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Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

reuters.com

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Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#161
Again we are seeing a more systematic issue that commercial pilots don’t have stick and rudder skills. Automation has taken over 95% of the job. They push the throttles up to take off power, pull back on the stick, and then punch the auto-pilot and sit back and enjoy the ride. Then they don’t fly or input anything into flying until landing where they again fly the plane for the last 3-5 minutes of the flight. I would be interested to see the experience level/age of the pilots. As I think the retiring generation of pilot was much more equipped to deal with this type of issue. Then the new generation of pilot. I included an article lamenting this decreased skill we are seeing. It’s refering to the Miracle on the Hudson. But I think it applies here as well. [1]

[1]https://nymag.com/news/features/53788/index1.html

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#162

Again we are seeing a more systematic issue that commercial pilots don’t have stick and rudder skills. Automation has taken over 95% of the job. They push the throttles up to take off power, pull back on the stick, and then punch the auto-pilot and sit back and enjoy the ride. Then they don’t fly or input anything into flying until landing where they again fly the plane for the last 3-5 minutes of the flight. I would…

Afaik autopilot has always played a large role, I used to have a few beers, amoungst company, with a retired SA first officer or engineer - someone in the cockpit anyway, they basically mastered sleeping upright once they reached desired altitude, helpful as they were all hungover as fuck. I'm sure they were all capable though. Autopilot handled 95% of flight even back then - 20 years ago I'd gather given his age. Wasn't a bullshiter about anything else so I'd (I at least) take his account as accurate, esp when hearing about the arms cargo etc.. and meeting other pilots that would visit

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#163

Again we are seeing a more systematic issue that commercial pilots don’t have stick and rudder skills. Automation has taken over 95% of the job. They push the throttles up to take off power, pull back on the stick, and then punch the auto-pilot and sit back and enjoy the ride. Then they don’t fly or input anything into flying until landing where they again fly the plane for the last 3-5 minutes of the flight. I would…

This is rather inflammatory at best, and pretty derogatory to the vast majority of pilots who spend upwards of $100,000 to gain the skills necessary for an ATPL, spending anywhere from 1000-2500 hours flying aircraft older than yourself using technology that predates WW2, and even WW1 in some cases. Stick and rudder skills is all you have to get through the first 100 or so hours of your flying career.

What you're seeing is a consequence of companies willing to skimp on training and certifications, pressuring authorities and manufacturers to find workarounds, and keeping the folks actually flying the thing in the dark about it.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#164
post #7

Earlier quoted context omitted.

That's the most amazing revelation to me so far. The same plane had an identical uncontrolled-dive problem the day before, which required an emergency power cut to the improperly-engaged motor, and somehow that incident didn't ground the plane or even result in any effective advisory to the next crew. Further, the Bloomberg story reports: "The Indonesia safety committee report said the plane had had multiple failures…

Or at the very least, entered into the aircraft maintenance log. Back in my flying days, we had to enter every issue, large or small, into the aircraft maintenance logbook, and we also had to check it before each new flight to see what other crews had experienced, and whether the fault was signed off as 'fixed' or an 'up' fault that we could take into the air with us on the next flight. I believe the tighter turnarou…

It wasn’t clear to me from the article if this was the exact same plane or merely same type.

But the hiding of this information on the initial reports of that incident suggest there might be some fear of corporate culpability. Perhaps the pilots DID log it and it was ignored and the plane was turned around and flown again with a faulty AoA and without passing on the “lessons learned”. Will be interesting as we learn more.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#165
post #150

The previous flight had exactly the same issue. This is what that pilot wrote in the logs; After parking, the PIC informed the engineer about the aircraft problem and entered IAS (Indicated Air Speed) and ALT (altitude) Disagree and FEEL DIFF PRESS (Feel Differential Pressure) light problem on the Aircraft Flight Maintenance Log (AFML). The PIC also reported the flight condition through the electronic reporting syste…

MCAS problems weren't a memory item for any pilot, the memory item is Runaway Stabilizer and exhibits different behaviour to MCAS.

Which is to say that they'll be receiving sim training for Runaway Stabilizer, learn what to expect (wheel moves continuously, hard nose down, etc), and then in real life have MCAS cause the same issue but in a substantively different way (change, delay, change, delay, etc).

Without the benefit of hindsight why not try the Memory Item: Engine Surge / Stall or Uncommanded Roll? Both of which could exhibit as an uncommanded nose down.

The reality of the situation is that some pilots immediately went straight for Runaway Stabilizer whereas others did not. That's a problem. That's a TRAINING problem. The type rating should have included additional training against the Runaway Stabilizer Memory Item for MCAS so "I've seen this before" is second nature.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#166

Earlier quoted context omitted.

There is a trim position indication. It's to the left and right of the throttles. It's a critical thing to check before starting the takeoff roll. You can see it on the copilot's side here by the trim wheel. http://www.b737.org.uk/images/stabtrim_200.jpg

Yes, thinking about that, not having any pilot-visible indication would be quite some point of failure at lift-off. Still wondering whether MCAS and other automatation systems have a representation of that position indication. I can't currently come up with an idea of how to implement that in an easy, yet error-resilient way. Usually you would initially drive into a reference position, then integrate the motor's acti…

FYI It does look like the graphs here indicate "pitch trim position" which I believe is the absolute value.

https://reports.aviation-safety.net/2018/20181029-0_B38M_PK-...

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#167

Best book I've ever read on the root cause ("tight coupling") of accidents: https://en.wikipedia.org/wiki/Normal_Accidents From its Wikipedia entry: >"Normal Accidents: Living with High-Risk Technologies" is a 1984 book by Yale sociologist Charles Perrow, which provides a detailed analysis of complex systems from a sociological perspective. It was the first to "propose a framework for characterizing complex technolog…

See the post mortem of the THERAC-25 debacle.

The consequences of reckless software interlocks and poorly trained operators has been known for a long time now.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#168

Best book I've ever read on the root cause ("tight coupling") of accidents: https://en.wikipedia.org/wiki/Normal_Accidents From its Wikipedia entry: >"Normal Accidents: Living with High-Risk Technologies" is a 1984 book by Yale sociologist Charles Perrow, which provides a detailed analysis of complex systems from a sociological perspective. It was the first to "propose a framework for characterizing complex technolog…

I cannot recommend this book enough. I will also point out that some sections of it are highly entertaining. In fact, the tanker collision chapter is laugh-out-loud funny.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#169
post #150

The previous flight had exactly the same issue. This is what that pilot wrote in the logs; After parking, the PIC informed the engineer about the aircraft problem and entered IAS (Indicated Air Speed) and ALT (altitude) Disagree and FEEL DIFF PRESS (Feel Differential Pressure) light problem on the Aircraft Flight Maintenance Log (AFML). The PIC also reported the flight condition through the electronic reporting syste…

One wonders, when the prior flight landed with the stab trim system switched off, who switched it back on before the next departure? And was there no question raised as to why it was off?

It's not normal to have that system switched off at any time. There are even guards over the switches to ensure they are only operated deliberately.

Re: Cockpit voice recorder of Lion Air jet depicts pilots' frantic search for fix

#170
post #150

The previous flight had exactly the same issue. This is what that pilot wrote in the logs; After parking, the PIC informed the engineer about the aircraft problem and entered IAS (Indicated Air Speed) and ALT (altitude) Disagree and FEEL DIFF PRESS (Feel Differential Pressure) light problem on the Aircraft Flight Maintenance Log (AFML). The PIC also reported the flight condition through the electronic reporting syste…

MCAS problems weren't a memory item for any pilot, the memory item is Runaway Stabilizer and exhibits different behaviour to MCAS. Which is to say that they'll be receiving sim training for Runaway Stabilizer, learn what to expect (wheel moves continuously, hard nose down, etc), and then in real life have MCAS cause the same issue but in a substantively different way (change, delay, change, delay, etc). Without the b…

> That's a problem. That's a TRAINING problem.

Isn't the root problem still related to the fact that the AoA sensors were returning wrong information and the MCAS was simply reacting to that in a dangerous and non-obvious way?

I guess the pilots should be aware of this type of system reaction but still it seems like something that should be fixed at a higher level than training (indicators, backup AoA sensors, detecting dangerous descent after trigging nose down, etc).

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