• Title/Summary/Keyword: Aircraft Accident Investigation

Search Result 27, Processing Time 0.023 seconds

Suggestions for the Improvement of Aviation and Railway Accident Investigation Board in Korean (항공사고조사위원회의 업무개선에 대한 제언)

  • Han, KyoungKeun;Choi, YounChul
    • Journal of the Korean Society for Aviation and Aeronautics
    • /
    • v.25 no.4
    • /
    • pp.187-194
    • /
    • 2017
  • ICAO Universal Safety Oversight Audit Programme is a comprehensive evaluation for aviation safety matters, including aircraft operation, licensing and aircraft incident/accident investigation. As this programme is measures aviation safety level of States, there is a need to meet international standards, especially in the field of aircraft incident/accident investigation. This research discusses points required to satisfy international standards, which are independence and autonomy of an accident investigation board, the lack of the enough number of investigators and efficient management of those personnel, the effective composition and use of an investigation report, an accident investigation itself to build big data and the creation of a cooperation system among States. This paper suggests various opinions in order to enhance aviation safety especially through aircraft accident investigations, using case studies from the US, UK and Japan.

Accident Analysis & Lessons Learned of B737MAX JT610 from a Flight Control System Design Perspective (비행제어시스템 설계 관점의 B737MAX JT610편 사고분석과 교훈)

  • Moon, Jung-Ho;Cho, Hwankee
    • Journal of the Korean Society for Aviation and Aeronautics
    • /
    • v.28 no.1
    • /
    • pp.106-114
    • /
    • 2020
  • The Lion Air JT610 accident in Indonesia in October 2018, along with the Ethiopian Airline ET302 accident in March 2019, is an significant aircraft accident that detects defects of the B737MAX aircraft. Shortly after the accident, the FAA prohibited operation of the aircraft. This action has affected the market environment of airlines and aircraft manufacturers around the world. In October 2019, Indonesian Traffic Safety Committee released an accident investigation report for Lion Air JT610, which concluded that the causes of the accident were MCAS design defects, lack of education and training, and errors in the repair process. This paper summarizes the flight control system of the B737MAX aircraft, the causes of the accident based on the final accident investigation report, and provides considerations for aircraft design and retrofit.

Study on Aircraft Accident Investigation (군항공기사고조사에 관한 연구)

  • Kim, Hae-Ma-Joong;Ha, Hong-Young;Hong, Sang-Beom
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.18
    • /
    • pp.325-362
    • /
    • 2003
  • In an effort to enhance the independence of and expertise in military aircraft accident investigation, a permanent accident investigation board should be established. Establishing permanent accident investigation board would render the military accident investigation more reliable and would increase its public esteem. Because there is no provision governing the responsibilities of the investigation and cooperation between civil and military authority in case that both civil and military aircraft are involved, it is necessary to fill this gap by enacting appropriate laws. In case of civil aircraft accident investigation involving a military issue, it would be better to allow military authority to be involved in the investigation. For the betterment of investigation, it is also necessary to provide a field investigator an authority to directly collect relevant information. Since the sole purpose of accident investigation is to prevent the recurrence of aircraft accidents, the scope of information disclosure should be limited and the investigation report shall be used for neither criminal procedure nor disciplinary procedure so that the objectivity of the investigation should be ensured.

  • PDF

A Study on the Development of New Tools for Investigation the Potential Accident Factors (사고잠재요인 조사도구개발에 관한 연구)

  • Kim, Chil-Yeong;Song, Byeong-Heum;Mun, Bong-Seop
    • Journal of the Korean Society for Aviation and Aeronautics
    • /
    • v.8 no.1
    • /
    • pp.41-56
    • /
    • 2000
  • In the Aircraft Incident Reporting System(AIRS), It is important to collect and gather date about aircraft incidents by means of systemic methods and make it materials for study in the view point of aircraft accident in the future. Especially, the development of such effective tools can be one of main factors determining whether the investigation of potential accident factors succeeds or fails. For such a reason and the purpose of aircraft accident prevention, the AIRS compatible to each county has been developed early and been adopting now in several countries involving USA. First this study examine the actual condition about investigation method tools of potential accident factors used in several countries and investigation and analyze them, finally present the method which can improve more acceptable forms to flight crew used at the KAIRS(Korean AIRS).

  • PDF

A Study on the System of Aircraft Investigation (항공기(航空機) 사고조사제도(事故調査制度)에 관한 연구(硏究))

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.9
    • /
    • pp.85-143
    • /
    • 1997
  • The main purpose of the investigation of an accident caused by aircraft is to be prevented the sudden and casual accidents caused by wilful misconduct and fault from pilots, air traffic controllers, hijack, trouble of engine and machinery of aircraft, turbulence during the bad weather, collision between birds and aircraft, near miss flight by aircrafts etc. It is not the purpose of this activity to apportion blame or liability for offender of aircraft accidents. Accidents to aircraft, especially those involving the general public and their property, are a matter of great concern to the aviation community. The system of international regulation exists to improve safety and minimize, as far as possible, the risk of accidents but when they do occur there is a web of systems and procedures to investigate and respond to them. I would like to trace the general line of regulation from an international source in the Chicago Convention of 1944. Article 26 of the Convention lays down the basic principle for the investigation of the aircraft accident. Where there has been an accident to an aircraft of a contracting state which occurs in the territory of another contracting state and which involves death or serious injury or indicates serious technical defect in the aircraft or air navigation facilities, the state in which the accident occurs must institute an inquiry into the circumstances of the accident. That inquiry will be in accordance, in so far as its law permits, with the procedure which may be recommended from time to time by the International Civil Aviation Organization ICAO). There are very general provisions but they state two essential principles: first, in certain circumstances there must be an investigation, and second, who is to be responsible for undertaking that investigation. The latter is an important point to establish otherwise there could be at least two states claiming jurisdiction on the inquiry. The Chicago Convention also provides that the state where the aircraft is registered is to be given the opportunity to appoint observers to be present at the inquiry and the state holding the inquiry must communicate the report and findings in the matter to that other state. It is worth noting that the Chicago Convention (Article 25) also makes provision for assisting aircraft in distress. Each contracting state undertakes to provide such measures of assistance to aircraft in distress in its territory as it may find practicable and to permit (subject to control by its own authorities) the owner of the aircraft or authorities of the state in which the aircraft is registered, to provide such measures of assistance as may be necessitated by circumstances. Significantly, the undertaking can only be given by contracting state but the duty to provide assistance is not limited to aircraft registered in another contracting state, but presumably any aircraft in distress in the territory of the contracting state. Finally, the Convention envisages further regulations (normally to be produced under the auspices of ICAO). In this case the Convention provides that each contracting state, when undertaking a search for missing aircraft, will collaborate in co-ordinated measures which may be recommended from time to time pursuant to the Convention. Since 1944 further international regulations relating to safety and investigation of accidents have been made, both pursuant to Chicago Convention and, in particular, through the vehicle of the ICAO which has, for example, set up an accident and reporting system. By requiring the reporting of certain accidents and incidents it is building up an information service for the benefit of member states. However, Chicago Convention provides that each contracting state undertakes collaborate in securing the highest practicable degree of uniformity in regulations, standards, procedures and organization in relation to aircraft, personnel, airways and auxiliary services in all matters in which such uniformity will facilitate and improve air navigation. To this end, ICAO is to adopt and amend from time to time, as may be necessary, international standards and recommended practices and procedures dealing with, among other things, aircraft in distress and investigation of accidents. Standards and Recommended Practices for Aircraft Accident Injuries were first adopted by the ICAO Council on 11 April 1951 pursuant to Article 37 of the Chicago Convention on International Civil Aviation and were designated as Annex 13 to the Convention. The Standards Recommended Practices were based on Recommendations of the Accident Investigation Division at its first Session in February 1946 which were further developed at the Second Session of the Division in February 1947. The 2nd Edition (1966), 3rd Edition, (1973), 4th Edition (1976), 5th Edition (1979), 6th Edition (1981), 7th Edition (1988), 8th Edition (1992) of the Annex 13 (Aircraft Accident and Incident Investigation) of the Chicago Convention was amended eight times by the ICAO Council since 1966. Annex 13 sets out in detail the international standards and recommended practices to be adopted by contracting states in dealing with a serious accident to an aircraft of a contracting state occurring in the territory of another contracting state, known as the state of occurrence. It provides, principally, that the state in which the aircraft is registered is to be given the opportunity to appoint an accredited representative to be present at the inquiry conducted by the state in which the serious aircraft accident occurs. Article 26 of the Chicago Convention does not indicate what the accredited representative is to do but Annex 13 amplifies his rights and duties. In particular, the accredited representative participates in the inquiry by visiting the scene of the accident, examining the wreckage, questioning witnesses, having full access to all relevant evidence, receiving copies of all pertinent documents and making submissions in respect of the various elements of the inquiry. The main shortcomings of the present system for aircraft accident investigation are that some contracting sates are not applying Annex 13 within its express terms, although they are contracting states. Further, and much more important in practice, there are many countries which apply the letter of Annex 13 in such a way as to sterilise its spirit. This appears to be due to a number of causes often found in combination. Firstly, the requirements of the local law and of the local procedures are interpreted and applied so as preclude a more efficient investigation under Annex 13 in favour of a legalistic and sterile interpretation of its terms. Sometimes this results from a distrust of the motives of persons and bodies wishing to participate or from commercial or related to matters of liability and bodies. These may be political, commercial or related to matters of liability and insurance. Secondly, there is said to be a conscious desire to conduct the investigation in some contracting states in such a way as to absolve from any possibility of blame the authorities or nationals, whether manufacturers, operators or air traffic controllers, of the country in which the inquiry is held. The EEC has also had an input into accidents and investigations. In particular, a directive was issued in December 1980 encouraging the uniformity of standards within the EEC by means of joint co-operation of accident investigation. The sharing of and assisting with technical facilities and information was considered an important means of achieving these goals. It has since been proposed that a European accident investigation committee should be set up by the EEC (Council Directive 80/1266 of 1 December 1980). After I would like to introduce the summary of the legislation examples and system for aircraft accidents investigation of the United States, the United Kingdom, Canada, Germany, The Netherlands, Sweden, Swiss, New Zealand and Japan, and I am going to mention the present system, regulations and aviation act for the aircraft accident investigation in Korea. Furthermore I would like to point out the shortcomings of the present system and regulations and aviation act for the aircraft accident investigation and then I will suggest my personal opinion on the new and dramatic innovation on the system for aircraft accident investigation in Korea. I propose that it is necessary and desirable for us to make a new legislation or to revise the existing aviation act in order to establish the standing and independent Committee of Aircraft Accident Investigation under the Korean Government.

  • PDF

A Study on the Legal Issues relating to the Aircraft Accident and its Investigation (항공기사고와 사고조사에 관한 법적 제 문제에 대한 고찰)

  • Kim, Jong-Bok
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.19 no.2
    • /
    • pp.137-162
    • /
    • 2004
  • Generally the aircraft accident caused a great loss of lives, severe property damages including aircraft's total loss and thus, affect enormous emotional and economic damages to the public. We, therefore, should try every efforts to prevent the re-occurrence of aircraft accident by examining the cause of accident closely and discovering it through aircraft accident investigation. Though the object of an accident investigation is not to apportion blame but to discover a cause or causes of an accident to prevent future accidents, the cause of an accident would play a vital role in determining the liability of the carrier, legal relationship with the third party and jurisdiction, etc. in the aviation litigation. Therefore, it is very important that aircraft accident investigation are carried out by a professional and independent agency. Also, it needs for us to be careful in applying investigation results in the courts not to be deterrent to discovering the cause of accident. Korea now has the Aviation Accident Investigation Agency Board under the Korean Ministry of Construction and Transportation, but unfortunately it is often pointed out that it lacks professionalism and independency due to the bureaucratism of the Government. We, therefore, should establish a professional and independent aircraft accident investigation agency like United States' NTSB and reflect the issues mentioned-above on the new Act.

  • PDF

A Study on Legal and Institutional Improvement Measures for the Effective Implementation of SMS -Focusing on Aircraft Accident Investigation-

  • Yoo, Kyung-In
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.32 no.2
    • /
    • pp.101-127
    • /
    • 2017
  • Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.

  • PDF

A Study on the Legal and Systemic Aspect of Aviation Accident Investigation Organization -Focusing on the Improvement Method- (항공사고조사기구(航空事故調査機構)에 관한 법적(法的) 제도적(制度的) 고찰(考察) -개선방안(改善方案)을 중심(中心)으로-)

  • Yoo, Kyung-In;Kim, Maeng-Sern
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.19 no.1
    • /
    • pp.109-139
    • /
    • 2004
  • The first successful sustained powered flight by Wright Brothers was further extended to the rapid development of aviation technology, that led to transpacific flights, the invention of supersonic planes, and enabled hundreds of people to travel in the space, in addition to the fact that around 10 people had stepped on the moon, all of which were made possible within the very same century. However, on the back side of this most wondrous human technology, the vulnerableness to the aviation accident has been constantly accompanied with, right from the very beginning stage of the aircraft development. Moreover, the development of future aircraft is being focused on the aircraft performance, the increment of the number of passengers aboard and also its speed. In proportion to these phenomena of mega sizing the aircraft, the development of new technology and the increment of air traffic volume, the number of aviation accident is expected to augment, resulting in the enormous loss of human lives and properties. In order to prevent the disastrous aviation accident as such, it is essential to conduct the accident investigation in a specialized, systematic and scientific manner. In search for the method to attain the effective function of the aviation accident investigation organization, in this study, issues were examined as follows: The full-time Board Members and the establishment of an integrated investigation agency, The systematized security of status as an accident investigator, Inclusion of a human factors specialist in the investigator group organization, liability limit of an accident investigator Stipulation of the definition and the investigation scope of an accident and serious incident, along with the main body of conducting the investigation into the accident involving both civil and public aircraft, in the regulations related to the accident investigation.

  • PDF

Aviation Accident Investigation Organization and Assistance to Aircraft Accident Victims and Their Families for Air Operation Accident (항공 사고 조사 기구와 항공운항사고 시 희생자 및 그 유가족 지원에 대하여)

  • Lee, Hak-Bong;Song, Byeong-Heum;Byeon, Sun-Cheol
    • 한국항공운항학회:학술대회논문집
    • /
    • 2016.05a
    • /
    • pp.95-98
    • /
    • 2016
  • It is true that Aircraft accident investigation organization of Republic of Korea does not have independent role structurally and administratively. Also, in the event of an aviation accident it does not take the appropriate response and post-institutional measures for victims and their families support. With aware of this fact and to improvement this research paper present approach direction and suggestion of issues and implications for those by researching the operational practices of the United State's Victim Family support.

  • PDF

Classification and Analysis of Human Error Accidents of Helicopter Pilots in Korea (국내 헬리콥터 조종사 인적오류 사고 분류 및 분석)

  • Yu, TaeJung;Kwon, YoungGuk;Song, Byeong-Heum
    • Journal of the Korean Society for Aviation and Aeronautics
    • /
    • v.28 no.4
    • /
    • pp.21-31
    • /
    • 2020
  • There are two to three helicopter accidents every year in Korea, representing 5.7 deaths per 100,000 flights. In this study, an analysis was conducted on helicopter accidents that occurred in Korea from 2005 to 2017. The accident analysis was based on the aircraft accident and incident report published by the Aircraft and Railway Accident Investigation Board. This Research analyzed the characteristics of accidents occurring in Korea caused by human error by pilots. Accident analysis was done by classifying the organization, flight mission, aircraft class, flight stage, accident cause, etc. Pilot's huan error was classified as Skill-based error, decision error and perceptual error in accordance with the HFACS taxonomy. The accidents caused by pilot's human error were classified into five categories: powerlines collision, loss of control, fuel exhaustion, unstable approach to reservoir, and elimination of tail rotor.