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Comair Lexington Crash CVR

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Comair Lexington Crash CVR

Old 23rd Jan 2007, 20:49
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Originally Posted by pls8xx
Your mind can play tricks on you. Look at an instrument hundreds of times where the light is always green, say the word "check". One day the light will be yellow, but your mind will anticipate "green". You are apt to say "check" and move on. But if you have been saying "green" and one day the light is yellow, when you look at the instrument and say green, your eyes say yellow and your mind rebels. For it to work you must be looking at the light at the instance you say the word.
I like the way you think. Running checklists and doing things by rote time after time after time leads to exactly what you state. My company required exact phraseology for each response and many of them were "check". Before I retired, I used to give the copilots fits because I did exactly what you recommend rather than the rote "check". Whenever I did it by rote, the words flowed out in perfect order but they didn't always agree with what I had answered for.
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Old 23rd Jan 2007, 21:09
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pls8xx,
First of all, I agree with a lot of what you say. I also find your system very good, and sure will use it. Thank you for sharing your experience with us
The only thing that I don't fully agree with, is that it would lead to 0 errors (not doubting it might have worked with you). Our brain is made in such a way that in some cases, we'll hear "turn right", think "turn right", repeat "turn right" and happily turn left. We sometimes see and hear what we expect to see and hear. In case you don't know it already, have a look at James Reason's Human Error and Absent Minded?: Psychology of Mental Lapses and Everyday Errors.
It is indeed possible to reduce to a minimun the risk of error, using checklists and other tools, but not to 0 I'm afraid, especially in case of fatigue or other issues that could affect the performance.
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Old 24th Jan 2007, 04:34
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I'd like to add my own experience to what pls8xx said.

My work environment is complex and I make many decisions everyday that have both serious and not so serious consequences, and some of the tasks I perform have zero tolerance for errors. I don't use a single strategy to prevent errors for these decisions and tasks, but use a variety of task specific strategies to prevent the errors. What the various error prevention strategies have in common is that they each have some form of double checking of the task I just did, or the decision I just made. From experience I've found that I often make mistakes, but always catch them before they produce anything serious.

This is a mental discipline I've developed over the years and it serves me well. I don't waist energy on strategies for decisions with minimal consequences, but only on those decisions with serious consequences. As part of my professionalism, I've also learned to recognize that certain conditions and circumstances raise the consequence levels, and so require greater diligence in the decision making processes.

When fatigued, I recognize that my ability to process relevant information and to make the correct decisions is reduced. If I'm fatigued and still have to make the decisions, then I do a form of mental "load shedding" to get rid of everything in my environment that's not essential, so I can concentrate and make the right decisions. When I know I'm too fatigued to make the right decisions, then I postpone making the decisions until later when I'm more rested, and I know I can process all the information accurately.

This mental discipline is sometimes boring and tedious, but is very necessary when the consequences of a wrong decision are just too serious.
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Old 24th Jan 2007, 05:40
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Originally Posted by BoeingMEL
So, the guys first of all manage to climb aboard the wrong aircraft.... then talk almost endlessly about promotion/training/dining/wives/kids/changing diapers.
This tells you they where...... NORMAL COMMERCIAL PILOTS !
Got your PPL yet?
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Old 24th Jan 2007, 06:04
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FS

Nicely put and what we all like to practise but this bit...

"When I know I'm too fatigued to make the right decisions, then I postpone making the decisions until later when I'm more rested, and I know I can process all the information accurately."

Oh... what luxuary....
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Old 24th Jan 2007, 06:18
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pls8xx, flyblue, and fs have got it right.

It is called "cognitive dissonance" (=acting differently from what you see, hear...) and plays a vital role in risk construction and reduction. Many procedures, including communication, still donīt sufficiently take cognitive dissonance into account.
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Old 24th Jan 2007, 08:02
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FSafety "load shedding" -No chat until SBelt signs off?

People had make referenced to chit chat about kids etc., but what are the thoughts? I'm not a pilot but for my early morning car drive the radio is banned (particularly if the screen-blower is full on!) until out onto the highway and settled in. That's my equivalent of the cruise. There is a whole process of getting oneself in the right frame of mind for doing something and surely banning chit-chat unless the seat belt sign is off would hardly be onerous would it? Apologies if that is already the rule.
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Old 24th Jan 2007, 19:39
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Thoughts on safety

First I would like to thank the forum for not flaming a non pilot for posting. It would seem that my post was taken in the light it was given, something for consideration, to be used or discarded as one sees fit.

I could have done a better job of explaining the technique I proposed. Most all of us have seen the football reciever who thinks to run before the ball is caught. The result is a dropped pass, a lapse of mental discipline.

The important thing in reading an instrument is to move the raw information from the instrument to the brain, without making any translation or interpretation in the process. Once the mind has captured the raw data, then, and only then, should evaluation begin. See what I'm saying? Catch the ball first.

There are a lot of people who go to work every day at an occupation from which they may not come home. It might be a plane crash, a semi that missed the curve, a pile of logs that rolled unexpectedly, a construction trench that colapsed, or a farm tractor roll-over. Dead is dead.

There are some common traits to accidents that pop up all over, such as complacency and over-confidence. I characterize over-confidence as an absense of reasonable fear.

The career carpenter who loses his fear of the power saws he uses, cuts his fingers off. If you have met as many carpenters as me you have seen those missing fingers. I think of pilots as a pretty safe bunch of guys. If they made pilots out of carpenters no one in his right mind would get on a plane.

I own a big Craftman's table saw. I was afraid of it the first time I used it. Thirty years later, I'm still afraid of it. The thing can hurt you in the blink of an eye. From early on, every time I reach for the switch, I pause to ask myself "Are you sure you know what is about to happen?" Did I have my mind on the set-up, or was I just going through the motions? Do I feel good about this? Maybe I waste a lot of time re-checking things, but I do still have all my fingers.

Today I'm going to imagine that I am a pilot. One of the first things I'm going to do is adopt a philosophy that goes something like this: "I am the pilot. I may make a mistake. I might kill myself and a lot of other people too. But I am not about to let anyone else kill me. I am the pilot."

So I'm out on the runway, the SOP complete, ready to roll. Or am I? Start down that runway and in a matter of seconds I will be past the Point of Commitment, at which time the plane sustains flight long enough to go around and land, or I'm dead. If there is to be any reassessment of the situation. it has to be done before the roll.

So I lean back in my seat and say the words "T minus 20, fly or die." Why? Because I want both feet planted on reality. I may have done a hundred take-offs with this plane on this runway. That won't save my hide today. The only thing that matters is the situation today, right now. I might just take a minute to think things through. Or ten. Hell, I might sit here til they come tow the plane onto the grass. The decision to go or re-evaluate is mine. But the reality really is "T minus 20. fly or die."


One of my favorite quotes of Will Rogers ...

There are three kinds of men. The one that learns by reading. The few who learn by observation. The rest of them have to pee on the electric fence for themselves.
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Old 24th Jan 2007, 21:22
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Originally Posted by pls8xx
I could have done a better job of explaining the technique I proposed. Most all of us have seen the football reciever who thinks to run before the ball is caught. The result is a dropped pass, a lapse of mental discipline.....

There are three kinds of men. The one that learns by reading. The few who learn by observation. The rest of them have to pee on the electric fence for themselves.
pls8xx,

What your saying is part of what I spoke of when I mentioned a "culture of discipline". Your are dead on when you speak of having to maintain the level of respect and fear of what you are doing and the implications of doing it wrong. The challenge is that it becomes very difficult to maintain that level of awareness and focus on your own. That is where it become incumbent for the organization as a whole to support and encourage this activity. I would think that is the overall goal of CRM, but obviously the dew is off that lily.

There are a number of obvious reasons why we seem to be seeing more failures that are based not wrong thinking per say, but in lack of awareness. More automated process in the aircraft, a society where distraction is becoming more the norm, an industry that seems to care less about it's employees are but a few of the causes. But whatever the causes are, and no matter how numerous they are, when someone sits down in the front seat of an airlplane, everything in the processes that are used should be centered on focusing attention, and maintaining it. No one should feel awkward about making sure the rest of the crew is equally focused. That is where the change in culture has to take place. I too am not a pilot, but I can clearly see cultural changes are crucial to keeping air travel as safe as it can be.

Patrick
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Old 25th Jan 2007, 08:45
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Originally Posted by pls8xx
I own a big Craftman's table saw. I was afraid of it the first time I used it. Thirty years later, I'm still afraid of it. The thing can hurt you in the blink of an eye. From early on, every time I reach for the switch, I pause to ask myself "Are you sure you know what is about to happen?" Did I have my mind on the set-up, or was I just going through the motions? Do I feel good about this? Maybe I waste a lot of time re-checking things, but I do still have all my fingers.

Today I'm going to imagine that I am a pilot. One of the first things I'm going to do is adopt a philosophy that goes something like this: "I am the pilot. I may make a mistake. I might kill myself and a lot of other people too. But I am not about to let anyone else kill me. I am the pilot."

So I'm out on the runway, the SOP complete, ready to roll. Or am I? Start down that runway and in a matter of seconds I will be past the Point of Commitment, at which time the plane sustains flight long enough to go around and land, or I'm dead. If there is to be any reassessment of the situation. it has to be done before the roll.
That is very good advise pls8xx. But you need to keep something in mind. I will refer back to your tablesaw analogy;

Do you get up at 4:00am and go straight to your workshop to turn on the saw? On your way to the saw, do you get into the wrong workshop? Just as you are going through your mental preparations to switch it on, do 3 different people come in and ask you to hurry up?

This isn't meant as a wise-ass coment, it is just an example of the pressures put on pilots to do a safety-related job with many, many distractions. You do raise a very good point, which is to take your time to pay attention to your task at hand. That, IMHO, is the most important tool in our arsenal to prevent accidents. The second is the guy next to you doing the same thing. Unfortunately, we got rid of the third pilot. They use to act as a barrier and filter to all the people who use to come in to the cockpit during heavy workload periods. Let's hope we never get rid of number two. When we do, I'll make sure to buy ****t-loads of Greyhound and Amtrak stock.

As one goes through their aviation carreer, you meet and fly with many different pilots. But there are some that stand out, ones that you really learn from. I can say that out of the many pilots that I really admire and learned from, the one quality they all shared was that they were very patient and slow with there operation. Always taking their time to let things progress at their own pace. Things happened when they happened, and no-one was ever rushed. That means no-one rushed us, but also means that we don't rush anyone else. Be it another crewmember, a fueler, ATC, or even maintenance.

For some reason, some people in this industry are hell bent on keeping to the all important schedule. When is the last time that someone came into an operating room to tell the doctor that they should operate quicker cause there are patients waiting for their turn? You can't rush safety. Yet people think that it is OK to rush the person that will transport you through the air, 6miles above terra firma, at 85% the speed of sound in an alluminum/fiberglass tube. Just as dangerous is rushing the guy who is loading 120 metric tonnes of combustible liquid into the same tube in which you will be ridding. Or even the guy who is tightening the bolt that fastens the wheel that allows you to roll to a speed of 180mph when you leave the ground. You get the point.

Now, as the Captain, one of the most important things you must do is set the tone. If you come running into the cockpit and right away start rushing, you are gonna pressure the team of people arround you into the same trap, even if they are fighting to slow themselves down. Even if you don't say a word, they are gonna read your body language and follow you down that path. People try to avoid conflict, so they won't interpret the danger and just try to take on the higher workload of rushing through their job.

I always briefed my flight attendants and FOs that they take their time and that any delay we take will be my responsibility. I will back them up 100% and they need not worry. My only concern is that they do their job to the best of their ability and take their time.

If you see maintenance on the airplane when you arrive at the gate, then wait until they get off the airplane to begin your duties. Even if you don't tell them to hurry, they will instantaneously start to hurry when they see you start to do your job. That's how we humans operate, we are funny creatures.

I believe that there are certain pressures that Managers can put on their crews to hurry. You could have a policy that makes pilots explain their delays, like my previous job. Even if you don't punish late departures, just calling someone into the office to explain themselves is enough to deter them from taking their time and doing things right.

This pressure isn't always exerted in a negative way. For example, I believe SWA pays their pilots extra for arriving early. Now, I've met my share of pilots, and one thing I can say for sure is that we have some seriously tight people in our ranks. Some will do anything for a little extra money. I don't know if SWA still has this policy, but I know that they had the BUR and MDW accidents during this policy. And I've seen some other incidents with SWA aircraft that, although funny, could have led to serious implications under different circumstances.

So how did this time pressure come to be? I think that flying has become so routine that people have forgotten the underlying danger. The low accident record is attributable to the professionalism of all people involved in aviation. Not just crews, but aircraft builders and everybody else that is part of the complex puzzle that makes up this great industry. Accidents have become so rare that everybody knows that flying is safer than driving to the airport. But maybe we need to remind them that as safe as flying might be, the chances of turning your body into cornflake-sized pieces during a car accident are very rare, but pretty common in an aircraft accident.

So please, take your time and remember that a late arrival is better than never. That is where we as pilots earn our money; making sure that all these distractions and influences don't keep us from professionaly doing our job.
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Old 25th Jan 2007, 13:39
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Now, as the Captain, one of the most important things you must do is set the tone.
Back when I was PIC, I always included this in the preflight brief: "I run checklists slow, I taxi slow, and I fly slow. If anything ever happens to me, I want everyone to say, 'Wasn't that the guy that was so slow?' " A much better reputation to have than the opposite.

On the other hand, I was a young DC10 F/O at an ACMI carrier when we showed up at 4 am for a departure from Chicago to Basel. The departure had already slipped 4 hours. The captain said, "I want to be starting engines at 5am."

Well, there were maintenance logbook issues to be resolved, and more fuel to be put on, and at 5 am we were nowhere near ready.

The PIC had an absolute sh!t-fit, screaming that we were late, we were supposed to be out at 5, what the hell was wrong with us. I let him rant for awhile then pointed out meekly that the 5 am thing was SELF-IMPOSED, that obviously neither the company nor the customer gave a wet slap about an on-time departure, that all this tension just makes it worse.

Thing was, he was a good guy and a great pilot otherwise. I think alot about that flight.....
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Old 25th Jan 2007, 18:23
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Originally Posted by pls8xx
One of my favorite quotes of Will Rogers ...

There are three kinds of men. The one that learns by reading. The few who learn by observation. The rest of them have to pee on the electric fence for themselves.
... and ... there are those who never learn.
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Old 25th Jan 2007, 18:25
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sadly, the discipline spoken of by the previous posters is no longer "cool". or with it, or HIP, or HEP or whatever.

Laid Back is where its at, right chicky baby.


non cool:

taxichart on approach clip

veryify runway with localizer

watch for runway markings to measure runway remaining.

using full power takeoffs with full planes.


===


cool:


being laid back.

not worrying about charts, I got it all memorized


not wearing glasses you need.


each takeoff and landing is the same routine thing...it ain't brain surgery...it ain't a lunar landing.


==
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Old 26th Jan 2007, 14:48
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411A, you're absolutely right. We regionals know nothing of professionalism, standardization, and high training standards. That's why this kind of thing could only happen at a regional. No major would every do anything like that. Or like forgetting to set the flaps on an MD-80 departure, or descending a perfectly flyable airplane into a swamp because a gear indicator was burned out, or trying to fly a 6 degree glideslope to a short runway in a 737, touching down halfway down the runway at over 180 kts, or...

You really don't know what you're talking about.


Oh, and has anyone proven that the crew wasn't GIVEN the wrong a/c assignment in the first place? That has happened to me more than once.

Last edited by Fokker28; 26th Jan 2007 at 15:08.
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Old 27th Jan 2007, 03:24
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These guys blew the pre-takeoff-checks too. It's sad what you can miss when your guard is down.

Fortunately no pax.
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Old 27th Jan 2007, 17:00
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Just another lonely 'nugget'...

Eye on the Sky Worthy of Praise
Controller averted possible jet crash

January 27, 2007 - Pensacola News Journal

Veteran air traffic controller J.D. Smith of Pensacola is going to Washington to be honored with a major safety award for averting a possible disaster last fall at Pensacola Regional Airport.

Smith will be honored Monday by the National Air Traffic Controllers Association for his action that prevented an incoming Northwest Airlink passenger jet from landing on a runway that was closed and littered with heavy machinery and debris.

He will receive the Archie League Medal of Safety Award, named for the nation's first air traffic controller.

In announcing the award, the Association said Smith's "keen awareness of the airspace prevented a possible major runway accident from occurring."
"This save is remarkable for several reasons," said NATCA Southern Region Safety Representative Perry Doggrell. "For him to notice a plane was lined up on the wrong runway, two or three miles out from the airport, from a radar screen is incredible. There were no windows, so he could not look outside and see the aircraft approaching. He only had his radar screen."

Full Article
http://www.pensacolanewsjournal.com/...701270323/1006
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Old 27th Jan 2007, 19:45
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The Lexington ATC was NOT doing traffic count after he cleared Comair 5191 for takeo

.

To Whom It May Concern:

The FAA has told us that the lone controller at Lexington tower turned his back on Comair 191 and was busy with "administrative duties, traffic count" after he cleared Comair191 for takeoff while it was on the wrong runway. Initially, he admitted seeing Comair on the wrong runway and later changed his testimony..

The FAA released the tapes the other day and I downloaded it from their site at....

http://www.faa.gov/data_statistics/a.../comair_tapes/

If you download the ATC Communications audio (MP3) tape there and play it, you can hear Diane English, an FAA employee, say she made the tape from 0944 Coordinated Universal Time - 1026 Coordinated Universal Time on August 27, 2006. The accident occurred at 1006 Coordinated Universal Time.

If you want to understand what happened, download the tape and play it while you read the following information....

At 06:52 into the tape, Comair 191 calls clearance delivery for his clearance to Atlanta.

Christopher Damron, operating initials CD, the lone controller, was working four positions. (1) Flight data/clearance delivery(FD/CD) where he had to contact center and transmit clearances to aircraft on one frequency, (2) Ground Control (GC) where he had to issue taxi clearance and watch taxiing aircraft on ramp and taxiways on another frequency, Local Control (LC) where he had to watch aircraft on the runway and in the traffic pattern in the control zone out to five mile radius on a third frequency, and Radar Departure Control (DC) where he had to give heading to fly for arrivals and departures below 10,000 ft. on a fourth frequency. This is not too much to handle if things fall in a staggered sequence, but when you get busy, someone has to wait. You can't talk on four frequencies at once or talk to ten aircraft at once. In the business, it's called going "Down the tubes". During the day, all these positions are manned and in addition the local control position can be split between two controllers. There is a supervisor and cab coordinator (CC) also who monitor all positions to insure safe operations. I have a photo I took a LGB where you can see ten controllers in the tower cab.

As you listen to the tape, you will see that CD doesn't have a lot of time to catch his breath in the minutes before Comair is cleared for takeoff. After that, he has nothing to do. He let his guard down. These times show it to some degrees but his transmissions are sometimes lengthy and there is little time between each transmission.

At 06:58, CD issues Comair his clearance to ATL and..
At. 07:12 Comair reads back the clearance and admits he missed his arrival route into ATL. CD had to spell it out for him.

At 13:30 CD makes a blanket broadcast that the ATIS has changed to Bravo and the new altimeter setting is 30.00.

At 13:54, the controller, operating initials Charley Delta, calls ARTCC. He doesn't key his microphone while dialing (old rotary pulse phone) but has to key in to talk to center at 13:58. That is when you hear CD breathing and the music in the background from the radio. He unkeys his mike at 14:05 and the music can no longer be heard. We hear it again at 14:09 when he keys in. ARTCC hasn't come up on the line so the music can only be in the tower cab. At 14:08, ARTCC comes on the line and CD requests a release on Skywest 6819. Center releases him and CD gives his initials and hangs up at 14:12. The music stops at that time.

At 16:04 into the tape, Comair 191 advises he is about to push back.
At 16:09, ATC responds Roger, advise ready for taxi.
At 16:11, Comair says Roger.

At 16:32 into the tape, Eagleflight 882 calls for taxi and at 16:43 he taxis him to RWY22.
At 17:26, Skywest 6819 calls for takeoff clearance at RWY22
At 17:30, ATC says Thanks, turn right heading 270, Runway 22, cleared for takeoff. Since there was only one active runway, it is not required that ATC specify the runway when issuing takeoff clearance.
At 17:35, Skywest 6819 acknowledges cleared for takeoff.

At 18:33, Eagle 882 calls ready for departure
At 18:36, ATC replies, Eagle 882, roger, hold short.
At 18:40, Eagle 882 acknowledges, Hold short of the runway.

At 18:57, Comair 191 advises he is ready for taxi instructions and states that he has Alpha. At 13:30 the ATIS changed to Bravo and he was not aware that the ATIS had changed .This means he has listened to the Airport Terminal Information Service (ATIS) on a separate frequency which gives him the active runway, winds, altimeter setting, and other NOTAMS (Notice To Airman) about taxiway closures, instrument approach outages, lights out of service, etc. You can also hear it on the phone, as well. In the government pages of the white pages, it's under Transportation, Department of, FAA, ATIS. To his credit, CD caught this and re-issued and winds and altimeter to Comair.

At 19:02, Comair 191 acknowledges that he is to taxi to rwy 22.
At 19:09, CD clears Eagle 882 for takeoff
At 19:11 CD calls radar contact on Skywest 6819 and gives him further instrutions.

At 20:27, CD calls radar contact on Eagle 882 and gives clearance to 10,000FT.

At 20:48 CD goes on the land line and dials center (ARTCC).
At 20:55 CD again keys his mike and we hear the music. While waiting for center, Skywest 6819 can be heard on the speaker in the background saying he is passing 10,000ft.and requesting a turn to 300 degrees to avoid weather. CD approves his request and immediately center comes on the line and CD request a release on Comair. He had to be watching Comair approaching the approach end of the short runway because he call for the release in advance of him arriving at runway 22.


At 21:09 CD keys his mike and again we hear the music and hear him tapping the flight progress strip for Comair191 on the console. He asked center for a release on Comair and center issues the release, CD gives his initials and hangs up the line.

He immediately calls another sector and requests the 300 heading for Skywest 6819 to "get around some weather", but he had already approved the turn for Skywest.

At 21:19, CD tells Skywest 6819 to contact center.
At 21:23 Skywest acknowledges the frequency change.

At 21:25 CD gives Eagle 882 a new heading
At 21:30 Eagle882 acknowledges the turn.

At 22:07 Comair 121 transmits that he is ready to go.

At 22:10 CD says Comair 191, Lexington Tower, fly runway heading, cleared for takeoff.

If Comair 191 is at the approach end of the wrong runway, he is nowhere near runway 22. In an interview CD acknowledges that he saw Comair 191 on the wrong runway and NOT on the taxiway to runway 22, but 30 minutes later changed his testimony.

At 22:14 Comair acknowledged fly runway heading, cleared for takeoff.

CD immediately focuses back on Eagle 882 and ...

At 22:17 CD asked Eagle 882 if the heading he gave him worked for him or did he want a further turn to the northwest of the weather that's ahead of him.

At 22:23 Eagle 882 says "That looks fantastic, thank you very much"

CD missed the response and...

At 22:25 CD transmits "Say again, please" to Eagle 882, while Comair is rolling on the wrong runway. He is NOT doing traffic count as the FAA is telling us.

At 22:26, Eagle882 repeats "This heading looks great,

At 22:30, CD is probably looking at the radar scope as he is talking to Eagle 882 and giving him a frequency change to center.

This is 16 seconds after he cleared Comair for takeoff and he hasn't seen him rolling on the wrong runway. He was supposed to scan his runway when he cleared him for takeoff and should have noticed him on the wrong runway. He claimed he did see him on the wrong runway but said nothing to him and didn't cancel his takeoff clearance.

It's odd that a station agent for American Eagle saw Comair on the wrong runway, but the controller claims he saw nothing,..... eventually.

Here's the articles...

http://www.kentucky.com/mld/kentucky/16486163.htm

and..

http://www.kentucky.com/mld/kentucky...kentucky_local

In this second article, it states....

Damron told investigators that he did not know the plane had taken off from the wrong runway until a union official, who had reviewed radar data, told him. If Comair would have taken off on the right runway, he would have contacted tower on departure and CD would have issued radar contact. CD should have been at the radar scope waiting for Comairs call instead of doing the traffic count.

According to the other tape I downloaded at the FAA site at...

http://www.faa.gov/data_statistics/a.../comair_tapes/

this one labeled..

ATC Phone Call to Fire and Rescue audio (MP3)*

CD pulled the crash phone and reported the aircraft crash, (an Alert III ) at 06:29 into the tape.

Again, the crash phone recording was narrated by Diane English. The tape runs from 1002 CUT-1013CUT on August 27, 2006

That means that CD pulls the hook at 1008:30 CUT. That is about 2 1/2 minutes after the crash. Traffic count doesn't take 2 1/2 minutes to perform. The accident occurred at about 1006 CUT. CD had to be doing something else for that other two minutes. What could he have been doing for all that time? Maybe he took the clipboard over to the radio to change stations. He wouldn't have gone to the bathroom when he was expecting a call from Comair.

He tells the crash crew that the aircraft is off the approach end of runway 8. That is the departure end of runway 26. 80 plus 180 degrees is 260, BUT then he tells the crash crew the aircraft took off of runway 22. I can't understand how he thought Comair took off runway 22 and ended up off the departure end of runway 26. If he took off of 22, he would have had to go off the right side of runway 22 before he got halfway down the runway.

If there would have been a second controller working the radar scope, CD could have been watching his runway a lot closer, but that is no excuse when the runway is the primary responsibility. CD wasn't focusing on his primary responsibility, the runway, but let his attention focus in the wrong direction dealing with radar traffic in the air. Traffic count had nothing to do with this accident.

CD had three departures in a short period of time with a lot of coordination with ARTCC. He is listening to music in the background. If he did the traffic count when he was finished talking with Eagle882, Comair was at the departure end of runway 26 or colliding into the trees off the departure end. Comair crashed before he started the traffic count. He should have seen it happening. CD should have been watching his runway. Aircraft in the air pose little threat to safety compared to ones on the runway.

CD never did tell us why he wasn't looking at the radar scope and telling Comair that he had radar contact on him. He should have been wondering why no radar target showed up at the departure end on runway 22. The traffic count scenario is just smoke and mirrors.

Today, I read an article about the FAA refusing to have weather band radios in the control towers siting it would be a distration. Here's the article....

http://blogs.usatoday.com/weather/20..._yes_radi.html

According to a spokeswoman from the FAA, the decision to pull the radios seeks to limit distractions for controllers and ensure safe operation of the airspace.

We had a radio with a cd player in the tower cab at MYF and we used to bring our own cd's to work and listen to them while working traffic. Once at LGB tower, we had a portable TV in the tower cab watching a football game and I forgot to take it home when the tower closed. The next morning, the chief saw it and demanded to know who's it was. I confessed and he chewed my butt until I promised him it would never happen again.


Traffic count should be done on the hour and is a secondary function. The crash occurred at about 6 minutes after the hour. Six minutes prior to the accident, CD was busy with Eagle882 ready for departure. Traffic count is not important. CD had three departures and all he had to do was write down 0-2-0-0-0 on a clipboard to complete the traffic count, Takes all of two seconds. Comair was on the wrong runway for close to 25 seconds.

Here is some inside information for the layman, you don't have to turn your back on the runway to do traffic count. You read the numbers off the counter in front of you and put them on a clipboard, again, in front of you. He should have been watching his radar scope when Comair was no longer on the runway, again in front of him. There is NO reason to turn your back.

The pilot and first officer were given toxicology tests after the crash but I have never heard of a controller being tested for drugs or alcohol following and accident or incident. We hear of the TSA people reporting pilots when they smell alcohol on their breath and they have been pulled off of airliners and registered massive amounts of alcohol in their systems.

Since the 70's, control towers that used to be above the terminals were moved across the airport and the public never came in contact with us if we didn't want them around. At Christmas, pilots used to drop off gifts for us, it's an old tradition. We got candy and cookies, but the main item offered to us was booze, and lots of it. Why would you want to give your controller a bottle of scotch, I never understood it. When I tell people about all the drugs being used on the job, the number one response I get is "Well, it's a really stressful job, isn't it?" I guess they feel if you are in a stressful job, you ought to be able to shoot up a little heroin now and then.

The FAA knows that the public knows nothing about the functions of a control tower and it is easy to "hoodwink" the masses. Now you know the truth.

I came across a letter to AvWeb from a controller claiming things are worse now than when I blew the whistle. AvWeb has been able to confirm her identity. Her letter is at ....

http://www.avweb.com/eletter/archive...printable.html

I have been at this for close to 20 years now. Who is looking out for the safety of the flying public? The FAA ALWAYS says safety is their number one concern. If that was true, they wouldn't have hired one on my co-workers after he had been busted twice in the US Navy for trafficing in drugs. And another who would come to work drunk once a week. They would not have hired me when they knew I had vision problems. But they fired me when I had seen it all too many times and told my chief we were getting tipped off about random drug testing and over half of us were using on the job. He was the one who tipped us off the day before the drug team arrived so we could switch shifts with a non-using controller, if we could find one. And the guy who the chief told was the guy who was dealing all the drugs.

I have played tapes of telephone calls with my co-workers where they admit knowledge of druguse on the job to my Congressman, Duncan Hunter, and to the press in San Diego. Nothing is done. I have sent the tapes to the Aviation Subcommittee of Congress and to the White House. Nothing is done.

Who is going to stop this from happening again and again. We have been ignored, attacked, and accused of having our own agenda by the press, government officials, and family members of such tragedies as TW800, Swissair111, Egyptair990, and ValuJet 592. Now one of the Comair191 family members has asked me to remove him from my mailing list.

We are the head wiring experts from Boeing and the Dept. of Defense, airline pilots, two FAA lead airline inspectors, an FAA security expert who reported problems at Boston Logan and resigned after the FAA cooked his reports (before 9/11), an airline mechanic, and the inventor of the smoke hood for airline cockpits. Everyone talks about wanting to make sure nothing like this happens again, but when we give them what they need to do something about it, it's "shoot the messenger".

The press could report these crimes, but they refuse to let the people know the truth in our land of the free. I have told reporters that if they get this story past their editor, the next big story they will be working on is the bear problem at the dump. How can our President say people are jealous of our freedom?

Now YOU know the truth about what happened to Comair191. The NTSB final report will say that the controller had his back turned away from the runway and nothing more. If you don't believe me, look at how the NTSB covered up the crash of VJ592 and screwed over the families there. You can read all about it on my website at....

http://users.sdccu.net/chickenlittle

The Congress won't let me testify because they can't have everyone knowing the real story about aviation safety and the way they are watching over the system. We will just have to hear about more innocent people dying by the hundreds over and over again. I will be wasting my time for decades to come.

Regards,


James Bergquist
Air Safety Activist
Former USAF and FAA air traffic controller
Former San Diego Country NATCA representative
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Old 27th Jan 2007, 21:09
  #78 (permalink)  
 
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It's all gone quite out there

Sounds like the truth is coming to light!!

James Bergquist
Air Safety Activist
Former USAF and FAA air traffic controller
Former San Diego Country NATCA representative
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Old 28th Jan 2007, 08:34
  #79 (permalink)  
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The only truth which has come to light is the advisability of having chart 10-9 open and viewable for consultation along with checking the heading bug when in position. A truth which may come to light is that of First Officers (and perhaps even Captains) being so saturated by check lists and the house-keeping duties involving V speeds and numbers that situational awareness during the taxi phase is lost. The reason as to why the takeoff was continued along an unlit runway will never be understood.

Tuning localizer receivers for runway confirmation prior to takeoff is pure fluff, whistle blowing referenced to ATC for this particular accident is nothing more than an irrelevant tilting at the windmills which belong to a different (personal) agenda.
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Old 28th Jan 2007, 14:12
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Definitely we can see that the controller was a very busy man keeping lots of balls in the air.

As far as the music is concerned, it may have helped keep him alert on the graveyard shift. Whether it was a distraction depends on the volume. A sports event would be a far greater distraction.

Assuming the tower is located in the terminal building, it seems the thresholds for Rwys 26 and 22 are pretty much in line; so, it would not be that hard to fall to the illusion that Comair was at 22 instead of 26 in the dark if all he could see was the lights.
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