Yemenia A-310 accident 2009 report
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ANACM analysed that the frequent target altitude changes including the display of 0 were inadvertent inputs while the heading bug was intended to be operated. The target altitude of 3000 feet, selected repeatedly, had no operational justification, the go-around altitude was 8000 feet.
They should never have been anywhere near the controls of a aircraft.
The report provides an excellent example of how accidents happen and the sequence of events is pretty clear. To write it off as pilot error because they were idiots is however a bit too simplistic.
There is a whole chain of causal factors. The crew composition and training would be a good place to start. Both pilots were experienced on type, but the co-pilot was 50 with 3600 hours of which 3000 were on type. The commander was 45 with 8000 hours / 5000 on type. So they had been flying the aircraft for many years without killing themselves. However it is an unusual pattern of experience. The co-pilot seems to have started straight on this widebody at a pretty advanced age and it is unclear how much help he was.
The flight was scheduled in the middle of the night to a tricky airfield experiencing difficult weather conditions. It is clear that the circle to land with some airfield lighting defective would be stressful. To be fair this is not an everyday maneuver, although I sense 411A rolling over in his grave at that comment. With hindsight it is clear that these guys needed a lot more training to be able to perform one safely.
Things went wrong early with an unexpected and apparently unbriefed approach. The real problem occurred when in a high stress moment in the middle of the night on downwind the pilot flying apparently mistook the altitude for the heading bug. When the aircraft responded unexpectedly the crew became confused and lost control of the aircraft. The large pitch power changes and mode confusion at low level over a dark sea clearly overwhelmed the crew.
I would suggest that a significant portion of blame rests with the airline in setting up this situation.
There is a whole chain of causal factors. The crew composition and training would be a good place to start. Both pilots were experienced on type, but the co-pilot was 50 with 3600 hours of which 3000 were on type. The commander was 45 with 8000 hours / 5000 on type. So they had been flying the aircraft for many years without killing themselves. However it is an unusual pattern of experience. The co-pilot seems to have started straight on this widebody at a pretty advanced age and it is unclear how much help he was.
The flight was scheduled in the middle of the night to a tricky airfield experiencing difficult weather conditions. It is clear that the circle to land with some airfield lighting defective would be stressful. To be fair this is not an everyday maneuver, although I sense 411A rolling over in his grave at that comment. With hindsight it is clear that these guys needed a lot more training to be able to perform one safely.
Things went wrong early with an unexpected and apparently unbriefed approach. The real problem occurred when in a high stress moment in the middle of the night on downwind the pilot flying apparently mistook the altitude for the heading bug. When the aircraft responded unexpectedly the crew became confused and lost control of the aircraft. The large pitch power changes and mode confusion at low level over a dark sea clearly overwhelmed the crew.
I would suggest that a significant portion of blame rests with the airline in setting up this situation.
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I would suggest that a significant portion of blame rests with the airline in setting up this situation.
Controversial, moi?
....and all other airlines and operators that through policy and SOP do NOT encourage manual flying as well as visual approaches!
You are not seriously saying that a circling approach at night into a poorly lit area with high terrain would be safer flown manually (assuming competent hand flying skills)?
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Are we trying to blame the airline, the French, the aircraft, the autopilot when two pilots fly a fully servicable aircraft into the sea?
I suspect these guys started to clench their buttocks the moment they heard 30 kts. Nervous and incompetent. Not unusual with some ME pilots. Hotshots when the wx is fine and sliding down an ILS.
What they said at the end sums up the whole mess: Allah!
I suspect these guys started to clench their buttocks the moment they heard 30 kts. Nervous and incompetent. Not unusual with some ME pilots. Hotshots when the wx is fine and sliding down an ILS.
What they said at the end sums up the whole mess: Allah!
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You are not seriously saying that a circling approach at night into a poorly lit area with high terrain would be safer flown manually (assuming competent hand flying skills)?
There were two pilots in that Airbus. Clearly whoever was handling that night was incompetent by any standards. The support pilot, be he the captain or first officer, was also incompetent at his prime task of monitoring the flight path and offering support at the right time without overdoing the talking.
As has been discussed in thousands of words in these forums, when todays flight simulator sessions are 90 percent button pushing and staring at the MAP mode, it is inevitable that incompetent crews will often be out of their comfort zone and risk making a complete hash of handling the aircraft, once the disconnect red button is pressed and the autopilot says "handing over - all yours captain".
The solution has been obvious for years yet ignored by aircraft manufacturers and operators alike. That is what simulators are for; and that is to train pilots how to fly the aircraft type safely both in IMC and visually. To be equally competent on automatic and manual flight.
The current accent on 90 percent button pushing in the simulator leaves no time remaining in a session for the essential practice at skilful hand flying on instruments. The plethora of loss of control accidents has graphically demonstrated this fact.
Last edited by Tee Emm; 1st Jul 2013 at 11:43.
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Not directing comment at anyone here however a visual approach in an large jet airliner has jack all to do with the PF displaying his or her exemplary stick and rudder skills. Yes there is an element of manual flying, however like a circle to land (a visual manoeuvre initiated after an an instrument approach) this usually only occurs when turning base to final or on short final. It not a procedure which requires zero automation, contrary to the 'Sabena method' as it was once touted by a few trainers in my airline.
As M.Mouse suggests, the automation, used accurately and to effect, eases workload, increases situational awareness and allows a far from everyday occurrence to be a more relaxed procedure for both pilots. 9/10 it will follow what is briefed rather than having the PM working like a one armed coat hangar whilst his PF is maxed out manually flying a procedure that he may only handle a couple of times in a year.
The biggest thing that stuffs people up is the aircrafts inertia. Some brains cannot keep up with this hulk of aluminium, flesh and fuel as it is being poled round the sky, especially when a more taxing, less common manoeuvre is being flown. I'm not advocating the fact that we shouldn't fly manually but I am making the point that where these approaches go wrong is when people don't have a clear plan, don't appreciate the position of their PF and completely misinterpret the performance of their aircraft and their own capabilities within it.
I'm being prepared to be shot down by the hand flying purists who see differently.
As M.Mouse suggests, the automation, used accurately and to effect, eases workload, increases situational awareness and allows a far from everyday occurrence to be a more relaxed procedure for both pilots. 9/10 it will follow what is briefed rather than having the PM working like a one armed coat hangar whilst his PF is maxed out manually flying a procedure that he may only handle a couple of times in a year.
The biggest thing that stuffs people up is the aircrafts inertia. Some brains cannot keep up with this hulk of aluminium, flesh and fuel as it is being poled round the sky, especially when a more taxing, less common manoeuvre is being flown. I'm not advocating the fact that we shouldn't fly manually but I am making the point that where these approaches go wrong is when people don't have a clear plan, don't appreciate the position of their PF and completely misinterpret the performance of their aircraft and their own capabilities within it.
I'm being prepared to be shot down by the hand flying purists who see differently.
Last edited by Callsign Kilo; 1st Jul 2013 at 11:54.
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I love it when the old guys come here with their: In my days we were all competent, blablabla.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
Controversial, moi?
I actually think the statements made here are not mutually exclusive. I am saying that autoflight systems, briefed properly and used properly, make a less commonly flown approach safer and also dramatically reduces the workload.
I do also agree that manual flying skills do need to be maintained but the last thing I would advocate if flying the approach which led to this disaster would be to manually fly it!
The world has changed and despite the dreadful avoidable accidents which still occur automation has and continues to make the flying of large airliners safer than ever before.
Loss of manual flying skills and basic competence are a completely different subject. I do wonder whether the pilots who displayed such monumental incompetence evident in so many recent tragic accidents could ever be trained to be safe and competent with or without using automation.
I do also agree that manual flying skills do need to be maintained but the last thing I would advocate if flying the approach which led to this disaster would be to manually fly it!
The world has changed and despite the dreadful avoidable accidents which still occur automation has and continues to make the flying of large airliners safer than ever before.
Loss of manual flying skills and basic competence are a completely different subject. I do wonder whether the pilots who displayed such monumental incompetence evident in so many recent tragic accidents could ever be trained to be safe and competent with or without using automation.
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I do wonder whether the pilots who displayed such monumental incompetence evident in so many recent tragic accidents could ever be trained to be safe and competent with or without using automation.
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You are not seriously saying that a circling approach at night into a poorly lit area with high terrain would be safer flown manually (assuming competent hand flying skills)?
...and no I'm not saying you shouldn't use the automatics if you know how to, but I am saying that when you co.. it up you should be able to fly yourself out of it either manually or on automatics without getting wet! And it goes without saying if you never practice, it'll be a lot harder when you need to.
I'm not that old BTW I'll have to do this for another 15-18 years I'm afraid and I sure am glad that we were taught to be airmen and pilots in the -80's and not only system operators and slaves of the automatics!
Last edited by Hotel Charlie; 1st Jul 2013 at 14:50.
Originally Posted by ManaAdaSystem
I love it when the old guys come here with their: In my days we were all competent, blablabla.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
Yeah! Another willie-waggin' competition!
Given pilot's inability to distinguish heading and altitude knob it even might be, though later mishandling of the aeroplane when AP packed up suggest that this "safer" would still be unacceptably unsafe.
My company has no specific guidelines on automation use in circling and I don't care if my F/Os create PBD circuit, use HDG-V/S or fly manually as long as they fly us on appropriate track and profile. Can be performed safely in any way aforementioned - messed up too.
It is.
So? As if there are no cases where 200hrs on type performed well under duress or 10 000 hrs messed up royally after minor hiccup.
So? While I fail to spot the trickiness, isn't the ability to throw away too tricky approach one of the basic tools of pilots' trade?
The horrors of night circling with REIL inop! FFS, it's visual maneuver - you don't see, you go around!
Click, click, click. Ooops, didn't help this time. Couldn't fly autopilot and couldn't fly manually- which is not indication of poor manual but rather mental skills. Crew had no idea what were they getting into so no surprise in being unable to get out of trouble.
Solution is correct but not everyone is ignoring. A colleague of mine went recently job hunting. Got offered a position despite "overconfident and not using enough A/P" remark on check.
Originally Posted by M. Mouse
You are not seriously saying that a circling approach at night into a poorly lit area with high terrain would be safer flown manually (assuming competent hand flying skills)?
My company has no specific guidelines on automation use in circling and I don't care if my F/Os create PBD circuit, use HDG-V/S or fly manually as long as they fly us on appropriate track and profile. Can be performed safely in any way aforementioned - messed up too.
To write it off as pilot error because they were idiots is however a bit too simplistic.
However it is an unusual pattern of experience. The co-pilot seems to have started straight on this widebody at a pretty advanced age and it is unclear how much help he was.
The flight was scheduled in the middle of the night to a tricky airfield experiencing difficult weather conditions.
It is clear that the circle to land with some airfield lighting defective would be stressful.
The large pitch power changes and mode confusion at low level over a dark sea clearly overwhelmed the crew.
The solution has been obvious for years yet ignored by aircraft manufacturers and operators alike. That is what simulators are for; and that is to train pilots how to fly the aircraft type safely both in IMC and visually. To be equally competent on automatic and manual flight.
Welcome back Clandestino, I was worried something unfortunate had happened to you.
Your firm's ambivalence about how people fly approaches is not I hope the reason for the lengthy notam about qualification required for the 30 approach at Dubrovnik. Obviously the Croatian authorities feel the need to flag up difficult approaches and the need for training at certain carriers. Maybe you have some inside knowledge on this?
Actually I think there are some similarities between Dubrovnik and Moroni. Both are by the sea but influenced by terrain and high winds, which can cause unusual effects at certain times of year. Moroni obviously trumps Dubrovnik in that it is an isolated island aerodrome out in the Indian Ocean.
One thing that did strike me once they were flying manually is that the philosophy I am used to, of autothrottle off in manual flight would have been much better. However I do accept that given the sorry state of the rest of their flying it may well have made no difference.
Your firm's ambivalence about how people fly approaches is not I hope the reason for the lengthy notam about qualification required for the 30 approach at Dubrovnik. Obviously the Croatian authorities feel the need to flag up difficult approaches and the need for training at certain carriers. Maybe you have some inside knowledge on this?
Actually I think there are some similarities between Dubrovnik and Moroni. Both are by the sea but influenced by terrain and high winds, which can cause unusual effects at certain times of year. Moroni obviously trumps Dubrovnik in that it is an isolated island aerodrome out in the Indian Ocean.
One thing that did strike me once they were flying manually is that the philosophy I am used to, of autothrottle off in manual flight would have been much better. However I do accept that given the sorry state of the rest of their flying it may well have made no difference.
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I love it when the old guys come here with their: In my days we were all competent, blablabla.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
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Originally Posted by Tee Emm
The solution has been obvious for years yet ignored by aircraft manufacturers and operators alike. That is what simulators are for; and that is to train pilots how to fly the aircraft type safely both in IMC and visually. To be equally competent on automatic and manual flight.
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Originally Posted by ManaAdaSystem
I love it when the old guys come here with their: In my days we were all competent, blablabla.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
The barriers built into todays cockpits, GPWS and EGPWS are there because you old guys kept flying into mountains and other obstacles. They are there because you messed up again and again, despite your superior flying skills and situational awareness.
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Think about it logically for a second. The AF447 scenario - being at night over the middle of the ocean - offers a complete lack of external visual reference points. A visual representation of an aircraft pitching and rolling in what would effectively appear as a black void would be of dubious analytical value, would it not?