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The BA B744 That Nearly Stalled At JNB, Verdict  
User currently offlineoly720man From United Kingdom, joined May 2004, 6757 posts, RR: 11
Posted (4 years 3 months 2 days 20 hours ago) and read 20902 times:

Following on from this over a year ago

Serious Incident: BA 744 At JNB (by Kaitak May 13 2009 in Civil Aviation)

the crew get high praise for averting a near disaster

http://www.flightglobal.com/articles...caping-near-stall-on-take-off.html

South Africa's Civil Aviation Authority has praised the airmanship of British Airways Boeing 747-400 pilots who battled to prevent a low-altitude stall after the leading-edge slats unexpectedly retracted during lift-off from Johannesburg.


wheat and dairy can screw up your brain
38 replies: All unread, showing first 25:
 
User currently offlineyellowtail From United States of America, joined Jun 2005, 6184 posts, RR: 2
Reply 1, posted (4 years 3 months 2 days 19 hours ago) and read 20877 times:

"aerobatic skill"...once again (like Sully)...superior airmanship and skills outside of day to day flying save the day. Maybe airlines should start to encourage its crews to take up gliding, aerobatics etc ...dare I say even give them bonuses for having such skills.


When in doubt, hold on to your altitude. No-one has ever collided with the sky.
User currently offlinebigjuliechc From New Zealand, joined Oct 2008, 41 posts, RR: 0
Reply 2, posted (4 years 3 months 2 days 7 hours ago) and read 19513 times:

Shades of the the Gimli Glider incident, perhaps? Also the Galunggung Glider incident!


bigjuliechc
User currently offlinefaro From Egypt, joined Aug 2007, 1551 posts, RR: 0
Reply 3, posted (4 years 3 months 2 days 7 hours ago) and read 19366 times:

Quoting bigjuliechc (Reply 2):
Shades of the the Gimli Glider incident, perhaps? Also the Galunggung Glider incident!

As well as LH 540, the first crash of a 747 in Nairobi in 1974. It's amazing that a slat incident occurred again on take-off on the same aircraft...

Faro



The chalice not my son
User currently offlineRJ111 From , joined Dec 1969, posts, RR:
Reply 4, posted (4 years 3 months 2 days 7 hours ago) and read 18991 times:

Quoting yellowtail (Reply 1):
"aerobatic skill"...once again (like Sully)...superior airmanship and skills outside of day to day flying save the day. Maybe airlines should start to encourage its crews to take up gliding, aerobatics etc ...dare I say even give them bonuses for having such skills.

Aerobatic Skills did not save the day at all, what to do should be obvious to any pilot at any level.

Not that i'm taking anything away from the F/O. He kept his cool and did everything right - he deserves praise.


User currently offlineSAS-A321 From Denmark, joined Mar 2002, 401 posts, RR: 0
Reply 5, posted (4 years 3 months 2 days 7 hours ago) and read 18685 times:

Quoting RJ111 (Reply 4):
Aerobatic Skills did not save the day at all, what to do should be obvious to any pilot at any level.

Not that i'm taking anything away from the F/O. He kept his cool and did everything right - he deserves praise.

Exactly



It's Scandinavian
User currently offline747classic From Netherlands, joined Aug 2009, 2155 posts, RR: 14
Reply 6, posted (4 years 3 months 2 days 7 hours ago) and read 18687 times:

In its inquiry report into the 11 May 2009 incident, the CAA says the crew had "no notion" that the slats had retracted before rotation. There is no separate indication in the cockpit for leading-edge slat position.

Remarks :

- factual fault : the 747-400 is equipped with Leading Edge (LE) flaps (kruger and variable camber), no slats are installed.
- Why is no LE flap indication on the 747-400 installed, or is this suppressed during T/O ?. Following the LH Nairobi accident master LE annunciator lights (extended and in transit) were added on the pilots panel of the 747-100/200 aircraft. Also the T/O warning logic was adapted. Later also 747-300 and SP aircraft were built according the same standard.
Maybe to much pilots info (dials, lights) deleted in the 747-400 ?



[Edited 2010-07-01 03:54:57]


Operating a twin over the ocean, you're always one engine failure from a total emergency.
User currently offlineJBirdAV8r From United States of America, joined Jun 2001, 4491 posts, RR: 21
Reply 7, posted (4 years 3 months 2 days 4 hours ago) and read 15975 times:

Quoting 747classic (Reply 6):
- factual fault : the 747-400 is equipped with Leading Edge (LE) flaps (kruger and variable camber), no slats are installed.

Nit picked, congratulations....

Quoting 747classic (Reply 6):
- Why is no LE flap indication on the 747-400 installed, or is this suppressed during T/O ?. Following the LH Nairobi accident master LE annunciator lights (extended and in transit) were added on the pilots panel of the 747-100/200 aircraft. Also the T/O warning logic was adapted. Later also 747-300 and SP aircraft were built according the same standard.

Quick and dirty explanation without an abundance of research: LE flap retraction during T/R activation is the expected condition, hence no flap asymmetry/disagree warning. I'm no 747 systems expert, but we've got some on this board. Doubt an aural/visual warning would have made a difference as the retraction was past V1--actually, if the crew had reacted to that past V1 rather than flying the airplane, you would have had a runway overrun and possibly many casualties.

Your situation is a little different. IIRC during the Lufthansa Nairobi accident the LE flaps never positioned as commanded, which would certainly have resulted in something like a LE FLAP DISAGREE alert on the EICAS of a 747-400.

I think the real question is whether or not there should be some kind of logic change for LE flap retraction on reverser activation, and how difficult it would be to implement. As this is the only incident I know of in the past 40 years, I am not sure it will happen.

[Edited 2010-07-01 06:02:11]


I got my head checked--by a jumbo jet
User currently offlineJBirdAV8r From United States of America, joined Jun 2001, 4491 posts, RR: 21
Reply 8, posted (4 years 3 months 2 days 4 hours ago) and read 15931 times:

Quoting RJ111 (Reply 4):
Aerobatic Skills did not save the day at all, what to do should be obvious to any pilot at any level.

Actually prior real-world experience can quicken reaction time, as you don't have to parse exactly what's happening in your brain. So yes, it helped, even though competent pilots know what to do.  



I got my head checked--by a jumbo jet
User currently offlineDH106 From United Kingdom, joined Jun 2005, 626 posts, RR: 1
Reply 9, posted (4 years 3 months 2 days 4 hours ago) and read 15686 times:

Quoting 747classic (Reply 6):
- factual fault : the 747-400 is equipped with Leading Edge (LE) flaps (kruger and variable camber), no slats are installed.

This has been debated on the forum before.
Boeing calls it's variable chamber flaps, "slats". Presumably this is because notwithstanding the fact they deploy differently to 'true' slats, they do have a small gap (slot) between the flap and the wing - unlike the inboard Kruegers.



...I watched c-beams glitter in the dark near the Tanhauser Gate....
User currently offline747classic From Netherlands, joined Aug 2009, 2155 posts, RR: 14
Reply 10, posted (4 years 3 months 2 days 3 hours ago) and read 14294 times:

Quoting JBirdAV8r (Reply 7):
Quick and dirty explanation without an abundance of research



Nice answer. Next time, look first at my profile , more than 15000 hours on the 747-200/200F/300, plus (restricted) 747 ground engineer licenced.

I only wondered why there is no easily visible LE flap indication(or warning) in front of the pilots.
In the classic 747 it was always possible to see the actual LE flaps configuration (all extended : green or in transit amber) for the pilot not flying (and FE) on the fwd panel. During engine reverse you always could see the cycling of the LE flaps indicator lights.
In this case the failure happened just before Vr., so normally the T/O warning must have been activated shortly (ground safety relays still in ground mode). After rotation the stick shaker came in.
If you would have had a LE position indication, you could have been immediately aware of your (aerodynamic) problem and could act accordingly.
However, in this case it was impossible to extent the LE flaps as long as the faulty override signal of the T/R was present.
The reaction of the PF was excellent, but if he was informed of the nature of the problem by the PNF, it would have been easier.
Next time, conditions could be even more restrictive, rotation could be a little bit different and the speed bleeds off faster after rotation and they won't make it.

Quoting JBirdAV8r (Reply 7):
I think the real question is whether or not there should be some kind of logic change for LE flap retraction on reverser activation



I agree, the reverse actuated LE operating system must be modified, but some LE indication warning (pop up on EICAS) in case of a combination of airborne AND flap lever 10 or 20 selected AND LE flaps retracted, is also welcome.



[Edited 2010-07-01 08:08:12]


Operating a twin over the ocean, you're always one engine failure from a total emergency.
User currently offlineplanespotting From United States of America, joined Apr 2004, 3527 posts, RR: 5
Reply 11, posted (4 years 3 months 2 days 3 hours ago) and read 14292 times:

Quoting RJ111 (Reply 4):
Aerobatic Skills did not save the day at all, what to do should be obvious to any pilot at any level.

Not that i'm taking anything away from the F/O. He kept his cool and did everything right - he deserves praise.

  

Quoting JBirdAV8r (Reply 8):
Actually prior real-world experience can quicken reaction time, as you don't have to parse exactly what's happening in your brain.

He probably got his "real world experience" by just being a pilot. Every student pilot learns that If the plane starts to buffet, you push down. Every airline pilot should know if the stick shaker goes off, you push down.

That's what pilots do (although, in regards to Colgan 3407, for some reason that isn't always the case).



Do you like movies about gladiators?
User currently offlineALWAYSONTHERUN From Netherlands Antilles, joined Jan 2010, 464 posts, RR: 0
Reply 12, posted (4 years 3 months 2 days 3 hours ago) and read 14061 times:

Quoting JBirdAV8r (Reply 7):
I'm no 747 systems expert, but we've got some on this board.

Yep, and I guess you happened to be talking to one:

Quoting 747classic (Reply 10):
look first at my profile , more than 15000 hours on the 747-200/200F/300, plus (restricted) 747 ground engineer licenced.


Kudos to the BA pilots, if there´s such a thing as a BA "Hall of Fame" I guess these guys should be in there, right next to the volcanic ash boys of BA 009.
Perhaps they are not "heroes" as such--> but pilots that kept their cool when the pressure was on, and how many accidents happened because of pilots who were not able to accomplish that?


###I´m Always On The Run###



"Failure is not an option, it comes standard in any Windows product" - an anonymous MAC owner.
User currently offlineULMFlyer From Brazil, joined exactly 8 years ago today! , 475 posts, RR: 1
Reply 13, posted (4 years 3 months 2 days 2 hours ago) and read 13894 times:

Quote:
The inquiry concluded that, although the reversers were stowed, their translating cowls were nevertheless seated relatively far rearwards.

Any idea what caused this on 2 different engines? I suppose this is the relevant question. Is there a direct link to the report?

Thanks.



Let's go Pens!
User currently offlineSpeedbird741 From Portugal, joined Aug 2008, 654 posts, RR: 0
Reply 14, posted (4 years 3 months 2 days 2 hours ago) and read 13499 times:

Quoting ULMFlyer (Reply 13):

Here you go

http://www.caa.co.za/resource%20cent...%20&%20incid/reports/2009/0717.pdf


Speedbird741



Boa noite Faro, Air Portugal 257 climbing flight level 340
User currently onlinereadytotaxi From United Kingdom, joined Dec 2006, 3281 posts, RR: 2
Reply 15, posted (4 years 3 months 2 days 2 hours ago) and read 13449 times:

Is there a "simulation" out there on the web about this incident does anyone know?


you don't get a second chance to make a first impression!
User currently offlineSpeedbird741 From Portugal, joined Aug 2008, 654 posts, RR: 0
Reply 16, posted (4 years 3 months 2 days 2 hours ago) and read 13058 times:

Quoting 747classic (Reply 6):
- Why is no LE flap indication on the 747-400 installed, or is this suppressed during T/O ?

Not that it matters, as this does not regard normal operations, but the 744 does have separate indications for the 4 groups of variable camber and the 2 groups of krueger LE flaps when in alternate flap mode.

Quoting 747classic (Reply 10):
I agree, the reverse actuated LE operating system must be modified

From the official report linked above,

"Boeing developed a draft SB aimed only at the 747-400/RR
engine combination fleet to be sent to the FAA for their review no
later than June 1, 2009. Information gathered from the Boeing SB
draft, was that the intent of the SB would be to remove the auto
stow feature of the leading edge flaps based on the 'unstow' signal
from the thrust reversers. The feature would still function based
on reverse handle selection and air/ground logic. This would make
the 747-400's Rolls Royce powered airplanes similar to the older
models. This can be accomplished by re-terminating the
appropriate ‘unstow’ signal wire, essentially disabling it."


Speedbird741



Boa noite Faro, Air Portugal 257 climbing flight level 340
User currently offlinefca767 From United Kingdom, joined Nov 2006, 1769 posts, RR: 1
Reply 17, posted (4 years 3 months 2 days 2 hours ago) and read 12686 times:

Quick Question:

I know that Flaps enable you to get off the ground quicker, provided you have the extra power to overcome more drag created by flaps. So Am I right that if it got airbourne during the Slats being up, that it would stay up and then the airspeed will increase more easily due to lack of the slat's drag.


User currently offlineAR385 From Mexico, joined Nov 2003, 6236 posts, RR: 31
Reply 18, posted (4 years 3 months 2 days 1 hour ago) and read 12097 times:
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Quoting faro (Reply 3):
As well as LH 540, the first crash of a 747 in Nairobi in 1974. It's amazing that a slat incident occurred again on take-off on the same aircraft...

It´s not amazing at all, as the reason for the Nairobi accident was totally different than this BA incident. In Nairobi, the Lufthansa pilots did not complete their checklists correctly, thus initiating take-off with the leading edge flaps retracted because the pneumatic system which operates them was not switched on.

In the BA incident the leading edge flaps rectracted when the system governing them received false and intermittent thrust reverser unlock signals from the no. 2 and no. 3 engines. Such an occurrence had not been identified during the design of the system´s leading edge flaps retraction logic.

The two causes for these two 747´s LE flaps retracting are completely different and unrelated, so it is wrong to say "amazing how such and such can happen twice on the same aircraft" as if there was something wrong in the design.

Quoting bigjuliechc (Reply 2):
Shades of the the Gimli Glider incident, perhaps? Also the Galunggung Glider incident!

Not really. In those instances, both aircraft were thousands of feet up.

Quoting 747classic (Reply 6):
There is no separate indication in the cockpit for leading-edge slat position.

There is an indication. It is in the extended flap EICAS display but that display was not brought up, quite understandably. The other available indication was a color change of the flap display in the regular EICAS display which apparently is hard to see.

Boeing plans to change the system logic withdrawing the reverser unlock signal from the autoretract logic, which would continue to function based on the reverser handles and air/ground logic.


User currently offlineoly720man From United Kingdom, joined May 2004, 6757 posts, RR: 11
Reply 19, posted (4 years 3 months 2 days 1 hour ago) and read 11397 times:

Quoting fca767 (Reply 17):
So Am I right that if it got airbourne during the Slats being up, that it would stay up and then the airspeed will increase more easily due to lack of the slat's drag.

The slats are there to increase the incidence at which the aircraft can fly, i.e. the amount of lift generated. With no slats, the incidence the aircraft flew at would have been reduced - hence nearly stalling because, being hot, high & heavy they needed as much lift as possible. With lower lift the climb rate would have been reduced. Retracting the undercarriage would probably have had the greatest effect on drag.

As the aircraft tried to climb out from Tambo International Airport, known for its 'hot and high' environment, the jet lost a "significant amount of lift", says the CAA, and the stick-shaker immediately engaged, warning of an approaching stall.

Instead of following the typical climb profile, the first officer - whose aerobatic experience meant he was familiar with buffet - controlled the aircraft through the stall warning and buffeting by executing a shallower climb, while the commander supported the manoeuvre by calling out heights above ground.


As an example, this report has graphs showing lift and drag with slats/flaps. This is indicative of what may have happened on the B747.

http://ntrs.nasa.gov/archive/nasa/ca...asa.gov/19820007142_1982007142.pdf

Look at figure 14a, p97, and compare the diamond and delta triangle symbols. Diamond without slats, triangle with slats.

The bottom graph, CL, is the lift coefficient and is a measure of the lift generated. The diamonds show the lift increasing linearly until around 8deg, then the graph levels off and then reduces after 14deg - stall. The triangles show the lift increasing linearly to about 18deg before levelling off. The effect of the slats, then, is to increase the lift range of the wing from 8deg to 18deg, in this case. Note that the reduction in lift coefficient from about 2.5 to 1.7, above 16deg, shows the lift reducing by about a third. This is the sort of situation that the crew of the B747 would have found themselves in..... considerable drop in lift and having to fly at a lower incidence to maintain lift without stalling.

Looking at the CD graph, for the drag. Upto 8deg the drag is much the same for both configurations with the slat deployed case being marginally higher. Above 8deg, the no slat case has a higher drag, because of flow separation over the wing upper surface (stall).



wheat and dairy can screw up your brain
User currently offline747classic From Netherlands, joined Aug 2009, 2155 posts, RR: 14
Reply 20, posted (4 years 3 months 2 days ago) and read 10348 times:

Quoting Speedbird741 (Reply 14):
Here you go

http://www.caa.co.za/resource%20cent...7.pdf

Thanks speedbird for the link to the original report, here as some quotes :


"The take-off was planned at reduced-power and the first officer was the
handling pilot for the departure".

At max. perf. lim T/O weight and full T/O power it could have ended not so good.

"The changes in the EICAS display of the flap position, as a result of the
Group ‘A’ LE flaps auto-retract system operation, is minimal.

"The aircraft rotated and became airborne at approximately 176kt. During
these events the flight deck crew did not notice that the Group ‘A’ LE
flaps had automatically retracted".

"The cockpit crew had no notion that the Group ‘A’ LE flaps had
automatically retracted prior to rotation as there is no separate
indication on the flight deck for the position of the LE flaps during
normal LE flap operation. The extended ‘FLAPS’ display appears
automatically on the main EICAS for non-normal configurations such
as alternate flaps, flap asymmetry, and LE or TE flap disagreement
with flap control lever position".

"Although there was no separate indication on the flight deck for the
position of the LE flaps as mentioned in the above paragraph, the
retraction of the Group ‘A’ LE flaps is shown as a color change on the
flap indicator EICAS display which is hardly visible on the P2 Pilot
Center Instrument Panel".

One of the recommendations, besides the AD for changing the reverse actuated LE logic.

"Introduction of a flight deck crew “alert/approval/override” facility prior
to an inadvertent change to critical control surfaces"

This includes the LE flaps !!!

"The apparent increase in the number of software related incidents
involving various type certificated aircraft is becoming a cause of concern.
There is also a common thread through many recent accidents and it is time to
train for a new type of emergency that addresses the failure modes in highly
automated aircraft. The interface between pilots and aircraft automation, as well
as how this should be incorporated into aviation training, requires a review. This
includes addressing how automation fails, how pilots should cope with it and
how to get through the failures. New phrases for automation failures that were
similar to "dead foot, dead engine" slogans that helped them identify which
engine had quit are now needed."

Very good report, but are all the recommendations already in force ?      



Operating a twin over the ocean, you're always one engine failure from a total emergency.
User currently offlinejayeshrulz From India, joined Apr 2007, 1029 posts, RR: 2
Reply 21, posted (4 years 3 months 1 day 23 hours ago) and read 9985 times:

"Engines 2 and 3 REV Amber (cowl position) within approx 15 secs of each other during the roll. As the aircraft was still on the ground this resulted in a command to the FCU's to retract the L/E flaps Group A. The reverser commands to the FCU's operate in pairs 1&4 2&3
The L/E flaps probably extended again as the a/c became airborne"


"The changes in the EICAS display of the flap position, as a result of the
Group ‘A’ LE flaps auto-retract system operation, is minimal.

"The aircraft rotated and became airborne at approximately 176kt. During
these events the flight deck crew did not notice that the Group ‘A’ LE
flaps had automatically retracted".

"The cockpit crew had no notion that the Group ‘A’ LE flaps had
automatically retracted prior to rotation as there is no separate
indication on the flight deck for the position of the LE flaps during
normal LE flap operation. The extended ‘FLAPS’ display appears
automatically on the main EICAS for non-normal configurations such
as alternate flaps, flap asymmetry, and LE or TE flap disagreement
with flap control lever position".

"Although there was no separate indication on the flight deck for the
position of the LE flaps as mentioned in the above paragraph, the
retraction of the Group ‘A’ LE flaps is shown as a color change on the
flap indicator EICAS display which is hardly visible on the P2 Pilot
Center Instrument Panel".



I'm sorry but can someone please help me in simpler words what these terms mean?
Like Group A LE and flap asymmetry.....
Please!

Also, what went wrong in this case?

I am really wanting to know about this incident, but i really cannot understand these technical terms  
Thank you.



Keep flying, because the sky is no limit!
User currently offlinefca767 From United Kingdom, joined Nov 2006, 1769 posts, RR: 1
Reply 22, posted (4 years 3 months 1 day 23 hours ago) and read 9718 times:

Quoting oly720man (Reply 19):
Looking at the CD graph, for the drag. Upto 8deg the drag is much the same for both configurations with the slat deployed case being marginally higher. Above 8deg, the no slat case has a higher drag, because of flow separation over the wing upper surface (stall

Thanks for the references, and your explanation, this makes more sense now  


User currently offlineMD95 From Italy, joined Apr 2005, 104 posts, RR: 0
Reply 23, posted (4 years 3 months 1 day 23 hours ago) and read 9635 times:

I was asking myself, why the TO was not aborted immediatly after receiving the Amber indication that the REV were in transit? This occured at the beginning of the TO roll.


dario
User currently offlineULMFlyer From Brazil, joined exactly 8 years ago today! , 475 posts, RR: 1
Reply 24, posted (4 years 3 months 1 day 22 hours ago) and read 8768 times:

Quoting MD95 (Reply 23):
I was asking myself, why the TO was not aborted immediatly after receiving the Amber indication that the REV were in transit? This occured at the beginning of the TO roll.

Your question is valid, but your premise is mistaken. According to the report, the #3 amber msg was received when speed was already at 125.6 kts, hardly at the beginning of the roll, though still below V1 which was 150 kts. #2 amber msg came at 159.9 kts.

According to pros in another forum, SOPs state that you do not abort above 80 kts for an amber msg to avoid a high-speed rejection (hot brakes, etc.)

Cheers.



Let's go Pens!
25 DH106 : I suppose that begs the question then - why is a reverser unlock under these conditions 'only' an amber warning as it's potentially catastrophic shou
26 spacecadet : Is it, on a 747 with four engines? Reverser deployment in flight isn't necessarily catastrophic. It depends on the airplane, and I'm not sure about t
27 AR385 : There are a number of items that during certain flight operations will be amber. That is the case here. A reverser showing unlocked / unstowed during
28 mcg : What was the root cause? Why did the reverser sensor give an erroneous signal?
29 DH106 : I wasn't implying it was in all phases of flight, but in this case I was contending that if either/both of the affected engine's reversers HAD actual
30 Tristarsteve : It wasn't an erroneous signal, the reversers had moved a fraction, enough to bring the unlock sensors to far. With both inboard reverser unlocks at f
31 OldAeroGuy : I've never seen any Boeing publication that refers to the 747 Variable Camber Kruegers (VCK's) as slats. Slats are a distinctly different type of lea
32 JBirdAV8r : Thanks for telling me what I do and have trained scores of others to do. Look. Training is one thing--experience is another. Experience compliments t
33 747classic : Nice to know that, no further comments.
34 DocLightning : Well, folks, the next time you are about to complain that pilots are overpaid...
35 Speedbird741 : He is not tooting his horn about anything, he is merely sharing what he did/does for a living, which happens to be something that makes him no strang
36 RJ111 : Well every bit of flight "helps" future flights one way or another, the question is how much. You said yourself 99.9% of pilots would have been succe
37 spacecadet : Yes, that's true, however it seems that reverse thrust alone might not cause an accident and perhaps that's why the reverser indication is only an am
38 ALWAYSONTHERUN : Who´s snarky now? Have you bothered to read other post of 747 Classic………he has been quite productive in other threads over a long period of ti
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