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Air Asia Pilot Response Leads To Plane Crashing (wsj.com)
hcs_$reboot writes: The investigation took a year, but we finally know why Air Asia Flight QZ8501, en route to Singapore from the Indonesian city of Surabaya on December 28 last year, crashed into the Java Sea, killing all 162 people on board. The crash was caused by a combination of system malfunctions and improper pilot responses to cascading electrical and rudder-system problems. A cracked solder joint on the Airbus A320 resulted in an electrical interruption that caused computer-generated warnings of a rudder malfunction. The problem occurred four times during the flight. The first three times, the flight crew responded according to standard procedure, investigators said. The fourth time, however, the flight-data recorder indicated actions similar to those of circuit breakers being reset. That led the autopilot to disengage. Investigators said the crew was unable to react appropriately to "a prolonged stall condition," ending in the crash. The investigation points to weaknesses in pilot training in dealing with upsets, or when an aircraft is angled greater than 45 degrees.
In pilot lingo "issues" like this are called squawks and I would speculate that many commercial carriers (part 135 under FAA) fly with them every single day. I've flown on an AA MD80 with an engine that had to be started with an external APU (starter was broken), SWA 737 with a missing flap track fairing (one of the pylons out on the wing). Inoperative instrumentation is common too. Nothing surprising about this plane flying in this condition. The problem is the pilots didn't focus on the three objectives, drilled in training (in order): Aviate, Navigate, Communicate. Fail on #1 while they were playing with circuit breakers and silencing alarms. The GA stuff I fly has inop equipment all the time (especially rentals)
During the interview with the Indonesia AirAsia management, one of the discussion topics was related to upset recovery training. The approved Operation Training Manual covers the upset recovery training in Chapter 8. The module consisted of ground and simulator training. The ground training provides the flight crew with the background, definition, cause of aircraft upset, aerodynamic and aircraft systems in relation with aircraft upset. Recovery methods consider various aircraft attitude and speed including post upset conditions.
The upset recovery training had not been implemented on Airbus A320 training, since it is not required according to the Flight Crew Training Manual and has not been mandated by the DGCA.
worse.......
The Airbus A320 QRH chapter Computer Reset stated that: In flight, as a general rule, the crew must restrict computer resets to those listed in the table, or to those in applicable TDUs or OEBs. Before taking any action on other computers, the flight crew must consider and fully understand the consequences. The consequences of resetting FAC CBs in flight are not described in Airbus documents. It requires good understanding of the aircraft system to be aware of the consequences.
So we have a case of...
1. Alarm keeps going off
2. Reboot computer, hoping it will shutoff pesky alarm, but instead we don't understand consequences and knock out autopilot.
3. Without autopilot plane rolls and stalls, both human pilots do opposite things and make condition uncoverable.
Training issue....
Planes break, computers fail, and humans spill coffee. Pilots need the training to respond with automaticity when bad things happen We see this time and time again.