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Continental Airlines Crash


Kip Powick

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FAA just gave an breifing on the initial FDR and CVR data, the crew noted significant icing on the wing and windshield, airframe icing was selected on, gear was selected down, and when flap 15 was selected the aircraft began to pitch and roll significantly, just before the recording ended the gear and flaps were selected up.

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FAA just gave an breifing on the initial FDR and CVR data, the crew note significant icing on the wing and windshield, airframe icing was selected on, gear was selected down, and when flap 15 was selected the aircraft began to pitch and roll significantly, just before the recording ended the gear and flaps were selected up.

Obviously there is still much to be learned, and I hope that I'm wrong, but the facts to this point are pointing to a loss of control due to icing. The Great Lakes area is well known for the development of cumulous clouds that are filled with super-cooled liquid droplets. Yesterday's conditions were ideal for it.

I have personal experience with control difficulty that occurred when the flaps were extended on the approach in those conditions. We were in a light twin (equipped with similar deicing equipment to the Q400) on the approach to Erie, PA. We picked up significant icing during the descent and approach, and we cycled the boots 3 times, with the ice on the wings being shed as expected each time. On final, when I called for full flaps, the pitch began to increase as the flaps moved. I had the elevator full forward and the pitch continued to increase. I instinctively selected the flaps back to 1/2 and as soon as they retracted, I regained control, but with somewhat sloppy control feel. I gradually increased the power to bring up the airspeed which improved the control feel, and then continued the approach and landing. After we got on the ground, we found that the horizontal stabilizer had not been deiced due to a failure of the boot. There was approximately 2 inches of ice on the stab and ice had formed on the upper surface most of the way back to the elevator. We were very lucky that day, and it gave me a new respect for airborne icing. Fortunately I had a change of underwear in my bag.

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Bean,

So now you are sharing information that people share with you in private and one would think in confidence, don't be surprised if the CEO in questions stops talking to you.

It's not the first time I've mentioned this.

We last spoke a couple of weeks ago.

cool26.gif

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You can be assured that no one wants to wake up in the morning and read about any incidents of any kind.

It's OK Bean. I was not implying that you or anyobody was unsympathetic. Pilots have an intimate knowledge of what goes on up there and as such share an intimated understanding of what it might feel like. Stuff like this really hurts on a professional level. It's a sad day. sad.gif

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Bean;

Well, we don't have 20/20 hindsight - nowhere near it, and although I know that is just an expression, it isn't useful and can mislead in these kinds of cases. We are looking through a glass, very darkly, with very little information, relatively speaking.

Whether a climb or descent would have been better isn't possible to say, for a number of reasons.

The "structure" of the weather system would have to be analyzed. Icing was forecast for between 3000ft and 8000ft but where "warmer" air would have been would have been a complex assessment for the crew. Likely there wasn't an inversion so the air would decrease in temperature in a climb but higher may have held less icing conditions...it is difficult to say.

We dont' know what parameters the recorders have - it may be a simple system with a couple of hundred basic parameters or it could be like a FOQA recorder which has much denser, (finer granularity) data, generally speaking. We don't know if Colgan was running such a program, but that recorder wouldn't have survived anyway. The key data here will be control wheel/column and control surface positions, flap position and timing, vertical 'g' readings as well as the obvious pitch and roll data. Remarkable work can be done with CVR information in terms of "teasing" out subtle airframe vibrations for possible association (or not) with abnormalities.

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Bean;

Well, we don't have 20/20 hindsight - nowhere near it, and although I know that is just an expression, it isn't useful and can mislead in these kinds of cases. We are looking through a glass, very darkly, with very little information, relatively speaking.

Whether a climb or descent would have been better isn't possible to say, for a number of reasons.

The "structure" of the weather system would have to be analyzed. Icing was forecast for between 3000ft and 8000ft but where "warmer" air would have been would have been a complex assessment for the crew. Likely there wasn't an inversion so the air would decrease in temperature in a climb but higher may have held less icing conditions...it is difficult to say.

We dont' know what parameters the recorders have - it may be a simple system with a couple of hundred basic parameters or it could be like a FOQA recorder which has much denser, (finer granularity) data, generally speaking. We don't know if Colgan was running such a program, but that recorder wouldn't have survived anyway. The key data here will be control wheel/column and control surface positions, flap position and timing, vertical 'g' readings as well as the obvious pitch and roll data. Remarkable work can be done with CVR information in terms of "teasing" out subtle airframe vibrations for possible association (or not) with abnormalities.

I understand the complexities involved, the dangers of snap judgements and the possibility that no human action of any kind would have changed the tragic outcome.

However, were you flying in those conditions, with things happening quickly, what would your gut instinct / experience / "the book" tell you do?

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With hindsight tragically being 20-20 in this case, what would be the best course of action under the speculated conditions of this accident?

Climb or continue the approach?

How about just continue the approach and land like every other aircraft did that night?

There maybe something very important to learn here, but like Don says, there is no 20/20 hindsight yet.

It is possible that something or someone caused a situation that was impossible to forecast or avoid.

We'll have to wait for the results of the investigation.

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The issue of tailplane icing has been known for a long time now. I've been in that icing stuff myself more times than I care to remember in lots of differnt turboprop types. I can't remember how many times we were warned to NOT extend the flaps in icing conditions on the approach. Icing in and of itself is not a very big deal if the de-ice boots are working properly AND they get used effectively. I have been in some icing flights where we had to pop the boots every 30 seconds or so, which is a very quick buildup. The thing about it though, is that the horizontal stab is not visible from the cockpit so the crew can not see what's going on back there.

I have landed a couple of times with some of the Beech aircraft when a boot failed to kick the ice off with a couple if inches of ice on the horizontal stab and the aircraft got really sloppy in pitch control. Both times excessive approach speed probably saved our arses, but it sure burned up a lot of runway on landing. The real problem with that kind of situation is that the runway is also probably going low CRFI too so the braking is lousy too.

We did an approach into CYXD (Edmonton City Centre) last year in our Citation jet last year with lots of icing stuck on everything and our de-ice boots on the tail did not seem to be kicking the ice off because the pitchdown was noticeable when we extended the flaps. The runway was about .60 CRFI but because of the icing in flight we had to approach flapless at about 15 knots over our normal landing flap Vref. The charts said we were fat, dumb and happy for stopping, but I sure wasn't, although I might be fat and dumb sometimes. After we landed we could find no problems with the boots on the horizontal stab, but there was lots of residual ice stuck to the edges of the boots where they are glued to the stab and made little ice "bridges" that probably buggered up the airflow over the stab a bit.

In hindsight I probably should have just climbed up and gone to Regina or something but we, after a discussion with my co-pilot stayed on the approach and landed after touching down with a Veeeery long landing rollout that lit off the anti-skid almost continuously and used almost all the runway.

Like J.O. wrote, icing is no fun, but an approach is possible if the aircraft is working properly and the crew uses the de-icing stuff properly.

I've also been in flight and just diverted after hearing about severe icing at our destination. I'm getting too old and just chicken out when I hear about moderate to severe icing on an approach to an airport.

What caused the crash in Buffalo remains to be seen. Perhaps icing was an issue. Perhaps the age and experience of the Captain will be factors in this as well. I certainly hope not, but only time will tell.

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Question 1

........there was an "expert pilot" on TV today and he stated that the Dash8 had leading edge deicer boots, the kind you turn on when you get a build up and then turn off and let the ice build up again before you turn them on again, (similar to what we had on the old DC3)....but he stated that FAA had recently, (1 or 2 years ago) mandated that deicer boots were to be turned on and left on when encountering ice and the "on-off-on" procedure was no longer the correct method.

I find this a remarkable statement and was wondering if the "boot" equipped aircraft now do as he says. No one challenged his statement and apparently this guy had a zillion hours and is a well respected pilot and very knowledgeable...

Question 2

I was reading in the latest issue of McCleans where the fellow who invented CRM was being interviewed and his comments were concerning the Hudson Huddle. He was asked if the manufactuerer checked engines as to their survivability upon ingesting a bird. He stated the engine manufactuerers did do that procedure. He was asked what type of birds were shot into the engines. He answered, " Frozen turkeys". Is this true???

Again this guy was touted as an expert on all things having to do with aviation, (can't remember his name and it wasn't my magazine smile.gif ever try to read and keep an eye on an 18 mo child biggrin.gif )

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Kip there's been some new info out there dispelling the old Ice Bridging tales. After extensive testing they were never able to make ice bridging happen on boots that actually worked properly. So the new recommendation(I don't think it's a mandate) is to run them continuously when in icing conditions.

Boeing recommends using the NG's anti-ice system as a de-icer, yet still states you can use it as anti-ice as well, but with the risk of runback.

As for the frozen turkeys I think it's a myth, or a one time accident that happened during testing, and I think it's supposed to be a chicken, not a turkey. I believe it is supposed to be a freshly thawed chicken they use.

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Stolen From CD's Post entitled "Flying in Icing Conditions"

In 1999, the FAA issued an Airworthiness Directive (AD 99-19-18) that mandated revisions to AFM to advise flight crews to activate airframe pneumatic de-icing boots at the first sign of ice accumulation.

That sorta answers question #1 of my last post.

CC.....OK, thanks for the info. Back in the dark ages we were cautioned about ice building up on moving boots so we used to wait until there was a good bit of ice on the leading edge of the wing before turning the boots on.......but...I don't think we could classify the DC 3 as having a high performance wing biggrin.gif so perhaps our procedure back then was OK ( most of todays aircraft have an approach speed which was our cruising speed) tongue.gif

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This one is interesting that I read recently. because the manufacturer didn't change their AFM to reflect the latest recommendations on de-ice boot operation.

Full narrative is here.

http://www.ntsb.gov/ntsb/brief2.asp?ev_id=...C07LA081&akey=1

NTSB Identification: NYC07LA081.

The docket is stored in the Docket Management System (DMS). Please contact Records Management Division

Nonscheduled 14 CFR

Accident occurred Saturday, March 17, 2007 in Beverly, MA

Probable Cause Approval Date: 8/28/2008

Aircraft: Cessna 500, registration: N511AT

Injuries: 6 Uninjured.

During the landing descent in instrument meteorological conditions , the copilot of the Cessna 500 noticed that the windscreen was picking up a trace amount of rime ice. Neither crewmember saw any ice on the wings, and the crew did not activate the deicing boots. The approach seemed normal until reaching approximately 100 feet above ground level, when the crew experienced what the copilot described as a "burble," and the airplane rolled "steeply" to the right. The pilot stated that there was "no buffet and no warning." The crew attempted to recover, but were unsuccessful, and the right wingtip struck the runway overrun area. Postflight inspection revealed "light rime ice" on the wings, horizontal stabilizer, and radome. The airplane was certificated for flight into known icing conditions, but no ice detector, or stall warning system was installed. The Citation 500 was certificated with full span deicing boots on the wing leading edge, but this airplane had been modified with electrically heated anti-ice panels on the inboard wing leading edge. The deicing boots had no automatic or continuous mode. Both pilots had taken Federal Aviation Administration (FAA) approved systems training for the Cessna 500. The pilot stated that he had heard about "ice bridging," at the training provider and his company. The copilot stated that "unless you have 1/4 to 1/2 inch of ice" the boots should not be activated. A review of the Cessna model 560 airplane flight manual (AFM) revealed that like the Cessna 500 operating manual, it advised pilots to wait for ice to build before inflating the pneumatic de-icing boots. Both the study guide and the AFM stated that, "Early activation of the boots may result in ice bridging on the wing." In 1996, the FAA conducted icing evaluations of the Cessna 560. These evaluations resulted in modifications to the stall warning system to increase stick shaker speed in icing conditions, but did not change the procedures for pneumatic de-ice boot operation. In 1997, the Safety Board recommended that, "leading edge deicing boots should be activated as soon as the airplane enters icing conditions because ice bridging is not a concern." A 1997 industry workshop reported that there was no substantiation for the phenomenon of ice bridging. In 1999, the FAA proposed several airworthiness directives (ADs) on 17 airplane models (including Cessna 500, 501, 550, 551, and 560 ) that would have required manufacturers to change the AFMs so that pilots would be required to inflate de-ice boots as soon as ice accumulation began. Cessna Aircraft Company succeeded in convincing the FAA to withdraw the proposed ADs. In December 2002, the FAA issued advisory circular AC 91-74, which stated that there were few, if any, documented cases of ice bridging on modern boot designs. In February 2005, the Safety Board investigated an icing accident involving a Cessna 560, and review of the AFM again revealed guidance that stated that the pneumatic de-icing boots should be activated when ice is 1/4 to 1/2 inch thick. In December 2006, the FAA released a report stating that test results supported "the activation of lifting surfaces" deicers at the first detection of ice formation on the aircraft's lifting surfaces and for the operation of pneumatic deicers in an automatic cycling mode." Although more than 10 years have passed since it was established that ice bridging does not occur, the FAA has not taken any regulatory action, and Cessna Aircraft Company has only removed the references to ice bridging in it's AFMs but, still advises to wait until the ice thickness is 1/4 to 1/2 inch before activating the surface de-ice. Since 1982, the Safety Board has investigated 43 icing occurrences involving turbine-powered airplanes. These events have resulted in 201 deaths and 16 serious injuries. In the past 4 years, the Safety Board has issued 18 recommendations and one Safety Alert related to icing. As of June 2008, actions to reduce dangers to aircraft flying in icing conditions remain on the Safety Board's 10 Most Wanted List. The Safety Board has classified the FAA response to this issue as "Unacceptable."

The National Transportation Safety Board determines the probable cause(s) of this accident as follows:

The inadequate guidance and procedures provided by the airplane manufacturer regarding operation of the pneumatic de-icing boots. Also causal was the Federal Aviation Administration's inadequate directives which failed to require manufacturers to direct flightcrews to immediately operate pneumatic deicing boots upon entering icing conditions.

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I was reading in the latest issue of McCleans where the fellow who invented CRM was being interviewed and his comments were concerning the Hudson Huddle. He was asked if the manufactuerer checked engines as to their survivability upon ingesting a bird. He stated the engine manufactuerers did do that procedure. He was asked what type of birds were shot into the engines. He answered, " Frozen turkeys". Is this true???

I remember seeing a video from the NRC that used frozen chickens and fired them at the a/c engines as well as windscreens etc.

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After flying lots of different aircraft with boots, I can only say that they work pretty good, IF they are working properly. I always worried about the tail end though, because it can't be seen from the cockpit. Wings are different though because in most of the lighter aeroplanes, you can see them. That's likely the case with the Q400's too.

Most of the little planes I've been working with lately have a "continuous cycle" system that keeps cycling the boots on approach (or whenever they are turned on) about every 2 minutes. I can only hope that the crew that were flying in Buffalo had that stuff turned on. If they did have it turned on and could not kick the ice off the wings and tail, there is a design issue that might have to be dealt with.

The old "ice bridging" theory has been gone for a while now because no proof ever showed that it happened. I never saw it and always popped the boots whenever I saw any kind of ice on the wings even if it was just a "skiff" of ice and it always mostly came off in the breeze.

The little Citation jets that I fly however, still recommend an additional 8 knots to the Vref on approach if there's even a hint of ice remaining stuck on the wing leading edges. That 8 knots stretches out landing distance about an extra 800 feet however. Going into Ft. McMoney (CYMM) or CYXD can make things a bit of an ass tightener.

I know most of the "big" planes have hot leading edges so icing isn't usually a problem that I'm aware of, but us guys flying little jets still get into the BS with speeds and short runways.

This is only my musings and the speculations of an old pilot however. The NTSB will get to the reason this crash happened, so please let's see what comes out next year when the pro's get their answer as to what caused this unfortunate crash.

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Just saw a report by the NTSB on CNN that the crew was discussing the icing conditions inbound to Buffalo and according to the FDR, the de-ice equipment (boots) was selected on.

Jazz uses the "boots on at first sign of ice" policy. We used to do it the old way but not anymore.

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I remember seeing a video from the NRC that used frozen chickens and fired them at the a/c engines as well as windscreens etc.

I wonder why?? Birds aren't frozen when they fly.(the again perhaps they are frozen with fear when ecountering an aircraft ?? laugh.gif )

I remember when they were testing the Tutor windscreen in California...they were firing frozen chickens at the windscreen and the windscreens were breaking....dilmma..dilemma, until somene suggested thay perhaps they should thaw them out.........then the windscreen passed certification biggrin.gif

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I have lots of respect, but that doesn't change my opinion that the Q400 seems to have issues.

There is at least one airline CEO I know of stateside that will not fly in turbo props, period.

cool26.gif

One CEO's parnoia does not a trend make. While "fear" in and of itself is not stupid, statements promoting it are. If your statement is true, he has no place at the helm of an airline.

IMVHO

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