KSFO 777 incident

[FlyingMonkey]

Well, I'm a low time pilot so clearly others know better than me on this. I just assumed if they see an unsafe condition they would at least "strongly suggest" corrective action. Of course what they can actually see and determine with the information they have is surely debatable.

[Roger Lee]

The tower may not know what is wrong or what action to take and if they became involved they would be liable. They only provide spacing and separation they leave the flying to us.

[FlyingMonkey]

Okey dokey!

[FastEddieB]

Andy,

 

Go arounds are common, but I don't ever recall one for a pilot being on the wrong glide path.

 

I see pilots drag it in low all the time, and I've been known to set up exercises where we're way high and the pilot has to slip like crazy to get down. In neither case have I heard a go around called by the tower.

 

I don't know how common tower tours are post-911, but they're very educational. In any case, once cleared to land, it would be unusual for a tower controller to actuslly be watching a plane approach and land - most often they're focusing on the next plane in the queue, anyway.

[Ed Cesnalis]

The PIC (right seat captain) told the NTSB that he thought the auto throttles were maintaining speed and the first thing he noticed was that they were low. It appears that the airspeed had completely fallen out of his cross check.

[sandpiper]

Ed - when you say go arounds are common are you talking about GA? As for air carriers (Part 121) they rarely, in my observations, go around. In fact, because it is a seldom done event, one major carrier incorporated more go around practice in their sim training about 2 years ago. This was due to a couple of incidents where go around experience would have been beneficial.

[Duane Jefts]

Go Around procedures are taught extensively to the point they are second nature in the two major airlines I flew for.

[opticsguy]

One thing I will say, nearly all the airline pilots I know here in the states own or partly own a small airplane and get re-aquainted with stick-and-rudder (and airspeed) skills regularly, as a hobby. There is essentially NO GA in China, Korea, or Japan, so these guys are only getting simulator time or actual flight time in the big birds. I doubt there is one KAL pilot that can fly a GA plane on his own time or money.

 

The guy who did my CT transition training flew 777s for NWA. I'll bet he knows how to control airspeed. Nuff said.

[Ed Cesnalis]

Ed - when you say go arounds are common are you talking about GA? As for air carriers (Part 121) they rarely, in my observations, go around. In fact, because it is a seldom done event, one major carrier incorporated more go around practice in their sim training about 2 years ago. This was due to a couple of incidents where go around experience would have been beneficial.

 

Yes, even talking about LSA. When I approach a SOCAL airport with jet traffic its not uncommon for me to be instructed to remain a pattern altitude on final and go around. When the traffic isn't working out I'm the one that gets diverted not the FoKker.

 

Technically that might not even be a go around. If traffic doesn't clear the runway the tower will calll a real go around.

[sandpiper]

Duane, Wm.Ince:

 

I'm sure this carrier had these procedures included in their ongoing training but for whatever reason they felt a need to increase emphasis.

[FlyingMonkey]

When I worked at Delta Airlines across the street from the runway in ATL, we used to see go arounds occasionally. I would not say "all the time", but not infrequently. I have been on a Delta flight that did a go around also.

[Ed Cesnalis]

When I said all the time I was referring to GA and 'go arounds' for separation.

[Ed Cesnalis]

And I still say we are all running off at the mouth and implying or infering things that may have no relationship to the actual eventts. Yet, not a one of you readers looked at the Leveson approach, did you? If the culture is wrong, by god our culture has it's own fatal flaws.

 

I looked at it. In this case the 777 crew demonstrated that they lack basic skills almost certainly due to not hand flying and the problem becomes worse due to the cultural issues.

 

You cannot look to our/western cultural issues in order to fix this. The bullets in the introduction to Levevson's Model address new hazards, new environment and new complexity.

 

The problem with the Koreans has become basic airmenship and CRM. Years ago they had to bring in Western trainers and make changes or lose their access to western airports. They brought in the trainers but the cultural barrier is winning that battle not the western trainers. Japan is proof that this doesn't need to exist.

 

Call me racist, I would make this argument to my Korean friend and he would agree with me. The available data clearly demonstrate that the left seat Captain couldn't fly the visual and that the right seat Captain couldn't do his job, he wasn't even monitoring airspeed. The other pilots failed to call for a go-around as well, they were not flying a stable approach and all four of them should have been concerned but they either were not paying attention or were not willing to speak up. In either case the problem that was addressed by requiring western trainers apparently has not been solved.

[WmInce]

. . . "Call me racist," . . .

 

No . . . I will not call you a racist.

 

But you are a Monday Morning Quarterback . . . just like a lot of other folks.

 

Just for once, I would like to see people wait until all the facts are in before passing judgements.

 

Perhaps, it is the human ego that makes that so difficult for some people to do.

[Ed Cesnalis]

No . . . I will not call you a racist.

 

But you are a Monday Morning Quarterback . . . just like a lot of other folks.

 

Just for once, I would like to see people wait until all the facts are in before passing judgements.

 

Perhaps, it is the human ego that makes that so difficult for some people to do.

 

 

The LCA/checkairman in the right seat admitted the approach was first high and not aligned and then low, he didn't notice the airspeed was approaching stall. Those are his words and they match the available data.

 

The pilots also admitted that the auto-throttles were employed when they were not. They didn't even know who was flying the airplane, they thought the AT had it but failed to monitor airspeed.

 

If the CTSW passenger in Taos tells us that they were practicing engine out maneuvers should we believe him or wait a year for a report?

[WmInce]

Why the rush to judgement?

[Ed Cesnalis]

Why the rush to judgement?

 

Counting the UA flight holding short, more than 500 people almost died. The rush isn't on this investigation, we already know enough to realize that the requirements placed on the Korean airlines re CRM and training appear to be unmet. There is a rush to look into that.

[WmInce]

Counting the UA flight holding short, more than 500 people almost died. The rush isn't on this investigation, we already know enough to realize that the requirements placed on the Korean airlines re CRM and training appear to be unmet. There is a rush to look into that.

 

Perhaps you missed your calling.

Maybe you should have gone to work for the NTSB.

 

Have a great day!

[Duane Jefts]

Both the cultural CRM issue and the lack of hand flying are pretty well documented from various sources. These issues didn't exist during the wars and some countries like Japan have overcome them. The performance of the 4 pilots support the assertions. They didn't get low, slow and behind the power curve in 1 second, it took time. Someone should have lunged from the back seat and advanced the throttles rather than have ~ 500 lives at risk. Something seems seriously wrong and deserves a look.

 

Is there any information that puts all four pilots in the cockpit during the landing phase. Its been my experience that the 2 non flying pilots have first class seats blocked off for their rest. I don't know but the 777 may have separate seating elsewhere for non flying, but assigned pilots. Anyone have know where the 2 non flying pilots were for landing?

[Duane Jefts]

Perhaps you missed your calling.

Maybe you should have gone to work for the NTSB.

 

Have a great day!

 

I can assure you that when an incidenty of this proportion occurs, the airline will immediately look at all aspects of the incident. They will go through all of the "what if's" and if there is a shortcoming in procedures or human interactions contrary to thdeir approved operating procedures, they will make immediate changes to accomodate a safer 0peration. I think that is what CT was, in part, refering too.

 

When the NTSB eventually offers their findings, the company should already have made changes addresing any shortcomings to their operating procedures.

[Ed Cesnalis]

Is there any information that puts all four pilots in the cockpit during the landing phase. Its been my experience that the 2 non flying pilots have first class seats blocked off for their rest. I don't know but the 777 may have separate seating elsewhere for non flying, but assigned pilots. Anyone have know where the 2 non flying pilots were for landing?

 

Thanks Duane,

 

I was sure I read that, but I can't find it and can see it doesn't make sense.

[Ed Cesnalis]

Then again, on airlinepilotsforum today there are posts that sound like they are all 4 in the cockpit. Like this one talking about the pilots claim of a bright light.

 

I've been lazed while flying and it went something like this: "...I can't see, you have the aircraft...". I'll give the benefit of the doubt for the guy getting "bright light" in his eyes, but what about the other three guys? What's their story?

[Ed Cesnalis]

This article is very good: http://avherald.com/h?article=464ef64f&opt=7168

 

most recent info:

 

On Jul 8th 2013 the NTSB reported the pilots' flight bags and charts were located, the proper (approach) charts for San Francisco Airport were in place at the cockpit. There were 4 pilots on board of the aircraft, they are being interviewed on Jul 8th. The cockpit was documented and the switch positions identified. Both engines were delivering power at time of impact consistent with the flight data recordings, the right hand engine found adjacent to the fuselage showed evidence of high rotation at impact. The aircraft joined a 17nm final, the crew reported the runway in sight before being handed off to tower. The autopilot was disconnected at 1600 feet 82 seconds prior to impact, the aircraft descended through 1400 feet at 170 KIAS 73 seconds prior to impact, descended through 1000 feet at 149 KIAS 54 seconds, 500 feet at 134 KIAS 34 seconds, 200 feet at 118 KIAS 16 seconds prior to impact. At 125 feet and 112 KIAS the thrust levers were advanced and the engines began to spool up 8 seconds prior to impact, the aircraft reached a minimum speed of 103 KIAS 3 seconds prior to impact and accelerated to 106 knots. The vertical profile needs to be assessed first. There was debris from the sea wall thrown several hundred feet towards the runway, a significant portion of the tail is ahead of the sea wall in the water.

 

On Jul 8th 2013 South Korea's Ministry of Transport reported the captain (43, ATPL, 9,793 hours total) of the ill-fated flight was still under supervision doing his first landing into San Francisco on a Boeing 777, although he had 29 landings into San Francisco on other aircraft types before. He was supervised by a training captain with 3,220 hours on the Boeing 777, all responsibilities are with the training captain.

[Duane Jefts]

This article is very good: http://avherald.com/...4ef64f&opt=7168

 

most recent info:

 

On Jul 8th 2013 the NTSB reported the pilots' flight bags and charts were located, the proper (approach) charts for San Francisco Airport were in place at the cockpit. There were 4 pilots on board of the aircraft, they are being interviewed on Jul 8th. The cockpit was documented and the switch positions identified. Both engines were delivering power at time of impact consistent with the flight data recordings, the right hand engine found adjacent to the fuselage showed evidence of high rotation at impact. The aircraft joined a 17nm final, the crew reported the runway in sight before being handed off to tower. The autopilot was disconnected at 1600 feet 82 seconds prior to impact, the aircraft descended through 1400 feet at 170 KIAS 73 seconds prior to impact, descended through 1000 feet at 149 KIAS 54 seconds, 500 feet at 134 KIAS 34 seconds, 200 feet at 118 KIAS 16 seconds prior to impact. At 125 feet and 112 KIAS the thrust levers were advanced and the engines began to spool up 8 seconds prior to impact, the aircraft reached a minimum speed of 103 KIAS 3 seconds prior to impact and accelerated to 106 knots. The vertical profile needs to be assessed first. There was debris from the sea wall thrown several hundred feet towards the runway, a significant portion of the tail is ahead of the sea wall in the water.

 

On Jul 8th 2013 South Korea's Ministry of Transport reported the captain (43, ATPL, 9,793 hours total) of the ill-fated flight was still under supervision doing his first landing into San Francisco on a Boeing 777, although he had 29 landings into San Francisco on other aircraft types before. He was supervised by a training captain with 3,220 hours on the Boeing 777, all responsibilities are with the training captain.

 

Good article. Clears up some questions. Would really like to hear the voice recorder.

[Ed Cesnalis]

Would really like to hear the voice recorder.

 

It will clear up the blinding flash I think. He first reported it to the Korean authorities and then the NTSB but at the time of the flash ( 500 ft ) he was already slow and slowing. Some speculate that it was a cultural, face saving excuse. I don't see how a flash gets you to stall speed, that must have been a case of thinking the AT were controlling airspeed and failing to monitor the speed.

 

I was just wondering, we seem focused on the nose high, attitude that certainly diminished performance, but what about the fact that in order to pivot the nose up that high you have to pivot the tail down quite low? Its not just a question of performance but of clearance too. The mains as well as the tail were lowered just prior to being sheered off.