Garuda B733 at Malang on Jul 22nd 2011, hard landing

Last Update: July 23, 2014 / 22:01:04 GMT/Zulu time

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Incident Facts

Date of incident
Jul 22, 2011

Classification
Report

Cause
Hard landing

Airline
Garuda Indonesia

Aircraft Type
Boeing 737-300

ICAO Type Designator
B733

In July 2014 the NTSC released their final report concluding the probable causes of the accident were:

During the circle to land approach, the aircraft was turned too early that might cause the aircraft higher above the normal approach path and not on the correct track and was taken over by the PIC.

The approach was un-stabilized until below 300 feet and the absent of reminder from the other crew to go-around. These actions inconsistent to the operator standard operating procedures as well as the CRM philosophy.

The NTSC reported that the touch down produced a vertical acceleration of +3.473G.

The NTSC analysed that during final approach, below 500 feet the speed reduced to 118 KIAS (Vref was 130 KIAS) prompting the first officer, now pilot monitoring to call the speed. Any speed deviation below Vref immediately fulfills the criteria of an unstable approach and should have prompted a go-around.

The NTSC analysed that the pitch oscillated creating a rate of descent of up to 1080 fpm, any rate of descent above 1000 fpm requires a go-around due to violation of stabilized approach criteria.

The bank angle varied from 9 to 21 degrees, there was no specification of the bank angle within the stabilized approach criteria however.

The NTSC stated: "Refer to the recorded data in the FDR indicated that the aircraft was on unstabilized approach while in an VMC condition until below 300 feet which required to go-around."

The NTSC analysed that the captain assessed the first officer under line training would not be able to handle and correct the approach and therefore took control of the aircraft. The Boeing flight crew manual states however: "Any significant deviation from planned flight path, airspeed, or descent rate should be announced. The decision to execute a go-around is no indication of poor performance. Note: Do not attempt to land from an unstable approach."

Although the aircraft was not within the criteria of stabilized approach below 300 feet AGL, there was no call to go around or call the unstable approach. The NTSC stated: "the PIC decision to take over control and continued the approach on an un-stabilized approach and absent of reminder from the other crew was not consistent with the operator standard operating procedures as well as the CRM Policy."
Incident Facts

Date of incident
Jul 22, 2011

Classification
Report

Cause
Hard landing

Airline
Garuda Indonesia

Aircraft Type
Boeing 737-300

ICAO Type Designator
B733

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