Dana MD83 at Port Harcourt on Feb 20th 2018, overran runway by 300 meters

Last Update: April 25, 2019 / 18:03:56 GMT/Zulu time

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Incident Facts

Date of incident
Feb 20, 2018

Classification
Accident

Airline
Dana Air

Departure
Abuja, Nigeria

Destination
Port Harcourt, Nigeria

Aircraft Registration
5N-SRI

Aircraft Type
McDonnell Douglas MD-83

ICAO Type Designator
MD83

Airport
Port Harcourt International Airport, Port Harcourt

Airport ICAO Code
DNPO

A Dana Air McDonnell Douglas MD-83, registration 5N-SRI performig flight 9J-363 from Abuja to Port Harcourt (Nigeria) with 44 passengers and 5 crew, landed on Port Harcourt's runway 21 in poor weather conditions at about 19:10L (18:10Z), overran the end of the runway, went through the localizer antenna and came to a stop on soft ground about 298 meters/980 feet past the end of the runway. The aircraft was evacuated, no injuries are being reported, the aircraft sustained substantial damage however.

Nigeria's Airport Authority reported flight 9J-363 overshot the runway in Port Harcourt probably because of heavy rain accompanied by strong winds and storm.

The airline reported the aircraft skidded off the runway as result of very stormy weather and severe winds. All passengers and crew disembarked safely.

Nigeria's Accident Investigation Board (NAIB) have opened an investigation.

On Mar 7th 2018 the NAIB released their preliminary report stating the crew performed the LOC approach runway 21, the MDA was adjusted to 460 feet AGL due to the outage of the glideslope signal. The captain (59, ATPL, 18,881 hours total, 941 hours on type) took control of the aircraft about 6nm before touchdown, disconnected the autopilot at 400 feet AGL, the aircraft touched down about 1000-1500 feet past the runway threshold. The crew later commented that the runway looked flooded with water that did not drain well. Spoilers and Reversers were deployed and brakes were applied, the aircraft went beyond the end of the runway and came to a stop 298 meters past the runway end slightly to the left of the extended runway center line with the nose gear collapsed and the right hand wing firmly on the ground. After the aircraft came to a stop both engines were shut down and emergency power was turned on, however, the PA system did not work, the cockpit door needed to be opened to issue the instruction to evacuate. The evacuation was done only through the forward left door, the slide at that door did not inflate however. No injuries occurred.

The aircraft sustained substantial damage, runway 03 approach lights were broken and the nav antenna (supposedly the localizer antenna) was damaged.

On Apr 25th 2019 the NAIB released their final report concluding the probable causes of the accident were:

The accident was caused by an underestimation of the degradation of weather conditions (heavy rain, visibility and strong wind on short final and landing), and, the failure by the crew to initiate a missed approach which was not consistent with the company’s SOP.

Contributing factors to this accident were:

- Non-compliance to SOP in meeting crew competency and complement.

- Ineffective two-way communication between the ATC and DAN0363 during final approach prevented the flow of technical information on runway surface condition and other relevant meteorological information essential to safety.

- Failure of the crew to crosscheck the prevailing wind and also to obtain landing clearance from the ATC during final approach after contact with ATC was restored.

The NAIB reported the first officer (31, CPL, 358 hours total, 89 hours on type) was pilot flying. The aircraft joined a LOC only approach to runway 21 (glideslope was inoperative) when the captain (59, ATPL, 18,881 hours total, 941 hours on type) realized the DME 2 equipment was not operating and took control of the aircraft. The crew tuned the LOC frequency on NAV 1, switched to AP 1 and set the VOR frequency on NAV2.

12nm before the runway the aircraft was handed off to tower. As the VOR was not showing on NAV2, the crew reselected the LOC frequency on NAV2, VOR on NAV1 and switched back to AP2. The LOC TRACK mode became active. The crew selected the tower frequency, however, was unable to establish contact. The crew selected the gear down and flaps to 40 degrees, Vref was selected to 130 KIAS. About 90 seconds after the first attempt to contact tower the crew selected the correct tower frequency and established contact with tower.

The NAIB wrote:

According to CVR recordings, the Captain instructed the First Officer to watch out for the runway. A few seconds after, the Captain was heard yelling for wipers. After a while, the Captain sighted the runway and instructed the First Officer to report to Tower “Runway in sight...landing”. Thirty-two (32) seconds later, an aural warning “Sink rate”! “Sink rate”!! “Sink rate”!!! “Sink rate”!!!! came ON.

The aircraft descended through approach minimums (460 feet AGL), crossed the threshold and did a smooth touchdown on the runway at 7,972 feet from the threshold in high winds of 360 degrees /22 kt. The aircraft landed without obtaining landing clearance from the ATC.

According to the Captain, during landing roll, the brakes were applied while simultaneously deploying thrust reversers to maximum; all spoilers automatically deployed after the nose wheel was lowered to the ground. The crew continued to apply brakes until maximum braking was commanded. The aircraft could not be stopped during brake application and the Captain continued applying the brake pedals to maximum.

The aircraft remained on the runway centerline until about 200 feet short of the runway end, then veered left, exited the paved surface and came to a stop 978 feet past the end of the runway about 33 feet to the left of the extended runway center line.

The aircraft received substantial damage, in addition a number of runway approach lights were broken, the ILS antenna and ILS light stand were damaged.

The NAIB analysed that hydroplaning had not taken place, there was no reverted rubber on any of the tyres though two tyres were worn to limits. The runway had been wet. The NAIB wrote: "There was no evidence of any defect or malfunction in the aircraft that could have contributed to the accident."

The NAIB analaysed that the captain was properly licensed and fit to fly the aircraft, however wrote: "However, the Captain was not eligible to conduct the flight with a pilot that is not released to fly unsupervised, because the Captain was neither a Type Rating Examiner (TRE) nor a Check Pilot at the time of the accident. Therefore, the crew complement was not appropriate."

With respect to the first officer the NAIB analysed: "Although the First Officer was trained and certified on type aircraft, he was not competent and eligible to operate the accident flight (DAN0363) or any flight categorized by DANA Airlines as Public Transport." and subsequently stated: "The investigation believes that the first officer’s low experience increased the workload of the Captain during the entire remaining flight. During this very busy phase of approach, it was established that the Captain was the only one who was actively alert in the cockpit including runway look-out when he was supposed to focus on the instruments and calculations for appropriate decision making."

The NAIB analysed the approach and continuation to landing:

The landing weight used by the crew was 116,000 lbs. For flaps 40 degrees landing the VREF speed selected by the crew was 124 KIAS (See Appendix 1B) and still added the minimum wind correction of 6 KIAS for a VAPP of 130 KIAS. This extra speed had to be managed by the crew in order to cross the runway threshold at their planned VREF speed. The aircraft crossed the threshold at approximately 135 KIAS, or 10 knots faster than that calculated for the actual landing weight of the aircraft. The SOP required crew to initiate a missed approach when the target airspeed was exceeded by plus 10/minus 5 knots.

Also, the investigation determined that due to the high winds, (360 degrees/22 knots) the prevailing component suggested a tail wind of 19 knots and a crosswind of 11 knots for Runway 21 respectively. With this phenomenon, a missed approach should have been appropriate and most likely a change of runway that was most favourable by wind (in accordance with DANA Airline’s SOP) and landing aids. It is likely that the crew did not consider the situation to warrant an overshoot; the crew believed that the entire approach was stabilized, and the runway was in sight with disregard to the presence of high winds and other presence of deteriorating metrological conditions.

The aircraft touched down 7,972 feet past the runway threshold, with the runway length of 9,843 feet only 1871 feet of runway remained (Editorial note: the relevant narrative in the analysis section 2.4 appears entirely confused referencing but misrepresenting the performance calculations in Appendix 2, this summary therefore resembles the performance computation of appendix 2, subsequently confirmed in section 2.6 of the analysis). With the present weather and runway conditions and the present approach speed 10 knots above Vref=124 KIAS the required landing distance, according to law, would have been 11,302 feet exceeding the available landing distance. The actual factored landing distance for the wet runway at landing conditions was computed at 6741 feet suggesting that after touchdown a distance of 5741 feet would have been necessary for roll out.

Related NOTAMs:
A0082/18 - ILS/DME IPC 110.3MHZ RWY 21 U/S. 21 FEB 16:30 2018 UNTIL 21 MAY 16:30 2018 ESTIMATED. CREATED: 21 FEB 16:38 2018

A0079/18 NOTAMN
Q) DNKK/QMRLC/IV/NBO/A/000/999/0601N00657E005
A) DNPO B) 1802202130 C) 1805202130 EST
E) RWY 03/21 CLSD

Metars:
DNPO 202000Z 16003KT 5000 -TSDZ BKN006 FEW018CB 22/21 Q1007 NOSIG=
DNPO 201900Z 24013KT 1500 TSRA BKN006 FEW018CB 22/21 Q1006 NOSIG=
DNPO 201700Z 23007KT 9999 TS BKN011 FEW020CB 32/25 Q1005 TEMPO 5000 -TSRA=
DNPO 201600Z 25007KT 9999 TS BKN011 FEW020CB 32/24 Q1005 NOSIG=
DNPO 201500Z 24007KT 9999 TS BKN012 FEW020CB 33/24 Q1005 TEMPO 5000 -TSRA=
DNPO 201400Z 19010KT 9999 BKN013 FEW021CB 33/24 Q1006 TEMPO 5000 -TSRA=
DNPO 201300Z 24004KT 9999 BKN013 FEW021CB 33/25 Q1007 TEMPO 5000 -TSRA=
Incident Facts

Date of incident
Feb 20, 2018

Classification
Accident

Airline
Dana Air

Departure
Abuja, Nigeria

Destination
Port Harcourt, Nigeria

Aircraft Registration
5N-SRI

Aircraft Type
McDonnell Douglas MD-83

ICAO Type Designator
MD83

Airport
Port Harcourt International Airport, Port Harcourt

Airport ICAO Code
DNPO

This article is published under license from Avherald.com. © of text by Avherald.com.
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