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Alaska Airlines flight 1282 NTSB preliminary report [pdf]

ntsb.gov

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Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#62
If people are looking for additional in-depth reading on how this happened, The Air Current did a great write-up on this systemic mistake using internal Boeing sources a month ago that the NTSB report fully supports: https://theaircurrent.com/aviation-safety/127-days-the-anato...

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#63
post #13

> The accident airplane was required to be equipped with a CVR that retained, at minimum, the last 2 hours of audio information, including flight crew communications and other sounds inside the cockpit. >The CVR was downloaded successfully; however, it was determined that the audio from the accident flight had been overwritten. The CVR circuit breaker had not been manually deactivated after the airplane landed follow…

> Given how cheap flash is these days How cheap is flash that will survive a sudden stop from 400mph to 0 mph in no seconds flat, will survive a post-crash fire, and/or submersion for years in salt water? Flash data retention at high temps is TERRIBLE (and gets worse for MLC/TLC/etc), see any flash datasheet. It is NOT nearly as simple a problem as you might think. Yes, it is a solvable problem, but please do not dis…

I don't think the problem you're describing is actually a problem.

Exposure to super-high temps occurs in a small set of circumstances, all of which overlap with the destruction of the recording device and the cessation of incoming data. So we only need the same 1.2GB (or whatever) of high-temperature-tolerant storage.

The 25 hour storage can be on normal flash, as if we're more than 2 hours past the incident and data is continuing to come in, then the incident of interest did not destroy the airplane, and the flash will have remained within its normal operating parameters.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#64

Earlier quoted context omitted.

If my job involved taking the lives of hundreds of humans in my hands, then I would expect that, at least during the hours in which said lives are my responsibility.

IMHO surgical theatres should have permanent multi-perspective cameras recording everything for the same reason.

There you also have patient privacy to take into account.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#65

Earlier quoted context omitted.

If my job involved taking the lives of hundreds of humans in my hands, then I would expect that, at least during the hours in which said lives are my responsibility.

IMHO surgical theatres should have permanent multi-perspective cameras recording everything for the same reason.

Only if the patient consents (or their family if they are unable to give legal consent), otherwise no for patient privacy.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#66
post #13

> The accident airplane was required to be equipped with a CVR that retained, at minimum, the last 2 hours of audio information, including flight crew communications and other sounds inside the cockpit. >The CVR was downloaded successfully; however, it was determined that the audio from the accident flight had been overwritten. The CVR circuit breaker had not been manually deactivated after the airplane landed follow…

The largest US pilots union opposes it on pilot privacy grounds. (To be clear, I think having an expectation of vocal privacy while you are in charge of an airliner is absurd.)

Well, there is the theory and then there is the reality.

Theory: having less privacy makes things easier for accident investigators, post-mortem.

Reality: In this case, the pilots did their job and got the plane down safely despite rapid depressurization and literally having their headsets sucked off of their heads. It is extremely unlikely to be pilot-error that a door-plug ripped off the airframe at 16,000' or that investigators would learn anything significant from the process in the flight-deck before or after the incident. At least nothing that would root-cause this incident.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#67
post #19

Depressurization happened around 17:12:33 PST but the aircraft continued to climb until 17:13:41 PST, and the autopilot was configured for 10k ft at 17:13:56 PST. Why did it take the pilots a full minute to begin an emergency descent after the failure? I would expect that the nature of the accident would be clear nearly immediately, at least in the need to descend the aircraft.

You can't leave your assigned altitude/trajectory without coordinating with ATC. Otherwise you may collide with another plane, which would make a bad situation worse.

Also, running checklists for specific types of emergencies.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#68
post #19

Depressurization happened around 17:12:33 PST but the aircraft continued to climb until 17:13:41 PST, and the autopilot was configured for 10k ft at 17:13:56 PST. Why did it take the pilots a full minute to begin an emergency descent after the failure? I would expect that the nature of the accident would be clear nearly immediately, at least in the need to descend the aircraft.

I would expect that the nature of the accident would be clear nearly immediately

Not really. The cockpit door was blown open, and the pilot's headsets were blown off. It was a pretty chaotic event, and when you are flying an airplane, you definitely don't want to figuratively "jerk the wheel" - you remain calm and start running checklists.

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#69
post #24

The fact that a critical piece of the evidence was cell phone photos sent between workers coordinating door re-assembly doesn't exactly instill a whole lot of confidence in their permit-to-work process. I didn't like it when it was medical teams doing shift handover via a Google Doc, and I don't like it when it's a matter of flight safety either. Or, as Homer might eruditely say: "guess I forgot to put the bolts back…

This is a puzzling attitude to me. Every time we technologists see a crappy proprietary solution being used for a problem, the first exclamation is, "why not use ? That's so dumb, they spent $10k on that tool when they could have spent $100 on X!" There must be a middle ground here- the paradox is that Google, Apple, etc have this ability to generate user friendly software and hardware at scale. But they aren't consi…

The issue here isn't using google chat, the accusation is that this was Spirit and Boeing conspiring to not record these in the proper work order system under the pretence that this work was being done by Spirit as-if-it-were pre-delivery.

Read https://www.airlinepilotforums.com/safety/146074-boeing-inte...

And then this from the doc: "The investigation continues to determine what manufacturing documents were used to authorize the opening and closing of the left MED plug during the rivet rework."

https://s3.documentcloud.org/documents/24410269/report_dca24...

Re: Alaska Airlines flight 1282 NTSB preliminary report [pdf]

#70
post #21

Earlier quoted context omitted.

The largest US pilots union opposes it on pilot privacy grounds. (To be clear, I think having an expectation of vocal privacy while you are in charge of an airliner is absurd.)

[flagged]

I (person who blamed the pilots union above) actually like unions. I could probably even say good things about pilot unions; I would say that part of the reason US airlines have fewer accidents than some other wealthy countries is the effect the unions have had on resisting attempts to work pilots through dangerous levels of fatigue, and on ensuring pilots can report dangerous situations and have them comprehensively fixed without retaliation.

I don't have faith in "market forces" to do those things, and consider the state of aviation in some other countries to be a living experiment showing why.

The opposition to cockpit recording is bonkers, though.

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