Asiana Recommendations
Boeing should be required to enhance training for pilots of 777s to “improve flight crew understanding of autothrottle modes and automatic activation system logic,” the U.S. National Transportation Safety Board (NTSB) says.
The recommendation is one of 27 included in the NTSB’s final report on the July 6, 2013, crash of an Asiana Airlines 777 when it struck a seawall during approach to San Francisco International Airport. The crash killed three of the 307 people in the airplane, and 49 others were seriously injured. The airplane was destroyed.
The NTSB said the probable cause of the crash was the flight crew’s “mismanagement of the airplane’s descent during the visual approach, the pilot flying’s unintended deactivation of automatic airspeed control, the flight crew’s inadequate monitoring of airspeed and the flight crew’s delayed execution of a go-around.”
The NTSB’s investigation of the accident prompted its issuance of 15 safety recommendations to the U.S. Federal Aviation Administration (FAA), including one that calls on the FAA to require Boeing to develop the enhanced 777 training and another that says the agency should require operators and trainers to provide the training to 777 pilots.
Other recommendations to the FAA said that the agency should require Boeing to include in the 777 crew training manual “an explanation and demonstration of the circumstances in which the autothrottle does not provide low-speed protection” and convene a panel of experts to identify the most effective methods of training flight crews in using automated systems for flight path management.
Other recommendations — among them, dealing with the need to comply with standard operating procedures, the need to give Asiana pilots more opportunities for manual flight and the need for improved emergency communications — were issued to Asiana, Boeing, the Aircraft Rescue and Firefighting Working Group and the city and county of San Francisco.
A full discussion of the NTSB final report will be included in the October issue of AeroSafety World.
Proposed Penalty
Southwest Airlines is facing a proposed $12 million civil penalty because of the U.S. Federal Aviation Administration’s (FAA’s) charge that it failed to comply with federal regulations in making repairs on three Boeing 737s.
Southwest has 30 days from its notification of the FAA’s proposed action to respond.
The FAA said in a statement released in late July that Southwest had conducted “extreme makeover” alterations beginning in 2006 to eliminate the potential for cracks in the skin of 44 airliners. The airline’s contractor, Aviation Technical Services (ATS), did not comply with required procedures in replacing fuselage skin and in stabilizing the airplanes on jacks, the FAA said.
The agency also said that the airplanes were returned to service and operated on flights in 2009 while not in compliance with U.S. Federal Aviation Regulations. In addition, the FAA said that Southwest did not properly install water drain mast ground wires on two 737s in compliance with an airworthiness directive; these airplanes were operated on more than 20 passenger flights after the airline became aware of the problem and before it was corrected.
Double Meaning
Eurocontrol is warning pilots and air traffic controllers that confusion could result from use of the phrase “at pilot’s discretion,” which is common in the United States but not understood globally.
“In the United States, the meaning of ‘at pilot’s discretion’ in radio telephony voice communications related to climb/descent clearances is promulgated to include the option for pilots to level off at intermediate levels,” Eurocontrol said in a safety reminder message issued in late July.
“However, the meaning of this phrase … is not understood globally, and there is a risk that its use outside the U.S. could lead to adverse safety outcomes if non-U.S. based controllers unwittingly approve pilot requests to climb/descend at their own discretion.”
Eurocontrol said its advisory was intended to caution controllers in countries other than the United States that their use of the phrase in response to a request from a U.S. pilot could result in “a situation where they approve the request for ‘own discretion’ (to climb/descend) without recognizing the potential of an unexpected outcome — i.e., a possible intermediate level off.”
Use of the phrase “when ready,” as prescribed by the International Civil Aviation Organization, does not imply that an intermediate level-off is acceptable and precludes misunderstanding, Eurocontrol said.
Undetermined Cause
Limited access to the Antarctic site of the Jan. 23, 2013, crash of a de Havilland DHC-6-300 Twin Otter and the absence of data from the airplane’s cockpit voice recorder (CVR) left accident investigators unable to determine the accident’s cause, the Transportation Safety Board of Canada (TSB) says.
The three crewmembers — the only people aboard the airplane — were killed when it struck Mount Elizabeth, perhaps after flying into clouds during a repositioning flight from South Pole Station, with an intended landing site of Terra Nova Bay, the TSB said in its final report on the accident, released in June.
Weather conditions kept rescue personnel from reaching the site for two days and prevented accident investigators from thoroughly examining the wreckage, the report said. Investigators also found that the CVR had not been functioning the day of the accident.
The report noted that after the accident, the operator implemented actions intended to mitigate flight risks, including improving the accuracy of Antarctic aviation navigational charts, developing visual flight rules routes for longer flights, altering pre-start checklists “to confirm that an adequate oxygen supply is on board the aircraft and that the [CVR] is functional,” and amending global positioning system operating procedures to ensure correct data input.
Coping With Armed Conflicts
The International Civil Aviation Organization (ICAO) has established a task force — headed by David McMillan, chairman of the FSF Board of Governors — to address issues stemming from the July 17 downing of a Malaysia Airlines Boeing 777 over eastern Ukraine, killing all 298 people aboard.
Authorities say the airplane, en route at 33,000 ft, was struck by a missile fired from an area where pro-Russian separatists had been fighting Ukrainian government forces.
The Task Force on Risks to Civil Aviation Arising From Conflict Zones will review methods that might be used to improve the gathering of information about armed conflicts and how they might endanger civil aviation.
The task force will focus on methods of effectively collecting and disseminating “information and intelligence that might affect the safety of our passengers and crew,” ICAO said, adding that ICAO member states have been “reminded … of their responsibilities to address any potential risks to civil aviation in their airspace.”
McMillan, a former director general of Eurocontrol, said that the industry must “apply lessons learned from the tragedy of [Malaysia Airlines Flight 17] … to fill any gaps that may exist to better assess and share risks from and near regional conflict zones.”
ICAO said the aviation community asked it to address “fail-safe channels for essential threat information to be made available to civil aviation authorities and industry” and “the need to incorporate into international law, through appropriate [United Nations] frameworks, measures to govern the design, manufacture and deployment of modern anti-aircraft weaponry.”
An ICAO safety conference, including all 191 ICAO member states, will be held in February 2015, in part to discuss these issues.
IATA said that “clear, accurate and timely information on risks is critical.”
IATA Director General and CEO Tony Tyler added, “We were told that flights traversing Ukraine’s territory at above 32,000 ft would not be in harm’s way. We now know how wrong that guidance was. It is essential that airlines receive clear guidance regarding threats to their passengers, crew and aircraft. Such information must be accessible in an authoritative, accurate, consistent and unequivocal way. This is the responsibility of states. There can be no excuses.”
Upgrade for Serbia
Serbia has received a Category 1 safety rating from the U.S. Federal Aviation Administration (FAA), signifying that its civil aviation authority is operating in compliance with International Civil Aviation Organization safety standards.
The rating, based on an FAA assessment conducted earlier this year, represents an upgrade from the Category 2 rating that Serbia has held since 2006. A Category 2 rating signifies that a country’s civil aviation authority is deficient in one or more areas, including relevant legislation or regulations, technical expertise, trained personnel, record keeping or inspection procedures.
The FAA conducts safety reviews of all countries that have air carriers flying to and from the United States, and of those that have applied for such flights.
Serbian airlines currently do not fly to the United States, but the rating change means that they may apply to the FAA and U.S. Department of Transportation for authority to do so.
In Other News …
Air Methods could face a $428,000 civil penalty proposed by the U.S. Federal Aviation Administration (FAA), which said the emergency medical services (EMS) operator flew helicopters without conducting required inspections of night vision imaging system–compatible lighting filtration installations. The company has 30 days from receipt of the FAA’s enforcement letter to respond. The agency has proposed a $110,000 civil penalty against another EMS operator, Air Evac EMS, for operating a Bell 206 on several passenger flights even though its chin bubble window — a window at the front of the helicopter that allows the pilot to see below — was not installed in accordance with the manufacturer’s instructions. The FAA says the company has discussed the matter with the agency. … New pilot licensing regulations take effect in Australia in September, and over the next four years, some 40,000 licenses that have been issued under Civil Aviation Regulations Part 5 will be reissued under the new Part 61. New requirements also will be implemented for flight reviews and proficiency checks, the Australian Civil Aviation Safety Authority says.
Compiled and edited by Linda Werfelman.