Final NTSB report on Colgan/CO 3407

I will never keep my mouth shut in the cockpit if I feel my CA us doing something unsafe. Hell I've had to play instructor(I'm not a CFI) and literally walk through an approach or soemthing like that. It happens. Just because the guy is in the left seat doesn't mean a damn thing. I had worse luck than the poster above the CA was always "right" no matter what which made it difficult but I think when you have 2 different pilots in the cockpit you're gonna have some things you don't agree on safety wise.

Boy, wonder how those guys flew for so long without you.

Anyhow, macho-ism aside, I've always been able to steer a Captain a little if needed, it's not so much a instructor thing (I am a II-MEI) just nudging things in the right direction if needed. No one in the cockpit wants to die, sometimes if I just bring something up as a question things will start working in the direction I'd rather see them go.
 
I've had to walk a CA through an approach before (although I was an instructor :) ). He was actually cool about it, though. We had just gotten approved for GPS approaches like a day earlier, and he'd been at the airline for a while, so he missed the whole GA GPS revolution. It was a "Hey, I've never flown a GPS approach. Would you mind walking me through it?" type thing. Honestly, I'd rather a CA (or FO) be honest than try to bluff their way through it acting like they know what's going on.
 
Boy, wonder how those guys flew for so long without you.

Anyhow, macho-ism aside, I've always been able to steer a Captain a little if needed, it's not so much a instructor thing (I am a II-MEI) just nudging things in the right direction if needed. No one in the cockpit wants to die, sometimes if I just bring something up as a question things will start working in the direction I'd rather see them go.

No macho-ism here it's really funny you extracted that reaction to my statement. Just agreeing with other posts.
 
Didn't read the accident report; Don't really wish too.

That said, I can't help but wonder if the crew thought that it was a tailplane stall. Wasn't it snow and ice conditions that night? Food for thought.

Well you should probably read it then. If I remember right, been a while since I read the weather for the day, but it was reported light icing.

The presentations, just click the PDFs, take about 20 minutes to read through and give you most of the information.

The very first power point:

"Airplane had minimum ice accretion"
"Ice accretion did not affect crew's ability to fly and control airplane"

A later power point:

"Other entries optional, but "icing" or "eice" must be entered in icing conditions"

*Pointing to the entry by the pilots* "ICING or EICE not entered"

It would seem evident that if the pilots didn't enter icing information they:

1) Forgot to do it
2) Didn't think they were in icing and likely wouldn't think they had a tail stall

___________________________BREAK_____________________________

Something I didn't see: "Stick pusher activated three times"

I am sorry, but what was he possibly thinking? The above shows that the pilot likely didn't think he was in icing. So why would he pull till the pusher activated, three separate times?

Someone else mentioned this, "if I recall....80 percent power..." I don't recall who. I just read the whole thread so my mind is on overload. Anyways here is the confirmation to that, "Captain pulled back on control column and added power short of the rating detent"

They do not specify a percentage, that I read at least.

Finally, someone else commented on the trim and use of the stick when discussing the trim being set too far aft. Correct me if I am wrong airline folks, but the trim is responsible for about 70 percent of a large jets control and the stick for 30. A reverse of the typical GA aircraft.

The result of too far aft trim in a transport aircraft would be an inability to recover the pitch with the stick. Something I suspect was not likely in this accident.


***Insert mikes disclaimer here***
 
When they say vfr conditions I assume they mean the field was vfr. I remember reading that night of more than just light icing. So they must have picked up quite a bit to start these chain of events.
 
I'd imagine the design of the aircraft makes it real hard to visually check for ice unless it's real bad but there must ice lights at least. And in that situation(known ice conditions) I'd imagine SOP would be to activate de ice systems regardless if they thought they were icing up or not. Can anyone comment on that? Would they be required to run the boots by either checklist or company policy?

Our SOP mandates we run the boots every 3 min in known conditions in the pilatus but it's so easy to look for ice on the wings. Justnot the tail which could be a similar situation in this case.
 
Finally, someone else commented on the trim and use of the stick when discussing the trim being set too far aft. Correct me if I am wrong airline folks, but the trim is responsible for about 70 percent of a large jets control and the stick for 30. A reverse of the typical GA aircraft.

The result of too far aft trim in a transport aircraft would be an inability to recover the pitch with the stick. Something I suspect was not likely in this accident.


***Insert mikes disclaimer here***

That's probably aircraft dependent. If the Q400 has a full-flying stabilator, then yes, the trim setting would have a significant effect on pitch stability.

That being said, don't forget about the position of the thrust line in relation to the CG. These transport category airplanes with engines high- or aft-mounted engines don't pitch up with power addition. In fact, it's quite the opposite; the nose-down pitching moment when power is applied can be very strong in those types of aircraft. In this case, the captain would have had to pull even harder than normal to get the pitch to where it ended up.
 
I'd imagine the design of the aircraft makes it real hard to visually check for ice unless it's real bad but there must ice lights at least. And in that situation(known ice conditions) I'd imagine SOP would be to activate de ice systems regardless if they thought they were icing up or not. Can anyone comment on that? Would they be required to run the boots by either checklist or company policy?

Our SOP mandates we run the boots every 3 min in known conditions in the pilatus but it's so easy to look for ice on the wings. Justnot the tail which could be a similar situation in this case.

Again, not speaking for the Q400, but many aircraft have a section on the windscreen, nose, etc. that the CFM notes as a place to watch for ice accretion when you can't see the wings.
 
Again, not speaking for the Q400, but many aircraft have a section on the windscreen, nose, etc. that the CFM notes as a place to watch for ice accretion when you can't see the wings.

Yes, it's called a "representative area" many.
 
Finally, someone else commented on the trim and use of the stick when discussing the trim being set too far aft. Correct me if I am wrong airline folks, but the trim is responsible for about 70 percent of a large jets control and the stick for 30. A reverse of the typical GA aircraft.

I don't know about the Q400 trim system, but nearly every airplane with an AP I have flown will very easily let you set the power wrong, ap trims aft until it is about to stall, and then the autopilot flips off. All the power in the world is not going to save you from full stick backpressure and full aft trim. Does anyone know what the trim settings were, or if they were changed?

***Insert mikes disclaimer here***
 
Again, not speaking for the Q400, but many aircraft have a section on the windscreen, nose, etc. that the CFM notes as a place to watch for ice accretion when you can't see the wings.

I am not sure if this is what you are referring to, but slide 4 and 8: http://www.ntsb.gov/events/2010/Clarence-Center-NY/Airspeed-selection-and-stall-training.pdf

Also, to the CG and again I don't know if this is right: http://www.websweiler.de/fspassengers/Dash8400.jpg

From that it looks to me the engines are mounted forward of a normal CG location. The thrust line might be above the CG, but there isn't a way to tell from any picture/articles I could find. Even so, it certainly isn't by much just from visual inspection of the picture. Since the arm would be so small the moment isn't likely significant. Disclaimer: Only speculation, I have not flown the Q400. Do we have a Q400 guy in here to comment on how power effects pitch?
 
"Dude, you full-scaled my Safety Meter. Go missed!" :D


Funny... but that's more or less how it goes.

Granted, I don't exactly yell about a 'Safety Meter' or anything like that.

This is something we can all learn from Colgan 3407.

A first officer should always be prepared, just as a captain is, to take control of things should things get out of hand or the other crewmember incapacitated.

Mind you, I don't mean FOs should be sitting there hovering like a CFI waiting to snag the controls from the CA. That's not really what I'm getting at. What I'm saying is that there are two of us for a reason. Whenever one of us is degraded by illness or fatigue to the point of sole reliance on the other crewmember, we have to recognize that we've reached a point of no return. Not only are we unable to 'overlap' the abilities of the other pilot, but we're loading up the other pilot because they have to 'double cover' everything to ensure that same level of confidence as if you were still full capable.


Recently, an Eagle Union email detailed a flight where the CA became incapacitated during the takeoff roll. The FO not only had to recognize this, but make all decisions as a CA acting on his behalf, and do it all by himself.

He successfully aborted the takeoff and cleared the runway, all while coordinating CFR response, and did it with minimal steering control.


Would all of us be prepared to do so? At our best? At our worst?
 
To all that didn't care for the comment, I respect your opinion but disagree. I wasn't bashing them as individuals, ie a personal level, but the word incompetent was in reference to their piloting ability.

Like was said before, they took a perfectly good airplane and plowed it into the ground.

Everyone is assuming I didn't have family on board that airplane. Think about that for a second and picture it as a member of your family being killed. We wake up everyday in America and assume we're going to go about our day and live.

Passengers boarded that Colgan flight and assumed the pilots knew what they were doing. Yet they forgot to fly the airplane. I compare that to driving and not pressing on the accelerator. If you want to go, your right foot presses that gas pedal, just like you move the thrust levers forward to go. Easy stuff.

To lay another comparison out there. These pilots were given a job to fly people from point A to B in a safe matter. They showed up to work unfit to fly and one admitted over the CVR "should have called in sick," and I know there are many other things I could quote, but you get my point. We as pilots are supposed to show up to work fit to fly. They weren't. Just like we expect people not to drive drunk. Think how much hatred there is towards a drunk driver that kills. In essence, breaking this down you could make a close comparison to drinking and driving and what these two pilots did. They flew impaired. Plain and simple.

We as pilots need to look ourselves in the mirror and realize we have the ability to erode make a positive influence on this professoin. How we dress, the seriousness at which we view our training, striving to always be better, showing up to work fit to fly, not taking a job just because it's the only thing out there, etc.

I agree, we take this accident and learn from it...
 
I'd imagine the design of the aircraft makes it real hard to visually check for ice unless it's real bad but there must ice lights at least. And in that situation(known ice conditions) I'd imagine SOP would be to activate de ice systems regardless if they thought they were icing up or not. Can anyone comment on that? Would they be required to run the boots by either checklist or company policy?

Our SOP mandates we run the boots every 3 min in known conditions in the pilatus but it's so easy to look for ice on the wings. Justnot the tail which could be a similar situation in this case.

The Q400 has posts on the wipers with lights to visually ID ice, as well as and electronic ice detection system that gives you an ED message of "Ice Detected" which then turns white when ice protection is appropriate ( all on)

we have 4 levels of ice protection. 0 is all off (only when parked at the gate) and shut down. Level 1 is engine bypass doors open, both Mains and stby pitot heats on. Level 2 adds windscreen heat and prop blade deice. It also sets a minimum requirement of 65 deg C for the oil temp ( oil heats the engine inlet area) - bypass door heat is AC powered and automatic, no setting needed, and importantly, the "Increased Ref" switch is set to Increase, putting the Stall protection computers into "icing" mode (adding roughly 20kts to most areas of the stall protection envelope. Level 3 adds deice boots. Fast for climb, descent, or when slow isn't enough. slow can be used in cruise.

Level 1 is the minimum protection level anytime the aircraft is operating (ground/flight)
Level 2 is selected when : On Ground, IAT 10deg or less, visible moisture, runway contamination, visibility less that 3/4mi. Inflight - Temps 5deg or less, visible moisture.
Level 3 for whenever ice is detected either visualy on the representative surfaces or, by the ice detection system.

The boots operate in 6 different sections, alternating at the inboard section of the wing, also alternating the engine inlet boots to prevent a dual flame out in the case of ice ingestion when the boots inflate. The inflate cycle is 6 seconds per section, and is inflated to 17-20psi... A warning is received for less than 17 psi in 6 seconds. The recently inflated boot is then suctioned back to the wing surface with ejector pump suction. Each Section is controlled by a dual distribution heated valve, which allows ice protection with a bleed source leak, or an engine failed. Fast mode has a 36 second Active, followed by a 24 second dwell period, each boot section is deflated for 54 seconds during the deice process though. Slow adds a minute to the dwell time.

Deice air is provided by a full time, intermediary bleed, which is not connected to the High or low service bleeds, allowing ice protection with a bleed leak.

Both main pitot tubes are heated by AC power, and Both will operate with the loss of 1 ac gen. The Standby is DC powered and will operate with only 1 of 6 power sources operating.

The windscreen heat is also ac powered, the FO's side will load shed in the case of a TRU failure and DC gen Failure. The Captains side window is also heated with a separate switch. Normal mode heats to 90deg within 5 minutes, or a warning activates.

Stall speed is calculated by the SPM ( stall protection module) which take AOA, speed, flap, power, temp, altitude data, Increased ref switch, and calculates a stall speed. It also activates both the stall pusher, and shaker.

Stall Pusher depending on conditions may be less than .83Vso, and I believe that in certain conditions, the shaker itself may activate below Vso as well.
This is due the high level of airflow over the wings from the props at high power settings.


The Q400 has a elevator, one of the reasons for the .64Mmo . The engines are mounted 5(?) degrees nose low, to counter the effects of location relative to cg. it may be more or less than 5 deg, i forget. There is a slight pitch force change with power change, but not much.

The Trim on the Q only adjusts the "position" of the elevator actuators. If you hit the trim disconnect, it will resort to flying exactly where the control collum is. This also disengages elevator feel though... so it would be tricky, but you wouldn't have to fight the trim. I honestly have no idea where the trim would reset to if reengaged... maybe hitting the trim discon switch light as soon as you ran into a problem would buy you time to prep for it..

from design, and testing, bombardier claims that the Q400 tail is not supposed to have a tailplane stall. ymmv:(
 
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