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Spanair accident at Madrid

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Spanair accident at Madrid

Old 19th Sep 2008, 15:52
  #1861 (permalink)  
PJ2
 
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HarryMann;
Now, back to why this wrong configuration was used at take-off....
Absolutely. The diagrams and explanations are sufficient for understanding by most, so back to "why?"

sevenstrokeroll;
it is simply too hard to communicate with some on this forum...good luck to you all.
Yes, it is, isn't it? I applaud your efforts none the less. As you see, most professionals who contributed earlier and tried to provide insight for earnest and serious non-professionals, have left. This is a very thorough thread with answers to most questions. All it takes is a little patience and respectful effort.

It's not so much "giving up" as spending one's time in more productive and less redundant endeavours. Your efforts are inspiring and well worth reading but the dialog is essentially over for most. Johnny-come-lately elementary questions which clearly reflect lack of effort and the basic courtesy of reading before writing, have thorough, detailed answers which are in the thread already and unless one has the time and inclination, do not warrant further effort.

LUALBA, in reference to your post to sevenstrokeroll:
You have issued your final report of the accident.

Incredible how someone can affirm at this time so many things without all the information. Maybe you are right, maybe not, but what is extremly clear is that you can NOT AFFIRM AT THIS POINT the reasons why the AC crash.
Regardless of intent, you gain no ground by shouting, (bolding), which is how your post comes across in print. However, it's a free forum and to each his own.

Second, sevenstrokeroll has made comments which, to aviation safety professionals and many airline crews, ring true and which have a long and interesting history within the safety community and which many believe apply to this accident. The comments made are nowhere near a "report", but are familiar observations which should, but likely won't, form part of the investigative work and formal report, in this accident. You are right that we cannot affirm without all doubt removed, that these factors played a role in this accident, but that was not the intent - rather, they are "sign-posts" which point to the way this accident will likely have unfolded.
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Old 19th Sep 2008, 16:08
  #1862 (permalink)  
 
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737 flapless takeoff "succesful" in actual flight

@PH-OY-73:

These guys did an actual flapless take-off in a 737 and survived (barely):
ACN: 658970 (1 of 1)

Time / Day

Local Time Of Day : 1801 To 2400
Date : 200505

Place

Locale Reference.Airport : DCA.Airport
State Reference : DC

Environment

Flight Conditions : VMC
Light : Night

Aircraft : 1

Controlling Facilities.Tower : DCA.Tower
Operator.Common Carrier : Air Carrier
Make Model Name : B737-800
Operating Under FAR Part : Part 121
Flight Phase.Climbout : Takeoff
Flight Phase.Ground : Taxi
Flight Plan : IFR

Component : 1

Aircraft Component : Stall Protection System

Person : 1

Affiliation.Company : Air Carrier
Function.Flight Crew : Captain
Function.Oversight : PIC
Qualification.Pilot : ATP
Experience.Flight Time.Last 90 Days : 210
Experience.Flight Time.Total : 8000
Experience.Flight Time.Type : 1200
ASRS Report : 658970

Person : 2

Affiliation.Company : Air Carrier
Function.Flight Crew : First Officer
Qualification.Pilot : ATP
Qualification.Pilot : Commercial
Qualification.Pilot : Flight Engineer
Qualification.Pilot : Instrument
Qualification.Pilot : Multi Engine
Qualification.Pilot : Private
Experience.Flight Time.Last 90 Days : 100
Experience.Flight Time.Type : 2000
ASRS Report : 658968

Events

Anomaly.Aircraft Equipment Problem : Critical
Anomaly.Non Adherence : Company Policies
Anomaly.Other Anomaly
Anomaly.Non Adherence : Published Procedure
Anomaly.Non Adherence : FAR
Independent Detector.Other.Flight CrewA
Independent Detector.Aircraft Equipment.Other Aircraft Equipment
Resolutory Action.Flight Crew : Regained Aircraft Control
Resolutory Action.Flight Crew : Overcame Equipment Problem
Consequence.Other : Company Review

Assessments

Problem Areas : Flight Crew Human Performance
Problem Areas : Aircraft
Primary Problem : Flight Crew Human Performance

Narrative

WE PUSHED BACK FROM THE GATE AND I INSTRUCTED THE FO TO START BOTH ENGS, ANTICIPATING A SHORT TAXI. WE PERFORMED THE AFTER START CHKLIST AND THE FO CALLED FOR TAXI. AS WE STARTED THE TAXI, I CALLED FOR THE TAXI CHKLIST, BUT IMMEDIATELY BECAME CONFUSED ABOUT THE RTE AND QUERIED THE FO TO HELP ME CLEAR UP THE DISCREPANCY. WE DISCUSSED THE RTE AND CONTINUED THE TAXI. WE WERE CLRED TO CROSS RWY 4, AND I ASKED THE FO TO SIT THE FLT ATTENDANTS. HE MADE THE APPROPRIATE PA. WE WERE CLRED FOR TKOF RWY 1, BUT THE FLT ATTENDANT CALL CHIME WASN'T WORKING. I HAD CALLED FOR THE BEFORE TKOF CHKLIST, BUT THIS WAS INTERRUPTED BY THE COMS GLITCH. AFTER AFFIRMING THE FLT ATTENDANTS READY, WE VERBALLY CONFIRMED BEFORE TKOF CHKLIST COMPLETE. ON TKOF, ROTATION AND LIFTOFF WERE SLUGGISH. AT 100-150 FT AS I CONTINUED TO ROTATE, WE GOT THE STICK SHAKER. THE FO NOTICED THE NO FLAP CONDITION AND PLACED THE FLAPS TO 5 DEGS. THE REST OF THE FLT WAS UNEVENTFUL. WE WROTE UP THE TKOF WARNING HORN BUT FOUND THE CIRCUIT BREAKER POPPED AT THE GATE. THE CAUSE OF THIS POTENTIALLY DANGEROUS SIT WAS A BREAKDOWN IN CHKLIST DISCIPLINE ATTRIBUTABLE TO COCKPIT DISTR. THE TAXI CHKLIST WAS INTERRUPTED BY MY TAXI RTE CONFUSION. THE BEFORE TKOF CHKLIST WAS INTERRUPTED BY A FLT ATTENDANT COM PROB. AND FOR SOME REASON, THE TKOF WARNING HORN CIRCUIT BREAKER POPPED, REMOVING THE LAST CHK ON THIS TYPE OF THING. BOTH OF US FEEL OURSELVES TO BE HIGHLY DILIGENT PROFESSIONALS. WE GOT OURSELVES IN A BOX BY ALLOWING OURSELVES TO BE DISTR FROM THE CHKLIST. FROM NOW ON, IF I AM INTERRUPTED WHILE PERFORMING A CHKLIST, I INTEND TO DO THE WHOLE THING OVER AGAIN.

Synopsis

FLT CREW OF B737-800 TAKES OFF WITH FLAPS UP.
ASRS - Aviation Safety Reporting System
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Old 19th Sep 2008, 16:24
  #1863 (permalink)  
 
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Nathless I must inquire if Aerodynamics is better, supercedes, improves upon, or was just there first, or what? If better than Stick and Rudder, how do you know if you didn't read it?
'Aerodynamics' was required reading for a rather Prussian style government sponsored flying course I took years ago at Saufley Field. My Drill Instructor whispered gentle words of encouragement to help me study.

'Stick and Rudder' is undoubtedly a great book but I've usually been too busy flying for a living to read much about how to do it. The Brits always love 'Handling the Big Jets' by Davies. All of these texts are decades old but the basics don't change much.
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Old 19th Sep 2008, 16:40
  #1864 (permalink)  
 
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It seems that, these guys did a brave flapless/slatless take off on an MD-83 and (barely) survived.

The official CIAIAC preliminary report (over a year old), though, still doesn't mention these (presumed) facts.

05-06-2007. OE-LMM. McDonnell-Douglas MD83. Aeropuerto de Lanzarote (Las Palmas) - CIAIAC - Ministerio de Fomento

We will patienly wait for the final report, although I'm not sure what's taking so long in a case where the airplane was intact and the crew available for investigation. Gravevine is that crew found the famous c/b pulled, thus TOWS was inop, thus they took off w/o realizing the flaps weren't out ...

This close to another accident like this, I heard. Luckily, some of the flight conditions, crew response (and shear luck) were more in their favor ...

Last edited by justme69; 19th Sep 2008 at 20:34.
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Old 19th Sep 2008, 16:47
  #1865 (permalink)  
 
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Had some time left on our 737-800 simulator session the other day and tried a few take-offs with clean wing:
Perhaps the 15 years of development between the MD-80 and the 737-NG make a difference?
The 737-800 has about 5% lower wing loading then the MD-82, not considering the winglets, so that may cause a small difference.

However, your text implies the simulated rotation was at a Vr appropriate for the flapless configuration, whereas JK5022 in all probablity rotated at the Vr for the intended, flapped, configuration. Big difference I'd say.
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Old 19th Sep 2008, 16:52
  #1866 (permalink)  
 
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It seems other automatic security cameras captured part of the accident:

telecinco.es MiTele - Informativos - Sociedad - Imágenes exclusivas del accidente aéreo de Barajas

Soon after the accident, security was notified and they started to manually point many cameras to the area, it seems.

Those that prefer the copy of the DRAFT of the preliminary CIAIAC report in pdf format, can fetch it from here:

http://www.elmundo.es/documentos/200...or_barajas.pdf

One more survivor has left the hospital and another was sent to a different, local hospital a few days ago.

Only five survivors remain with medical issues of importance. One remains in very serious condition, but doing better.

Last edited by justme69; 19th Sep 2008 at 17:21.
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Old 19th Sep 2008, 17:44
  #1867 (permalink)  
 
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@ snowfalcon2

The simulation was done, of course, with speeds for normal take-off -in this case flaps 5.
Otherwise the simulation would indeed be irrelevant.
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Old 19th Sep 2008, 19:09
  #1868 (permalink)  
 
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Simulation

I think simulation is irrelevant if:
1. the pilot knows what's coming
2. the pilot knows he's not going to die.
It's another story when you rotate, the plane is not behaving as expected, and you find yourself fighting for your life.
I've flown 'heavy metal' for 35 years, including 5 years on MD-80.
I've always appreciated [U]mechanical[U] checklists; when conscientiously used by all crew members they can prevent embarrassing moments.
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Old 19th Sep 2008, 19:31
  #1869 (permalink)  
 
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Hurry up syndrome: Flapless TO

Forgive me if this was posted but I gave up reading this thread as there appear to be a lot of **&&*(^(&* threads


The Errors are in the System[B][/B]

1) Has anyone performed a flapless TO in the MD-80 at MTOW with a tailwind with a co-pilot with about 1000 hours epxerience who was not briefed on it ? Out of curiosity ?

Interesting how the Chief investigator and two pilots have resigned from the Investigation, something is cooking.

Amongst the items that may be discussed The Error producing conditions include the regulations, time pressure, SOP's, Human factors, situational awarendThe civil aviation authority,financial pressure on the people, maintenance, Boeing, SB's . What else ?

You know what the people who know the most will say ?
Nothing.

Anyone know about the NTSB and Boeing peoples input into the investigation.

Lets let the PROS do their jobs out of respect to the dead.
We must be very patient. A good investigation can take years.

Look at Dryden.
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Old 19th Sep 2008, 20:37
  #1870 (permalink)  
 
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So that means wait years to hear what the readout was on the FDR and CVR? Meanwhile no attempts are made to prevent a repeat of this crash? Someone has to come forward soon with the data. Remember this is not the first time this has happened so it won't be the last. Keeping everything secret does not promote safe operations.
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Old 19th Sep 2008, 20:39
  #1871 (permalink)  
 
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Killer Items Checklist

May I suggest a placard in a conspicuous location:

Killer Items
  • Flaps
  • Trim
  • Spoilers
  • Runway Heading
  • Controls Full and Free
The title could be Line up Check for squeamish managements.

All of these items have figured in takeoff accidents, but this is a list that should be kept deliberately short even though many SOPs specify additional pre-takeoff items such as lights, transponder, time, radar...
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Old 19th Sep 2008, 20:59
  #1872 (permalink)  
 
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PJ2
You are quite right, most serious professionals ceased contributions to his thread some time ago. I despair of the constant theorising and the rehashing of poorly understood aircraft aerodynamics. Well done seven stroke roll and others for sticking with it.
Way, way back it was clearly suggested that this was an attempted takeoff without slat and/or flap, all the evidence points to that. The task now is to identify the critical path of events which resulted in the accident and find a way to prevent a recurrence. There has obviously been a worldwide failure to do that so far.
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Old 19th Sep 2008, 21:58
  #1873 (permalink)  
 
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So that means wait years to hear what the readout was on the FDR and CVR?
Absolutely FDR & CVR readouts take a long time to interpret, and need to experts to do so, after assistance from outside agencies etc. Each parameter needs to be validated and cross referenced before drawing conclusions. The only benefit for a "quick" readout is for the PPRuNe speculators

I for one do not like the "steady" leak of info here, I think legitimately from the Spanish media, in turn from the judicial inquiry (?) NB it is only that - a judicial inquiry for prosection purposes (if appropriate). It is not seemingly an "accident investigation" i.e. to draw lessons for prevention of future accidents.

From my own hunches, if you are really anxious to read a full report and FDR / CVR download, I should read the NW report... I suspect this will eventually be chillingly similar

NoD
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Old 19th Sep 2008, 22:13
  #1874 (permalink)  
 
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Yes, the NW report will probably be chillingly simular. Are you concluding then with no facts that is what happened? I guess we can just put everything away and go home then. They must know with FDR and CVR readouts what happened. Where were the flaps, what power setting they used and what they said has been available for quite some time now. Keeping that information secret serves no purpose in the interest of safety.
What purpose does it serve?
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Old 19th Sep 2008, 22:26
  #1875 (permalink)  
 
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At least one of the flap actuators (screw jacks) was stated as being extended 12cm. The nice thing about screw jacks is they maintain the same state after hydraulic pressure/flow is removed. There is zero chance an impact can cause one to move.
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Old 19th Sep 2008, 23:46
  #1876 (permalink)  
 
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The task now is to identify the critical path of events which resulted in the accident and find a way to prevent a recurrence. There has obviously been a worldwide failure to do that so far.
What causes you to make such a comment?

What do you feel is an appropriate timeline?
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Old 20th Sep 2008, 05:16
  #1877 (permalink)  
 
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Meanwhile no attempts are made to prevent a repeat of this crash?
Number of successful MD80 take-offs both before and after the accident seems to discredit this statement, whatever caused the crash.
I am prepared to stand corrected if this case is proven to be caused by something that no application of current procedures could prevent, but I doubt I'll be.

speeds for normal take-off -in this case flaps 5
Now what are the speeds for normal take-off in NG? On my bus V2s for the same weight, but for different runways can differ up to 25 kt. High k in kVs can help you get away with a too low config. Let's wait for the report to see what were the actual speeds used and what was the actual configuration.

Provided that the the leaked draft is accurate, behaviour of the airplane is consistent with stall at the upper fringes of the ground effect. Historically, such stalls were cused by either too low speed, lesser config that intended or wing icing. And we can rule out icing here.
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Old 20th Sep 2008, 06:25
  #1878 (permalink)  
 
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At least one of the flap actuators (screw jacks) was stated as being extended 12cm. The nice thing about screw jacks is they maintain the same state after hydraulic pressure/flow is removed. There is zero chance an impact can cause one to move.

i think you'll find that the opposite is the case. the md80 does in fact have flap actuators and slat actuators. if they hydraulic system is depressurised they will gravity extend

Last edited by Wirelock; 20th Sep 2008 at 06:26. Reason: sp
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Old 20th Sep 2008, 06:28
  #1879 (permalink)  
 
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There seems to be plenty of "unofficial" and quite a few "official" reports of initiating TO w/o flaps/slats. ASRS is full of them.

Some on the MD80's, like 629134, or 327158, including this one where TO alarms had not been checked: 722714, some in other models of airplanes like 402337, or 91277, or like the one informally reported here at http://www.pprune.org/rumours-news/3...ml#post4376707 - Thankfully the config alarm did sound and the pilots took the appropiate actions.

Or even some instances where the aircrafts did take off clean (and luckily, didn't crash), like the recently mentioned 658970, or the MD-83 in Lanzarote (http://www.pprune.org/rumours-news/3...ml#post4374228 ), or this one commented here informally: http://www.pprune.org/rumours-news/3...ml#post4350214 , and with TOWS also not-tested and inoperative (at that time). And, of course, the Northwest case that ended in the Detroit accident.

I guess the TO config alarms are there for a reason. Pilots do forget to deploy the flaps/slats for take-off often enough to warrant the trouble to put them in in the first place. We won't go into lowering gear for landing ...

I don't think you can blame all these occurrences (the tip of the iceberg?) on "poor training" or "poor procedures" or "rushed crew" or whatever.

Some of them are just, plain pure and simple, human error. As long as there are humans and errors to be made ... they eventually will.

Nobody wants to die in a car/truck/bus/train/boat accident, yet, everyday, hundreds of people, even very skilled professional drivers with extensive experience, make all sorts of mistakes and "shortcuts" in basic security (checking your wheels, safety belt, lights at night, not talking on your cell phone when driving, not drinking, etc) leading to hundreds of accidents and related victims.

Pilots are humans. Therefore, no matter how much training, time, or experience, they are fallible.

And about the flap actuators, let's not forget, that the crew could've also tried to deploy them late in the course of the accident in an attempt to exit the stall or whatever reason. Totally speculative, but the flaps could even have been "stuck" when the handle was pushed, and the "jerk" of the first fall actually jerked the handle/unstuck the flaps and slowly started to come out only to crash some 1km later. Not saying that it happened or anything, just that it is not out of the question (although highly unlikely).

What matters is that enough evidence is found that conclusively points at the flaps(/slats) not being deployed in the critical moments of the take-off. And that hopefully it will also be established whether the crew tried to deploy them at all or the command was actually never called for.

Last edited by justme69; 20th Sep 2008 at 15:56.
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Old 20th Sep 2008, 07:40
  #1880 (permalink)  
 
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Are you concluding then with no facts that is what happened?
No - read my post(s) - heavily caveated.

They must know with FDR and CVR readouts what happened.
No - not to the standard required of an accident report / investigation. They know what the data says... not know what and crucially why, something happened (or not). That takes a lot of analysis and even trick cyclists

Keeping that information secret serves no purpose in the interest of safety.
What purpose does it serve?
Uninformed chattering, wild conclusions, accusations etc. In the press and as shown in the last 94 pages here It always has been that way (see BA38) - why should this accident be different

NoD
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