Madrid crash investigation finds wing flaps failed
Spanair did not apply routine safety checks on warning systems before each flight ago
Routine safety checks recommended over 20 years ago which could have prevented the Barajas plane crash on 20th August were not applied by Spanair. The preliminary report into the crash by the Spanish Civil Aviation authorities (CIAIAC) indicates that the flaps on the wings which help support the plane on take off were not in the correct position and that the warning system which would have alerted the pilots to this error did not work properly.
A similar accident in another MD-82 plane occurred in Detroit in 1987 and as a result the manufacturer of this type of Aircraft now McDonell-Douglas (now Boeing) recommended that all airlines test their warnings systems before each flight. However, it has been discovered that Spanair only carries out safety checks on this feature before the first flight of the day and when there is a change of pilot.
As expected the report has uncovered a chain of both human and technical errors. The report which has been sent to all the parties involved, describes what happened in the moments prior to the crash and ends with the recommendation that it become obligatory to check warning systems before each flight.
The doomed aircraft arrived in Madrid from Barcelona on the day of the crash at 10.13 hours on 20th August without any reported incidents. It refuelled in Barajas where it was scheduled to fly to Las Palmas and was given the all clear to go to the runway. According to information gained from one of the black boxes the flaps were opened to 11 degrees. Take off was authorized at 13.25 hours. However, when the plane got to the runway the pilots communicated a small problem a minute and a half later and asked for permission to leave the runway.
The plane then left the runway and technicians tested the fault which had been detected which was related to overheating (105 degrees) in one of the temperature gauges. The technicians then proceeded to open the electrical circuit which connected the heating to the RAT temperature gauge where the problem had occurred. When tested again the gauge then showed a normal temperature setting so the aircraft was once again given the all clear to return to the runway. However at this point the flaps were at 0 degrees. The report does not clarify whether this was due to a technical fault or human error.
However, whatever the cause of this error it appears that the alarm system designed to alert the pilot if this happens did not work. According to the report no alarm sound which would have indicated that the flaps were completely shut was recorded by the black box.
It is not known why this alarm system did not work but it does examine the relation of this alarm system to the RAT temperature gauge which had been faulty earlier.
The report points out that according to the manufacturer alarm systems should be checked at the beginning of the day and in stopovers without exception. However Spanair only asks its pilots to check this once a day or when both pilots change.
Therefore if these instructions were followed the crew of flight JK5022 would have carried out this safety check in Barcelona and would not have repeated it in Madrid.
Routine safety checks recommended over 20 years ago which could have prevented the Barajas plane crash on 20th August were not applied by Spanair. The preliminary report into the crash by the Spanish Civil Aviation authorities (CIAIAC) indicates that the flaps on the wings which help support the plane on take off were not in the correct position and that the warning system which would have alerted the pilots to this error did not work properly.
A similar accident in another MD-82 plane occurred in Detroit in 1987 and as a result the manufacturer of this type of Aircraft now McDonell-Douglas (now Boeing) recommended that all airlines test their warnings systems before each flight. However, it has been discovered that Spanair only carries out safety checks on this feature before the first flight of the day and when there is a change of pilot.
As expected the report has uncovered a chain of both human and technical errors. The report which has been sent to all the parties involved, describes what happened in the moments prior to the crash and ends with the recommendation that it become obligatory to check warning systems before each flight.
The doomed aircraft arrived in Madrid from Barcelona on the day of the crash at 10.13 hours on 20th August without any reported incidents. It refuelled in Barajas where it was scheduled to fly to Las Palmas and was given the all clear to go to the runway. According to information gained from one of the black boxes the flaps were opened to 11 degrees. Take off was authorized at 13.25 hours. However, when the plane got to the runway the pilots communicated a small problem a minute and a half later and asked for permission to leave the runway.
The plane then left the runway and technicians tested the fault which had been detected which was related to overheating (105 degrees) in one of the temperature gauges. The technicians then proceeded to open the electrical circuit which connected the heating to the RAT temperature gauge where the problem had occurred. When tested again the gauge then showed a normal temperature setting so the aircraft was once again given the all clear to return to the runway. However at this point the flaps were at 0 degrees. The report does not clarify whether this was due to a technical fault or human error.
However, whatever the cause of this error it appears that the alarm system designed to alert the pilot if this happens did not work. According to the report no alarm sound which would have indicated that the flaps were completely shut was recorded by the black box.
It is not known why this alarm system did not work but it does examine the relation of this alarm system to the RAT temperature gauge which had been faulty earlier.
The report points out that according to the manufacturer alarm systems should be checked at the beginning of the day and in stopovers without exception. However Spanair only asks its pilots to check this once a day or when both pilots change.
Therefore if these instructions were followed the crew of flight JK5022 would have carried out this safety check in Barcelona and would not have repeated it in Madrid.
1 Comments:
In Detroit, the problem was that the pilots disabled the warning after several repositions. Undoubtedly the same thing occurred in Madrid. Last words of Detroit pilots on flight voice recorder were "oh shit, flaps." Failure to follow the checklist and overriding warnings is a basic discipline problem.
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