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Analysis Of A Crash

Author: D. Brooks


Edition: Model Aviation - 1999/04
Page Numbers: 33, 34, 35, 36, 38

FOR EVERY unusual unexpected eventflight accident willthere root cause simple statement has basic premise investigation full-scale aircraft disasters National Transportation Safety Board objective investigation board sh identify . cause crash learning able prevent future crashes might spring same cause According August 1987 Nuclear News article failure analysis root causes fall three categories equipment failure procedural error personnel error Equipment failure could caused design deficiency maintenance deficiency manufacturing defect premature accelerated wearout procedure could incomplete incorrect Personnel error could include following procedure training deficiency lack attention communication deficiency root cause analysis productive cause must something can change affect process leads undesired event can affect experience level kind April 1999 33 U Don Brooks amount training example cannot change human nature humans make mistakes So root cause seek must some unique factor action present accomplished could have prevented event unique something must also something within power change Since became AMA Intro Pilot Instructor have prevented certain destruction flying model times too count Students make errors early flying sessions two years instructing five students aircraft has damaged once instance failed prevent damage model actually made damage model worse would have student flying himself repaired shattered wing flew model again next weekend event could bear scrutiny under same examination premise used fullscale aircraft accidents What thing changed could have prevented crash might ask worry about spend time trying analyze crash death crash crash several very important reasons Safety pilots observers first primary reason risk flight operation obligations RC pilot conduct flight operations such safety risk minimized safety persons property compromised AMA members sign statement indicating will abide AMA Safety Code Any crash places aeronauts bystanders observing flight operations risk injury Prevention future crashes same root cause enhances model flight safety Preventing damage fledgling pilots aircraft he/she learns second important reason unwritten contract beginning flying student likelihood destroying his/her aircraft much less he/she spends extra $100 joins AMA local flying club purpose learning fly Otherwise beginner might well think Heck can crash airplane own no additional cost innovations AMA has tried increase safety persons model being flown insist use buddy box flight instruction Intro Pilot program Use buddy box makes transition student instructor control instantaneous discretion instructor necessarily case old days transmitter box handed off wrenched away case may Preventing crashes beginners aircraft enhances enjoyment hobby relieves instructor rebuilding models doesnt own third reason others may learn lessons unusual event ie crash prevent similar problems own third reason cause writing like fly whatever aircraft fledgling pilot brings field long structurally aerodynamically sound use students aircraft rather because students enjoy learning seeing own aircraft go airborne Before going buddy box training flight test-fly students airplane myself become familiar aircrafts flight characteristics make sure aircraft sound also use students radio equipment have several different buddy cord combinations allow hook up radios almost system students brought very attractive Almost Ready Fly ARF model field flight instruction progressed well through initial stages flight training able make level turns figure-eights could fly traffic pattern flying landing approaches increasing skill So time let him go way landing discussed taking final approach way through touchdown including line up flare control during transition flight ground contact shutting off engine necessary after aircraft ground landing approaches preset throttle stick master control box full power potential go-around should needed abort landing attempt made five six good saves aborting missed approaches particular day keep aircraft harm felt confident no matter what did could take care problem Little did know next landing approach looked good turn onto final little short 34 Model Aviation Van Puttes Pattern model crashed landing windy hazy conditions gust flipped model its back Pylon Racing models must mechanically sound flown high degree skill under racing conditions Component failure pilot error disastrous 900 Combined light crosswind left model headed angle across 100-foot-wide runway touchdown good student pulled throttle way back buddy box engine would die released trainer switch take control model throttle stick still preset full throttle go-around engine roared back life airplane accelerated before could kill engine master control left wing struck vertical irrigation pipe marker edge runway severely damaging wing panel wasnt pretty wasnt sure could repair After ARFs dont come plans What lessons can learned What real root cause crash What thing corrected would have prevented unfortunate event root cause analysis describes observable effect asks identify causes effect cause becomes next effect question posed forth have assigned effect/cause item number item can tracked through process continue process until item becomes 24W 42 H 25 HP 205 lb 39 Lx275 W Prop 18x 10 $ 479 original cause can correct root cause item corrected would have prevented event will prevent future such events possible could contributing causes must root cause root cause analysis crash described goes something like Effect 0 aircraft struck stake Causes 1 aircraft wrong heading 2 engine would shut off Effect 1 aircraft wrong heading Causes 3 student made no rudder correction final approach change heading 4 instructor did correct faulty heading Effect 2 engine would shut off Causes 5 slave transmitter throttle control would close throttle sufficiently Effect 3 student made no rudder correction final approach change heading Causes 6 Previous flight training emphasized using rudder Effect 4 instructor did correct faulty heading Cause 7 instructor failed follow correct landing procedure Item 7 first items original cause asks did Smoke Mufflers 3W Motors made 3W-Modelimotoren Initially ava asle 3W 78 100 120/140 182 Johnson Smoke Mufflers 3W 2 cycle oil 110 mix 3385 oc $1375 l998TOCHats$1250 Fuel Lne Foot $70 3W Velocity Stacks $1795 MICRO DIGITAL MOTOR CONTROLLERS SAFE 110 GLITCH POVER ON SOFT LOV TORQUE START UP HIGH RATE SMALL SIZE LIGHT VEIGHT SELF ALIGNS TO YOUR TRANSMITTER NO ADJUSTMENT NECESSARY MICRO DEMON 100 2OAMP 1-14CELL 12 x085 xO39 13g/A6oz wires 4700Hz includes setup LED *NI* MICRO DEMON 02 *NWj* 2OAMP 6-8CELJ, BEC BRAKE 21 g/75oz wires 4700Hz 18 x085 x039 includes setup LED.$5995 SPEED DEMON 200 35AMP 1-16cELL 16 xl 0 x0A2 26g192oz wires 2400Hz..$8295 VIPER MODEL PRODUCTS 3475 Edison icy Suite Menlo Park CA 94025 1-800-592-8473 VISA MASTERCARD 43% Giles G 2O2 Designed byTOC Pilot Wolfgang Matt Wingspan 114 Fuse length 110 Tne G 202 features Gel-coated Fiberglass fuselage prebuilt wings 3Wi2OiB2Fand stabs removable 1196cc 729 1fl3•Sleeves Wingtabe Stabtube instaled 847 lbs hp74L x 122WAilerons elevator radder ready 3W-I 40iB2-F nged 376cc / 839 in3I ng gear support installed & Firewali Kit $ 950 3W-240iB2 Twin 23 HP3W-I ~iIes G 202g orts ugs per cylinder IS HP lwith 3W I2OiB2IF 3 7 $ 2295 $ 2195 GiIesI40B2F $ 3295 Quality repair service 3W factory trained technician 3W-60i 3W-70i 3W-48 iB2 973cc15t3 r3 93 HP 70 ID 755Lx iw 3W78 B2 Prop26x 12$ 1225 3W-I2OiB2 3W-140 iB2 60 cc/36 in5 • 60 HP 528 lb x 40W Prop 22 x 12 70 cc/42 in3 65 HP 528 ID x 40W Prop 22 x 12 48 cc/29 in5 • 50 HP 454 lb x 103W Prop 20 x 12 78 cc/465 in3 74 HP 65 lb 57L x II 0W Prop 24 x 10 196 cc/729 in3 115 HP 847 lb 69Lx 124W Prop 28x 12 1376 cc/839 in5 • 135 HP 858 lb x 130W Prop 30 x 12 $585 $675 $795 $1095 $1350 $1530 Aircraft International Inc Phone 7327610997 3W Sales & Service Center untry Meadow Drive s Neck N] 07722 ax 73276 8585 r Visit Website wwwaircraft-intlcom call Grand Opening Specials April 1999 35 $ 1350 AMA SINGE 1936 3W motors include electronic auto advance ignition carry3W Front Intake _-Motors 5~j~IiLIDEIaD 3W 2082 3W 40B2 nowava abea F n kemo orsanwell PLANE WOULD LOOK WITH THIS SENSATIONAL PROPELLER source MO engines RIBBON mufflers instructor correct aircraft heading answer committed procedure error instructor did follow correct landing procedure nor ensure followed throughout approach Experience factor hut critical item contributing cause engine shut down properly commanded student airplane would have coasted safely stop runway Effect 5 slave transmitter throttle control would close throttle sufficiently Causes 8 No preflight verification made slave transmitter would kill engine Effect 6 Previous flight training emphasized using rudder Cause 9 flight training program did call practice flying rudder vs aileron Item 9 second cause/effect items original cause can changed corrected specifically correction made flight training program have student fly landing pattern rudder rudder aileron rather relying aileron alone gets student used feel rudder stick reaction airplane rudder input makes muchimproved flying approach path made change subsequent flight sessions involved shooting landing approaches following week student pilot made four almost-picture-perfect landings right down runway centerline using rudder primary directional control approach also incorporated use 36 Model Aviation THINK HOW GREAT YOUR new SYNTEC variable pitch propellers will make model look great will fly great well pitch two three four blade propellers fully adjustable 4 24 beautifully finished hard maple blades produced three styles size range 18 30 Blade pitch controlled calibrated dial front SYNTEC hub Mounting hardware available engines 120c1 larger Try airplane today experience convenience variable pitch beauty SYNTEC SYNTEC van-pitch propellers distributed exclusively through IN rd Enterprises Inc GERARD ENTERPRISES INC W226 N825 Eastmound Dr Waukesha WI 53186 414 521-0547 Fax 414 521-0551 THE BATTERY TOOL field box tool 4 9 cell batte packs Use voltmeter loaded voltmeter check pack charge Use tt dtscharge pack read tts capactty Unit discharges 300 ma auto shar-off 11 v per rett Cycles nacks charging Battery Tool $5895 4-pc Universal Cord Set $1595 Add $5 S&H FREE shipping order both JANTRONICS 406 7273001 http//wwwwtpnetIDBEST/jtIjantronicshtmI • lIIJuII IIS Tools designed modelers modelers. gave us problem Du-Bro came up solution Making true Z-bends has long complex problem could done well until now 1 Z-Bender Z-Bender makes true 90 degree Z-bends Du-Bro 072 push rods No damage rod -just professional looking bend Unlike other tools cannot accommodate right-angle bends new Z-Bender makes true 90 degree bends Made CNC machined steel aluminum handles must-have item workbench field box Ask catalog number 783 youd like see 4-40 ver sion call us tolifree email us comments Call Write free catalog Du-Bro Products Inc 480 Bonner Rd PO Box 815 Wauconda IL 60084 1-800-848-9411 fax 847-526-1604 email rc@dubrocom website http//wwwdubrocom rudder earlier own flight training sequence item contributing cause accident root cause Would better heading have prevented accident answer maybe throttle still too high slave transmitter throttle stick idle accident may have happened some other location field Effect 7 No preflight verification made slave transmitter would kill engine Cause 10 preflight checklist incomplete root cause Item 10 original cause preflight checklist incomplete preflight checklist something can changed student able lower throttle setting fully airplane would have coasted safe landing off-heading 100foot-wide runway Further root cause proper functioning slave controller throttle control verified during preflight would have prevented accident would have no need instructor take control aircraft sequence events would have stopped aircraft wrong heading safe runway sequence events led accident 1 preflight checklist incomplete root cause As result 2 No preflight verification made slave transmitter would kill engine As result 3 slave transmitter throttle control would close throttle sufficiently Therefore 5 engine would shut off As result 6 aircraft struck stake corrective action root cause incorporate verification preflight checkoff list slave transmitter indeed set up same master both direction movement capability shut off engine contributing cause fact student held incorrect heading airplane final approach 1 flight training program did call practice flying rudder vs aileron contributing cause Therefore 2 Previous flight training emphasized using rudder As result 3 student made no rudder correction final approach change heading As result 4 aircrafi struck stake second contributing cause fact instructor did intercede adjust incorrect heading airplane final approach 1 instructor failed follow correct landing procedure contributing cause Therefore 2 instructor did correct faulty heading As result 3 aircrafi wrong heading As result 4 aircraft struck stake lack action instructor error judgment failing follow correct landing procedure making tradeoff between two goals maximizing training value minimizing risk contributing cause although sufficient result accident itself decreases margin error brings us closer accident Whether youre pilot instructor pilot student can use simple approach failure analysis tool examine few model crashes better learn occurrences prevent repeating mistakes Good flying Brooks 900 Bower Dr Idaho Falls ID 83404 Add $400 SNpping & HandlingOEALERS.if CIikIIxtaru Wit mpty.OADER DIRECT 38 Model Aviation cleEDSOLMmteurinomwIWawUwiuthWu.. AdjustablEU44P SiLOSM4SFO $1606 FitFITS Motor46 EMYA40 60ENIA 6010120 HP/40 10WEIRA6010120 OTHERS40 00 SoOTHERS 60tt 120 NO DRILUNG TAPPUG SSD Send Free Catalog & Discount Sheet SP PARTS AVAILALE.. Make Ottack PoyaMe 10 Ii DISCOUNT FOR AMA MEMOSASEdon Enterpri. t7

Author: D. Brooks


Edition: Model Aviation - 1999/04
Page Numbers: 33, 34, 35, 36, 38

FOR EVERY unusual unexpected eventflight accident willthere root cause simple statement has basic premise investigation full-scale aircraft disasters National Transportation Safety Board objective investigation board sh identify . cause crash learning able prevent future crashes might spring same cause According August 1987 Nuclear News article failure analysis root causes fall three categories equipment failure procedural error personnel error Equipment failure could caused design deficiency maintenance deficiency manufacturing defect premature accelerated wearout procedure could incomplete incorrect Personnel error could include following procedure training deficiency lack attention communication deficiency root cause analysis productive cause must something can change affect process leads undesired event can affect experience level kind April 1999 33 U Don Brooks amount training example cannot change human nature humans make mistakes So root cause seek must some unique factor action present accomplished could have prevented event unique something must also something within power change Since became AMA Intro Pilot Instructor have prevented certain destruction flying model times too count Students make errors early flying sessions two years instructing five students aircraft has damaged once instance failed prevent damage model actually made damage model worse would have student flying himself repaired shattered wing flew model again next weekend event could bear scrutiny under same examination premise used fullscale aircraft accidents What thing changed could have prevented crash might ask worry about spend time trying analyze crash death crash crash several very important reasons Safety pilots observers first primary reason risk flight operation obligations RC pilot conduct flight operations such safety risk minimized safety persons property compromised AMA members sign statement indicating will abide AMA Safety Code Any crash places aeronauts bystanders observing flight operations risk injury Prevention future crashes same root cause enhances model flight safety Preventing damage fledgling pilots aircraft he/she learns second important reason unwritten contract beginning flying student likelihood destroying his/her aircraft much less he/she spends extra $100 joins AMA local flying club purpose learning fly Otherwise beginner might well think Heck can crash airplane own no additional cost innovations AMA has tried increase safety persons model being flown insist use buddy box flight instruction Intro Pilot program Use buddy box makes transition student instructor control instantaneous discretion instructor necessarily case old days transmitter box handed off wrenched away case may Preventing crashes beginners aircraft enhances enjoyment hobby relieves instructor rebuilding models doesnt own third reason others may learn lessons unusual event ie crash prevent similar problems own third reason cause writing like fly whatever aircraft fledgling pilot brings field long structurally aerodynamically sound use students aircraft rather because students enjoy learning seeing own aircraft go airborne Before going buddy box training flight test-fly students airplane myself become familiar aircrafts flight characteristics make sure aircraft sound also use students radio equipment have several different buddy cord combinations allow hook up radios almost system students brought very attractive Almost Ready Fly ARF model field flight instruction progressed well through initial stages flight training able make level turns figure-eights could fly traffic pattern flying landing approaches increasing skill So time let him go way landing discussed taking final approach way through touchdown including line up flare control during transition flight ground contact shutting off engine necessary after aircraft ground landing approaches preset throttle stick master control box full power potential go-around should needed abort landing attempt made five six good saves aborting missed approaches particular day keep aircraft harm felt confident no matter what did could take care problem Little did know next landing approach looked good turn onto final little short 34 Model Aviation Van Puttes Pattern model crashed landing windy hazy conditions gust flipped model its back Pylon Racing models must mechanically sound flown high degree skill under racing conditions Component failure pilot error disastrous 900 Combined light crosswind left model headed angle across 100-foot-wide runway touchdown good student pulled throttle way back buddy box engine would die released trainer switch take control model throttle stick still preset full throttle go-around engine roared back life airplane accelerated before could kill engine master control left wing struck vertical irrigation pipe marker edge runway severely damaging wing panel wasnt pretty wasnt sure could repair After ARFs dont come plans What lessons can learned What real root cause crash What thing corrected would have prevented unfortunate event root cause analysis describes observable effect asks identify causes effect cause becomes next effect question posed forth have assigned effect/cause item number item can tracked through process continue process until item becomes 24W 42 H 25 HP 205 lb 39 Lx275 W Prop 18x 10 $ 479 original cause can correct root cause item corrected would have prevented event will prevent future such events possible could contributing causes must root cause root cause analysis crash described goes something like Effect 0 aircraft struck stake Causes 1 aircraft wrong heading 2 engine would shut off Effect 1 aircraft wrong heading Causes 3 student made no rudder correction final approach change heading 4 instructor did correct faulty heading Effect 2 engine would shut off Causes 5 slave transmitter throttle control would close throttle sufficiently Effect 3 student made no rudder correction final approach change heading Causes 6 Previous flight training emphasized using rudder Effect 4 instructor did correct faulty heading Cause 7 instructor failed follow correct landing procedure Item 7 first items original cause asks did Smoke Mufflers 3W Motors made 3W-Modelimotoren Initially ava asle 3W 78 100 120/140 182 Johnson Smoke Mufflers 3W 2 cycle oil 110 mix 3385 oc $1375 l998TOCHats$1250 Fuel Lne Foot $70 3W Velocity Stacks $1795 MICRO DIGITAL MOTOR CONTROLLERS SAFE 110 GLITCH POVER ON SOFT LOV TORQUE START UP HIGH RATE SMALL SIZE LIGHT VEIGHT SELF ALIGNS TO YOUR TRANSMITTER NO ADJUSTMENT NECESSARY MICRO DEMON 100 2OAMP 1-14CELL 12 x085 xO39 13g/A6oz wires 4700Hz includes setup LED *NI* MICRO DEMON 02 *NWj* 2OAMP 6-8CELJ, BEC BRAKE 21 g/75oz wires 4700Hz 18 x085 x039 includes setup LED.$5995 SPEED DEMON 200 35AMP 1-16cELL 16 xl 0 x0A2 26g192oz wires 2400Hz..$8295 VIPER MODEL PRODUCTS 3475 Edison icy Suite Menlo Park CA 94025 1-800-592-8473 VISA MASTERCARD 43% Giles G 2O2 Designed byTOC Pilot Wolfgang Matt Wingspan 114 Fuse length 110 Tne G 202 features Gel-coated Fiberglass fuselage prebuilt wings 3Wi2OiB2Fand stabs removable 1196cc 729 1fl3•Sleeves Wingtabe Stabtube instaled 847 lbs hp74L x 122WAilerons elevator radder ready 3W-I 40iB2-F nged 376cc / 839 in3I ng gear support installed & Firewali Kit $ 950 3W-240iB2 Twin 23 HP3W-I ~iIes G 202g orts ugs per cylinder IS HP lwith 3W I2OiB2IF 3 7 $ 2295 $ 2195 GiIesI40B2F $ 3295 Quality repair service 3W factory trained technician 3W-60i 3W-70i 3W-48 iB2 973cc15t3 r3 93 HP 70 ID 755Lx iw 3W78 B2 Prop26x 12$ 1225 3W-I2OiB2 3W-140 iB2 60 cc/36 in5 • 60 HP 528 lb x 40W Prop 22 x 12 70 cc/42 in3 65 HP 528 ID x 40W Prop 22 x 12 48 cc/29 in5 • 50 HP 454 lb x 103W Prop 20 x 12 78 cc/465 in3 74 HP 65 lb 57L x II 0W Prop 24 x 10 196 cc/729 in3 115 HP 847 lb 69Lx 124W Prop 28x 12 1376 cc/839 in5 • 135 HP 858 lb x 130W Prop 30 x 12 $585 $675 $795 $1095 $1350 $1530 Aircraft International Inc Phone 7327610997 3W Sales & Service Center untry Meadow Drive s Neck N] 07722 ax 73276 8585 r Visit Website wwwaircraft-intlcom call Grand Opening Specials April 1999 35 $ 1350 AMA SINGE 1936 3W motors include electronic auto advance ignition carry3W Front Intake _-Motors 5~j~IiLIDEIaD 3W 2082 3W 40B2 nowava abea F n kemo orsanwell PLANE WOULD LOOK WITH THIS SENSATIONAL PROPELLER source MO engines RIBBON mufflers instructor correct aircraft heading answer committed procedure error instructor did follow correct landing procedure nor ensure followed throughout approach Experience factor hut critical item contributing cause engine shut down properly commanded student airplane would have coasted safely stop runway Effect 5 slave transmitter throttle control would close throttle sufficiently Causes 8 No preflight verification made slave transmitter would kill engine Effect 6 Previous flight training emphasized using rudder Cause 9 flight training program did call practice flying rudder vs aileron Item 9 second cause/effect items original cause can changed corrected specifically correction made flight training program have student fly landing pattern rudder rudder aileron rather relying aileron alone gets student used feel rudder stick reaction airplane rudder input makes muchimproved flying approach path made change subsequent flight sessions involved shooting landing approaches following week student pilot made four almost-picture-perfect landings right down runway centerline using rudder primary directional control approach also incorporated use 36 Model Aviation THINK HOW GREAT YOUR new SYNTEC variable pitch propellers will make model look great will fly great well pitch two three four blade propellers fully adjustable 4 24 beautifully finished hard maple blades produced three styles size range 18 30 Blade pitch controlled calibrated dial front SYNTEC hub Mounting hardware available engines 120c1 larger Try airplane today experience convenience variable pitch beauty SYNTEC SYNTEC van-pitch propellers distributed exclusively through IN rd Enterprises Inc GERARD ENTERPRISES INC W226 N825 Eastmound Dr Waukesha WI 53186 414 521-0547 Fax 414 521-0551 THE BATTERY TOOL field box tool 4 9 cell batte packs Use voltmeter loaded voltmeter check pack charge Use tt dtscharge pack read tts capactty Unit discharges 300 ma auto shar-off 11 v per rett Cycles nacks charging Battery Tool $5895 4-pc Universal Cord Set $1595 Add $5 S&H FREE shipping order both JANTRONICS 406 7273001 http//wwwwtpnetIDBEST/jtIjantronicshtmI • lIIJuII IIS Tools designed modelers modelers. gave us problem Du-Bro came up solution Making true Z-bends has long complex problem could done well until now 1 Z-Bender Z-Bender makes true 90 degree Z-bends Du-Bro 072 push rods No damage rod -just professional looking bend Unlike other tools cannot accommodate right-angle bends new Z-Bender makes true 90 degree bends Made CNC machined steel aluminum handles must-have item workbench field box Ask catalog number 783 youd like see 4-40 ver sion call us tolifree email us comments Call Write free catalog Du-Bro Products Inc 480 Bonner Rd PO Box 815 Wauconda IL 60084 1-800-848-9411 fax 847-526-1604 email rc@dubrocom website http//wwwdubrocom rudder earlier own flight training sequence item contributing cause accident root cause Would better heading have prevented accident answer maybe throttle still too high slave transmitter throttle stick idle accident may have happened some other location field Effect 7 No preflight verification made slave transmitter would kill engine Cause 10 preflight checklist incomplete root cause Item 10 original cause preflight checklist incomplete preflight checklist something can changed student able lower throttle setting fully airplane would have coasted safe landing off-heading 100foot-wide runway Further root cause proper functioning slave controller throttle control verified during preflight would have prevented accident would have no need instructor take control aircraft sequence events would have stopped aircraft wrong heading safe runway sequence events led accident 1 preflight checklist incomplete root cause As result 2 No preflight verification made slave transmitter would kill engine As result 3 slave transmitter throttle control would close throttle sufficiently Therefore 5 engine would shut off As result 6 aircraft struck stake corrective action root cause incorporate verification preflight checkoff list slave transmitter indeed set up same master both direction movement capability shut off engine contributing cause fact student held incorrect heading airplane final approach 1 flight training program did call practice flying rudder vs aileron contributing cause Therefore 2 Previous flight training emphasized using rudder As result 3 student made no rudder correction final approach change heading As result 4 aircrafi struck stake second contributing cause fact instructor did intercede adjust incorrect heading airplane final approach 1 instructor failed follow correct landing procedure contributing cause Therefore 2 instructor did correct faulty heading As result 3 aircrafi wrong heading As result 4 aircraft struck stake lack action instructor error judgment failing follow correct landing procedure making tradeoff between two goals maximizing training value minimizing risk contributing cause although sufficient result accident itself decreases margin error brings us closer accident Whether youre pilot instructor pilot student can use simple approach failure analysis tool examine few model crashes better learn occurrences prevent repeating mistakes Good flying Brooks 900 Bower Dr Idaho Falls ID 83404 Add $400 SNpping & HandlingOEALERS.if CIikIIxtaru Wit mpty.OADER DIRECT 38 Model Aviation cleEDSOLMmteurinomwIWawUwiuthWu.. AdjustablEU44P SiLOSM4SFO $1606 FitFITS Motor46 EMYA40 60ENIA 6010120 HP/40 10WEIRA6010120 OTHERS40 00 SoOTHERS 60tt 120 NO DRILUNG TAPPUG SSD Send Free Catalog & Discount Sheet SP PARTS AVAILALE.. Make Ottack PoyaMe 10 Ii DISCOUNT FOR AMA MEMOSASEdon Enterpri. t7

Author: D. Brooks


Edition: Model Aviation - 1999/04
Page Numbers: 33, 34, 35, 36, 38

FOR EVERY unusual unexpected eventflight accident willthere root cause simple statement has basic premise investigation full-scale aircraft disasters National Transportation Safety Board objective investigation board sh identify . cause crash learning able prevent future crashes might spring same cause According August 1987 Nuclear News article failure analysis root causes fall three categories equipment failure procedural error personnel error Equipment failure could caused design deficiency maintenance deficiency manufacturing defect premature accelerated wearout procedure could incomplete incorrect Personnel error could include following procedure training deficiency lack attention communication deficiency root cause analysis productive cause must something can change affect process leads undesired event can affect experience level kind April 1999 33 U Don Brooks amount training example cannot change human nature humans make mistakes So root cause seek must some unique factor action present accomplished could have prevented event unique something must also something within power change Since became AMA Intro Pilot Instructor have prevented certain destruction flying model times too count Students make errors early flying sessions two years instructing five students aircraft has damaged once instance failed prevent damage model actually made damage model worse would have student flying himself repaired shattered wing flew model again next weekend event could bear scrutiny under same examination premise used fullscale aircraft accidents What thing changed could have prevented crash might ask worry about spend time trying analyze crash death crash crash several very important reasons Safety pilots observers first primary reason risk flight operation obligations RC pilot conduct flight operations such safety risk minimized safety persons property compromised AMA members sign statement indicating will abide AMA Safety Code Any crash places aeronauts bystanders observing flight operations risk injury Prevention future crashes same root cause enhances model flight safety Preventing damage fledgling pilots aircraft he/she learns second important reason unwritten contract beginning flying student likelihood destroying his/her aircraft much less he/she spends extra $100 joins AMA local flying club purpose learning fly Otherwise beginner might well think Heck can crash airplane own no additional cost innovations AMA has tried increase safety persons model being flown insist use buddy box flight instruction Intro Pilot program Use buddy box makes transition student instructor control instantaneous discretion instructor necessarily case old days transmitter box handed off wrenched away case may Preventing crashes beginners aircraft enhances enjoyment hobby relieves instructor rebuilding models doesnt own third reason others may learn lessons unusual event ie crash prevent similar problems own third reason cause writing like fly whatever aircraft fledgling pilot brings field long structurally aerodynamically sound use students aircraft rather because students enjoy learning seeing own aircraft go airborne Before going buddy box training flight test-fly students airplane myself become familiar aircrafts flight characteristics make sure aircraft sound also use students radio equipment have several different buddy cord combinations allow hook up radios almost system students brought very attractive Almost Ready Fly ARF model field flight instruction progressed well through initial stages flight training able make level turns figure-eights could fly traffic pattern flying landing approaches increasing skill So time let him go way landing discussed taking final approach way through touchdown including line up flare control during transition flight ground contact shutting off engine necessary after aircraft ground landing approaches preset throttle stick master control box full power potential go-around should needed abort landing attempt made five six good saves aborting missed approaches particular day keep aircraft harm felt confident no matter what did could take care problem Little did know next landing approach looked good turn onto final little short 34 Model Aviation Van Puttes Pattern model crashed landing windy hazy conditions gust flipped model its back Pylon Racing models must mechanically sound flown high degree skill under racing conditions Component failure pilot error disastrous 900 Combined light crosswind left model headed angle across 100-foot-wide runway touchdown good student pulled throttle way back buddy box engine would die released trainer switch take control model throttle stick still preset full throttle go-around engine roared back life airplane accelerated before could kill engine master control left wing struck vertical irrigation pipe marker edge runway severely damaging wing panel wasnt pretty wasnt sure could repair After ARFs dont come plans What lessons can learned What real root cause crash What thing corrected would have prevented unfortunate event root cause analysis describes observable effect asks identify causes effect cause becomes next effect question posed forth have assigned effect/cause item number item can tracked through process continue process until item becomes 24W 42 H 25 HP 205 lb 39 Lx275 W Prop 18x 10 $ 479 original cause can correct root cause item corrected would have prevented event will prevent future such events possible could contributing causes must root cause root cause analysis crash described goes something like Effect 0 aircraft struck stake Causes 1 aircraft wrong heading 2 engine would shut off Effect 1 aircraft wrong heading Causes 3 student made no rudder correction final approach change heading 4 instructor did correct faulty heading Effect 2 engine would shut off Causes 5 slave transmitter throttle control would close throttle sufficiently Effect 3 student made no rudder correction final approach change heading Causes 6 Previous flight training emphasized using rudder Effect 4 instructor did correct faulty heading Cause 7 instructor failed follow correct landing procedure Item 7 first items original cause asks did Smoke Mufflers 3W Motors made 3W-Modelimotoren Initially ava asle 3W 78 100 120/140 182 Johnson Smoke Mufflers 3W 2 cycle oil 110 mix 3385 oc $1375 l998TOCHats$1250 Fuel Lne Foot $70 3W Velocity Stacks $1795 MICRO DIGITAL MOTOR CONTROLLERS SAFE 110 GLITCH POVER ON SOFT LOV TORQUE START UP HIGH RATE SMALL SIZE LIGHT VEIGHT SELF ALIGNS TO YOUR TRANSMITTER NO ADJUSTMENT NECESSARY MICRO DEMON 100 2OAMP 1-14CELL 12 x085 xO39 13g/A6oz wires 4700Hz includes setup LED *NI* MICRO DEMON 02 *NWj* 2OAMP 6-8CELJ, BEC BRAKE 21 g/75oz wires 4700Hz 18 x085 x039 includes setup LED.$5995 SPEED DEMON 200 35AMP 1-16cELL 16 xl 0 x0A2 26g192oz wires 2400Hz..$8295 VIPER MODEL PRODUCTS 3475 Edison icy Suite Menlo Park CA 94025 1-800-592-8473 VISA MASTERCARD 43% Giles G 2O2 Designed byTOC Pilot Wolfgang Matt Wingspan 114 Fuse length 110 Tne G 202 features Gel-coated Fiberglass fuselage prebuilt wings 3Wi2OiB2Fand stabs removable 1196cc 729 1fl3•Sleeves Wingtabe Stabtube instaled 847 lbs hp74L x 122WAilerons elevator radder ready 3W-I 40iB2-F nged 376cc / 839 in3I ng gear support installed & Firewali Kit $ 950 3W-240iB2 Twin 23 HP3W-I ~iIes G 202g orts ugs per cylinder IS HP lwith 3W I2OiB2IF 3 7 $ 2295 $ 2195 GiIesI40B2F $ 3295 Quality repair service 3W factory trained technician 3W-60i 3W-70i 3W-48 iB2 973cc15t3 r3 93 HP 70 ID 755Lx iw 3W78 B2 Prop26x 12$ 1225 3W-I2OiB2 3W-140 iB2 60 cc/36 in5 • 60 HP 528 lb x 40W Prop 22 x 12 70 cc/42 in3 65 HP 528 ID x 40W Prop 22 x 12 48 cc/29 in5 • 50 HP 454 lb x 103W Prop 20 x 12 78 cc/465 in3 74 HP 65 lb 57L x II 0W Prop 24 x 10 196 cc/729 in3 115 HP 847 lb 69Lx 124W Prop 28x 12 1376 cc/839 in5 • 135 HP 858 lb x 130W Prop 30 x 12 $585 $675 $795 $1095 $1350 $1530 Aircraft International Inc Phone 7327610997 3W Sales & Service Center untry Meadow Drive s Neck N] 07722 ax 73276 8585 r Visit Website wwwaircraft-intlcom call Grand Opening Specials April 1999 35 $ 1350 AMA SINGE 1936 3W motors include electronic auto advance ignition carry3W Front Intake _-Motors 5~j~IiLIDEIaD 3W 2082 3W 40B2 nowava abea F n kemo orsanwell PLANE WOULD LOOK WITH THIS SENSATIONAL PROPELLER source MO engines RIBBON mufflers instructor correct aircraft heading answer committed procedure error instructor did follow correct landing procedure nor ensure followed throughout approach Experience factor hut critical item contributing cause engine shut down properly commanded student airplane would have coasted safely stop runway Effect 5 slave transmitter throttle control would close throttle sufficiently Causes 8 No preflight verification made slave transmitter would kill engine Effect 6 Previous flight training emphasized using rudder Cause 9 flight training program did call practice flying rudder vs aileron Item 9 second cause/effect items original cause can changed corrected specifically correction made flight training program have student fly landing pattern rudder rudder aileron rather relying aileron alone gets student used feel rudder stick reaction airplane rudder input makes muchimproved flying approach path made change subsequent flight sessions involved shooting landing approaches following week student pilot made four almost-picture-perfect landings right down runway centerline using rudder primary directional control approach also incorporated use 36 Model Aviation THINK HOW GREAT YOUR new SYNTEC variable pitch propellers will make model look great will fly great well pitch two three four blade propellers fully adjustable 4 24 beautifully finished hard maple blades produced three styles size range 18 30 Blade pitch controlled calibrated dial front SYNTEC hub Mounting hardware available engines 120c1 larger Try airplane today experience convenience variable pitch beauty SYNTEC SYNTEC van-pitch propellers distributed exclusively through IN rd Enterprises Inc GERARD ENTERPRISES INC W226 N825 Eastmound Dr Waukesha WI 53186 414 521-0547 Fax 414 521-0551 THE BATTERY TOOL field box tool 4 9 cell batte packs Use voltmeter loaded voltmeter check pack charge Use tt dtscharge pack read tts capactty Unit discharges 300 ma auto shar-off 11 v per rett Cycles nacks charging Battery Tool $5895 4-pc Universal Cord Set $1595 Add $5 S&H FREE shipping order both JANTRONICS 406 7273001 http//wwwwtpnetIDBEST/jtIjantronicshtmI • lIIJuII IIS Tools designed modelers modelers. gave us problem Du-Bro came up solution Making true Z-bends has long complex problem could done well until now 1 Z-Bender Z-Bender makes true 90 degree Z-bends Du-Bro 072 push rods No damage rod -just professional looking bend Unlike other tools cannot accommodate right-angle bends new Z-Bender makes true 90 degree bends Made CNC machined steel aluminum handles must-have item workbench field box Ask catalog number 783 youd like see 4-40 ver sion call us tolifree email us comments Call Write free catalog Du-Bro Products Inc 480 Bonner Rd PO Box 815 Wauconda IL 60084 1-800-848-9411 fax 847-526-1604 email rc@dubrocom website http//wwwdubrocom rudder earlier own flight training sequence item contributing cause accident root cause Would better heading have prevented accident answer maybe throttle still too high slave transmitter throttle stick idle accident may have happened some other location field Effect 7 No preflight verification made slave transmitter would kill engine Cause 10 preflight checklist incomplete root cause Item 10 original cause preflight checklist incomplete preflight checklist something can changed student able lower throttle setting fully airplane would have coasted safe landing off-heading 100foot-wide runway Further root cause proper functioning slave controller throttle control verified during preflight would have prevented accident would have no need instructor take control aircraft sequence events would have stopped aircraft wrong heading safe runway sequence events led accident 1 preflight checklist incomplete root cause As result 2 No preflight verification made slave transmitter would kill engine As result 3 slave transmitter throttle control would close throttle sufficiently Therefore 5 engine would shut off As result 6 aircraft struck stake corrective action root cause incorporate verification preflight checkoff list slave transmitter indeed set up same master both direction movement capability shut off engine contributing cause fact student held incorrect heading airplane final approach 1 flight training program did call practice flying rudder vs aileron contributing cause Therefore 2 Previous flight training emphasized using rudder As result 3 student made no rudder correction final approach change heading As result 4 aircrafi struck stake second contributing cause fact instructor did intercede adjust incorrect heading airplane final approach 1 instructor failed follow correct landing procedure contributing cause Therefore 2 instructor did correct faulty heading As result 3 aircrafi wrong heading As result 4 aircraft struck stake lack action instructor error judgment failing follow correct landing procedure making tradeoff between two goals maximizing training value minimizing risk contributing cause although sufficient result accident itself decreases margin error brings us closer accident Whether youre pilot instructor pilot student can use simple approach failure analysis tool examine few model crashes better learn occurrences prevent repeating mistakes Good flying Brooks 900 Bower Dr Idaho Falls ID 83404 Add $400 SNpping & HandlingOEALERS.if CIikIIxtaru Wit mpty.OADER DIRECT 38 Model Aviation cleEDSOLMmteurinomwIWawUwiuthWu.. AdjustablEU44P SiLOSM4SFO $1606 FitFITS Motor46 EMYA40 60ENIA 6010120 HP/40 10WEIRA6010120 OTHERS40 00 SoOTHERS 60tt 120 NO DRILUNG TAPPUG SSD Send Free Catalog & Discount Sheet SP PARTS AVAILALE.. Make Ottack PoyaMe 10 Ii DISCOUNT FOR AMA MEMOSASEdon Enterpri. t7

Author: D. Brooks


Edition: Model Aviation - 1999/04
Page Numbers: 33, 34, 35, 36, 38

FOR EVERY unusual unexpected eventflight accident willthere root cause simple statement has basic premise investigation full-scale aircraft disasters National Transportation Safety Board objective investigation board sh identify . cause crash learning able prevent future crashes might spring same cause According August 1987 Nuclear News article failure analysis root causes fall three categories equipment failure procedural error personnel error Equipment failure could caused design deficiency maintenance deficiency manufacturing defect premature accelerated wearout procedure could incomplete incorrect Personnel error could include following procedure training deficiency lack attention communication deficiency root cause analysis productive cause must something can change affect process leads undesired event can affect experience level kind April 1999 33 U Don Brooks amount training example cannot change human nature humans make mistakes So root cause seek must some unique factor action present accomplished could have prevented event unique something must also something within power change Since became AMA Intro Pilot Instructor have prevented certain destruction flying model times too count Students make errors early flying sessions two years instructing five students aircraft has damaged once instance failed prevent damage model actually made damage model worse would have student flying himself repaired shattered wing flew model again next weekend event could bear scrutiny under same examination premise used fullscale aircraft accidents What thing changed could have prevented crash might ask worry about spend time trying analyze crash death crash crash several very important reasons Safety pilots observers first primary reason risk flight operation obligations RC pilot conduct flight operations such safety risk minimized safety persons property compromised AMA members sign statement indicating will abide AMA Safety Code Any crash places aeronauts bystanders observing flight operations risk injury Prevention future crashes same root cause enhances model flight safety Preventing damage fledgling pilots aircraft he/she learns second important reason unwritten contract beginning flying student likelihood destroying his/her aircraft much less he/she spends extra $100 joins AMA local flying club purpose learning fly Otherwise beginner might well think Heck can crash airplane own no additional cost innovations AMA has tried increase safety persons model being flown insist use buddy box flight instruction Intro Pilot program Use buddy box makes transition student instructor control instantaneous discretion instructor necessarily case old days transmitter box handed off wrenched away case may Preventing crashes beginners aircraft enhances enjoyment hobby relieves instructor rebuilding models doesnt own third reason others may learn lessons unusual event ie crash prevent similar problems own third reason cause writing like fly whatever aircraft fledgling pilot brings field long structurally aerodynamically sound use students aircraft rather because students enjoy learning seeing own aircraft go airborne Before going buddy box training flight test-fly students airplane myself become familiar aircrafts flight characteristics make sure aircraft sound also use students radio equipment have several different buddy cord combinations allow hook up radios almost system students brought very attractive Almost Ready Fly ARF model field flight instruction progressed well through initial stages flight training able make level turns figure-eights could fly traffic pattern flying landing approaches increasing skill So time let him go way landing discussed taking final approach way through touchdown including line up flare control during transition flight ground contact shutting off engine necessary after aircraft ground landing approaches preset throttle stick master control box full power potential go-around should needed abort landing attempt made five six good saves aborting missed approaches particular day keep aircraft harm felt confident no matter what did could take care problem Little did know next landing approach looked good turn onto final little short 34 Model Aviation Van Puttes Pattern model crashed landing windy hazy conditions gust flipped model its back Pylon Racing models must mechanically sound flown high degree skill under racing conditions Component failure pilot error disastrous 900 Combined light crosswind left model headed angle across 100-foot-wide runway touchdown good student pulled throttle way back buddy box engine would die released trainer switch take control model throttle stick still preset full throttle go-around engine roared back life airplane accelerated before could kill engine master control left wing struck vertical irrigation pipe marker edge runway severely damaging wing panel wasnt pretty wasnt sure could repair After ARFs dont come plans What lessons can learned What real root cause crash What thing corrected would have prevented unfortunate event root cause analysis describes observable effect asks identify causes effect cause becomes next effect question posed forth have assigned effect/cause item number item can tracked through process continue process until item becomes 24W 42 H 25 HP 205 lb 39 Lx275 W Prop 18x 10 $ 479 original cause can correct root cause item corrected would have prevented event will prevent future such events possible could contributing causes must root cause root cause analysis crash described goes something like Effect 0 aircraft struck stake Causes 1 aircraft wrong heading 2 engine would shut off Effect 1 aircraft wrong heading Causes 3 student made no rudder correction final approach change heading 4 instructor did correct faulty heading Effect 2 engine would shut off Causes 5 slave transmitter throttle control would close throttle sufficiently Effect 3 student made no rudder correction final approach change heading Causes 6 Previous flight training emphasized using rudder Effect 4 instructor did correct faulty heading Cause 7 instructor failed follow correct landing procedure Item 7 first items original cause asks did Smoke Mufflers 3W Motors made 3W-Modelimotoren Initially ava asle 3W 78 100 120/140 182 Johnson Smoke Mufflers 3W 2 cycle oil 110 mix 3385 oc $1375 l998TOCHats$1250 Fuel Lne Foot $70 3W Velocity Stacks $1795 MICRO DIGITAL MOTOR CONTROLLERS SAFE 110 GLITCH POVER ON SOFT LOV TORQUE START UP HIGH RATE SMALL SIZE LIGHT VEIGHT SELF ALIGNS TO YOUR TRANSMITTER NO ADJUSTMENT NECESSARY MICRO DEMON 100 2OAMP 1-14CELL 12 x085 xO39 13g/A6oz wires 4700Hz includes setup LED *NI* MICRO DEMON 02 *NWj* 2OAMP 6-8CELJ, BEC BRAKE 21 g/75oz wires 4700Hz 18 x085 x039 includes setup LED.$5995 SPEED DEMON 200 35AMP 1-16cELL 16 xl 0 x0A2 26g192oz wires 2400Hz..$8295 VIPER MODEL PRODUCTS 3475 Edison icy Suite Menlo Park CA 94025 1-800-592-8473 VISA MASTERCARD 43% Giles G 2O2 Designed byTOC Pilot Wolfgang Matt Wingspan 114 Fuse length 110 Tne G 202 features Gel-coated Fiberglass fuselage prebuilt wings 3Wi2OiB2Fand stabs removable 1196cc 729 1fl3•Sleeves Wingtabe Stabtube instaled 847 lbs hp74L x 122WAilerons elevator radder ready 3W-I 40iB2-F nged 376cc / 839 in3I ng gear support installed & Firewali Kit $ 950 3W-240iB2 Twin 23 HP3W-I ~iIes G 202g orts ugs per cylinder IS HP lwith 3W I2OiB2IF 3 7 $ 2295 $ 2195 GiIesI40B2F $ 3295 Quality repair service 3W factory trained technician 3W-60i 3W-70i 3W-48 iB2 973cc15t3 r3 93 HP 70 ID 755Lx iw 3W78 B2 Prop26x 12$ 1225 3W-I2OiB2 3W-140 iB2 60 cc/36 in5 • 60 HP 528 lb x 40W Prop 22 x 12 70 cc/42 in3 65 HP 528 ID x 40W Prop 22 x 12 48 cc/29 in5 • 50 HP 454 lb x 103W Prop 20 x 12 78 cc/465 in3 74 HP 65 lb 57L x II 0W Prop 24 x 10 196 cc/729 in3 115 HP 847 lb 69Lx 124W Prop 28x 12 1376 cc/839 in5 • 135 HP 858 lb x 130W Prop 30 x 12 $585 $675 $795 $1095 $1350 $1530 Aircraft International Inc Phone 7327610997 3W Sales & Service Center untry Meadow Drive s Neck N] 07722 ax 73276 8585 r Visit Website wwwaircraft-intlcom call Grand Opening Specials April 1999 35 $ 1350 AMA SINGE 1936 3W motors include electronic auto advance ignition carry3W Front Intake _-Motors 5~j~IiLIDEIaD 3W 2082 3W 40B2 nowava abea F n kemo orsanwell PLANE WOULD LOOK WITH THIS SENSATIONAL PROPELLER source MO engines RIBBON mufflers instructor correct aircraft heading answer committed procedure error instructor did follow correct landing procedure nor ensure followed throughout approach Experience factor hut critical item contributing cause engine shut down properly commanded student airplane would have coasted safely stop runway Effect 5 slave transmitter throttle control would close throttle sufficiently Causes 8 No preflight verification made slave transmitter would kill engine Effect 6 Previous flight training emphasized using rudder Cause 9 flight training program did call practice flying rudder vs aileron Item 9 second cause/effect items original cause can changed corrected specifically correction made flight training program have student fly landing pattern rudder rudder aileron rather relying aileron alone gets student used feel rudder stick reaction airplane rudder input makes muchimproved flying approach path made change subsequent flight sessions involved shooting landing approaches following week student pilot made four almost-picture-perfect landings right down runway centerline using rudder primary directional control approach also incorporated use 36 Model Aviation THINK HOW GREAT YOUR new SYNTEC variable pitch propellers will make model look great will fly great well pitch two three four blade propellers fully adjustable 4 24 beautifully finished hard maple blades produced three styles size range 18 30 Blade pitch controlled calibrated dial front SYNTEC hub Mounting hardware available engines 120c1 larger Try airplane today experience convenience variable pitch beauty SYNTEC SYNTEC van-pitch propellers distributed exclusively through IN rd Enterprises Inc GERARD ENTERPRISES INC W226 N825 Eastmound Dr Waukesha WI 53186 414 521-0547 Fax 414 521-0551 THE BATTERY TOOL field box tool 4 9 cell batte packs Use voltmeter loaded voltmeter check pack charge Use tt dtscharge pack read tts capactty Unit discharges 300 ma auto shar-off 11 v per rett Cycles nacks charging Battery Tool $5895 4-pc Universal Cord Set $1595 Add $5 S&H FREE shipping order both JANTRONICS 406 7273001 http//wwwwtpnetIDBEST/jtIjantronicshtmI • lIIJuII IIS Tools designed modelers modelers. gave us problem Du-Bro came up solution Making true Z-bends has long complex problem could done well until now 1 Z-Bender Z-Bender makes true 90 degree Z-bends Du-Bro 072 push rods No damage rod -just professional looking bend Unlike other tools cannot accommodate right-angle bends new Z-Bender makes true 90 degree bends Made CNC machined steel aluminum handles must-have item workbench field box Ask catalog number 783 youd like see 4-40 ver sion call us tolifree email us comments Call Write free catalog Du-Bro Products Inc 480 Bonner Rd PO Box 815 Wauconda IL 60084 1-800-848-9411 fax 847-526-1604 email rc@dubrocom website http//wwwdubrocom rudder earlier own flight training sequence item contributing cause accident root cause Would better heading have prevented accident answer maybe throttle still too high slave transmitter throttle stick idle accident may have happened some other location field Effect 7 No preflight verification made slave transmitter would kill engine Cause 10 preflight checklist incomplete root cause Item 10 original cause preflight checklist incomplete preflight checklist something can changed student able lower throttle setting fully airplane would have coasted safe landing off-heading 100foot-wide runway Further root cause proper functioning slave controller throttle control verified during preflight would have prevented accident would have no need instructor take control aircraft sequence events would have stopped aircraft wrong heading safe runway sequence events led accident 1 preflight checklist incomplete root cause As result 2 No preflight verification made slave transmitter would kill engine As result 3 slave transmitter throttle control would close throttle sufficiently Therefore 5 engine would shut off As result 6 aircraft struck stake corrective action root cause incorporate verification preflight checkoff list slave transmitter indeed set up same master both direction movement capability shut off engine contributing cause fact student held incorrect heading airplane final approach 1 flight training program did call practice flying rudder vs aileron contributing cause Therefore 2 Previous flight training emphasized using rudder As result 3 student made no rudder correction final approach change heading As result 4 aircrafi struck stake second contributing cause fact instructor did intercede adjust incorrect heading airplane final approach 1 instructor failed follow correct landing procedure contributing cause Therefore 2 instructor did correct faulty heading As result 3 aircrafi wrong heading As result 4 aircraft struck stake lack action instructor error judgment failing follow correct landing procedure making tradeoff between two goals maximizing training value minimizing risk contributing cause although sufficient result accident itself decreases margin error brings us closer accident Whether youre pilot instructor pilot student can use simple approach failure analysis tool examine few model crashes better learn occurrences prevent repeating mistakes Good flying Brooks 900 Bower Dr Idaho Falls ID 83404 Add $400 SNpping & HandlingOEALERS.if CIikIIxtaru Wit mpty.OADER DIRECT 38 Model Aviation cleEDSOLMmteurinomwIWawUwiuthWu.. AdjustablEU44P SiLOSM4SFO $1606 FitFITS Motor46 EMYA40 60ENIA 6010120 HP/40 10WEIRA6010120 OTHERS40 00 SoOTHERS 60tt 120 NO DRILUNG TAPPUG SSD Send Free Catalog & Discount Sheet SP PARTS AVAILALE.. Make Ottack PoyaMe 10 Ii DISCOUNT FOR AMA MEMOSASEdon Enterpri. t7

Author: D. Brooks


Edition: Model Aviation - 1999/04
Page Numbers: 33, 34, 35, 36, 38

FOR EVERY unusual unexpected eventflight accident willthere root cause simple statement has basic premise investigation full-scale aircraft disasters National Transportation Safety Board objective investigation board sh identify . cause crash learning able prevent future crashes might spring same cause According August 1987 Nuclear News article failure analysis root causes fall three categories equipment failure procedural error personnel error Equipment failure could caused design deficiency maintenance deficiency manufacturing defect premature accelerated wearout procedure could incomplete incorrect Personnel error could include following procedure training deficiency lack attention communication deficiency root cause analysis productive cause must something can change affect process leads undesired event can affect experience level kind April 1999 33 U Don Brooks amount training example cannot change human nature humans make mistakes So root cause seek must some unique factor action present accomplished could have prevented event unique something must also something within power change Since became AMA Intro Pilot Instructor have prevented certain destruction flying model times too count Students make errors early flying sessions two years instructing five students aircraft has damaged once instance failed prevent damage model actually made damage model worse would have student flying himself repaired shattered wing flew model again next weekend event could bear scrutiny under same examination premise used fullscale aircraft accidents What thing changed could have prevented crash might ask worry about spend time trying analyze crash death crash crash several very important reasons Safety pilots observers first primary reason risk flight operation obligations RC pilot conduct flight operations such safety risk minimized safety persons property compromised AMA members sign statement indicating will abide AMA Safety Code Any crash places aeronauts bystanders observing flight operations risk injury Prevention future crashes same root cause enhances model flight safety Preventing damage fledgling pilots aircraft he/she learns second important reason unwritten contract beginning flying student likelihood destroying his/her aircraft much less he/she spends extra $100 joins AMA local flying club purpose learning fly Otherwise beginner might well think Heck can crash airplane own no additional cost innovations AMA has tried increase safety persons model being flown insist use buddy box flight instruction Intro Pilot program Use buddy box makes transition student instructor control instantaneous discretion instructor necessarily case old days transmitter box handed off wrenched away case may Preventing crashes beginners aircraft enhances enjoyment hobby relieves instructor rebuilding models doesnt own third reason others may learn lessons unusual event ie crash prevent similar problems own third reason cause writing like fly whatever aircraft fledgling pilot brings field long structurally aerodynamically sound use students aircraft rather because students enjoy learning seeing own aircraft go airborne Before going buddy box training flight test-fly students airplane myself become familiar aircrafts flight characteristics make sure aircraft sound also use students radio equipment have several different buddy cord combinations allow hook up radios almost system students brought very attractive Almost Ready Fly ARF model field flight instruction progressed well through initial stages flight training able make level turns figure-eights could fly traffic pattern flying landing approaches increasing skill So time let him go way landing discussed taking final approach way through touchdown including line up flare control during transition flight ground contact shutting off engine necessary after aircraft ground landing approaches preset throttle stick master control box full power potential go-around should needed abort landing attempt made five six good saves aborting missed approaches particular day keep aircraft harm felt confident no matter what did could take care problem Little did know next landing approach looked good turn onto final little short 34 Model Aviation Van Puttes Pattern model crashed landing windy hazy conditions gust flipped model its back Pylon Racing models must mechanically sound flown high degree skill under racing conditions Component failure pilot error disastrous 900 Combined light crosswind left model headed angle across 100-foot-wide runway touchdown good student pulled throttle way back buddy box engine would die released trainer switch take control model throttle stick still preset full throttle go-around engine roared back life airplane accelerated before could kill engine master control left wing struck vertical irrigation pipe marker edge runway severely damaging wing panel wasnt pretty wasnt sure could repair After ARFs dont come plans What lessons can learned What real root cause crash What thing corrected would have prevented unfortunate event root cause analysis describes observable effect asks identify causes effect cause becomes next effect question posed forth have assigned effect/cause item number item can tracked through process continue process until item becomes 24W 42 H 25 HP 205 lb 39 Lx275 W Prop 18x 10 $ 479 original cause can correct root cause item corrected would have prevented event will prevent future such events possible could contributing causes must root cause root cause analysis crash described goes something like Effect 0 aircraft struck stake Causes 1 aircraft wrong heading 2 engine would shut off Effect 1 aircraft wrong heading Causes 3 student made no rudder correction final approach change heading 4 instructor did correct faulty heading Effect 2 engine would shut off Causes 5 slave transmitter throttle control would close throttle sufficiently Effect 3 student made no rudder correction final approach change heading Causes 6 Previous flight training emphasized using rudder Effect 4 instructor did correct faulty heading Cause 7 instructor failed follow correct landing procedure Item 7 first items original cause asks did Smoke Mufflers 3W Motors made 3W-Modelimotoren Initially ava asle 3W 78 100 120/140 182 Johnson Smoke Mufflers 3W 2 cycle oil 110 mix 3385 oc $1375 l998TOCHats$1250 Fuel Lne Foot $70 3W Velocity Stacks $1795 MICRO DIGITAL MOTOR CONTROLLERS SAFE 110 GLITCH POVER ON SOFT LOV TORQUE START UP HIGH RATE SMALL SIZE LIGHT VEIGHT SELF ALIGNS TO YOUR TRANSMITTER NO ADJUSTMENT NECESSARY MICRO DEMON 100 2OAMP 1-14CELL 12 x085 xO39 13g/A6oz wires 4700Hz includes setup LED *NI* MICRO DEMON 02 *NWj* 2OAMP 6-8CELJ, BEC BRAKE 21 g/75oz wires 4700Hz 18 x085 x039 includes setup LED.$5995 SPEED DEMON 200 35AMP 1-16cELL 16 xl 0 x0A2 26g192oz wires 2400Hz..$8295 VIPER MODEL PRODUCTS 3475 Edison icy Suite Menlo Park CA 94025 1-800-592-8473 VISA MASTERCARD 43% Giles G 2O2 Designed byTOC Pilot Wolfgang Matt Wingspan 114 Fuse length 110 Tne G 202 features Gel-coated Fiberglass fuselage prebuilt wings 3Wi2OiB2Fand stabs removable 1196cc 729 1fl3•Sleeves Wingtabe Stabtube instaled 847 lbs hp74L x 122WAilerons elevator radder ready 3W-I 40iB2-F nged 376cc / 839 in3I ng gear support installed & Firewali Kit $ 950 3W-240iB2 Twin 23 HP3W-I ~iIes G 202g orts ugs per cylinder IS HP lwith 3W I2OiB2IF 3 7 $ 2295 $ 2195 GiIesI40B2F $ 3295 Quality repair service 3W factory trained technician 3W-60i 3W-70i 3W-48 iB2 973cc15t3 r3 93 HP 70 ID 755Lx iw 3W78 B2 Prop26x 12$ 1225 3W-I2OiB2 3W-140 iB2 60 cc/36 in5 • 60 HP 528 lb x 40W Prop 22 x 12 70 cc/42 in3 65 HP 528 ID x 40W Prop 22 x 12 48 cc/29 in5 • 50 HP 454 lb x 103W Prop 20 x 12 78 cc/465 in3 74 HP 65 lb 57L x II 0W Prop 24 x 10 196 cc/729 in3 115 HP 847 lb 69Lx 124W Prop 28x 12 1376 cc/839 in5 • 135 HP 858 lb x 130W Prop 30 x 12 $585 $675 $795 $1095 $1350 $1530 Aircraft International Inc Phone 7327610997 3W Sales & Service Center untry Meadow Drive s Neck N] 07722 ax 73276 8585 r Visit Website wwwaircraft-intlcom call Grand Opening Specials April 1999 35 $ 1350 AMA SINGE 1936 3W motors include electronic auto advance ignition carry3W Front Intake _-Motors 5~j~IiLIDEIaD 3W 2082 3W 40B2 nowava abea F n kemo orsanwell PLANE WOULD LOOK WITH THIS SENSATIONAL PROPELLER source MO engines RIBBON mufflers instructor correct aircraft heading answer committed procedure error instructor did follow correct landing procedure nor ensure followed throughout approach Experience factor hut critical item contributing cause engine shut down properly commanded student airplane would have coasted safely stop runway Effect 5 slave transmitter throttle control would close throttle sufficiently Causes 8 No preflight verification made slave transmitter would kill engine Effect 6 Previous flight training emphasized using rudder Cause 9 flight training program did call practice flying rudder vs aileron Item 9 second cause/effect items original cause can changed corrected specifically correction made flight training program have student fly landing pattern rudder rudder aileron rather relying aileron alone gets student used feel rudder stick reaction airplane rudder input makes muchimproved flying approach path made change subsequent flight sessions involved shooting landing approaches following week student pilot made four almost-picture-perfect landings right down runway centerline using rudder primary directional control approach also incorporated use 36 Model Aviation THINK HOW GREAT YOUR new SYNTEC variable pitch propellers will make model look great will fly great well pitch two three four blade propellers fully adjustable 4 24 beautifully finished hard maple blades produced three styles size range 18 30 Blade pitch controlled calibrated dial front SYNTEC hub Mounting hardware available engines 120c1 larger Try airplane today experience convenience variable pitch beauty SYNTEC SYNTEC van-pitch propellers distributed exclusively through IN rd Enterprises Inc GERARD ENTERPRISES INC W226 N825 Eastmound Dr Waukesha WI 53186 414 521-0547 Fax 414 521-0551 THE BATTERY TOOL field box tool 4 9 cell batte packs Use voltmeter loaded voltmeter check pack charge Use tt dtscharge pack read tts capactty Unit discharges 300 ma auto shar-off 11 v per rett Cycles nacks charging Battery Tool $5895 4-pc Universal Cord Set $1595 Add $5 S&H FREE shipping order both JANTRONICS 406 7273001 http//wwwwtpnetIDBEST/jtIjantronicshtmI • lIIJuII IIS Tools designed modelers modelers. gave us problem Du-Bro came up solution Making true Z-bends has long complex problem could done well until now 1 Z-Bender Z-Bender makes true 90 degree Z-bends Du-Bro 072 push rods No damage rod -just professional looking bend Unlike other tools cannot accommodate right-angle bends new Z-Bender makes true 90 degree bends Made CNC machined steel aluminum handles must-have item workbench field box Ask catalog number 783 youd like see 4-40 ver sion call us tolifree email us comments Call Write free catalog Du-Bro Products Inc 480 Bonner Rd PO Box 815 Wauconda IL 60084 1-800-848-9411 fax 847-526-1604 email rc@dubrocom website http//wwwdubrocom rudder earlier own flight training sequence item contributing cause accident root cause Would better heading have prevented accident answer maybe throttle still too high slave transmitter throttle stick idle accident may have happened some other location field Effect 7 No preflight verification made slave transmitter would kill engine Cause 10 preflight checklist incomplete root cause Item 10 original cause preflight checklist incomplete preflight checklist something can changed student able lower throttle setting fully airplane would have coasted safe landing off-heading 100foot-wide runway Further root cause proper functioning slave controller throttle control verified during preflight would have prevented accident would have no need instructor take control aircraft sequence events would have stopped aircraft wrong heading safe runway sequence events led accident 1 preflight checklist incomplete root cause As result 2 No preflight verification made slave transmitter would kill engine As result 3 slave transmitter throttle control would close throttle sufficiently Therefore 5 engine would shut off As result 6 aircraft struck stake corrective action root cause incorporate verification preflight checkoff list slave transmitter indeed set up same master both direction movement capability shut off engine contributing cause fact student held incorrect heading airplane final approach 1 flight training program did call practice flying rudder vs aileron contributing cause Therefore 2 Previous flight training emphasized using rudder As result 3 student made no rudder correction final approach change heading As result 4 aircrafi struck stake second contributing cause fact instructor did intercede adjust incorrect heading airplane final approach 1 instructor failed follow correct landing procedure contributing cause Therefore 2 instructor did correct faulty heading As result 3 aircrafi wrong heading As result 4 aircraft struck stake lack action instructor error judgment failing follow correct landing procedure making tradeoff between two goals maximizing training value minimizing risk contributing cause although sufficient result accident itself decreases margin error brings us closer accident Whether youre pilot instructor pilot student can use simple approach failure analysis tool examine few model crashes better learn occurrences prevent repeating mistakes Good flying Brooks 900 Bower Dr Idaho Falls ID 83404 Add $400 SNpping & HandlingOEALERS.if CIikIIxtaru Wit mpty.OADER DIRECT 38 Model Aviation cleEDSOLMmteurinomwIWawUwiuthWu.. AdjustablEU44P SiLOSM4SFO $1606 FitFITS Motor46 EMYA40 60ENIA 6010120 HP/40 10WEIRA6010120 OTHERS40 00 SoOTHERS 60tt 120 NO DRILUNG TAPPUG SSD Send Free Catalog & Discount Sheet SP PARTS AVAILALE.. Make Ottack PoyaMe 10 Ii DISCOUNT FOR AMA MEMOSASEdon Enterpri. t7

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