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Old 28th Apr 2017, 21:24
  #1541 (permalink)  
 
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It always amazes me how quickly (supposedly professional) pilots on this forum are so quick to engage in mud-slinging and massaging their own egos. This is not about casting blame, nor is it necessary about pin-pointing exactly the cause.

It's about learning from a terrible tragedy and trying to evolve in the right direction as the aviation community. Their families and colleagues would expect no less.
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Old 28th Apr 2017, 21:40
  #1542 (permalink)  
 
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This is not about casting blame, nor is it necessary about pin-pointing exactly the cause.

It's about learning from a terrible tragedy and trying to evolve in the right direction as the aviation community. Their families and colleagues would expect no less

In order to learn do we not have to first understand what happened and to do that we have to figure out the causes that led to the tragedy?

Every single one of us could wind up as the topic of discussion in a Thread such as this one..... as long as we go flying....that is the first thing we have to accept.

If you don't get that....then you must get yourself a copy of Ernie Gann's "Fate is the Hunter" and read it very carefully and contemplate what he talks about in that Classic.


“Anyone can do the job when things are going right. In this business we play for keeps.”
Ernest Gann "Fate is the Hunter"
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Old 28th Apr 2017, 21:44
  #1543 (permalink)  
 
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Megan, I am saying I would NOT have succumbed to the same fate as this crew!

16k hours and 27 years over the ocean HAS taught me one or 2 things. The first, and most important, would be to have a damn good RADAR image at 200 feet AND to not fly over red blobs AND to crap my pants if the RADALT went off AND after it did, to react ASAP if a guy in the back with a A FLIR told me shortly thereafter to TURN.

A CDFA is an easily deployable procedure you can place over any target or waypoint. Before anyone try's to claim "SAR can't do this"......that's exactly what the TRANS DOWN program provides.
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Old 28th Apr 2017, 21:47
  #1544 (permalink)  
 
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Originally Posted by gulliBell
Instead, if the same sortie had been flown in the simulator on their annual competency check, it would probably be an automatic fail for the PIC.
Or alternatively, if flown in exact detail, it might have brought to light some of the latent threats, be they operational, procedural, technological, cultural, skill-based or otherwise, which ultimately converged to enable this awful tragedy.
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Old 28th Apr 2017, 22:04
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DB,

Any reason one could not use BKSDC for such a waypoint and approach from overhead Belmullet at or above MSA?

Punt's post 1509 has the graphic.
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Old 28th Apr 2017, 22:11
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Originally Posted by SASless
In order to learn do we not have to first understand what happened and to do that we have to figure out the causes that led to the tragedy?

Every single one of us could wind up as the topic of discussion in a Thread such as this one..... as long as we go flying....that is the first thing we have to accept.

If you don't get that....then you must get yourself a copy of Ernie Gann's "Fate is the Hunter" and read it very carefully and contemplate what he talks about in that Classic.
I'm not suggesting we don't look for the causes, merely that the natural human reaction to want to pin blame on someone or something is not an appropriate response in this instance.

Trust me, on more than one occasion me and my crew could have been the unfortunate topic of conversation on this forum.

I do get it and I have read Gann (amongst many others). My point is that this was a very complex scenario involving a myriad of factors that might feasibly never be 100% 'solved'. I'm coming from a perspective of understanding versus blame. I get that this ethos is not for everyone.
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Old 28th Apr 2017, 22:29
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Originally Posted by DOUBLE BOGEY
Megan, I am saying I would NOT have succumbed to the same fate as this crew!

16k hours and 27 years over the ocean HAS taught me one or 2 things. The first, and most important, would be to have a damn good RADAR image at 200 feet AND to not fly over red blobs AND to crap my pants if the RADALT went off AND after it did, to react ASAP if a guy in the back with a A FLIR told me shortly thereafter to TURN.

A CDFA is an easily deployable procedure you can place over any target or waypoint. Before anyone try's to claim "SAR can't do this"......that's exactly what the TRANS DOWN program provides.
Point taken DB. I didn't realise that you had renamed "Trans down/Trans down to Hov" to CDFA. But what kind of MAP would you recommend in this case when flying/approaching to Blacksod?

Last edited by Search&Rescue; 28th Apr 2017 at 22:45.
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Old 28th Apr 2017, 22:38
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Exactly as I see it as well.

I was not singling you out in my post....that was just a statement of how I see things.

There is a passage in Gann's book where he lists a tally of Crews killed in all kinds of crashes during the early days of the US Airline Industry.....making the point that our real nemesis is "Fate" (as he calls it...) and that sometimes skill, knowledge, experience, education, training, just isn't enough.

I suppose over time we have learned lessons and have a better understanding of how these sad events occur....and are better at using technology to assist in the examination of those causes but in the end...there is a factor over which none of us have any control.

SAR flying for civilian pilots has got to be among the most challenging flying there is as they tend to find themselves being called out in weather that most of us are able to avoid sticking our noses into and go places that do not have any infrastructure to assist in their mission.

Oil and Gas offshore flying has become pretty routine anymore after its Cowboy Days early on. EMS flying has also gone through a couple of tough periods but seems to be doing better. Forestry work has improved and Fire Fighting is getting much safer.

Perhaps this tragedy will see SAR units taking a very critical look at how they are doing business and look for improvements.
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Old 28th Apr 2017, 22:57
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Originally Posted by megan
Posts #1549 & #1550 An appalling statement from a sim instructor if you don't mind me saying so gulliBell...
In the context of what I said, I stand by it. You can crash the sim doing malfunctions during the training phase of re-currency any number of times and all is good, just hit the reset button and try again. But during a check-ride, where we don't normally throw in malfunctions, except for an OEI missed, busting a minima, aircraft limitation, or flying into something, ordinarily scores the PIC a fail. That must be the outcome based on the widely accepted training competency criteria.
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Old 28th Apr 2017, 22:58
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Originally Posted by justanotherflyer
Or alternatively, if flown in exact detail, it might have brought to light some of the latent threats, be they operational, procedural, technological, cultural, skill-based or otherwise, which ultimately converged to enable this awful tragedy.
Yes, I agree.
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Old 28th Apr 2017, 23:04
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Originally Posted by SASless
Exactly as I see it as well.

I was not singling you out in my post....that was just a statement of how I see things.

There is a passage in Gann's book where he lists a tally of Crews killed in all kinds of crashes during the early days of the US Airline Industry.....making the point that our real nemesis is "Fate" (as he calls it...) and that sometimes skill, knowledge, experience, education, training, just isn't enough.

I suppose over time we have learned lessons and have a better understanding of how these sad events occur....and are better at using technology to assist in the examination of those causes but in the end...there is a factor over which none of us have any control.

SAR flying for civilian pilots has got to be among the most challenging flying there is as they tend to find themselves being called out in weather that most of us are able to avoid sticking our noses into and go places that do not have any infrastructure to assist in their mission.

Oil and Gas offshore flying has become pretty routine anymore after its Cowboy Days early on. EMS flying has also gone through a couple of tough periods but seems to be doing better. Forestry work has improved and Fire Fighting is getting much safer.

Perhaps this tragedy will see SAR units taking a very critical look at how they are doing business and look for improvements.
Your last paragraph could be a fitting response to this entire thread.

I'm not totally convinced by the 'fate' argument as I feel that this is another aviation tragedy that could have been avoided. Fate implies the unavoidable.

Yes, the SAR regime is a highly demanding and niche area of aviation. Now is the time for improvement of safety margins via thorough external scrutiny.
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Old 29th Apr 2017, 07:04
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What is the UK SAR safety record over say the last 25 years? Do those working within it feel particularly vulnerable with current practices, equipment and systems? Who externally would be competent to carry out an effective and valid review?
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Old 29th Apr 2017, 07:25
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Originally Posted by rotorspeed
What is the UK SAR safety record over say the last 25 years? Do those working within it feel particularly vulnerable with current practices, equipment and systems? Who externally would be competent to carry out an effective and valid review?
IMHO the SAR Aviation Communities are doing an OUTSTANDING job all over the world in order to Save Others! All the Crews are usually very dedicated and professional. If you consider them flying AWSAR day/night even in 0/0 weather conditions at low level, there haven't been that many major incidents or accidents during last 10 years, or? So, let's wait for the Final Accident Report before starting wild speculations and blaming SAR Communities for poor practices!

Last edited by Search&Rescue; 29th Apr 2017 at 19:00.
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Old 29th Apr 2017, 08:51
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Any help available

Hi. First let me state I am not a pilot. I am just an interested observer with a life long fascination with flying.

Much has been said about the shortcomings of this crews briefing. And we know that the two people in the front seats were unfamiliar with this part of the coast and particularly the approach to Blacksod. So my question is: what could/should they have done to acquire more information about the let down and potential dangers on the run-in before they arrived? We know they made repeated unsuccessful attempts to contact 116 who would have been the obvious ones to provide local knowledge and specific advice on the approach. No ATC was available to them at that time in the morning. Would there have been any personnel at Blacksod? Or what about the coastguard or their controlling ops? Both of which would have had access to local charts? Flying 'under the duvet' in the dark in an unfamiliar and inhospitable coastline I think I would want to be as prepared as I could be. Someone mentioned mindset, I think in those conditions an 'open mind' i.e. hyper alert was what was needed.

Or could there have been misplaced pride or , dare I say, stubbornness that this was not a particularly hazardous mission by their standards and they shouldn't need any outside assistance. I only say this because my wife often accuses me of that! After all their very job entailed them doing the impossible and so often they were the only help around and on their own.

Apologies if these questions seem naive. Don't flame me!
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Old 29th Apr 2017, 09:04
  #1555 (permalink)  
 
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Perhaps it should be understood that SAR can be done very differently depending on requirements, equipment, environment and particularly culture before tarring all SAR operators with the same brush.

UK SAR has an excellent safety record but how things are done in UK compared to EIRE will not be identical - different ethos, different companies providing the crews, different operational tempo and different equipment levels.

I know that this accident will have been the subject of crewroom discussion and training team focus in the UK and probably across the world and if that adjusts small areas of operation to remove even one hole in the cheese then it will be a good thing.

However, the idea that this will lead to a root and branch review of how SAR is done is fantasy unless you just don't want people to get rescued.

Dedicated SAR crews have worked for years to identify and minimise risk wherever possible but the fact remains that the places you are asked to go when the job phone rings are often hazardous and the time pressures, when people are relying on you to save their lives, don't go away.
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Old 29th Apr 2017, 12:10
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No one has suggested the UK or Irish Coast Guaed has done a poor job or has a bad safety record.

That being said...is there room for improvement, benefit to taking a fresh view at practices, and generally taking a look for potential problems?

If the immediate knee jerk reaction is to say "NO!".....I submit there is a problem.
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Old 29th Apr 2017, 13:36
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Originally Posted by holdatcharlie
..Much has been said about the shortcomings of this crews briefing.

...what could/should they have done to acquire more information about the let down and potential dangers on the run-in before they arrived?

...Both of which would have had access to local charts?

...Flying 'under the duvet' in the dark in an unfamiliar and inhospitable coastline I think I would want to be as prepared as I could be.
1. Nobody outside the investigation team has heard the crew briefing, so whether there were shortcomings in the brief nobody here can say.

2. Two points. One is a systematic process of continuous improvement, if there were deficiencies in the operational route guide (or anything else) they should have been identified and amended long ago. The operator QA systems are primarily responsible for this. The other aspect, we don't know anything of the pre-flight planning that was undertaken on this sortie. This is something that the investigation no doubt will review in time.

3. The published aeronautical charts, together with the route guide, should have been sufficient for planning purposes without reverting to other map sources. The WAC chart and operator route guide map both had Blackrock lighthouse spot height indicated.

4. Yes, exactly. Does the contracted "scramble" time to be airborne on this SAR contract give the crews enough time to flight plan before departure? If not, did they have enough resources on-board the aircraft to flight plan adequately during the one hour transit to the search area? I guess both of these questions will also be of interest to the investigation.
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Old 29th Apr 2017, 14:59
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I suspect a significant factor here with regard to SAR ops will turn out to be R116's crew's familiarity with the type of mission they were scrambled to. Those aircraft on the west coast are a lot more active than those on the east - not surprisingly. The busiest is R115 at Shannon, which in 2014 completed 310 missions whilst R118 at Sligo wasn't far behind on 277. In contrast R117 at Waterford completed 187 and R116 at Dublin just 130 - the same (131) as in 2003, when - and this is interesting - just 13 missions were at night, compared to 57 for Shannon. And from R116's Dublin base, it's likely few of those were off the much less familiar and hostile west coast.

So we have a picture here whereby R116 may only have flown 3 or 4 night missions over to the west coast - and off it - in the last year. Which fits with their stated lack of familiarity with Blacksod. Perhaps someone with more knowledge can provide a more accurate estimate?

Of course this means flight planning needed to be even more carefully done, and charts and route guides appropriately clear, for rare and challenging missions to be flown safely.

Does anyone know why R115 from Shannon was not available to provide top cover that night? They would doubtless have been far more familiar with Blacksod and its approach.
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Old 29th Apr 2017, 15:04
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4. Yes, exactly. Does the contracted "scramble" time to be airborne on this SAR contract give the crews enough time to flight plan before departure? If not, did they have enough resources on-board the aircraft to flight plan adequately during the one hour transit to the search area? I guess both of these questions will also be of interest to the investigation.
I presume their callout time to airborne time is the same as UK which will be 45 mins .

Even if it is an hour, it should be remembered that they will have had to come in from home as I believe this is the norm there if they live close enough to the base.

They will at least not have to have dealt with sleep inertia as the callout was relatively early.

As to adequate flight planning - usually on a scramble you have enough time for the co-pilot to look at a map along with the rearcrew whilst the pilot gets the aircraft going and then, if the weather isn't a major factor, much of the detail can be fleshed out en route - often because you get scrambled with scant information which is updated on the way.

The cruise period should have allowed enough time to discuss the letdown so we will have to wait for the full CVR transcript (if we ever see it) and the final report to know.

I don't think there is any kneejerk 'NO' to suggestions of review but, as mentioned previously, continuous review is a fact of life in modern aviation - it is just a question of how urgently recommendations are turned into action and that often depends on money and ethos.
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Old 29th Apr 2017, 20:27
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Ok complete ignorant here regarding SAR - hope will not be tossed under the bus outright

Following this thread for a few weeks now I am still wondering about the 200ft zero vis flying. Is there something technical or procedural into it ? I know the ocean is a big place but there might be quite a few things 200ft above water (such as large marine vessels, offshore windmills, etc)... I am sure they thought that it was perfectly safe but is there any fundamental reason not to elect to fly somewhat higher ?
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