1

DRAFT AIRSHOW ACCIDENT REVIEW 2012

The tenets expressed in this review are those of the author and addresses a sample of significant accidents and incidents at aerial events worldwide in 2012, both during actual events and during rehearsals and includes, airshows, air races, flypasts, and air capability demonstrations; in fact, any event at which an aircraft is displayed or rehearses for an air event, in which the flow of the event is jeopardised.

Des Barker

“I have learned that carelessness and overconfidence are usually far more dangerous than deliberately accepted risks.” (Wilbur Wright 1900 in a letter to his father)

INTRODUCTION

If there was an international newspaper that covered airshows, the headlines at the end of the airshow calendar for 2012, would most probably have read: “An Historic Achievement - Year Ends With No Spectator or Public Deaths”. Why would this be so newsworthy? Well, since the inception of ‘air events’ in 1908, there have hardly been any years without death or injury to spectators or members of the public – such years are relatively rare. However, despite this achievement in reducing collateral losses, the death’s of thirteen display pilots in one year, remains unacceptable and emphasizes the requirement for ongoing ‘in your face’ safety education programmes for airshow participants from both the ground and air community. Every year, events on the periphery of airshows, in some way or the other, affect the community, positively, or negatively, and 2012 had its fair share.

AIRSHOW EVENTS

FAA Public Hearing “Galloping Ghost”.

Most significantly in the USA, the display community anxiously watched the deliberations emanating from the FAA public hearing into the Reno Air Race accident 2011 in which Jimmy Leewards’ souped-up’ Mustang, “Galloping Ghost”, crashed in front of VIP boxes, killing Leeward and 10 spectators and injuring 70. The recommendations flowing from the FAA hearing could have had significantly adverse effects on the airshow community, not only air racing. However, the community were relieved, in January, when an FAA official stated: “it's unlikely there will be significant changes to airshow and air race safety rules”. If the FAA becomes aware "of a risk that exceeds the boundary of what we think is acceptable, we will make those changes. But not currently," he said.

The ‘good news’ of January was to turn in to rather bad news by the end of 2012 and could constitute a threat in future to the airshow community, particularly in terms of insurance costs. A ‘wrongful death’ lawsuit was filed in Texas on 31 October 2011 by the wife of a man killed in the crash. A $25 million lawsuit against the pilot and the Texas company that modified the Mustang, ‘Galloping Ghost’ was filed calling the crash a “predictable result of a reckless drive for speed by a risk-taking pilot and crew, coupled with an insatiable drive for profit by those who stood to profit from the show. The decisions arising from the court case, could set a precedent for litigation in future airshow accidents and incidents, the results of which are not yet evident.

At the time of the crash, the defendant in the case, was in fourth place and was rounding the last pylon when the plane pitched up, rolled inverted and then pitched down. The airplane crashed into the box section of the seats and exploded in front of the grandstands.

Craig Salerno, husband to Sezen Altug and father of two young children, was sitting in the box sitting area and was killed instantly. According to the lawsuit, the former military aircraft had undergone major modifications. The plaintiff argued that the P-51D airplane was never designed to operate at speeds approaching 550 mph. Defendant Richard Shanholtzer, an expert in aircraft modifications, changed the aerodynamics of the aircraft, such as shortening the wingspan over 10 feet from the plane’s original design, the suit states.

According to the lawsuit, the aircraft mechanics reported that the pilot’s team was having trouble with the electronically controlled trim-tab and that the aircraft lost the trim-tab, causing it to abruptly pitch up and as a result, the pilot lost consciousness and complete control of the aircraft. In an interesting legal twist on matters, defendant Reno Air Racing Association is accused of:

·  Negligence for failing to warn spectators of the risks associated with the air race.

·  Negligence for failing to test the plane’s modifications.

·  Failing to examine the parameters of the expected flight.

·  Failing to warn spectators that the plane was having issues.

·  Failing to warn spectators of the inherent risks with the race itself and spectator positioning.

The plaintiffs asked for an award of damages not to exceed $25 million in compensatory and punitive damages for loss of consortium, loss of society, loss of earning capacity, pain and suffering, mental anguish, interest and court costs.[1]

For 2012, organizers of the National Air Racing Championships secured $100 million in necessary insurance and changed the race course for the fastest planes to keep them farther from spectators by moving the largest pylon course for the 49th annual championships away from the crowd. The change would include the softening of some curves to ease the gravitational pull on pilots, including coming out of a stretch called the "Valley of Speed" where aircraft flying at speeds up to 500 mph gain momentum on the high Sierra plateau north of Reno. It will make the race course on the turn there, more consistent and probably less of a g-strain, for the less experienced race pilots. The announcements were made after a ‘blue ribbon panel’ of experts appointed by the association unveiled its list of safety recommendations, including formalizing plane inspection procedures.

The four-member panel, also advised further study of possible age limits for pilots. Jimmy Leeward was 74. The panel talked at length about whether age limits or other increased medical requirements should be imposed, but decided that they were not qualified to make "what are in effect medical recommendations." Instead, they urged the association to create a formal position of director of aerospace medicine to review areas such as pilot age and the medical impact of gravitational forces on pilots.

Other suggestions included creating an internal evaluation program modeled after the kind airlines use and formalizing inspection procedures to be sure "uncorrected discrepancies" regarding airplane modifications "do not slip through the system." The association continues to face financial challenges, having lost about $1 million last year and facing a $1.7 million increase in its insurance premium under the new deal with underwriters.[2]

International Council of Airshows

ICAS Board of Directors, in it’s ongoing drive to enhance safety, adopted a resolution that read, in part, that in 2017, ICAS will be an organization that…“is recognized as a leader in the general aviation and aerial entertainment arenas, and sets the world standard for airshow safety, performer proficiency and industry business practices, resulting in a stable foundation for the growth and development of the airshow industry.”

In that light, several Key Result Areas (KRA) with a “Board Champion”, were assigned to oversee several action plans. Ralph Royce’s Key Result Area assignment is Safety, and he was tasked with developing a set of draft goals which, if achieved, would pave the way for a successful achievement of the five-year ICAS vision.

At this point Royce has started with the general goals, with the how and why particulars to be fleshed out when the Safety goals will be matched with other 9 or 10 affected KRAs, a detailed analysis to refine the targeted items would commence and develop a specifically measurable, realistically achievable, and timely flight plan to achieve the objective. The first areas identified as possible KRAs include:

þ  Analysis/Summary of safety issues to be sure we really know where and what the real safety issues are rather than what everybody thinks they are;

þ  Continue to institutionalize the Safety Management Program, give it a prominent role in the industry and wide dissemination of its findings;

þ  Flying Safety to include pilot selection and progression; maneuvers and maneuver packages; air boss industry endorsement; professionalizing the ACE program, role of the military, clear and consistent interpretation of ICAS and FAA rules etc;

þ  Ground Safety to include all aspects of site build-up/teardown, the aerobatic box and its depiction; ingress/egress; etc;

þ  Relationship of the industry to the other industry safety organizations and their programs and to the regulating organization and its policies.

Red Arrows

Across the Atlantic in the UK, demonstrating a stringently disciplined approach to safety, Britain’s first female Red Arrows pilot, Flt Lt Kirsty Stewart, Red 9, with one year of her tour remaining, was transferred from the tightly-knit aerobatic outfit to a ground role, suffering from stress after the deaths of two members of the team in 2011. Flt Lt Jon Egging, Red 4, died in August 2011 when he crashed near Bournemouth after a display and in November 2011, Flt Lt Sean Cunningham, Red 5, was killed when he was ejected from his Hawk T1 while it was on the runway at RAF Scampton.

The strain of the double tragedy left Stewart unable to be absolutely focused on flying for another demanding display season. Senior officers were concerned and ruled that she was not "in the right place" to fly and made the tough decision to reassign her.[3]

An MoD spokesman said: "The Red Arrows will conduct aerobatic displays with seven aircraft rather than the usual nine in 2012 due to the unavoidable posting of one of their pilots. "With safety paramount, the quality of the displays remain vitally important, it has been decided that seven aircraft presents the most visually-balanced and dynamic formation. The team will still carry out official flypasts with nine aircraft and will return to a full aerobatic formation of nine aircraft in 2013."

ICASs ‘OPS BULL’

ICASs monthly safety newsletter “Ops Bull” introduced ‘real and relevant’ safety article topics to provide continuous ‘in your face’ safety messages to focus the airshow community on the environmental risks that exist in airshows and display flying. Typical topics covered included "Safety is for sissies!" which highlighted the basics of surviving the airshow circuit thorough briefings and de-briefings, frequent practice and continual risk identification and mitigation.

Thoughtful consideration of energy management issues and how to respond to emergency situations at every point in the maneuver sequence, rigorous self-assessment before every flight, active elimination of pre-flight distractions, unemotional consideration of constructive criticism offered by fellow pilots, careful integration of new maneuvers into an established air show sequence, meticulously well-maintained equipment and an ongoing program to maintain physical conditioning were some of the pointers offered.

There is nothing any of us can do that will completely eliminate the risks inherent in low-level aerobatic flying, but approaching those risks as a professional is an airshow performer's surest path to predictable outcomes on every flight. It's not enough to simply aspire to being safe; it takes a commitment to professionalism.

In another article, “Pride Goeth Before a Fall”, the writer argued the timeless admonition that translates well in any language, including the language of airshows. In the event that a performer, event organizer or support service provider compromises the pride they take in doing their work, the results can be catastrophic. If a performer settles for less than his very best effort during a particular performance or on an individual maneuver, the fall will come. The margins for error are often so small that a tiny lapse, even by a veteran, can have tragic consequences. And, sadly, this lesson has been written in the blood of some of industry’s most talented and experienced pilots.

Similarly, even well-established shows can suffer problems and even tragedies, if key individuals become too confident or casual while working in the unforgiving airshow environment. Allowing activities that are unsafe, unplanned or against the established best practices and regulations, will eventually result in financial, publicity or safety problems.

In fact, the proverb could be even more appropriate for the airshow community with a little light editing: ‘professionalism goeth before the fall’. In other words, when we stop giving, demanding and expecting the very best of ourselves, those we work with and those we work for, the end result will always be failure. Thankfully, the inverse is also true; when we give, expect and execute in accordance with the highest standards of excellence, the end result will always be success.

The physiological aspects of display flying are not necessarily afforded the required attention and in this particular case, in the Midwest, drought adversely affected vast expanses of the country which experience record high temperatures and record low precipitation. ICAS made a call to take a collective step back and examine how the airshow industry should respond to environmental conditions. Such record-setting extremes can cause significant issues for both performers and event organizers alike, so the negative aspects of heat effects were revisited by considering the effect of heat on energy burn and fatigue, particularly critical during complex activities such as aerobatics.

The effect of sweating and fluid loss and the importance of replenishment to enable the body can still function at its peak performance levels, was emphasised. Decision making, G tolerance and even spectator health are directly impacted. Performers - drink more water. Event organizers - have more water available for performers and spectators. In two separate cases during the last twelve years, grass fires in parking areas at airshows resulted in immense fires causing millions of dollars in damage to the cars parked there. You’ll hear these incidents referred to as “Car-B-Ques.”.

Another article on Risk Mitigation addressed the topic from the perspective of the game of risk, ‘Black Jack’ from a point of view of small changes in risks, have big rewards. The airshow business needs simple tools that performers and producers can use to tip the odds and rake the table. The ICAS initiative to change the culture of airshow safety is about making rational decisions regarding the risks and searching for ways to reduce them. A simple methodology to start the process was propagated: