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Posted

One of my friends told me that he had counselled a pilot a few times about his dangerous behaviour. Then the "accident" - I call it a murder-suicide - and my friend was criticised by the coroner for not reporting him to CASA.

 

We've discussed this subject here before, and we will again.

 

http://www.northernstar.com.au/story/2012/05/18/pilots-gross-negligence-cause-of-ultralight-crash/

 

"I'm devastated. I just can't believe that for so long people just sat on their hands and did nothing, even though they knew this young man was taking risks and flying dangerously," she said.

I visited interstate recently and some-one confided in me a concern he had about a particular pilot and aerobatics - why tell me, nothing I can do. I've had a few short discussions with people like that over the years eg some-one told me he "saw an instructor do aerobatics in a Piper Warrior" - tell the owner of the aeroplane or CASA - he didn't.The stories rarely have a happy ending.

 

 

Posted
One of my friends told me that he had counselled a pilot a few times about his dangerous behaviour. Then the "accident" - I call it a murder-suicide - and my friend was criticised by the coroner for not reporting him to CASA.We've discussed this subject here before, and we will again.

http://www.northernstar.com.au/story/2012/05/18/pilots-gross-negligence-cause-of-ultralight-crash/

 

I visited interstate recently and some-one confided in me a concern he had about a particular pilot and aerobatics - why tell me, nothing I can do. I've had a few short discussions with people like that over the years eg some-one told me he "saw an instructor do aerobatics in a Piper Warrior" - tell the owner of the aeroplane or CASA - he didn't.

 

The stories rarely have a happy ending.

The Coroners Court is not a comfortable place for pilots. Try not to go there!

 

It seems that we are highly critical of each other,for often finnicky reasons, in these online forums - but avoid reporting dangerous pilots because of the good ol' Aussie 'don't dob in your mates' tradition. There are some other reasons but we've long been conditioned by the aussie anti-authority attitudes of our elders.

 

It's a fact that high risk activities such as aeros and low flying attract the risk takers. Often these are really skilled pilots, but just haven't had the experience to know their limitations. As well, there's an attitude prevailing in these pilots that you can DYO training in these activities, and that will shorten up the endorsement time,(= save money), when you 'have' to gain the endorsement. And it's quite daunting to try to counsel an 'alpha' male - as it might end in your being assaulted, plus it seems to incentivise them to exceed their previous stupidity.

 

I cringe when hearing of new PPL's heading out to the station country to become a stationhand.... with 'special responsibility' for using the station aircraft for 'stock-spotting'. We all know that's just a euphemism for low level mustering. Without any training - either via official instructing or on-the-job instruction, it's dangerous stuff. Then, if they survive, the word was/is spread via the aero club bar method. These days, a record of their exploits might also turn up on U-tube.

 

happy days,

 

 

Guest trishok
Posted

Northern Star Newspaper Lismore dated 17/5/2012

 

"THE GRANDMOTHER of the pilot who was one of two men who died in an ultralight crash at Tatham in 2010 has told a coronial inquest her grandson's ADHD contributed to their death.

 

Michael O'Keefe and his passenger Josef Hainaut died on a return trip to Casino from Lismore when their ultralight crashed into a paddock on May 7, 2010.

 

Patricia O'Keefe said her grandson Michael was diagnosed with attention deficit hyperactivity disorder (ADHD) when he was aged four. She described him as "a law unto himself" and "a handful" due to ADHD which he had been unmedicated for since he was six.

 

"I do think that ADHD did contribute to Michael and Josef's death and my doctor does too," she said.

 

"I do believe Michael and Josef died because of Michael's impulsive behaviour."

 

Mrs O'Keefe told the court there were now draft regulations put in place by the Civil Aviation Safety Authority (CASA) regarding pilots with ADHD.

 

The court heard Mr O'Keefe's licence was never suspended but after he was spoken to about performing illegal manoeuvres in February 2009 he did not fly for about 12 months.

 

The man responsible for police investigations into aviation fatalities, Chief Inspector Hurley, said he was in no doubt that if the engine had failed Mr O'Keefe would have had the skills to land the ultralight.

 

Mrs Hainaut's solicitor David Evenden said the family would like to see changes in the requirements for scheduled maintenance, for which the onus currently falls on the pilot, through changes in regi- stration guidelines for recreational aircraft.

 

Mr Evenden and Coroner's Assistant Sgt Rowe retired at 3pm to consider their recommendations for the Coroner.

 

Coroner Jeff Linden will hand down his recommendations today."

 

Adult ADD ADHD Self Test

 

[/url]

 

Adult ADHD ADD Checklist

 

General Adult

 

[/url]ADHD

 

Symptom

 

Checklist

 

In conjunction with other diagnostic techniques the following general adult ADHD checklist helps further define ADHD symptoms. No ADHD adult has all of the symptoms, but if you notice a strong presence of more than 20 of these symptoms, there is a strong likelihood of ADHD.

 

Please read this list of behaviors and rate yourself (or the person who has asked you to rate him or her) on each behavior listed. Print the text below and then, using the following scale, and place the appropriate number next to the item. The scoring procedure is at the end of the test.

 

0 = Never 1 = Rarely 2 = Occasionally 3 = Frequently 4 = Very Frequently

 

IMPORTANT: This is not a tool for self-diagnosis. Its purpose is simply to help you determine whether ADHD may be a factor in the behavior of the person you are assessing using this checklist. An actual diagnosis can be made only by an experienced professional.

 

Past History

 

_____ History of ADHD symptoms in childhood, such as distractibility, short

 

attention

 

span

 

, impulsiveness or restlessness. ADHD doesn't start at age 30.

 

_____ History of not living up to potential in school or work (report cards with comments such as not living up to potential)

 

_____ History of frequent behavior problems in school (mostly for males)

 

_____ History of bed-wetting past age 5

 

_____ Family history of ADD, learning problems,

 

mood

 

disorders

 

or substance abuse problems

 

Short Attention Span/Distractibility

 

_____ Short attention span, unless very interested in something

 

_____ Easily distracted, tendency to drift away (although at times can be hyper focused)

 

_____ Lacks attention to detail, due to distractibility

 

_____ Trouble listening carefully to directions

 

_____ Frequently misplaces things

 

_____ Skips around while reading or goes to the end first, trouble staying on track

 

_____ Difficulty learning new games because it is hard to stay on track during directions

 

_____ Easily distracted during sex causing frequent breaks or turnoffs during love making

 

_____ Poor listening skills

 

_____ Tendency to be easily bored (tunes out)

 

Restlessness

 

_____ Restlessness, constant motion, legs moving, fidgety

 

_____ Has to be moving in order to think

 

_____ Trouble sitting still, such as trouble sitting in one place for too long, sitting at a desk job for long periods, sitting through a movie

 

_____ An internal sense of anxiety or nervousness

 

Impulsiveness

 

_____ Impulsive in words and/or actions (spending)

 

_____ Say just what comes to mind without considering its impact (tactless)

 

_____ Trouble going through established channels, trouble following proper procedure, an attitude of, "Read the directions only if all else fails."

 

_____ Impatient, low frustration tolerance

 

_____ A prisoner of the moment

 

_____ Frequent traffic violations

 

_____ Frequent, impulsive job changes

 

_____ Tendency to embarrass others

 

_____ Lying or stealing on impulse

 

Poor Organization

 

_____ Poor organization and planning, trouble maintaining an organized work/living area

 

_____ Chronically late or chronically in a hurry

 

_____ Often has piles of stuff

 

_____ Easily overwhelmed by tasks of daily living

 

_____ Poor financial management (late bills, checkbook a mess, spending unnecessary money on late fees)

 

_____ Some adults with ADHD are very successful, but often only if they are surrounded with people who organize them.

 

Problems Getting Started and Following Through

 

_____ Chronic procrastination or trouble getting started

 

_____ Starting projects but not finishing them, poor follow through

 

_____ Enthusiastic beginnings but poor endings

 

_____ Spends excessive time at work because of inefficiencies

 

_____ Inconsistent work performance

 

Negative Internal Feelings

 

_____ Chronic sense of underachievement, feeling you should be much further along in your life

 

_____ Chronic problems with self-esteem

 

_____ Sense of impending doom

 

_____ Mood swings

 

_____ Negativity

 

_____ Frequent feeling of demoralization or that things won't work out for you

 

Relational Difficulties

 

_____ Trouble sustaining friendships or intimate relationships, promiscuity

 

_____ Trouble with intimacy

 

_____ Tendency to be immature

 

_____ Self-centered; immature interests

 

_____ Failure to see others' needs or activities as important

 

_____ Lack of talking in a relationship

 

_____ Verbally abusive to others

 

_____ Proneness to hysterical outburst

 

_____ Avoids group activities

 

_____ Trouble with authority

 

Short Fuse

 

_____ Quick responses to slights that are real or imagined

 

_____ Rage outbursts, short fuse

 

Frequent Search For High Stimulation

 

_____ Frequent search for high stimulation (bungee jumping, gambling, high stress jobs, ER doctors, doing many things at once, etc.)

 

_____ Tendency to seek conflict, be argumentative or to start disagreements for the fun of it

 

Tendency To Get Stuck (thoughts or behaviors)

 

_____ Tendency to worry needlessly and endlessly

 

_____ Tendency toward addictions (food, alcohol, drugs, work)

 

Switches Things Around

 

_____ Switches around numbers, letters or words

 

_____ Turn words around in conversations

 

Writing/

 

Fine

 

Motor

 

Coordination

 

Difficulties

 

_____ Poor writing skills (hard to get information from brain to pen)

 

_____ Poor handwriting, often prints

 

_____ Coordination difficulties

 

The Harder I Try The Worse It Gets

 

_____ Performance becomes worse under pressure.

 

_____ Test anxiety or during tests your mind tends to go blank

 

_____ The harder you try, the worse it gets

 

_____ Work or schoolwork deteriorates under pressure

 

_____ Tendency to turn off or become stuck when asked questions in social situations

 

_____ Falls asleep or becomes tired while reading

 

Sleep/Wake Difficulties

 

_____ Difficulties falling asleep, may be due to too many thoughts at night

 

_____ Difficulty coming awake (may need coffee or other stimulant or activity before feeling fully awake.)

 

Low Energy

 

_____ Periods of low energy, especially early in the morning and in the afternoon

 

_____ Frequently feeling tired

 

Sensitive To Noise Or Touch

 

_____ Easily startled

 

_____ Sensitive to touch, clothing, noise and light

 

--------------------------------------------------------------------------------

 

When you have completed the above checklist, calculate the following:

 

Total Score: _______

 

Total Number of Items with a score of three (3) or more: _______

 

Score for Item #1: _______

 

Score for Item #6: _______

 

Score for Item #7: _______

 

More than 20 items with a score of three or more indicates a strong tendency toward ADHD. Items 1, 6, and 7 are essential to make the diagnosis.

 

The amino acids, vitamins and minerals required to produce the neuro-transmitters in sufficient quantities associated with ADD/ADHD are available in one multi-amino acid formula called beCALM'd. You can learn more about it by going to:

 

http://www.adhd-becalmd.com/?id=10006

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Do you think that pilots may have higher rates of ADD/ADHD than the general public? I guess I wonder if the allure to flying may attract people who think quickly, and are willing to ‘push the envelope’ more – i.e. ADD/ADHD’ers.
     


     

 

 

 

 

 

 

 

http://www.addadhdblog.com/adhd-medication-and-commercial-pilots/#1f06c

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Posted

The findings of this, and the recommendations to the Minister, may well be that you will need to get an Airworthy Certificate from a Level 2 every year and provide that with your registration renewal.

 

Other findings are:

 

- The RAAus enforces the obligations of reporting to them if you see someone flying "Not Quite Right" i.e. dangerous, or any other thing that you feel may not be of an acceptable/legal standard.

 

- The RAAus initiate a "written policy" of others reporting to them any type of flying that may not be of an acceptable/legal standard and processes to facilitate that reporting even to an extent of Anon reporting

 

- The investigation of Legislative Guidance of publishing pilot certificate suspensions/cancellations in some manner

 

Note...the above are my own words

 

 

Posted
Northern Star Newspaper Lismore dated 17/5/2012"THE GRANDMOTHER of the pilot who was one of two men who died in an ultralight crash at Tatham in 2010 has told a coronial inquest her grandson's ADHD contributed to their death.

 

.....snip......

 

  1. Do you think that pilots may have higher rates of ADD/ADHD than the general public? I guess I wonder if the allure to flying may attract people who think quickly, and are willing to ‘push the envelope’ more – i.e. ADD/ADHD’ers.
     
     

 

 

http://www.addadhdblog.com/adhd-medication-and-commercial-pilots/#1f06c

 

I would be very wary of putting much weight to a family member's testament of ADHD as a causal factor. Especially as she said that he has been off meds since the age of 6 - even if the meds worked then, they rarely work the same or have much effectiveness at all in adults. And you have to allow for the dark period of the nineties, where many kids were given the latest buzz diagnosis (ADHD) who were nothing worse than disobediant and distractible, and other pervasive developmental disorders such as autism were also often misdiagnosed as ADHD. It is a fantastic cover for many parents who have done a shocking job; a good excuse for a number of kids to not bother trying to improve their behaviours; and a genuine problem for a much smaller group who can be treated very successfully.

 

I wouldn't expect the prevalence of ADHD to be higher among pilots than the general population. Too many of the observations listed would get in the way of successfully learning to fly for someone who has not socialised at least some of their behaviours.

 

 

  • Like 1
Posted

I spoke to a pilot who witnessed the accident victims fly into a small private strip... apparently after being told not to. Said pilot apparently physically restrained the passenger from getting back into the aircraft for departure and after giving them a piece of his mind and told him "Your mate is going to kill you one day"...

 

Hearing this story I could not help but think that this would have been the last thing going through the passengers mind at the time of impact... Yet he still got in the aircraft. No mention of any "ADHD" issues for the passenger.

 

 

Guest davidh10
Posted

Unfortunately, there have been a number of fatal accidents in the last couple of years alone, in which the flight was undertaken after receiving a peer warning.

 

A nanny state, however isn't the answer, either for maintenance compliance, or pilot behaviour.

 

This idea that you can fix everything with legislation is ill-founded. People have to take responsibility for their own actions. It isn't always someone else's fault.

 

Where it is really difficult is when a person is unable to assess the risk and is poorly advised or informed, as may happen with a passenger.

 

 

Posted

This sort of thing has always happened, but I think it is more prevalent now. People were banned from aerodromes etc. Coronial inquests sometimes come out with some weird recommendations and statements, that don't seem very realistic. The judiciary battles in the aviation environment. There was an enquiry years ago involving a plane called the DH Drover powered by 3 Gipsy Major 10 mk2 engines. The judge was famously said to have asked. Which wing has the 2 engines on it? Nev

 

 

  • Like 1
Guest ozzie
Posted

gee a Trilander would have really flipped him out.

 

 

Guest ozzie
Posted

Pretty sure that this accident involved the aircraft that was pretty sus in the condition dept and had been signed off in the condition report as OK when he bought it. if i remembered the disscussion correctly of the incident as previously dicussed on the forum. Even though the pilot was operating it outside the regs it is capable of aerobatics and should have stayed together. 50% of the contributing factors i'd have thought.

 

 

Posted
Pretty sure that this accident involved the aircraft that was pretty sus in the condition dept and had been signed off in the condition report as OK when he bought it. if i remembered the disscussion correctly of the incident as previously dicussed on the forum. Even though the pilot was operating it outside the regs it is capable of aerobatics and should have stayed together. 50% of the contributing factors i'd have thought.

If I understand correctly ( and I may not), this aircraft was flown like this for some time prior to crashing.

My question is, was he doing his own maintenance (or not), or employing someone else (paid or unpaid) to carry out the maintenance? As harsh as it sounds, if he was responsible for his own maintenance, and his flying ( several warnings & advice according posts here), surely we can safely say that he has chosen to ignore the laws of physics, and has paid the ultimate price via the laws of natural selection. My only real beef with the whole situation, is that some parts of society seem to feel that this reflects poorly on those who just happen to enjoy the same (recreational aviation, not flying foolishly), and that the regulations should be tightened, when reality is if the existing regulation had been adhered (or even just the laws of physics) to he would be alive. So what would be the point of creating new legislation to be ignored, other than to shift blame to someone still living after the fool kills themselves?

 

 

  • Like 2
Posted

For those who are not aware, trishok is Michael's mother.

 

She very bravely came on here on the July 2010 thread "Drifter double fatality near Lismore" with some down to earth posts.

 

Her contribution this time puts another dimension on this crash.

 

From memory she was as interested as we were in trying to get right to the bottom of the sequences which occurred to ensure the same thing couldn't happen again.

 

Thanks Trish, ADHD gives us something more to think about.

 

 

Posted
For those who are not aware, trishok is Michael's mother.She very bravely came on here on the July 2010 thread "Drifter double fatality near Lismore" with some down to earth posts.

 

Her contribution this time puts another dimension on this crash.

 

From memory she was as interested as we were in trying to get right to the bottom of the sequences which occurred to ensure the same thing couldn't happen again.

 

Thanks Trish, ADHD gives us something more to think about.

No, I was not aware, and my apologies if she found what I had to say offensive, and I sincerely hope that I never have to experience the trauma that she has had to deal with.

That said, in order to reduce (I don't belive that you will ever fully prevent) this type of occurrence, the events must be viewed objectively without emotion, and the real causes identified. Since legislation prohibiting the behaviour was already in place, I just cannot see what good further legislation could achieve, without further harm to freedom of others.

 

 

Posted
For those who are not aware, trishok is Michael's mother.

Nor was I aware, and my reply was not meant to be personal. I spend about half of my working week assessing kids for learning disabilities, autism, ADHD and others, and I tend to jump in if these conditions are mentioned. Certainly no offence was intended, but I can never go along with the suggestion that something like ADHD was a major contributor. Sadly, plenty of people have made similar choices over the years, with similar results, and I haven't seen anything to suggest that medical conditions were to blame.

 

 

Guest trishok
Posted

Thankyou Turboplanner, and M61A1, I am not Michael's mother, but his grandmother. I appreciate your concerns for the family's feelings, however do not let this limit your frank and honest discussions here because the aim of me posting is to help prevent this type of tragedy from happening yet again.

 

In June, 2010, in your thread "Drifter Double Fatality near Lismore" , there was much speculation about the cause of the accident, and much comment about RaAus investigations of accidents but very little, or no, feedback to the pilot population as to their findings.

 

This was causing frustration amongst members as being non conducive to helping prevent further accidents or to furthering a culture of safety for the increased protection of pilots, passengers and the community.

 

This lack of information to RaAus members was stressed as a matter needing to be changed several times during the coronial inquiry.

 

Some of your forum posters had commented that the most commonly published "Cause of crash and fatality=pilot error", was insufficient explanation to help pilots prevent similar accidents.

 

Facthunter, The Coroner may be a layman, however he relies on the expert knowledge of many senior aviation personnel, and most credibly, the knowledge, expertise and information provided by Detective Inspector Hurley, Police Aviation Expert Investigator (himself an aerobatic pilot of longstanding, amongst many qualificataions). The brief to the Coroner was nearly 12 inches high. This Inquiry was investigated absolutely thoroughly following two years of careful preparation).

 

TO END SOME OF THE SPECULATION HERE, I OFFER THE FOLLOWING:

 

MECHANICAL AND STRUCTURAL CONDITION OF THE ULTRALIGHT:

 

The Investigator of the ultralight crash told the coronial investigation he would not have been flying in the aircraft as he knew it had been ditched into the ocean in 2005.

 

(1) The investigator was satisfied the plane was in an airworthy condition.

 

(2) There was no evidence of engine failure in the wreckage.

 

(3) The wings were intact after the crash.

 

(4) The investigator was aware of the plane's history, (i.e. it had been fully submerged in salt water after it was ditched into the ocean off Stradbroke Island in 2005 by its former owner. Following that incident, this inspector had physically sighted the state of the aircraft.

 

(5) Following purchase by Michael in 2008 it was noted that the aircraft's wings needed corrosion treatment and one of the working cables needed replacing.

 

(6) The assessment of the cable by the investigator after the crash was that it was serviceable but in poor condition.

 

(7) One SMALL wire had broken on the left wing, and this had occurred on impact, and did not contribute to the crash.

 

(8) The photos of the rust condition of the plane taken by a prospective purchaser of the plane that were circulating after the accident, were shown to the Inquiry.

 

(9) The plane was not in that condition of disrepair when it crashed.

 

(10) The plane was capable of performing aerobatics, but was not licensed to do so.

 

THERE WAS NOTHING STRUCTURALLY WRONG WITH THE PLANE. IT WAS AIRWORTHY.

 

However,

 

The Coroner found that "evidence was forthcoming that owners of ultralight aircraft are responsible for the maintenance of those aircraft.... while there are certified mechanics capable of maintaining/repairing those planes there is no requirement for those people to be used for major services. In respect of that issue I make a recommendation below..

 

iv) Legislation requiring all aircraft to undergo regular maintenance checks by an accredited level 2, maintenance engineer at such times as may be determined by CASA and/or RaAus. In addition consideration be given to annual renewal of aircraft registration with the requirement of an up to date certificate from an accredited level 2 maintenance engineer as to the airworthiness of aircraft."

 

CAUSE OF CRASH:

 

AEROBATICS/DANGEROUS AND ILLEGAL FLYING

 

The evidence of witnesses at the scene:

 

One witness told the court of coming out her back door and hearing the aircraft before she saw it. She said then the engine cut and the plane glided before several attempts to re-start it failed.

 

Then she said the plane pitched nose down and spun five times before it disappeared from sight.

 

"I saw the aircraft spiralling toward the ground," she said.

 

"While it was spiralling the wings were intact."

 

Her neighbour, the other eyewitness, backed up her evidence in all areas except he could not recall seeing the plane gliding and the attempts to restart the engine.

 

Chief Inspector Hurley said he was in no doubt that if the engine had failed the pilot would have had the skills to land the ultralight. He told the court that when doing a spin, the engine is operating at idle, not cut, even though it may sound like it is stopped from the ground.

 

He and the other experts believe that the crash was caused when the aircraft did not recover from the spin.

 

The pilot miscalculated recovery and left it too late at around 300 ft.

 

The GPS showed that the plane fell from 700 metres to 0 in (i think, 0.5?).

 

The pilot had a reputation amongst the flying fraternity for performing illegal spins in his ultralight. A DVD was tendered in evidence of several YouTube video clips of him performing spins. Michael had posted self-incriminating video on YouTube performing the same manoeuvre that the experts believe caused the crash.

 

The Coroner said that regrettably this manner of flying was not uncommon for him. e.g. just over a week after gaining his passenger endorsment he performed aerobatic tricks, loops and spirals and the "death dive" with a passenger on board and he had asked the passenger to film the experience. She was too scared to do so but she acknowledged she experienced an ADRENALIN RUSH!

 

CORONER

 

The Coroner acknowledged that for all of these manoeuvres the pilot was not trained but more importantly his licence precluded such activities.

 

He also said " the deceased O'Keeffe was described by a variety of witnesses as a risk taker and someone who resented any adverse suggestions about his flying ability. He was an accident waiting to happen. Only a short time before the crash O'Keeffe had been at the Inglewood Air Show and was seen by at least 50 pilots to perform manoeuvres which caused safety concerns. These included inappropriate take offs, low flying and there were suggestions he was takiong fare paying passengers including young children for joy flights.

 

"THIS INQUIRY OBTAINED NO EVIDENCE THAT ANYONE MADE A COMPLAINT TO RaAUS ABOUT THESE MANOEUVRES."...

 

to be cont'd

 

 

Posted

I can't speak for Trish, but I think she understood why we have these discussions.

 

The ADHD puts a different dimension on it which maybe you could talk about.

 

What Oz is saying about the aircraft being designed for aerobatics also points to other matters.

 

 

Posted

Having met the pilot concerned, he was a very, "she'll be right" type person. I refused to fly with him after an offer from him one time, I didn't know any of his past history at that time, but from what I saw I didn't feel right about it. I told him what he was doing wasn't right and he shouldn't. It was shrugged off.

 

The maintanence side of things were a little concerning too but the initial behaviour was primarily the instigator to the accident in my opinion.

 

Trishok and I have spoken at the time of the accident and she knows my thoughts.

 

 

Posted

I think I should let you know that many posts from this site were copied and presented in the Coroners Inquest

 

 

Guest trishok
Posted

ULTRALIGHT DOUBLE FATALITY AT TATHAM NSW 7 MAY 2010

 

AUSTRALIAN CULTURE OF "NOT DOBBING"

 

RESPONSIBILITY FOR REPORTING ILLEGAL FLYING ACTIVITIES

 

DEATHS WERE PREVENTABLE

 

YOUTUBE VIDEOS SHOWING DANGEROUS AND ILLEGAL ACTIVITIES COMMON KNOWLEDGE AMONGST THE FLYING FRATERNITY AS WELL AS OBSERVATIONS AND HEARESAY

 

It was stressed time and again over each day of the Inquiry that the deaths could have been prevented if the pilot was grounded. If his dangerous and illegal flying had been reported to the relevant authorities, with proper investigation carried out and appropriate disciplinary action undertaken.

 

The prevalent culture of "not dobbing", or "fear of reprisal" was consistently evident during the examination of witnesses.

 

The Coroner investigating the cause of the ultralight double fatality of 7th May, 2010 at Tatham NSW

 

said:

 

"Given the evidence of improper flying over a lengthy period it is disturbing that no action was taken to suspend or cancel O'Keeffe's licence to prohibit him from flying. There are a number of factors that contributed to this lack of action, namely

 

(a) There is an unfortunate, albeit prevalent, culture within recreational pilot groups not to report poor flying and to a great degree there appears to be an attitude that these matters can be dealt with, it at all, in house.

 

(b) As a result of (a) above I am satisfied that ....... ........ as a Chief Flying Instructor was in fact under an obligation to inform RaAus of the apparent existence of the video and of the admission made to him by O'Keeffe. This should have been done on an urgent basis and should have been accompanied by recommendations about the urgent need to suspend O'Keeffe's ;licence. THIS OBLIGATION IS CONTAINED IN THE RA AUS OPERATIONS MANUAL, which sets out the duties and responsibilities of Chief Flying Instructors, including the obligation to report incidents that contravene the manual and relevant legislation as well as being responsible for promoting positive safety culture.

 

© Many witnesses said that their knowledge of the actions of the deceased O'Keeffe was from rumour/second hand sources.

 

(d) Many witnesses believed that someone else had taken action and on that basis thlught that matters were already in hand.

 

(e) A lack of statutory power to require owners of aircraft to disclose the name and place of abode of a person flying their aircraft on a particular day.

 

As a consequence of all of the material above mentioned I recommend the following:

 

PROPOSED RECOMMENDATIONS

 

(two A4 pages...

 

Cont'd next post

 

 

Posted
I think I should let you know that many posts from this site were copied and presented in the Coroners Inquest

A timely reminder for all Ian.....

 

 

Guest trishok
Posted

ULTRALIGHT DOUBLE FATALITY AT TATHAM NSW 7/05/2010

 

CORONIAL INQUEST 14-17 MAY 2012 LISMORE NSW

 

PROPOSED RECOMMENDATIONS

 

1. a) RA-Aus reinforce to its members that there should always be positive obligations on all members to report any illegal or dangerous flying that might be in contravention of the Operations Manual and/or Regulations.

 

b) RA-Aus reinforce to its members that any evidence suggesting illegal, dangerous or unsafe flying on a passenger-carrying flight requires a member pilot, Instructor, Senior Instructor, or Chief Flying Instructor, to make an immediate mandatory notification to the Operations Manager.

 

2. RA-Aus review its system for receiving and handling complaints about member pilots that relate to flight safety issues, including:

 

a. developing a procedure for documenting these complaints;

 

b) developing a procedure for investigating these complaints;

 

c) developing procedures to protect a person who lodges a complaint, including an anonymous complaints system if appropriate.

 

These procedures are to be written procedures and are to be implemented by RA-Aus as soon as practicable.

 

3. That the findings in this Inquest be referred to the Minister of Transport for adoption, so as the Minister gives consideration to enacting legislation that grants RA-Australia its own laws and or regulations, which governs the following issues.

 

i) Disciplinary system that protects the rights of both RA-Australia members and the protection of the Community.

 

ii) Legislation enforcement that gives the Operations Manager or Assistant Operations Manager the power to immediately suspend and ground a pilot on the written recommendation of either:

 

a) A combination of two members, one of which must be an Instructor (at a minimum); or

 

b) A Chief Flying Instructor, Pilot Examiner or Regional Operations Co-Coordinator.

 

c) That such suspension be for a period of 28 days or until the matter is determined by a court or tribunal whichever is the later.

 

iii) Legislative guidance regarding publishing information about member pilots who have had their licences suspended or cancelled. In particular if names are to be published whether that should be via a secure or limited site.

 

iv) Legislation requiring all aircraft to undergo regular maintenance checks by an accredited level 2, maintenance engineer at such times as may be determined by CASA and/or RA-Aus. In addition consideration be given to annual renewal of aircraft registration with the requirement of an up to date certificate from an accredited level 2 maintenance engineer as to the airworthiness of aircraft.

 

v) Legislation requiring owners of aircraft to identify upon demand the pilot of any aircraft owned by them if required by a member of the police force, CASA or RA-Aus.

 

 

Guest Andys@coffs
Posted

So let me see if I got this right:-

 

1) There was much speculation that the aircraft was NOT airworthy

 

2) The was NO evidence at the time of the crash and the investigation thereafter, that the Aircraft was NOT airworthy.

 

3) Despite 2, a recommendation has been made that only a paid person (Lev 2) can determinne if it is or isnt airworthy and at regular times through out the life of the aircraft it must be inspected......

 

4) Pressumably those that build and maintain their own 19 registered aircraft will have to do the same even though arguably they might well be more knowledgable than the Level 2 about their specific aircraft.

 

So, no direct evidence of a problem where such evidence would be obvious if it existed, and as a result of unsubstantiated speculation of a problem we are all going to be lumbered with a bunch of impossed additional obligations when clearly the coroner found that the root cause was the pilot behaveour and cultural issues all unlrelated to the airworthiness of the aircraft.....

 

What have I over simplified?

 

Andy

 

 

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