TransAsia in the water?

[lomapaseo]

Yes we need an explained CVR full transcript corelating to the DFDR

It is also a wonder that even the world media have shut up on this news.What has ATR themselves got to account for in all this?

Yes a full analysis of the CVR and DFDR is needed. That takes time so don't expect it for a while.

Analysis of this detail ids done behind the scenes with expertise and joint party cooperation. It typically doesn't get published until it is understood and agreed by the majority.

The world media has already satisfied the majority of their readers with news releases and have moved on to other news of "todays" interest elsewhere.

ATR has no need to jump ahead of the investigation by announcing opinions until/unless they need to publish a recommendation specifically concerning their product.

[Trackdiamond]

lomapaseo

I agree with all you have quoted. I understand Accident investigation enough to know the lead times involved and dissemination of "filtered" information..but that doesn't stop the public demanding it.

Little was revealed to the public concerning the possible crew error..after they were hailed as heroes..it was left at that.Could it be the Taiwanese authorities have muscled their objection against any further media reporting?

Am sure if it was a systemic problem on the type under investigation EADS/ATR would have dissemninated an AD or SB by by now. It is upto ATR726 operating crew who are members of this forum to tell whatever they know that could benefit this forum with our curious analyses.It would seem this story has already lost momentum until something new develops.
Perhaps it is time to move on.

[Hunter58]

Airbus would do what?

ATR is an independent company from Airbus, even if the latter by name is a 50% shareholder and a subcontractor for the assembly line. The other 50% are with Italy...

If anyone publishes anything concerning ATR it will be ATR itself.

[FullOppositeRudder]

The has been a lot of discussion about stick and rudder skills - or perceived lack thereof.

This series currently showing in Australia on SBS TV has been very interesting viewed against this background of this discussion. OK, there's a bit journalistic drama added, but I would sit behind these pilots anywhere ....

Here is a youtube URL for the first in the series:

https://www.youtube.com/watch?v=xBu-2EP_eMU

It's an English production; maybe most PPruNers have seen it before. (It sometimes takes while for these things to reach the southern colonies).

[broadreach]

FullOppositeRudder, thanks for the link.

Perhaps mistakenly, I'm trying to compare PNG flying with bush piloting in other parts of the world. The guys interviewed and filmed in your linked clip seem to be mostly Europeans looking to build hours and an entry to regionals and then majors in Europe. Pretty much the same in the Americas although for some reason I get the impression that North American bush pilots like what they do and stick with it.

I wonder, are there no Chinese, Indians, other Asians in Susi's PNG ops and those of their contemporaries?

[oblivia]

Culture

Asia: 4.4 billion people in 49 countries. Generalisation much? I also work in Asia, and it's my opinion that anyone who talks about "Asian culture" talks about human culture but hasn't worked out that not looking caucasian does not automatically equate to incompetence, lack of proficiency and foresight.

I've lived and worked in Asia for 15 years (nothing to do with aviation) and I think I understand what is meant by such comments—deference to authority, rote learning, superstition.

I agree that much of this is not unique to Asia and is typically a question of economic and social development. But that doesn’t make it any less real.

Which countries in Asia are not top-down, hierarchical societies? Which have a strong rule of law? Which have vibrant democracies that give voice to ordinary people? Which have a free press that encourages accountability for those at the top? Which have a tradition of independent academic enquiry? Which have a welfare system that means people aren’t terrified of losing their jobs? Which are free from corruption?

The answer is that no country in Asia has all of these things, and most have none of them at all. It’s not about race or culture—it’s about the basic institutions of advanced democracies.

It’s not my place to say how much any of this matters when it comes to CRM or aviation safety, but my lay view would be that I notice less of this deferential conservatism in free but poor India, and more of it in rich but restrictive Japan/Korea. (Plenty in SE Asia and China too.)

Even so... I suspect that such things only have an effect at the margins, which is not to say that they are unimportant, but a far bigger challenge is how Asia will find the 500k+ new pilots (plus another 500k+ mechanics) that Boeing predicts the region will need during the next two decades. It seems unlikely that these new pilots will be getting extra hours in aerobatic planes (or even extra hours in a sim)...

[ekw]

Oblivia - very well put. Of course personality plays a role as well. There are plenty of narcissistic captains of all nationalities who would crucify you for correcting them if you turned out to be wrong.

[Icarus2001]

Bashing "Asian culture" does seem to be a default position for some. However...

I post this because I think all the predominantly western criticism of Asian aviation safety on this forum, often based on a bunch of premature conclusions, needs to be rebutted.

I think it fair to say that it is based on statistics...

http://www.fearofflyinganxiety.com/w...t-airlines.jpg

Go to page 20 of this report...
http://www.icao.int/safety/Documents...port_FINAL.pdf

Lies, damn lies and statistics?

[marchino61]

Not a useful statistic for comparing safety by region

Go to page 20 of this report...
http://www.icao.int/safety/Documents...port_FINAL.pdf

That chart shows only the percentage of accidents that occurred in each region. Without knowing how much air traffic there was in each region I'm unable to compare how many crashes there were per flight or per million miles....or any other sensible definition of safety.

[cris95123]

Asian culture is.120 hrs By month...... on ATR It Looks like 120 legs a month.....Tired crew never do good job...EVEN in asia......thailand DCA have been downgraded to level B ...next Taiwan
My personal records on ATR
India ........125 hrs
Philippines .105hrs
Indonesia ...113 hrs (28 days)
Thailand .....129 hrs (28 days)
my colleagues records
Laos ........+120hrs ( 13 days duty w/o day off)
Indonesia ...140 hrs
Taiwan........120 hrs
In Asia ..they believe FDTL is minimum duty.... )

[FlightlessParrot]

Asian Culture

Now that this subject has been opened for discussion can we begin by defining what this "Asian culture" being referred to in here means? There is still a high proportion of non Asian western and other pilots serving the carriers in Near East and Far eastern Asian countries so let us be absolutely sure what we are projecting in bashing this Asian Culture.Let us be specific so we can arhue it out and be more learned shall we?

Two points made in a recent article in the New Zealand Morning Herald:

1. The FO was born in Hong Kong, and spent 15 years in New Zealand, including secondary school and initial flying training, thus, highly formative years. Excessive deference due to cultural factors is less likely, then, I think (especially as Hong Kong, on casual observation, does not seem exactly hide-bound).

2. There was some discussion as to why someone with so many hours was FO, and the phrase "command failure" was bandied around. The article claims he was, in fact, a captain, called in to fill an FO's shift.

Alas, the article refers to him as "hero pilot," but we don't really know yet, do we?

http://http://www.nzherald.co.nz/nz/...ectid=11397934

[Shaggy Sheep Driver]

There was some discussion as to why someone with so many hours was FO, and the phrase "command failure" was bandied around. The article claims he was, in fact, a captain, called in to fill an FO's shift.

If you read back to the relevant posts you'll see why it's postulated that his being a captain might have been part of the CRM problem (if there was a CRM problem - it looks that way right now, but we don't have CVR yet).

[Iron Duck]

Culture

I've lived and worked in Asia for 15 years (nothing to do with aviation) and I think I understand what is meant by such comments—deference to authority, rote learning, superstition.

Any objective look at different cultures will reveal their different propensities to deferentiality. Japan remains quite deferential; it's a culture of which I have long direct experience. On the other hand, deferentiality can crop up anywhere. The cockpit of the KLM 747 at Tenerife turned out to have been a highly deferential society.

The CVR will eventually reveal whether undue deferentiality was a significant factor here.

[FrequentSLF]

That chart shows only the percentage of accidents that occurred in each region. Without knowing how much air traffic there was in each region I'm unable to compare how many crashes there were per flight or per million miles....or any other sensible definition of safety.

pag 10 have a table showing the accident ratio per million departures

[Fareastdriver]

I think it fair to say that it is based on statistics...

Fear of Flying - Learn how to overcome flying phobia

Apart from Xiamen Airlines, a minor player in China, none of the Chinese (China Airlines is Taiwan) airlines feature. Chinese airlines are the major people movers in Asia.

[Lonewolf_50]

Just a thought for the culture club here:
How many years or decades did it take the "Western" airlines and cultures (and for that matter military cultures) to address cockpit gradient and develop other CRM concepts and tools that are now industry standards?

How much effort went into that, and still goes into that? It didn't just happen.

One of the challenges inherent in this progress is a bit of a paradox: the Captain bears ultimate accountability for the conduct of his flight. This won't change any time soon, and so the balancing act has to be dealt with as an ongoing challenge for any captain/aircraft commander. It takes effort and development of some of those "people skills" that don't fit nicely into boxes and checklists.

As we used to say about a lot of thing: "If this stuff was easy, anybody could do it."

Back to the accident at hand: if there were confusing indications of what was wrong with the #2 engine, wherein the interpretation of what the engine and its instrumentation were telling the crew, what were they? If it was enough to induce the captain to command the good engine to shut down, the community who fly this model of aircraft would likely benefit from understanding that anomaly.
Possible CRM issue: when you both can't agree on what's wrong with the engine ...
When available, a CVR transcript might be very educational.

[HDRW]

I've been looking at the FDR traces that have been released, and would like to share my analysis.
My credentials: I'm an amateur at this, but I have been debugging computer systems for over 40 years, so I'm used to looking at what evidence there is, and trying to work out what happened.

So: "Correct me if I'm wrong" applies to all of the below! When I say "the system" I mean some part of the automation - I don't know enough to say which particular box is involved, and it doesn't really matter at this point. All times are approximate, as it's a bit tricky to interpolate between the marked times.

It looks like everything was OK until 52:30. Then (at about the same time):
Objective TQ1 rose to 100%
No.1 Bleed Valve was closed
Prop.2 started to feather

I believe this is "Autofeather and Uptrim" by the system, because it believed No.2 engine had a problem.

Engine 2 Flame Out Warning was given
Fuel Flow 2 started to reduce, followed by No.2's ITT and RPMs (NL, NH, NP) and torque.

This seems to be the system bringing No.2 back to Idle, but without moving the Power Lever (can it do that on this aircraft?)

I'm going to call the small amount of time over which the above happened: "Point 1".

52:40 As a result of the above, No.2 spooled down, and by now it was at idle, feathered. (Its torque trace starts a strange triangle-wave, with about a 4-second period, spiking from zero up to about 150%.)

Power Lever 1 is retarded a bit, I'm assuming by the crew. CVR would be useful at this point to find out who/why.
They are still climbing, albeit slowly, until:
53:04 PL1 is retarded a lot further, then further still, then PL2 is firewalled, then PL1 pulled back further still, with consequent reduction of TQ1 to practically zero. Prop.1 is still in normal pitch and NP1 is about 80%, so for the next five seconds or so it must be windmilling. I'm calling this "Point 2".

53:20 Prop.1 starts to feather and Fuel Shutoff 1 is closed, shutting down that engine, (and with its torque trace taking on the same triangular wave pattern as No.2, and then its oil pressure trace doing the same thing).

53:28 they have both props feathered, No.1 shut down, No.2 idling but with its PL still firewalled, and they're at about 1200', descending.

Without the CVR we can only imagine what happens in the flight deck for the next three-quarters of a minute, but then:
54:14 Fuel Shutoff 1 is reopened, PL1 advanced slightly, so this is a relight attempt. They are at about 700'. "Point 3"

54:19 No.1 is spooling up, but Prop.1 is still feathered and not really turning.

54:27 Power Lever 2 is retarded most of the way, the Flame Out 2 warning stops, and Prop.2 starts to unfeather, so the system seems to think No.2 is OK now, and starts to spool it up, but it never contributes any thrust - unfeather never completes and the RPMs and torque barely get off the stops before the end of the trace, so I don't see the "sudden thrust from No.2 raised the right wing" happening, as some have said.

As I see it these are the questions:

1. What caused the system to "think" there was a No.2 flameout at Point 1? Before that the engine indications should still have looked normal to the crew, but it seems they had no chance to override the spool-down that resulted, and perhaps no reason to think they needed to.
2. Why was PL1 retarded 10 seconds after Point 1? It wasn't to shut down the engine as it was only a 10degree change.
3. At Point 2 they seem to have ignored the normal readings of No.1 and the "Idle" readings of No.2, and shut down No.1 Is this a "confirmation" problem because they were expecting No.1 to be a problem before they set off? Also, would the windmilling No.1 "confirm" they were shutting down the bad engine?
4. Why did retarding PL2 clear the erroneous Flame Out condition (not just cancelling the warning, but also bringing up the fuel flow and unfeathering)?
5. If they had retarded PL2 at Point 3 instead of trying to restart No.1, would they have got out of the situation in time?
6. (Unimportant) What's with the three triangle-wave traces?

Finally, why are the FDR traces all engine related, except the Main Gear, VHF1 (what is this?) and height readings? Where is the airspeed, vertical speed, control positions, etc?

Cheers,
Howard

[Lost in Saigon]

Originally Posted by Lonewolf_50

.........................

Back to the accident at hand: if there were confusing indications of what was wrong with the #2 engine, wherein the interpretation of what the engine and its instrumentation were telling the crew, what were they? If it was enough to induce the captain to command the good engine to shut down, the community who fly this model of aircraft would likely benefit from understanding that anomaly.
Possible CRM issue: when you both can't agree on what's wrong with the engine ...
When available, a CVR transcript might be very educational.

I would be very surprised to find out there is some kind of and "anomaly" which contributed to them shutting down the wrong engine.

It shouldn't be the Captain ordering which engine to shut down. It is the Flying Pilot(FP) who instructs the the Non-Flying Pilot(NFP) to do the engine shutdown drill (memory items) or engine shutdown checklist.

Shutting down an engine is not a one step process. First the NFP placed his hand on the power lever and asks the FP to confirm it is the correct one. Then the NFP will slowly bring the power lever to idle. After those first two steps you should know with 100% certainty that you have the correct engine.

If all looks normal to both pilots(three in this case) then the NFP places his hand on the Condition Lever and again asks the FP to confirm he has the correct Condition Lever. THEN you bring the Condition Lever to the Cut Off or Shut Off position.

I have done hundreds of shutdowns in the Simulator and occasionally someone will start by placing their hand on the wrong power lever. Usually the flying pilot will catch it. In a very few cases they will miss identify the power lever and end up pulling back the power on the working engine. There is instant feedback that you have the wrong engine and a simple push forward on the lever fixes everything.

It is very difficult to imagine how this experienced 3 man crew accidentally shut down the WRONG engine if they followed the correct engine shutdown procedure.

Yes, it will be VERY interesting to read the CVR transcripts.

[Royale]

1. What caused the system to "think" there was a No.2 flameout at Point 1? Before that the engine indications should still have looked normal to the crew, but it seems they had no chance to override the spool-down that resulted, and perhaps no reason to think they needed to.
2. Why was PL1 retarded 10 seconds after Point 1? It wasn't to shut down the engine as it was only a 10degree change.
3. At Point 2 they seem to have ignored the normal readings of No.1 and the "Idle" readings of No.2, and shut down No.1 Is this a "confirmation" problem because they were expecting No.1 to be a problem before they set off? Also, would the windmilling No.1 "confirm" they were shutting down the bad engine?
4. Why did retarding PL2 clear the erroneous Flame Out condition (not just cancelling the warning, but also bringing up the fuel flow and unfeathering)?
5. If they had retarded PL2 at Point 3 instead of trying to restart No.1, would they have got out of the situation in time?
6. (Unimportant) What's with the three triangle-wave traces?

Very interesting analysis HDRW.

1. Could the ATPCS system have erroneously activated and feathered prop #2? It looks like a distinct possibility.

2. We will have to wait for the CVR for that one.

3. We will have to wait for the CVR for that one.

4. I believe that as part of the start sequence for eng #1 the crew selected the PWR MGT switch to MCT, thereby cancelling the autofeather signal from the ATPCS system, this i think caused eng #2 to begin to revert to normal.

5. I don't think so, as I believe this to be an ATPCS issue.

6. I have seen DFDR spikes before and they seem to appear when the recorded value is 0, some sort of "noise" on the recording, I am certain that they are not relevant to the accident.

[Royale]

If all looks normal to both pilots(three in this case) then the NFP places his hand on the Condition Lever and again asks the FP to confirm he has the correct Condition Lever. THEN you bring the Condition Lever to the Cut Off or Shut Off position.

On the ATR you even have an intermediate position before fuel shut off, called feather, and you really don't want to go past that point unless you are 100% certain. I doesn't take that long to unfeather the propeller again.