Accident Case Study: Emergency Management
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- Опубліковано 21 вер 2024
- Link to certificate, WINGS credit, and ASI transcript: bit.ly/ACSEmer...
Description: As safety-minded pilots we need to make conservative decisions for the best chance of a positive outcome. In this case study, we share lessons drawn from this pilot's unfortunate decisions during a vacuum pump failure in instrument meteorological conditions. Take this opportunity to boost your awareness of critical and proper decision making in an emergency.
All pilots who watch these AOPA videos should be advised: When you hear ominous piano music when you're flying, get ready for something to go down.
XD
Darrin Nunyah ⭐️⭐️⭐️⭐️
And I thought my humor was dark
It's akin to walking into a room and spotting ammo, armor and medkits... you can expect for shit to get real around the following corner!
Or, if you hear that narrator's voice. "She had logged 150 hours, and 14 on this aircraft". Welp! We're puttin' her back in the hangar. Not flying today.
I went home after watching this, started a flight in P3D. Departed in IMC conditions and set vacuum and VSI to fail in 3-5 mins. Using only instruments and vectors from ATC (no GPS).. within 120 seconds I was in an uncontrolled steep spiral descent, where I overstressed the aircraft and crashed.... and I had the advantage of knowing the instruments were going to fail.
That's terrifying.
Yeah, I love trying to put myself in these situations in the simulator… makes you much more aware of what can happen, and how hard it really is. It sucks that he made the right call and had ATC over ride him in error.
@@nikhayes3396 as an ATC, 90% of them don't know dick about actual flying.
And not having your physical body play tricks on your brain.
@@AdamFlyer113 💯
The announcer has such a perfect voice and delivery in all these videos
Homefront absolutely agree
Yes, he is very good.
Enunciates well.
That is why he is the announcer.
Reminds me of the narrator for CSB (United States Chemical Safety Board) videos. Those are also pretty damn interesting, the case studies are anyway, their other videos aren't bad but those case studies/investigation videos ...I could binge watch those in a heartbeat. Just like these case studies.
He sounds a bit like Morgan Freeman.
I cannot believe he went back into IMC no-gyro. Once in the clear I would have followed the blue sky and landed at a VFR airport.
I believe the suggestion of ATC of trying for a non-gyro approach was enough for the pilot to change his mind. This is an important lesson to us about decision making and and know when to say no.
Yeah the letters WTF come to mind
Or just descended to 500 agl and kept an eye out for obstacles. I’m sure dodging a few well light communications towers and tall buildings on the approach would’ve been much easier then whatever he was trying to attempt with no an inoperable vacuum system. Sure you would be breaking the 1000agl minimum over built up areas limit, but could’ve declared an emergency and been fine.
You've got that right!!
as they repeatedly say, easy to see the better decisions from the ground at 0 mph and 1G. : )
I can't understand how both the pilot and the ATC were so cool about the no vacuum situation. Vacuum failure in IMC is an immediate emergency call. Try to fly straight and level using the magnetic compass and the turn coordinator. Small heading corrections with the rudder. Fly to regain VMC conditions in the shortest possible time and STAY in VMC.
Agreed, but a lot of ATCs don't fly and might not know the severity. This was pilot error, not ATC ... Ultimately it's the person flying who needs to communicate with ATC and make them aware. When he entered clear skies that should've been discussed and it's his own fault for voluntarily choosing IMC over VFR.
ATC was very poor here. Is the location related to that problem?
@@steviesevieria1868 smaller airports for sure
Stay in VMC - that's the key. I've made it a point to not fly solo until I become very proficient in IMC. Weather (and your ego) can get you anytime.
ATC aren't pilots nor mechanics, by and large. It's up to the pilot.
See the other video I think it was N440H Beechcraft. He never declared an emergency and ATC didn't know what lack of vacuum meant.
This is the second ASI video I have watched today with the SAME EXACT SCENARIO and SAME EXACT OUTCOME.
- dry vacuum pump
- no backup
- fails while in IMC
- pilot and ATC both fail to state and understand the seriousness of the situation
- tragic preventable loss of life
So sad!
the other was a Beechcraft Bonanza
"I've just lost some gyros" in IMC should be IMMEDIATELY followed with "Declaring an emergency"
As a pilot and ex-controller, I think this video should be standard viewing for all pilots and controllers. And now, for less than 2 grand, you can have a completely separate electric '6 pack' in a 3 inch sq. box. See Garmin or Dynon.
No need. You can get a $200 iPad with GPS and load it with Foreflight or Garmin Pilot and have a full backup to everything including navigation.
What do you think of foreflight on an iPad as a backup? It has that HSI feature, with artificial horizon, altitude, airspeed, and heading... Are you familiar with it? Your thoughts please?
@@goneflying140 I know it’s not certified. Does not mean it won’t save your life tho
@@gbigsangle3044 If you are screwing around with your IPAD during an In Flight Emergency with no gyros....you shouldn't be a pilot. Install a secondary Attitude Indicator.
These videos are incredibly well produced - sadly they are always so tragic, but they are very interesting to watch. Keep up the good work.
toString yep awesome ly produced
mayday mayday mayday, vectors to columbus. live to see another day. entered VMC, back to IMC partial panel -> failure of pilotage, dead
Agreed
@@nolimitrc1 great im so fucking glad you agree
I just don't understand why they are so afraid of declaring an emergency. Even more than losing their lives
Perhaps because to declare emergency means to admit that you are not in total control anymore. It can be even scary to admit that. You want to tell yourself you got everything under control, just a little bit more. Until its so late that declaring doesn't help you anymore.
It's a probability thing. If the pilot knew that his two options were to declare an emergency or die, he wouldn't hesitate to declare an emergency. He figured the chance of anything going wrong was low enough that an emergency declaration wasn't warranted. It turned out he was wrong, but it's not like he intentionally chose death.
Hubris.
Machismo?
Because he's a surgeon. Ego.
I think this point can't be stressed enough, you as the pilot are the final authority when it comes to the operation of the aircraft. You are allowed to and even expected to decline ANY ATC instruction which you believe compromises the safety of that and other aircraft. You have access to information the controller doesn't. Work with them to find that best solution.
100% spot-on comment. There is a lifetime waiting on the ground that you can spend at WAR with the NTSB if you're correct in your judgement. Much better than "Accident was survivable."
Yeah this whole thing was ridiculous he should have taken command of his craft. It was clear no gyro in IMC was a nogo for him. Why either would go for ILS approach again is crazy. Hit alternate VFR airport
IMC? Failed Gyro?
I'm declaring an emergency.
...and you would be well-advised to do so.
Tom B I can’t fly an airplane, but after 400 episodes of ACI and 20 of AOAO, I know all failure modes. Lost your elevators? Control direction using asymetric engine power. Small aircraft and the ATC cancels your clearance in favour of a Boeing and it makes you feel overwhelmed? Declare emergency to land. Ultimate armchair master of failure-mode-only piloting.
Adrien Ragot oh that video. Poor girl in the cirrus.
@@antoy384 Ha ha, great comment!
@@antoy384 What's ACI. I don't fly, and don't ever plan to fly but for some reason these videos are endlessly entertaining to me.
I’m not a pilot, but these videos would be really useful if I were. They’re nicely produced. Not too brief or too laboured, neither sensational nor understated, with a human touch in the analysis - a disarming bedside manner this narrator has. This particular story is harrowing. As for who’s to blame; I think the video covers all the bases.
Completely agree. I intend to become a pilot when I can afford it and will watch all of these videos multiple times as partial preparation.
It's no bullshit and matter of fact but isn't sensational or snide about it. It's very educational
No gyros not good.
A common factor in many accidents is a pilot using GA as basic transportation rather than a recreational hobby. Your skill set and plane quality need to be much higher if you’re going to rely on flying with a deadline.
I often wonder if some of these people trying to use a more affordable AC for transportation are trying to save money and have paid off an IA to pencil whip the annual on problems they consider small instead of paying to fix it immediately. My father is an AP/IA and some of the stories I’ve heard of mechanics being paid off is terrifying.
@Kyle Taylor I think that is part of it. But a lot of pilots just don't put much time into preventative maintenance. It's a shame and one reason why renting from a good business can be nice
L I onmllmm pop
Mom ok lo 😮😅po😮pllo oooopoooooo pm oloi
Poplkm lol kpokom
This is why I could just never fly. A car, you can pull over and take a breather. A plane, if you're alone, there's no escape.
I'm in IMC and my vacuum pump is broken...hmm yes! I'll stay in IMC and try an instrument approach! Why not!!!
Sarcasm anyone??
I’m no pilot or controller but man do I love these videos. I’ve binge watched this channel for the last 3hrs now! These training videos are top notch.
I believe the suggestion of ATC of trying for a non-gyro approach was enough for the pilot to change his mind. This is an important lesson to us about decision making and and know when to say no. RIP.
Love this channel. No drama, no BS, but straightforward information that is of extreme importance to us pilots.
Problem was the pilot was a surgeon.
As a surgeon I can tell you we don't like feeling or admitting that we're not in charge.. we rarely ever ask for help during surgery, we just power through and get through it on our own as much as possible.
It's a necessary personality as a surgeon to be in charge of the situation, but not so much as a pilot.
Ironically the comment above yours says "I think this point can't be stressed enough, you as the pilot are the final authority when it comes to the operation of the aircraft."
Your excessive ego doesn't mean you are actually in control - all the adults can see through your insecurity
@@kristoffersmith8289 what did AK do to you?
Its never necessary to try to still be in charge when you're over your head in surgery. It's your HIPPA responsibility to ask for assistance. The patient is the priority--not your ego. I hope you never operate on me.
I'm not a surgeon, but I'm pretty sure they don't operate alone in a room with just the patient. Maybe your field could use some CRM training.....
When you don't appreciate the gravity of a dangerous situation, gravity will take over.
Goal as a pilot, never be in an Air Safety Institute "case study" video.
These are the goals of non pilots too.
Is that your go to comment for every vid. STFU
@@donaldadams4826 I never said this more than once.
These videos are so frigging sad. But you learn so much from them. Its amazing how many of these tragedies could have been avoided.
the goal is to be here living if you get here... not to be here in magnetis like this man
I hate watching these videos but I know I must. Thank you aopa for these series. They are a great reminder for the need for recurrent training and staying out of bad situations. Safe flying everyone
+DocsOnAPlane why do you hate watching them?
Nick Manning Because the pilots audio ends suddenly
As always a great video. I modified my 180 with a standby electric vacuum pump in the event I lost the engine driven pump. Lost it in VFR and the standby worked like a charm.
Thats called redundancy...and you made it home. Lets try an ILS approach into IMC with broken gyros and a bad attitude (indicator). Doesn't work too well.
Great idea I don't own a plane but if I did it would have back up electric attitude indicator. I am a aircraft mechanic and I have changed many failed vacuum pumps,they fail more than most realize.
A completely unbelievable decision to go back into the clouds partial panel after having struggled with maintaining control for a while. He saw he couldn't do it, he caught a break and broke out of IMC, and then he went back in. Incredible courage with little explanation as to why.
Your series of videos has convinced me that the most terrifying thing that can happen to any GA pilot is a vacuum pump failure in IMC. I literally bought synthetic vision as a backup. During my instrument training partial panel flying was never stressed as all that important, it was more an annoying thing we had to learn for the checkride. This really puts it into perspective.
If one is not totally 100% qualified and
competent to fly IMC, then 🥺 please - stay w/ VFR always,❤️
Huge problem with military doctors, for some reason more so than civilian doctors, is the inability to recognize when they're in over their heads.
We love our former military doc's it is the new ones that we dread. Don't get me started on NP and PA's.
Oh, I'm so glad to see this comment, Just watched this episode three times and said to a friend, "I wonder whether the fact that he was not only a doctor, but a MILITARY doctor, played into his cavalier attitude about the situation."
I just earlier watched another of your videos about a no-gyro partial panel situation. So when this guy so _casually_ mentioned he'd lost gyros, didn't declare an emergency, didn't seem in any hurry to get out of IMC, I was like "ARE YOU KIDDING ME?!"
300ft OVC put him behind the 8 ball before he left the home field. He didn't know his own limitations and lack of practice soon went to sensory overload.......he almost saved himself with the Columbus get out of jail card, but then blew it completely. Really informative video............
+LG Loffelmacher Excellent response to the clip, and its unfortunate & sad ending...surely ATC could have given weather for him at his alternate as it was quite close anyway, but to then get him to retry a 2nd ILS after such a badly failed 1st attempt at it...not good.
ATC op should have diverted him (gyro failed/course tracking up & down), and given him new heading/vectors to alternate or just get him out of there.
Pilot SHOULD HAVE also declared an emergency waaaay before things got so bad for him...disorientation sucks..
PILOT IS IN COMMAND & CAN OVERIDE ANY & ALL NOTIFICATIONS BY ATC if the pilot feels the situation is unsafe....BY SAYING "UNABLE" in response, THEN, ATC can offer further advice/guidance/course/action....they are there to help us.
Great clips from AOPA, and it shows it is so important for pilots & students to be able to recognise their own limitations....shoot a couple of ILS tracks to Mins. from under the hood yourself in training...ask your instructor to show you these and PRACTICE them....it COULD save a life...YOURS..!! Stay safe guys.....
These are invaluable videos. Thank you AOPA so much for releasing them, and please continue doing so!
I remember this day very well. I was on I95 when we seen the plane coming down. We had just left the airport. I had no idea this was the accident that took the life of the doctor from Cape Fear regional medical center.. so sad. Being in the clouds with no gyro is a very deadly combination. God rest this mans soul, as many lives as he has saved in his life, to have his own taken. God bless his family
Text books are great for knowledge but these videos really give pilots the wisdom that's sometimes lacking in our own flying (myself included). Very well done. I recommend all of ASI's training materials to my students. Great work!!
When the instruments fail, the vacuum pump has failed some time before that. Always check the pump constantly so you can anticipate.
These videos make me sad, but they are great lessons. Awesome channel!
The pilot's communication (short-quick, minimal syllables) was that of someone who was distracted under much duress. But he clearly asked for an alternate. At that point all efforts should've been to re-vector, not bring him back around into the same problem.
But, the pilot should've repeated his request.
I personally found the ATC's decision to retry an ILS approach extremely puzzling. You have just watched a guy barely able to fly his airplane in IMC, then ask you to get diverted to his alternate, and after all that you decide to make him wade into the soup again?
I simply don't get what was going through ATC's head at the time.
A video that must be watched, studied, trained and incorporated in each flight!
The last sentence in almost every one of these videos are cogent and universal: “A positive outcome is by no means guaranteed.”
I can't imagine not saying the "e" word after a vacuum failure, or pressing on afterwards into IMC when it isn't required.
No doubt but it's tough, clearly his mind was in a fog. Controllers should know that a vacuum failure in IMC is an emergency. Or at least they could ask, "do you wish to declare an emergency?"
Tytus Abrahamson I wonder if they understood it was a vacuum failure. He mentions a gyro issue but it seems like he was non-specific as to what the issue was or how serious it was until fairly late in the problem.
At least he was solo flying b
M1A1cavalryman Vacuum pumps are notorious for failing before their purported lifetime. Have been for decades. That’s why a lot of pilots have resorted to a second pump or ‘peanut’ attitude indicator etc. The overriding problem,apart from being proficient and comfortable on partial panel, is that most pilots don’t include the vacuum! gauge in their instrument scan most of the time, and who can really blame them? The effect is that the attitude and directional indicators ,not having off-flags pop up straight away and only slowly giving wrong signals, the pilot may not realize anything is out-of-whack until it’s too late in actual IMC. He may not even realize that it’s not the gyro instruments that have screwed up, but the pump.IF, and it’s a big IF, he can realize this and get on the turn coordinator ,flying partial panel while trying to cover up the vacuum powered gyros, he’s o.k. Accident statistics from the last 40 or so years suggest that a lot of pilots never managed this---and those type of accidents were usually fatal!!
Not a pilot but just love engineering and technology and accident analysis.
Being a pilot is certainly not a thing for just anybody to do.
Since 2001 the FAA has made recommendations for ATCs to be trained in equipment failure. However, the ruling is not specific, training is sporadic, and none of the 3 controllers interviewed claimed they had training with scenarios caused by loss of gyros. They knew what it meant--no heading--but they didn't know what it meant to a pilot's inability to control the plane. They also did not know the weather of the alternate. The ATCs were not trained properly.
he had no gyros.... I don't think giving him an ILS approach was a good idea. His vacuum instruments was his go-around back up instruments, and he didn't have it available... The pilot should have NEVER left VFR once he was out of it... He was ill-prepared for this situation...
CCCC.Climb, Call, Confess and Comply.
Good advice. Not bad at all actually...
Also circle...do a couple 360’s to buy time while you get your plan and bearings straight.
No place for compliance. Climb, Call, Confess, Co-ordinate.
@Bill j Those 4Cs apply when you are needing help. However, in order to know where you are going you need to know where you are. Once your situational awareness is in order proper pilot decision making starts. That's how it is done in aviation.
He did comply after already having requested rerouting to a VFR airport but being told to attempt another ILS approach, and that that very well possibly cost him his life.
Please add one or two of these type videos per month, they're amazing.
Even though many of these videos are discussing the factors, decisions and events that lead to someone's death i really appreciate not only the sensitivity the air safety institute takes with the production but also the educational quality. If all pilots of every experience level studied these i truly believe everybody will learn something. As a pilot myself I can honestly say that if I ever am involved in a fatal flight my hope is that someone will learn from any mistake that is made so history doesn't repeat.
Conclusion - when ATC tells you to do something that will kill you dont listen to them. He was already cleared to where he could do a visual approach and would likely have lived if the controller didnt send him back in to clouds.
Joseph Howard when ATC makes a mistake the pilot dies. When a pilot makes a mistake the pilot dies.
My sentiments entirely! If it was me, I'd nose dive the damn thing down to VFR, level out at 2 or 300, watch out for terrain of power lines etc. then start buzzing the ground for the final couple of clicks in preparation for an early flare...
He could have declined instruction. He just didn't know what he was doing in the moment... and that was the real killer. PIC... so act like one.
I like to say "person in command" since it is applicable in every day life to anyone mired in a highly stressful and dynamic situation. Not just pilots.
If he became visual like was speculated and then flew back into cloud, he killed himself. Plain and simple.
ATC did a good job in my opinion. After the clearance to alternate and him not complying due to control difficulties, atc rang the emergency bell for him and offered immediate and concise help.
Unintentional suicide.
These videos should be mandatory viewing for all small craft pilots. Especially those who have a tenancy to think they're smarter then everyone else... Which seems to be the case in basically 90% of these situations.
If you have 'lost some gyros' how are you 'getting there'? What does that mean? ATC doesn't seem concerned but that is due to his professionalism, I imagine. The controller asks the pilot if he can do gyro/non-gyro turns and the pilot replies, "I think so." You don't need to think about that one; you either can or you can't. When part of the answer to an ATC's query is 'I think so', things are about to go south.Bad situation all around.
"yeah I think so I can probably maybe do this we'll see I'm gonna try" bad day incoming. What does a controller do when a plane crashes? Get another cup of coffee.
@@rykehuss3435
Serious question; you think they are really that heartless?... me: I hope not!
@@bandlfamaccount5309 what are they supposed to do? Abandon tower and run 5 miles to the crash site? It's not heartless, there just nothing they can do but their job while emergency services locate and take over.
As soon as he said “I think so” I was just like …….I’m gonna take that as a no
I think this is one of the best asi videos.
I really appreciate these videos I've been wanting to get my pilot's license ever since I was a kid but I never really understood potential hazards that I need to be prepared for thank you
Every morning I get up, work out, and then practice partial panel instrument approaches to minimums in XPlane 11. I'll also set the winds, turbulence, and wind shear to make sure there's some bounce to it. About every two weeks I take turns under the hood or as a safety pilot with a friend of mine--again, partial panel (of safety pilot's choosing), icing scenarios, and lost comms. Ya gotta practice for when things go wrong with no way out but to face them.
Christopher Olsen you are my hero! That’s how I want to fly to! Plus some acrobatic for stall and spin recovery would be helpful too :) I think all pilots should experiment under controlled conditions to find their extreme limits. It should be fun to try and learn challenging things.
Flying is super easy..... until it isn’t...
i cant imagine how horrifying it must be with a vacuumpump failure in IMC with no backup.
Not having a backup is the first fatal decision any pilot can make...do not fly even in VFR without backup systems. These days there is no excuse for not having backups like a tablet with GPS on it and redundancy for the instruments.
this. One reason why I no longer have vacuum pumps in my plane
Why is it so disastrous immediately?? I’m dumb. These things just render you incapable of flying the plane anymore?
@@enshk79flying in IMC (Instrument Meteorological Conditions) condition with zero visibility without any instrumentation like an artificial horizon is basically a death sentence because you have no ground reference and you cannot rely on your organ of balance. so sooner or later you will end up in a turn without noticing and hitting the ground without seeing it or very short before impact.
Four hours over nine years??
Shit, I’d be hard-pressed to get into my car with that amount of experience over such a timeframe, much less a plane. That’s absurd.
No idea why I'm watching these videos, but they are very interesting and well done. I do know a few pilots and can at least now have some understanding of their challenges.
I am a doctor and considering getting my private pilots license. Doctors like anyone else get into trouble because they do not know their limitations. I suspect there are also a larger number of doctors that get their private pilots license and also their own plane more than any other profession due to financial ability and their education based on the sciences. I have heard surgeons are over represented in plane accidents more than other specialists but I do not know this is true. It would not surprise me since the surgical specialist is at the apex of specialties and I can see how they are known to have nerves of steel and take it upon themselves to make final and urgent decisions without asking for help. It is not in their nature to admit when they are in over their heads. As for me I am a psychiatrist and do not need to keep from asking for advice, help in the middle of a surgery. My experience in surgeries ended as a med student when I would just hold retractors and take directions from the surgeon. I have been reading and watching videos about topics important in getting a private pilots license. One thing that is missing is what a pilot has to fear or be afraid of when declaring an emergency. From my understanding there is nothing to fear or be afraid of but this info is lacking in the literature of my private pilots license text book. How many of these videos involving accidents seem to have the theme that the pilot is not clear with ATC telling them of their predicament at all or until it is too late?
Perhaps because of these videos and audios it's all too real and out there now to see/hear and make validity of some of these mistakes unlike the old days of hearsay about an event, like a news clipping and you filled in the blanks. You being a psychiatrist and me operating railroad locomotives and working the ground switching cars for a few decades we can each surmise how one wrong split second move can be one that has no return. I'm not a pilot and can't vouch for what becomes in the mind of each in situations however I know well enough after seeing a career of mishaps on a railroad that it's an instant safe course of action regardless of personality. That is a fact written in blood in my field both witnessed and experienced. All I hope for you now is should your test come that you are gifted an ATC that feels you and puts it out in a tone that you may need to place your direction in him. How are you coming along in your flight pursuit?
Bill, nothing bad comes to you for declaring an emergency. They may ask you to explain and if clearly not warranted they may have you take some additional training, no big deal compared to assuming unnecessary risk up in the sky. Remember the moto - speed that thrills is a speed that kills. I am sure that pilot was sweating it up there, it's obvious in his voice. When you are sweating it, assume command, do what you know is safe and / or declare an emergency. Lastly, there may be some contributing factors to doctor accidents such as they fly faster planes, and often after long hours and in a rush to get to their remote clinic in time for the next day, dealing with these factors is part of a pilot's basic training (IMSAFE), but it takes discipline to sticking to them even after many hours of experience.
@@dantee7893 ive been seeing a lot of comment in various video stated that the pilot could have been save if they declared emergency. What actually will happen after pilot declare emergency?
@@arashishinkaku169 First, let me state the obvious, when losing gyro's in IMC, that's an emergency, meaning there's real risk for life. Second, once declaring emergency the controller must give the pilot priority and make sure other aircraft stay clear. Giving priority means going according to pilot's request to Columbus under VMC, and not suggesting another attempt at local IMC airport. Simply declaring emergency is also a mental thing affecting both the pilot and the control, removing any doubt as to the seriousness and gravity of the situation. I could be wrong, but it appears to me that while the controller obviously realized something was wrong, he did not draw the proper conclusion that the pilot is simply not in control, of the aircraft and himself.
@@dantee7893 so, declaring emergency means that ATC just follow with pilot's plan along with the pilot have the highest priority in landing? It may explain it in this case, but i still cant see how it would make a huge difference for other case
These are the best videos on youtube
I want to sit in the section of the plane that has the planes numbers on the outside, that part of the plane always stays whole after the crash...
I love the intro, I’ll listen for it when I fly to make sure I won’t die in the next few minutes
I lost one of my doctors, a well-known Houston surgeon who loved to fly his experimental ultralight aircraft as a hobby, to a crash in 1981.
It’s really important that aviators watch this kind of analysis, but I can’t help felling really sad with it. Nobody wants to do mistakes, nobody wants to get in dangerous situations, it’s really easy for us watching it all in the comfort of our homes to get conclusions we might not get in time if we were there. Good flying to us all, and that those losses may not be in vain.
You can tell this was a very nice fellow and didn't want anyone to fuss over him. Too bad the alternate airport was not kept.
The tricky part of partial panel is flying the magnetic compass and correlating that with the CDI. This is what I think happened with this pilot I always taught compass turns and timed turns but the best fundamental technique I realized is to make a std turn in the correct direction for a few seconds then level wings and allow compass to stabilize. " turn a little wings level". Repeat until you're on the desired heading. Then once on course, make the same small corrections laterally referencing the cdi and turn coordinator. Makes life much easier. Hope this helps a bit.
Skunkowork I agree . Trying to fly the mag. compass with all its lag , lead , and acceleration errors is extremely difficult . The Army used to teach that to its rotary-wing pilots , but I doubt they do so today. I also doubt any of them ever used it on a precision approach!
As you say, timed turns are the way to go on partial panel. Personally, I’d use std. rate for the first half , and half std. for the last half of instrument approaches, but that’s just a matter of taste. BTW do you know of any flight sims that actually incorporate ANY of these mag. compass foibles in their programs? I doubt that, too. Must be yet another confusing detail for the desk flyers if , or when, they ever try flying a real aircraft.
@@davidwhite8633 I know some instrument trainers use Microsoft flt sim software, it simulates compass errors to an extent. The lead, lag and timed turns are a good base but I found better results from my students when referencing the compass as in my previous comment. Basically if I'm using the old fluid compass, I just do a std rate turn until I see the heading in the window, then I level wings. And make small, quick turns to center it. When you have to fly, navigate, communicate, and troublshoot a problem. Simple is easiest and safest.
As a professional communicator, I understand that busy people who have to repeat boring information tend to speed up their cadence. But many of these controllers need to slow down their speech and focus their thought process once critical or emergency situations occur. ATC sounded perturbed with the pilot and was speaking so fast he sounded like a winded auctioneer. I'm sure his goal wasn't to kill the pilot but he did way more to hurt than help, sadly.
Great vid ASI, such an awful accident. Thanks for this informative series.
Rest in Peace, Sir
Retired Col. Virgil Thomas "Tom" Deal Jr., 63.
Am currently a student pilot thankfully I have a healthy discussion attitude w the atc & tower in requesting different instructions. E.g. Requesting a runway w papi instead of runway w no lights when I was tired or requesting vectors and asking for confirmation when am confused.
I live north of Fayetteville and am very familiar with them . A couple of years ago the controllers there were a “little different “. I called in from the north and could not get them on frequency, other pilots also could not get them either so I switched to 133.0 and Fayetteville approach answered I received flight following to Kcre . A few minutes later ATC says contact on 133.0 so I acknowledged with him at 4500. He starts screaming to switch to 133.0 myself and other pilots informed him we were all on 133.0 after that silence and I finally contacted Myrtle beach approach they informed me Fayetteville had already hand me off to them . The controllers there now are better.
Pilot did not state 2 imperative things: 1st: REQUEST NO GYRO VECTORS; 2nd Declare EMERGENCY. ATCS could have arranged an Radar Surveillance App (ASR) or Precision Radar App (PAR) into FBG. Pilot's responsibility to tell ATC what assistance is required: he did not.
As PIC declare a emergency. Make sure you are at a safe altitude and have plenty of fuel. Maintain straight and level. Until you can do that don't do anything else. Unless we are flight instructors it is likely we are rusty. So keep the wings level and your altitude level and tell the controller that that is what you are doing. Aviate, navigate, and communicate. In that order.
Speaking for us non-pilots, the critical mistakes and prescribed solutions here seem entirely intuitive. In layman's terms, it seems a pilot's basic training fundamentals are what will usually keep tragedy at bay.
The pilot in command and ONLY the pilot in command is responsible for the safe operation of the aircraft.
There was an accident some years ago, a small commuter turbo-prop was cleared into position to hold near the mid part of the runway, as the small plane did not need the entire runway to take off. But before she cleared the commuter to take off she forgot about them and cleared a Boeing (767 I think) to land on the same runway. The running lights of the commuter were lost in the runway lights and was not seen. The Boeing struck the commuter, crushing it and the Boeing crashed into a building killing several people, including one of the pilots, and of course everyone on the commuter.
The investigators placed most of the blame on the controller, but I think this was a bit unfair. I think most of the blame belongs to the pilot of the commuter, who should have been anticipating clearance at any moment. He he head that another plane had been cleared to land on that same runway, he should have reminded the controller he was still their, holding in position.
Never assume the controller remembers you are there. If you have the smallest suspicion you've been forgotten call them. I know of at least one case where a general aviation Cessna was at 4000 over Stockton, Ca on thick fog. He was flying North IFR and was told to turn right to 090 to avoid other traffic. After just a few minutes he had not been told to resume his course, and though he couldn't see them he knew he wasn't far from 7000 high mountains. He called ATC to let them know he was still headed East was was about to run into the mountains. He was cleared at once to turn back to the north.
He had been flying East for just 3 minutes, another 2 minutes would have placed him in real danger of hitting rocky clouds. Controllers are highly skilled, but they are also over worked and prone to mistakes. It is the pilot's job to catch these mistakes. Don't just blindly follow instructions hoping that the controller will keep you safe. Use your SA and common sense.
Those FSX graphics and aircraft are great.
Great accident case study, thank you for your efforts and for sharing it.
Fort Bragg is right there and has PAR. Civilians can land at military airfields in an emergency!
Unfortunate, wonder why he tried again instead of sticking to his plan to divert to VFR alternate. I assume the stress clouded judgment.
Don't blame the controllers. The pilot clearly did not have an accurate perception of his own capabilities; answering the controllers with "Im OK" type responses when he clearly wasn't; a denial of reality on his part? Or perhaps he didn't actually know he was in trouble? In addition he failed in his responsibilities at various times: not notifying ATC of the loss of capabilities when he detected it; not cancelling IFR and remaining in VMC when he could have, etc. The controllers are there to help and made good efforts to get things sorted out, but in the final analysis the responsibility is the pilot's.
The controllers sounded disinterested and annoyed, especially the second approach controller with his snarky "you didn't turn at all" comment. The NTSB agrees which is why they placed a lot of blame on ATC's failure to recognize an emergency situation even after the pilot said he wasn't OK.
Shit controlling on both the part of the controller and the supe standing behind him. Embarrassing at best
Don’t blame the controllers? Seems that the NTSB already did...partially.
But they (experts) point out that the controllers should have known from his responses that he was not ok. He sounded almost drunk to me early on, or drugged. That changed to "I'm ok".
Tragic. I wonder if he was aware that his alternate was VFR? If so it is hard to understand why he would have reentered IMC with a failed gyro. You would hope the automatic response to such a failure would be to declare an emergency.
I think the pilot was too timid to speak up. Some are like that. I'm a passive aggressive person who'll do almost anything to avoid a conflict, but I'm working on that as we speak/type.
I've seen too many accident reports like this.
I hope my automatic response would be just that. I'd hate to die, or worse, kill an innocent person(s) because of my passiveness. That's defiantly something for me to keep working on.
who/what are you defying?
ATC. One way or another if you have someone giving you instructions or who you expect to give you 'permission' to do something, even if you're well within your rights to ignore what they tell you, unless you can be sufficiently assertive it's easy to fall into the trap of just blindly following instructions even when they are probably stupid.
Plus, if you're kinda shy or have non-confrontational tendencies you're not likely to attempt to disagree or argue with the controllers even if you think they're being idiots.
I know that for myself, certainly, I have social anxiety, and as a student pilot that is by far my biggest issue that I'm having to deal with;
I fly outside of areas that have formal ATC controlled airspace, but dealing appropriately with radio calls makes me nervous at the best of times, and being nervous puts you at risk for making stupid mistakes.
It's something I know I'll have to work on if I hope to continue flying, but it's very difficult considering how much I struggle with it in day-to-day life.
Yet poor/awkward communication and not being very assertive may just be a bit embarrassing in say a shop, yet in the air it can be a matter of life and death at times...
Grammar police whoop whoop!
Smart phones can download free apps as backups. Compass, altimeter, horizon... I'm sure there are more. Compass has been standard on iPhone since inception, IIRC.
One thing I've learned from watching these videos is that having a medical degree and a pilots license will result in tragedy.
Too much confidence and pride - distorts rational judgement!
I’m already hoping this guy survived. Announcer just said he’s a chief of surgery in a major city. Imagine the lives affected if he doesn’t. 😢
This is like X-files but the mystery always ends with “and the pilot made a serious error in judgment.”
Thank you for posting this. This is a great all be it tragic lesson. It makes it real. I'm sure it will help us all try to recognize and acknowledge adverse situations more quickly.
*albeit (I'm not a spelling Nazi. I hate them, but just thought you'd find this useful)
as a mechanically minded person i have to ask.... why, after so many accidents, are critical systems such as attitude and heading indicators, single point failure systems?
As usual, excellent video. Surprised,however, there was no discussion of the post-crash inspection of the turn-and-bank indicator (a misnomer for the old WWII needle and ball I had in my Cherokee 160) or the more modern turn coordinator this aicraft probably had. Neither one shows attitude but they do show rate of roll initially then rate of turn when roll stops. The pilot must have had some knowlege of that and seemed to follow the controller’s no-gyro instructions (turn/stop turn) successfully for a while. Curiously the narration never covers the challenges of flying in IMC with the TC (and its electrically powered gyro) with no pitch information except the altimeter and airspeed indicator. It’s not too tricky if you’re proficient, which this pilot clearly was not. Tragic he did not stick to his guns and go to the good VFR at Columbus. That’s a missing point in the narration too…both the pilot’s and ATC’s failure to go for the simplest least risky option: stay VFR or get to VFR ASAP.
ATC did what they could. I feel sorry for this pilot. He tried his best but failed to embrace the gravity of his situation. He should have declared an emergency and sought VFR conditions immediately.
ATC fucked up......should have let him go to Columbus....jeeezzzz
@@zardiw They cleared him to Columbus, but he didn't go.
> "failed to embrace the gravity"
@@cityuser They called him back for a second approach, after seeing that he'd regained control of the aircraft, not realizing that it was because he'd gone back into VFR.
Not directed at you personally, but it's scary how many people fail to understand UA-cam videos.
So atc know he has limited panel and is obviously having huge difficulty flying his aircraft, yet they continue to barrage him with multiple instruction transmissions.
"Four miles from approach fix, turn right northbound 010, maintain 2000' until established on the localiser, clear ils runway 4". Stop. Just stop. Vector him to long final. Descend him to lowest vector altitude and clear him for the ils from ten miles out if needs be.
Not impressed.
I'm a controller and you forget most controllers are not pilots, nor are we taught about aircraft mechanics or avionics for 300 different types of aircraft. If you say vacuum failure probably 90% would assume your hand vacuum isn't picking up crumbs from the floor. Nor is it clear he's having difficulty flying, just that he's maybe distracted and wasn't watching his altitude and heading. Pilots are expected to tell ATC what they need and what they can or can't do if they're having problems. We can't see in your cockpit. This pilot should have said we need to stay in VMC (or get to VMC), otherwise the controller (who doesn't know your flight conditions) will assume you can accept normal handling. If you don't ask for a long final then the assumption is you can take a shorter turn (especially when you've indicated you're an emergency which the assumption is you want to get on the ground ASAP). Controller did nothing wrong here.
Indeed it's the pilot's fault 100% here. He just doesn't want to admit he can't fly the plane and needs help. Instead he's acting as if he's in control and can actually follow directions.
kewkabe Clearly the NASB disagrees with you. It’s one thing for a non-pilot, or -non-ATC to have that opinion, even a retired pilot or ATC, but for a current ATC to have that opinion is disturbing. Clearly the ATC shared some responsibility in recognizing the pilots situation and suggesting corrective action. Even if just 1% he shared. It is not true that “he did nothing wrong”
@@Bankable2790 PIC decides what to do. The controller asked him what he needed. Im not going to start suggesting what the pilot needs to do as im not certified to fly that plane or 100 percent informed on the problem or his ability.
@Uhhh kewkabe and A did not learn all the lessons from the video.
So many of these cases tell me that the most important thing for a pilot to do is to fly their airplane. Don't listen to atc, passengers, or anyone else... Fly your airplane and declare an emergency if necessary. It's a lot easier to argue with ATC than to dig yourself out of the crater you created by letting someone else make decisions for you.
Pilot was calm all the time!!
Stadard protocol for partial panel should be " loss of critical instrumentation" 😥
Not enough of these videos. Please make more.
What are the consequences for declaring an emergency?
Doesnt make sense why some pilots are so reluctant to declare, when the emergency is out of their control.. it's as if they're avoiding declaring emergency because it jeopardizes their license or something
No consequence with anything broken in the airplane. I have declared twice just because of a rough running engine. First priority, got on the ground, got it fixed. Both times I said my number, declaring emergency, and landing runway. Never assume anything not working is not going to get worse.
Watching these excellent videos can be sooooo depressing.
Pilots need to assume that ATC has no idea what partial panel flying is like and/or no gyro. Most controllers are NOT pilots. The pilot in command has final decision and must not be afraid to be firm with requests to ATC. They might think you are a jerk but it’s better to be an alive jerk than a dead nice guy. In most cases ATC will go above and beyond in order to help facilitate a safe landing but we must be informed fully of the situation. We are just looking a lines on a scope.
If possible I suggest any regularly flying pilot to request a tour/walk through of your local tracon/rapcon. It can help pilots understand what we are working with and how providing more information only benefits everyone. Rest In Peace to this pilot
We practice partial panel to be IFR rated, never realizing that a true Vacuum failure won't have a failure flag indication. The only indication will be erroneous and inaccurate information from instruments you're used to trusting.
As soon as I heard "Physician" I knew it wasn't going to end well......
The worst pilots are arrogant. Doesn't matter what they do in real life for their work. It's about attitude and flying enough to stay current and proficient...not whether you take out kids tonsils for a day job.
The title "Accident Case Study" didn't give it away, you think? Have any of these had a happy ending?
To this pilots defense he sounded quite cordial and was clearly having troubleand making that point known here the second controller was the one with the attitude.
These arrogant men put their family lives at risk as well. Its so so sad. R.I.P
Diverting to the alternate that was Vfr would clearly be the safest decision. I wonder however if instrument covers over the inop attitude indicator and DG would have helped? I feel like failed instruments are extremely confusing and distracting especially regarding the hard IFR at that airport
Planes with no auxiliary vacum pump should not be allowed to fly in IFR conditions at all. This pilot was not taking his situation seriously, he should have announced emergency as soon as he saw his gyros were not working properly but he kept flying in circles calmly talking to the controllers like it was no big deal and in the end it cost him his life. When I watch to some of these episodes I just can't believe how ignorant some of these pilots were before becoming a crater in the ground. For the love of God just announce an emergency.
The second controller's voice had a hint of annoyance and less of concern. Pilots under stress could do without a condescending tone.
You hear that in a lot of accident tapes. The reason is arguably very human: ATC is ripped out of his normal work-flow by no fault of his own and there simply isn't anyone to blame but the pilot (even if the pilot isn't actually to blame). Sometimes they don't even know that something is wrong, they just assume it's one of "those" pilots again. The lesson of this should be:
to pilots: Don't ever care about the feelings of ATC. There is a reason the order is Aviate, Navigate, Communicate. May they curse you to hell, you just save your aircraft!
to ATC: Give pilots the benefit of the doubt. You may not know what's happening or how much they are in over their head. If you are right, possible pilot deviation can wait until they are on the ground.
If you cant still be assertive when hearing a condescending tone maybe not be a pilot.
@@sporkeh90 No, it was more than that. The pilot was obviously under stress and the controller had been told he was having problems during the handoff from Fayetteville tower. There was no need for such a nasty attitude. At 7:47 he says "stop turn" even though he knows the pilot wasn't actually turning... and then he has the gall to sound annoyed when tells the pilot he wasn't actually turning. Since the pilot was already confused, that made the situation even worse. He should have immediately vectored him (as best he could) above the clouds and towards Columbus. Instead, he acted like a jerk. I hope he learned something from this unfortunate situation.
As a GA pilot you should be aware of and prepared for asshole ATC. Most ATC are very professional and friendly. However, in busy areas they hate our slow planes. Most centers are used to dealing with professional jet pilots. When they hear a piper or a cessna they get bothered because for whatever reason, they assume we don't know how to fly.
@sallygo1234 Well, this specific pilot didn't sound like that. He was also very forthcoming about his difficulties and requested the alternate himself. But the real deciding factor here is that the pilot was in a life-or-death situation and the controller _wasn't._ Once the controller realized the pilot couldn't navigate or handle no-gyro turns in IMC he should've brought up flying to his alternate, not get snippy with him right before directing him to an approach that he obviously couldn't fly. After listening to a number of these videos, I'm amazed at how poorly most controllers seem to comprehend the basics of flying these days.
That eerie music and the picture of trees really close together. Yikes.
Somehow the pilot made it out of IMC, then flew right back into it??!! WOW!
Yet another dangerous doctor