I normally write a column on instrument flying, which usually covers procedures and avionics. There are times that aviation decision-making and human factors both play a role in aircraft accidents, whether IFR or VFR. There are many contributing factors to aircraft accidents. For example, in instrument flying, it may be misunderstanding procedures or not understanding the equipment onboard the aircraft. Another factor contributing to aircraft accidents can relate to maintenance. For example, we recently found a bolt that was not tightened down, allowing some baffling to rub on the fuel line, which was about to rupture. If this should happen, we are in deep trouble because it would probably cause an engine fire.
Accidents can happen in VFR or IFR conditions that are caused or partially caused by human factors. There is another area to consider in aircraft accidents, and a lot of us look at those as being very stupid because much of this goes back to human factors and aeronautical decision-making. I have prepared a presentation, “Hold My Beer and Watch This.” I will be presenting this on an FAA webinar in late August or early September. This presentation highlights several accidents that were caused by simple pilot stupidity. In other words, not thinking about the issue and the consequences before we do them, which make us shake our heads and wonder how these accidents could happen.
In our Bonanza Baron Pilot Training Program (BPT), we have a course dealing with human factors and aeronautical decision-making. An example of an IFR accident was when the pilot ignored good judgment and decided after a long day of fishing in Florida, to depart the next day in the early hours of the morning, and head for Hampton Roads, Virginia. With the pilot being tired and not having properly analyzed the weather, he departed Key West, Florida for Hampton Roads. After two unsuccessful approaches in low IFR conditions, strong winds, turbulence, and running low on fuel, along with being unfamiliar with the aircraft avionics package, the pilot attempted an approach to Norfolk, Virginia, which ended up killing himself and two passengers. We must wonder what this pilot was thinking.
A VFR example of another bad decision was a pilot who decided to fly through the St. Louis arch. This pilot did not have an accident and brags about how he pulled off this stunt. Many of these same types of situations, however, end up in accidents and many of them are fatal. My presentation on PowerPoint, “Hold My Beer and Watch This,” encompasses situations that many of us cannot believe.
There are five (5) hazardous thought patterns that are taught to pilots in flight training, and it is important for us to recognize these situations and stop a dangerous situation from happening before it begins
Another part of this thought process involves “destination-itis.” On one of my own situations, I departed Ilopango Airport (MSSS) in El Salvador heading to my home airport of Lone Rock, Wisconsin (KLNR) with a friend as co-pilot. After arriving at Key West, Florida, we cleared U.S. Customs, refueled, checked weather and filed for Bowling Green, Kentucky (KBWG), which was our next fuel stop. After an already long day of flying, we departed on our final leg with a full load of fuel for Lone Rock, Wis. (KLNR). Approaching Rockford, Illinois (KRFD), we contacted Flight Service for updated weather to learn that Lone Rock had a low ceiling and poor visibility in snow, while at the same time Dane County Regional Airport in Madison, Wis. (KMSN), 35 miles to the east, still showed clear skies. In my determination of “get home-itis,” and a desire to sleep in my own bed that night, I made a poor decision and did an icy approach into Lone Rock. There was no such thing as a go-around as I had picked up a heavy load of ice. I could have easily diverted to Madison, gotten a motel, and returned home the next day, but didn’t. We all fall for these scenarios.
In many cases, lessons are learned but not applied until years later. I applied the above learned lesson many years later when I was returning from Deer Lake, Newfoundland in my Bonanza. I cleared U.S. Customs in Houlton, Maine (KHUL), and refueled in Akron, Ohio (KAKR). While crossing Lake Michigan, I checked the weather radar on Sirius XM Weather, which was not available to me in the previous incident. I saw a line of thunderstorms encroaching at my destination airport (Lone Rock, Wisconsin KLNR). My decision then was to go into Madison, park the airplane, and fly home the next day.
In one of my previous columns, I spoke about new technology to eliminate some of our human factors. This was called Controller-Pilot Data Link Communications (CPDLC), which allows controllers and pilots to transfer clearances digitally, eliminating the human factor of having to enter and read them back. A study has been done on human factors showing that automobiles driven by autopilots are seven times less likely to get into accidents (Tesla autopilot). Today, and for many years in the future, humans will be making decisions, and human factors will be a contributing factor in accidents and incidents. It may be a mechanic forgetting to tighten a bolt, a controller giving a bad clearance, a pilot programing a flight management system (FMS), or a simple communications error. The best we can do is recognize the hazardous thought patterns, develop new procedures, and use “checklists.” Look on the FAA website for the date of my webinar presentation: “Hold My Beer and Watch This.” Watch for upcoming events to be posted later. https://www.faasafety.gov/spans/events/eventlist.aspx
