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ENOUGH!
I have no doubt this has been raised in past 38 (39??) pages BUT: - IF loadsheat to crew was acurate; - IF pax numbers were about right; - IF fuel was unaltered from briefed flight plan then for the PIC at least to not have IDEA of what the T/O figure should be, let alone the F/O to have some idea should be just...unacceptable. I say this only as I presently operate as a foreign PIC where if anything screws up I, yes, I (me, me,me) will go to gaol (jail) - not the F/O, dispatcher, manager, owner or any other prick. Me - and me alone! The heroics and ability from the crew to "rescue" the disaster is admirable. The fact that the same crew actually PLACED the aircraft in the disaster situation????? (And before the obvious comments... yes I screw up every day in small ways, I would hope that reveals constant, ongoing weaknesses in human nature - and so I don't make the sort of massive, stupid f**kup these guys made.) Just a thought. Cheers galdian |
so I don't make the sort of massive, stupid f**kup these guys made yes I screw up every day in small ways Everything that happened after that IS open to conjecture at this time, which is why the ATSB will take 9 months plus to do their report. If you don't like the conversation, don't take part :* :mad: |
It wasn't me...
The funny thing is, everytime an accident happens, and the facts come to light, everybody's response is "It couldn't be me!"
Yet seemingly preventable accidents continue to happen. I'm sure the MEL guys, the AMS guys, and countless pilots before them, when told about their future accident, would deny that it could happen to them. Instead of judging others aeronautical abilities based on limited information, we should look at ourselves, see what we can learn from this, and think about what personal safeguards we each have in place to keep us from being next. |
MEL tailstrike
Helen,
I think you are overly harsh on Galdian-because he/she does not agree with your viewpoint does not mean he/she is an ar$e. I have significant 340 experience at EK and elsewhere and the facts raised by Galdian are valid as indeed are yours. We are given the authority and responsibility as commanders to mitigate errors,we all make them it just depends on how you grade the error and this was a major one. Career limiting infact-but it could have been far far worse and as any commander will acknowledge we are there to prevent these events in between 90% airways boredom. Blue skies,IC |
IC
Fair enough, I was reacting to the ENOUGH, so his ar$e is removed :ooh: I disagree on your statement that his point about awareness is valid. I didn't know the crew so I don't know how recent their experience was on the 345. It's already been said that being 340 current doesn't mean 345 current. Like many here, I'm wondering how some things happened but I'm not going to say that items should have been noticed because none of us know why they weren't. According to the initial report, the F/O had 425 hours on the A345. About 70 of that would have been CCQ and the rest could have been doing augment and operating the short NZ sectors. So, worst case, at about 35 hours for the DXB-Oz-NZ-Oz-DXB, that's a whole 10 trips with 20 operating sectors at light weights. Even if half were operating at heavy weights, that's not much to fall back on. Then add 190 hours of A343 ops and the waters get muddier. Fair winds, H-D |
It looks like in this case, history part at least repeated itself, which traditionally in many cases allow the accident to take place.
For the sake of a few dollars, someone decided that they knew better and there were not, as would be the norm two laptops used as a cross check. Compiling figures on two units, appears to be more diligent that using one, than having the calculations checked on one. Then there was the problem of stress caused by the pre flight flight deck conferances, and then it slipped past the crew that the AUW was far too low. It is very apparent that the calculations were wrong and it was not picked by checking. However there must have been other factors that should have been revealed. Most pilots, engineers and Loadmasters, and at least when I served, the loadmaster and engineer would calculate what the AUW would be, at the least the co pilot but usually the person doing the take off would do the card too, if they all when compared by the engineer, did not agree then the start up was not commenced until there was agreement. In any case the figures produced did not get challenged, but I fail to see how with the load sheet, included the fuel, cargo a SLF did not come up to the gross weight, then again something was wrong. After all you know the pax, you know the cargo, you know the fuel that is required, and you know the empty weight of the airlane, in other words an experienced crew should have a very good idea what the AUW would be. I fail to understand with an airplane about to conduct a very long flight, that they could accept that the airplane was lighter than it was. 100 tons is a lot to loose and bells should have been ringing. Maybe the answer partly is not allow people into the flight deck, until such time as the important take off factors have been checked. I mean we are not talking about big time here, but never the less it is proberly the most important check before flight. The other thing is if there had been two laptops used, the error would have been revealed, sounds like some penny pinching there. In conclusion I feel that even though they made a mistake, the crew did an amazing airman ship show in recovering the situation. Looks to me that the mangement were looking for someone to take the wrap, and not have the finger pointed at them. Now their actions show that they too have responsibilty. Instead of hanging the pilots out to dry, management should have immediately looked at all the facts, and then decided what action they should take. by them not waiting until the investigation to reveal the total situation. The crew cocked up, but did a great recovery job, management cocked up too, but just pointed the finger, the safety officer he condoned the use of cheap and non recogmended proceedures, so really it is the comapny who was partly to blaim. In the pilots being made to take the blame, is the easy way out, and if the incident became so bad that it was an accident, and they and many others had died, I am sure the company at least would have said pilot error. The company needs to stand up and accept that they too played a major part, the pilots could have had action taken against them. But to dismiss them with all the associated problems that will cause, clearly indicates that management is remote from the real world. A bit choping off a finger because it has a scratch. I for one believe that both pilots today, are and would be better pilots because of this matter. I for one would travel with them, and I suspect that if some the factors had not existed, this incident would not have occurred. Regards Col |
Re post #776:
everybody's response is "It couldn't be me!" |
One wonders why pilots are doing performance calculations on laptops and then having to manually input the data coughed up into the FMS. As we have seen on a number of occasions (MEL, AKL, MK and there must be others) the routine is ripe for errors. Yet the technology has been available for years to overcome the problem IMHO (not being a jet driver).
From the Honeywell website (my bolding)- The Honeywell Weight and Balance System measures aircraft gross weight and center of gravity using sensors mounted on the aircraft landing gear. A dual system is capable of being certified as an alternate means of providing dispatch weight and balance information. The system is designed so that any individual component can be changed out without re-weighing the system. The system is standard equipment on the Freighter version of 747-400 aircraft. The system interfaces directly with the Flight Management Computer system on the aircraft and the output is displayed on the Multifunction Control Display Unit (MCDU). An optional Remote Dedicated Display Unit can be utilized in the cargo bay. FLIGHT INTERNATIONAL 1 July 1989 747 auto-balance system certificated The US Federal Aviation Administration has certificated an electronic weight and balance measuring system (WBS) on the Boeing 747-400. The Honeywell Air Transport Systems division WBSs were installed ready for operation in the 747-400s recently delivered to KLM and Lufthansa. Certification does not yet clear it as a primary system, but as a means of checking the standard weight and balance calculations. The system gives real-time readouts of aircraft weight and centre of gravity. KLM selected an optional cargo bay remote display for monitoring by loaders. Because actual (not estimated) aircraft weight is measured automatically, departure delays caused by late passenger or cargo arrival can be minimised because cockpit paperwork and calculations are eliminated. The system automatically alerts the crew if loading limits are exceeded. Certification has cleared the WBS to an accuracy of ±1 percent, and the dual system is designed ultimately to be certificated as a primary means of dispatch to FAR Part 121 standards. Lufthansa hopes for European certification of its dual WBS as a primary dispatch system. In the meantime it is useful as a means of checking the accuracy of conventional loadsheets, and particularly for giving an accurate final readout on the CG position. The Honeywell WBS consists of landing-gear-mounted load sensors, a calibration module containing all gear parameter information, a digital computer unit, a pitch attitude sensor, a cockpit display, and an optional remote dedicated display unit. A dual system such as Lufthansa's includes two variable reluctance sensors per wheel, or a total of 36 sensors. Air France, China Airlines, and French independent airline UTA have ordered the WBS for their 747-400s, and Alitalia and China Airlines for their McDonnell Douglas MD-l1s. As I understand it Airbus has such a system available as an option and has been certified on the A300-600, A310, A320, A330, A342 and A343. What is holding back the fitting of such tools? Short term monetary considerations, forgetting the old maxim "If you think this is expensive try having an accident". Perhaps the industry may have been better served in the long term (and I hate to say it - its the old railway crossing argument) if there had been loss of life. Thats when political pressure is brought to bear, the airlines themselves are rarely proactive on such matters and it requires mandating from some authority before they stir (kicking and screaming). David Beaty Firstly, there should be an acknowledgment that if and when the pilot makes a mistake, his will probably be the final enabling one at the apex of a whole pyramid of errors down below. This will, in turn, take the heat off investigations – the ‘we intend to find and punish the culprit’ syndrome. Only then can the pilots come forward and admit to mistakes they made or nearly made, and the reasons why can be coolly analysed and lessons learned. Stanley Roscoe wrote that: The tenacious retention of ‘pilot error’ as an accident ‘cause factor’ by governmental agencies, equipment manufacturers and airline management, and even by pilot unions indirectly, is a subtle manifestation of the apparently natural human inclination to narrow the responsibility for tragic events that receive wide public attention. If the responsibility can be isolated to the momentary defection of a single individual, the captain in command, then other members of the aviation community remain untarnished. The unions briefly acknowledge the inescapable conclusion that pilots can make errors and thereby gain a few bargaining points with management for the future. Everyone else, including other crew members, remains clean. The airline accepts the inevitable financial liability for losses but escapes blame for inadequate training programmes or procedural indoctrination. Equipment manufacturers avoid product liability for faulty design. Regulatory agencies are not criticised for approving an unsafe operation, failing to invoke obviously needed precautionary restrictions, or, worse yet, contributing directly by injudicious control or unsafe clearance authorisations. Only the pilot who made the ‘error’ and his family suffer, and their suffering may be assuaged by a liberal pension in exchange for his quiet early retirement – in the event that he was fortunate enough to survive the accident Thus far it seems EK has ticked every box in the Beaty and Roscoe statements. The technology is available, what is lacking is the will. |
It would be great except the weight and balance system on A330/A340 never worked properly, and I understand that nobody is flying it.
A GA pilot will know all the critical speeds to the nearest knot, it surprises me that an experienced crew would not 'intuitively' recognise the difference in V1, Vr, V2 speeds resulting from a 100 TONNE typo error when calculating the TO performance. The speeds would have been out by double figures, and a good airman should have noticed. That said a certain A330 operator had the mother of all tailstrikes when the PNF (a captain) scribbled down the VR, as 136 instead of 156, and the PF (another captain) dutifully rotated. They flew on and then managed to do a hard landing at the other end... |
With widebody aircraft at such high TOWt's it is often the case EVEN WITH THE CORRECT CALCULATION ENTERED INTO THE FMGC to rotate in the last 1000m of a large international runway. The crew were expecting of course to rotate well down the runway as all previous flights would have done. To put to bed the issue of the rotate speed awareness, it is more a factor of how long it took them to get the intial acceleration going, that would be more of a tell tale that things were not going as planned as the slow Vr speed would only be picked up too late as happened on EK407 when TOGA was THEN applied. Having said that, in 25yrs of flying, I cannot say my personal accelerometers are that good to assume the intial acceleration is always as it should normally be.
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A good airman probably would have picked up the error but most of us are average airman and this is not the first time a tailstrike has occurred because of incorrect weights being used. What has to happen is the development of a system that is 100% reliable. Did this type of occurrence exist when takeoff performance was calculated manually? Its no good saying that the systems are robust enough as clearly they are not.
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I'm sure mistakes of one type or the other are as likely to be made with manual calculations.. In fact, delving into the orange take-off charts for the big 'Buses is fraught with potential mistakes - more so actually at light weight because of the requirements regarding min control speed..
For example on the 330 if Vr was below Vmca then I recall we just had to add equal speeds to the V1 and Vr (I say recall - may be slightly mistaken) and make no change to the flex temp. However on 340 if speeds were too slow you'd have to reenter the charts at a lower flex temp that gave higher speeds associated with it... I saw plenty of mistakes made there:\ |
A good airman probably would have picked up the error V1-150, VR-161, V2-173. 230kgs V1(VMCG)-142, VR-142, V2-159. One does'nt have to be real sharp to notice the difference, me thinks. |
Did you intend to type those weights above? Just wondering if they were:
typos your reading what you expected to see or intentional. |
EPR
For your 747 example, perhaps more to the point, what was TOGA EPR and what was the reduced EPR?
EPR of 1.14. Isn't zero thrust 1.00 by definition? |
...you know, this whole thing is becoming quite stupid because of stupid people who haven't got a clue what they're talking about!! :(:(
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It would be great except the weight and balance system on A330/A340 never worked properly, and I understand that nobody is flying it. |
HotDog:
a 747 Classic with RB211-524 D4 engines at SL +15deg. 330kgs, non de rated thrust takeoff speeds, Flaps 10: V1-150, VR-161, V2-173. 230kgs V1(VMCG)-142, VR-142, V2-159 I know, I know, everyone knows you meant 330tons. I just wanted to show to all the posting astronauts how easy it is to make a little typo ........ |
OK, the weights quoted from the performance manual pages are Tons. The presentation is as printed in the manual. Sorry I didn't clarify that in my post, I guess some people understood what I was talking about.:ok:
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I would have thought that any one with half a brain would know 1000kgs is a tonne! But, then again, most current airline pilots seem to have less than half a brain! This thread is rapidly becoming an embarrassment to our profession!
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The speeds would have been out by double figures, and a good airman should have noticed. There is no logic to the Speeds / Flap setting used... Even on 1 type, you cannot get a "feel" for what the figures should be. Try flying 3 or 4 variants, and much as I would like to be able to "gross error check" the figures, all you can do is type whatever the printer/computer spits out. Your control of the situation is checking the data input(s). Not safe or satisfactory IMHO, but we are just the employees at the end of the chain :oh: NoD |
Obie, I presume you are refering to my input on this thread? Anyone with half a brain and familiar with performance graphs would not be in any doubt about the weights quoted. Yes, some professionals are a bit of an embarrassment.:rolleyes:
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Quote:
"I would have thought that any one with half a brain would know 1000kgs is a tonne!" Agreed, but Hot Dog's missing 'k', or zeros (330kgs, 230kgs) shows how significant a typo can be. Sort of makes the point of this thread, I suppose... |
tuskegee airman made a very pertinent comment pertaining to the essence of this accident.
We are all human, and humans make mistakes. Aviation is about managing those mistakes so they don't become significant threats to flight safety. |
This tailstrike is remarkably similar to the SQ tailstike at AKL. The SQ pilots entered the ZFW in the TOW line of the FMC.As the fuel load was aprox 100 tonnes the end result was the same.First digit in the the TOW line was entered as 2 instead of 3.
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I wasn't actually referring to you Hotdog!
However, now that you mention it... why don't you stick to engineering and leave the flying up to us? :ok: |
Dear Obie
Desperate got the drift, you didn't. Embarrassing, isn't it, as you pointed out. |
Desperate "I would have thought that any one with half a brain would know 1000kgs is a tonne!" Agreed, but Hot Dog's missing 'k', or zeros (330kgs, 230kgs) shows how significant a typo can be. Sort of makes the point of this thread, I suppose... What next? Do we have to use the full word kilogram insted of kg or nautical miles per hour instead of knots, instead of kts...this could go on forever.:ugh::ugh: Please don't turn thread into pedantic ramblings and trivia...let those with something constructive to offer make their point without being picky on trivial points.:ok: +G |
It is not about picking on trivial points, far from it.
It is about all those self appointed astronauts who just can't/won't understand how a experienced crew could put in a 2 for a 3 and not detect it. In their contribution they then make similar typos, like nuatical .... or assumptions. To me it was clear that 330kgs meant 330'000kgs, but I would never generously round down even a widebody by 999kgs, so it is basically a error. Picking-up such typos is just what some discussions are about. I simply hate the kind of contribution like ".. they should really have picked it up. I fly 20 different types of boeingbusses, but I can smell a wrong Vspeed just by my professionalism .." - implementing this could never happen to them and the MEL crew was just a screw-up. That was my sarcastic drift, now back to serious theories .... |
Pool, I agree that these little typo's can lead to big mistakes...In an aircraft...on these threads can't we allow a few?
+G |
Earlier I proposed having the laptop software provide required braking distance from V1 and using that as a signpost, but Oakape ably pointed that a bad weight invalidates the braking distance.
An alternative is having the software show time to 80 kt. Assuming the software integrates thrust, acceleration and speed over time (as opposed to simply looking up static tables), time and distance to V1 are numbers the software must derive for a particular runway, weight, altitude, temperature, gradient, thrust setting, wind component etc. since the required runway length is the sum of distance to V1 plus the greater of braking distance for a V1 reject or distance to screen height without an engine plus required margins. On the way to V1, the software also derives the time and distance to 80 kt. If you don't have 80 kt. by the expected time, you are either over stated weight, under thrust, have a brake dragging etc. |
software
The problem is that certification standards won't allow full integration.
The FMS is driven by a 1970's 8086 processor that CAN'T do single point takeoff calculations. The class 1,2,3 on board that can are not allowed to push weights and V speeds into the FMS. Alltogether they are not allowed to talk to and synchronize with the weight and balance system on the ground . So it is the pilot's mark1 mod0 eyeball and brain to make sense of the lot and transpose takeoff data from one to the other. Its all about safety they say. But if banks (who are even more paranoid about safety) would think the same about a carbon based lifeform and safety in the loop, there wouldn't be any ATMs. Cash would still be delivered by the postman. The legislator must perform a 180 and allow the push of data into the FMS and if it is just for a plausibility check. (Okay pool... I am sure you ll find a reason to have a go at me again. Secretly I believe you are my ex-wife) |
RatherBeFlying...
Would that not require all airfields to install "distance markers" of some sort .... paint/post/signs .. Otherwise how do you know when you've reached this "critical acceleration point". More to the point what do you actually do ..... stop,go, more power and how do you arrive at the decision? To be truly effective surely it needs to be an "always stop" choice which then creates multiple stop decision points? |
I fail to understand with an airplane about to conduct a very long flight, that they could accept that the airplane was lighter than it was. 100 tons is a lot to loose and bells should have been ringing. From what I understand, every weights in MCDU and System Display were according to the load sheet and a TOW of 363 tonnes. All weight information presented to the crew by the airplane screens were correct and in total accordance with the W&B. The only mistake was to type in the Performance laptop a 2 instead of a 3, 263 instead of 363. Actually, VERY easy to do that kind of mistake. In my eyes, the best chance to catch that mistake was to question that extreme 74 degrees Celsius as a FLEX when you go for 14 hours with a full load ... I HOPE ??? I would have caught it ... By now, learning from their experience, I HOPE I would get it. |
Obie your comment was too cryptic for me. Were you talking about my remark re EPR 1.14?
If so, please explain? In return, my take; was once they had dealt with all the crap before start (tiredness, company procs, distractions etc) and were taxying, that there was only one chance for them (and in future any of us all) to recognise the bullsh1t, and that was to ask the simple question - "doesn't an EPR of 1.14 a look little low tonight, given that we are departing for 15 hours at 10t below MTOW??" Even if they had recognised this at the point of setting thrust on takeoff and gone TOGA, yes - it may have still been a tailscrape, but that would have been on the runway, and as an incident would have died a natural death many pages ago. |
Just a suggestion :O
When the fuel figures are sent back by acars, additional info of Rwy in use/OAT/Surface wind could easily allow some gross error check figures to be added to the loadsheet. In fact, they could relatively easily add the whole set of figures which would be even better. However, in the interests of time/money etc, a flex and green dot would suffice. It shouldn't be difficult to do, they have the software already. If some rocket surgeon posted this weeks ago, my apologies, too much to read now. :) |
Would that not require all airfields to install "distance markers" of some sort .... paint/post/signs .. |
MM5.5, I agree with having the FMS do these calculations -- if only we can get the certification authorities to get their heads around it.
In fact, it seems that laptops with manufacturer sanctioned software is an end run about the certification bureaucratic hoops involved with putting these capabilities into FMS. Introduction of laptops into cockpit performance calculations seems to have increased the proliferation of information sources already populated with FMS, performance charts and ACARs -- and has introduced more ways to get things wrong as we have also seen with MK in Halifax. If the crew is expected to dash off a quick critical calculation in a compressed timeframe, they need a straightforward SOP that perhaps excludes unneeded bodies / distractions in the cockpit while this is being done. 42psi, both time and distance to 80 kt. (or other speed if necessary) are equally valid for performance monitoring, but I don't think we will see distance boards put up anytime soon and stopwatches are readily available. |
The latest 'Flight International' which has just dropped in to my 'inbox' has a half page article on the incident, most interestingly citing Emirates now introducing a second laptop on the flight deck, to perform independent performance calculations. Obviously their SOP was not to have two laptops.
My point exactly, as per my previous post! |
The latest 'Flight International' has a half page article on the incident, most interestingly citing Emirates now introducing a second laptop on the flight deck to perform independent performance calculations. My point exactly, as per my previous post! Then you have two completely separate, independent data sources for v figures. |
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