Case Analysis – Pilot Error in the Air France 447 Crash
Human Error as a Cause of Commercial Aviation Accidents
Pilot errors account for about 80% of the total aviation accidents. Pilot errors may be termed as the decisions or actions or the lack of proper action by a pilot contributing to the occurrence of an accident. Pilot errors or human errors resulting in commercial aviation accidents may be caused by failure to exercise due diligence, simple mistakes, or poor judgments (Husna, 2013). The errors are broadly categorized into two broad classes as follows: tactical errors, which are often related to the pilot’s poor decision of inaction and results from inexperience, inebriation, and fatigue, and operational errors related to the problems in comprehending flight instructions and training. This paper looks into the Air France 447 commercial plane crash that was concluded to have been caused by pilot error after several investigations. Hire our assignment writing services in case your assignment is devastating you.
The 2009 Fatal crash of Air France 447 that killed all the 228 people on board was concluded to have been caused by operational errors of the crew due to inappropriate responses towards the technical problems that arose at high altitude until they lost total control of the situation (Whitfield, 2012). BEA-France’s aviation accident investigating authority issued a report on the accident detailing the mismanagement of the cockpit by the two co-pilots. There was a poor sharing of roles and profound confusion in the cockpit as the events leading to the accident rapidly unfolded. A malfunction of the speed sensors resulting from icing of the pitot tubes, which triggered the autopilot mode and disengagement of the auto-thrust that resulted in the loss of accurate speed information, prompted the two pilots to engage in a series of actions that were not appropriate responses to such a situation.
Failure to read the stall warnings given by the plane resulted in the plane entering a stall and losing altitude rapidly at more than 10,000 fpm (Whitfield, 2012). The pilots were not aware that the loss of the speed information had reverted the plane into manual control and were, therefore, supposed to be in control of the plane. Confusion during the training of the 1330 pilots made them think that they were in an overspeed situation rather than a stall buffet, which caused the plane to plunge into the ocean due to rapid loss of altitude. Stall warnings were also designed to go on and off as the plane fluctuated in low airspeed levels, adding to the confusion of the two pilots (Hodgkin, 2017). This accident showed the pilots’ vulnerability to misreading warnings in the cockpit, which inhibited them from taking the right course of action. The pilots had not been trained to handle situations like this where pitot tubes malfunctioned, and thus judgment on the cause of action was difficult for the two pilots (Husna, 2013)
BEA’s recommendations and changes following this accident included a requirement for additional airspeed training, an increase in the frequency of pitot tube maintenance checks, and better relief crew instructions (Whitfield, 2012). High-altitude stall approach training would be vital in helping the pilots rule out cases of overspeeding when the plane has entered a stall. A further improvement to enhance the safety of the plane would be to add an angle of attack indicator in the cockpit for the pilots to judge when the plane is approaching a stall.
References
Hodgkin, E. (2017, April 3). Air France 447 – Is this what caused the tragic plane crash that killed 228 people? Retrieved from Express: https://www.express.co.uk/life-style/life/787465/Air-France-flight-447
Husna, H. (2013, May 21). How human error can cause a plane crash. Retrieved from BBC Travel: http://www.bbc.com/travel/story/20130521-how-human-error-can-cause-a-plane-crash
Whitfield, B. (2012, July 6). Air France 447 Crash: Final Report Points to Pilot Error, Confusion. Retrieved from Flying: https://www.flyingmag.com/technique/accidents/air-france-447-crash-final-report-points-pilot-error-confusion
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Question
Process
I. Review materials from outside sources regarding the case
II. Diagnose the case (identify the issue/problem, define the significance of the issue/problem)
III. “Size-up” the case (determine the influence of the issue/problem, decide what was done well, and identify what could be improved)
IV. Provide recommendations (identify courses of action; what would you do differently?)
Develop a case analysis on this topic: Select a commercial aviation accident that was concluded to have resulted from pilot error. Determine the primary and any secondary human factors contributing to the accident. Consider pilot training, organizational culture, organizational rules/policies, ergonomics, aircraft design limitations, etc., when identifying an issue for your case analysis. As always, draw upon previous module knowledge to help you conduct your analysis.
Refer to the assignment guides and rubric in the activity and ensure your case analysis conforms to the assignment requirements. Use the rubric as a guide when completing this assignment. Remember to draw upon previous module knowledge to help you conduct your analysis.
In order to receive full credit, assignments must be submitted by the due date. You may lose points for late submissions. No submissions are accepted after the last day of the module/week. Collectively, case analyses are worth 40% of your course grade.
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