Flight Safety Information February 4, 2019 - No. 025 In This Issue Incident: Transavia B737 at Amsterdam on Feb 1st 2019, navigation system problems Incident: Alitalia A332 at Seoul on Feb 1st 2019, rejected takeoff due to engine problem Incident: Southwest B737 at Hartford on Feb 1st 2019, cabin did not pressurize Incident: United B738 at San Jose on Feb 1st 2019, engine shut down in flight Incident: Virgin Australia B738 near Newcastle on Feb 1st 2019, cargo smoke indication Incident: Norra AT72 at Tallinn on Jan 30th 2019, overheating relay in cockpit EVAS - Cockpit Smoke Protection Incident: Canada A320 near Colorado Springs on Jan 27th 2019, engine rolled back in mountain wave Incident: Transat B738 near Pittsburgh on Jan 31st 2019, loss of cabin pressure Incident: Jetblue A321 at Los Angeles on Jan 31st 2019, lightning strike Cessna 510 Citation Mustang suffers temporary runway excursion at Paris-Le Bourget Cessna 414A Chancellor - Fatal Accident (California) Jet's landing gear fails at Gerald R. Ford International Airport IS-BAO Operator Continuous Improvement Roundtable at 2019 NBAA IOC Boeing, FAA Probed In Lion Air Crash Specialized 'ping' detector from D.C. could be deployed to find air ambulance wreckage ONLINE SURVEY REQUEST 2019 AIR CHARTER SAFETY SYMPOSIUM Incident: Transavia B737 at Amsterdam on Feb 1st 2019, navigation system problems A Transavia Boeing 737-700, registration PH-XRB performing flight HV-6331 from Amsterdam (Netherlands) to Valencia,SP (Spain), was climbing out of Amsterdam's runway 36L when the crew requested to level off and receive vectors advising they had navigation problems. The aircraft stopped the climb at FL090 while the crew was working the checklists. The crew subsequently decided to return to Amsterdam advising they had a problem with their navigation systems, they needed some time to prepare the return. The aircraft landed safely back on Amsterdam's runway 36R about one hour after departure. A replacement Boeing 737-800 registration PH-HZX reached Valencia with a delay of 4 hours. http://avherald.com/h?article=4c3b96be&opt=0 Back to Top Incident: Alitalia A332 at Seoul on Feb 1st 2019, rejected takeoff due to engine problem An Alitalia Airbus A330-200, registration EI-EJN performing flight AZ-759 from Seoul (South Korea) to Rome Fiumicino (Italy), was accelerating for takeoff from Seoul's runway 34 when the crew rejected takeoff at low speed (about 45 knots over ground) due to a problem with the right hand engine (CF6), which fluctuated between 60 and 90% N1. The aircraft returned to the apron. The occurrence aircraft remained on the ground for about 44 hours, then positioned to Rome as flight AZ- 8759. http://avherald.com/h?article=4c3b948f&opt=0 Back to Top Incident: Southwest B737 at Hartford on Feb 1st 2019, cabin did not pressurize A Southwest Airlines Boeing 737-700, registration N211WN performing flight WN-1694 from Hartford,CT to Tampa,FL (USA), was climbing out of Hartford's runway 33 when the crew stopped the climb at 10,000 feet due to problems with the cabin pressure and returned to Hartford for a safe landing on runway 06 about 45 minutes after departure. Passengers reported they felt discomfort and pain as result of the cabin pressure problems. The FAA reported the aircraft returned due to a possible problem with the cabin pressure. https://flightaware.com/live/flight/SWA1694/history/20190202/0015Z/KBDL/KTPA http://avherald.com/h?article=4c3b906b&opt=0 Back to Top Incident: United B738 at San Jose on Feb 1st 2019, engine shut down in flight A United Boeing 737-800, registration N27205 performing flight UA-1079 from San Jose (Costa Rica) to Newark,NJ (USA) with 128 people on board, was climbing out of San Jose's runway 07 when the left hand engine (CFM56) suffered repeated compressor stalls prompting the crew to stop the climb at about 6500 feet MSL, shut the engine down and return to San Jose. The aircraft landed safely on San Jose's runway 07 about 20 minutes after departure. The flight was cancelled. http://avherald.com/h?article=4c3a241e&opt=0 Back to Top Incident: Virgin Australia B738 near Newcastle on Feb 1st 2019, cargo smoke indication A Virgin Australia Boeing 737-800, registration VH-VOT performing flight VA-938 from Brisbane,QL to Sydney,NS (Australia) with 170 people on board, was enroute at FL320 about 70nm northwest of Newcastle,NS (Australia) when the crew received a cargo smoke indication and decided to divert to Newcastle. The aircraft landed safely on Newcastle's runway 12 about 20 minutes later. The passengers disembarked normally and were bussed to Sydney. The airline reported the aircraft diverted to Newcastle due to a warning indication in the cargo hold. The occurrence aircraft positioned to Melbourne,VI (Australia) departing Newcastle about 7 hours after landing, but has not yet resumed service about 19 hours after landing in Newcastle. http://avherald.com/h?article=4c3a0a40&opt=0 Back to Top Incident: Norra AT72 at Tallinn on Jan 30th 2019, overheating relay in cockpit A Norra Nordic Regional Airlines Avions de Transport Regional ATR-72-212A on behalf of Finnair, registration OH-ATK performing flight AY-1031 from Helsinki (Finland) to Tallinn (Estonia) with 41 passengers and 4 crew, landed on Tallinn's runway 26 when immediately after touchdown smoke appeared in the cockpit prompting the crew to declare Mayday. The aircraft vacated the runway and subsequently stopped clear of the runway. The aircraft was evacuated. There were no injuries, the damage to the aircraft is being assessed. The airline reported the aircraft was taxiing when smoke in the cockpit prompting the crew to evacuate the aircraft. On Feb 1st 2019 The Aviation Herald learned a relay for anti-ice overheated nearly causing a fire in the cockpit just after touchdown (and not after vacating the runway as initially had transpired) emitting a lot of smoke. Estonian and Finnish Accident Investigation Boards were notified of the occurrence. http://avherald.com/h?article=4c3a0753&opt=0 Back to Top Back to Top Incident: Canada A320 near Colorado Springs on Jan 27th 2019, engine rolled back in mountain wave An Air Canada Airbus A320-200, registration C-FLSS performing flight AC-795 from Toronto,ON (Canada) to Los Angeles,CA (USA) with 145 passengers and 5 crew, was enroute at FL360 about 85nm southwest of Colorado Springs,CO (USA) when the aircraft encountered a mountain wave, the left hand engine (CFM56) rolled back from 90 to 60% N1 and began to vibrate, the aircraft lost speed and began to descend. The crew advised ATC and requested a descent to FL300. No ECAM warnings occurred. A short time later the left hand engine recovered in full, the crew continued the flight to Los Angeles for a safe landing. The Canadian TSB reported no emergency was declared. The operator's maintenance is investigating the cause. https://flightaware.com/live/flight/ACA795/history/20190127/2130Z/CYYZ/KLAX http://avherald.com/h?article=4c3a18ab&opt=0 Back to Top Incident: Transat B738 near Pittsburgh on Jan 31st 2019, loss of cabin pressure An Air Transat Boeing 737-800, registration C-GTQX performing flight TS-703 from Roatan (Honduras) to Toronto,ON (Canada) with 161 passengers and 6 crew, was enroute at FL350 about 50nm southeast of Pittsburgh,PA (USA) when a problem with the pressurization occurred prompting the crew to don their oxygen masks and initiate an emergency descent to 10,000 feet. While at 10,000 feet the crew regained control of the cabin pressure, cancelled the emergency and continued to Toronto at 10,000 feet for a safe landing about 55 minutes after leaving FL350. The Canadian TSB reported there were no injuries, the operator's maintenance is troubleshooting the problem. https://flightaware.com/live/flight/TSC703/history/20190131/2045Z/MHRO/CYYZ http://avherald.com/h?article=4c3a1786&opt=0 Back to Top Incident: Jetblue A321 at Los Angeles on Jan 31st 2019, lightning strike A Jetblue Airbus A321-200, registration N946JL performing flight B6-324 from Los Angeles,CA to New York JFK,NY (USA) with 153 passengers and 6 crew, was climbing out of Los Angeles' runway 06L when the aircraft was struck by lightning. The crew stopped the climb at 10000 feet MSL and returned to Los Angeles for a safe overweight landing on runway 07R about 25 minutes after departure. The FAA reported the aircraft sustained unknown damage when it received a lightning strike after departure. A replacement A321-200 registration N942JB reached New York with a delay of 4:20 hours. The occurrence aircraft is still on the ground in Los Angeles about 25 hours after landing back. https://flightaware.com/live/flight/JBU324/history/20190131/1824Z/KLAX/KJFK http://avherald.com/h?article=4c3a1183&opt=0 Back to Top Cessna 510 Citation Mustang suffers temporary runway excursion at Paris-Le Bourget Date: 22-JAN-2019 Time: 17:10 UTC Type: Cessna 510 Citation Mustang Owner/operator: Private Registration: F-GMTJ C/n / msn: 510-0222 Fatalities: Fatalities: 0 / Occupants: Other fatalities: 0 Aircraft damage: Minor Category: Serious incident Location: Paris Le Bourget (LBG) - France Phase: Landing Nature: Departure airport: Düsseldorf International Airport (DUS/EDDL) Destination airport: Paris-Le Bourget Airport (LBG/LFPB) Investigating agency: BEA Narrative: The Cessna 510 Citation Mustang touched down 800 metres before the displaced threshold of runway 25 at Paris-Le Bourget Airport in France. The aircraft slid and travelled to the left and departed the left side of the 400 metres after the beginning of the runway and ran 400 metres over the grass before coming to a halt, 50 metres from the runway edge. The pilot resumed taxiing in the grass and came back onto the runway just before taxiway B1. He taxied to his parking spot Hotel 5 under his own power accompanied by the ARFF. Weather reported about the time of the incident (1710Z): LFPB 221700Z AUTO 17006KT 6000 OVC007 02/01 Q1003 BECMG 4000 BR LFPB 221800Z AUTO 19010KT 7000 OVC006 02/00 Q1002 NOSIG https://aviation-safety.net/wikibase/wiki.php?id=221432 Back to Top Cessna 414A Chancellor - Fatal Accident (California) Date: 03-FEB-2019 Time: c. 13:45 LT Type: Cessna 414A Chancellor Owner/operator: Registration Pending Registration: N414RS C/n / msn: 414A0821 Fatalities: Fatalities: 1 / Occupants: 1 Other fatalities: 4 Aircraft damage: Written off (damaged beyond repair) Location: Orange County, Yorba Linda, CA - United States of America Phase: Initial climb Nature: Unknown Departure airport: Fullerton Municipal Airport - KFUL Destination airport: Fullerton Municipal Airport - KFUL Narrative: The aircraft impacted residential terrain in Yorba Linda, California. The airplane was partially consumed by the post-impact fire and two occupants onboard received fatal injuries. One residential structure was substantially damaged and two injuries have been reported. Updated information is that the aircraft had one POB and one fatality. There were four fatalities and two significant injuries to occupants of the house that the aircraft crashed into. NBC further reports that the aircraft burst into flames and nosedived into the ground spreading wreckage over four blocks of the neighborhood. https://aviation-safety.net/wikibase/wiki.php?id=221520 Back to Top Jet's landing gear fails at Gerald R. Ford International Airport Grand Rapids, Mich. - An express flight from Grand Rapids to Houston experienced a faulty take off Saturday night. ExpressJet Airlines confirmed the landing-gear of flight 4077 collapsed while being pushed back from the gate by ground support equipment prior to take off. We're told 47 customers and three crew members safely deplaned through the main cabin door. Everyone onboard was directed to another aircraft before continuing their travel plans. No injuries were reported. https://fox17online.com/2019/02/03/jets-landing-gear-fails-at-gerald-r-ford- international-airport/ Back to Top Back to Top Back to Top Boeing, FAA Probed In Lion Air Crash A New York Times investigation of the Oct. 29, 2018, Lion Air Boeing 737 MAX crash suggests marketing considerations were at least partly behind Boeing's and the FAA's joint decision to not specifically train pilots in the maneuvering characteristics augmentation system (MCAS) that may have played a role in the crash. The Times story quotes various named sources as saying that Boeing wanted to maintain the cross compatibility between the new aircraft and earlier versions of the 737, thus simplifying conversion training and reducing costs for airlines buying the MAX. The difficulty was that the physically larger engines that accomplish the plane's main selling point-better fuel economy-had to be mounted higher and farther forward than on its predecessors and that significantly changed low-speed flight characteristics. MCAS was designed to compensate for the MAX's increased tendency to stall in a low-speed turn by adjusting the angle of the horizonal stabilizer. The system takes data from one of two angle of attack indicators (there's no redundancy or agreement requirement) and was designed to automatically push the nose down if an incipient stall was detected. Boeing convinced the FAA that because the system maintained the basic flight characteristics of earlier versions that pilots did not need specific training on MCAS even though its inclusion was considered necessary for certification of the aircraft. The Times story also notes that other regulators at least initially determined that pilots should be made aware of MCAS. European regulators wanted pilots to be trained on it but eventually accepted the FAA's and Boeing's position. Brazil, however, stuck to its guns and required specific training for pilots on MCAS. Boeing didn't hide the addition of MCAS. It's described in operation and maintenance manuals and was explained in technical briefings with prospective customers. It also included an emergency checklist covering disabling the system. But because they were not specifically trained in its use, most pilots didn't know it was there and that it operated fundamentally differently from the speed trim system that operated the stabilizer setting on earlier 737s. Notably, pulling back on the yoke on older aircraft disables the automatic trim. Pulling back does not deactivate MCAS on the MAX. Something the Times couldn't determine was whether MCAS was tested in a failure mode, either in the simulator or on the aircraft itself. The predominant theory on the root cause of the crash was that faulty AOA data resulted in an erroneous and extreme reaction from the MCAS, pushing the aircraft into a high-speed dive that the pilots could not recover from. Boeing and the FAA are under investigation by the National Transportation Safety Board and Indonesian authorities to determine if the decision to skip pilot training in the new system played a role in what became the worst air crash of 2018. https://www.avweb.com/avwebflash/news/Boeing-FAA-Probed-In-Lion-Air-Crash- 232225-1.html Back to Top Specialized 'ping' detector from D.C. could be deployed to find air ambulance wreckage in Southeast Alaska Kake in Southeast Alaska. (Kim Murphy/Los Angeles Times/MCT archive) Federal air safety investigators are shipping to Alaska a device rarely, if ever, used here to aid in so far unsuccessful efforts to find the air ambulance that apparently crashed into the waters off Kake on Tuesday. The decision comes as friends and family mourn the loss of the three crew members aboard the Guardian Flight aircraft: 63-year-old pilot Patrick Coyle, 30-year-old flight nurse Stacie Rae Morse and 43-year-old flight paramedic Margaret Langston. A candlelight vigil was planned for Friday night in Juneau from 6 until 6:19 p.m. -- the time the plane was expected to land in Kake. Guardian Flight planned vigils Friday evening throughout the state, and in Arizona, Washington and California, to commemorate and pay respect to the three missing crew members. Vigils in Alaska were planned in Anchorage, Ketchikan, Fairbanks, Sitka, Kake, Nome, Haines, Hydaburg, Willow and Klawock. The Beechcraft King Air 200 turboprop took off from Anchorage on Tuesday around 4 p.m. to make the roughly 600-mile flight for a patient pickup in the Tlingit village but never arrived. Searchers spotted debris from a plane, including part of a wing, in the area of the plane's last known location over Frederick Sound but was not able to locate any wreckage or crew members. The U.S. Coast Guard suspended the search for victims Thursday evening amid worsening seas. There is no active search underway at this point, authorities say. But it's possible that federal aviation safety investigators could deploy a specialized device to try to find the wreckage. The King Air was equipped with a cockpit voice recorder with an attached underwater locator beacon, according to Clint Johnson, Alaska chief for the National Transportation Safety Board. Alaska investigators are waiting on a shipment from the agency's Washington, D.C., headquarters of an underwater acoustic locator that reads the pings the box may be emitting, Johnson said. It should arrive Monday. The portable unit operates like a metal detector: The operator wears headphones and listens for the sound of a signal from the device, placed on the end of a long pole that's submerged in the water. The use of the device is not assured. It takes a two-hour boat ride from Petersburg to get to the search area, Johnson said, and high seas aren't suppose to abate until a "very narrow window" of decent weather currently forecast for later next week. "Nothing is set in stone, but we're looking at the next weather window to be able to get down there with probably two of our investigators," he said. Alaska State Troopers said Friday afternoon that they have opened a missing persons case on the three people in the plane but are not currently attempting to look for the crew. The Coast Guard conducted an intensive search involving multiple vessels with help from numerous agencies including troopers for three days, spokeswoman Megan Peters said. It's possible troopers could assist National Transportation Safety Board investigators if weather and resources allow, Peters said. "We know this is a horribly emotional time for the families, and also the friends and the co-workers," she said. "We'll do what we can, but also have to look at what's already been done." https://www.adn.com/alaska-news/aviation/2019/02/02/specialized-ping-detector- from-dc-could-be-deployed-to-find-air-ambulance-wreckage-in-southeast-alaska/ Back to Top ONLINE SURVEY REQUEST Dear Participant, You are being asked to participate in a research study to evaluate pilot decision-making. This study is expected to take approximately 5 minutes of your time. In order to participate, you must be at least 18 years old and currently employed as a professional pilot. Participation in this study is voluntary, and you may choose to opt out of the study at any time. If you choose to opt out, your data will be destroyed. We appreciate your consideration and time to complete our study. Please click on or copy and paste the URL below: https://goo.gl/forms/9ITjTgICot9o9Jjp1 For more information, please contact: Dr. Stephen Rice scrice@outlook.com We appreciate your interest and participation! Curt Lewis