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-   -   Spanair accident at Madrid (https://www.pprune.org/rumours-news/339876-spanair-accident-madrid.html)

Rananim 6th Sep 2008 13:42

Question to Mad Dog pilots
 
Has there ever been a MD SB detailing this relay c/b,its function,and the implications if it is left tripped?Does your airline safety program monitor all type-related incidents/accidents and disseminate that info to you asap?
Accident investigation is supposed to eliminate the possibility of ascenario being repeated.Only way to do that is through data dissemination via AD's/SB's and company safety programs.

A37575 6th Sep 2008 14:04


The Reason model of causality probably fits to some extent to this event, however, the event also may serve to indicate that the behavior of aviation safety systems are in fact dynamically non linear and also have unbounded chaotic behavior, which results in stochastic or non deterministic system behavior. Accidents can happen
I see it all now..

philipat 6th Sep 2008 14:18

English Translation
 
A37575:


I see it all now..
In plain English: **** happens (AKA Murphey's Law)

Riccardo 6th Sep 2008 15:51

Pulling CB's during ground activities...........

I absolutely agree with desk jockey. We do it so often.

Personally I take a piece of paper from my pocket or flight deck, write in big fat letters which CB(s) I have pulled and hang it off the glareshield.

Just a gentle reminder - belt and braces.

Right Way Up 6th Sep 2008 17:43

From my 1st post it could easily be construed that I believe the accident was due to a CB being pulled. That would be a very unfair assumption from my part. However from Wing1011s excellent post it seems there is a workaround to complete a daily which very nearly helped write off a serviceable aircraft with the loss of all onboard. Thats why those aircraft should be modified. In this accident my gut feeling is that there will be a lot of human factor issues involved. (I truely hope not). It is down to us & the authorities/manufacturers to learn & improve safety from them!

forget 6th Sep 2008 17:58


pichu17. Weight on Wheels is in the Main Landing Gear. Ground sensing is in the Nose Gear. The Take Off Configuration Warning depends on the ground sensing – of the Nose Gear.
Why is the critical TOCW fed from a single point option – the one with the highest chance of failure?

The only reason I can think of is that this arrangement allows disabling of the TOCW audios (ground checks etc.) with the least affect on other systems. I’ll bet there’s an interesting design history on this; and I suspect the first DC9/MD80 TOCW was originally wired to the WOW switch.

threemiles 6th Sep 2008 19:04


Accident investigation is supposed to eliminate the possibility of ascenario being repeated.Only way to do that is through data dissemination via AD's/SB's and company safety programs.
If all the current assumption become confirmed, it will be interesting to see whether the Spanish Civil Aviation Accidents and Incidents Investigation Commission (CIAIAC) will admit as an contributing factor, that an earlier release of the final report of the almost accident of OE-LMM (ACE June 07) may have found its way into Belgrano or an Alert SB or a Spanair company safety program, thus early enough to increase the chance to save JKK5022.

Though OE-LMM is registered in Austria the investigation is led and the final report is to be issued by ....Spanish Civil Aviation Accidents and Incidents Investigation Commission (CIAIAC)

PJ2 6th Sep 2008 21:01

XPMorten;

Do modern EICAS systems in any way warn you if a CB has been pulled?
Yes, the Airbus A320/A340 series fleet types indicate open CB's on the lower ECAM display. These messages come on when the event occurs, or are otherwise hidden from the crew until the "STATUS" button is pushed during the cockpit check to inform crews of these and other messages as to the status of the aircraft. These messages may be recalled at any time and reviewed.

That said, there are very few CB's in this fleet type's cockpits. Most are downstairs in the E&E Bay.

The Air-Ground sensing on the Airbus is substantially different than previous types and has no CB's as such to "interrupt" sensing and is instead controlled and monitored by 2 "LGCIUs"...Landing Gear Control Interface Units. These two computers alternate between 1 and 2 on each leg. The receive inputs from proximity and position detectors on the gear shock absorbers, gear doors, cargo door components and locking mechanisms, door sills and 4 flap attachments (slat attachments are not mentioned). In other words it is not a single-point failure design such as one which senses nosewheel oleo compression. Keep in mind that the latter design philosophy was sufficient at the time and that the Airbus technology was developed long after. In other words, this isn't a "Boeing vs Airbus" thing, please.

pichu17 6th Sep 2008 21:52

forget
All DC9 and md80 series are similar in this item.

beamender99 6th Sep 2008 21:54

Hoping the guys up front have got things right certainly occurs to regular SLFs at certain hot high locations like HRE.
Quite a few years ago, it was most reassuring to get a PA from the front
saying " For those of you who are regular guests of our airline the take of run is much longer than usual so please do not have any concerns"

( some SLFs do visibly time the roll )

Smilin_Ed 6th Sep 2008 22:40

And, What Do They DO?
 

( some SLFs do visibly time the roll )
And just what do they do if they perceive that it's taking too long? Rush forward and pull the throttles back?:rolleyes:

justawanab 6th Sep 2008 23:43

Perhaps officially introduce an additional role for the senior F/A. "Check slats and flaps". By some designated point in the taxi out, if the slats and flaps aren't visibly set then notify the flight deck. This takes the onus off aware passengers and removes any stigma involved in the F/A "telling the pilots how to do their job" or for that matter the aware passenger/s telling the cabin crew. After all, the flight crew already tell the cabin crew to "arm door and prepare for take-off" so why not the other way around as well?

justme69 6th Sep 2008 23:54


If all the current assumption become confirmed, it will be interesting to see whether the Spanish Civil Aviation Accidents and Incidents Investigation Commission (CIAIAC) will admit as an contributing factor, that an earlier release of the final report of the almost accident of OE-LMM (ACE June 07) may have found its way into Belgrano or an Alert SB or a Spanair company safety program, thus early enough to increase the chance to save JKK5022. Though OE-LMM is registered in Austria the investigation is led and the final report is to be issued by ....Spanish Civil Aviation Accidents and Incidents Investigation Commission (CIAIAC)
It does make me mad that they have to be so picky about putting out an impeccable and good looking report that it takes them for freeking ever to make when, with the information they have already, they could easily by now, only a few weeks after the accident, put out a WHOLE LIST OF LIKELY SCENARIOS that may or MAY NOT have been the cause of this accident but that MAY shed light on THEORETICAL but plausible situations on how it could've been.

But no. They have to be 99.999% sure of the cause of the accident even if it takes them 2 years and they have to produce all the pretty pictures and review all the information from every source and every blueprint from every manufacturer.

Meanwhile, 2 years down the road, another airplane falls victim of the same (or similar) cause.

Reports HAVE to be both, fast and accurate. Since they usually can not be both things at the same time, PRELIMINARY INNACCURATE REPORTS should be made available, just detailing that those are not PROVEN FACTS YET and reminding that it's all speculative until a final report comes out.

But keeping NEAR TOTAL TIGHT-LIP SILENCE for 2 years and then detailing to the last tiny fact exactly what happened in 100 pages when actually 4 paragraphs are enough in most cases, is NOT the best way to conduct this investigation "business".

So yes. I do blame the CIAIAC lack of preliminary and constant information for contributing to this or other (potential, theoretical, speculative) cause for the accident.

Because I knew about OE-LMM first hand, I always wanted to find out what caused that near catastrophy. It had to be through an informal forum like this and over 1 year later that I have finally reached "peace" with myself on the (likely) cause.

And I applaud the idea of cabin crew checking for visual wing configuration and function early on take-off. After all, they are familiar with the aircraft and their lives are at stake as much as anyone elses and perhaps a call on their side alerting the cockpit of potential problems could be valuable, if indeed a number of "false alarms" are bound to happen (better safe than sorry).

wozzo 7th Sep 2008 00:55


Originally Posted by Smilin_Ed (Post 4377968)
And just what do they do if they perceive that it's taking too long?:rolleyes:

I guess they pray.

BeechNut 7th Sep 2008 01:32


it makes me wonder whether someone down the back, with a bit more courage, might have made a difference.
Is there really anything a PPL could do?

At the end of the day, I've pretty much concluded that I have to count on the professionalism of the crew to keep the odds of this sort of accident very low indeed (and the record does seem to bear that out).

Perhaps you pros might think otherwise; if so, feel free to whip me in public...

CecilRooseveltHooks 7th Sep 2008 06:46


It does make me mad that they have to be so picky about putting out an impeccable and good looking report that it takes them for freeking ever to make when, with the information they have already, they could easily by now, only a few weeks after the accident, put out a WHOLE LIST OF LIKELY SCENARIOS that may or MAY NOT have been the cause of this accident but that MAY shed light on THEORETICAL but plausible situations on how it could've been.

But no. They have to be 99.999% sure of the cause of the accident even if it takes them 2 years and they have to produce all the pretty pictures and review all the information from every source and every blueprint from every manufacturer.

Meanwhile, 2 years down the road, another airplane falls victim of the same (or similar) cause.

Reports HAVE to be both, fast and accurate. Since they usually can not be both things at the same time, PRELIMINARY INNACCURATE REPORTS should be made available, just detailing that those are not PROVEN FACTS YET and reminding that it's all speculative until a final report comes out.

But keeping NEAR TOTAL TIGHT-LIP SILENCE for 2 years and then detailing to the last tiny fact exactly what happened in 100 pages when actually 4 paragraphs are enough in most cases, is NOT the best way to conduct this investigation "business".

So yes. I do blame the CIAIAC lack of preliminary and constant information for contributing to this or other (potential, theoretical, speculative) cause for the accident.

Because I knew about OE-LMM first hand, I always wanted to find out what caused that near catastrophy. It had to be through an informal forum like this and over 1 year later that I have finally reached "peace" with myself on the (likely) cause.

And I applaud the idea of cabin crew checking for visual wing configuration and function early on take-off. After all, they are familiar with the aircraft and their lives are at stake as much as anyone elses and perhaps a call on their side alerting the cockpit of potential problems could be valuable, if indeed a number of "false alarms" are bound to happen (better safe than sorry).
justme, sadly this is somewhat a product of my homeland's litigious society. There are huge claims to be paid, and anything short of a final and correct report is unacceptable. There is probably already a 'hearse chaser' offering to file suit against Spanair, Boeing, AENA, city of Madrid etc based on a WSJ article or a 'killer ravine'....

borghha 7th Sep 2008 08:51

what happened to OE-LMM? was it the case that was described earlier on by an italian poster about a flight leaving lanzarote?

justme69 7th Sep 2008 11:04

Borghha: yes, that's the one we were talking about. The austrian MD-83 leaving from Lanzarote flying for Air Comet.

threemiles 7th Sep 2008 11:26


But keeping NEAR TOTAL TIGHT-LIP SILENCE for 2 years and then detailing to the last tiny fact exactly what happened in 100 pages when actually 4 paragraphs are enough in most cases, is NOT the best way to conduct this investigation "business".
That is why the British Investigators have issued two interim reports since the event happened, which was in January. Imagine another 777 having the same problem...

NigelOnDraft 7th Sep 2008 11:33

In the event that in the Spanair accident No Flaps/Slats was a factor.. and also the OE-LMM incident (?) out of interest, what does/can the latter add to the well documented and reported Northwest accident?

NoD

HarryMann 7th Sep 2008 11:54

IF, a big if, this scenario proves to be correct, would it not suggest that overall, there has been too much reliance on volountary operational and maintenance practices rather than mandatory ones... yes I know, I haven't worded that correctly, as far as airline procedures and certificating/licensing bodies work together, but hopefully you get my drift.

I'm saying, that if there's a loaded gun lying around, everyone near it must be aware (it's loaded), and that awareness not left to chance.

sevenstrokeroll 7th Sep 2008 12:56

Flying depends on everyone doing things right and not being cheap about anything.

Whether it is servicing the nose strut frequently and properly, or changing procedures to include a configuration check by an outside authority at the runway threshold, things have to be done to insure this type of accident doesn't happen again.

threemiles 7th Sep 2008 13:57


what does/can the latter add to the well documented and reported Northwest accident?
The reason why the t/o warning did not sound was not found, e.g. as the CB panel was destroyed.

The C/B panel on OE-LMM was not destroyed.

3NM

411A 7th Sep 2008 16:11


After all, the flight crew already tell the cabin crew to "arm door and prepare for take-off" so why not the other way around as well?
Simply because....CC don't know sh!t from shinola about the technical aspects of the operation of an airplane.

Poof in Boots 7th Sep 2008 16:44

Well 411A. perhaps it should be a Cabin Crew check to look through a window to see if the Flight Crew have remembered to select flaps for take-off.

Could be done after "Cabin Secure" checks.

You lot can't be trusted obviously.

Rainboe 7th Sep 2008 17:48

What a completely harebrained idea. I believe the supporters are cabin crew? Let's forget that one shall we? What are we going to do at night? Can't see the wings. Could we get them to stick their heads out of the bottom before landing to check the gear down? As they are looking out, perhaps we could get them to manually wind the flaps back in after take off to save the pumps, too!

Rightbase 7th Sep 2008 18:44

Boundaries?
 

What a completely harebrained idea.
Where does CRM stop?

411A 7th Sep 2008 19:33


Where does CRM stop?
Fortunately, and according to some of the oft repeated harebrained CC ideas...firmly at the reinforced FD door.
Night flights are a perfect example, as Rainboe correctly pointed out.

Some CC really do believe they 'know the score'...sadly, very few do.
A perfect example;
B747, after landing Cairo, circa 1987.
The number two Roller began to wind down after thrust reverse cancellation, whereupon slight aft end torching was noticed.
A small tail pipe fire.
Flight deck crew was notified by the tower, and provided the appropriate drill.
Case closed.
It was only later, that a CC member mentioned to her supervisor that she tried, without contacting the FD via interphone, to start an evac, because she noticed...'flames from the engine.'
That evac, had it been successful, would have been from the L4 door...right in line with the number two engine.
The reason the evac was not started?
The poor CC broke her fingernail trying to break the copper safety wire on the evac signal cover.
Manager flying, was advised.
Word came down...get rid of this particular uninformed CC, pronto.
Exit via duely issued.
Then, even stonger copper safety wire was fitted to the evac signal cover, just as a precaution...to keep CC from making complete fools of themselves, and endangering SLF, who might follow the CC harebrained, misinformed, untimely 'instructions'.

Rainboe 7th Sep 2008 19:51

Bloody hell it's hard work trying to keep this lot under control, isn't it? Like trying to herd cats! We are poor sheepdogs tasked with keeping herds of sheep from getting lost on wild Welsh mountainsides.

Still, somebody has to do it!

DeRodeKat 7th Sep 2008 19:54

to PASSENGER in the BACK
 
Fokker 70/100 and A-300 do not use flaps for take-off. Do not alert the crew on those :=

Skipness One Echo 7th Sep 2008 20:00

The A300 sure as Hell does (!) Incidentally there's a lot of politicking and egos in this thread between the old style Gods on the flightdeck and the lesser mortals. Suffice to say that if I had been on an MD80 that had crossed the runway holding point with no flaps and the take off about to commence I would be banging on the flight deck door demanding the nice man's attention. Alas I am only what you snidely refer to as "self loading freight" so in your pampered little world I daresay I have no right to an opinion. Thanks God people who hold these views are dying out.

Rightbase 7th Sep 2008 20:11


she tried, without contacting the FD via interphone, to start an evac
No "CRM" there then! Good result.:ok:

esa-aardvark 7th Sep 2008 20:15

flaps slats .. .whatever
 
Dear Rainboe,
I suppose it's not beyond the wit of mankind to design flaps
slats etc so that they could be seen from the cabin, or heaven forbid some kind of rear view mirror such that they could be
seen from the cockpit. I am only high mileage SLF, but I can see that as soon as you let go of the control freak image that you apparently have you might realise that those crew in the
back of the aircraft actually might prefer to contribute to safety, rather than die trying. Actually I, as many others, have
extremely acute night vision, maybe your staff do too. Do you know ? Night take-offs may not be the problem that you think they are. ie Sorry to be rude, and I am sure you will have the smart answer, just put a light on the bloody things.
Cabin crew don't see the light - there may be a problem.

I'm sorry, and I don't mean this badly, maybe you are part
of a generation which does not want to see that there may be solutions which you have not thought off.

kind regards, John:ok:

Rainboe 7th Sep 2008 20:56

It's not a solution. What if it is raining heavily? It breaks down! Would you like to put a flap gauge at the cabin crew station? Maybe landing gear lights and electrical supply indications...and pressurisation controllers and hydraulic switches. Maybe then we'll see how the senior flight attendant likes her transfer to being flight engineer? Heck, even give her the landing gear switch at Door 1L?

I really think we should go back to this section being mainly for pilot discussions! Once again it gets hijacked by crazy amateurs! Current procedures are just fine. They are backed up by TOCW. If that doesn't work, or you don't understand, you should not be partaking of this discussion and reasons should be found why it wasn't working. But all these threads at the moment are being hijacked by inane ideas and you are scaring the professionals away!

idle bystander 7th Sep 2008 21:08


Current procedures are just fine
Obviously

Please see the title of the thread, Mr Rainboe

Rainboe 7th Sep 2008 21:18

Well I am all for sticking a rear view mirror in .....somewhere, or a flap gauge at Door 1L, or having the Senior flight attendant stick her head outside the door to check the flaps are out, and out of a hatch below to check the gear down if you think that is the answer! There is a pilot checklist procedure backed up by TOCW which should do the job. If the system did not work, then that is to be examined, not pie in the sky daftness!

DeRodeKat 7th Sep 2008 21:20

To Skipness One Echo
 
Quote:
The A300 sure as Hell does


I dunno... Can you see flaps extended here? - I can't
http://www.airliners.net/photo/Lufth...603/1387752/L/

glad rag 7th Sep 2008 21:30

idle bystander
 
You beat me to it!!

west lakes 7th Sep 2008 21:37

I'm trying hard to get my head round this check of the take off configuration.

Present system (from my recollection)(simplified)
Aircraft boards, starts engines c/c do safety demo & check seat-belts and other items take their seats at front and rear bulkheads, report to F/D. Aircraft reaches runway and takes off

Suggested
Aircraft boards, starts engines c/c do safety demo & check seat-belts and other items take their seats at front and rear bulkheads, report to F/D. Aircraft reaches runway, C/C member of staff unstraps, walks back, leans over passengers to look out of window both sides to check flaps & slats, walks back to front? resumes seat & reports to flight deck (as I doubt wings can be seen from door windows)
So lots of puzzled pax as to why this check is done, it would do wonders to nervous passengers
Delays as this check is done, reducing airport capacity.

Just asked the wife, who is a slightly nervous passenger, the first comment she made was " I'd wonder what was wrong with the wings"

Right Way Up 7th Sep 2008 21:45

Unfortunately 411a and (surprisingly) Rainboe confirm their time from an age where pilots were skygods & infallible. If a crewmember calls up to my flight deck & points out a concern, I thank them very much for their input (however irrelevant) & then explain why everything is ok.


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