MAX’s Return Delayed by FAA Reevaluation of 737 Safety Procedures
I have not read the report yet.
Interesting is the three crew flight, that they also reset the cut out switches (briefly). Lightly noted in the FAA AD as not to do.
Also what seems a very dodgy component repair shop has been running for 10 years or more and the serious deficiencies were not picked up by FAA audits or customer audits and then reported.
Interesting is the three crew flight, that they also reset the cut out switches (briefly). Lightly noted in the FAA AD as not to do.
Also what seems a very dodgy component repair shop has been running for 10 years or more and the serious deficiencies were not picked up by FAA audits or customer audits and then reported.
I have not read the report yet.
Interesting is the three crew flight, that they also reset the cut out switches (briefly). Lightly noted in the FAA AD as not to do.
Also what seems a very dodgy component repair shop has been running for 10 years or more and the serious deficiencies were not picked up by FAA audits or customer audits and then reported.
Interesting is the three crew flight, that they also reset the cut out switches (briefly). Lightly noted in the FAA AD as not to do.
Also what seems a very dodgy component repair shop has been running for 10 years or more and the serious deficiencies were not picked up by FAA audits or customer audits and then reported.
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Interesting addendum (p286 of the report) on the original intermittent AOA sensor failure that triggered this whole cascade:
The resolver 2 of the AOA sensor part number 08-NCW-24YQ was removed for further examination at the Moog facility in Blacksburg, VA. A physical examination and analysis conducted on June 5-6, 2019 by a group consisting of representatives from NTSB, Boeing, FAA, Collins, and Moog. The failure mode was a temperature dependent intermittent open rotor that eventually failed to operate at lower temperatures.
Using CT Scans, physical examinations, and Scanning Electron Microscope (SEM) imaging, the open circuit was found to be a broken magnet wire on the rotor coil. A loose loop in the coil of the magnet wire had been epoxied between two different insulators on the rotor with different coefficients of thermal expansion for each insulator. As the rotor was exposed to cyclic differences in operating temperature over time, it is likely that the difference in the expansion rates of the two insulators induced a localized stress in the coil wire that led to a fatigue break in the wire that was open or closed dependent on temperature.
Using CT Scans, physical examinations, and Scanning Electron Microscope (SEM) imaging, the open circuit was found to be a broken magnet wire on the rotor coil. A loose loop in the coil of the magnet wire had been epoxied between two different insulators on the rotor with different coefficients of thermal expansion for each insulator. As the rotor was exposed to cyclic differences in operating temperature over time, it is likely that the difference in the expansion rates of the two insulators induced a localized stress in the coil wire that led to a fatigue break in the wire that was open or closed dependent on temperature.
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I'm pretty sure Bend alot was speaking of the penultimate flight, which had a deadheading pilot, not the accident flight, which had the engineer.
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Original Bloomberg
https://www.bloomberg.com/news/artic...-later-crashed
As the Lion Air crew fought to control their diving Boeing Co. 737 Max 8, they got help from an unexpected source: an off-duty pilot who happened to be riding in the cockpit.
Recent Seattle Times
https://www.seattletimes.com/busines...-pilot-errors/
Since Boeing hadn’t informed airlines or pilots about MCAS, the captain and his first officer didn’t understand what was happening. But they were lucky in that a third pilot, another Lion Air first officer, was along for the free ride, sitting in the jump seat in the cockpit.
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I'll remind you here that your question was about the Airspeed Unreliable procedure, which I answered specifically.
Beyond that, here is absolutely no requirement to make an either/or choice regarding which checklists to execute. However, there sometimes is a need to prioritize multiple checklists. Remove MCAS from the equation entirely, and this crew probably still had at least six different non-normal procedures to run through just because of the AOA malfunction.
Beyond that, here is absolutely no requirement to make an either/or choice regarding which checklists to execute. However, there sometimes is a need to prioritize multiple checklists. Remove MCAS from the equation entirely, and this crew probably still had at least six different non-normal procedures to run through just because of the AOA malfunction.
As for practicing the stab trim checklist during training, I think the last time was almost three decades ago. A few years before that, I would have done the yo-yo maneuver in a sim...with no motion, and mounted inside a railcar. Both of those practice sessions were in the Air Force...I do not think I have ever done it in formal training, in the civilian world. It certainly needs to be reemphasized, especially now.
Psychophysiological entity
Having read in for nearly a year, I'm ever increasingly flummoxed by some of the basic operating philosophies I'm reading here. In a 'Crowd of pilots', many of whom are current on the NG, there seems to be a discussion about reading the printed word in the midst of a flight which had quickly become chaotic. Most agree it was a very demanding slew of symptoms that would have been nothing less than alarming, but I can not begin to imagine reaching for check-lists in the midst of the early stages as though it would have been some kind of cure-all. But that pales in comparison to handing over the flying to a junior FO under these circumstances.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
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Having read in for nearly a year, I'm ever increasingly flummoxed by some of the basic operating philosophies I'm reading here. In a 'Crowd of pilots', many of whom are current on the NG, there seems to be a discussion about reading the printed word in the midst of a flight which had quickly become chaotic. Most agree it was a very demanding slew of symptoms that would have been nothing less than alarming, but I can not begin to imagine reaching for check-lists in the midst of the early stages as though it would have been some kind of cure-all. But that pales in comparison to handing over the flying to a junior FO under these circumstances.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
The furthest ASI is on the standby IFSD (near the Captain) then the Captains PFD speed tape, which is more than 20 inches away from the First Officers PFD.
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Having read in for nearly a year, I'm ever increasingly flummoxed by some of the basic operating philosophies I'm reading here. In a 'Crowd of pilots', many of whom are current on the NG, there seems to be a discussion about reading the printed word in the midst of a flight which had quickly become chaotic. Most agree it was a very demanding slew of symptoms that would have been nothing less than alarming, but I can not begin to imagine reaching for check-lists in the midst of the early stages as though it would have been some kind of cure-all. But that pales in comparison to handing over the flying to a junior FO under these circumstances.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
For months, there seemed to be a consensus about Pitch and Power, but now some seem to be saying that reaching for the right check-list would have been the answer to such wildly disparate challenges. I feel the symptoms were initially too confusing to go down any predefined logic-line. The 'Aviate' phase was a crescendo of disorientating psychological demands. The FO makes a good call with the first of the symptoms. The furthest ASI is what, 20" away? The next, perfectly visible.
Given that the aircraft was quickly becoming difficult to fly and the prime cause for that seemed to them that the STS was working in reverse . . . just what check-list would they be aiming for? I have a very strong feeling that there was no sensible time to work through Unreliable Airspeed, and it was after all, not all that high on the list.
It's fair to say that the pilots were presented with a set of symptoms that no civil aircrew should be burdened with, but with this comes the prime issue of co-pilot experience. It is being addressed, but I would suggest that it join other issues on a top priority list.
No, the crew shouldn't be buried in the checklist. They should perform the memory items and fly the aircraft to a safe altitude where they can stabilize the aircraft, prioritize their actions, and then run the appropriate checklists. That did not happen.
Forget MCAS for the moment. This crew was not well-prepared to handle the AOA malfunction and subsequent warnings, annunciations and divergent instrument readings. They were not prepared because they were never properly trained to handle this malfunction even though it was, in theory, a high priority memory item procedure. There has been a massive training failure, and it has occurred at airlines across the board. Yet, has anything really changed in this regard since these accidents? Among the 737NG pilot community that participates here, I would ask if any of you have seen any significant changes in your company's training regime that would better prepare you for an AOA malfunction on takeoff? I've seen nothing at my airline.
Unfortunately the discussion around MCAS and Boeing's liability tends to suck most of the oxygen out of the room when examining these tragic events. There are other lessons here, and I'm greatly concerned that those lessons are going to be lost because so many people are looking at the bright shining object that is known as MCAS.
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Yet, has anything really changed in this regard since these accidents? Among the 737NG pilot community that participates here, I would ask if any of you have seen any significant changes in your company's training regime that would better prepare you for an AOA malfunction on takeoff? I've seen nothing at my airline.
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I will again make the observation that, with the exception of a single MCAS cycle (after which the crew extended the flaps) the ONLY malfunction that this crew was dealing with for the first five minutes was a malfunctioning AOA sensor. That's it. Almost all of the confusing elements that presented themselves during that time could happen TODAY on any 737NG currently flying. These things can happen again on every MAX once they are flying again. Every. Single. One. None of the proposed remedies changes this reality.
No, the crew shouldn't be buried in the checklist. They should perform the memory items and fly the aircraft to a safe altitude where they can stabilize the aircraft, prioritize their actions, and then run the appropriate checklists. That did not happen.
Forget MCAS for the moment. This crew was not well-prepared to handle the AOA malfunction and subsequent warnings, annunciations and divergent instrument readings. They were not prepared because they were never properly trained to handle this malfunction even though it was, in theory, a high priority memory item procedure. There has been a massive training failure, and it has occurred at airlines across the board. Yet, has anything really changed in this regard since these accidents? Among the 737NG pilot community that participates here, I would ask if any of you have seen any significant changes in your company's training regime that would better prepare you for an AOA malfunction on takeoff? I've seen nothing at my airline.
Unfortunately the discussion around MCAS and Boeing's liability tends to suck most of the oxygen out of the room when examining these tragic events. There are other lessons here, and I'm greatly concerned that those lessons are going to be lost because so many people are looking at the bright shining object that is known as MCAS.
No, the crew shouldn't be buried in the checklist. They should perform the memory items and fly the aircraft to a safe altitude where they can stabilize the aircraft, prioritize their actions, and then run the appropriate checklists. That did not happen.
Forget MCAS for the moment. This crew was not well-prepared to handle the AOA malfunction and subsequent warnings, annunciations and divergent instrument readings. They were not prepared because they were never properly trained to handle this malfunction even though it was, in theory, a high priority memory item procedure. There has been a massive training failure, and it has occurred at airlines across the board. Yet, has anything really changed in this regard since these accidents? Among the 737NG pilot community that participates here, I would ask if any of you have seen any significant changes in your company's training regime that would better prepare you for an AOA malfunction on takeoff? I've seen nothing at my airline.
Unfortunately the discussion around MCAS and Boeing's liability tends to suck most of the oxygen out of the room when examining these tragic events. There are other lessons here, and I'm greatly concerned that those lessons are going to be lost because so many people are looking at the bright shining object that is known as MCAS.
Most of the worlds NAA's do not train "outside the box". Companies see the cost of training as "expensive" which reduces their overall profit, per the bean counters, thus reducing quality training time. This reduction fails to address proper system knowledge and procedures, an important aspect in operating a commercial jet aircraft.
Years ago Boeing reduced the "training footprint" in reaction to Airbus's training footprint!
The crew of the fatal flight had many different caution messages and warnings.
1) Stall warning
2) IAS disagree
3) Elevator feel
and so on.
So what checklist, would they run and what was covered during their transition course?
Most NAA's adopt the Boeing type rating course and tailor the course to the requirements of their respective NAA's (not FAA) to meet the standard for issuance of the type rating.
The adopted "Boeing" course covers "runaway stabilizer" and "airspeed unreliable" (without stall warnings, feel diff, IAS disagree etc). During the transition course stalls and UPRT are part of the type course but are not included with other cautions and warnings, such as the accident crew were faced with. Current flight simulators are basically programmed to a level which covers basic malfunctions, so any "deeper" system integrated faults attached to other systems cannot be selected by the Instructor.
The crew had no exposure in training to all of the other cautions and warnings (that they received during the flight) during their initial (transition) course.
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Boeing ups its ' safety ' optics- add a submariner - gives new meaning to ' dive dive dive "
Boeing said Friday (oct 26) that the former military head of the U.S. Navy has been elected to its board, part of a broader effort to improve the plane maker’s safety oversight.
Retired Navy admiral John Richardson stepped down in August as chief of naval operations, with the final part of his career dominated by reviews of Navy safety, training and readiness after two at-sea collisions killed 17 sailors.
Boeing recently amended its governance rules to make safety-related experience a criterion for choosing future directors as part of a board review of its engineering and internal reporting practices overseen by Edmund Giambastiani Jr. , a retired U.S. Navy admiral who sits on the company’s board.
Mr. Richardson, a former submarine commander, will join the Boeing board’s aerospace safety committee, alongside Mr. Giambastiani. Other members include Duke Energy Corp. CEO Lynn Good and Larry Kellner, who led one of the predecessor companies of United Airlines Holdings Inc
Retired Navy admiral John Richardson stepped down in August as chief of naval operations, with the final part of his career dominated by reviews of Navy safety, training and readiness after two at-sea collisions killed 17 sailors.
Boeing recently amended its governance rules to make safety-related experience a criterion for choosing future directors as part of a board review of its engineering and internal reporting practices overseen by Edmund Giambastiani Jr. , a retired U.S. Navy admiral who sits on the company’s board.
Mr. Richardson, a former submarine commander, will join the Boeing board’s aerospace safety committee, alongside Mr. Giambastiani. Other members include Duke Energy Corp. CEO Lynn Good and Larry Kellner, who led one of the predecessor companies of United Airlines Holdings Inc
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My intuitive "feel" on this is the crews faced very complex scenarios that they were untrained for, and this contributed to the two MAX accidents.
However, the raw data of the accident rates suggests that the 737-NG operation globally is remarkable immune to a catastrophic outcome bases on the exact AoA failures, the consequent cacophony of warnings and noise, even though they share the same sensors and architecture with the sole exception of the MCAS system. As far as I am aware, there have been no hull losses due to flight control issues for the NG.
Globally, NG crews have dealt with these failure modes and landed the aircraft safely in 22 years and 100+ million flights.
However, the raw data of the accident rates suggests that the 737-NG operation globally is remarkable immune to a catastrophic outcome bases on the exact AoA failures, the consequent cacophony of warnings and noise, even though they share the same sensors and architecture with the sole exception of the MCAS system. As far as I am aware, there have been no hull losses due to flight control issues for the NG.
Globally, NG crews have dealt with these failure modes and landed the aircraft safely in 22 years and 100+ million flights.
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My intuitive "feel" on this is the crews faced very complex scenarios that they were untrained for, and this contributed to the two MAX accidents.
However, the raw data of the accident rates suggests that the 737-NG operation globally is remarkable immune to a catastrophic outcome bases on the exact AoA failures, the consequent cacophony of warnings and noise, even though they share the same sensors and architecture with the sole exception of the MCAS system. As far as I am aware, there have been no hull losses due to flight control issues for the NG.
Globally, NG crews have dealt with these failure modes and landed the aircraft safely in 22 years and 100+ million flights.
However, the raw data of the accident rates suggests that the 737-NG operation globally is remarkable immune to a catastrophic outcome bases on the exact AoA failures, the consequent cacophony of warnings and noise, even though they share the same sensors and architecture with the sole exception of the MCAS system. As far as I am aware, there have been no hull losses due to flight control issues for the NG.
Globally, NG crews have dealt with these failure modes and landed the aircraft safely in 22 years and 100+ million flights.
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Yes, I did mention that specifically. Essentially I am making the argument that the in-service data suggests the NG is resilient, despite the overwhelming nature and complexity of AoA failures. That is not to say that things cannot be improved, they almost certainly can, but the system has coped.
This may be the key to the design decisions that Boeing made with the quick and dirty MCAS implementation. They were lulled into a belief that the crews would again, cope. This turned out to be a catastrophic assumption in hindsight.
This may be the key to the design decisions that Boeing made with the quick and dirty MCAS implementation. They were lulled into a belief that the crews would again, cope. This turned out to be a catastrophic assumption in hindsight.
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So if the Lion crew had switched everything off AP AT etc etc and flown and trimmed the a/c manually to a safe speed (using thrust setting) and safe height with pitch & power (assume flaps up) to sort things out,
it was always going to be impossible for them because MCAS would over ride anything they did and still put the nose down, leaving the guys in a complete muddle
(Thinking why is it doing this?)
Re the comment made above ''This crew was not well-prepared to handle the AOA malfunction and subsequent warnings'' -
I thought that Lion Air had not purchased the AOA disagree display option?
So with all the other startle factors and warnings going off how would the crew recognise an AOA disagree was the sole issue here?
Am I correct in thinking this?
Thanks
it was always going to be impossible for them because MCAS would over ride anything they did and still put the nose down, leaving the guys in a complete muddle
(Thinking why is it doing this?)
Re the comment made above ''This crew was not well-prepared to handle the AOA malfunction and subsequent warnings'' -
I thought that Lion Air had not purchased the AOA disagree display option?
So with all the other startle factors and warnings going off how would the crew recognise an AOA disagree was the sole issue here?
Am I correct in thinking this?
Thanks
Between the lines "we will not hold you to account........ if you do not............" and possibly start up under a different name next week fast tracked by the FAA.
No not cynical at all.
A small correction please to my post at #3317. I suggested that foreign validations of FAA Type Certification would have detected deficiencies in design of MCAS. KNKT report at 1.17.8 tells us that Indonesian DGCA did validate TC and did discuss MCAS. Implies that DGCA saw nothing amiss