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Aviation Fatigue Regulation should Obey the Law of Common Sense

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    Automated Cockpit Props up Undertrained Pilots

    The Asiana investigation continues.

    Back in July, the pilot who was insecure about making a visual approach in a 777 crashed at San Francisco International Airport on a visual approach in Asiana Flight 214’s Boeing 777. Specifically, he told NTSB investigators “it was very difficult to perform a visual approach with a heavy airplane.” The glideslope was not working at the San Francisco airport, and that was an instrument the (*undertrained) pilot was relying on. The plane came in so low the tail struck the seawall and broke off. The video below shows the plane rotate 360 degrees and catch fire by the runway.

    New Asiana Crash Video

    Video with news commentary

    Before impact, the relief pilot in the jump seat repeated several times “sink rate” trying to warn the pilots at the controls that the jet was too quickly losing altitude. One of the pilots said “It’s low.” Then there was a stick shaker alert (which occurs when the plane is about to stall from flying too slowly. I once had a pilot do a presentation that included the disturbing grinding of the stick shaker alarm as it violently vibrated the control yoke. It’s an alarming direction to the pilots to increase thrust.)

    When the stick shaker went off, the instructor called for a go around. It went off four seconds before impact. It was too late.

    Both the instructor and the captain were relying on the auto throttle, and both were unaware it was off.

    In George’s Point of View

    I do not know how anyone can watch the surveillance video of the Asiana crash and not marvel that of the three hundred and seven people aboard the plane, there were only three deaths.

    I’m not discounting the wounds of the injured, nor those three deaths, nor the tragedy of one of the teen victims being run over by an airport crash tender. (That’s a whole tragedy by itself—who knows if she might have survived but for being so obscured by foam that she was not visible to crash responders—through the firemen who carried her out surely must have known she was there.)

    A dozen critically injured, a hundred-sixty-nine injured, but only three deaths.

    It’s nothing short of a miracle. Especially on inspecting the condition of the burned out shell of the hull. Especially on reviewing the just-released surveillance video that shows the plane splintering after impacting the firewall, cartwheeling like a crippled gymnast down the runway and dissolving into a cloud of dust and flame. No jet fuel fire here——leaking oil ignited as it poured on to a hot engine.

    The Kazan crash (Tatarstan Airlines Flight 363) from November 17th is fresh in my mind. Everyone aboard–fifty people (forty-four passengers and six crew) all died. The plane just fell from the sky while landing at an impossible 75-degree-nose-down attitude, piloted by a pilot whose license is apparently fake. Everyone in that crash died. (Tatarstan surveillance below.)

    Of course one can see the physics—that everyone on the Tatarstan flight received the full direct impact, versus how the rolling of the Asiana plane dispersed some of the impact energy. Still, there is tremendous force in a crash.

    I know I should be talking about pilot training, because this is yet another crash that appears to be due to pilots becoming too dependent on technology. But I will focus on that another day. Right now, I am overwhelmed after looking at the crash tape.

    Asiana—Cartwheeling Catastrophe
    I am surprised that I have neither heard or seen choruses of amazement that all but three people survived the rolling catastrophe in San Francisco. Some credit should perhaps go to the rescue crew, quick actions of the cabin crew, performance of the emergency slides, and maybe even the aerodynamics of the 777 whose seats are required to withstand 16g of dynamic force.

    Sure, there was error involved in this crash, but when you look at the survival rate, some credit is due to the 5.5 billion Boeing put into research, development and safety of the 777.

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    Coming together to Counter Airport Insecurity

    airport baggage scanner

    The current state of things requires us to be vigilant anywhere we go these days. I have been thinking of a starting an ongoing conversation regarding safety. I am troubled by Esteban Santiago’s Fort Lauderdale-Hollywood International Airport attack on Friday afternoon. Any traveler who puts as many miles as I do on a plane is bound to be as troubled. We should try to find suggestions, and solutions, and speak out.  

    Here’s what I’m thinking: Federal laws allow you to check-in handguns, rifles and ammunition.  I’ve been thinking there’s a literal bandaid that would help—a red banner or flag or something that sticks on the luggage that states LEGAL FIREARM INSIDE. As a consequence, if we see this banner on the carousel, we are informed. We know to be vigilant, without having to be vigilante.  

    If baggage claim areas have armed guards, that would be another step. They can’t do it all and it will take time to implement.  My banner idea can be implemented immediately.  If individuals are uncomfortable having such a banner, then they should rethink shipping their weapons out ahead of their travel as cargo or something.  

    What possible, realistic solutions do you have?

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    ATR De-Icing


    Ice is the friend of no plane.

    But there was no excuse for the icing problem on the UTAir flight that we are calling the Tyumen crash.

    On that flight, both Pratt & Whitney Canada PW124 engines were operating till impact. The plane reached 690 feet and banked 35 degrees to the right, then rolled left banking at 50 degrees, demonstrating instability in the roll axis. Why? Ice.

    The ATR 72 had a decent safety record until the 1993 icing incident that caused a fatal crash. This problem was handled by Avions de Transport Regional, the planes designers, by adapting the icing characteristics of the aircraft. They added icing boot extensions to the wing leading edges. (A deicing boot is a ice protection system installed on aircraft surfaces to permit a mechanical deicing in flight.)

    The UTAIr 72 was not de-iced at Tyumen before the fatal flight. There’s not much benefit to adding a safety feature if it is ignored.

    The ATR 72-210 is equipped with PW 127 engines with a maximum certified takeoff rating of 2750 SHP, and a normal power rating of 2475 SHP. The ATR 72 employs a four bladed propeller. The engine has a reduction gearbox assembly . Because the ATR 72-210 is “stretched” ( much longer than the 42s) ATR 42 pilots are warned about taking off an ATR 72 with too excessive a takeoff pitch angle, which would cause the tail would strike the runway. The ATR 72 has a maximum takeoff weight of 47,465 lbs., and carries 11,020 lbs. of fuel. The engine noise and vibration from the props can get uncomfortable.

    Most pilots would not need to be reminded that de-icing is essential when the conditions for ice are likely.

    The NTSB has investigated fifty icing accidents and 202 fatalities from 1998 to 2007. We might be able to conjecture that at least some of these incidents would not have happened if the planes had been properly de-iced to begin with, though for some this is too simplistic an assumption.

    There were fatal consequences to ATRs which ignored de-icing as demonstrated by the UTair ATR 72 that crashed after taking off from Tyumen in Siberia, killing 31 and mangling 12.

    After the disaster, UTAir said that all UTAir planes would henceforth have mandatory de-icing, a change from allowing the pilot to decide whether or not to deice.

    Icing has also been determined as the as cause of two earlier fatal ATR 72 crashes:

    • -Aerocaribbean Flight 883 crashed near Sancti Spiritus November 2010 killing 68 when the plane encountered extreme meteorological conditions that caused it to ice up at 6,100 meters.
    • -American Eagle Flight 4184 crashed killing 68 when in a holding pattern over Chicago encountering a supercooled cloud and rain causing ice which had built up on the wings.

    Icing can take place in a temperature band from minus 12 to plus 4 Celsius.

    We have seen a dozen ATR 72 accidents caused by other events:

    • July 2011-The Eurolot ATR 72 collided with a baggage truck in Warszawa-Frédéric Chopin Airport in Poland.
    • Nov 2009-The Kingfisher ATR 72 skidded off the runway on landing at Mumbai-Chhatrapati Shivaji International Airport in India.
    • August 2009-The Bangkok Airways ATR 72 that skidded off the runway and struck the Koh Samui Airport ATC tower in Thailand.
    • Feb 2008-The Air Bagan ATR 72 that skidded off the runway on takeoff from Putao Airport in Myanmar.
    • July 2007-The Jet Airways ATR 72 made a heavy landing before the mid-point of the runway and bounced a couple of times before going off the runway at Indore Airport, India.
    • March 2006-The Air Deccan ATR 72 that made a landing at Bangalore Airport that was so hard, the new plane had to be sold as spare parts.
    • Aug 2005-The Tuninter ATR 72 ran out of fuel, both engines quit and the plane ditched in the sea killing 16.
    • March 2004-The American Eagle ATR 72 that made a bounced landing before skidded off the runway injuring 13 while landing at Luis Munoz International Airport, Puerto Rico.
    • Dec 2002-The Transasia Airways cargo flight that crashed into the ocean killing 2 crew.
    • Jan 1995-The cargo ATR 72 that crashed in Taiwan killing 4 crew.
    • Dec 1994-The Air Gabon ATR 72 skidded off the runway and struck trees while landing at Oyem Airport.
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    Remembering Air Blue Flight 202: July 28


    In George’s Point of View


    Sometimes all we do is listen. We listen to the families speak of their loved ones, listen to the little ones cry, the child who loves snowflakes because that is what her father called her. The wife and children with no means of support and feeding themselves with empty spoons. Knowing that no matter what we do, we cannot bring them back, nor fill that empty place. Still we do what we can on behalf of the families.

    This will be the first July 28 in history when these 152 people will not be living on this earth. We want to remember these people who lost their lives in such a tragic and unnecessary way. They deserve to be remembered.

    Some remember those who are no longer with us by using symbols. Memorials like the one promised. There are other symbols, like the bird in flight that symbolizes a soul, or a chain with a broken link.

    There is a tradition dating back to ancient times of placing rosemary by the graves of loved ones. “There’s rosemary, that’s for remembrance; pray, love, remember;” Hamlet, (V.iv.124)

    I was going to talk about more ways that people remember, but I must pause here. In ancient times they put rosemary by the graves of loved ones. Some people still do. But we cannot lay sprigs of rosemary for remembrance at the feet of our loved ones, because there are families still waiting for a memorial promised before the first anniversary of the crash. Waiting a year to lay their flowers and their grief.

    Instead of a bouquet of flowers, we have a bouquet of broken promises. Shall we count them?

    A broken promise to share the final investigative report.
    A broken promise over the Monument at the crash site (they want it elsewhere); and a broken promise over the 72 unmarked graves.
    A broken promise over Airblue being grounded for negligence, malpractice, manslaughter.
    A broken promise to assist the families.
    Or maybe we can call this a pending promise, as we wait for an independent inquiry board and a pending promise of greater safety in the skies over Pakistan.
    We have our Rosemary for remembrance, but it is bittersweet.

    CDA is constructing a memorial for the Air Blue Flight 202 just a few miles from Damn-e-Koh, Islamabad
    CDA is constructing a memorial for the Air Blue Flight 202 just a few miles from Damn-e-Koh, Islamabad
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  • Nothing Happened in Nashville…

    Remember the story of the boy who cried wolf? In the days when people’s lives depended on their herds, someone had to be there to watch over them. So our boy had the watch, and got tired, or was mischievous, or maybe he fell asleep, or was just plain old bored. Whatever the reason, he claimed to see a wolf when there wasn’t one. So the whole town went into overdrive emergency mode, and turned out in full force to protect the herd. But of course, there was no wolf. Everyone breathed a sigh of relief, patted the boy on the back sympathetically, and went back to what they were doing. Everything got back to normal. After a time, the boy, for whatever the reason, got bored again, or tired, or mischievous. Maybe he liked all that energy or attention he got the first time he’d cried wolf. Whatever the reason, he did it again. And of course the town rose up into emergency overdrive again, bringing swords and pickaxes and plowshares and whatnot, but of course, there was no wolf. So when the townspeople headed back, they didn’t amend their procedures; they didn’t put up cameras, or send a new watch team in. No pat on the back for the boy this time–they just went back to what they were doing. And of course, the infamous third time he called, the town rose to the occasion, but there was no occasion. They had another chance to amend their procedure, but no, this time they glared at the boy, and went back to what they were doing. This is when they should have put someone else there, because he’d lost all credibility. It was inevitable that now that everyone was desensitized, the wolf was going to show up. And so he did. And of course, the boy cried wolf this time because this time there was a wolf, and of course as the story goes, by now no one believed him when he sounded the alarm, even though this time it was really an emergency.

    So, this is why I have been wrestling with whether or not to write about the Northwestern Nashville event. The one where the plane was stopped over a suspicious looking package that turned out to be christmas ornaments. The one that has figured so highly in the news. It seems to be very important that 75 passengers and five crew members were evacuated, screened and for two hours, dogs and a bomb unit searched the plane and nothing was found. The plane went on its way.

    But here’s the rub.

    This was an emergency procedure. The package could have been dangerous. It could have been a red herring, while something else was on the plane that was more dangerous. The boy did NOT cry wolf. The boy did his job. The herd was safe, and went on its way unharmed.

    This is a non-event. Passengers reboarded after about two hours and the flight continued. A few people had their schedules rattled. Maybe a little more importantly, a few people had their calm rattled, but ultimately nothing was lost but a few hours. This was a good thing for all concerned. Can you say “Your Homeland Security Dollars At Work?”

    It is important for us to remember that the watch worked.

    Perhaps the whole emergency procedure turned out in the long run to be nothing more than a drill. But the value of a drill is that it hones skill. Practice builds expertise.

    I am sure in some countries, anti-American spindoctors are chuckling over keystone-cop-three-stooges retellings of our efforts at national security. I hope there are no such versions in this country. Because the watch worked.

    The package could have meant another disaster. It could have been bad news. It could have meant the end for 80 individuals, and grief and terror for the rest of the country. Instead, it was just another piece of lint that got caught in the filter.

    We should be thrilled at the effectiveness at the filter, not ridiculing the process anywhere (except perhaps on Saturday Night Live or in the desperate humor of late night talk show hosts no one is taking seriously anyway.)

    We should not be distracted by this non-event. We should be glad that our emergency crews are out there, doing their jobs, flexing their muscles, refining their procedures and keeping the watch. In the words of Winston Churchill, It is no use saying,” ‘We are doing our best.’ We have got to succeed in doing what is necessary.”

    We are doing what is necessary.

    The boy has not cried wolf. Neither should the media.

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