Transavia B738 at Malaga on Dec 2nd 2016, landed below final fuel reserve after diversion and go around due to runway incursion

Last Update: March 7, 2018 / 16:01:15 GMT/Zulu time

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Incident Facts

Date of incident
Dec 2, 2016

Classification
Report

Flight number
HV-6729

Destination
Seville, Spain

Aircraft Registration
PH-HZW

Aircraft Type
Boeing 737-800

ICAO Type Designator
B738

A Transavia Boeing 737-800, registration PH-HZW performing flight HV-6729 from Amsterdam (Netherlands) to Seville,SP (Spain) with 171 passengers and 6 crew, was on approach to Seville's runway 09 about to reach the initial approach fix when another aircraft suffered a burst tyre and became disabled on the runway. As result the Boeing was instructed to enter a hold, after completing three circles ATC informed the crew that the runway would remain closed for at least 10 more minutes at which point the crew decided to divert to Malaga advising they did not have sufficient fuel anymore to hold for that long. The aircraft climbed out and was on final ILS approach to Malaga's runway 13 when a Swiftair ATR-72-212A registration EC-LYI performing flight UX-5036 from Malaga to Madrid,SP (Spain) lined up runway 13 although having been told to hold short of the runway. As result tower instructed the Transavia to go around, the crew initiated the go around, 1410kg of fuel remaining, and declared emergency due to being low on fuel. The Boeing positioned for another approach to runway 13 and landed safely with 1034kg of fuel remaining (required minimum fuel 1133kg).

Spain's CIAIAC released their final report concluding the probable causes of the incident were:

The incident analyzed in this report was caused by the successive delays introduced into the flight for reasons beyond the control of its crew.

The following factors are deemed to have contributed to this event:

- The inefficient handling of the incident that caused the closing of the runway at the destination airport, in terms of the exchange of information between the stations involved and the lack of a realistic time estimate for a return to normal operations.

- The misinterpretation by the crew of the aircraft with callsign AEA5036 of the controller’s instruction, which resulted in that aircraft’s runway incursion.

The CIAIAC analysed with respect to the disabled aircraft in Seville: "taxiway E3, where the aircraft stopped, and the building of the airport’s firefighting service are practically opposite the TWR, not far from it (500 m and 870 m away, respectively). The controller would thus have had a good view of the entire area. It might have been this good view that allowed him to realize that the aircraft only had to be moved a few meters to leave the runway clear, in which case it could have been placed back in use."

The analysis becomes even more critical of the airport authority in Seville: "The exchange of information between the airport authority and the TWR does not seem to have been as effective as desired. In fact, during those 10 minutes, the controller did not receive any calls informing him of the work to move the aircraft. Even the calls he placed in an effort to obtain information were unsuccessful."

With respect to the runway incursion at Malaga the CIAIAC reported that the Swiftair was instructed to hold short of runway 13 after reporting ready for departure, however read back "Line up runway 13 and wait" and proceeded to line up the runway. The CIAIAC analysed:

As the crew of the aircraft with callsign AEA5036 recognized, after receiving the controller’s instruction, they began taxiing into the runway, going past the holding point marking, before the controller could warn them of their incorrect acknowledgement of his instruction.

Based on the definition provided in the first paragraph of this section, since the aircraft crossed the holding point marking, even if it only went a meter beyond it, this would qualify as a runway incursion.

In such a case, as specified in the RCA, the controller should take action as indicated in letter a) of point 4.5.5.4.1 and “instruct a landing aircraft to initiate a go-around or missed approach procedure”, which is what the controller at the Málaga TWR did.

Therefore, his actions are deemed to be fully consistent with the requirements in the RCA.

The CIAIAC rated the runway incursion a category D event signifying: "an incident that meets the definition of runway incursion such as incorrect presence of a single vehicle/person/aircraft on the protected area of a surface designated for the landing and take-off of aircraft but with no immediate safety consequences."

With respect to the Transavia flight the CIAIAC analysed that the crew had added 231kg of fuel to the operational flight plan enabling them to use Malaga and Jerez as alternates. Weather forecasts did not indicate any adverse weather situation. The CIAIAC did not indicate any issue with the flight crew's management of the flight and fuel.

Two safety recommendations to the Spanish Airport Operator, Seville Airport, were issued as result of the investigation.
Aircraft Registration Data
Registration mark
PH-HZW
Country of Registration
Netherlands
Date of Registration
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Airworthyness Category
Legal Basis
Manufacturer
The Boeing Company
Aircraft Model / Type
737-800
ICAO Aircraft Type
B738
Year of Manufacture
Serial Number
Aircraft Address / Mode S Code (HEX)
Maximum Take off Mass (MTOM) [kg]
Engine Count
Engine
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Engine Type
Incident Facts

Date of incident
Dec 2, 2016

Classification
Report

Flight number
HV-6729

Destination
Seville, Spain

Aircraft Registration
PH-HZW

Aircraft Type
Boeing 737-800

ICAO Type Designator
B738

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