PPRuNe Forums

PPRuNe Forums (https://www.pprune.org/)
-   Safety, CRM, QA & Emergency Response Planning (https://www.pprune.org/safety-crm-qa-emergency-response-planning-93/)
-   -   Polish Presidential Flight Crash Thread (https://www.pprune.org/safety-crm-qa-emergency-response-planning/415657-polish-presidential-flight-crash-thread.html)

LGW Vulture 19th May 2010 09:16

Polish Presidential Flight Crash Thread
 
BBC Reporting non-flight crew members on flight deck just before accident.

BBC News - Non-crew in cockpit in Polish president's plane crash

Fox3WheresMyBanana 19th May 2010 10:38

:=As I, and a number of others have said, Let's wait for the audio. I still think that will make any speculation unnecessary. Wouldn't be at all surprised to find, though, that the Non-Crewie On Flight Deck's hat had a lot of scrambled egg on it, or was ADC to same relaying orders.

HEATHROW DIRECTOR 19th May 2010 10:45

Not sure why there should appear to be anything unusual. I have been on the flight-deck of several airliners, along with other non-crew members, several times so it could be totally innocent.

Ptkay 19th May 2010 10:47

PAP (Polish Press Agency) suggests that the person was the Chef of PAF, Gen. Blasik himself, also a pilot.

In relation to this it is very interesting, that his deputy, Gen. Zaleski,
acting Chief of PAF since the accident, resigned yesterday.

Did he know, what was to be published today?

BBC:

Shortly after the crash, there was speculation that passengers may have put pressure on the crew to land in Smolensk, though Polish officials said at the time that there was no evidence to substantiate such claims.

On Wednesday, the head of the inter-state air committee, Tatyana Anodina, said the investigation had established "in the cockpit there were individuals who were not members of the crew".


Was the "back seat driver" performing the landing...??

ekw 19th May 2010 11:05

"The voice of one of them has been identified exactly"

That could be double speak for "it was the President's voice". His is probably the only voice that could be recognised without voice analysis.

And he does have 'previous' for this.

Ptkay 19th May 2010 11:15

Official MAK web page preliminary report:

Google translated:

Click "Information" then "News", May 19th

Google Tłumacz

Ptkay 19th May 2010 11:18

Images from the official MAK report
 
http://www.mak.ru/russian/info/news/...m_101_pic1.jpg

http://www.mak.ru/russian/info/news/...m_101_pic2.jpg

http://www.mak.ru/russian/info/news/...m_101_pic3.jpg

Ptkay 19th May 2010 11:32

Two most important aspects quoted from the report::

"Trial approach"

"a. At the request of the crew they carried out their "trial" approach to decision height (100 meters).
b. ATC informed the crew after the third that from 100 meters they must be prepared to perform a go-around."


Autopilot on.

"a. The glide path was performed on automatic pilot in the longitudinal and lateral channels, as well as with the automatic thrust. Turning off the autopilot in a longitudinal canal and automatic thrust occurred while trying to do a go-around 5 and 4 seconds respectively before the collision with an obstacle (tree), which led to the beginning of the destruction of aircraft structure. Turning off the autopilot in the lateral channel occurred at the time of the third collision with obstacles, which led to the beginning of the destruction of the structure."

Landing on AP with no ILS and just GPS and altimeter ??? :sad:

I can't believe it!

Fake Sealion 19th May 2010 11:36

Without the benefit of translation, but do the pictures in image #2 of the previous post indicate the aircraft rolled through 90 left, hit the trees and and continued rolling until it impacted inverted?

Ptkay 19th May 2010 11:47


Without the benefit of translation, but do the pictures in image #2 of the previous post indicate the aircraft rolled through 90 left, hit the trees and and continued rolling until it impacted inverted?
Yes, indeed.

Feathers McGraw 19th May 2010 11:50

The photo sequence would seem to indicate collision with one tree, resulting in left roll, then further tree impacts at near 90 degree left bank and continuing roll to inverted before final impact. Tu-154 has l/e devices doesn't it? Damage to one would reduce lift on that wing...

Ptkay 19th May 2010 11:50

They didn't react to the warnings, just looked outside the windows,
probably all of them, the AP was flying...

b.The first warning by the TAW system of type PULL UP was 18 seconds before the collision with an obstacle, which led to the early destruction of the aircraft structure. Prior to this, double message of type TERRAIN AHEAD was issued.

vovachan 19th May 2010 12:33

I am going to go out on a limb here and blame the flyby. Is it even a normal procedure? The thing is they were not actually coming in for a landing, they were just going to take a peek... no big deal!

Is this a procedure that is trained for, in terms of who is doing what? Because I agree with the previous poster - it sounds like they were on autopilot the whole time, just along for the ride.

Fake Sealion 19th May 2010 13:27


Autopilot on.

"a. The glide path was performed on automatic pilot in the longitudinal and lateral channels, as well as with the automatic thrust. Turning off the autopilot in a longitudinal canal and automatic thrust occurred while trying to do a go-around 5 and 4 seconds respectively before the collision with an obstacle (tree), which led to the beginning of the destruction of aircraft structure. Turning off the autopilot in the lateral channel occurred at the time of the third collision with obstacles, which led to the beginning of the destruction of the structure."

Landing on AP with no ILS and just GPS and altimeter ???

I can't believe it!
If there was no ILS available how would attempting an approach under AP assist them over and above a hand flown approach to MDA. Is this another altimeter setting error issue and/or was someone on the flightdeck reading the non-barometric GPS altitude info ie above sea level.

vovachan 19th May 2010 14:16

Several question immediately arise.

- Captain=530 hrs on type, FO=160 hrs, Nav = 30 hrs, FE=235 hrs. Isn't this a bit too low, even by Colgan Air standards?

- They were performing a "test" approach to 100m. What the hell is a test approach?

- It sounds like there were at least 3 VIPs in the cockpit. How do you even fit 3 fat guys into a Tu154 cockpit??

mikeepbc 19th May 2010 14:40

Regarding pax in the cockpit, according to the Polish representative accredited to the Commission, they are heard on the CVR tape between 20 and 16 minutes before the crash. Nobody says they were sitting inside. The cockpit door remained open.

mikeepbc 19th May 2010 15:34

I wonder if the Tu-154 AP/autothrottle use the RA data in such a situation... Anyone knows?

MartinS 19th May 2010 16:09

Further bits of info from an article in Polish:
- TU-154 had 19 tons of fuel at departure from Warsaw
- one of the voices unofficially identified in the cockpit at 20 to 16 minutes before crash is that of General Andrzej Blasik, PAF chief
- 4 minutes before the crash the crew of JAK-40 aircraft on the ground in Smolensk informed the crew of the Tu-154 that visibility on the ground is 200m
- TAWS "PULL UP" is heard at 18 seconds before the crash

Does the TAWS command indicate they were not planning to land the plane? Would TAWS warnings be inhibited if the aircraft was configured for landing?

Dowódca si? powietrznych by? w kabinie Tu-154? - Wiadomo?ci - WP.PL

Checkboard 19th May 2010 18:35

A missed approach from the minima only has a designed terrain clearance of 100 feet. The clearance is allowed to be this low as it is classified as a "rare event". Common events require higher clearances to allow for variation in flying technique and standards. Because this is recognised as a less safe manoeuvre, most of Europe has some form of approach ban in order to prevent flying the approach to the minima with the probable expectation of then having to perform a low level missed approach.

Ptkay 19th May 2010 18:37

The unfortunate closing of the other thread has resulted
in scaring away our Russian friends, so helpful until now.

We need their comments and translations from the other forums
to understand many things.

For example, how the AP works on Tu-154?

Anybody any comment?

brak 19th May 2010 18:56

FWIF, another link to automatic Google translation of the report:
Google Translate

Here is the part that really made me wonder:
"Group 1: The overall level of flight operations and training of crew members of the Tu-154M in the 36th Regiment Air Force Republic of Poland
a. The unit does not maintain detailed training program for flight crews. Regular periodic training on the simulator to practice skills of crew interaction and technology, including special situations in flight, are not carried out;
b. The unit does not maintain a manual for interaction and operation of the crew members for the 4-member crew. Flights are carried out directly using the Aeroplane Flight Manual for aircraft, designed for minimum crew, ie 3 persons (without navigator)."

mary meagher 19th May 2010 22:05

Ptkay, post 21
 
Your request has been passed on to our Russian friend Alice 025.

Hope she can help.

Pugilistic Animus 19th May 2010 23:07


Captain=530 hrs on type, FO=160 hrs, Nav = 30 hrs, FE=235 hrs. Isn't this a bit too low, even by Colgan Air standards?
Military:cool:

in the airmail days a seasoned veteran had 200hrs...but the selection process was more natural:E

aterpster 19th May 2010 23:26

checkboard:

A missed approach from the minima only has a designed terrain clearance of 100 feet. The clearance is allowed to be this low as it is classified as a "rare event". Common events require higher clearances to allow for variation in flying technique and standards. Because this is recognised as a less safe manoeuvre, most of Europe has some form of approach ban in order to prevent flying the approach to the minima with the probable expectation of then having to perform a low level missed approach.
Are you speaking of Russian criteria that does not meet PANS-OPS criteria and specifications?

Alice025 19th May 2010 23:47

Ptkay, this is text in Russian for you to google into English, describing how CAY-154-2 works. "Simply saying, System of Automated Piloting 154-2 is an autopilot, providing stabilisation of the airplane by the channels of crane and tangage. These channels are independent. Can work in different regimes/modes. It is possible to have automated piloting by one channel - and hand piloting by the other. Depending on the regime/mode switched on the system provides: " - see there a list.

??????????.?? | ????-154-2

PS Hello everybody :o), I got a call to be back and translate a bit where needed :o)

gwillie 20th May 2010 00:45

Is there a better alternative to Google Translate?

This does not exactly inspire confidence:

Unit 3 Preparing the aircraft for flight

a. a. Самолет перед вылетом был полностью исправен. The plane before the flight was completely defective....
Google Tłumacz

oleczek 20th May 2010 01:44

This is what you get for depending on Google translator. It completely reversed sense of the statement. It (the statement) actually means that the plane was fully functional.

Olek

mikeepbc 20th May 2010 04:33


A missed approach from the minima only has a designed terrain clearance of 100 feet.
100 metres -- they still don't use feet in Russia (and most coutries of the former Soviet Union).

Ptkay 20th May 2010 07:57


PS Hello everybody :o), I got a call to be back and translate a bit where needed :o)
Alice.

Thanks a lot.

Nice to see you again. :ok:

jsypilot 20th May 2010 09:08

Thanks for new thread
 
Surprised by the BBC news item yesterday, I was very pleased to see that this thread was started. Thanks to all participants.

Ptkay 20th May 2010 09:38

My attempt to translet the crucial part of the above "Commersant" article part:

"According to Russian experts, the main cause of the accident were the mistakes of the Polish pilots who committed them when landing. The first was to start the approach to inaccurate navigation system, a/c in autopilot mode, which was categorically wrong. Set the machine to the beginning of the glide path, for which, according to his calculations, aircraft had to descent, the commander set the autopilot V mode to descent speed of 4 m / s and started landing, assuming that at these parameters chassis touch the ground at the beginning of the strip. Meanwhile, the navigator was checking the altitude of the aircraft by radio altimeter - a device which determines the distance to the ground by radio signal reflected from it. Fatal role in the crash, according to experts, played a rather flat and a long valley with depth of about 40 m, located across the glide path, and the inexperience of the navigator. When the plane was flying above the bottom of the valley and the ground began to go down, navigator panicked and began to constantly tell the commander that they are above the glide path and do not descent. The commander, in turn, trusted his subordinate and increased - doubled - the vertical rate of descent - up to 8 m / sec. Valley under the glide path in the meantime was over, replaced by a prolonged rise of the hill, and the pilots forgot to increase the vertical velocity.

The crew, according to experts, tired as soon as possible to catch a glimpse under the fog to see the ground - but the ground, meanwhile, rushed towards them. To get the crew out of the fast descent, the ATC was shouting the pilots "one hundred first, the horizon!!" (101-flight number, immediately stop the decline and change in level flight .-" editior "), and the system TAWS, was heard in the audio recording of the cockpit with the phrase" Pull up ! ". However, the crew was busy with a visual search of ground and no one has listened. They pulled up only after seeing the birch straight ahead, but it was already too late.

It should be noted that the Polish side does not agree with this position. According to Polish experts, the ATC command "One hundred first horizon!" sounded too late, when the plane had dropped below one hundred meters decision height. Russian experts suggest, however, that the ATC simply could not keep track of the radar screen label due to too great rate of descent of the aircraft."


If the FDR will confirm the inputs of the PF to the AP, mentioned above, then the are few questions left...

Alice025 20th May 2010 10:22

Sure, but Kommersant is still just a newspaper. The main news is MAK investigation committee first press-conference held 10 am yesterday, and their fact-sheet/press-release.

They didn't say it all, say, 1/3. Records of the talk in the flight desk are NOT released. Records and photo-material of the equipment and how it was sued and the talk in the control tower are NOT released. The route by which the plane approached the aerodrome, the parameters of the glissade, and how the plane set into it - are NOT released.
Reason for crash is NOT identified, no conclusions drawn.

Just, separate facts, some intermediate investigation results, were given.
Still, something.

The Smolesnk blog also livened up and is buzzing checking how the MAK fact sheet fits the previous data gathered on the ground.

Currently the discussion centers re how automated piloting TU154 system is compatible with UNS-1D (because fact sheet said UNS-1D was functioning throughout, this is news for Russians) - and what possibly it could be when both are installed.
The main news seems to be this automated piloting on which they were landing.

Re TAWS all seems reasonable it began to scream when the plane was above the hill-top in approach to the runway, on the other side of the big hole in the terrain. 1,100 metres away from the tree touch. First TAWS screamed (above the hilltop) then it was quiet (the plane was hoovering over the hole in the ground) - the crew must have thought they gained height, all is OK, while in fact under them was a temporarily short abbyss/hole in the ground, along their approach to the aerodrome. Then TAWS began to speak again, when the other side of the hole began growing up, the plane was approaching the other side of the hole, the 2nd hill.

Alice025 20th May 2010 10:27

MAK didn't say either when the 2+ additional people in the pilot's cabin left it, and did they. That additional people entered the cabin, 2 for sure may be more, - but did they leave it - this is not said.

Interflug 20th May 2010 11:05


"According to Russian experts, the main cause of the accident were the mistakes of the Polish pilots who committed them when landing. The first was to start the approach to inaccurate navigation system, a/c in autopilot mode, which was categorically wrong. Set the machine to the beginning of the glide path, for which, according to his calculations, aircraft had to descent, the commander set the autopilot V mode to descent speed of 4 m / s and started landing, assuming that at these parameters chassis touch the ground at the beginning of the strip. Meanwhile, the navigator was checking the altitude of the aircraft by radio altimeter - a device which determines the distance to the ground by radio signal reflected from it. Fatal role in the crash, according to experts, played a rather flat and a long valley with depth of about 40 m, located across the glide path, and the inexperience of the navigator. When the plane was flying above the bottom of the valley and the ground began to go down, navigator panicked and began to constantly tell the commander that they are above the glide path and do not descent. The commander, in turn, trusted his subordinate and increased - doubled - the vertical rate of descent - up to 8 m / sec. Valley under the glide path in the meantime was over, replaced by a prolonged rise of the hill, and the pilots forgot to increase the vertical velocity...


If this is indeed what happened, then we don't need to talk about the crash anymore but what makes pilots play Russian Roulette with all except one chamber full of bullets
while being trusted with the lifes of 100 people. Even if you are pressured to land in bad conditions, is this how you exercise basic airmanship?

The navigator shouting that the plane did not descent, while in fact the terrain was dropping, was inexperienced? For Gods sake, you are not supposed to make such a mistake after being a certified navigator with even zero hours of practical experience yet.

The pilot did not look at his altimeter and vertical speed indicator, to cross check if they were actually descending? Hard to imagine...

Alice025 20th May 2010 13:00

I will translate MAC fact sheet, may be not all at once.

Of established facts and circumstances of the catastrophe of TU-154

Material given is factual information, received in the course of investigation, conducted by the technical MAK committee together with the Appointed Representative of the Republic of Poland and a large group of Polish experts, who used various sources incl. ground and on-board means of objective control, as well as flight and technical documentation.
Should new documentation data follow and be analysed, the material below will be made more full.
The material below and its separate parts are not the analysis of the reasons of the aviation incident, is not aimed at establishing a share of someone's guilt or area of responsibilty, and therefore should not be interpreted as such.
For the convenience of perception the established facts are grouped into groups. All time marks are given in tying with the local Smolensk time which is congruent with Moscow time. Time of Warsaw is 2 hrs in delay.

Group 1: General level of flying work organisation and preparation of the members of the crews of TU-154M in the 36th Regimennt of Air Force of the Republic of Poland.

a. In the division is absent a detailed programme of preparation of the flying staff. Regular periodic trainins in the simulator for the rehearsing the skills of mutual interaction and technology of the crew work, including special occasions during a flight, are not conducted;

(note - from me. the Polish commander said there aren't simply simulators with them for flying TU-154 or TU154M. if they had in the first place - they would train.)

b. In the division is absent an Instruction on mutual interaction and technology of work of the crew members in the 4-member crew set. Flights are conducted by using directly the RLE ? of the airplane, developed for the minimum crew q-ty, that is 3 people (without a navigator).

Group 2 Forming of the crew and their preparation to the flight on 10 April 2010.

a. The crew was formed several days prior to the flight in the set of the KVS (Kommander of the Air Vessel), second pilot, "shturman" (navigator) and board-engineer. Total flight time and self-conducted flight time on TU154M in this particular capacity
for the KVS: total - 3,480 hrs approx., in TU154M - 530 hrs approx.
Second pilot: total - 1,900 hrs, in TU154M - 160 hrs
Shturman (navigator): total -1,070 hrs, in TU154M - 30 hrs
Board-engineer: total 290 hrs, in TU154M - 235 hrs.

b. In the process of the pre-flight preparation the crew received under their signature meteo-data which included: factual weather and forecast for the airport of departure, factual data and forecast for the spare aerodromes. factual weather and forecast for the flight route.
Factual weather and forecast for the aerodrome of destination Smolensk-Northern the crew had not (note from me - HAD NOT).

c. Actual/meaningful aero-navigation data on the aerodrome of destination Smolesnk-Northern, including acting NOTAM ?, the crew had not (note from me HAD NOT).

(???? what did it have.)

Ptkay 20th May 2010 13:03


The navigator shouting that the plane did not descent, while in fact the terrain was dropping, was inexperienced?
Navigator had just 30 h on type. :eek:

On top of that, where could he get the information from,
that the terrain was dropping before the runway,
when the MAK report says:

c. The crew did not have current aeronautical data for the destination aerodrome Smolensk "North", including the existing NOTAMs .

Alice025 20th May 2010 13:27

Group 3 Airplane preparedness to the flight

a. The plane before the take off was fully operative.(OK)
The filling of fuel was about 19 tons which was enough for the flight on the given route, taking the spare aerodromes as selected into account. Analysis of the fuel showed that on the physical-chemical composition there are no notes/comments overall (from me, a careful phrase, means "looks like alright").
Take-off mass and centering did not go beyond the limis set by RLE.

(from me - again RLE. Looks like it's a manual attached by the factory to the plane they make)

b. The plane was equipped with te system of early warning of ground nearing TAWS and a system of flight operation UNS-1D (FMS). Both systems, TWS and FMS were switched on during the flight and working/operative (OK and worked).

Group 4 Aerodrome preparedness to the flight

a. 16 March 2010 a pecial commission of Russian experts performed a technical flight with the aim of establishing the preparedness of the aerodrome to meeting Air Force TU-154 and TU-134. By the analysisi of the results of the works conducted there was made a general conclusion that the aerodrome is fit to accept the above-mentioned types of Air Force (of Russia, presumambly - from me), but with taking in account a row of Recommdendations, incl. proper condition of radio-technocal equipment used and light-signal equipment used at the course of landing of 259 degrees.

??

b. 25 March 2010 were conducted control flights of all equipment and systems of the aerodrome. (may be, the fixed something btw 18 and 26th March that the commission found un-fitting. from me.)

By the results of the controls was made the overall conclusion that the parameters and exactness characteristics of the landing radio-locator, Far and Near Beakons ("in-bringing radio stations") with Markers, light-signal equipment and radio-stations complies with the demands of the state aviation of Russia and are fit for providing for the flights.

Means for performing automated or directive go for the landings respectively the Smolensk-Northern aerodrome has not.

c. 5 April 2010 was signed Act of Technical Survey of the aerodrome Smolesnk-Northern for accepting special flights.
Overall conclusion of the Act: the aerodrome is ready for accepting special flights at the condition of the established minimum of the weather. The Table of the established Minimum-s for MKpos 259 degrees (MKpos?) and categories "B" and "D" (Yak-40 and TU-154) requires the go for landing at the weather minimum of 100x1,000 m.

d. 10 April 2010, according the Report of the Responsible Specialist, in the time period 7am-8am, at conductiong the pre-flight check-up of the light-technical equipment, it were fit and workable.
Immediately after the catastrophe of the TU-154 there was no possibility to check the workability of the lighttechnical equipment due to the high intensivity of the in-coming flights up to 5pm on the 11th April 2010 (from me - they didn't check until the next day evening)
Comments on the work of the light-technical equipment of the aerodrome from the side of the crews arriving to the aerodrome on the 10th and 11th of April the Technical commission received not (from me - nobody complained)
(kind of vague and careful, about lights)

Ptkay 20th May 2010 13:33


Alice translation:
b. In the division is absent an Instruction on mutual interaction and technology of work of the crew members in the 4-member crew set. Flights are conducted by using directly the RLE ? of the airplane, developed for the minimum crew q-ty, that is 3 people (without a navigator).

(from me - again RLE. Looks like it's a manual attached by the factory to the plane they make)
So, the navigator didn't have clear written instruction, what he is
supposed to do?

The CRM in this case was an absolute disaster. :(

Alice025 20th May 2010 13:38

-interruption -
There was a leak to the Polish media from "knowledgeable sources" present at black boxes recordings played. The man commented that overall, the atmosphere in the pilots' cabin was quite cheerful and relaxed, talks on private matters and on general matters, until the last seconds of the flight when the hell so to say suddenly broke out.

The pilots in the Smolesnk blog all found the leak very weird and imporable, as they find that there was absolutely nothing to be "cheerful and relaxed" about, in approach to Smolesnk-Northern, given the very minimalistic areodrome equipment, tricky terrain in approach and the awful fog. But, to the opposite, every man who wanted to live would be in quite, how to say, all hands on deck mode, in full concentration, close to alarm.

Alice025 20th May 2010 14:06

Ptkay, what there was there was. Somehow they were flying before, even to Haiti. Though I don't know with navigator or without. Must be before - to better equipped aerodromes. And even to this very Smolensk one - as well!

Group 5 Conducting the flight before entering the zone of responsibility of the Smolensk-Northern aerodrome.

a. Flight out from Warsaw was performed at 9:27, with a delay of 27 minutes to the already changed flight time (9:00). Previously the flight was planned for 08:30.

b. The flight was going through the territories of three states: Poland, Belarus and Russia. Echelon of flight 10,000 metres approximately.

Radio-talks with the despatchers of Minsk and Moscow were conducted in English, with the despatcher of Smolesnk-Northern - in Russian.

(what did they talk with Moscow about?) (Moscow must have been their spare aerodrome?, on top of Minsk)

Group 6 On informing the crew of the weather in the aerodrome of destination as worse than the established minimum.

a. During the flight, the crew was repeatedly informed of this by the despatchers from Minsk, Smolensk, as well as by the Yak-40 crew of the Air Force of Poland, who conducted landing in Smolesnk-Northern at 9:15, which is approximately 1hr 30 minutes before the catastrophe:

- at 27 min approx. before the catastrophe, when the plane in lowering mode was crossing the height of 7,500 metres, despatcher of Minsk-Kontrol informed the crew that in their aerodrome of destination is fog, visibility 400 metres.

- At establishing connection with the aerodrome Smolensk-Northern the crew twice received the info from them that in the aerodrome is fog, visibility 400 metres, conditions for accepting them - there are not.

- At the same time approximately (16 minutes before the catastrophe), from the crew of Yak-40 of the Republic of Poland Air Force, the crew of TU-154 received information about visibility 400 metres and vertical visibility of 50 metres

- At about 11 minutes before the catastrophe the crew of Yak-40 informed the crew of Tu-154 that the crew of the Russian IL-76 performed two "go-s" (at it) and left for the spare aerodrome.

- 4 minutes before the catastrophe the crew of Yak-40 informed that their own estimation of visibility is 200 metres.


All times are GMT. The time now is 07:37.


Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.