Asiana 214

[cowpatz]

Accident report Summary

Animation

[Ian Warren]

One hell of an interesting break down in the animation and compare in the read, with this , it good to be able to put the FS into the area of mistakes to compare ...

I did the very same thing during the incident at Christchurch just over 11 years ago with the Air Adventures Piper Navajo Chieftain - when that happened i was a gloomy night and on hearing I was on the FS in real world weather to try and explain what may have happened

[NZ255]

What do you think about the Boeing speed protection recommendations?

[cowpatz]

The FLCH mode and resultant Autothrottles in HOLD is a trap to the unwary on nearly all Boeing glass aircraft.
It is disappointing to see Boeing not improve on this known aspect on the 777 or even the 787. It should have a 'wake up' function (whereby the thrust is applied if speed drops below a determined value) as it does when in other modes. A simple software change I would have thought.
Normally when flying an ILS the AT is in speed mode (If the AT is in HOLD mode it will change to SPD when capturing the glideslope). Even though the pilot was on a visual approach the norm is an ILS approach and perhaps subconsciously he was thinking that the aircraft AT system would control the speed as it does on an ILS.
The rapidly changing/deteriorating picture at the end, together with no real time on type, would have lead to increased anxiety and confusion with a consequential inability to think clearly. A similarity here with the 737 incident at CHC.
The monitoring pilot was significantly to blame here as he was in the best position to see the deterioration and call for a GA much earlier. Of course there are cultural issues at play here too which is a different matter entirely.

[NZ255]

QUOTE (cowpatz @ Jun 26 2014,11:48 AM) <{POST_SNAPBACK}>

Of course there are cultural issues at play here too which is a different matter entirely.

FO can't speak his mind to the Captain because of respect?

[omitchell]

QUOTE (NZ255 @ Jun 26 2014,1:24 PM) <{POST_SNAPBACK}>

FO can't speak his mind to the Captain because of respect?

That has brought down a Korean Air Cargo Boeing 747-2B5F freighter (Korean Air Cargo Flight 8509) in England 22 December 1999. They wouldn't speak up to the Senior officer despite 2 of the flight crew noticing the problem. Cultural protocol wouldn't allow it. This was supposed to have been trained out of pilots of Korean Air after that incident. The co-pilot shuld have taken control due to a faulty instrument on the Captain's side but his culture and their views of taking offense from questioning or removing control from a person senior to them wouldn't allow him to do so, he was stuck in thousands of years of tradition...

[Ian Warren]

QUOTE (NZ255 @ Jun 26 2014,2:24 PM) <{POST_SNAPBACK}>

FO can't speak his mind to the Captain because of respect?

Sometimes that depends on what culture your are from , It is well known regarded, well least in theory to share .. there are famed instances where peoples in command have the mind meld (tea towel thru the ears) and have the second pilot not have the ability to stand up and say YO ! ... this happens in every industry ...

... and ya do get the real cocks out there and many classic examples are people that should not driving a pushbike little alone an aeroplane ... to be, or to assertive your self, going above the leaders head to control and fix is a primary ... A lot of people don't have the guts to do it!

[cowpatz]

QUOTE (NZ255 @ Jun 26 2014,1:24 PM) <{POST_SNAPBACK}>

FO can't speak his mind to the Captain because of respect?

The pilot monitoring was the training Captain. The Pilot flying was his senior officer in the Air Force. In the animation you will here the monitoring pilot use the word "Sir".

Even though Korean may utliise a "heavy crew" (3 or 4 pilots to augment and allow for inflight rest) the local pilots will only have the 2 operating pilots on the flight deck. Expat pilots will usually have all or at least 1 of the supplementary pilots on the flight deck as well (seats for 4).
The more eyes and ears the better. It may have helped in this circumstance.

[Splitpin]

Good post CP ... Cheers.
I have experienced the Asian culture just resigning themselves to fate first hand .... not at your level , but scary non the less.
A few years ago i did a stint as a tour driver (sorry this wont take long) I had a group from Japan , 50 in all. We were heading to Queenstown .
The tour leader asked me if they could go up to coronet peak before going to the hotel , it was springtime , and no snow to speak of , so i said yes .... so up we went , slowly with 50 bod's and 60 odd bags.
Anyway , time to come down .... the coach was an import from Singapore , it had an electronic gear shift , exhaust brake , and a retarder (like an elecrtic brake on a train)
I started the decent , and found it was too slow in 2nd gear (over rev warning was sounding) so i slowed right down and tried to select 3rd and engaged the retarder .... the gearbox wouldnt engage ..... and we were picking up speed ... foot hard on the brake , after a few meters i knew the retarder wasnt working .... my foot even harder on the brake now... and to fast to engage any gear.

I could tell we weren't going any faster , but it wasn't slowing down either ( decending at about 25 -30k) Thank God the road was clear ... i had to use every bit of road.(even at that speed) I advised the tour leader there was a problem , and i may have to put the coach into the hillside to stop it .... no reaction ! so down we go .... almost at the bottom , i told him " we are going to cross the main road , tell them to brace in case we hit something" ..... nothing !! by now the smell of overheated brakes and the smoke is obvious .... anyway God was onboard that day .... we rolled off the bottom of that hill and no traffic either side , and came to smoky stop a few yards down the road.
My hands were still locked on the wheel ... both my feet were welded to the centre pedal ... and that tour leader asked me if we would be at the hotel in time for dinner !

I called the company that night and was told the retarder had been disabled while they waited for parts .... would have been nice to have known that before i left.
Anyway , i got 100% pissed , called the owner at 3am and told him to stick it .... got a cab to the airport in the morning and flew home , i still dont know how that group got on.

Sorry to bore you , but it (the Korean thing) made me remember.

[omitchell]

QUOTE (Splitpin @ Jun 26 2014,10:43 PM) <{POST_SNAPBACK}>

Good post CP ... Cheers.
I have experienced the Asian culture just resigning themselves to fate first hand .... not at your level , but scary non the less.
A few years ago i did a stint as a tour driver (sorry this wont take long) I had a group from Japan , 50 in all. We were heading to Queenstown .
The tour leader asked me if they could go up to coronet peak before going to the hotel , it was springtime , and no snow to speak of , so i said yes .... so up we went , slowly with 50 bod's and 60 odd bags.
Anyway , time to come down .... the coach was an import from Singapore , it had an electronic gear shift , exhaust brake , and a retarder (like an elecrtic brake on a train)
I started the decent , and found it was too slow in 2nd gear (over rev warning was sounding) so i slowed right down and tried to select 3rd and engaged the retarder .... the gearbox wouldnt engage ..... and we were picking up speed ... foot hard on the brake , after a few meters i knew the retarder wasnt working .... my foot even harder on the brake now... and to fast to engage any gear.

I could tell we weren't going any faster , but it wasn't slowing down either ( decending at about 25 -30k) Thank God the road was clear ... i had to use every bit of road.(even at that speed) I advised the tour leader there was a problem , and i may have to put the coach into the hillside to stop it .... no reaction ! so down we go .... almost at the bottom , i told him " we are going to cross the main road , tell them to brace in case we hit something" ..... nothing !! by now the smell of overheated brakes and the smoke is obvious .... anyway God was onboard that day .... we rolled off the bottom of that hill and no traffic either side , and came to smoky stop a few yards down the road.
My hands were still locked on the wheel ... both my feet were welded to the centre pedal ... and that tour leader asked me if we would be at the hotel in time for dinner !

I called the company that night and was told the retarder had been disabled while they waited for parts .... would have been nice to have known that before i left.
Anyway , i got 100% pissed , called the owner at 3am and told him to stick it .... got a cab to the airport in the morning and flew home , i still dont know how that group got on.

Sorry to bore you , but it (the Korean thing) made me remember.

Wasn't a Ritchies coach was it? Knew a guy that worked for them up here. Took a group to the Bay of Islands, brakes failed completely on the way down the hill into BoI, they told him to drive the coach back to Auckland (Remember what I just said about the brakes....) and get a new one. He told them where to go, left the coach on the side of the road, hired a car and drive home, never went back to work for them...

[Ian Warren]

QUOTE (Splitpin @ Jun 26 2014,11:43 PM) <{POST_SNAPBACK}>

Good post CP ... Cheers.
I have experienced the Asian culture

Sorry to bore you , but it (the Korean thing) made me remember.

One hairy ride ! those stick in your mind for ever , I was a Pax on one when a similar thing happened but not to that extreme ... funny it was a school bus trip visiting Lyttleton and it was my father driving it , an old Mk4 Reliance .... He became the class hero .. My old man stayed driving for the CTB till the day he died.

[Ian Warren]

QUOTE (cowpatz @ Jun 26 2014,12:48 PM) <{POST_SNAPBACK}>

The FLCH mode and resultant Autothrottles in HOLD is a trap to the unwary on nearly all Boeing glass aircraft.
It is disappointing to see Boeing not improve on this known aspect on the 777 or even the 787. It should have a 'wake up' function (whereby the thrust is applied if speed drops below a determined value) as it does when in other modes. A simple software change I would have thought.
Normally when flying an ILS the AT is in speed mode (If the AT is in HOLD mode it will change to SPD when capturing the glideslope). Even though the pilot was on a visual approach the norm is an ILS approach and perhaps subconsciously he was thinking that the aircraft AT system would control the speed as it does on an ILS.
The rapidly changing/deteriorating picture at the end, together with no real time on type, would have lead to increased anxiety and confusion with a consequential inability to think clearly. A similarity here with the 737 incident at CHC.
The monitoring pilot was significantly to blame here as he was in the best position to see the deterioration and call for a GA much earlier. Of course there are cultural issues at play here too which is a different matter entirely.

It would be worth a sheared cockpit experience , go thought the motions, I have done that and followed procedure with an airline pilot well worth and a great learning experience , I wonder how well the Captain Sim 777 works in that mode in multiplay.