Asiana flight crash at San Francisco
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b767drvr
Just when I thought the excuses couldn't get any more absurd...!
Click-click, click-click... aimpoint/airspeed... aimpoint/airspeed... obligatory, "Nice landing captain!"... taxi to the gate.
Click-click, click-click... aimpoint/airspeed... aimpoint/airspeed... obligatory, "Nice landing captain!"... taxi to the gate.
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I haven't seen any speculation about whether the low energy state was even recoverable from the point where it was detected. Or to put it another way; given the aircraft is at the correct speed and position at 500' (notwithstanding that the Thrust Levers were at Idle), how long is the window for detection before the situation is unrecoverable?
A few points to consider:
-It is not clear from the data available when the recovery was commenced and what technique was used (eg the TOGA switch may have been pushed sometime after recovery was attempted).
-Speed may have continued to decay after initial thrust correction.
-Recovery from at or near stick shaker involves significant altitude lost. Speed must be recovered before attempting pitch up to avoid a secondary stall.
I think the window could be as short as 15 seconds. I could be completely wrong; I bet by now many people have replicated the situation in a proper 777 simulator. How did it go?
A few points to consider:
-It is not clear from the data available when the recovery was commenced and what technique was used (eg the TOGA switch may have been pushed sometime after recovery was attempted).
-Speed may have continued to decay after initial thrust correction.
-Recovery from at or near stick shaker involves significant altitude lost. Speed must be recovered before attempting pitch up to avoid a secondary stall.
I think the window could be as short as 15 seconds. I could be completely wrong; I bet by now many people have replicated the situation in a proper 777 simulator. How did it go?
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Human Factors and Automation
"I fear the day that technology will surpass our human interaction, the world will have a generation of idiots"
Albert Einstein ( 1879- 1955 )
If we have not already past this point, we are just about there. What lies beyond it is what I fear.
Albert Einstein ( 1879- 1955 )
If we have not already past this point, we are just about there. What lies beyond it is what I fear.
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I have a feeling there will be sweeping changes throughout the industry.
Of course, that's just the beginning, there's so much more to the job, and the term "aircraft manager" comes to mind. But it's imperative to be more then just an "automation manager"! It has been said all ready:
Automation was designed to reduce your work load, not fly your airplane because you can't.
Every airline should actively encourage their pilots to keep their raw data handflying skills up to date. (By that I mean A/P, A/Thr and F/D's off!)
Here you can read how it's done in the airline I fly for!
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Originally Posted by tilnextime
I can only speak for one branch of the military, but we had no such standard as "minimum", only "fully qualified" or "not qualified" for the duty position and flying tasks to which assigned. Whatever mission tasks a given assignment entailed, you had to be trained and evaluated to "fully qualified" to perform crewmember duties on a flight assigned such tasks, unless flying with an instructor pilot.
That line would the "minimum"
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HPSOV L :
Interesting question, (assuming the nominal at 500' is corect), to paraphrase:
How long did it take the for the speed display to go from nominal to an -alarmingly- low value and what margin was then available from that point to recover?
A complementary question would be "what was the pilots scan rate" and given that rate for how many scans would an alarming speed value be displayed?
I am also wondering if the speed tape includes a "trend" indicator or just absolute value, "132 : dropping fast" might be more noticeable than a plain "132".
I haven't seen any speculation about whether the low energy state was even recoverable from the point where it was detected. Or to put it another way; given the aircraft is at the correct speed and position at 500' (notwithstanding that the Thrust Levers were at Idle), how long is the window for detection before the situation is unrecoverable?
How long did it take the for the speed display to go from nominal to an -alarmingly- low value and what margin was then available from that point to recover?
A complementary question would be "what was the pilots scan rate" and given that rate for how many scans would an alarming speed value be displayed?
I am also wondering if the speed tape includes a "trend" indicator or just absolute value, "132 : dropping fast" might be more noticeable than a plain "132".
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unless the accident is the result of violating the law. Even then, it has only happened once, to my knowledge.
A classic case that I recall was the sentencing to 18 months prison time of both MD-11 JAL pilots (in Japan) for causing 14 deaths in an accident that took place in 1997.
Last edited by olasek; 22nd Jul 2013 at 19:08.
In 1992 when Swissair got the Fokker 100 they had two near misses during visuals into Nice. Both around the 500ft mark during final turn when the stick shaker went off.
Before that we were taught that the auto throttle was full time unless switched off on the overhead panel.
Apparently the later 100s would automatically re engage when the gear went down.
2013 and Boeing doesn't have this feature!
Before that we were taught that the auto throttle was full time unless switched off on the overhead panel.
Apparently the later 100s would automatically re engage when the gear went down.
2013 and Boeing doesn't have this feature!
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Originally Posted by olasec
I think there are some prosecution once in a while, a recent case was the 2005 crash of Challenger at Teterboro, the accident uncovered the whole slew of shenanigans the operators of this flying outfit were engaged in.
Originally Posted by olasec
A classic case that I recall was the sentencing to 18 months of prison time of both MD-11 JAL pilots (in Japan) for causing 14 deaths in an accident that took place in 1997.
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I have been flying commercially since 70's. A mixture of singles, twins, biz-jets, tail-draggers, aeros & then needles & dials B732 on to LNAV/VNAV/EFIS/EICAS Boeings. I was trained to fly then operate an a/c. Flying was encouraged and operating also; each for the appropriate & suitable scenario.
I now train self sponsored newbies on the standard LNAV/VNAV type a/c. The syllabus covers what to do on an SOP day. It then covers standard QRH non-normals, again in an SOP environment. I try to inject a little reality into the training, if the cadets are sharp and there is time to spare: often unlikely. The training on a TQ course is very basic. There is no training on a TQ course of anything complicated. That's OK. But, the same is true on a command course. They might experience multiple QRH failures, that's all. They do not learn what to do it the automatics mis-behave. They do not practice basic aircraft control should the whizz-bang computers pack up. They do not learn the 'traps' of the automatics and their dangers. There's not a lot of 'what if' discussion. It's all too simple and uncomplicated, but that is where many accidents arise, the uncommon, the misuse of the automatics or lack of basic handling skills. Basic handling skills should be encouraged on a daily basis, but is not. The emphasis is on absolute adherence to SOP's to avoid getting anywhere near the edge of the envelope. The problem arises when circumstances, which include malfunctions- ATC- mother nature- pilot mistakes bring you towards the edge and out of your regular comfort zone. Can you handle it, can your work out what is going on and what to do about it. More often than not, no. It is a spiral, spinning down to more SFO, Bali, TSL, AF 447, etc. etc. Is there any answer from the authorities? It is happening worldwide. FAA, EASA, and the Far East authorities have a common problem, but are they opening a discussion into a coordinated solution? I don't think so. It is too much to hope the individual companies to start solving the problem as many are of he opposite philosophy. It's a sad future in the short term.
I now train self sponsored newbies on the standard LNAV/VNAV type a/c. The syllabus covers what to do on an SOP day. It then covers standard QRH non-normals, again in an SOP environment. I try to inject a little reality into the training, if the cadets are sharp and there is time to spare: often unlikely. The training on a TQ course is very basic. There is no training on a TQ course of anything complicated. That's OK. But, the same is true on a command course. They might experience multiple QRH failures, that's all. They do not learn what to do it the automatics mis-behave. They do not practice basic aircraft control should the whizz-bang computers pack up. They do not learn the 'traps' of the automatics and their dangers. There's not a lot of 'what if' discussion. It's all too simple and uncomplicated, but that is where many accidents arise, the uncommon, the misuse of the automatics or lack of basic handling skills. Basic handling skills should be encouraged on a daily basis, but is not. The emphasis is on absolute adherence to SOP's to avoid getting anywhere near the edge of the envelope. The problem arises when circumstances, which include malfunctions- ATC- mother nature- pilot mistakes bring you towards the edge and out of your regular comfort zone. Can you handle it, can your work out what is going on and what to do about it. More often than not, no. It is a spiral, spinning down to more SFO, Bali, TSL, AF 447, etc. etc. Is there any answer from the authorities? It is happening worldwide. FAA, EASA, and the Far East authorities have a common problem, but are they opening a discussion into a coordinated solution? I don't think so. It is too much to hope the individual companies to start solving the problem as many are of he opposite philosophy. It's a sad future in the short term.
Last edited by RAT 5; 22nd Jul 2013 at 23:12.
Rat5
You are right...it is a problem because, generally, the authorities are incompetent..whether it is because they are watching their backsides, looking after their mates in the airlines and aircraft manufacturers or just not up to the job it is for others to decide.
Whilst the crews get the blame and the autorities do not sort out the equipement and training we will continue to have accidents which could have been avoided and often have been forecast.
You are right...it is a problem because, generally, the authorities are incompetent..whether it is because they are watching their backsides, looking after their mates in the airlines and aircraft manufacturers or just not up to the job it is for others to decide.
Whilst the crews get the blame and the autorities do not sort out the equipement and training we will continue to have accidents which could have been avoided and often have been forecast.
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It is too much to hope the individual companies to start solving the problem as many are of he opposite philosophy. It's a sad future in the short term.
If margins are tight and the company sees this:
Automated sector: Fuel used 2,305 kg
Partially hand-flown sector: Fuel used 2,357 kg
The accountants see that 52 kg they multiply it by the number of sectors the company flies a day and decide that hand-flying costs their company £X.XX per year.
Safety arguments are dismissed by the comfort of knowing that if lack of ability to fly does cause a crash, it will likely to be the other guy's plane which will crash.
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767....I believe it is not an excuse, what I think, SoS's point, and mine is, is that it is the system in Korea, as the underlying cause, that has to be looked at...much of asian analysis at their incidents focuses on the "what" and not the "why", easier to blame a couple of guys and save face, thus protecting the system. Point is, why two apparently qualified pilots drive a perfectly sound aircraft into the ground...they didn't do it on purpose, they "knew" they where doing the right thing, as hundreds of times before. For an insight into the Korean frame of mind is, just look at the zillion posts about KAL..what they think is the "right" frame of mind to operate a multi crew airliner is not what the rest of the world thinks....my two cents
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nose cone damage
This is a screen shot from the Fred Hayes video
Should the nose cone have more damage than this? Assuming the 650,000 pound plane picture above was cartwheeling?
video:
Should the nose cone have more damage than this? Assuming the 650,000 pound plane picture above was cartwheeling?
video:
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.....as I was diverging, noticed the thing was developing an annoying nose down tendency and discovered I was 15 knots below Vref F30. The thrust levers were at idle from a previous exercise and it happened in seconds. And I supposedly knew I was in manual thrust! Silly me.
It takes exposure to manually handling the aircraft to get this ability to sense when things are not right but it is one of the life saving skills that old timers developed that prevented many accidents.
Too bad the guy flying the Asiana had not developed the 'touch'. To my mind, a pilot who doesn't know how to sense and react to the cues is a cripple.
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I just watched the Nat Geo reconstruction of the THY AMS stall crash. There was a comment from an eminent lady in USA who is an expert on human behaviour in automated environments. She declared that humans are very bad monitors of automation yet that is what a modern airline pilot needs to be. The solution is that NASA is researching new designs of automation to make the human interface more intuitive and easy. Better displays that are easier to understand; more accessible data/info, i.e. not having to page through CDU's to find the piece of info you want, but at a single touch of a button; voice activated equipment etc. etc.
This was in response to "why did the crew not realise their airspeed was decaying?" They did not know that the RA fault would cause the thrust levers to go to idle and they expected them to do that anyway as they were attacking the G.S. from above and trying to slow down. They were in monitoring mode, but not on top of it.
Well. if I'm attacking the G.S. from above and close to the runway, and trying to configure I can assure you that I am not passive and relaxed watching the needles & dials do their thing, but I am in a heightened state of alertness and making damn sure the autos are doing what I want and the a/c following suit. If it ain't then I know what to do about it and if all else fails I will disconnect and fly the sucker.
Once again the solution from the technocrats is to try and make a better human automatic interface; introduce more warning systems; make the automatics more intuitive etc. etc. No-one has suggested better flying training; better understanding of the a/c envelope; better understanding the capabilities of the automatics - their limitations and traps; better hands on skills to put the pilot back in touch with the a/c. The solution to pilots being lousy monitors and watching the automatics crash the a/c is to address the automatics rather than the pilot.
I'm sure the solution lies in a combination of both. What is certain is that there should be a lot more training of how to best use the automatics then we have now. The understanding of them which I witnessed on the line in many companies was very scant. The TQ courses and LT is focused on using the automatics to stay well inside the SOP envelope. "If you do that you are safe," is the mantra preached every prof check. Incidents happen when people are outside their comfort zone which is bounded by their knowledge envelope. A survivable incident can become an accident because the human intervened in the wrong way due to ignorance. Either ignorance of what is going on, or ignorance of what to do about it. You can make all the fancy gizmos you want to give the pilot lots of info, but they still have to know what is going on and what to do about it. SOP's can not cover all eventualities. Back to basics has to be an option.
We are debating this due to a few well published crashes. A disturbing number in such a short period; and from various cultures in various different airlines and on different types. In other words the common thread is the behaviour of the pilot. What needs to be known, to assess the extent of the problem, is how many similar incidents have been near misses and we never hear about them. Just how deep is the problem? I suspect worse than we dare imagine.
With regard to THY stall at AMS. The program said Boeing had received >2000 incident reports of faulty RA's. Numerous reports of a sudden thrust to idle. No other crashes; the pilots intervened and took over. There was no comment about why the difference. Could it have been different training qualities? Whatever; should it really mean that 1 accident out of 100's of incidents needs a rethink the whole automatic/human interface rather than address the issue purely from the human angle? The technocrats love to do it that way, perhaps a few 'old farts' in the training departments could achieve what is desired.
This was in response to "why did the crew not realise their airspeed was decaying?" They did not know that the RA fault would cause the thrust levers to go to idle and they expected them to do that anyway as they were attacking the G.S. from above and trying to slow down. They were in monitoring mode, but not on top of it.
Well. if I'm attacking the G.S. from above and close to the runway, and trying to configure I can assure you that I am not passive and relaxed watching the needles & dials do their thing, but I am in a heightened state of alertness and making damn sure the autos are doing what I want and the a/c following suit. If it ain't then I know what to do about it and if all else fails I will disconnect and fly the sucker.
Once again the solution from the technocrats is to try and make a better human automatic interface; introduce more warning systems; make the automatics more intuitive etc. etc. No-one has suggested better flying training; better understanding of the a/c envelope; better understanding the capabilities of the automatics - their limitations and traps; better hands on skills to put the pilot back in touch with the a/c. The solution to pilots being lousy monitors and watching the automatics crash the a/c is to address the automatics rather than the pilot.
I'm sure the solution lies in a combination of both. What is certain is that there should be a lot more training of how to best use the automatics then we have now. The understanding of them which I witnessed on the line in many companies was very scant. The TQ courses and LT is focused on using the automatics to stay well inside the SOP envelope. "If you do that you are safe," is the mantra preached every prof check. Incidents happen when people are outside their comfort zone which is bounded by their knowledge envelope. A survivable incident can become an accident because the human intervened in the wrong way due to ignorance. Either ignorance of what is going on, or ignorance of what to do about it. You can make all the fancy gizmos you want to give the pilot lots of info, but they still have to know what is going on and what to do about it. SOP's can not cover all eventualities. Back to basics has to be an option.
We are debating this due to a few well published crashes. A disturbing number in such a short period; and from various cultures in various different airlines and on different types. In other words the common thread is the behaviour of the pilot. What needs to be known, to assess the extent of the problem, is how many similar incidents have been near misses and we never hear about them. Just how deep is the problem? I suspect worse than we dare imagine.
With regard to THY stall at AMS. The program said Boeing had received >2000 incident reports of faulty RA's. Numerous reports of a sudden thrust to idle. No other crashes; the pilots intervened and took over. There was no comment about why the difference. Could it have been different training qualities? Whatever; should it really mean that 1 accident out of 100's of incidents needs a rethink the whole automatic/human interface rather than address the issue purely from the human angle? The technocrats love to do it that way, perhaps a few 'old farts' in the training departments could achieve what is desired.
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Rat 5 " no-0ne has suggested better training" : I think, many have. I did but my post was deleted. Proper airline funded training with the result of proper airline pilot training selection will help a lot. The actual ab-initio training should include lots of handling and stick & rudder emphasis as the levels of automation and benefits are slowly introduced. Airline pilot managers should stop being brow-beaten by the bean counters and encourage handflying. We all know the level of automation we are in. Some enjoy split mode, full auto or pure manual. Doesn't matter a stuff but because of system anomoly or failure , pilots might become unsure of what George is doing. Full encouragement to knock out the autopilot, auto thrust & FLY the aircraft and then quizing the event is always the safe option.
How do you get a feeling for an aircraft by out-of-trim when you never get out of trim?
How do you expect pilots to practice manual thrust approaches when you provide them with tiny little useless sticky levers that are horrible to use (and make the SOP auto thrust every time)?
How do you expect a pilot to be cautious about the serviceability of a system when he is told it will always fail with a ding and an ECAM?
Why should a pilot be concerned about stalling, when the manufacturer states the aircraft cannot be stalled?
This accident is a demonstration of what happens when you put an Airbus pilot into a cruder machine, coupled with a few other lined up holes. I fear that the authorities will focus on those other holes (new LTC failing to do his job) and leave the problem unsolved.
In the mean time, pilots on highly automated and protected aircraft had better make it their personal responsibility to practice their basic skills. Because the SOP writers and accountants will do their best to stop you.
How do you expect pilots to practice manual thrust approaches when you provide them with tiny little useless sticky levers that are horrible to use (and make the SOP auto thrust every time)?
How do you expect a pilot to be cautious about the serviceability of a system when he is told it will always fail with a ding and an ECAM?
Why should a pilot be concerned about stalling, when the manufacturer states the aircraft cannot be stalled?
This accident is a demonstration of what happens when you put an Airbus pilot into a cruder machine, coupled with a few other lined up holes. I fear that the authorities will focus on those other holes (new LTC failing to do his job) and leave the problem unsolved.
In the mean time, pilots on highly automated and protected aircraft had better make it their personal responsibility to practice their basic skills. Because the SOP writers and accountants will do their best to stop you.