UIA B738 at Paris on Nov 11th 2018, navigation error

Last Update: November 22, 2019 / 16:54:56 GMT/Zulu time

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Incident Facts

Date of incident
Nov 11, 2018

Classification
Incident

Flight number
PS-128

Destination
Kiev, Ukraine

Aircraft Registration
UR-PSB

Aircraft Type
Boeing 737-800

ICAO Type Designator
B738

A UIA Ukraine International Airlines Boeing 737-800, registration UR-PSB performing flight PS-128 from Paris Charles de Gaulle (France) to Kiev (Ukraine), departed Charles de Gaulle's runway 27L (northern runway pair) and immediately after departure turned south without clearance into the departure path of the southern runways.

An Air France Airbus A320-200, registration F-HBNJ performing flight AF-7624 from Paris Charles de Gaulle to Bordeaux (France), departed Charles de Gaulle's runway 26R (southern runway pair) at the same time. Recognizing the unexpected turn by the UIA Boeing ATC instructed the A320 to stop climb at 2000 feet.

France's BEA reported the UIA Boeing 737 turned south without clearance after departing the northern runway pair, while an Air France A320 was departing the southern runway pair. ATC kept the A320 down at 2000 feet, the separation between the two aircraft reduced to 300 feet vertical and 2.27nm horizontal. The BEA rated the occurrence an incident due to a navigation error and opened an investigation.

Both aircraft continued to their destinations without further incidents.

On Nov 22nd 2019 Ukraine's NBAAI reported that runways 26R and 27L were indicated as active departure runways via ATIS. With runway 26R being closer to their stand the crew thus prepared runway 26R and standard departure route RANUX2B associated with runway 26R in their FMS.

About 12 minutes prior to slotted engine start up time and about 37 minutes prior to slotted departure time the crew received clearance for runway 27L and standard departure route RANUX2A. The crew indicated they would need to request extra time for the setup (ATC indicated this would not be a problem) but ultimately did not issue that request and the slot times remain unchanged. The crew had been interrupted by a ground agent delivering the load sheet to the crew. As result the crew did not cross check the FMS, indicated ready for departure shortly before slot time to start engines and departed with the FMS tracking RANUX2B.

After the aircraft turned into the departure path of runway 26R the separation between UR-PSB and F-HBNJ reduced to 300 feet vertical and 2.65nm horizontally, until both aircraft received and carried out instructions by their controllers at north and south tower which sent the aircraft on diverging flight trajectories again defusing the developing conflict. Both aircraft were in clouds (ceilings at 1400 feet) at that time.

The crew of F-HBNJ reported that it was difficult to comply with the sudden altitude restriction to 2000 feet due to the high climb rate, they overshot to 2100 feet before descending to 2000 feet again. They were stunned to not hear the conflicting aircraft on radio yet see a silhouette in the clouds of it slightly above them, they could also see the aircraft on their TCAS screen.

UIA have reviewed and modified procedures to ensure that a cross check of FMS settings occur before departure on airports with parallel runways.
Incident Facts

Date of incident
Nov 11, 2018

Classification
Incident

Flight number
PS-128

Destination
Kiev, Ukraine

Aircraft Registration
UR-PSB

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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