Monday, March 11, 2019

Ethiopian Airlines, Boeing 737-8 MAX, ET-AVJ: Fatal accident occurred March 10, 2019 in Addis Ababa, Ethiopia

NTSB Identification: DCA19RA101 
14 CFR Non-U.S., Commercial
Accident occurred Sunday, March 10, 2019 in Addis Ababa, Ethiopia
Aircraft: BOEING 737, registration:
Injuries: 157 Fatal.

The foreign authority was the source of this information.

The government of Ethiopia has notified the NTSB of an accident involving a BOEING 737 that occurred on March 10, 2019. The NTSB has appointed a U.S. Accredited Representative to assist the government of Ethiopia's investigation under the provisions of ICAO Annex 13 as the State of Manufacturer of the airplane.

Prosecutors in 737 MAX Probe Focus on Boeing Disclosures to Regulators, Customers

Scrutiny is part of broader investigation into how the jetliner was developed and certified

By Andy Pasztor, Andrew Tangel and Aruna Viswanatha
March 22, 2019 7:33 p.m. ET

Federal investigators are looking into whether Boeing Co. provided incomplete or misleading information about the 737 MAX aircraft to U.S. air-safety regulators and customers, people familiar with the matter said.

The focus on disclosures to regulators, which hasn’t been previously reported, is part of a broader investigation into how the jetliner was developed and certified, some of these people said.

The criminal investigation, which is in early stages, began last year, weeks after a 737 MAX operated by Lion Air crashed in Indonesia on Oct. 29, according to one of these people. The same model plane, flown by Ethiopian Airlines, crashed less than five months later.

Agents with the Federal Bureau of Investigation and the Transportation Department’s inspector general’s office are working in tandem under the direction of federal prosecutors, the people familiar with the matter said. The agents involved are from offices in Seattle, Chicago and elsewhere, these people added. Boeing is based in Chicago but manufactures the 737 MAX at its facility in Renton, Wash., near Seattle.

Boeing hasn’t been accused of wrongdoing.

“The 737 MAX was certified in accordance with the identical FAA requirements and processes that have governed certification of all previous new airplanes and derivatives,” Boeing said.

The Federal Aviation Administration said previously the 737 MAX, which entered service in 2017, was approved to carry passengers as part of the agency’s “standard certification process.” It said its safety-review procedures “are well established and have consistently produced safe aircraft.”

The agency is conducting its own inquiry into how the jet model was certified and whether various agency offices properly oversaw technical analyses prepared by Boeing and submitted to the FAA, according to a person familiar with the details. A Senate Commerce subcommittee on Wednesday is expected to kick off what is likely to be a series of congressional hearings on both sides of Capitol Hill exploring these and other matters.

The Transportation Department said earlier this week its inspector general is conducting a separate administrative audit to determine precisely what actions the FAA took in approving the safety of the jet.

Some of the investigators’ questions have related to information and safety reports Boeing provided to the FAA during the agency’s certification of the aircraft, one of the people familiar with the matter said. Other subjects the investigators have asked about include the aircraft’s design, how training was devised, disclosures in pilot manuals, and whether safety was compromised in favor of business concerns, people familiar with the matter said.

Investigators have asked FAA officials about Boeing’s disclosures related to a stall-prevention system in the MAX and what was disclosed to airlines and pilots, one of these people said. The FAA offices involved with certifying the plane and approving training requirements have been told by the inspector general’s office to retain all electronic documents and email related to the 737 MAX, The Wall Street Journal has previously reported.

The Journal also previously reported that the Justice Department’s criminal division issued a grand jury subpoena to at least one person involved in the 737 MAX’s development. The broad demand for documents sought information about the aircraft, including correspondence such as email.

A prosecutor in the department’s fraud section was listed as a contact in the March 11 subpoena. Senior prosecutors in the fraud section have notched experience in major cases in recent years involving automobile giant Volkswagen AG and air bag maker Takata Corp., both manufacturers accused of misleading regulators and consumers.

The document-retention directive applies to internal FAA communications, as well as electronic communications between Boeing and the agency, people familiar with the matter said.

Agents with the FBI and DOT inspector general’s office are looking into whether there were potential irregularities in the FAA’s safety-review process for the aircraft, some of these people said.

Boeing Crashes Spur Debate Over How Much Pilot Training Is Enough 

After 737 MAX disasters, regulators and aviation industry reassess whether some cockpit crews possess enough experience to handle emergencies

The Wall Street Journal
By Alison Sider and Robert Wall
Updated March 18, 2019 4:29 p.m. ET

The crashes of two Boeing Co. 737 MAX planes within five months are prompting regulators and pilots to reassess the bare minimum amount of training crews are required to complete before flying the new model.

They are also reigniting broader debate across the aviation industry about whether overall experience levels among some crews are adequate when flights encounter trouble.

The discussion is being sparked by possible malfunctions of the new 737 MAX model’s stall-prevention system. The system has come under scrutiny after the two crashes. Boeing is developing a software fix, expected in the coming weeks, while regulators and the plane maker are debating the additional training needed.

When an Ethiopian Airlines MAX plane plunged from the sky last week within six minutes of taking off, killing all 157 aboard, the senior pilot was Yared Getachew, who had more than 8,000 flight hours, including 1,500 as captain. Ahmed Nur Mohammed, the first officer on the flight, was relatively junior, with 350 hours of flight experience.

Newly hired U.S. airline pilots must have at least 1,500 hours of flying experience unless they are former military pilots or graduates of colleges and universities with professional aviation programs. That means both pilots in the cockpit are experienced and able to back each other up when things go awry.

The rule was put in place after the 2009 Colgan Air crash that killed 50 people near Buffalo, N.Y., and investigators blamed on a tired crew who didn’t properly react to stall warnings. Carriers have at times sought, unsuccessfully, to reduce the 1,500-hour minimum to head off pilot shortages.

Since 2006, some pilots outside the U.S.—including in the fast-growing Asian market, as well as in Europe—have been licensed under a rule that fast-tracks students into the co-pilot seat in as little as 18 months, with as little as 240 hours including simulator time. The policy was developed, in part, to help fill cockpits at a time of rapid growth for the airline industry.

Ethiopian Airlines said it pairs less-experienced first officers with more experienced captains as a safety measure.

Some studies have shown that pilots with fewer than 1,500 hours fly safely. But several aviation experts said the licensing system can change the dynamics in the cockpit, putting the two crew members on unequal footing.

James Higgins, chairman of the aviation department at the University of North Dakota, said a few hundred hours might not be enough experience when pilots are grappling with an emergency situation when the control system isn’t operating normally.

The cause of the Ethiopian Airlines crash is still unknown, but the Ethiopian transport minister said Sunday an initial analysis of the plane’s black boxes, which store key flight data, showed “clear similarities” with another MAX flight, operated by Lion Air of Indonesia, that crashed in October, killing all 189 aboard.

The Lion Air crew battled the airplane for the 11 minutes after takeoff before the plane plunged into the Java Sea. The system, based on erroneous sensor inputs, thought the crew was about to stall the plane and repeatedly pushed its nose down. The pilot, who tried to recover the plane but eventually lost control, had about 6,000 hours of experience and the co-pilot 5,000 hours.

Investigators in the Ethiopian Air crash are expected to focus on whether the more junior Ethiopian crew encountered similar conditions, according to safety experts. The pilot, who airline Chief Executive Tewolde Gebremariam said had “an excellent flying record,” reported flight-control issues before all contact was lost. Both pilots trained at Ethiopian Airlines’ aviation academy.

A senior U.S. 737 MAX pilot said that very junior co-pilots might not be able to help the senior captain manage the number of alerts and actions needed to recover from a system malfunction, especially those they haven’t encountered in a simulator, such as the fault in the stall-prevention system known as MCAS.

Indications that both sets of crew were battling their 737 MAX jetliners have reinforced growing concerns across the airline industry that pilots have become too dependent on cockpit automation that plane makers introduce to make flying safer, but can become a trap when the equipment malfunctions.

“You have the people who have grown up with so much technology...we have to make sure they know how to hand fly the airplane, too,” said Capt. Jon Weaks, president of Southwest Airlines Co.’s pilot union.

Keeping costly new training to a minimum was a selling point for the MAX. Pilots that fly a common 737 model needed only a couple of hours of extra education that could be performed on a computer to become familiar with variances between the aircraft rather than spending time in a flight simulator.

Pilots were never specifically trained, for instance, on MCAS. There is disagreement among pilots and airline officials about whether such additional training was necessary, because a procedure exists that allows a pilot to disable the stall-prevention system while flying the airplane.

The U.S. Federal Aviation Administration’s decision that extra flight-simulator training on the automated system wouldn’t be required for pilots transitioning from older models is an area the U.S. Department of Transportation’s inspector general is looking at, asking that documents related to it be retained, The Wall Street Journal reported Sunday.

Boeing said the training and materials for the 737 MAX adhere to international standards and “followed a process that was absolutely consistent with introducing previous new airplanes and derivatives. The process for the flight crews is to ensure they have all the information to safely operate the airplane.”

Is the Pilot or Robot the Problem?

Aviation faces a turning point on automated flight after a Boeing tragedy.

The Wall Street Journal 
By Holman W. Jenkins, Jr.
March 19, 2019 7:12 p.m. ET

As more information comes out about two Boeing crashes, it’s clear that a big system malfunction was at work. Not the famed “MCAS” system, designed to help a pilot avoid an aerodynamic stall, whose snafu is strongly implicated in last October’s crash of a late-model 737 MAX in Indonesia and is suspected in last week’s crash of a 737 MAX in Ethiopia.

That system seems clearly to have been badly designed, in a way neither Boeing nor the Federal Aviation Administration would have approved if they had understood what they were doing. The truth is, their own bureaucratic systems seem accidently to have delivered into the cockpit a kludge that never should have been allowed near a plane that would be carrying passengers.

And yet the fact that the two planes were allowed to crash may not be blamable solely on faulty anti-stall software that, when fed improper data, can push the nose dangerously toward the ground.

U.S. airlines have been flying the new 737 MAX for nearly two years. Pilots seem to have coped with the plane’s troubled automation system with little fuss or bother. Before last year’s crash in Indonesia, a Lion Air crew flying the same jet appears to have had no trouble responding to the system’s flawed performance. After the Indonesia crash, 737 MAX pilots around the world were coached on the system’s flaws and given remedial training. The captain in last week’s Ethiopian Airlines crash was highly proficient. So why didn’t he avoid the crash if the accidents are as similar as now suspected?

While these questions remain unanswered, Boeing’s critics have widened the search for culprits to make what they know substitute for what they don’t. First it was the software, then it was shortchanging 737 MAX pilots of training. Boeing also was blamed for how it hung a new engine on the 737’s wing, and then for sticking with the 737 at all instead of building an all-new plane.

There may be something to each of these complaints but an alternative rabbit hole has been to ask whether the industry’s growing reliance on computers has left pilots unready to intervene and compensate when something goes wrong.

In reality, there is no good reason to fault Boeing’s decision to keep its 737 flying rather than seeking to certify an all-new aircraft. Likewise, the fact that new engines fitted on the 737 MAX cause it to generate more lift under certain circumstances than previous models is hardly a defect.

The real screw-up seems to have been Boeing’s decision to use software code not to fix an aerodynamic problem but to make the new jet, from the pilot’s point of view, seem to handle like the old jet. In essence, Boeing tried to make the 737 MAX a simulator of the 737 NG.

That is, when manually flying the new plane, pilots could add the same amount of power and stick as they did in the old plane and get the same result—because software would secretly compensate for the tendency of the new plane’s nose to rise.

Boeing compounded this choice with the hard-to-believe decision to make MCAS dependent on data from a single, fallible “angle of attack” indicator. We’ll see what comes out of the many investigations now under way, but the solution could be as easy as junking MCAS altogether and training pilots to fly the new plane in accordance with its actual flying characteristics.

Still, Boeing has 4,600 outstanding orders for the 737 MAX. This would seem to refute definitively the argument that the market wanted an all-new aircraft. In fact, the mystery of recent crashes may be telling us the opposite: The time is not yet ripe for a new plane.

Boeing, for one, has said its air-cargo customers already are clamoring for an aircraft that can fly itself. Unmanned aerial drones are acquiring operational experience and hours of flight data that may soon give us more information about how such systems perform under every kind of real-world scenario than we have about human pilots.

Meanwhile, though automation is credited with improving safety, an important question is: Which automation? Should we thank the kind that helps airplanes stay on course and intervenes if the pilot makes an ill-advised maneuver? Or the kind that increasingly takes the pilot out of the loop altogether? Notice that Boeing’s faulty software was designed to operate in those rare moments when a pilot is flying the plane by hand.

These questions, sadly, relate to more than just accident prevention. As the overall crash rate declines, incidents of suicide-by-pilot have started to account for an alarming percentage of air fatalities. Think the Germanwings Airbus crash of 2015, the EgyptAir crash of 1999, and quite possibly the disappearance of Malaysian Airlines flight 370 in 2014.

We hope the implications are clear. Replacements for the 737 or Airbus’s comparable A320 would be expected to carry the industry for the next 50 years. Before launching new planes, the companies and their customers and regulators need to decide what exactly they want the pilot to do in the future, and if they want a pilot at all.


Anonymous said...

Why cannot Boeing ask all 737 MAX to be grounded and carry on a transparent investigation in a swift and decisive manner? Why do they keep on harping the same note "we are investigating and no need for any changes now"? People are dying for heavens sake! Are they playing politics here?

Anonymous said...

^^^^. Boeing can ask all they want. However, in the US it takes the FAA to issue an Emergency Airworthiness Directive to ground the planes. Having said that, Boeing contends that there is no reason to ground the plane.

Anonymous said...

Given that it’s a new plane, my guess is that there’s something wrong with the software. Boeing should immediately ask that all these planes be grounded. If these two crashes had happened in the United States that would already have happened.

Anonymous said...

^^And that's just it. They did NOT happen in the US (or any other Western nation for that matter). Indonesian based airlines were banned from flying in EU nations due to safety concerns up until a few years ago. This safety included a crash of an Airbus A320 due to pilot error not following correct procedures to the aircraft's flight computers as they were supposed to.

For every Ethiopian and Lion Air 737-MAX flying, there are 150 more Western and Chinese MAX's flying with no reported problems. That's a red flag right there, and the investigation should expand beyond the aircraft itself as a failure point. In other words, training and maintenance should be looked at as well by these two airlines. And they are.

Regarding the Lion Air crash, some are looking at the possibility of a malfunctioning flight data sensor may have led the stall prevent system (MCAS) to trigger - which overrides the pilot's inputs. Possible causes are improper maintenance as basic as not covering all sensor ports on the aircraft's nose. It would not be the first time this type of loss of control crash from computer flight data mismatch occurred if that is indeed a contributing factor in the accident.

In any event, as one who regularly flies on Southwest as do family and friends, we need to get to the root cause of this issue.

Anonymous said...

End of April?!!!! What about the end of today? Those two planes did not just fall from the sky. How many more have to die before the Federal Aviation Administration does its job? There was a lot of gibberish after the first crash indicating safety changes recommended by Boeing had not been implemented properly. So what excuse is being used now? If Boeing believes the software fix will prevent further crashes, at least ground the planes until that is installed.

Anonymous said...

Apparently the countries that grounded this aircraft have no confidence in their aircrew to follow the correct procedures.

Anonymous said...

One more Max 8 crash and Boeing is done fur. The lawsuits will force them into receivership.

Anonymous said...

Co-Pilot had 200 hrs that was reported don't know if it was TT or time in type. Once again everybody's trying to run with pure speculation. These planes were first delivered in 2017, There are a lot of newbys trying to fly and maintain these new aircraft, if you don't want to fly drive its your choice. Even crazy politicians have now become self proclaimed experts on aviation........Aeroflot is ready to book your next flight....go with them.

Anonymous said...

Co-Pilot had 200 hrs that was reported don't know if it was TT or time in type. Once again everybody's trying to run with pure speculation.

^^^ Yes, everyone is speculating!
Until the relevant investigations are complete, there will be no way to know what went wrong on the two fatal flights. Until now there is a lot of speculation and educated guessing, which is normal and very human.

Jim B said...

Reported as trailing smoke, cargo items falling out and loud rattling (or banging) sound.

Does not act like a MCAS software issue.

Does not appear to be a pilot proficiency issue.

FAA is interested in facts but there is investigative contamination of the wreck site.

I would be inclined to look into a cargo door opening up or perhaps one of the wheel fairing doors got loose and ended up hitting the elevator.

It is always possible a cargo conveyor was driven into the latch mechanisms.

Time to inspect the existing fleet.

Anonymous said...

Hysteria in all quadrants, on all continents in both hemispheres ...

Anonymous said...

The Federal Aviation Administration is currently doing great harm to the safety reputation of the United States aviation industry. There is a reasonable suspicion worldwide that the 'independent' Federal Aviation Administration is in fact in bed with Boeing and profit comes before lives. Worrying and also counterproductive as the 737 Max will be de facto grounded in any case.

Anonymous said...

I'm not a computer tech geek or an aircraft designer but I am a private pilot. I have a theory for some of these recent large plane crashes that I would like to hopefully have individuals in the know respond to the feasibility of such a scenario. It seems that the majority of these crashes have occurred with Boeing built aircraft. MH370 was a 777, Amazon crash a 767, this crash a 737. Do they all use a similar computer system for the flight deck? Is it possible for a computer hacker to gain access to the system and override the controls from the pilots? Could this be a new form of terrorism? Is it possible to do this from a laptop in the passenger compartment or even from the ground? Obviously if it is possible(I think anything is possible if one puts their evil mind to it),the airlines would never want this info getting out to the public as it would bring an end to the airline industry as we know it. I stick to my Piper Arrow & Cessna 172 with cables & pulleys and me giving the inputs to the flight control surfaces thank you very much!

Anonymous said...

Incredulous that a flight control system would have a single point of failure. As a retired aeronautical engineer, I am extremely concerned for the state of my beloved profession.

Anonymous said...

Having a system that pushes the nose down, and that must be turned off in case of malfunction because it can't be overridden by a pilot's control inputs -- in what universe is that consistent with keeping pilots at the center of cockpit control?

Anonymous said...

Not all computer safety systems on the new jets are all bad, like the time the crew of a 787 full throttled the handles at the end of the runway for takeoff and nothing happened, elev trim was set at full deflection either up or down.....Oooops!.

Anonymous said...

Computer Science majors without flight experience should not be coding for flight control system. It should be a mandate that learning to fly is a pre-req for all coders that work on flight control system. And the underlying assumption to trust the sensors. I have CS degree and PPL. Some of the decisions made by CS majors who doesn't care about flying is to blame. A lot of CS majors have this ego that they can separate all use cases into buckets to be handled by the code. And that pilots are not be trusted..... Because Sensors > Humans is the motto. Oh and don't get me started with sensor fault detection(trust 2 out of 3, but what happens when 2 out of 3 sensors fail at the same time)?

This is speaking from experience working on coding projects and even my own experience.


P.S. I won't get into a self driving car either.

Anonymous said...

Claiming these planes are safe while simultaneously saying the cause of these crashes is unknown seems inherently contradictory and untrustworthy. As a layperson with no expertise in these matters, I find it hard to believe that no one outside the United States, someone "without a dog in the hunt" is capable of providing accurate unbiased data download. In the meantime why not value life beyond commerce and ground the Max fleet worldwide until the cause is determined?

National Transportation Safety Board = An independent agency who often criticizes the Federal Aviation Administration.

Anonymous said...

Just like A&P need to be qualified, code monkeys off of computer science schools shall not be allowed unless thy have relevant work experience and pass qualification exams and specific procedures, starting with accountability.
If a major bug is found... how will the (outsourced) dev team be punished and held accountable?

Who are the imbeciles who didn't take into account the more powerful engines that the 737 Max has in the autopilot software, as reported by outlets now as the root cause of both crashes?

I hope the NTSB comes down hard on software development for aeronautical uses and emits procedures and recommendations. As for the relatives of the 300+ dead because of ineptitude in the software industry, I do hope they sue and sure all the software companies even in India and China for this egregious criminal behavior. There's no 2 ways around it.

Software for planes shall be made the same way it was made for the Space Shuttle... almost perfect.

"What makes it remarkable is how well the software for the space shuttle works. This software never crashes. It never needs to be re-booted. This software is bug-free. It is perfect, as perfect as human beings have achieved. Consider these stats : the last three versions of the program — each 420,000 lines long-had just one error each. The last 11 versions of this software had a total of 17 errors. Commercial programs of equivalent complexity would have 5,000 errors."

Anonymous said...

I am a pilot and my father was a pilot for Delta Air Lines. In the old school of flying pilots were taught “no matter what happens in the cockpit, fly the airplane”. What that meant was that the responsibility to keep the aircraft flying is job one, even if there is a fire in the cockpit or every warning in the aircraft systems are chiming away. Every good pilot knew exactly what this meant. It meant that the Pilot in Command could never delegate the safe flight of the aircraft to anyone or anything - including the aircraft itself.

That was before software and the “self-driving” culture that invaded cockpits many years before reaching automobiles. But the principle still applies. It has become more difficult to implement, perhaps too much so.

Anonymous said...

The FAA is a wholly owned subsidiary of Boeing and other big aviation corps. They would have turned a blind eye had trump not made a spectacle of it. The rest of the world made a good call. Capitalism over safety, the FAA seems cool with that.

Anonymous said...

How wonderful for Ethiopian Air that the WSJ writes about how they are the shining star of this poverty stricken African nation. They have a $100M facility with a pool for training.

The plane crashed and there isn't a single sentence about the pilots, their training, or their qualifications to handle an in flight emergency.

Anonymous said...

The plane is aerodynamically flawed and requires constant computer or human intervention to keep it stable during takeoffs. No amount of software or pilot training can fix this fundamental flaw ... a plane needs to be inherently stable, as it needs to fly not just in perfect circumstances, but in a variety of weather and other challenging conditions.

Boeing took an old plane body and added a larger heavier engine to it, rather than designing a new plane. The engine had to be moved forward and the front of the plane lengthened and and made higher to fit the engine so that it would not hit the ground. Yet the plane did not go through approval as a new plane, but just as a derivative of an older approved plane, even though aerodynamically it's dramatically different, as Boeing rushed to deliver planes competitive with Airbus. Astonishing that this happened!

Anonymous said...

Boeing tried to sell the 737MAX as being essentially the same as the 737NG series (models 600. 700. 800, and 900) despite the LEAP engines being mounted quite differently than the CFM56 engines on the NG series, resulting in a pronounced tendency for the nose to pitch up.

There is only one 737MAX simulator in the United States, and Boeing argued that specific MAX simulator training was not necessary. Boeing also argued that it did not want to inform pilots of the new MCAS system because it did not want to "overload" them.

The cost argument was that because the MAX was similar to previous models, extensive training was not required.

The events of the past few months indicates that perhaps this was unwise.

Anonymous said...

Unfortunately, Boeing has brought this on through their obstinate tone-deaf insistence that they are right in the face of a public relations disaster. It is obvious that the 737 MAX is not the same plane as previous models. No doubt in the hands of a highly trained crew flying well maintained aircraft, there would probably never be a problem with the 737 MAX. In the hands of poorly trained crews and poorly maintained aircraft, which is a large part of the world, the 737 MAX fails where older models had no problem. In the world of sales "perception is reality" and world opinion perceives the 737 MAX to be unsafe and Boeing in their hubris to be unreliable.

Anonymous said...

Look for more airlines to cancel orders unless Boeing can quickly allay safety concerns and maybe slash prices. There will be a hit to Boeing's bottom line since the 737 MAX was their cash cow. Shows that skimping on safety is penny wise and pound foolish!