CNN posted this story where a co-pilot accidentally bumped a control while adjusting his seat, sending the plane into a 26 degree dive. Disaster was only averted by the pilot returning from the restroom, as apparently the co-pilot lacked the training to correct the error. From the article:
The aviation agency report concluded that the 25-year-old co-pilot had not been trained in the specific scenario the jet encountered and “probably had no clue to tackle this kind of emergency.”
Fortunately disaster was averted, as this story seems to have all the elements Reason’s Swiss Cheese model of accidents requires:
- Organizational influences – training, and perhaps design of controls
- Unsafe supervision – temporary absence of supervision
- Preconditions for unsafe acts - inadequate experience for the complexity of the situation
- Unsafe acts – Slip, mis-activation of a control
(These are, of course, guesses based on a short news article — I don’t pretend to know everything about this accident.)
Photo Credit grey_um