Hero's welcome for killer

[Terralthra]

As for the "they were getting a slap on the wrist" thing, Nielsen's murder occurred before the criminal investigation had even begun

Didn't Skyguide people try to blame everything on the Russian airliner crew immediately after the incident, even before any charges were levied?

Looks like, yes. Nielsen, on the other hand, resigned from his position and put out a statement expressing remorse for the deaths and saying simply that he was not the only one at fault.

It's possible that his murder prompted the criminal investigation of the crash, or at least, got it moving faster. That's just supposition, though.

[K. A. Pital]

Apparently with an attempt to bribe Kaloev, Skyguide made things worse;

Kaloyev presented a document received from a law firm in Hamburg dated 11 November 2003. It was an amicable agreement in which Skyguide offered Kaloyev 60,000 Swiss francs for the death of his wife and 50,000 francs for the death of each of his two children. In return, Skyguide asked Vitaly Kaloyev to decline any claims to the company. The document infuriated the man: he decided to meet the company's Director Alan Rossier and flight control officer Peter Nielsen in person.

That could certainly affect his thinking. Offering money to stop the pursuit of justice against Skyguide? If I was him, and in a similar mental condition, I'd confront and possibly kill the director though, even if it were a bit harder.

[Fingolfin_Noldor]

Apparently with an attempt to bribe Kaloev, Skyguide made things worse;

Kaloyev presented a document received from a law firm in Hamburg dated 11 November 2003. It was an amicable agreement in which Skyguide offered Kaloyev 60,000 Swiss francs for the death of his wife and 50,000 francs for the death of each of his two children. In return, Skyguide asked Vitaly Kaloyev to decline any claims to the company. The document infuriated the man: he decided to meet the company's Director Alan Rossier and flight control officer Peter Nielsen in person.

That could certainly affect his thinking. Offering money to stop the pursuit of justice against Skyguide? If I was him, and in a similar mental condition, I'd confront and possibly kill the director though, even if it were a bit harder.

As scumbags go by, what possessed the prosecution to lay down such lenient charges? Is the prosecution going to pursue this further? Or are they too lazy or are there vested interests?

[PeZook]

Kaloyev presented a document received from a law firm in Hamburg dated 11 November 2003. It was an amicable agreement in which Skyguide offered Kaloyev 60,000 Swiss francs for the death of his wife and 50,000 francs for the death of each of his two children. In return, Skyguide asked Vitaly Kaloyev to decline any claims to the company. The document infuriated the man: he decided to meet the company's Director Alan Rossier and flight control officer Peter Nielsen in person.

Holy fuck...they should've known better than to make such a proposal to a Russian of all people.

As far as Nielsen goes, while I don't approve of vigilantism, frankly...he was a dumbass. When confronted by an obviously distraught person in a state of emotional unrest, you should be trying to placate him, not act all smug and superior. His refusal to say "sorry" just escalated the situation.

[Adrian Laguna]

<snip apologist tripe>

Obviously, you have no experience in any kind of profession where ethics and public safety are part of the job. If you witness unsafe practices, it is your ethical duty to do everything within your power to rectify the situation, and to resign in protest if those actions are ineffective. Saying nothing and continuing to draw a paycheque makes you a willing accomplice.

I had not considered that, probably because, as you say, I have not worked in a profession involving public safety.

He was working at an extreme responsibility job. Neglience in some areas just does not get the preface "criminal" because it doesn't lead to massive loss of human life. In this area, it does. Firing the responsible person is a grossly inadequate punishment. And the company's management should have gotten very tough sentences for contributing to Nielsen's failure by their reckless business practices.

I don't disagree that the management should have gotten tougher sentences. It is their mismagement that caused the situation.



Rather than continue this discussion. I've decided it might be best to see the conclusions reached by investigators who've spent more time and effort researching the incident, and had access to more information than any of us. Now, given the behaviour of the Swiss authorities we can conclude that there is a certain risk of bias on their part. There is also risk of bias on the part of Russian authorities, but this is rendered moot by the fact that, if I'm not mistaken, they did not conduct their own investigation. Fortunately, because the incident occurred in German airspace, the German Federal Bureau of Aircraft Accidents Investigation conducted their own investigation. I think we can consider them a neutral third party as they have no stake either way in the incident, Skyguide is not a German corporation, and the victims were not German citizens.

This is their report, conveniently in English.

I'm not going to pretend I actually read the whole thing. I could probably get away with it, but it would still be a lie. I read the parts dealing with Peter Nielsen as well as the analysis summary and conclusions.

The report overall suggests that Peter Nielsen is not responsible for what happened, and even goes so far as to state that even in light of the accident there is no reason to suspect his competence and professionalism. Interestingly enough, it implies that having one ATCO manning both consoles during low traffic in the middle of the night is not inherently unsafe. That is, provided the system is running up to spec. It wasn't, and neither of the controllers was made aware of the extent to which the maintenance work would affect the system. Thus neither could come to the conclusion that two operators would be required that night.

In all honesty I was actually expecting the report to be more damming of Nielsen. I went so far as to prepare a list ahead of time to put them in all the things he was responsible for. But there's hardly anything. He did fail to recognize early on that a conflict situation would develop later, but the aircraft were still far apart and the report gives no indication that he should have.

Relating to the aural warning Stas Bush mentioned, it says, "Even with the aural alert the ATCO would have been unable to recognize the situation was not evolving as he expected until further information was available. The TU154M was already complying with the descent instruction the ATCO did not know the B757-200 had initiated an RA related descent. He would not have been able to recognize the B757-200 was descending until the screen update at 21:35:12 hrs or if he had heard the crew's TCAS descent call a few seconds later. By this time it was unlikely that he could have formulated an instruction that would have averted the collision with sufficient safety." Later it says, "In the case of separation infringement with high closing speeds the aural STCA offers little use." This was such a case.

[Adrian Laguna]

As far as Nielsen goes, while I don't approve of vigilantism, frankly...he was a dumbass. When confronted by an obviously distraught person in a state of emotional unrest, you should be trying to placate him, not act all smug and superior. His refusal to say "sorry" just escalated the situation.

Evidence that he was acting smug and superior? Kaloyev's own statements about what happened do not support this, and in fact suggest the very opposite, that he wasn't dealing with it very well.

[K. A. Pital]

The report overall suggests that Peter Nielsen is not responsible for what happened, and even goes so far as to state that even in light of the accident there is no reason to suspect his competence and professionalism. Interestingly enough, it implies that having one ATCO manning both consoles during low traffic in the middle of the night is not inherently unsafe. That is, provided the system is running up to spec. It wasn't, and neither of the controllers was made aware of the extent to which the maintenance work would affect the system. Thus neither could come to the conclusion that two operators would be required that night.

That's self contradictory. If it's not an unsafe practice, then Nielsen is responsible for the crash, since it were normal operating conditions for ATCOs. If it's unsafe, then his fault is somewhat lessened, but not entirely gone.

How the fuck could you conclude that if it's not an unsafe practice, Nielsen is absolved from responsibility for what happened? He failed to recognize the situation at both early and late stages, having multiple times where he could have dealt with it with caution. He did not.

Besides the practice was unsafe: the ATCO was operating without some necessary tools. It says that if processes to "defend their absence" were introduced it wouldnot lead to a security loss, but immediately explains that they were not!

Besides, evaluating the ATCO's professionalism and competence is not relevant to establishing criminal neglience - an otherwise competent person can be criminally neglient, not least due to overconfidence in his own abilities (which is also what the report says, te ATCO was sure he could handle the situation without further assistance and sent the other gy away).

So all in all, he can't be absolved of responsibility for what happened. If a very competent architecture engineer designed a building that collapsed and murdered everyone inside, he'd be deep down in jail with his ass - I know this by personal contact with fellow engineers in the architecture institute, sme of whom faced manslaughter charges. A single little calculation error in engineering of an otherwise competent person = lots of dead folks.

Regardless of competence, no absolution of responsibility.

[K. A. Pital]

Evidence that he was acting smug and superior?

Maybe not smug, but _very_ dumb, worthy of a Darwin award.

When a person confronts you with photographs of his dead children and demands apology, you do NOT push the hand in which he holds the photos. That's... just stupid. Instead you apologize and try to retreat into a safe room with your family. Touching the man was bad enough, pushing his hand was yet worse.

[Adrian Laguna]

That's self contradictory. If it's not an unsafe practice, then Nielsen is responsible for the crash, since it were normal operating conditions for ATCOs. If it's unsafe, then his fault is somewhat lessened, but not entirely gone.

How the fuck could you conclude that if it's not an unsafe practice, Nielsen is absolved from responsibility for what happened?

Besides the practice was unsafe: the ATCO was operating without some necessary tools. It says that if processes to "defend their absence" were introduced it wouldnot lead to a security loss, but immediately explains that they were not!

It's not generally unsafe for a controller to handle both during the time period that he was. It is unsafe for said controller to do so while the system certain parts of the system are down. He was not made aware that the system would be down to the extent that it was. Ergo, he was not aware that he was going to be in an unsafe situation, and neither was his co-worker. By the time he became aware of that he couldn't handle it, there was nothing he could do about it. There were actually people standing by to provided assistance if he needed it, but according to the report nobody told him about it.

He failed to recognize the situation at both early and late stages, having multiple times where he could have dealt with it with caution. He did not.

He failed because he did not have the information required to recognize the situation, and circumstances beyond his control prevented him from gaining said information in time to do anything.

Besides, evaluating the ATCO's professionalism and competence is not relevant to establishing criminal neglience - an otherwise competent person can be criminally neglient, not least due to overconfidence in his own abilities (which is also what the report says, te ATCO was sure he could handle the situation without further assistance and sent the other gy away).

And given the information he had on hand, this belief was justified.

So all in all, he can't be absolved of responsibility for what happened. If a very competent architecture engineer designed a building that collapsed and murdered everyone inside, he'd be deep down in jail with his ass - I know this by personal contact with fellow engineers in the architecture institute, sme of whom faced manslaughter charges. A single little calculation error in engineering of an otherwise competent person = lots of dead folks.

Regardless of competence, no absolution of responsibility.

Fine, so the competence is a red herring. I still do not see anything he did that was against established procedure or any point wherein the circumstances could have reasonably allowed him to recognize the situation and do something about it.

[Adrian Laguna]

Dammit, I thought I'd answered this. Where'd it go?

When a person confronts you with photographs of his dead children and demands apology, you do NOT push the hand in which he holds the photos. That's... just stupid. Instead you apologize and try to retreat into a safe room with your family. Touching the man was bad enough, pushing his hand was yet worse.

I've already said that he may have been acting irrationally due to troubled feelings about what happened.

[K. A. Pital]

And given the information he had on hand, this belief was justified.

That is an excuse how? Example: a person at a construction site operates a crane, while sending the crane observer away. The crane crushes a person behind it, due to the crane driver operating the crane alone without a co-worker who would observe the machine's rear. He also knows that such operation can lead to severe consequences, yet assumes that it's okay with the "information on hand": the construction site is generally safe from trespassers; however, does it really mean there is no guilt of the person?

[Adrian Laguna]

And given the information he had on hand, this belief was justified.

That is an excuse how? Example: a person at a construction site operates a crane, while sending the crane observer away. The crane crushes a person behind it, due to the crane driver operating the crane alone without a co-worker who would observe the machine's rear. He also knows that such operation can lead to severe consequences, yet assumes that it's okay with the "information on hand": the construction site is generally safe from trespassers; however, does it really mean there is no guilt of the person?

Nielsen did not know that part. Because such an operation only leads to severe consequences if the system's down. Guess what he was never informed was going to happen?

[K. A. Pital]

And that aside, his fucking MANUAL demanded for the second contrller to be there, since he should have given unrestricted access to the landing station.

He also ceded control of the phone to technicians when demanded.

Allowed to switch the system in fallback mode, due to his lack of knowledge about features of such mode - this is NOT an excuse, just as not knowing the crane's operating features would not excuse a crane operator if he killed a person due tothat.

Why the ATCO was not familiar with the Emergency Manual?

The report eventually concludes that he did not see the need to call the other ATCO back even after knowing that he could NOT dedicate 100% attentin to one system as his MANUAL demanded.

How is this NOT neglience, praytell? "Little errors"? Well tought fucking luck; a construction engineer can be jailed for an error which was only a one of a complex of reasons which made a building collapse, I do not see why an ATCO should not be held to the same standard.

[Broomstick]

Good lord - that report is 116 pages!

I haven't read it yet, but I'm going to make some general statements about mid-air collisions.

First of all, it's no one person's responsibility to avoid mid-air collisions. In the US all involved parties are assumed to be at some fault until proven otherwise, and that would be both pilots as well as an air traffic personnel involved. The better the visibility the more responsibility held by the pilots. In "instrument conditions" where visibility is minimal or nil more responsibility is held by air traffic control.

While using just one controller is not inherently unsafe - hell, using no controller is not inherently unsafe given certain conditions - it certainly can be unsafe in some circumstances.

Equipment faults may well be a mitigating factor. However, it does not absolve a controller of all responsibility. If equipment is not functioning properly then common practice is, for example, to maintain greater space between airplanes as an additional safety measure. I have been in the air when a major radar facility covering Chicago O'Hare airspace has crashed (there's an equipment malfunction for you) and cooperation between pilots and air traffic control handled the situation without anyone being killed or even scaring the crap of out anyone.

Here's an analogy - you're driving down a residential street, at the proper speed limit, alert, doing your job - and a kid runs out from between two parked cars right in front of, so close it is impossible to stop your car. You hit the kid. The kid dies. Although you had no malicious intent, although you did everything right, you are still responsible for that death even if you are not at fault. And apology to the parents of the deceased for the tragic accident would not be out of line.

As I said, I have not read the report in detail and I'm going by what general knowledge I have. It seems to me the murdered controller was in some ways in the wrong place at the wrong time. He was not working with full resources, which was the result of decisions and actions made by other people. The two pilots (always a popular choice for blaming an accident on) involved were dead. This made it very easy to target the controller as someone who had to "pay" for this accident.

Fact is, airplanes do collide every year (although the rate has been falling for a couple decades). It should never happen, but it does. Leaving aside gross negligence, which is rare in these cases, these accidents are almost always the result of a chain of mistakes, decisions, and circumstances and not one single lapse of judgment. It's pretty rare for them to go to criminal trial (but not unusual for punishment to occur) although in the US civil lawsuits are the norm, for better or worse.

To compare it to the world of engineering - sure, buildings/other large structures should never fall down. But sometimes they do. Although the engineer/architect/builder falls immediately under suspicion there are times when forces exceed design parameters, such as during a wartime bombardment or terrorist bombing, during an earthquake of greater magnitude that local design requirements call for, intense hurricanes or tornadoes, and so forth. Assuming no inherent lack in design or construction, in such circumstances it is folly to hold any one person responsible however much society is calling out for vengeance - because that's what this was, a vengeance killing.

The fact so many children were involved has only made rational thought more difficult. Not that I in any fault parents for being emotional over the death of their children. It would be abnormal NOT to be. But not all the parents went and tracked down this controller, only one did. His emotional state was no doubt a contributing factor here (just as non-functional equipment was for the controller) but it does not absolve him of responsibility for killing another human being, nor does it make him a hero.

My understanding is also the TCAS procedures have been modified/updated and procedural changes have been made as a result of this accident which, one hopes, would reduce the chances of this happening again.

[K. A. Pital]

He was not working with full resources, which was the result of decisions and actions made by other people.

And himself too. He let the other guy go, ceded the phone to technicians. Later when the environment deteriorated, he still thought he was able to do it. He quite probably did notice how the environment deteriorated into critical and unforgiving to his faults and errors, but did not think a death would result.

Just like the driver in your example. And yes, that does not absolve him.

[Broomstick]

And that aside, his fucking MANUAL demanded for the second contrller to be there, since he should have given unrestricted access to the landing station.

It's a global issue of governments/agencies cutting personnel to the bone to save money, despite there being increased risk.

Controllers are human beings - they need to piss, they need to take the occasional break, even if it's short, because no one can concentrate deeply for hours on end without losing efficiency.

I think air traffic control is getting into circumstances where economic and political forces are reducing staffing to unsafe levels at times, but they get away with it because most of the time nothing bad happens. Only once in awhile.

The report eventually concludes that he did not see the need to call the other ATCO back even after knowing that he could NOT dedicate 100% attentin to one system as his MANUAL demanded.

It's all very well to pretend that a manual hundreds of pages thick (at least - I've seen one) is followed to the letter 100% of the time. It's all very well to pretend that cutting staffing to minimal levels is perfectly safe. It's not. Huge manual + minimal staff can equal less than ideal outcome.

Aviation is not flawless - lord knows, I wish it was - and the system has to have some capacity for error correction because errors invariably occur. Normally, those error-catchers work well and that's one reason aviation is, on average, the safest form of transportation known. Why do you think TCAS was invented? To give another layer of protection to guard against mid-airs. If the pilots don't catch the impending collision and the controllers don't the TCAS is supposed to - and it actually did in this case, but it contradicted the controller's orders.

OK, you're the pilot, what do you do? You have only seconds - if that long - to make a decision and act. Do you trust the TCAS and do what it says (that, by the way, will either say "climb" or "dive" - they are designed to communicate with other TCAS in close proximity so if one says "climb" the other says "dive" and vice versa) or do you trust the human and do what he says?

You get one chance to get it right. Just one.

(In the US, by the way, the rule, at least in the civilian world, is obey the TCAS and has been for some time, even before this crash)

No one wants to admit it, but controllers do make mistakes. So do pilots. When the system works those errors are caught early and corrected and do not pose a risk. Given that things break, people make mistakes, and no one controls the weather the system has to be able to accommodate errors. Consider it the equivalent of engineers designing structures to withstand more than their normal loads as a safety factor.

How is this NOT neglience, praytell? "Little errors"? Well tought fucking luck; a construction engineer can be jailed for an error which was only a one of a complex of reasons which made a building collapse, I do not see why an ATCO should not be held to the same standard.

Was he not found responsible? - along with others, I might point out.

Regardless, the controller was NOT given a death sentence! This was vigilante "justice" and a civilized society does not tolerate that as acceptable.

[Broomstick]

He was not working with full resources, which was the result of decisions and actions made by other people.

And himself too. He let the other guy go, ceded the phone to technicians. Later when the environment deteriorated, he still thought he was able to do it. He quite probably did notice how the environment deteriorated into critical and unforgiving to his faults and errors, but did not think a death would result.

Just like the driver in your example. And yes, that does not absolve him.

Never said it did absolve him of all responsibility. And he was found guilty. But let's not pretend his was the only responsibility here.

[K. A. Pital]

Was he not found responsible?

I guess so - the light repercursions were only directed at managers as far as I know. Probably they just dropped investigating himself due to him being already dead?

Besides, Skyguide took immense pains to stop this process: bribes of relatives of the deceased, as in Kaloev's case, accusations against the pilots of the planes. The killing took place in February 2004. The crash - July 2002. The bribing attempt - 2003.

After the murder of Nielsen, a criminal investigation finally happened - but even with such circumstances, only in May 2004.

[PeZook]

Leaving aside gross negligence, which is rare in these cases, these accidents are almost always the result of a chain of mistakes, decisions, and circumstances and not one single lapse of judgment. It's pretty rare for them to go to criminal trial (but not unusual for punishment to occur) although in the US civil lawsuits are the norm, for better or worse.

You know, that's an astute observation. Most catastrophes don't happen because of one error, but because of a string of errors made on several levels, sometimes years before the incident.

LIke the famous crash of an airliner in DC - the one which felt into the Potomac right after takeoff, grazing a bridge full of cars on the way. The disaster could've been averted to the last second, by just one good decision.

This is why I try to refrain from placing blame for an incident upon one person - there's more people involved in almost any case.

[Broomstick]

Leaving aside gross negligence, which is rare in these cases, these accidents are almost always the result of a chain of mistakes, decisions, and circumstances and not one single lapse of judgment. It's pretty rare for them to go to criminal trial (but not unusual for punishment to occur) although in the US civil lawsuits are the norm, for better or worse.

You know, that's an astute observation. Most catastrophes don't happen because of one error, but because of a string of errors made on several levels, sometimes years before the incident.

Indeed.

Here in the US the FAA beats that concept into the heads of pilots, controllers, and ground crew endlessly, even on my level of aviation (the pros tell me it's even more so on their level). Interrupt that "chain of errors" and no accident occurs.

Another example is the JFK, Jr. crash - there were a bunch of other airplanes confronting the same low/no visibility conditions (around 10 I think) but instead of pressing on into the night all those other guys made decisions that interrupted their progress towards an accident. (some decided not to fly at all, some turned back, a couple filed for instrument flight plans in the air - an option not available to Mr. Kennedy as he was not certified for such operations and I understand in many countries the option to file while in flight does not exist). Result - 1 fatal accident, and a bunch of accidents that didn't happen.

[Broomstick]

Besides, Skyguide took immense pains to stop this process: bribes of relatives of the deceased, as in Kaloev's case

In the US, what you call a "bribe" is called "an out of court settlement", although the amounts you quote would be considered insultingly low and, of course, the family has the option to refuse the settlement and proceed with the court case, and how the offer is presented is crucial, of course. Given the time and expense of legal remedies in the US this option may make more sense, and would be entirely separate from any criminal trial or accusations. I don't know how such an offer is viewed in the various European countries, but I suspect that cultural differences are a contributing factor in this tragic mess.

[Adrian Laguna]

He was not working with full resources, which was the result of decisions and actions made by other people.

And himself too. He let the other guy go, ceded the phone to technicians. Later when the environment deteriorated, he still thought he was able to do it. He quite probably did notice how the environment deteriorated into critical and unforgiving to his faults and errors, but did not think a death would result.

Just like the driver in your example. And yes, that does not absolve him.

The driver in her example was specifically stated to have done everything right, which is contrary to what you assert to be true about the ATCO in question.

He let the other guy go because he had not been informed about the extent to which the system would be down. Resources that he thought he had available were not available. Regarding the phones, once again, he was assured the back-up line was working. In the case of the environment deteriorating, the report notes states that it was mostly likely he did not realize what was happening, and he had not been given training that would have allowed him to do so.

[Terralthra]

In the US, what you call a "bribe" is called "an out of court settlement", although the amounts you quote would be considered insultingly low and, of course, the family has the option to refuse the settlement and proceed with the court case, and how the offer is presented is crucial, of course. Given the time and expense of legal remedies in the US this option may make more sense, and would be entirely separate from any criminal trial or accusations. I don't know how such an offer is viewed in the various European countries, but I suspect that cultural differences are a contributing factor in this tragic mess.

Settlements with the stipulation that the person receiving the settlement will not pursue civil claims are fairly common in most legal systems in Europe. Even if Kaloyev had accepted the settlement offer, it would have no bearing on a criminal investigation of the matter.

[Kanastrous]

Besides, as the guy did not intend to kill him but merely asked for an apology and went nuts when the man who was responsible for manslaughter refused that,

Bringing a deadly weapon along when you're just there to 'ask for an apology' raises the question of premeditation, to me...

[Darth Wong]

Never said it did absolve him of all responsibility. And he was found guilty. But let's not pretend his was the only responsibility here.

If someone is being accused of a criminal breach of responsibility, why does it matter that he was not the only one guilty?