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UPS Cargo Jet Crashes Near Birmingham Shuttlesworth International Airport

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  • Originally posted by elaw View Post
    I generally agree, but without having read the whole report I do notice one interesting technical issue (from page 15):

    I'm thinking either 1) those trees were 1,000+ feet high or 2) the EGPWS was not doing its job properly.
    Read pages 23-24 of the report. The Honeywell EGPWS was an older one and UPS has since claimed to be upgrading to a newer system that would give warning about 6 seconds sooner.

    But they were descending through 250ft at a ridiculous 1,500fpm when they got the 'sink rate' warning. At this point things like an altimeter and a vertical speed indicator would also provide plenty of warning.

    Unless you aren't watching instruments on an instrument approach because you are brain dead from fatigue.

    Comment


    • Originally posted by Evan View Post
      ...Unless you aren't watching instruments on an instrument approach because you are brain dead from fatigue.
      Basically concur with the recent comments including 'microsleep' types of things...

      ...but someone does need to point out the broadly applicable fundamental concept that FMS programming and approach briefing and autopilot tweaking and fatigue aside, you do not go blowing through minimum altitudes...

      A little more attention to that and a little less attention to the autopilot/fms might have prevented this.
      Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

      Comment


      • Originally posted by Evan View Post
        The Captain did see it coming: He told one colleague , “I can’t do this until I retire because it’s killing me.”
        A lot of pilots say that, even ones who do not fly a "backside of the clock" schedule. Generally, a desire for yet another Corvette and/or the need to feed ex-wives ##s 6, 7, and 8 keeps them around.

        Comment


        • Originally posted by ATLcrew View Post
          Generally, a desire for yet another Corvette and/or the need to feed ex-wives ##s 6, 7, and 8 keeps them around.
          I suspect a desire for yet another Lambo and the need to feed polo ponies #6, 7 and 8 has more to do with it.

          Comment


          • is it me or is 14 months awfully fast to have a final report out?

            Comment


            • 14 months is within the range of normal.

              Sure, it's "shorter than average", but this crash was not overly mysterious- with the FDR and CVR data all there, etc.

              Plus, I think they fret less when you haven't killed paying customers.
              Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

              Comment


              • Originally posted by Evan View Post
                I suspect a desire for yet another Lambo and the need to feed polo ponies #6, 7 and 8 has more to do with it.
                We're talking about a UPS A300 captain here, not the chief pilot for the dubai airwing...and even then, I think lambos and polo ponies are more inline with their employer's recreational activities.

                Comment


                • Originally posted by Leftseat86 View Post
                  We're talking about a UPS A300 captain here, not the chief pilot for the dubai airwing...and even then, I think lambos and polo ponies are more inline with their employer's recreational activities.
                  Exactly. The problem begins there.

                  Comment


                  • Originally posted by AVHerald
                    The NTSB wrote: "Although the flight crew set up and briefed a Continuous Descent Final Approach (CDFA) approach using the profile method, when the captain changed the autopilot to vertical speed mode, the approach essentially became a °dive and drive" approach." and continued: "Although CDFA was one of the techniques taught at UPS, the guidance for CDFA was found in the PTG, which is not an FAA-approved or -accepted manual."

                    The NTSB analysed: "By not properly sequencing the approach and leaving the original navigation path direct to KBHM in the FMC, a flight plan discontinuity was introduced that prevented the autopilot from engaging in profile mode, even though the 3.28° glidepath was programmed into the FMC and the profile mode was armed. Further, and in spite of the flight plan discontinuity, the FMC constructed a glidepath for the approach using the 3.28° angle and the total length of all the navigation legs in the FMC, including the improper direct-to-KBHM leg. Because this length was unrealistically long, the altitude of the glidepath was unrealistically high for the airplane's actual distance from the runway, rendering the glidepath meaningless."
                    Clusterf*ck.

                    Comment


                    • Originally posted by Evan View Post
                      [...The quoted part...]
                      So did they go below minimums or something?
                      Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

                      Comment


                      • Some interesting comments in the Member Robert L. Sumwalt's concurring statement.

                        The report states that, had the aircraft’s EGPWS software been updated by the company,
                        a “too low terrain” caution alert would have sounded 6.5 seconds earlier and 150 feet higher than
                        the EGPWS alert the flight crew received.
                        Numerous industry publications, including information presented at Airbus safety
                        conferences, have emphasized the importance of maintaining up-to-date terrain databases and
                        software. These software upgrades are offered free of charge. It is therefore incomprehensible
                        that a company such as UPS would not upgrade this critically important software.

                        Another safety enhancement that UPS did not take advantage of was activating autocallouts,
                        also known as “smart callouts.” With smart callouts, equipment on the airplane
                        announces altitudes as the aircraft descends. Industry best practices call for operators to activate
                        smart callouts. For example, Flight Safety Foundation’s seminal document on CFIT accidents1
                        states that “operators should … activate smart callouts at 2,500 feet, 1,000 feet, 500 feet, at the
                        altitude set in the decision height (DH) window and at 50 feet, 40 feet, 30 feet, 20 feet, and 10
                        feet for better crew terrain awareness.”
                        The Board unanimously approved a finding that had these callouts been activated, “it
                        would have made the crew aware of their close proximity to the ground and they could have
                        taken action to arrest the descent.”

                        Oddly, although other aircraft in the UPS fleet have these smart callouts, UPS did not
                        activate smart callouts on their A-300 fleet, despite industry recommendations that they be used.
                        As in the case of EGPWS software upgrades, had the smart callouts been activated, valuable lifesaving
                        cues would have been presented to the crew, possibly preventing the crash.

                        [The first critical error was failure to properly sequence the flight plan]

                        The second critical error, in my opinion, was failure to monitor altitude during the
                        approach, and this failure led to the CFIT. As such, the Board identified this error as one that was
                        causal to the crash. Even with weather reports that may have set an expectation for a less
                        demanding approach due to reported weather conditions; even with the crew not properly
                        sequencing the flight plan in the FMS; even with the captain not verbalizing his intentions after
                        not capturing the profile; even with the captain exceeding stabilized approach parameters and not
                        executing a missed approach; and, even with an first officer who was fatigued, the crash would
                        not have occurred if the crew had monitored altitude and not allowed the aircraft to descend
                        below the minimum altitude unless the runway was in sight.

                        --- Judge what is said by the merits of what is said, not by the credentials of who said it. ---
                        --- Defend what you say with arguments, not by imposing your credentials ---

                        Comment


                        • The National Transportation Safety Board determines that the probable cause of this
                          accident was the flight crew’s continuation of an unstabilized approach and their failure to
                          monitor the aircraft’s altitude during the approach, which led to an inadvertent descent below the
                          minimum approach altitude
                          and subsequently into terrain.
                          In Argentina we would say "figurita repetida".

                          --- Judge what is said by the merits of what is said, not by the credentials of who said it. ---
                          --- Defend what you say with arguments, not by imposing your credentials ---

                          Comment


                          • Originally posted by 3WE View Post
                            So did they go below minimums or something?
                            3WE, this is a classic case of a crew losing their SA. Part of that is due to fatigue (which should carry similar consequences as flying intoxicated IMHO). The other part of this was poor discipline with the automation, both in setting up the approach and monitoring it. Ultimately it was poor airmanship: failure to monitor basic instruments and/or to respect minimums, but that is often a consequence of degraded SA, and SA is a form of redundancy against human error with respect to airmanship. You can't simply rely on airmanship, not in the real world.

                            But what we have here is a class A clusterf#ck, from the F/O not calling in fatigued to the first twig snapping.

                            Comment


                            • Originally posted by Gabriel View Post
                              Some interesting comments in the Member Robert L. Sumwalt's concurring statement.
                              Originally posted by Some NTSB guy
                              The report states that, had the aircraft’s EGPWS software been updated by the company,
                              a “too low terrain” caution alert would have sounded 6.5 seconds earlier and 150 feet higher than
                              the EGPWS alert the flight crew received.
                              Um... did the terrain in the area rise 150 feet after the database was published?

                              I'm 110% in favor of updates as they describe, both in principle and in practice.

                              But I wonder if what was not said was that there was an *error* in the version of the database that aircraft was using. And if an error in the data contributed to this accident, they should say so.
                              Be alert! America needs more lerts.

                              Eric Law

                              Comment


                              • Originally posted by elaw View Post
                                Um... did the terrain in the area rise 150 feet after the database was published?

                                I'm 110% in favor of updates as they describe, both in principle and in practice.

                                But I wonder if what was not said was that there was an *error* in the version of the database that aircraft was using. And if an error in the data contributed to this accident, they should say so.
                                I also found that strange. 150ft and 6.5 seconds represent a HUGE difference...if the crash had occurred pre-update would that just not have been considered a factor then?

                                Comment

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