Three days of testimony before the National Transportation Safety Board (NTSB) last week about pilot fatigue, failed flying tests and cockpit warning systems placed a harsh spotlight on regional airline operations, pointing to numerous safety issues.
On February 12, 2009, a Colgan Air Bombardier Dash 8-Q400 (N200WQ) operating as Continental Connection Flight 3407, crashed during an instrument approach to Runway 23 at the Buffalo-Niagara International Airport (BUF), Buffalo, NY. All 49 persons on board were fatally injured and the airplane was destroyed by impact forces and post crash fire. There was also one ground fatality.
NTSB Acting Chairman Mark V. Rosenker said the hearing was being held for the purpose of supplementing the facts, conditions, and circumstances discovered during the on-scene and continuing investigation.
The expert testimony from NASA, FAA, Bombardier, Colgan and Air Line Pilot Association officials will assist the Safety Board in determining the probable cause of the accident and in making any recommendations to prevent similar accidents in the future. No determination of cause was rendered during the proceedings on the worst U.S. air crash in more than seven years. But the hearing exposed a slew of safety concerns involving pilot training, hiring, pay and fatigue.
The three-day hearing had a dramatic start with release of the ill-fated flight’s cockpit voice recorder transcript. Continental Connection Flight 3407 ‘s captain, Marvin Renslow, and copilot, Rebecca Shaw, appears to have violated the ‘sterile cockpit’ rule which prohibits extraneous conversation on the flight deck during landing approach.
The transcript also recorded concerns over the amount of icing. "I’ve never seen icing conditions. I’ve never deiced… I’ve never experienced any of that. I don’t want to have to experience that and make those kinds of calls. You know I’d have freaked out. I’d have like seen this much ice and thought, `Oh my gosh, we were going to crash,’ " Shaw says eerily, just minutes before the plane in fact did crash.
The cockpit voice recorder also documented activation of the stick-pusher, which automatically kicks in when a plane is about to stall, pointing the aircraft’s nose down into a dive so it can pick up enough speed to allow the pilot to guide it to a recovery.
However, when Flight 3407’s stick-pusher kicked in, Renslow pulled back on the plane’s control column, apparently trying to bring the aircraft out of the sudden dive by bringing the aircraft’s nose up. Pushing forward to gain speed is the proper procedure for a wing stall; the opposite is true for a horizontal tail stall caused by tailplane icing. NTSB investigators believe icing was not a factor in the fatal accident.
Flight 3407 experienced an aerodynamic stall, rolled over and crashed into a house, killing all 49 people aboard and one man in the house.
Board Member Debbie Hersman raised the issue of a low air speed warning system in questioning NASA scientist Robert Dismukes, an expert on cockpit distractions. Asked by Hersman if pilots might benefit from an earlier, audible low-speed warning system, Dismukes said: "Absolutely..That’s well worth looking at."
Testimony also indicated that Renslow and Shaw made critical errors that may have been the result of fatigue or insufficient training.
Renslow and Shaw were based at Newark Liberty International in New Jersey, but he commuted from his home near Tampa, FA. She lived with her parents near Seattle.
Shaw hopped a ‘red-eye’ flight to make Flight 3407. It is unclear how much sleep either pilot had the previous night.
Renslow had failed several flight simulator tests before and after he was hired by Colgan Air. He didn’t disclose his previous failures to Colgan when he was hired by the regional air carrier in 2005.
Cogan Air labeled as inaccurate allegations that the flight crew of Colgan Air Flight 3407 was scheduled by the company in such a way that it was impossible for them to get adequate rest before the flight.
"We want to emphasize that if there was a fatigue issue with Captain Marvin Renslow or First Officer Rebecca Shaw, it was not due to their work schedule. Colgan’s flight crew schedule provided rest periods for each of them that were far in excess of FAA requirements.
"Captain Renslow had nearly 22 consecutive hours of time off before he reported for duty on the day of the accident. That was nearly three times the FAA-minimum required rest period. Also, First Officer Shaw had been off work for three days since her last flight.
"Like all airlines, we support the right of our pilots to live where they choose. However, it is unclear if Captain Renslow made preparations to get proper rest prior to the flight. It is clear that First Officer Shaw did not reserve adequate time to travel from her home to her base in order to ensure she was properly rested and fit for duty.
Colgan also addressed the adequacy of pilot training at the regional air carrier. At issue is whether Renslow and Shaw received training specifically to deal with the situation that confronted them in the final seconds before the fatal accident.
"In fact, Colgan’s FAA-approved training program does provide comprehensive training on the stall warning system during initial Q400 ground school as well as annual recurrent ground school. In addition, a pilot does indeed receive hands-on experience in the flight simulator on the proper response to stick shaker activation, despite news reports to the contrary.
"Like all Colgan pilots, Captain Renslow and First Officer Shaw had thorough initial and recurrent training on how to recognize an impending stall situation through the stick shaker and how to recognize the aircraft’s response to a possible stall.
"Captain Renslow and First Officer Shaw did know what to do, had repeatedly demonstrated they knew what to do, but did not do it. We cannot speculate on why they did not use their training in dealing with the situation they faced," the company said.