The Management of Aegean Airlines & Olympic Air is committed to the conduct of our aviation activities to the highest possible safety standard. A management system is implemented which provides for the
compliance with all applicable regulatory requirements, meets all applicable standards and always consider
best practices, while monitoring safety compliance of all systems and established procedures. The safety
of our employees and customers relies on the commitment of management to a systematic and pro-active
attitude towards managing risk, identifying hazards and preventing damage/injuries.
Safety is the prime consideration and Aegean Airlines & Olympic Air recognize the importance of applying human factor principles in order to achieve it. It is the duty of each staff member to understand the
corporate self-disciplines required by Compliance Monitoring/Quality and Safety Standards and to participate in our goal for continuous self-improvement.
Each employee is responsible for cooperating with Quality Unit in order to identify non-conformances
and to the Safety Department so as to communicate any information that may affect the integrity of safety.
To promote a timely, uninhibited flow of information, Aegean Airlines & Olympic Air have promoted
and established a Just Culture which ensures no blame will be apportioned to individuals following their
reporting of mishaps, operational incidents or other risk exposures. Incidents or occurrences with elements
of wilful misconduct, gross negligence or criminal acts however, will be met with disciplinary and/or legal
action.
Our commitment is to:
Enforce safety as one of the primary responsibilities of all Heads of Functional Areas / Nominated
Persons / Managers;
Ensure that compliance with applicable regulation and standards is the responsibility of all personnel;
Support the Just Culture policy;
Implement an effective management system to ensure that customer and regulatory requirements are
met, and ensure that all employees are aware that Safety and Compliance is everyones responsibility;
Ensure safety and risk considerations are incorporated in its business, through a documented
management of change process;
Establish and implement hazard identification and risk management processes, including a hazard
reporting system, in order to eliminate or mitigate the safety risks associated with our operations
Achieve continuous safety improvement through continuous monitoring and measurement, and
adjustment of safety objectives and performance standards and achievement of these;
Develop the skills of employees to ensure that the Safety Management System can be maintained
through a process of recurrent training and an awareness program; and
Ensure that the necessary human and financial resources are available in order to allow our activities
to be carried out in accordance with Aegean Airlines & Olympic Air standards and this Safety and
Quality Policy Statement.
Dimitris Gerogiannis
Managing Director & Accountable Manager
contents
04 > EDITORIAL
06 > ARE JETS SAFER THAN TURBOPROPS?
EDITORIAL
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What is culture? This is probably among the most complex and most debated questions of the social science. Addressing the
concept of culture is like opening Pandoras Box unleashing most social science concepts and, as a consequence, a host of
analytical and definitional issues.
The word culture stems from the Latin colere, which means to grow or to process. Culture has to do with those aspects of human life that are not aspects of biology or unprocessed physical environment. This is culture in its broadest definition everything that is not nature has to be seen as culture.
Within the aviation society the concept usually refers to the values that the members of a group share, the norms they follow
and the procedures they create. As far as organizational culture is concerned it does not imply that it is necessarily attributable to an organization as a whole. On the contrary, organizations, depending on size and complexity, usually consist of
multiple cultures associated with different departments, hierarchical layers, occupations and so on.
In Ground Operations we see culture as the frames of reference through which information, symbols and behavior are interpreted and the conventions for behavior, interaction and communication are generated.
Ground Operations involves all aspects of aircraft handling at airports as well as aircraft movement around the airport,
except when on active runways. The safety challenges of ground operations arise in part, directly from those operations. Even
more important, ground operations concern the preparation of aircraft for departure in such a way that the subsequent flight
will be safe and according to legislation/company procedures; for example correct loading of cargo and baggage, sufficient
and verified fuel of adequate quantity and quality, etc..
Once again, last year a great effort has been done to minimize safety related incidents on the Ground. Safety Department
along with Ground Operations worked on a continued plan, focused on the improvement of the Safety Culture during aircraft
ground handling, which consisted of training sessions, station assessments and audits from our ground safety coordinator and
our QA auditors, one to one briefings, group meetings and close supervision.
On ramp handling training, special attention was particularly given to (a) Loading Height Limitations, on aircraft where violation of loading height limits is considered to be safety critical and (b) the proper securing of load, where bulk compartment
nets have to be properly secured and any defective items must be reported.
In addition to training and education we have successfully changed processes and procedures in order to improve safety on the
ground. Working closely with the Safety Departments of our ground handling providers we have placed in most of the airports
safety chains to restrict passenger access under aircraft wings.
The efforts made were intended to send out again our message, AEGEAN CARES FOR SAFETY. The measurable results of
this campaign were that safety events were reduced greatly.
Our effort continues this year with the campaign under the title: Important Notes for Safe Aircraft Loading. Apart from training sessions to major airports from our Airport Services trainers we are going to place a poster with the campaign name in
all ramp handling personnel briefing and rest areas. This poster has a check list of actions, describing correct procedures and
processes of loading with very simple words and images:
1. Bags loaded in accordance to the loading instructions
2. Cargo controlled by AWB number and destination
3. HEA/HER completely lashed and secured
4. Special loads (HUM/AVIH) loaded, lashed and secured
5. No Bags/cargo is loaded over cargo hold height limitations
6. Ramp agent to inform in writing Load Control about any change to the loading instructions prior to loadsheet release.
We believe that the above will contribute towards the further improvement of
our safety culture and add awareness during loading to ground personnel.
We still have to be extremely vigilant during turnaround activities.
Thank you for your cooperation in the development of our Safety Culture
during aircraft ground handling and maintaining our good safety record.
Panos Nicolaidis
Ground Operations Director
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Now that we understand that a turboprop is a turbine
(or jet) engine with a propeller on it, lets talk about the
questions I like to ask.
The real question!!!
Which is safer? The turbine or the piston engine?
> Lets clear the air for those who are unsure.
COMPOSITE MATERIALS
FOR AIRCRAFT STRUCTURES
By Agathoklis Logothetis,
Line Maintenance Engineer
Source: Skybrary
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REINFORCING FIBERS
When combined with a matrix, the reinforcing fibers
give the primary strength to the composite structure.
There are three common types of reinforcing fibers:
fiberglass, aramid and carbon/graphite. Other fibers
that arent quite as common include ceramic and boron.
All of these fibers can be used in combination with one
another (hybrids), woven in specific patterns (fiber science), in combination with other materials such as rigid
> Composites are years ahead of traditional aluminum alloy and are
the closest thing yet to an ideal aircraft material.
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Fiberglass
Carbon / Graphite
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Aramid
MATRIX MATERIALS
The function of the matrix in a composite is to hold
the reinforcing fibers in a desired position. It also gives
the composite strength and transfers external stresses to
the fibers. The strength of a composite lies in the ability
of the matrix to transfer stress to the reinforcing fibers.
A wide range of resin systems are used for the matrix
portion of fiber reinforced composites. Resin is an
organic polymer used as a matrix to contain the reinforcing fibers in a composite material. The newer
matrix materials display remarkably improved
stress distributing characteristics, heat resistance,
chemical resistance and durability. Most of the
newer matrix formulas for aircraft are epoxy resins.
Resin matrix systems are a type of plastic. Some companies refer to composites as fiber reinforced plastics.
There are two general categories of plastics: thermoplastic and thermoset. By themselves, these resins
do not have sufficient strength for use in structural
applications, however, when used as a matrix and
reinforced with other materials, they form the high
strength, lightweight structural composites used today.
Thermoplastic resins use heat to form the part into the
desired shape. However, this shape is not necessarily
permanent. If a thermoplastic resin is reheated, it will
soften and could easily change shape. One example
Fiber Science
The selective placement of fibers needed to
obtain the greatest amount of strength in various applications is known as fiber science. The
strength and stiffness of a composite depend on
the orientation of the plies to the load direction.
In order to derive maximum benefit from the use
Airbus A318/A319/A320/A321 Composite Structure.
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CORE MATERIALS
Core material is the central member of an assembly.
When bonded between two thin face sheets, it provides
a rigid, lightweight component. Composite structures
manufactured in this manner are sometimes referred to
as sandwich construction. Two popular core structures
are foam and honeycomb. The core material gives a
great deal of compressive strength to a structure. For
example, the sheet metal skin on a rotor blade has a
tendency to flex in flight as stress is applied. This constant flexing causes metal fatigue. A composite blade
with a central foam core, or honeycomb, will eliminate
most flexing of the skin because the core is uniformly
stiff throughout the blade. Honeycomb core structure
has the shape of natural honeycomb and has a very
high strength-to-weight ratio. Characteristics of honeycomb cores, when used in sandwich core construction,
have a high strength-to-weight ratio, high compression strength, a uniform distribution of stress, rigidity,
thermal and acoustical insulation and are fire resistant.
Honeycomb cores may be constructed of aluminum,
Kevlar, carbon, fiberglass, paper, Nomex, or steel.
The most common types used in aviation manufacturing are aluminum and Nomex. Foam core structures are
available in many different types, depending on the specific application. There are different densities and types
of foams for high heat applications, fire resistance,
repair foams, structural foams etc. When using foams
in the repair operation it is important to use the proper
type and density.
USES
Composites today are being used throughout the
world, on helicopters, military aircraft, commercial aircraft and homebuilt. Composites are being used in the
powerplants as well as the airframe designs.
Applications of composites on aircraft include:
Fairings
Flight control surfaces
Landing gear doors
Leading and trailing edge panels on the wing
and stabilizer
Interior components
Floor beams and floor boards
Vertical and horizontal stabilizer primary
structure on large aircraft
Primary wing and fuselage structure on new
generation large aircraft
Turbine engine fan blades
Propellers.
ADVANTAGES
The greatest advantage of using composites is the high strength-to-weight
ratio. Since weight is the one of the key
considerations for the use of any material in aircraft construction, if it can be
saved, more cargo, fuel or passengers
can be carried. A composite part can be
designed as strong as a metal part, but
with considerable weight savings. Typically 20 percent or more weight reductions are achieved when aluminum parts
are replaced with composite structures.
Composites also lend themselves well to
the formation of complex, aerodynamically contoured shapes. The parts do not
have to be flat, but can have smooth, sweeping contours that would be difficult and
expensive to fabricate from sheet metal.
The reduced drag produced by these contoured shapes,
in combination with the weight savings, enables an aircrafts range to be extended significantly. The number
of parts and fasteners may be reduced by the use of composites, as well, simplifying construction and reducing
cost. In some cases, very large structures can be manufactured in one piece, eliminating the riveting and seams.
Composites are becoming increasingly cost effective
as materials and manufacturing technologies mature
They may be designed to be very flexible, resisting vibrations, thus eliminating the problem of stress
fatigue found in metal structures. Moreover, they
dont corrode like metal does. However, they do have
their own problems, as they are not indestructible.
Reduced wear is another advantage of using composites. They will flex in flight without producing
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Before you decide to travel with your pet you should see
if your pet is of some race, if this race can travel with the
airline company that you have chosen and if it is welcome
in the country that you have chosen to visit. Aegean prohibits transport of some races, which are referred to the list
that you can find on Aegean official site (Travel information,
Travel preparation, Travelling with pets). When you have
checked the above information you can start your pet preparation for the trip.
The first you should check is your pet documentation, its
passport with number of chip (ID microchip) and its health
book.Your pet must have done the Anti-Rabies vaccine, and
it must been done at least three weeks before the trip even if
it is its first time or the yearly repetition. Furthermore by the
time you collect its papers, you should see if the destination
country requires any specific or other type of vaccination.
One of the necessary papers to travel with a pet is also
the certification by a veterinary doctor that your pet is in a
good and healthy condition to make the journey. Once you
have done with the paperwork you will have to deal with the
necessary details in the case that your pet have any health
issues, which it doesnt necessary risk your pets life during
the journey and also for the period of your stay at your destination. Make sure that for that period you have enough
pharmaceutical material.
Once you have finished with the necessary health documents, before you start with the details like choosing which
type of its toy you will take with you, you must make sure
that the transport case is one which will not only be approved
by the airline company you choose to travel, but it will also
be comfortable for your pet. Whether your flight is long or
not, whether your pet is small size or not, the best dimensions and those which are required are those that allow the
pet to stroll round, comfortably sit and lie in transport cage.
And for this, the maximum permitted weight for a cabin pet,
including the cage, is 8 kg and that cage dimensions allow
comfort and safe trip, having it under the front sit.
If your pet is traveling into Cargo, is forbidden to have
inside the case toys and edibles. Because they could cause
health problems during the flight, once the pet will deal with
them, and thats why if pet is not under your supervision is
prohibited to have them. If you want it to feel more comfortable you can have with it its favourite mat or blanket.
Water is also prohibited to be in the cage since during
the flight it is possible to pour and make the cage unsuitable
for travelling. If there is any external drinker it will be suitable for long journeys. Whether your pet is traveling with
you in the cabin or lonely in the Cargo, 12 hours before the
> The first you should check is your pet documentation, its passport with
number of chip (ID microchip) and its health book.
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DEGREE
OF EMERGENCY
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Pets and Airplanes can coexist.
journey do not feed it, so that there is time for digestion and
to relieve the organism from sickness, nausea etc. during the
trip. Also and the water will be limited and only periodically
small quantities.
The thing that will help your pet to get easier the journey
is the walk before it. Take a long walk with it, so its organism feels that need to take rest.
If your pet have a hyperactive character, sedative pill,
depending from its kilos, before the trip (always with advice
and veterinary prescription) will help it.Upon entering the
airplane, with pets traveling in the cabin of aircraft, it is
important to follow the instructions of aircraft crew.
For its safety it is important to your pet be placed under
the front seat and you sit next to the window, on this way you
will not hinder the exit of another passenger and also it will
have tranquility.
For the whole flight duration is very important to your
pet remain inside the cage, which is already known for it,
from the house remains, so by transferring into it and having
the feeling that you are next to it, it will feel secure and safe.
If you open its cage, and remove it out, it will understand
that the outdoor area is completely unknown so or it will
want to explore that or it will gain insecurities so it will want
to get inside your hug, and thats why is so important to
avoid every inconvenience.
Source: SkyBrary
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> Checklists only work if flight crews use them, the autopilot only works
when engaged in the correct mode.
Threat and Error Management (TEM) is a safety concept regarding aviation operations and human performance. TEM is both a safety philosophy and a practical
set of techniques. The easiest way to understand TEM is
to liken it to defensive driving for a motorist.
The purpose of defensive driving is not to teach
people how to drive a vehicle but to emphasize in driving
techniques people can use to minimize safety risks. TEM
does not teach pilots how to technically fly an airplane,
instead it promotes a proactive philosophy and provides
techniques for maximizing safety margins.
Threats
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Anticipated Threats
Threats which can be expected or known to
the flight crew. For example, flight crews can
anticipate the consequences of a thunderstorm
by briefing their response in advance, or prepare
for a congested airport by making sure they stay
vigilant for other aircrafts during the approach.
Unexpected Threats
Threats which can occur unexpectedly, such
as an in-flight aircraft malfunction that happens
suddenly without warning. In this case, flight
crews must apply skills and knowledge acquired
through training and operational experience.
Latent Threats
Threats which may not be obvious to flight
crews and may need to be uncovered by safety
analysis. Examples of latent threats include
equipment design issues, optical illusions even
shortened turn-around schedules.
Threats can be managed. Threat management is
defined as how crews anticipate, then respond to threats
and is considered as the most proactive option to maintain
safety margins in flight operations. Some of the tools and
techniques used in commercial aviation to manage threats
Errors
Flight crew actions or inactions which lead to deviations from intentions or expectations of another crew
member or procedures, reduce safety margins and
increase the probability of adverse events on ground or
during flight.
3 Error categories:
Aircraft handling
Deviations associated with the direction, speed,
configuration of the aircraft. They can involve
automation errors, such as dialing an incorrect
altitude, or hand-flying errors, such as getting
too fast and high during an approach.
Procedural
Deviations from regulations, flight manual
requirements or Standard Operating Procedures.
Communication
Involve a miscommunication between the pilots,
or between the crew and external agents such
as ATC controllers, flight attendants or ground
personnel.
Conclusion
TEM is not a revolutionary concept, but one that has
evolved gradually as a consequence of the constant drive
to improve the margins of safety in aviation through practical integration of Human Factors. Regardless of the type
of error, the effect on safety depends on whether the flight
crew detects and responds to the error before it leads to an
undesired aircraft state and unsafe situation.
An important learning and training point for flight
crews is the on-time switching from error management to
undesired aircraft state management and the illustration
of how easy it is to get locked-in to the error management
phase. It is of outmost importance to mention that despite
having in place the hard and soft TEM safeguards,
the last line of defense against threat, error, and undesired
aircraft states, is still, ultimately, the flight crew.
Even the best designed equipment is not enough to
ensure adequate Threat and Error Management performance. Checklists only work if flight crews use them, the
autopilot only works when engaged in the correct mode.
Effective crew coordination is the best way to manage
abnormal events in multi-pilot cockpits. Review, evaluation of plans, inquiry, is essential to manage a flight.
Last but not least, crews that exhibit good monitoring
and cross-checking, strong leadership, employ effective
workload management, develop contingency plans tend
to have fewer mismanaged threats as well as undesired
aircraft states and commit fewer errors compared to other
crews.
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Human Factors
vs Accident Causation
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> Latent failures provide great, if not a greater, potential danger to health
and safety as active failures.
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INCIDENT
FORUM
F R O M AV I AT I O N I N D U S T R Y
AIR SAFETY REPORTS FROM AIRLINES OPERATIONS
TYPE OF A/C
EVENT
A310
ATC PROBLEM
An A310 was being vectored for an ILS on to runway 00 at ZZZ. The A310
was cleared to and correctly read back a clearance to descend to 2500 feet
but subsequently descended below cleared level to approximately 1500 feet.
The ZZZ controller detected the error and instructed the A310 to climb back
to 2500 feet due to a 1200 feet. Probable cause of the event was altimeter
setting error.
B747-400F
FUSELAGE
DAMAGE UNSECURED
NOSE CARGO
STRAP
B737-800
EGPWS
ACTIVATION
Initially a VOR approach on runway 00 was flown. This has a steep slope and
following a tight and fast approach the aircraft was high and a go-around
was carried out. After that the crew decided to carry out an NDB approach
on rwy 00. There were CBs in the vicinity and the NDB needle fluctuated a
lot. At some point the fluctuation was such that the crew perceived this as
'station passage' and started the final descent. An EGPWS warning was
received and a go-around carried out.
EMB 145
WINDSHEAR
The aircraft was on its second approach into XXX following a hold due to
severe winds. At approx 1000ft AAL, speed was seen to rapidly fall by 20kts
as severe turbulence was encountered. The aircraft rolled rapidly to the
right and an uncommanded autopilot disconnect occurred. A go-around was
flown and the aircraft diverted to other airport.
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B777
TURBULENCE
PROBLEMS
In the cruise at FL380, turbulence was felt along with speed fluctuations of
+/-20kts. Altitude dropped rapidly to FL376 accompanied by an EICAS
'Altitude Alert' warning, altitude then rapidly increased to FL382. Speed was
contained with manual thrust lever inputs and the autopilot remained
engaged throughout, with instruments monitored and controls covered. ATC
were immediately informed of the altitude deviation and a descent to FL350
was given to avoid further encounters. An immediate PA was made for
passengers to be seated (the signs were already ON). One passenger
suffered a shoulder injury and two cabin attendants bumped their heads.
The wind was observed to vary from approx 300/90 to 300/175 within two
minutes.
A320
HARD LANDING
The crew flew a VOR/DME approach to Runway 00. The tower reported the
wind on the ground as variable 190/300. In the flare the aircraft touched
down on the runway hard and bounced. A TOGA go-around commenced as
the Captain took control but the engines were slow to spool-up and the
aircraft settled on runway more softly. There was sufficient runway
remaining to stop, so the thrust levers were closed and the aircraft stopped
on the runway.
A330
MAINWHEEL
TYRES
DEFLATED
Prior to departure to XXX, an instruction to carry out a high speed taxi test
was complied with. This was to verify that remedial action had been
successful, following a report of the aircraft pulling left during the take-off
run. Two high speed runs were carried out, but unfortunately the brake
temperatures rose rapidly, causing several main wheel tyres to deflate.
SUMMARY
The A321 stopped short of its intended parking position on stand 000, due to
the stand guidance system not being ON. ATC were reportedly informed.The
B777 was pushed back from stand XXX and its left wing struck the fin of the
stationary A321 causing substantial damage to both aircraft.The flight crew
of both aircraft declared a PAN and the Emergency services attended.
There were no reported injuries.
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The idea of a beneficial wingtip appendage, or wingtip device, has been around since the early 20th century,
when theoretical calculations first indicated that a vertical
endplate added to a wingtip would reduce the induced drag.
Early on, however, reality did not live up to the theoretical promise. The simple flat endplate turned out to be a
disappointment in practice because the added viscous profile drag more than offsets the saving in induced drag, and
the device fails to produce a net benefit. Whitcomb seems
to have been the first to recognize that it is possible to reap
the induced-drag benefit of an endplate, and at the same
time to realize a net benefit, by keeping the additional profile drag to a minimum through good aerodynamic design
practice.
The direct result of Whitcombs work is the classic
near-vertical winglet. Less directly, Whitcombs paradigm
of applying good design practice to keep the profile drag
low has also contributed to the development of concepts
other than the winglet. Both winglets and tapered horizontal span extensions have been put into commercial service,
and several other device concepts have also been proposed
and brought to varying levels of development.
Offsetting factors:
Profile drag is increased due to:
- Increased wetted area.
- Junction flows, high sectional
loadings, etc.
Weight is increased due to:
- The weight of the device itself.
- The weight of attachment
fittings.
- Increases in the weight of the
existing wing structure due to
increases in static loads and to
meet flutter and fatigue
requirements.
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Another possible benefit that has sometimes been put forward is that tip devices can reduce the strength of the vortex
wake, with the implication that this could lead to improved
Line drawing of wing tip vortices, in a non wing tip wing and in a blended (sharklet) tip device.
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> REPORT
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runway available at the airport and the one with a precision approach, would be closed from 0400 to 0500 CDT.
Because the flights scheduled arrival time was 0451, only
the shorter runway 18 with a non precision approach was
available to the crew. Forecasted weather at BHM indicated that the low ceilings upon arrival required an alternate airport, but the dispatcher did not discuss the low
ceilings, the single-approach option to the airport, or the
reopening of runway 06/24 about 0500 with the flight
crew. Further, during the flight, information about variable
ceilings at the airport was not provided to the flight crew.
The Captain was the pilot flying, and the First Officer was the pilot monitoring. Before descent, while
on the direct-to-KBHM leg of the flight, the Captain
briefed the localizer runway 18 non precision profile
approach, and the First Officer entered the approach
into the airplanes flight management computer (FMC).
The intended method of descent (a profile approach)
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(VDI), which is the primary source of vertical path correction information, would have been pegged at the top
of its scale (a full-scale deflection), indicating the airplane
was more than 200 ft. below the (meaningless) glidepath.
However, neither pilot recognized the meaningless information even though they knew they were above, not
below, the glideslope at the FAF. When the autopilot did
not engage in profile mode, the Captain changed the autopilot mode to the vertical speed mode, yet he did not brief
the First Officer of the autopilot mode change.
Further, by selecting the vertical speed mode, the approach
essentially became a dive and drive approach. In a profile
approach, a go-around is required upon arrival at the decision altitude (1,200 ft.) if the runway is not in sight; in a
dive-and-drive approach, the pilot descends the airplane
to the minimum descent altitude (also 1,200 ft. in the case of
the localizer approach to runway 18 at BHM) and levels off.
Descent below the minimum descent altitude is not per-
mitted until the runway is in sight and the aircraft can make a normal descent to the runway. A
go-around is not required for a dive and drive
approach until the airplane reaches the missed
approach point at the minimum descent altitude
and the runway is not in sight. Because the airplane was descending in vertical speed mode
without valid vertical path guidance from the
VDI, it became even more critical for the flight
crew to monitor their altitude and level off at the
minimum descent altitude.
About 7 seconds after the First Officer completed the Before Landing Checklist, the First
Officer noted that the Captain had switched
the autopilot to vertical speed mode; shortly
thereafter, the Captain increased the vertical descent rate to 1,500 feet per minute (fpm).
The First Officer made the required 1,000 ft
above airport elevation callout, and the Captain
noted that the decision altitude was 1,200 ft.
MSL but maintained the 1,500 fpm descent rate.
Once the airplane descended below 1,000 ft. at a
descent rate greater than 1,000 fpm, the approach
would have violated the stabilized approach criteria defined in the company flight operations
manual and would have required a go-around.
As the airplane descended to the minimum
descent altitude, the First Officer did not make
the required callouts regarding approaching and
reaching the minimum descent altitude, and the
Captain did not arrest the descent at the minimum
descent altitude.
The airplane continued to descend, and at 1,000
ft. MSL (about 250 ft above ground level), an
enhanced ground proximity warning system
(EGPWS) sink rate caution alert was triggered.
The Captain began to adjust the vertical speed in
accordance with companys trained procedure,
and he reported the runway in sight about 3.5 seconds
after the sink rate caution alert.
The airplane continued to descend at a rate of about 1,000
fpm. The First Officer then confirmed that she also had
the runway in sight. About 2 seconds after reporting the
runway in sight, the Captain further reduced the commanded vertical speed, but the airplane was still descending rapidly on a trajectory that was about 1 nautical mile
short of the runway. Neither pilot appeared to be aware
of the airplanes altitude after the First Officers 1,000-ft
callout. The cockpit voice recorder (CVR) then recorded
the sound of the airplane contacting trees followed by an
EGPWS TOO LOW TERRAIN caution alert.
Probable Cause & Contributing Factors
On June 2015 the NTSB released a companion video
http://www.youtube.com/watch?v=Dsr8C9fsYjo and
the Final Report.
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