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Air India Express Flight Blamed On Pilot  
User currently offlinekaitak From Ireland, joined Aug 1999, 12476 posts, RR: 37
Posted (3 years 10 months 1 week 2 days 19 hours ago) and read 5794 times:

The official report on the Air India Express crash in May has concluded that the cause of the crash was pilot error, resulting from fatigue; the aircraft approached the runway at too steep an angle and had insufficient runway to stop and as a result, overran and slid down an embankment, killing all but eight on board.

The Serbian captain had slept for much of the flight from DXB.

The report is likely to focus attention on fatigue; it will be interesting to see what his duty hours were over the last 24 hours and 30 days.

http://www.watoday.com.au/breaking-n...an-plane-crash-20101117-17xbf.html

24 replies: All unread, jump to last
 
User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 1, posted (3 years 10 months 1 week 2 days 9 hours ago) and read 5382 times:

This is shocking to say the least. The captain was asleep for over 50% of the flight from DXB! While the pilot has paid the price for his carelessness, AIX needs to be drawn and quartered for allowing this to happen.

Why didn't the Co-pilot slap this guy awake? What about cabin crew, did they not notice the 'loud snoring'?

Sadly, if the crew had not tried a GA they would have stopped successfully. FUBAR beyond all recognition.

I expect a lot of wrist slapping in the next few days and then all will be forgotten.


User currently offlineBuyantukhaa From Mongolia, joined May 2004, 2899 posts, RR: 3
Reply 2, posted (3 years 10 months 1 week 2 days 1 hour ago) and read 5053 times:

Quote:
A government official who did not want to be named told the Associated Press news agency that Indian media reports about the findings were accurate. [...] In June 2008, Air India denied reports that two of its pilots had been caught napping on the job. A flight from Dubai allegedly passed its destination of Mumbai because both pilots were fast asleep in the cockpit.
http://www.bbc.co.uk/news/world-11772562

Many questions: what made him fall asleep with 10,000 hours of experience? Tight scheduling? Illness? Why didn't the co-pilot not wake him up earlier? Why didn't the co-pilot take over controls and turn around? CRM anyone?!



I scratch my head, therefore I am.
User currently offlinefortunerunnner From United States of America, joined Jul 2010, 140 posts, RR: 0
Reply 3, posted (3 years 10 months 1 week 2 days ago) and read 4980 times:

Quoting comorin (Reply 1):
AIX needs to be drawn and quartered for allowing this to happen.

Pilot fatigue is universal phenomenon and not restricted to AIX, what does AIX has to do with Pilot's inability to stay awake besides possibly reducing their work hours.

Do you propose Colgan be banned from operating any additional flights???? If I recall they also had a crash in no so distant memory that was ultimately blamed on pilot fatigue so by your logic FAA should have banned them from flying by now.


User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 4, posted (3 years 10 months 1 week 1 day 22 hours ago) and read 4857 times:

Quoting fortunerunnner (Reply 3):
Pilot fatigue is universal phenomenon and not restricted to AIX, what does AIX has to do with Pilot's inability to stay awake besides possibly reducing their work hours.

A pilots job is to report for duty fit to take on the responsibility for the lives on board. This person slept through 50% of the flight from DXB, snoring loudly. This was dereliction of duty and is not dismissible as mere pilot fatigue. In another AI flight, both crew fell asleep, wandered off course for 20 minutes and had to be buzzed by ATC.

As for AIX, they are ultimately responsible for instilling a safety culture and CRM. Their challenge was to hire foreign pilots and acculturate them into the AIX 'way'. Hasn't worked out very well, if you read the posts and blogs on various av sites.

Pardon my outrage but 158 innocent souls died because somebody was asleep at the wheel. You won't find me sticking up for the pilot in this case. Or for AIX who were unable to maintain professional standards in the cockpit.

You bring Colgan because you erroneously assume I'm bashing AIX because they are Indian. Not so. I have many dear friends, ex classmates and others at AI/IC and they are far harsher than me when they talk about their workplace.


User currently offlinegarpd From UK - Scotland, joined Aug 2005, 2660 posts, RR: 4
Reply 5, posted (3 years 10 months 1 week 1 day 19 hours ago) and read 4712 times:

Although the ultimate blame must be put on a dead mans shoulders, one does have to question what led to this poor souls tiredness? Are AIX overworking their pilots?


arpdesign.wordpress.com
User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 6, posted (3 years 10 months 1 week 1 day 13 hours ago) and read 4513 times:

Quoting garpd (Reply 5):
Although the ultimate blame must be put on a dead mans shoulders

If you think about it, the copilot was equally culpable. He should have woken up the Captain well before landing, and made sure he was alert and fit to and the aircraft. They could have done a missed approach but that is a big no-no with AI. The last desperate act, of trying a GA was a bad decision as per the report.

It's all very sad, everybody paid the ultimate price. I do hope that any pilots on this forum will comment and educate us on this incident.


User currently offlinepilotaydin From Turkey, joined Sep 2004, 2539 posts, RR: 51
Reply 7, posted (3 years 10 months 1 week 1 day 13 hours ago) and read 4498 times:

In my experience as an incident and accident investigator....pilot fatigue is never a cause of an accident...it can only be stated as a contributing factor....but oh well, I guess some people have different agendas...


The only time there is too much fuel onboard, is when you're on fire!
User currently offlinerolfen From Germany, joined Jan 2006, 1809 posts, RR: 2
Reply 8, posted (3 years 10 months 1 week 1 day 13 hours ago) and read 4480 times:

There really ought to be a procedure for the second pilot to take over the PIC with authority. I don't know how many crashes I read about the co-pilot making comments and advising to go-around but only to be ignored and paying with his life. What's the use of having two pilots if the most obviously incapacitated pilot can still have authority.


rolf
User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 9, posted (3 years 10 months 1 week 1 day 13 hours ago) and read 4480 times:

Quoting pilotaydin (Reply 7):

Very happy to see you here   Could you please take a few minutes and give us your take on this incident? I would be most grateful.


User currently offlineRevelation From United States of America, joined Feb 2005, 12564 posts, RR: 25
Reply 10, posted (3 years 10 months 1 week 1 day 11 hours ago) and read 4378 times:

Quoting Buyantukhaa (Reply 2):
Many questions: what made him fall asleep with 10,000 hours of experience? Tight scheduling? Illness?

Or perhaps other human frailties? C'mon pilots are people, they can also have family stress, or can party too much, etc. I know lots of people jump to the worst conclusion, but not allowing for human frailties is just as big a mistake as presuming that's what happened.

How does a Russian pilot with thousands of hours put his teenage son into the pilot's chair?

Quoting Buyantukhaa (Reply 2):
CRM anyone?!

  

Quoting pilotaydin (Reply 7):
In my experience as an incident and accident investigator....pilot fatigue is never a cause of an accident...it can only be stated as a contributing factor....but oh well, I guess some people have different agendas...

  

Quoting rolfen (Reply 8):
There really ought to be a procedure for the second pilot to take over the PIC with authority. I don't know how many crashes I read about the co-pilot making comments and advising to go-around but only to be ignored and paying with his life. What's the use of having two pilots if the most obviously incapacitated pilot can still have authority.

That's a damn good point. I wonder why there isn't a "I relieve you, sir" procedure written into the rules, followed by an impartial hearing on the issue after the fact. That's more or less what happens in the military. If we're gonna dress these folks up in silly military-like uniforms, we should have better checks and balances in the system.



Inspiration, move me brightly!
User currently offlinepilotaydin From Turkey, joined Sep 2004, 2539 posts, RR: 51
Reply 11, posted (3 years 10 months 1 week 1 day 11 hours ago) and read 4339 times:

Quoting comorin (Reply 9):
Very happy to see you here Could you please take a few minutes and give us your take on this incident? I would be most grateful.

Thank you it's always a pleasure when someone is so respectful and kind on these forums!!

I believe that with most approach to landing accidents, pilots are not in analysis mode, we are more in action mode. Which means that we are either focused or fixated on doing something that we have done thousands of times again, in a second nature way. This means that in our minds, since we have approached and landed several hundred times before, we don't usually see anything out of the ordinary and our analysis of the situation is a passive one, we are in the rote motion of just performing the task. We look for several identifiers, such as gear is down, i see the runway, and due to the nature of human creation, we somehow assure ourselves that we can "make it". "everything is under control, I got this" We all do this, we all have this attitude whether we know ourselves or not.

Accidents such as this one do not have a pin pont statistic, unstabilized approaches occue in almost every airline in every part of the world, the problem rests with pilots understanding the results of landing after an unstable approach. Some don't know they're doing it, some know it but think they can stop in time, and sometimes, the approach is very stable in wet weather, but the touchdown is very very late. The AA aircraft in Jamaica, the Air France in YYZ, all late touchdowns.

Often times in the sim we approach and try to reach perfection, but rarely in global aviation are we shown bad approaches in the sim, the results of icy runways, the results of landing very very late beyond the touchdown. Pilots know little about their aircraft during non standard and abnormal conditions because technology has evolved so much. In my opinion this accident is just a classic unstabilized approach, add to that the problems with inter cockpit communication and rank/opinion voicing, you have a recipe for disaster. Aviation training needs to change at the roots if you as me, because the technology is new but the mind set is still 1970s 3 man crew, 1 man god.



The only time there is too much fuel onboard, is when you're on fire!
User currently offlineGoBoeing From United States of America, joined Jun 2000, 2698 posts, RR: 14
Reply 12, posted (3 years 10 months 1 week 1 day 11 hours ago) and read 4310 times:

I'm happy to see that this was the cause of the accident.

That is not to say I am happy that it happened, but since the crash did happen, I'd prefer it be due to pilot fatigue than anything else such as mechanical troubles etc.

It was actually the first thing I thought of back when I read the article about this crash the day it happened. It popped into my head like, "duh...look at the times this flight operated." Of course the article didn't mention it at the time, perhaps in the interest of not speculating as there was zero information at that point.

The more attention this serious issue receives, the better.


User currently offlinepilotaydin From Turkey, joined Sep 2004, 2539 posts, RR: 51
Reply 13, posted (3 years 10 months 1 week 1 day 11 hours ago) and read 4298 times:

Quoting GoBoeing (Reply 12):
That is not to say I am happy that it happened, but since the crash did happen, I'd prefer it be due to pilot fatigue than anything else such as mechanical troubles etc.

Pilot fatigue can not be cited as the reason why someone made a violation of SOP. You have to be careful with how you word these things, fatigue would be opening the wrong chart up, tuning in the wrong frequency, etc etc, but ignoring input from a crew member and continuing an approach which is unstable, this has nothing to do with fatigue, this is more of a god complex and dicipline issue...



The only time there is too much fuel onboard, is when you're on fire!
User currently offlinemandala499 From Indonesia, joined Aug 2001, 6872 posts, RR: 75
Reply 14, posted (3 years 10 months 1 week 1 day 10 hours ago) and read 4237 times:

Fatige is a universal issue. Whilst circadian upset concerns in the past were the domain of long haul ops... the rise in red-eye multi-timezone narrowbody ops has made this a (new-ish) issue for narrowbody operations.

Quoting fortunerunnner (Reply 3):
what does AIX has to do with Pilot's inability to stay awake besides possibly reducing their work hours.

Report for duty at 2030 for a 2130 departure... land at 2355LT (0125departure time zone) and then fly back to land at 0635...

Doing this once in a while is OK... back in the days when widebodies were the only flights doing these sorts of schedules the guy would have enough rest times as their monthly hours are largely eaten up by longer flights.

Narrowbody Ops are mainly short haul, with less days off work... now when a significant proportion of flights are of these types of schedules, it could have long term detrimental effects.

Knowing the guys' schedule patterns when doing this flight would give a lot more understanding (it's not just "what did you do in the previous 24hrs before the flight" thing).

There are companies who would send 3 people in the flight deck of a narrowbody for a schedule like this!

That's the fatigue issue...

I myself agree with PilotAydin on this:

Quoting pilotaydin (Reply 13):
Pilot fatigue can not be cited as the reason why someone made a violation of SOP. You have to be careful with how you word these things, fatigue would be opening the wrong chart up, tuning in the wrong frequency, etc etc, but ignoring input from a crew member and continuing an approach which is unstable, this has nothing to do with fatigue, this is more of a god complex and dicipline issue...

---

Quoting comorin (Reply 4):
I have many dear friends, ex classmates and others at AI/IC and they are far harsher than me when they talk about their workplace.

Oh... did any of them mention the case of "let's try and autoland this thing" and change their minds at the last minute?



When losing situational awareness, pray Cumulus Granitus isn't nearby !
User currently offlinefortunerunnner From United States of America, joined Jul 2010, 140 posts, RR: 0
Reply 15, posted (3 years 10 months 1 week 1 day 9 hours ago) and read 4157 times:

Quoting comorin (Reply 4):
AI/IC and they are far harsher than me when they talk about their workplace.

I'm not defending AIX or AI/IC way of doing things and they are very well known to have other management issues. I'll be the first one to agree to that.

However I was speaking about this accident and your reply about it that claimed due to this "AIX should be quartered".

AIX may have contributed to this pilot's stree/fatigue with tight scheduling but ultimately it is the pilot and co-pilot that are to be blamed for this incident.

Airline management has no way of verifying that this person has slept enough hours prior to reporting to duty.

May be AIX didn't tightly scheduled these pilot's as many think and he may have had enough break to recoup but he may have been out partying prior night and didn't sleep well or may have had other stress/mental condition that caused him to not sleep well....I dont know one way or the other and I don't claim to know it.

So ultimately the issue is in this case if pilot was sleeping and co-pilot did nothing to assume control of the plane and kept on relying on captain to make the call, the blame is to be placed on a pilot and co-pilot and not on AIX. AIX could not possibly have prevented this crash from occurring.

I took objection to your claim because you said AIX should be punished and by that logic Colgan should be as well as NW when two of their pilot's were browsing laptop and overshot their destination. My point is this has happened all over the world and not restricted to AIX so why one needs to apply a separate logic to AIX but not to other airlines.

Ultimately pilot were irresponsible in all of these incidences as they made the call to assume the responsibility when they may not be physically or mentally ready to assume it. They made a wrong call and hence 158 souls lost lives.


User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 16, posted (3 years 10 months 1 week 1 day 7 hours ago) and read 4042 times:

Quoting fortunerunnner (Reply 15):
I took objection to your claim because you said AIX should be punished and by that logic Colgan should be as well as NW when two of their pilot's were browsing laptop and overshot their destination. My point is this has happened all over the world and not restricted to AIX so why one needs to apply a separate logic to AIX but not to other airlines.

Fair enough, point taken. I agree with you that any airline should be punished for egregious negligence, regardless of country origin.

Interestingly:

AIX COO gets the sack:

Looks unrelated, but quite a shake up going on at AIX. I do hope AI's new COO will turn the airline around.

http://timesofindia.indiatimes.com/b...xpress-COO/articleshow/6950216.cms


User currently offlineditzyboy From Australia, joined Feb 2008, 718 posts, RR: 1
Reply 17, posted (3 years 10 months 1 week 1 day 4 hours ago) and read 3924 times:

Quoting comorin (Reply 1):
Why didn't the Co-pilot slap this guy awake?
Quoting comorin (Reply 4):
This person slept through 50% of the flight from DXB, snoring loudly. This was dereliction of duty and is not dismissible as mere pilot fatigue.

I am sure you are not alone in your sentiment, though my airline allows for controlled rest on certain patterns or sectors with a two man flight deck crew. As cabin crew, we have procedures at our airline for when there is controlled rest on the flight deck.


User currently offlineGoBoeing From United States of America, joined Jun 2000, 2698 posts, RR: 14
Reply 18, posted (3 years 10 months 1 week 22 hours ago) and read 3812 times:

Quoting pilotaydin (Reply 13):
Pilot fatigue can not be cited as the reason why someone made a violation of SOP. You have to be careful with how you word these things, fatigue would be opening the wrong chart up, tuning in the wrong frequency, etc etc, but ignoring input from a crew member and continuing an approach which is unstable, this has nothing to do with fatigue, this is more of a god complex and dicipline issue...

I don't have to be careful how I word anything.

I do know what you mean about not following procedures and poor CRM. However, articles did also include the fact that the captain would have been in a state of sleep inertia and the other pilot would most definitely be quite drowsy by that hour. So fatigue is certainly a factor.


User currently offlinepilotaydin From Turkey, joined Sep 2004, 2539 posts, RR: 51
Reply 19, posted (3 years 10 months 1 week 15 hours ago) and read 3661 times:

GoBoeing, I wasn't referring to your life personally....

[Edited 2010-11-19 03:58:56]


The only time there is too much fuel onboard, is when you're on fire!
User currently offlineBennett123 From United Kingdom, joined Aug 2004, 7613 posts, RR: 3
Reply 20, posted (3 years 10 months 6 days 10 hours ago) and read 3328 times:

I thought that there was already the scope for the PNF to take command.

If you don't want to do that, then either wake him up 30 mins early or wait until the gate, my understanding is that 1 pilot CAN fly it alone.


User currently offlineokie73 From United States of America, joined Mar 2006, 446 posts, RR: 0
Reply 21, posted (3 years 10 months 6 days 7 hours ago) and read 3215 times:

Quoting comorin (Reply 4):
A pilots job is to report for duty fit to take on the responsibility for the lives on board.

It's true that a pilot needs to report for work fit for duty or call in fatigued. However, it's not that simple. The crap you will get from your Chief Pilot if you have the balls to call and say you are too tired to fly is not worth it. Many, many airlines schedule their pilots in such a way that there is no way to get 8 hours of sleep, and then bully them into flying no matter how little sleep they got the night before.


User currently offlinecomorin From United States of America, joined May 2005, 4896 posts, RR: 16
Reply 22, posted (3 years 10 months 6 days 7 hours ago) and read 3169 times:

Quoting okie73 (Reply 21):
It's true that a pilot needs to report for work fit for duty or call in fatigued. However, it's not that simple. The crap you will get from your Chief Pilot if you have the balls to call and say you are too tired to fly is not worth it. Many, many airlines schedule their pilots in such a way that there is no way to get 8 hours of sleep, and then bully them into flying no matter how little sleep they got the night before.

That's bad news. Hopefully this will bring about change like the Colgan investigation did. Will this be classified as an accident or as negligence?


User currently offlinefortunerunnner From United States of America, joined Jul 2010, 140 posts, RR: 0
Reply 23, posted (3 years 10 months 6 days 6 hours ago) and read 3110 times:

Quoting comorin (Reply 22):

That's bad news. Hopefully this will bring about change like the Colgan investigation did. Will this be classified as an accident or as negligence?

I too hope that this brings about change in how AIX and all other airlines schedule their duty rotations as well as how co-pilots react to pilot's inability to make right decisions.


User currently offlinePITrules From United States of America, joined Jun 2000, 3203 posts, RR: 5
Reply 24, posted (3 years 10 months 5 days 17 hours ago) and read 2949 times:

Quoting Buyantukhaa (Reply 2):

Many questions: what made him fall asleep with 10,000 hours of experience?

I didn't know more hours means less susceptibility to fatigue   

Quoting fortunerunnner (Reply 3):

Pilot fatigue is universal phenomenon and not restricted to AIX,

Phenomenon? This isn't UFOs. Pilot rest/circadian rhythms/scheduling patterns have been understood for decades now. Too bad airlines put profit before science.

Quoting fortunerunnner (Reply 3):
what does AIX has to do with Pilot's inability to stay awake besides possibly reducing their work hours.

Hmm   

Quoting comorin (Reply 4):

A pilots job is to report for duty fit to take on the responsibility for the lives on board.

A company's responsibility is to provide an environment to allow its employees to do their job.

Quoting comorin (Reply 6):
They could have done a missed approach but that is a big no-no with AI.

Sounds like a company problem to me.

Quoting GoBoeing (Reply 12):
I'd prefer it be due to pilot fatigue than anything else such as mechanical troubles etc.

Couldn't disagree more. Pilot fatigue can be mitigated with proper rest rules. Its disappointing this continues.

[Edited 2010-11-21 01:40:35]


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