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Asiana flight crash at San Francisco

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Asiana flight crash at San Francisco

Old 20th Jul 2013, 07:07
  #2301 (permalink)  
 
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"Aircraft should cross ... The San Mateo Bridge at or above 1900."

So which is it, recommended or required? And from whence does the recommendation/requirement derive?
Good question. As a native English speaker and being fluent in 2 languages, the text has me confused.

As a former pilot, because I flew smaller aircraft I was always turned left base to final inside the bridge whenever VMC prevailed.

Nevertheless, has it not been established that they crossed the bridge at 2250?

Last edited by thcrozier; 20th Jul 2013 at 07:21. Reason: punctuation
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Old 20th Jul 2013, 07:39
  #2302 (permalink)  
 
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not allow them into our airports until they conform to our standards?
I'm afraid my comment on this may not be popular but if all countries adopted that approach, you may find that some US aircrew might struggle outside their homeland. Just because you have a large landmass, large economy etc does not justify riding roughshod over standard R/T, or pitching the level of expectation at those highly familiar with airport quirks. Throw a US only driver familiar and competent on his network into a busy holding scenario with Thunderstorms over Bombay and all of a sudden the roles might just reverse. As an English only speaker who has taken Heavy Jets to Europe, Asia, OZ, Middle East, NAM I can honestly say, and I am not alone in this, that it is easier to operate into some foreign language speaking ports but with careful spoken, phonetically correct, standard, (IAW signed up agreements), appropriately paced R/T, than it is into my absolute favourite nightstop, SFO. I'm not trying to be argumentative but surely the challenge should be to eradicate ANY possible contributory factors to this accident, not just focus on what MAY be the prime reason of a poorly flown (crashed) Viz Appr.
Finally, if you are going to use the phrase
our standards
I -> AGREE <- with you, BUT please look inwards and at ATC/Procedures as well as at us Pesky Foreigners.
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Old 20th Jul 2013, 08:40
  #2303 (permalink)  
 
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Should we have special regulations for foreign carriers that can't do a visual approach or just not allow them into our airports until they conform to our standards? How hard is looking out the window and lining up with a runway and have a clue how it should look?
That must be one of the most bigoted comments here so far. Maybe the rest of the world shouldn't use your airports until you can convince us that your crash rescue crews can safely attend an incident without killing the people they are meant to be saving? Or maybe we shouldn't fly 777s until we know that escape slides will not inflate inside the aircraft? (Yes, said in an antagonistic manner and by no means the way I think).

A better thing to do is look at the accident in its entirety and ensure that all lesson are learnt. FWIW, my view is that the following may need some thought and action:

Asiana training, CRM and SOPs
Boeing 777 cockpit switchery and the 'FDLC Trap'
Emergency slide deployment
Slam Dunks
ATC phraseology/terminology
Airport fire services SOPs
Runway maintenance planning

There are probably a lot more. If the only outcome of the investigation is a quick broadside at the Koreans then the NTSB will have completely failed in meeting their responsibilities.
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Old 20th Jul 2013, 09:45
  #2304 (permalink)  
 
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I agree, cows getting bigger.

Of course the PRIMARY NTSB recommendation will be something like:
"It is emphasized that aircrews must always monitor airspeed while flying, and always be ready to intervene in the AP system when necessary."

To me, as a pilot, this means that I will not learn anything from this crash. I have said about the same thing after the Turkish crash here in AMS.
Monitoring your airspeed -as a pilot- is sooooo basic, that it is unbelievable that there are people in a cockpit "flying" without watching their instruments! And simply letting it happen....

And then there are other symptoms/causes/contributing factors/etc. that others will learn something from. Sure, and this is also very noteworthy and necessary to investigate. But it will not have any direct influence on the way I fly airplanes.
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Old 20th Jul 2013, 10:10
  #2305 (permalink)  
 
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TBH, looking at the pictures of the wreckage under removal, I think that some of the more salient lessons to come out of this one will be those to do with survival aspects.

That aircraft is severely damaged, yet apart from the area around the tail, it more or less held together. Some of the seats had concertina-d. It's little wonder there were serious injuries. It would seem to me that the impact was pretty much at the upper limit of what could be termed a survivable accident.

Hopefully some direction or recommendations will come out, particularly to do with seat integrity and overhead locker restraints.

Secondly, I'm pi$$ed at those criticizing the airport fire crew that ran over the passenger. Without wanting to second-guess the outcome of the inquiry concerning that aspect of the accident, I would not be surprised in the slightest if that event is the part of it that will indeed be termed an accident. (As in: unavoidable.)

Nobody is likely to be harder on the driver of that fire tender than the person who was driving it.
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Old 20th Jul 2013, 13:53
  #2306 (permalink)  
 
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Looking at the pictures of the interior of the aircraft certainly puts the difficulties of evacuation into perspective. Not quite as simple as the cabin staff dance routine would suggest.
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Old 20th Jul 2013, 18:39
  #2307 (permalink)  
 
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I wonder

If, as the plane rotated, she was ejected out the back while the fuselage spun away counter clockwise, leaving her to the left side in front of the wing. Might explain that no one saw her get out the slide....also perhaps she was incapacitated and unable to get up and away from the on coming vehicles...

All conjecture of course. Terribly sad.
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Old 20th Jul 2013, 19:10
  #2308 (permalink)  
 
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Cows said: "A better thing to do is look at the accident in its entirety and ensure that all lesson are learnt. FWIW, my view is that the following may need some thought and action:

Asiana training, CRM and SOPs
Boeing 777 cockpit switchery and the 'FDLC Trap'
Emergency slide deployment
Slam Dunks
ATC phraseology/terminology
Airport fire services SOPs
Runway maintenance planning"


While I do not disagree that all of the above deserve attention, it still cannot explain how an experienced crew (or even an inexperienced crew) allowed their airspeed to bleed off to just over 100 kts
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Old 20th Jul 2013, 21:13
  #2309 (permalink)  
 
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@iflybt20

[Not a pilot] Thanks. Image 11 shows better than any of the previous photographs that I had seen how people could have been ejected from that portion of the plane and remained relatively intact.

Last edited by fotoguzzi; 20th Jul 2013 at 21:19.
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Old 20th Jul 2013, 21:52
  #2310 (permalink)  
 
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Originally Posted by thcrozier
It's pretty obvious that from whatever condition it was in over the bridge, it can decelerate and descend quickly enough to put it at a speed of 103 before reaching and below the seawall, which I believe is 12 feet high.
Yes.

All the discussion about glide angles, energy states, kinetic energy vs heights, etc. misses the point. Given that the flight was significantly higher than the restriction on the Charted Visual Procedure, and considerably faster than the speed restriction assigned by ATC, the fact that the plane ended up short of the threshold, lower than the runway and much slower than V-ref, demonstrates pretty conclusively that it was well within the capabilities of the airplane to slow to approach speed starting from 1900' at 5 NM and 180 knots.
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Old 20th Jul 2013, 22:12
  #2311 (permalink)  
 
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An account of the flight attendant who was trapped by the slide - by her husband who happened to be on board:

In Asiana crash, a husband's worst nightmare
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Old 20th Jul 2013, 22:16
  #2312 (permalink)  
 
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it was well within the capabilities of the airplane to slow to approach speed starting from 1900' at 5 NM and 180 knots.
Sure, that's not the difficult part.
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Old 20th Jul 2013, 22:34
  #2313 (permalink)  
 
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Re: Sawbone's ambulance

While important, the arrival of an ambulance on the scene of an accident can probably usually wait for a few more minutes than the arrival of a fire truck.

If there's no rescue crew there on time, then the need for a medical team is likely to be moot.
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Old 20th Jul 2013, 23:07
  #2314 (permalink)  
 
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While important, the arrival of an ambulance on the scene of an accident can probably usually wait for a few more minutes than the arrival of a fire truck.

If there's no rescue crew there on time, then the need for a medical team is likely to be moot.
The majority of the emergency response group did not appear to arrive on site until more than 20 minutes after the crash - as can be seen in the amateur video of the incident. This is backed up by the media reports that passengers who escaped and made their way towards the approach end of the runway, who found and were attempting to care for the seriously injured passengers, had to call 911 more than 20 minutes after the crash and essentially beg for help.

By all appearances - even 20+ minutes after the crash - there was almost no no emergency response to much of the accident scene. In the video you can see a police car race past the fuselage heading towards the approach end at high speed - but if memory serves me, that was just slightly before the larger group of ambulances etc arrived there.
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Old 20th Jul 2013, 23:34
  #2315 (permalink)  
 
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It would be interesting to hear what was discussed on the approach briefing, if there was one, prior to tod.
Did the new check airman in the right seat have the trainee scroll thru the map page and point out possible speed/alt hoowahs?
Did he brief the trainee on the approach notes emphasizing dme and altitudes and the configuration which would put them in the best energy state for a stabilized app by 1000 ft?
Did he make the trainee use the sec flt plan for possible runway changes?
Did he have the trainee explain the ma procedure for their primary/sec flt plan as written in their procedures?
These would be just a few of the items, but it lets the trainee know just WHO is in command, and on this flight there was no one in that capacity.

I always felt this was essential, more so with new captains, along with saying " if I'm not happy at 1000ft. I will take control."

I agree that fatigue had a role, however rest could have been rearranged to be back in the seat 3 hours out. I'm guessing on this but I played it this way on the MD11 as we always did double crew.
Anyway, long haul with 2 crews was never as bad as 2100 hr dept for SLC-DEN-OAK-DEN-SLC arriving at 0600.

So the point of this long, boring post is the need for communication, exercising command, using all the whiz bang tools of modern aviation, and assessing the ability of the trainee, and bottom line, if you're not happy with anything then fly it yourself.
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Old 21st Jul 2013, 00:43
  #2316 (permalink)  
 
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More info regarding the girl being hit here:

Coroner: Crash survivor was run over - SFGate

They say they have no idea how she ended up in the location where she was hit - which would appear to be between between the leading edge of the left wing and the escape slide. She had been sitting near the back of the plane with the other girl who was thrown from the plane and killed.
The question remains about the other girl killed - the one hit by the vehicle. If she was ejected or otherwise exited through the rear, then either she walked or someone carried her to the position where she was struck. I'd suppose it's also possible someone could have carried her down the slide, then laid her down in what they thought was a safe place in order to go help someone else.
Secondly, I'm pi$$ed at those criticizing the airport fire crew that ran over the passenger. Without wanting to second-guess the outcome of the inquiry concerning that aspect of the accident, I would not be surprised in the slightest if that event is the part of it that will indeed be termed an accident. (As in: unavoidable.)
If, as the plane rotated, she was ejected out the back while the fuselage spun away counter clockwise, leaving her to the left side in front of the wing. Might explain that no one saw her get out the slide....also perhaps she was incapacitated and unable to get up and away from the on coming vehicles...

All conjecture of course. Terribly sad.
I made an initial post on this here ...

Which led me to do a detailed review of the photo evidence and videos here

I documented the time line and actions of the fire response team, primarily to look at the circumstances of the young girl's being run over. My initial gut feel when I first saw the video was that fire trucks were unorganized and were literally driving thru the escaping passengers forcing some to scramble it seemed to avoid the trucks.

What I saw initiallyprompted my much more detailed review.

I gathered as much hi-rez photo evidence as possible, and then reviewed the invaluable amateur video - which captured from seconds after the airframe came to rest (even before slides were deployed) until appx 11+ minutes - in a contiguous uninterrupted block - then another many minutes sequence after a short break to apparently change SD cards.

I started out trying to determine what the evidence showed regarding the tragic situation with this young girl. By the time I was done several hours later, the incident response plan and training - the appearance of lack of organization, the failure to muster an emergency response throughout the entire scene, and the seeming complete inability to manage the fire once it got into the fuselage - had become, to me at least, another issue on top of the girls death.

In my opinion, admittedly from a layman, but with significant disaster response/emergency preparedness training ... :

(a.) it is inexcusable that this girl was run over - it could not have occurred until some 11+ minutes after the impact as:

(1)video shows no fire truck went that close to the aircraft before that, and most certainly did not approach that close to the aircraft in the direction the tire tracks over the girl showed,
(2) no foam at all was deployed for many minutes, until well after almost all pax escape activity in the area was over, and then only minimal isolated foam under the wing was deployed until more than 12+ minutes after the crash when the fuselage became engulfed in fire,
(3) the SAME fire truck was on station from minutes after the crash - in the the same vicinity as, and with an excellent view of, where the girl was run over - from before any foam was applied. The video shows this truck sat largely stationary (with a few changes of position,) with the cab within 30-50 feet away and facing the location where the girl was run over, from a few minutes after impact until it finally ran out of foam apx 17 minutes after the crash.
(4) this same truck monitored this area - to left side of aircraft, facing the left wing and rearmost forward slide - for the entire period, was the fire truck to apply the minimal targeted initial foam under the wing pylon, also was the truck that applied more significant foam after the fuselage became fully engaged, and by appearances, was also likely the truck that ran over the girl
(5) some have noted an early photo by an evac'ing PAX that seems to show some debris near where the girl was - yet later similar PAX photos show large numbers of people standing in same spot as the de-planed down the slide. If an injured young girl was there it is inconceivable to me all these people were ignoring her

(b.) the fire response appeared, to me at best, haphazard and disorganized, as:

(1) the initial trucks to arrive clearly appear to have driven thru streams of evac'ing PAX - and appear to have caused some to take action to get out of the way. This despite there being no evidence of fire on that left side of the aircraft,
(2) initial arriving trucks did not seem to have a clear plan - they got to the aircraft then some bunched up, then some drove back and forth. I understand they were likely looking for fire etc, however it would seem, with the admitted advantage of hindsight, that every truck should have a clearly delineated position, with the trucks initially ringing the aircraft.
(3) Despite the lack of fire on left side (there was no fire on left side, and no fire in the fuselage by all appearances, until something more than 12+ minutes after the crash), and passengers on the ground initially, NO truck had an outside spotter,
(4)This seems a serious safety breech. It may not have prevented the death - as once the fuselage was engulfed in flame it would probably have been deemed unsafe to have a spotter on foot outside, however had they had a spotter on the ground in the 12+ minutes before flames erupted, understanding the same truck was in roughly that same spot very near, and with good view of, the girls location, it seems unlikely she would not have been seen before the truck began the large scale foaming, more than 12 minutes after the crash.
(5) this same truck is the one that sprayed all the foam on the left side (until more than 18 or so minutes had passed when it ran out of foam) - they would have been the same truck that covered the girl in foam
(6) once the fuselage was fully engaged in fire it seemed clear the fire crews had no useful training in fighting that type fire. With fire burning thru the top of the rounded fuselage, trucks on both sides of the aircraft tried to shoot foam at top of the airframe, with almost all of it simply spraying over the top to no effect. They continued this until multiple trucks used up all their foam.
(7) each truck is equipped with an extendable boom for exactly this purpose - so they can attack the fire from above, at an angle that gets foam on the fire. Only one truck - on right side, appeared to have deployed its boom. The truck in question on the left side appeared to try to deploy their boom, but it appeared it may not have been operational as it never sprayed foam.
(8) Admittedly with hindsight again, but assuming their booms were all inoperative, the way to attack the fire to me seemed to be they had to get to rear of fuselage and spray foam along its length - which would get into the top of fuselage where fire was. After two of the trucks on opposing sides exhausted, largely wasting, their entire foam supply shooting perpendicular to the airframe one truck did position at the tail and was having more success.

You can see all this for yourself if you wish, and make your own assessment - watch the video noted in my past post on this noted above.

I think its important to realize the fire in the fuselage did not occur until more than 12+ minutes after the crash. The fire initially seen was on right side of aircraft, I'm assuming related to the engine there. This was largely under control by all appearances from the photos and videos as the 1st video ended at 11+ minutes. When 2nd video started (after presumably an SD card change) the fuselage had caught fire.

A few more things - there really wasn't "chaos" if you watch the video or look at the pics. The crew in that fire truck largely sat looking at the side of the aircraft, and simply observed for most of the first 11+ minutes.

More importantly - they had a pretty much clear view of the slide. If someone was brought down the slide and laid down there - that occurred well after most passengers were off - and the fire crew should have seen it.

Again, I believe it impossible the girl could have been there from the beginning as pics show a large number of people standing in that area during the evac. Someone would have been seen helping the girl.

The aerial and other pics show there is also almost NO debris ahead of the aircraft - on the left side or ahead of the left wing. I believe simple physics along with that evidence makes it all but impossible she was thrown there in initial crash. And other PAX and the fire crew both should have seen her in the 11+ minutes before the truck appears to have run over her.

These are simply my observations and opinions after reviewing the available evidence in some detail. They have the admitted benefit of hindsight. They may well be wrong. They are intended to be illustrative, observational and constructive and not to attack those persons involved. Other facts may emerge that offer additional insight, but there is a large body of evidence available already including a mostly continuous video of the scene.

I must admit, my informed opinion is the death of the girl does seem inexcusable to me. And I sincerely hope the fire department does a similar review and looks at how they can better respond. If that fire had occurred earlier would could have had a situation where a lot of people survived the crash only to perish in fire.

Last - I think seeing how the airframe burned raises important questions. Both this instance and the Ethiopian 777 fire showed similar traits - It seems clear a few more minutes at the Etiopian fire could have looked much like this one. Once fully engaged the Ariana fire burned strongly. It seems a review of flammability of composite airframes should be in order.

Again - please read my more detailed review which give minute by minute timeline and includes links to the photos and videos discussed.

Last edited by 220mph; 21st Jul 2013 at 01:02.
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Old 21st Jul 2013, 01:36
  #2317 (permalink)  
 
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I thought all airline pilots could do visual approaches because the windshield view makes it quite easy. How did these four on a clear day hit the rocks and nobody say anything? How can you prevent this from happening again? I have no idea unless pilots look out the window and understand where they should be. Autolands are not always available. We can't lower standards to the lowest common denominator and be efficient in ATC. Either learn how to fly all approaches, including visuals, or get out of your seat.
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Old 21st Jul 2013, 01:58
  #2318 (permalink)  
 
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While I do not disagree that all of the above deserve attention, it still cannot explain how an experienced crew (or even an inexperienced crew) allowed their airspeed to bleed off to just over 100 kts
I've been dispatched a number of times in a 767 with autothrottle inop. Even though the need for vigilance in modes like VS was discussed, I've still seen people get caught out and get a little slow before they've realised they had to catch the speed manually. Especially if the autopilot is in, every part of you is expecting the autothrottle to push the thrust up when the speed comes back, even if you've pre briefed.

The method at my airline - 744/767/737 - is if you handfly on approach, take the auto throttle out, so everything is back to basics and makes sense and you're not expecting anything to happen for you. Not sure about the 777, but maybe there is some merit in this line of thinking for that type, too.
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Old 21st Jul 2013, 02:02
  #2319 (permalink)  
 
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It would be interesting to hear what was discussed on the approach briefing, if there was one, prior to tod.
Did the new check airman in the right seat have the trainee scroll thru the map page and point out possible speed/alt hoowahs?
Did he brief the trainee on the approach notes emphasizing dme and altitudes and the configuration which would put them in the best energy state for a stabilized app by 1000 ft?
Did he make the trainee use the sec flt plan for possible runway changes?
Did he have the trainee explain the ma procedure for their primary/sec flt plan as written in their procedures?
These would be just a few of the items, but it lets the trainee know just WHO is in command, and on this flight there was no one in that capacity.
No amount of briefing will fix the inability to fly a visual approach.

if I'm not happy at 1000ft. I will take control
How about if I'm not happy at 1,000' we are going around. If the situation is that bad, starting over vs salvaging is a better choice.
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Old 21st Jul 2013, 02:15
  #2320 (permalink)  
 
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@iflytb20

Thanks for the link to the pics . I think that the T7 is a very durable airframe.
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