The “Groundhog Day” Accident

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What made this crash more than tragic was that it was foreseeable and likely preventable if not for the preference of profit over safety in some of the aviation industry and for the lax oversight of the Federal Aviation Administration in its failure to adequately address known safety risks related to icing.

Jim Hall, former chairman of the NTSB, quoted in the Buffalo News.

sld_icing1In aviation, there is an expression that the rules, regulations, designs and procedures are “written in blood” – meaning the tremendous safety that is built into our  air transport system comes at the steepest price of all: human lives. It is is a grim reality, but when people die in airplane crashes, the lessons learned generally do make it less likely history will repeat itself. We are supposed to learn from our mistakes, right?

Except, it seems, when it comes to ice. For as long as pilots have dared to fly their airplanes into the clouds, they have found themselves grappling with this efficient killer – and yet the accidents keep happening again and again – as if we are all living in Bill Murray’s “Groundhog Day” nightmare.

While it is way to early tbufo know what happened with certainty, he crash of Colgan/Continental 3407 in Buffalo appears to be a tragic replay of the the Comair crash in January 1997 outside Detroit, which itself was a repeat of the American Eagle crash in Roselawn, Indiana in 1994 – which had all the elements of the crash of American Airlines Flight 63 in Centerville, TN – in October of 1943!

There are plenty of other deadly crashes in between – way too numerous to mention (the grim list is here) – but some of them may be lodged in your memory: the Air Florida crash into the Potomac in Washington DC in 1982 – the DC-8 carrying US troops home for the holidays that went down in Gander, Newfoundland in 1985 – the USAir crash on takeoff at LaGuardia in March 1992 – or the chartered jet carrying TV executive Dick Ebersol and his family that crashed in Colorado in November 2004.

We are now in our seventh decade of watching ice laden planes fall out of the sky and you have to wonder why. The National Transportation Safety Board is also wondering. The Board made some recommendations to the FAA aimed at reducing the risks – and put them on top of its so-called “Most Wanted” list.

The NTSB is asking the FAA to:

  • change the way manufacturers evaluate new airplanes for performance in icing conditions.
  • require manufacturers to demonstrate their aircraft can operate for extended periods in Supercooled Large Drop icing conditions (cause of the Roselawn crash) or provide pilots a warning that these conditions exist so they take evasive action.
  • create more specific procedures for operation of ice protection systems and when to fly out of icing conditions.
  • require additional testing – with revised criteria – of turboprop airplanes currently in service to insure no unsafe conditions exist.
  • require flight crews to activate pneumatic boot systems to knock off ice the moment they encounter icing conditions.

In 2007, the FAA  put  these ideas into the rule-making pipeline – but only the rule that changes the way new airplane designs are tested for ice resilience has been made the the law of the land. It’s now been 15 years since the Roselawn crash – which crystallized (if you will) the impetus for change – and the rule-making process appears frozen in time.

“The pace of the FAA’s activities in response to all of these recommendations remains unacceptably slow, despite some encouraging action during 2007,” says the NTSB.roselawn

For its part, the FAA says it “has taken short-and long-term safety actions over the past 15 years to improve safety of aircraft that encounter icing conditions on the ground and in flight.” And it released a fact-sheet with a tally of actions taken since Roselawn. It boasts of “100 airworthiness directives to address icing safety issues on more than 50 specific aircraft types.”

But the rules that would change either require installation of ice detection equipment or changes in the way ice protection systems are operated – and the rule that affects supercooled large drop icing remains in limbo pending an “economic analysis.”

Whatever the bottom line may be when the bean counters are done, it is axiomatic that safety costs money – and the converse holds as well. The fact is, the airlines are not doing well (they were a leading edge indicator for the rest of us, I suppose) and the FAA has to walk the line between mandating safety improvements – and placing financially unbearable regulations on an ailing industry. It is probably no coincidence that the only rule that has been codified affects aircraft designs in development – and thus will not incur any direct costs to the airlines.

To borrow a phrase, if you want to know why ice is still killing people in airliners – you must follow the money. Blood money.

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11 Responses to “The “Groundhog Day” Accident”

  1. Pam Patterson Says:

    Miles,

    Good to locate you again. I didn’t realize until watching the crash news that you were no longer with CNN. Hate to say it but I’ve been disappointed with the way things are going there since You and Soledad were replaced in the AM show.

    However, I really also miss your expertise when it comes to all things aviation related. I found this blog entry very informative.

    I’ll be checking back now that I know where to find you. Good luck in all your new endeavors!

    Best,

    Pam Patterson

  2. Tracy Kornfeld Says:

    I am not a pilot nor do I play one on TV. I have a very rudimentary understanding of flying. I understand [and appreciate your detail] of the description of the deicing boots on turboprops. As an extreme novice, I would assume that engines generate a large amount of heat. Why can’t this heat be “piped” to the leading edge of the wings, tail and horizontal stabilizers? Does the freezing happen so quickly that the [what I think would be a high amount] heat that would be pumped into the leading edges not help with the potential problem?

  3. Colin Says:

    You called it Miles, they were indeed on autopilot right up to when the plane lost control, then the crash happened. As your post alludes to, hopefully this, not to mention some of your excellent posts to sources along the way on your blog, like the NASA video, will become required education to pilots and icing. We will never know the answer but, perhaps, had the pilots been manually flying, they’d have detected icing on the plane, and the entire event never happened.

    I’m very impressed with how expedited the information pertaining to the crash has been from the NTSB and other officials. The sooner the information of the how and why, the quicker pilots become aware or reacquainted with such information.

  4. Jon Says:

    Tracy.

    Pure jet planes do pipe the hot air from the compressor section of the jet engines to the wings and tail (sometimes) and it works fine.

    turboprop planes usually (but not all of them) use the boots. the plane in question uses boots, though the technology to heat the wings
    exists. the decision to use boots was partly to keep a common touch to the whole line of DASH8 planes…the previoius planes had boots.

    The best way NOT to crash in ice is to use the anti/de ice equipment to run away from ice as soon as you can…even Lindbergh on his famous flight encountered ice…he turned away to find warmer air to melt it off…the spirit of st. louis didn’t even have boots!

  5. gyrfalcon Says:

    Supposedly these folks had all their deicing equipment turned on 11 minutes after they departed Newark.

    The autopilot disengaged automatically *after* the plane got into trouble enough for a stall warning. Then the nose of the plane went violently up something horrible like 30 degrees, then violently down well below horizontal, etc.

    I’m not getting how the conditions could have been so spectacularly beyond normal that they exceeded the ability of functioning de-icing to this extent. Also, it’s my understanding that since the nose went up, not down, immediately after the autopilot disengaged, this rules out tailplane icing as the cause of the problem.

    So what icing or other condition would cause the nose to flip up?

    I’m no expert, but I sure haven’t heard/seen an explanation for what went wrong that explains the sequence of events here.

    Miles? You out there?

  6. Tom B. Says:

    I am sitting here listening to CNN cover this crash, and the fireball in Texas, and your absence is woefully apparent. I am glad you are doing well, I hope you find something soon that will allow you to share information to large numbers, the way you did in this post.

  7. scottsnav Says:

    Duh, yes, safety costs money. What about cars? 40,000 Americans die in car wrecks every year, so why don’t we legislate that all new models must have wrap-around air bags and collision avoidance systems and huge steel framing and be coated in pillows?

    Because nobody could afford to drive, that’s why. It doesn’t make sense to price something totally out of reach for everybody just because a small percentage of users won’t use common sense. Like pilots who fly on autopilot through icing conditions.

  8. mares2 Says:

    Glad to see that you’ve created a blog, Miles, and writing so passionately on news subjects. It’s heartening to read.

    I don’t put a lot of faith in these organizations cleaning up their acts, including under the Obama administration.. far from change we can believe in, it’s the same old, same old. I’m concerned that we won’t get much more than more pretense.

    The corruption with the FAA includes corrupt, cozy relationships with airlines, it’s lead to a decline of oversight, and allowed the industry to feel entitled to not comply with standards. It’s no different with the FDA. Growing up I never would have thought that we’d have fellow citizens dying from contaminated and unsafe food, drugs and other products. My family went through a frightening 5 months after my daughter was prescribed Entex PSE, months after the FDA had banned it (while allowing it to be distributed for another half a year, so the company wouldn’t lose money). It caused severe respiratory symptoms and an accelerated heart rate, at worst it could have caused her hemorrhagic stroke. I had to force my senator to make someone from the FDA contact me, as I’d been getting the run around… it’s sheer insanity, and I’m terrified, as I don’t trust our government any longer. The public feels it has no one to look out for their interests.

  9. gyrfalcon Says:

    According to a piece in the WSJ (http://online.wsj.com/article/SB123492905826906821.html) NTSB now thinks this was pilot error, not icing.

    Miles?

    • milesobrien Says:

      I suspect it was a combination of both. Remember: accidents are almost always the result of a confluence of factors.

  10. Jillian Says:

    Miles, I am so pleased that you are blogging on aviation and in such a wonderful way! I like this post a lot – and encourage people to be patient with the NTSB – it will be some time before they come to their final conclusion. Have you seen or heard about this lawsuit yet? http://tiny.cc/3atMU

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