Aircraft Maintenance Technology

APR 2017

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SAFET Y MATTERS STEPHEN CARBONE is an avid writer of aviation fiction; his first novel Jet Blast has appealed to mechanics, pilots, air traffic controllers, etc. by giving accurate depictions of the accident investigation process. A former airline mechanic, he has been involved in many aspects of commercial aviation and went on to investigate major aviation accidents for the NTSB. A member of ISASI, Stephen holds a Master's degree in systems safety from ERAU. His weekly blog can be found at: http:// jetblast.tateauthor.com 62 APRIL 2017 AIRCRAFT MAINTENANCE TECHNOLOGY n Nebraska, I coached my son's soccer team. There was this one kid on my team who moved like the living dead from those Zombie movies. The ball would fall in his zone and he'd move his arms as if running, while his legs operated at continent- drifting speed. I'm watching this comedy routine, thinking, 'Does he honestly think me, the parents, and the other team are that stupid?' That's called: Phoning It In. It's when one does not put their best foot forward; the lack of effort reflecting a failure of intent. I know he was a kid, didn't want to be there; probably played to please Mom or Dad. But he still let the team down with his total lack of effort. The world of aviation safety depends on the full exertion put forth by safety specialists; their diligence assures industry that we will learn from our mistakes; the industry will be that much safer. Indifferent responses to tragedy diminish us all; it cheapens what all aviators work hard to maintain: Safety. The 2013 National Airlines flight 102 crash in Bagram, Afghanistan, was a catastrophic end to a normal flight. Everyone has seen the 747's last moments: it appears to hang on its engines before nosing over, then pancaking in. This accident rep- resents a chance at salvation, a teaching moment. Each tragedy, an opportunity to prevent repetition, but only … only … if the correct lessons are learned. To begin with, this accident happened while flying a military charter, the type of contracted flights that have been going on for decades. This is important: The Department of Defense (DoD) audits the airlines it contracts to annually; they veri- fy the operator's cargo loading procedures are up to DoD's standards for the equipment and personnel being moved. They must do this. Why? Because air operators don't normally transport multiple 18-ton Cougar vehicles and 12-ton Mine-Resistant Ambush-Protected all-terrain vehicles. Some mili- tary equipment exceeds the normal dimensions of an 88-inch by 125-inch cookie sheet pallet. This is not an excuse; it speaks directly to the DoD's responsibility in this matter. And the air carrier's, in this case: National's. According to the National Transportation Safety Board (NTSB) archives, the investigators dispatched to Bagram had a limited combined knowledge of the types of air carrier issues they would be facing. The investigator-in-charge (IIC) was a general aviation accident investigator; he had inadequate air cargo industry and DoD knowledge, forcing him to rely heavily on the other on-site investigators. The NTSB's decision to dispatch investigators unfamiliar with air cargo and military charter pro- cedures is disturbing; the Board missed an opportu- nity to fix major problems by not having a working knowledge of how. The investigators' unfamiliarity with air cargo meant that little was accomplished in reconciling the probable cause or writing construc- tive recommendations about air carrier operations. LESSONS UNLEARNED SERIES: PHONING IT IN Phoning it in is when one pretends to put their best foot forward; follow the case of the 2013 National Airlines Flight 102 crash in Afghanistan By Stephen Carbone The investigators' unfamiliarity with air cargo meant that little was accomplished in reconciling the probable cause or writing constructive recommendations.

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