The reason he'll unlatch it the second time is that he'll interpret that checklist item as "operate latch."
LOL, that's funny, but if true it's also sad. "There is no substitute for thinking" and that includes checklists.
The reason he'll unlatch it the second time is that he'll interpret that checklist item as "operate latch."
Then...it all goes wrong, there is no way you are going to let your pride and joy lose it's door. .
Yes. The "Save the Plane" mentality. It's very hard to accept bending metal on something you just spent 5 years of your life building. There have been at least 2 fatal RV-10 accidents where the airplane was stalled at low altitude, following a power loss. The pilots just could not bring themselves to accept the circumstances.
It can be so overwhelming that the potential consequences don't even enter into the thought process until it is too late. It's a lot like sneaking up on someone and hollering at them when they least expect it. Only the coolest can look back at you without jumping and reacting.
Rather than get into arguments about redesigning the aircraft, let's either get back on track about checklists, best practices, and flying the aircraft whenever something unexpected happens, which I think can really add some valuable knowledge here to everyone, especially the new builders/flyers, or we can close the thread.
Vic
There are two issues being argued here.
1) Be a pilot. Follow your checklists, and in the event that something happens, concentrate on your main responsibility of flying the airplane. I don't think anyone disagrees with this.
2) Something as simple as a door should never (on its own) be a safety of flight issue, even if improperly operated. Door latches need to be simple and reliable. They shouldn't have a gotcha where they can result in the departure of a door when improperly latched.
Instructors need to handle item #1 on BFR's and at other opportunities.
Engineers need to address #2. Band Aid fixes such as extra latches are an improvement, but the goal should be to solve the underlying issue of a top hinged door with fiddly latches,
Avi8tor857 suggested that there could be good grounds for a redesign of the RV10 door. You strongly disagree and believe that adherence to a proper checklist would be sufficient. I think that both parties are surely entitled to their opinion.
However you are intimating in the post above that if Avi8tor857 and others continue to disagree with you then you will exercise your privilege as a moderator to close the thread. Some on VansAirforce may consider that to be an inappropriate intimidation of posters with an opposing view to your own.
Perhaps I should have said lets take the design change discusion to another thread?
Vic
This is exactly what I have been thinking ever since the first report of a door departing, and it was only reinforced by the first time I saw the doors and the locking mechanism in person.Trying to design warning systems and adding extra latches is approaching the the problem from the wrong direction. You don't fix an safety problem by making it more complicated you fix it by making it simpler. The simplest solution would be one that made the door opening below maneuvering speed an non-event.
We will never know for sure, as the pilots are not with us anymore. But I would submit that "saving the plane" may not be what is actually going through their mind. As GA pilots most of us don't get the chance to go through rigorous training that instills in you how to react in a sudden emergency. Unless you do it multiple times so that it becomes habit to ignore the massive noisy interruption, most people's first instinct is to deal with the problem. It can be so overwhelming that the potential consequences don't even enter into the thought process until it is too late. It's a lot like sneaking up on someone and hollering at them when they least expect it. Only the coolest can look back at you without jumping and reacting.
Someone pointed out to me once that in this situation, there's a possibility that the first time, the pilot will latch the canopy. The second time, he'll unlatch it. The third time, he'll swear a bit and latch it.
The reason he'll unlatch it the second time is that he'll interpret that checklist item as "operate latch."
If he misses the third reading the canopy remains unlatched.
Perhaps for subsequent checklist items, it might be better to have the list read "Visually check canopy."
Dave
Yes. The "Save the Plane" mentality. It's very hard to accept bending metal on something you just spent 5 years of your life building. There have been at least 2 fatal RV-10 accidents where the airplane was stalled at low altitude, following a power loss. The pilots just could not bring themselves to accept the circumstances.
I'm curious about why this particular accident would have people thinking about a door redesign. I understand the impulse to look first to the equipment and design. Considering the hierarchy of safety engineering, which I may discuss in a separate post, it is not unreasonable to consider a design change or engineering control to minimize a risk.
The Door separating if opened has been discussed often and if you google RV10 issues it is usually one of the top hits. If nothing else this weariness has to effect your enjoyment of the plane.
I agree, and will tell anyone that asks, that the door design is one of the very, very, few design weaknesses on the airplane.
I really want to build a 10 but the door design is a risk I can't accept so I haven't ordered the kit yet. There are things you can't change and you protect yourself with a check list, there are things you can redesign to make your check list shorter reducing your workload.
Mitigating risk can be done in many different ways......
Sometimes it is good to do it in more than one way.
Proper use of a check list is a very good place to start. That, coupled with a physical check of both doors and the door latched indicator system that is standard in the kit should catch a mistake.
Since it is true that none of us are perfect, when there are easy to implement secondary checks it is a good idea to use them.......
As already mentioned in an earlier post, the modern EFIS systems a lot of builders choose now a days are capably of sensing an unsecured door and warn visually and aurally warning you when the throttle is advanced for take off. This would be way # 2.
How many different ways are needed?
Sure, the doors could be made to open differently. But that in itself would not guaranty no more door related RV-10 accidents.
The Cirrus has doors that open more fwd. They tend to stay mostly closed if unlatched in flight. There is a high profile accident that occurred near KDVT years ago all because of an unlatch door. There is security camera video of the airplane just before impact that clearly shows the door unlatched.
The investigation determined probably cause as being the same as what it likely will for this RV-10 accident.
Yes agree completely, the checklist is the only way to prevent the door from coming open.
One of the best classes I have taken as a firefighter was on "physiological response to stress". The takeaway was that "you don't rise to the occasion, you sink to the level of your training". Unless you have practiced responding to a situation repeatedly, you will very likely get it wrong under severe stress. In these situations, you lose all fine motor skills (which could make it hard to secure a door), get narrowed vision, and have almost no critical thinking skills. There is simply no way to assure the proper response until you've ingrained it in your subconscious mind. As they say, don't train until you get it right, train until you can't get it wrong.
I have learned to temper judgement of actions taken by people under severe stress.
Chris
It saddens me to think it sometimes takes a tragedy like this to remind us how easily each of us could be brought down by an unexpected event that we would never anticipate nor train for. Rarely do inflight malfunctions follow a precise pattern that can be immediately resolved with a handy step-by-step written checklist that is routinely practiced. In my 50+ years of aviation I am fortunate to have survived, not necessarily by any suburb flying skills but by dedication to intense training programs and learning from various mishaps of others and myself. Reading all the posts the one overriding message says it all: No matter what action is required - fly the airplane first. The military acronym was FTFA. Indulge me with one related war story. I'll try to keep it brief.
A fairly new left seat KC-135A Captain taking off hot and heavy at a tropical military deployment base in the late 1960s. Immediately after rotation at about 170 knots a very loud bang, a smell of burning rubber, and an amber light on the panel illuminated which is one I hoped to never see inflight. It indicated when either the lower crew entry hatch or the cargo door were unlatched. From the cockpit the boom operator reported the crew entry hatch was secure. Those few seconds of hauling that overloaded Jurassic Jet off the meager remaining runway and cleaning it up while waiting for the cargo door to rip off and take some tail surfaces with it seemed like an eternity. That is called "pucker time".
I'll skip the technical details and obviously the aircraft remained intact to complete that mission because due to a series of circumstances one critical checklist item was inadvertently omitted by one of my crewmen. I took the heat from the commander but it taught me a valuable lesson that has stayed with me throughout my flying career. NEVER stop flying the airplane and checklists are sacred.
We hand our new GA pilots a certificate and then say 'oh, hey, if something bad happens, just fly the plane." Is that going far enough?
but there are a lot of people that would be alive today if when the engine quit they trimmed for a lowest sink rate glide and then sat on their hands and took what they got.... A minimum speed, in control impact with the ground is probably survivable in most all light aircraft.
Yep.
Forty five or so years ago, my instructor had this saying--------
"When a crash is inevitable, hit the softest thing you can-----as slowly as possible."
One of the best classes I have taken as a firefighter was on "physiological response to stress". The takeaway was that "you don't rise to the occasion, you sink to the level of your training". Unless you have practiced responding to a situation repeatedly, you will very likely get it wrong under severe stress. In these situations, you lose all fine motor skills (which could make it hard to secure a door), get narrowed vision, and have almost no critical thinking skills. There is simply no way to assure the proper response until you've ingrained it in your subconscious mind. As they say, don't train until you get it right, train until you can't get it wrong.
I have learned to temper judgement of actions taken by people under severe stress.
Chris