Kepner Tregoe Problem Solving Technique Stil lWorks

Rizal  Philippines  |  June 23, 2014

Yesterday, I had the opportunity to watch an air crash investigation at Nat Geo.  The episode  is about a Air  New Zealand Airbus 320 that crashed off the coast of France, on a acceptance (test flight) for no apparent reason.  Since it was on acceptance flight, it was supposed to have undergone thorough overhaul checking.

However, the investigation was able to probe/determine the cause of the crash by comparing the normal and the abnormal (what is what is not, where is where is not)



Some findings:

1, The angle of attack sensor apparently froze after the plane was washed with fire hose and its inside was inundated with water.  As the plane flew to 30,000 ft, the water froze the angle of attack sensor (which should be moving freely) wont budge because it was frozen.  The normal procedure was simply to wipe of the dirt.  Even for bikes, hose washing is not recommended because water can cause bearing to rust and rendered immobile

2.  Test flight at low altitude. The rule was to test flight at high altitude to give enough space/distance to correct errors and prevent fatal crash. The Airbus test flight was done below 10,000 ft.

3.  Too much reliance on computer.  Although the Airbus was a fly by wire plane (computer ran the plane) when the limits of safe flying were exceeded, the computer reminded the crew to switch to manual.  The crew thought that the computer was still flying the plane. And that was fatal.  All the 7 crew members perished from the crash

Some recommendation:

1.  Test flight at above 10,000 ft.

2.  Avoid inundating the angle of attack sensor

3.   Know the limits of computer.  Train the crew further on how to handle crisis situation, ie how to handle a plane that has gone out of control