Acknowledgements: Thomas P. Turner, Mastery Flight Training, Inc.

(Ed. Note: A Condensed version of an article by Tom from which all can learn from those who didn’t ….)

 Case 1:

A Falcon 50 business jet ran off the end of Runway 19 at Greenville, South Carolina. The ATP-certificated occupant of the left seat and the PPL Pilot seated in the right were killed. Two passengers suffered “serious” injuries and the aircraft broke apart. .... he airplane touched down "normally" at a normal touchdown point on runway .... the sole thrust reverser on the centre engine deployed .... the airplane "did not decelerate" as it continued down the runway....  and then went over an embankment ....  all three engines were operating at full power for at least 20 minutes after the accident with one engine running on until about 40 minutes after .... both airbrakes were extended .... both main landing gear were fractured and displaced aft into the flaps .... the braking anti-skid switch was in the No. 1 position, and there was an "INOP" placard next to the switch .... the Nos. 2 and 3 fire handles were pulled .... the parking brake was in the off position .... the left-seat pilot held an ATP certificate with a type rating for the Falcon 50 but with a limitation for second-in-command only. He held an FAA first-class medical certificate .... he reported 11,650 total hours of flight experience .... the right seat pilot held a private pilot certificate with ratings for single and multi-engine airplanes .... he did not hold an instrument rating .... he held a FAA second-class medical certificate .... he reported 5,500 total hours of flight experience.

 We don’t know if the pilots’ lack of qualification for operating the big tri-jet was a causal factor in the crash .... it’s easy to say, “these pilots were intentionally noncompliant with the regulations” .... anyone who believes in the need for any safety oversight of aviation at all should agree these pilots did not meet the minimum standard prescribed for the operation, assuming the NTSB preliminary information is correct. 

 Case 2:

Three skydivers and the pilot of a Cessna 182 died, and a fourth jumper was seriously injured, when it collided with terrain shortly after taking off ....  a witness reported that while the pilot was refuelling the airplane, he realised that the right wing fuel cap was missing .... a mechanic and the pilot decided to use "fuel cell tape" over the fuel filler port .... the flight then departed with a group of skydivers ..... the airplane returned, and the final group of skydivers boarded for departure .... the airplane taxied for take-off .... shortly after that a police car headed towards the end of runway 14 .... and a witness saw a huge fire at the end of the runway .... Cessna 182s have vented fuel caps …. air must be able to enter the tank through the fuel cap vent to permit fuel to be drawn from that tank …. a blocked or missing vent may prevent fuel from flowing from that tank to the engine.

 It’s unknown what may have led to the apparent departure stall of the skydiving Cessna 182, or if the unauthorised tape-over of the open fuel filler port in lieu of a proper fuel cap was involved in any way ....it’s probably easy to agree that the pilot was wilfully non-compliant with aircraft maintenance and certification standards by taking off with fuel cell tape in place of a missing fuel cap .... some, however, might feel there may be some justification for this unapproved modification .... the pilot may be unaware of the need for vented fuel caps in some airplanes, or of how vital those vents are to fuel system and engine operation .... the fuel system should work fine using the other tank, they might think .... the line between wilful noncompliance and acceptable modification may become a little fuzzy to some.

 Case 3:

The pilot of a Cirrus SR22T was hand-propping the aircraft .... when the engine started, the power apparently set fairly high, the unsecured airplane quickly began to move forward .... As the pilot is seen attempting to enter the aircraft to regain control, a passenger who was aboard is seen rolling off the airplane’s right wing, leaving the cabin apparently unoccupied .... the Cirrus accelerated into a hangar, causing substantial damage .... no significant injuries, although the pilot reportedly went to the hospital because of an injury to his arm .... a witness statement notes the pilot called a mechanic asking for a battery charge, as the airplane’s battery “did not have enough energy to turn over the prop” .... the mechanic told the pilot no mechanic would be at the airport “until Monday” .... six minutes later the pilot called the mechanic again, telling him the Cirrus had impacted a hangar .... the SR22TPOH contains a limitation that requires an operable battery be installed for flight .... arguably, a discharged battery is in violation of this limitation, but would you want to be the pilot having to make that argument? .... another witness pilot with SR22 experience noticed fuel leaking and, entering the cabin, turned off the fuel, pulled the mixture to idle and turned off the electrical system, all of which were still “on” .... It’s possible that if the pilot of the SR22T had chocked his airplane while he “propped” the engine, and/or if he had trained his passenger to pull the mixture control at the first sign the airplane was moving forward, that the admittedly high-risk hand-start would have been successful …. only leaving the pilot with possible other electrical system and/or battery failure issues in flight!

 I’ve heard some comment focusing not on the need to comply with type design and aircraft Limitations (requiring a delay until the battery may be recharged) but instead on the “correct” way to hand-prop an airplane .... when pilots hear this happened on a Saturday morning, and that charging it up couldn’t happen until Monday, some “go mentality” goal-oriented pilots would consider propping the airplane even if they had no prior experience doing so .... after all, why do we learn about how the magneto-powered ignition system works if we aren’t supposed to use this information to our advantage?

 Case links:

In all threecases there is acommon thread: The pilots were intentionally choosing to violate regulations, rules or good operating practice.

 So ask yourself: 

Where doYOU draw the line on wilful noncompliance with:

  • Pilot certification, qualifications and currency 

What if a pilot is legally qualified, but not current for a given operation? IFR currency? Night currency with passengers? Current in multi-engine airplanes, but not in singles? 

  • Airplane maintenance and airworthiness

Unapproved alterations? Inoperative fuel gauges or other required items, if you’ve developed a work-around?  The airplane is “a little” out of annual?

  • Deviations from Standard Operating Procedures (SOPs) or accepted practice

Are you willing to do things you wouldn’t normally do, if the usual way of doing things becomes inconvenient? 

Honestly answering that question every time you come upon the need to make a decision, then making an objective choice that avoids hazard and protects lives and equipment (in that order), is THE ESSENCE OF RISK MANAGEMENT. It is what it means to be IN COMMAND OF YOUR AIRCRAFT.



Tony Birth