So the preliminary investigation of QZ8501 crash was disclosed
a few days ago, 12 months after the fateful Airasia flight from Surabaya to
Singapore went down into the Java Sea.
The cause of the accident was highlighted as a congruence of
technical fault and lack of pilot training.
(A) Technical fault
The Rudder Throttle Limiter (RTL) is a component which operates the rudder of the plane. Records retrieved from the black box revealed that it failed 4 times during the
fateful flight. The pilots managed to resolve the issue during the first 3 occurrences.
However, on the 4th, one of them breached protocol and manually reset
the RTL by disconnecting the relay. The electrical circuits broke and resulted
in the plane carrying out a 6 deg/sec left roll (whereas a ‘safe’ roll is 2-3
deg/sec). Both pilots quickly tried to level the plane but did not immediately
notice that it was ascending. Awhile later, one pilot alerted to the other to bring the plane down; however
the instruction was overlooked. Unable to ascend any further, the plane then
stalled and plunged into the ocean, killing all 167.
The investigation also uncovered gross under-maintenance issues.
Horrifying was that the RTL had been reported faulty a staggering 23 times over
the last 12 months! Details such as the break down of the exact faults and
rectifications are not disclosed yet, but this shocking discovery raises many eyebrows of Airasia’s
maintenance regime and standards.
(B) Inadequate pilot training
One of the pilots was a former Airforce pilot. Apparently,
Airasia admitted that both pilots did not undergo emergency procedural training
(can’t recall the term for it) as they felt there is no likelihood of the occurrence
of such emergencies. Not sure what other flight operators opine of this. Unfortunately,
the decision made by the pilot to troubleshoot the RTL by taking matters into
this own hands (pun intended) was a severe lapse of the individual.
-----------------------------
This investigation does nothing to alleviate the pain,
sorrow and heartaches of the immediate families affected but I hope it at least
provides them with a reason... or a closure to their endless whys.
In addition, I hope this incident serves a wake-up call to all MRO companies to critically review their maintenance regime and not be complacent.
In addition, I hope this incident serves a wake-up call to all MRO companies to critically review their maintenance regime and not be complacent.
23 times in 12 months? By any standards that is too striking
a statistic, let alone from a critical component and for a flight operator! IMO,
this incident merely uncovered the tip of an iceberg of the incalculable, dormant
‘timebombs’ of all MRO operations. I am a serious advocate for an independent,
third-party analysis for all MRO operations. The analysis must be conducted CHC
– comprehensively and holistically and continuously. Before
any analysis can be done, there must be a reliable system which allows maintenance
records to be logged, documented and tabled. And of course, there’s no way that
maintenance activities can be logged down by themselves… an awful amount of
investment has to be put into technical skillsets training.
Half-joked to wifey that perhaps, just perhaps, I could consider the
path of a MRO consultant...
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