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Author Topic: Pilots Say Boeing Didn't Tell Them About a Safety Feature Tied to a Deadly Crash  (Read 1941 times)
OldGuy
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« on: November 14, 2018, 02:57:31 AM »

http://time.com/5453054/boeing-crash-737-max/

Two U.S. pilots’ unions say the potential risks of a safety feature on Boeing Co.’s 737 Max aircraft that has been linked to a deadly crash in Indonesia weren’t sufficiently spelled out in their manuals or training.

excerpted, much more at the link above...
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TheSkyHornet
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« Reply #1 on: November 14, 2018, 03:26:02 PM »

From the article:
Quote
Flight crews have a right to be concerned that details about the new system weren’t included in manuals and the short training courses they were
required to take before flying the upgraded 737

Is the issue here that the AFM didn't include the system description, or that the company's AOM and training materials didn't (and if it's in the AOM, it needs to be in training)?

I'm not huge on the "short training courses" line in the TIME article. I think that's an over simplification of differences training, both in ground and sim. I'm not familiar with the full differences between a 737-800 and a MAX 8, but I'm assuming that the Task Levels under the MDRs are a D- or E-level difference.

It may very well be that Boeing did not put a full system description in the AFM, and that the carriers never introduced it to flight crew members. But we don't know if that had any impact in the Lion Air accident.

Still more details to be learned here before major assumptions that Boeing contributed to the accident. Definitely something to address if Boeing did not include the automated push-over in the AFM; more so if they did and the carriers didn't.
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cnitas
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« Reply #2 on: November 14, 2018, 04:23:16 PM »

My read from the article is that Boeing did not include a system description in the AFM.  Therefore it was not in the company training, and thus pilots had no idea there was a system like this installed in the aircraft.


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TheSkyHornet
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« Reply #3 on: November 14, 2018, 04:43:55 PM »

My read from the article is that Boeing did not include a system description in the AFM.  Therefore it was not in the company training, and thus pilots had no idea there was a system like this installed in the aircraft.

That was my take as well, but I'm also reading a TIME re-write of a Bloomberg article quoting union representatives, not statements from the carriers or Boeing.

Working for an Embraer operator, there are definitely some -isms with the E-birds in the AFM. Embraer has a tendency to remove procedures from the AFM, which we, in turn, need to change in our AOM; and then come back to say "Oops, we should put that back in" with little explanation as to why it came out to begin with.

There's a definite delicate balance to the Operator-Manufacturer interface.
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Live2Learn
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« Reply #4 on: November 15, 2018, 03:42:21 PM »

Here's the FAA's Emergency AD issued over a week ago:   https://theaircurrent.com/wp-content/uploads/2018/11/B737-MAX-AD-1107.pdf.  The E. AD applies to Boeing 737 8's and 9's that are "certified in any category".   Several US airlines have 8's in their active fleet.  I've ridden in the back on several flights on those aircraft in the past year or so.  Obviously, without encountering the anomalous pitch sensor problem.  :o  Based on the E. AD date we can expect unmodified aircraft could still be in service for another 22 days.
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PHall
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« Reply #5 on: November 15, 2018, 04:10:30 PM »

Here's the FAA's Emergency AD issued over a week ago:   https://theaircurrent.com/wp-content/uploads/2018/11/B737-MAX-AD-1107.pdf.  The E. AD applies to Boeing 737 8's and 9's that are "certified in any category".   Several US airlines have 8's in their active fleet.  I've ridden in the back on several flights on those aircraft in the past year or so.  Obviously, without encountering the anomalous pitch sensor problem.  :o  Based on the E. AD date we can expect unmodified aircraft could still be in service for another 22 days.


There are currently no planned physical modifications that will be made to the aircraft.
It just instructs the pilots to run the Runaway Pitch Trim checklist, which they should have been doing already because uncommanded pitch trim operation is considered Runaway Pitch Trim and running the checklist is required.

Trust me, this is only the beginning, there WILL be more to come from the FAA and Boeing on this.
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CAPDepCom
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« Reply #6 on: November 15, 2018, 07:27:07 PM »

Personally, I find it hard to believe Boeing didn't include the content in any manuals, training or otherwise.  It's not like they don't have a QC department for their manuals (they do) or they just started manufacturing airplanes yesterday.
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PHall
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« Reply #7 on: November 15, 2018, 09:46:25 PM »

The flight manuals for civilian aircraft are much simpler then the one's for military aircraft.
The one's for military aircraft cover all of the systems on the aircraft in painstaking detail complete with diagrams.
The one's for civilian aircraft basically just tell you how to operate it with not a lot of systems explanation.
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CAPDepCom
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« Reply #8 on: November 16, 2018, 01:24:48 AM »

Not trying to argue, but my brother, who is a 21 year, senior engineer and exec at Boeing says differently.  As does an old friend of mine who, until three months ago, worked for 25 years at Boeing writing those manuals.
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THRAWN
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« Reply #9 on: November 16, 2018, 12:47:28 PM »

Anecdotal evidence versus first hand experience. Most anecdotes should start "Once upon a time"....or for our sea service friends, "No poo, there I was...."
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Strup
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sardak
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« Reply #10 on: November 16, 2018, 08:42:36 PM »

The new 737 MAX has larger engines than previous 737s. Ever notice how the nacelles are flattened on the bottom of most 737s?  That's for ground clearance, but Boeing couldn't make the nacelles flatter to gain ground clearance for the new engines. This required structural mods to the landing gear and wings and shifting the position and angle of the engines, resulting in CG and angle of attack changes.

The Maneuvering Characteristics Augmentation System (MCAS) was added to help stability and reduce risks for stalling at higher angles of attack. The system is well documented on the manufacturer side of the issue.  However, Boeing didn't think this was enough of a change that it required new training for pilots transitioning to the new MAX series, and the FAA agreed. In essence, the system would be transparent to the flight crew.  I can't imagine there was any deliberate hiding of the system.  The thinking was that dealing with stabilizer/pitch problems, high angles of attack and onset of stall would still be handled as in the past, MCAS is just there to "help."

AoA reading mismatches on several flight of the same Lion Air aircraft resulted in aircraft behavior crews weren't expecting, perhaps brought on by the MCAS. In all but the last flight, the crews managed to regain control.  As a consequence, the E-AD was issued to clarify emergency flight procedures.  There has been nothing released publicly regarding hardware and/or software changes and there is still work needed to determine what role the MCAS actually played.  The accident investigation is in the early phases and the CVR has yet to be located, which hopefully will help explain the crew's actions. The accident has certainly made the "transparent" MCAS system visible.

Mike
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NIN
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« Reply #11 on: November 17, 2018, 12:06:23 AM »

I have a friend who is a 737 captain for a US major.  A month or so back, her and her FO arrived to find their equipment was an 8 Max. Neither had flown an 8 Max, but apparently it was allowed,   so off they went.

I come from a similar background as phall, and knowing your systems can be the difference between making the right decision in the face of contrary info during an incident and winning the day,  or making a wrong decision with incomplete system knowledge and arriving at your own crash site.  SCE to AUX, anyone?

I thought it odd that a flight crew on a revenue flight would be flying a new major rev of a model without knowing the ins and outs of that rev beforehand.

(Unknown if they'd been familiarized with the aircraft previously in a ground procedures trainer or what....)


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TheSkyHornet
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« Reply #12 on: November 18, 2018, 01:35:29 PM »

I have a friend who is a 737 captain for a US major.  A month or so back, her and her FO arrived to find their equipment was an 8 Max. Neither had flown an 8 Max, but apparently it was allowed,   so off they went.

False. I don't buy it at all.

And if true, then a VDRP is in order for their training and crew scheduling programs.

They have to have training on the type before they can operate.
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SarDragon
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« Reply #13 on: November 18, 2018, 10:16:32 PM »

Let's keep it clean folks. Stay away from that rabbit hole that posts seem to go down all too frequently.
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Dave Bowles
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PHall
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« Reply #14 on: November 19, 2018, 02:01:10 AM »

I have a friend who is a 737 captain for a US major.  A month or so back, her and her FO arrived to find their equipment was an 8 Max. Neither had flown an 8 Max, but apparently it was allowed,   so off they went.

False. I don't buy it at all.

And if true, then a VDRP is in order for their training and crew scheduling programs.

They have to have training on the type before they can operate.

That would be true if the 737-700 MAX was considered a seperate type from the 737-700, but the FAA considers them to be the same type.

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NIN
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« Reply #15 on: November 19, 2018, 03:17:11 AM »

False. I don't buy it at all.

And if true, then a VDRP is in order for their training and crew scheduling programs.

They have to have training on the type before they can operate.



Who are you, Dwight Schrute?

I don't know about any ground prep/familiarity training they may have had in advance of flying the plane, like, I dunno, 2-3 days in the ground procedures training aid, or a day in the sim.

I just had to laugh because her comment was something like "My first clue it was the Max was by looking at the flap gauge. (That doesn't look right... what are we flying? lol)"

If I was boarding and heard the pilot say "What kind of airplane is this?" I'd be saying "Uh, yeah, I need to switch my flight please..."

I know her pretty well, she's a captain at a well established US airline that flies a lot more airplanes than just 737s. I think the crew scheduling and dispatch people know their business, too.
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Live2Learn
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« Reply #16 on: November 19, 2018, 04:57:26 AM »


...

I just had to laugh because her comment was something like "My first clue it was the Max was by looking at the flap gauge. (That doesn't look right... what are we flying? lol)"

If I was boarding and heard the pilot say "What kind of airplane is this?" I'd be saying "Uh, yeah, I need to switch my flight please..."


You speak great wisdom, oh Wise One.  I would be treading on your heels as you reversed course down the gangway.  +++100!  I would strongly consider switching airlines too.
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TheSkyHornet
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« Reply #17 on: November 19, 2018, 03:15:49 PM »

False. I don't buy it at all.

And if true, then a VDRP is in order for their training and crew scheduling programs.

They have to have training on the type before they can operate.

Who are you, Dwight Schrute?

I don't know about any ground prep/familiarity training they may have had in advance of flying the plane, like, I dunno, 2-3 days in the ground procedures training aid, or a day in the sim.

I just had to laugh because her comment was something like "My first clue it was the Max was by looking at the flap gauge. (That doesn't look right... what are we flying? lol)"

If I was boarding and heard the pilot say "What kind of airplane is this?" I'd be saying "Uh, yeah, I need to switch my flight please..."

I know her pretty well, she's a captain at a well established US airline that flies a lot more airplanes than just 737s. I think the crew scheduling and dispatch people know their business, too.

Chuckled out loud.

I'm just saying, from experience in crew scheduling, safety management, and regulatory compliance, the scheduling software provides a warning message when a crewmember is assigned to operate an aircraft that he/she is not qualified to operate.

This means that either the crew scheduling software was not updated to have a distinction between the 737NG and the MAX (say, for example, the software shows "737" as a generality rather than "738, 739, 7M8"), or the training/records department(s) incorrectly listed someone in the software as having completed Differences on the MAX. --- Both of these would/should result in a Voluntary Disclosure Report to the FAA, if the carrier identified it.

If the FO operated the flight knowing she did not complete qualification on the aircraft, it wouldn't even be accepted under ASAP; the FAA would have a field day with that investigation (considering I've seen the chaos caused by something like a 2-knot flap overspeed that went unreported to Maintenance).

So it's just an assumption, but I'm sensing perhaps the FO may have exaggerated, or the story was exaggerated on part of the Captain (friend or not). If this was a legitimate occurrence, as described, then the carrier has a serious problem on its shoulders. It may very well have already been addressed internally and with the feds. Did the aircraft even leave the ground? I can't see a Captain saying "Okay, well, you'll learn on the way."

Quote
but apparently it was allowed

It isn't allowed.

Never once did I see someone operate an aircraft without being qualified. Incorrect crew pairing under flight hours, expiration of currency, sure. Never saw someone climb into a flight deck without the required Differences Training.

This is just a selling point to the FAA for the need for SMS integration in the airline industry, and it's already a global PITA enough as it is.
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Live2Learn
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« Reply #18 on: November 19, 2018, 05:56:03 PM »

Today's AvWeb (https://www.avweb.com/eletter/archives/101/4194-full.html?ET=avweb:e4194:252117a:&st=email#231865) has a short article by Paul Bertorelli titled "UAL Union: Pilots Don't Need To Know About All Automatic Systems". 

Paul writes that "Todd Insler, chairman of the United Airlines ALPA unit, questioned why ALPA publicly pushed Boeing to provide more information on the auto trim system, insisting that pilots are already well trained to handle any uncommanded trim events. ... In an interview with the Seattle Times, Insler compared automated background systems on airliners to watching television. “I don’t need to know how it works,” he said."

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sardak
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« Reply #19 on: November 19, 2018, 07:21:40 PM »

Here is more detail than the AvWeb blurb on the stance of the unions and airllines on the MCAS issue.

https://www.seattletimes.com/business/boeing-aerospace/dispute-arises-among-u-s-pilots-on-boeing-737-max-system-linked-to-lion-air-crash/

And comments from Boeing engineers, executives, and more from the airlines.
https://www.seattletimes.com/business/boeing-aerospace/faa-evaluates-a-potential-design-flaw-on-boeings-737-max-after-lion-air-crash/

Mike
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OldGuy
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« Reply #20 on: November 20, 2018, 03:28:19 AM »

"Boeing rushed out a bulletin last week to inform pilots all over the world about the new flight control system and exactly what to do to shut it down if it goes haywire. But the Lion Air crew didn’t have that information and may have been confused by a key handling difference that the system could have caused during the flight."

Yikes. And you can quote me on that.

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TheSkyHornet
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« Reply #21 on: November 20, 2018, 05:33:26 PM »

Paul writes that "Todd Insler, chairman of the United Airlines ALPA unit, questioned why ALPA publicly pushed Boeing to provide more information on the auto trim system, insisting that pilots are already well trained to handle any uncommanded trim events. ... In an interview with the Seattle Times, Insler compared automated background systems on airliners to watching television. “I don’t need to know how it works,” he said."

Leave it to ALPA...

I just got into an argument yesterday over whether or not conditions needs to be listed in the AOM or GOM as to when a maintenance write-up is required for exceeding airspeed limitations (specifically Vmo) during flight.

The argument was "This is common sense. You can't put everything into a manual for every situation."
"So when a pilot doesn't write it up, it's literally because they're not required to. You can't hold them to it."
"Then they shouldn't be operating an airplane if they don't have that common sense."
"Why have manuals at all?"

Not everything needs to be in a manual, but any time there is going to be a cause-and-effect, it should be in there, especially if it involves aircraft performance, automated systems, or maintenance issues.

To say "pilots don't need to know how their aircraft works" is asinine.
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Live2Learn
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« Reply #22 on: November 20, 2018, 07:18:15 PM »


To say "pilots don't need to know how their aircraft works" is asinine.


+1

Especially if a mod will affect performance under excursions from a pre-set "normal" envelope, or could respond in a counter intuitive manner to a sensor or other system failure. 
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Live2Learn
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« Reply #23 on: November 21, 2018, 02:47:21 PM »

https://www.aviationtoday.com/2018/11/20/lion-air-boeing-737-investigation-places-flight-controls-focus/?marketo_id=30777932&mkt_tok=eyJpIjoiWkdVelkyWTJaV1kzWlRBMCIsInQiOiJnUkI4SjVRZkpMcVpLQnRhSFZxWXp6cjZ4aTFuNGdsdGF4QlRFT094cjdEUWRMM202eHlnXC9TWUI2bExTY21lN1RJaFVhM3FsR3E2OGh5STdhbjc0UzhBUWkybnppS0s0NE5FZ0Niam9PYUJNWTNoVVJyek05c1hEMFZlaGpaVXAifQ%3D%3D

Avionics International reports “an update on the crash investigation from Capt. Nurcahyo Utomo of Indonesia's National Transportation Safety Committee (KNKT) ...[said]..the FDR review also concluded that the aircraft airspeed indicator was malfunctioning on four consecutive flights prior to the crash. Utomo also indicated the pilots should have recognized the malfunction when it occurred on flight JT610."

Wouldn't intermittant failure of the ASI be a known, pre-existing airwortiness fail?
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PHall
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« Reply #24 on: November 21, 2018, 07:13:10 PM »

The crew on the previous flight had written it up and maintenance had "fixed" it and signed it off.
Intermittent write ups are a real pain to duplicate so I'm not really surprised they "thought" they had fixed it.
But the new crew should have been watching for this problem like a hawk and that's why you have the back up indicator.
It is totally independent from the "normal" airspeed indicators. About the only thing they share is the pitot-static system.
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TheSkyHornet
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« Reply #25 on: November 26, 2018, 04:39:31 PM »

I can't speak for Lion's entire organizational structure and what programs they're approved to conduct...

I would guess that the repeat write-ups really don't play into the legal maintenance airworthiness of the aircraft. This is more of a chronic tracking/trending issue under a CASS program to try to identify the systemic issue and correct it.

What they likely did was MEL it as much as possible, but when the write-up continued, they would do an Ops Check (which ran satisfactory because they couldn't duplicate it), and marked that off in the logbook. Thus, airworthy.
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