybe that ground school lesson wasn't structured and this potential glitch wasn't on a syllabus, maybe it was just that particular tech instructor, and when he moved on his successor didn't know, or failed to teach it. I suppose it's incumbent on those in instructional roles to ensure that lessons are properly structured and that hopefully such potential mistakes are not forgotten, as seems to have been the case here.

Bob Viking: I'm not sure what your argument is. It doesn't matter what role you operate an aircraft in, in this case the Hawk, you could be Red 1-10 or a Unit Test Pilot, the equipment is the same. I hope you're not saying that the RAFAT cannot learn from anyone else other than the RAFAT, or that once you hang up your g-suit, your experience no longer counts?

On the units where I served the issue of how the SPH safety pin could be incorrectly fitted was demonstrated in the mandatory six monthly ejection seat lecture for all personnel who entered a cockpit with a seat installed. Of course it is easy to see on the training seat, but a different matter when sitting in the aircraft. There was a campaign to increase the frequency of these lectures; I wouldn't be surprised if today they have ceased altogether.

Overstress
 

I'm obviously being far too subtle so I shall spell it out. My beef started with post 186.

Retired experts coming onto a thread such as this and criticising a guy who died in an accident and making out that it would never have happened to them because they're far too clever and were taught much better back in their day.

Someone pretty much makes out that Sean's accident was his own fault and I'm the only one who thinks that's out of order?!

If I am the only one then I apologise profusely but I doubt very much that the RAF of yesteryear was any safer then the RAF of today.

That's about as polite and obvious as I can manage.

BV

BV. The point is, it didn't happen to them, or you, or me. But I'm saddened when I see a life lost in a case such as this where continuity of knowledge just might have prevented it.

Perhaps as you are still in the Hawk role, as I was, it's difficult to accept that the viewpoints of others outside may have relevance. One day you will hang up your g-suit but you may find that you never truly 'leave' the F-J world. Will all your experience suddenly become worthless?

It's one thing to have an opinion. Quite another to use an anonymous website to air it for all to read.

The SI has clearly brought out all the lessons and everyone is now well aware of them for the future. I get that some of these lessons were already known about. Saying "I told you so" changes nothing.

You, and others, seem to think I have something against retired guys sharing the benefit of their experience. That is not correct. I do have something against retired guys sneering at the RAF of today and pretending everything was better when they were in. If that is not what you are doing then I don't have a beef with you.

Let's look at this from another angle. The longest running thread on this forum (that I am aware of) was the Chinook Mull of Kintyre thread. What if I had posted on there that I thought the pilots were to blame? Would you expect everyone to sit back and say "that's alright, BV, you're entitled to your opinion"?

Anyway, since I appear to be the only one who took issue with RetiredBA/BY's original post I'll give it a rest.

BV

People use anonymity on here for valid reasons. However I'd be happy to identify myself if you PM me. I'm personally gutted that Sean died in those circumstances. I don't think anyone is saying "I told you so", in my case (especially as an ex Flight Safety Officer) I'm just concerned that such a well-known gotcha (there were posters everywhere, some archived on this site) somehow got forgotten over time. No-one is sneering and I'm sure that BA/BY didn't intend that.

As you know, accidents usually involve a chain of events, holes in the cheeses. The handle was one link in the chain, the bolt torque another.

All the best

overstress:-
To which I would add the lack of a Safety Case Report. That alone meant that the Hawk was unairworthy as it lacked a legal RTS. Why didn't the MI pursue that, having creditably unearthed the lack of the Report? "It was outside its remit", do I hear? That in a nutshell is why UK Military Air Regulation and Accident Investigation should be independent of the Operator and of each other.

BV, I'm afraid that I disagree therefore with your claim that

as for

I can only say that I do have something against serving guys who portray those of us who are retired but care deeply for those like you who still serve in such a negative way.

The chain of events that led to Sean Cunningham's avoidable and tragic death started back in the late 80s/early 90s in my view.

Enough has been posted here in the Chinook, Hercules, Nimrod, Sea King, Tornado, and now Hawk airworthiness related fatal accident threads to point up that common root cause. Yet still RAF Investigations, and the MAA (nee MOD) Regulator fail to recognise it. That is unprofessional to say the least, and won't draw the lessons that prevent recurrence. If that is sneering, then I am guilty as charged.

Like overstress, if my PPRuNe ID is anathema to you I am quite prepared to reveal my true one to you via PM.

Good post Chug. You need to keep making your point. There might have been a problem with the seat or how it was used, but why was the aircraft in use?

dervish,
Why don't we just ground everything, no problems then. I would bet in hindsight that no military aircraft from day 1 even to the present would pass the current criteria.

That's what happens after a prolonged period of peace

In war time you accept the risks, as peace draws on the risks seem less and less justifiable

There seems to be a significant attitude from ex-serving former aircrew that things like this would never have happened in their day, or even more interesting, that they knew about the weaknesses of the seat pan firing handle design years ago and were told to look out for it.

The seat pan firing handle modification is very simple. If the culture of yesteryear was so wonderful, the standards of safety so great, how did no one manage to recommend a modification, report the unsatisfactory nature of the equipment they were given to use, or otherwise put anything in writing so that any apparent knowledge was more than anecdotal?

Reviews after the RAFAT event were extensive, and widely regarded to have revealed new information, not previously understood. If there were any indication that such things were known years ago, it is a failing of the previous generations to document them properly which lead to this.

Rather than smugly state how you would never have done something similar, and that standards must surely have slipped in the intervening years, ask why you never thought to raise a F765X - if you can genuinely say you understood the problem then as it was later revealed.

Dru.
The problem not so many years ago was that we were taught procedural safety as a foil to absolute physical safety (which is unachievable). I doubt anyone knew what a F765X was and would probably not have been encouraged to submit one.
I for one do not have the attitude to which you refer, and resent that particular line of yours. I believe that by luck of God this didn't happen to me and many others.
However I refer you still to my earlier post.

Mach2,
I don't claim this attitude is universal, nor that you exhibit it - clearly many of you do not, but it is notable in this thread.

M2N, if I might respond while we await dervish. The MAA seems to be doing as you suggest regardless of the reform that I propose, having rid us of our MR force and the ACO's Gliders (Oh sorry that's a "pause" isn't it?). I assume that you don't seriously propose what you have posted. Whatever the state of our operational fleets, they have to remain available for our defence no matter. Any Regulator, whether it be the MAA (nee MOD) or one independent of the MOD simply has to do the best with the hand it is dealt. The problem is that the MAA won't admit what the hand is that it has been dealt.

The MAA proclaims its bedrock to be Haddon-Cave's Nimrod Report. It is not bedrock, it is sand, hence the parable quoted earlier. By claiming the period late 80s/early 90s to be a "Golden Period" of airworthiness it sought to obscure the lasting damage to UK Military Air Safety rendered by RAF VSOs in that very period. Unless and until the RAF and the MAA face up to that fact (which they haven't so far in order to protect those same VSOs) then the extent and effect of their subversion cannot be assessed, and further accidents as covered by this thread can be expected.

HH, wartime risks are one thing, but aircraft that self combust or ejection seats that kill their occupants are unacceptable in peace or war.

drsoe, this isn't about being wise after the event, or worse still before it and saying nothing, this is about aviation. It will try to kill you given half a chance. You point to mods made to the MB seat that would have saved Sean Cunningham's life. Very good, but they didn't did they? Too little and too late! If the seat had a Safety Case Report, and the RAF a Flight Safety System that had fed back those 765's in good time, then such mods would have been incorporated without anyone having to die.

I understand the resentment of those doing the doing while we old farts simply hammer away at keyboards. We all want the same thing, the avoidance of avoidable accidents. That can only happen if we face up to reality. I maintain that the MAA has yet to do that.

Chug,
You are correct, it was tongue in cheek; however, as an ex Wg Cdr Spry, I always sought for open reporting of FS issues. It was an uphill battle, particularly against many sensitive engineers and VSOs. We nearly got there, but the hierarchy in the 80s brought open reporting down by trying to find out who the 'open' were. Things became even more difficult in the 90s.
I could go on, but..

Well perhaps you should M2N. Unless those like you, who experienced the pressures to just shut up and go away, testify to it here then we are all tarred with the same brush wielded by dru.

Chug et al
 

It looks like I will need to spell it out again.

I find it extremely difficult to understand why ANY pilot could not be utterly meticulous about checking and strapping into his seat, to have any strap out of place , let alone one through the firing handle and no notice the fact is absurdly bad airmanship.

And I still can't imagine why the pin was being replaced on the roll out with other aircraft in the vicinity, why on earth does, or perhaps did, the RAF allow such sloppy procedures?

The above was posted by RetiredBA/BY. You added that his post was well made. I don't really have an issue with you or others that seem to think I'm taking a pop at them. Indeed your posts are usually eloquent and well considered. You do come across as a little precious though by assuming I'm grouping you in with my initial statement.

I don't need to know your identity or that of anyone else. My point about anonymity is this. Would RetiredBA/BY happily walk up to the family of the deceased and state to their face that he believed their son exhibited absurdly bad airmanship? I doubt it very much. If he would then he is not someone I would wish to associate with.

Your points on this thread are about safety cases and the broader picture of RAF flight safety. You will notice I'm not getting involved in that. I could not add to your well made points and my knowledge would pale into insignificance against yours.

It is heartening to know that others agree with me (I have had a few PMs along these lines).

So please take my points as they were intended and don't think that I am in any way ageist or that I don't appreciate your support. The way you jump on drustsonoferp does reinforce my point somewhat though. As knowledgeable and wise as you are no-one is beyond criticism.

I hope I have, finally, made my point clearly enough.

BV:oh:

As Viking is probably reading thus let me make it absolutely clear that I was certainly not sneering at anyone, thats nonsense. Nor am I saying that things were safer in our day, they certainly were not, that was my point. We lost Lightnings at a dreadful rate, mainly reheat fires, the Canberra, a big Jet Provost on two but was a potential killer on one, killing even the Marham (Wyton ?) station commander near the end of its career in an asymmetric accident, to name just two. It gave me two nasty frights with engine failures at critical times, both outside ejection seat limits.

The number of Meteors lost in the '50s too, was truly dreadful, over 800.

A lot more Gnats were lost at Valley than Hawks, in which I have had a couple of flights, including XX310 now a Reds aircraft, Vampire T11s, on which I trained, too. Modern aircraft, civil and military, are vastly safer and more reliable than we had in the 60s but that is no reason to relax safety standards, and certainly not a reason to ignore the hard earned experience of your predecessors. I can still remember many aspects of my own ejection when not everything went exactly to plan.

I don't sneer at anyone and certainly not in a dreadful accident such as this.

But I will make one thing clear. As a former airline air safety officer and a member of the U.K. Flight safety committee, including two years as its Vice Chair, I Absolutely believe that if you are serious about safety you have to be brutally honest, no sacred cows, no, or as little emotion as possible, you need to get at the truth in order to prevent a recurrence.

I have no idea how the current "safety reporting system" works in the modern RAF, it seems to have some problems, but in civil aviation we created a "just culture" system. Creating it was hard work but it has created an incredibly high standard of safety in civil ops. The RAF may well have something to learn from it.

And just for Vikings point , I well know the personal effect of a fatality on families. My wife's sister was killed in an aircraft accident in which her brother in law, the pilot taking off at their farm strip, and their child survived . I have seen first hand the effects on the family, particularly the parents, it was truly dreadful not least because my father in law pulled. His dead daughter from the wreckage. . We are still unsure of the root cause but there are never any reasons not to try and get at the truth, human factors or technical, in order to prevent a recurrence and I know my parents in law shared that view.

So, of course I would hate to be in the situation you suggest, but is my absolutely sincerest wish that Sean' s loss will not be totally in vain if it prevents a recurrence.

Mach2number

Others more knowledgeable have answered this same question on other threads. The best answer is, and I paraphrase, what regulations do you think should now be waived? You may be correct about other military aircraft, but that just highlights that for seven years the MAA have been rewriting the regulations, when Hadden-Cave confirmed the problem was lack of implementation. If you keep looking at the final act, the seat cock up, you miss the worst failure of all. No safety case is indefensible.

I'm fairly sure that the F765X is a relatively recent thing, I'd never heard of it, had to google it. Perhaps someone can say when it was introduced.

F765X is the current form to request an amendment to Aircrew publications. Presumably there were others before it, or other mechanisms to request an amendment to publications?

BV, if I came across as precious or jumpy I apologise. As to being knowledgeable and wise, I'm old that's all, but that has some merit for anyone who's been aircrew in itself. Like overstress, I too was an FSO and was lucky enough to be that it seems at the zenith of the RAF Flight Safety System (merely going by what I have since learned on PPRuNe).

I didn't take BA/BY's post as being anything other than one of commenting on the published findings of the SI. You think that posting that is hurtful for his loved ones. I can only say that the greatest support experienced on other Airworthiness Related Fatal Accident threads has been from families of the deceased. More than anything they wanted others to be spared the pain and suffering they had experienced in losing their loved ones. It was they who castigated MOD apologists trying to shut down debate in their name!

Every tragedy is unique I know, but we cannot hope to avoid further ones unless we consider everything involved. The elephant in this room, and in all the other fatal accident threads, is the UK Military Air Regulator, aka the MAA, aka the MOD. It is fatally compromised and reform is urgent. If you are a UK Military Aviator that must concern you, it certainly does me and I'm retired! I have learned more about Military Air Safety on this forum than I ever did while serving. As an ex Flt Lt pilot, if I can do that so can you. Then you can become "knowledgeable and wise" too! :ok:

Derv, Chug et Al,
I am obviously not knowledgable. I hold no candle for the MAA. Neither would I cite waivers - I have been out of the RAF for 10 years. I merely state my opinions as follows: In the early 1980s, the RAF sought, maybe optimistically, to bring in a system of open reporting, without prejudice. All were encouraged to report incognito, any aviation problems, outside of the 765 system. It started well, but as it happened, some tried to find out who the 'incognito' were. Trust became lost, a period sometimes referred to as 'Flight Safety by Cruxifiction' ensued. Open reports dried up because punishment was possible. So here we are now 30+ years later, the lawyers have taken over the cruxifiction and any quick way of learning aviation lessons, short of accidents, has probably been lost for ever.. Its all very sad. Here endeth my last post on this issue.

Drustonferp, I (ahem) may have a dusty, mildewed copy of the Hawk aircrew manual somewhere. When I get home from my trip I'll look it up. I do recall some form of wording in the front saying any amendments should be addressed to OC Handling Squadron. It's a good point and I will be interested to see what the chapter on the Mk10 seat had to say in 1997.

overstress and dru. I might have (ahem) a copy of Hastings C Mk1 Pilots Notes. If I did, then the Notes to Users (AL2 May 61) would say that comments and suggestions should be forwarded to OC Handling Squadron, RAF Boscombe Down. But only if I did, you understand...

When I did a refresher course on the Hawk at Valley in 1980, I was briefed very thoroughly about the need to check that the seat firing handle was fully 'down' in its housing when reinserting the pin. Also that this had to be done visually, not by fumble and feel (e.g. the JP guillotine pin).

Same at Chivenor on the first of the new courses; brakes on, engine shut down, then L00K and replace the seat pin, then the canopy pin.

With a zero/zero seat, it would be utter folly to replace the pins with the engine running - should there be a fire, it might be your only way out!

mach2number

The use of MF765 (Unsatisfactory Feature Report) is laid down a number of documents, the primary one being the mandated procedural Defence Standard that controls maintenance of the build standard (now cancelled without replacement) – without which the safety case cannot be validated and no Release to Service can be issued. There, gliders in a nutshell.

In the early 1990s, funding to do this was cut by 28% per year, for over 3 years. Direct orders were issued not to use the MF765 (or MF760 fault reporting) systems – part of the “savings at the expense of safety” confirmed by Mr Haddon-Cave; although he dated them to 1998, not 1987, despite the actual documents and directives being submitted to him. There, systemic airworthiness failings in a nutshell.

While some of this work has been resurrected, by no means all – evidenced by the much abbreviated definition of it in the MAA documentation. Plainly, no-one in the MAA has ever managed such work before. There, current problems in a nutshell.

Sorry, to seem a little pedantic, but you mean functional safety, not physical. But you are right – very few are taught how to achieve either. And anyone who doesn’t know what a MF765 is, shouldn’t really be allowed near an aircraft unaccompanied. And anyone who encourages staff not to raise them shouldn’t be in employment. There, MoD’s personnel problems in a nutshell!

RetiredBA/BY #222
It was the RAF Wyton Station Commander I believe, an ex OC 100Sqn

BEagle
 

I first started flying aircraft with zero/zero bang seats in 2002. At least as far back as that we have been replacing pins on the taxi back. Indeed in certain aircraft we would fully unstrap and have the canopy open.

Should there be a fire the safest thing may be to shut the aircraft down and climb out.

You may now be horrified to hear this but consider how many uncontained engine fires there have been on the ground in this period (none that I am aware of). There have been several rapid egresses though where having the seat safe will have speeded (is this a word?!) up the process and made it more safe.

There have been procedural changes since Sean's accident but I won't go into them here. Please don't shoot the messenger.

BV:O

FZ - It was - I was ( a very new) OC Admin there at the time. Tragic accident

Heard court case now scheduled for 17 May 17.

BV, I started fast jet flying a couple of years before BEagle and from 75 onwards flew 6000 hours on zero/zero ejection seats. If my memory serves me correctly we used the simple principle that if the canopy was down we were strapped in and seats live. If the canopy/canopies were open we were seat safe and unstrapped. On any bang seat it is implicit that the occupant makes the seat SAFE at a time when it can be ensured SAFELY. If it was essential to taxi back with the canopy open (due to excess temperatures) then we stopped for 15 seconds and safed up the seat safely. Yes, and for you younger ones we used to fly jets that did not have AirCon and cockpit temperature could reach 50°C+

Indeed, it must have been positively chilly back in the day. The younger ones will have flown aircraft still without conditioning on the ground, lacking a canopy that could be opened for taxi and temperatures knocking on 50°C just walking out to the aircraft.

But yes, your point is well made - some of the 'norms' that crept in with pins, seat safety and checks did not help matters at all.

Beagle, D2,

Perhaps SOPs change. I've only ever had back seat trips so, I'm only talking from the perspective of a pax. I have always, on every single trip, been told to put both pins back in as we taxied back. Surely, unstrapping and hoofing it to safety is a better option than pulling the handle!

If it's folly to do so prior to engine shut down Beagle, I'd suggest that the current Hawk community disagree with you.

On the Tornado we would remove and stow all pins apart from the SPFH on crew-in. The 'live' canopy was lowered shortly after start, with the groundcrew hiding underneath. We would taxi out for a short distance before the remove, show and stow of the seat pins. Seat and canopy pins would be reinserted on the taxi back so that everything would be safe for the winch-back.

As far as I'm concerned, if you fly single seat then its your life and therefore your decision. I was always more comfortable being unstrapped on the taxi back and would justify that by saying it was quicker to egress if there was some kind of problem, but then again I didn't taxi out unstrapped.

In a two seat jet its a crew decision. Of course, when the canopy is down its not always appropriate to arm seats as the aircraft may be in a HAS or shelter.

Aircrew are clever people and spend years in training and IMHO are treated like children now by an organisation that seems to want to have a rule and procedure for everything.

What comes first, the design or the rules/procedures for using that design? "We've always done it that way" might not be valid if the design changes.