Monday, March 21, 2011

In response to the comment on my last post

Hi, i appreciate comments and definately love hearing what people have to say about my blog/posts. So im writing this in response to one of the comments. This isn't meant to sound negative or even a justification, but more just to explain my actions in a safety/commerical viewpoint. Well thats my aim at the moment anyway.

This was the comment. Again, i found it interesting, well enough to stimulate a post response!

Cedarglen said...

Mike, I just found your blog and this is the first post that I've read. I DARN good one, but I am surpized that no one has mentioned the IMPORTANT Safety Lesson that you learned. (OK, I'm a Safety Nut, especially for modest-hour commercial pilots.) As you relate the story, I find SEVERAL missed opportunities to either stay on the ground or return to ground sooner than you did. I can imagine that there were a few more 'hints' that have slipped you mind. In the most simple terms, if anything makes you question anything, stay on the ground until the concerns are resolved. Not taking off is NEVER a bad idea. I also have to wonder about the climb from 2000 to 2500. You knew there was a problem at 2000, but... Nuff said. You fixed your problem and learned an important lesson. Completing the take-off procedure with one engine is something that you are well trained to do. Having to actually DO IT, when there were alternatives, is a questionable decision.

I look forward to reading your new posts as well as your archive. Please don't take my comments as a personal attack. As noted, I am a Safety Geek and I miss few opportunities to encourage safety. -C
In the commercial, general aviation world, which exists in Australia, there is definately a tendancy to 'get the job done' mentality which has existed in every company i have worked for. It is within my rights to cancel flights due weather, ground planes due defects etc. I have done this many times before, and im sure it will happen many times in this future. On this particular occasion i had done run-ups and completed my pre-flight without problem. I had done fuel drains, signed and sighted the maintenance release, obtained a clearance, and was therefore satisfied that the aeroplane was airworthy.

We use a class 'a' maintenance system which means we have a maintenance release with the different actions required by certain dates, or hours flown and finally a deffered defect list on the rear. It is checked everyday by the pilot and is also crosschecked on the computer spreadsheet at work. However, when a defect is written up, it is written on a seperate book which is then put in the maintenance controllers records, as well as kept with the aircraft MR and with the pilot paperwork.

I will say this was an oversight, in that i did not scroll back through this book to see if things had been written up BEFORE, on the previous few flights. I generally haven't had to either, as when things are written up, the white piece of paper is left in the MR to signal that its either been fixed, or needs fixing, so the next pilot is aware of the problem. If the paperwork is missing, then it's usually a DDL item, and is not required for dispatch via our minimum equipment list. Anyway i am deviating from the point. I am trying to say that other pilots had similar experiences in this plane, however had either not mentioned it, or had written it up so it wasn't faulted when inspections were done. Apparently they only received vibrations on take-off, and no other time in flight. Either way, it was not the first occurance of it happening. Maybe it came down to their inexperience, but more should have been done or stated then. However, it wasn't and you already know how the events unfolded. But i come back to the point - i did run-ups and i couldn't fault it, and when the maintenance guys took the plane off me once i had written it up, it still couldn't be faulted.

So back to the flight itself, once i received weird feelings on take-off, i had normal indications on the gauges, i also had power. I was also not 100% current with the 402C. All these things considered, plus my run-ups and MR items seemed to be in check, i did not feel that there was any reason to not take-off, or at that point to continue the take-off. Again i will state i was unfamiliar with the 402 and really put it down to that initially. Once i reduced power and it still didn't feel right, then its time to trouble shoot the problem. (It's all good and well to sit on the ground pondering the problem or make a rash decision and turn around, when it may have been something simple, but in a commerical sense, i need to be sure that there is something wrong. Had i not taken off, the engineers again wouldn't have faulted it, and i would have just wasted a lot of time in being told that.)

However, at this point in flight i was still getting power and i was still slightly confused as to whether it was an engine issue, or me not being used to a plane. Once the vibrations got so bad, then i decided it was definately the plane and not my currency.

I defiantely agree that continuing a take-off with a dubious engine with a load of passengers in a piston twin, is virtually suicide especially in the crocodile infested water that surrounds everything here! If you did survive a crash, you would probably be posed with getting eaten as the next problem. However, i was airborne, i was still getting power, i was flying a SID, and i was troubleshooting a problem at the same time. If i was to turn around on a hunch, then how do i explain it to operations, maintenance and anyone else? I have done that before and got roasted over it, because maintenance couldn't fault it, i couldn't exactly tell them what was wrong, and it wasted a lot of people's time and i guess money.

So once i knew the extent of the situation i was in, then i made the decision to turn around and return to Darwin. I knew from my experience that -

  • The engine was producing power, but was causing airframe vibrations, which probably meant something wasn't right in the engine, but i had normal indications.
  • The moment i tried to 'lean' the engine, it started coughing and almost died - but fuel flow indications were normal. As was manifold pressure.
  • The vibrations were getting worse as flight continued

I know there are 2 sides to every story and safety is paramount and i agree, that it's my moral obligation as a pilot carrying passengers that safety is paramount and everything else is secondary. However, i believe i did everything correctly in identifying the problem in the air, and turned around when i was sure that something was pear shaped.

Anyway my feelings on the matter. Again, i enjoy the discussion and feedback.


  1. What Rand said.

    Would you/could you have done anything differently if facing the same problem? Were there any changes to the way your company does things as a result? Were the root causes communicated to the relevant parties?

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