Predicting and Preventing the Unwanted
A sample formal Occurrence analysis and discussion of its application using the January 2004 Haneda runway collision case. INTRODUCTION For a representative press article, see https://www.theguardian.com/world/2024/jan/03/japan-plane-crash-jet-haneda-airport-clear-to-land-japan-airlines Before Tuesday, Japan had not experienced a serious commercial aviation accident for decades. The…
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In this Chapter (page 145) I suggest that it is not necessarily easy to create an FTA that provides insight and is easy to understand. On page 156 I have written about the development of understandable fault trees. The purpose of…
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On page 151 (Chapter 9) I mentioned the need for care when selecting the Top Event, illustrating this with the story of an aeroplane whose engine separated from the wing mount. This case was American Airlines flight 191, A DC10…
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In Chapter 3 (and in Chapter 9) the models introduced make a distinction between Occurrence (time zone 2 in the Time Sequence Model) and Consequence. The process by means of which damage occurs is not specifically related to the damage…
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In Chapter 1, I reiterated Haddon’s point that there is a need to base our science on an understanding of processes rather than description of the phenomenon of interest. Here is what Haddon said in the introduction to his famous…
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Consider the Concorde crash of 25th July, 2000. The aircraft hit metal debris left on the runway by a preceding aircraft, a tyre burst and rubber fragment(s) punctured the wing skin leading to a fuel leak. The fuel was ignited…
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