Jetstar A320 at Sydney on Jul 28th 2014, departed with incorrect takeoff configuration
Last Update: February 26, 2015 / 15:55:49 GMT/Zulu time
Incident Facts
Date of incident
Jul 28, 2014
Classification
Incident
Airline
Jetstar Airways
Flight number
JQ-766
Departure
Sydney, Australia
Destination
Adelaide, Australia
Aircraft Registration
VH-VFU
Aircraft Type
Airbus A320
ICAO Type Designator
A320
Australia's TSB have opened a investigation into the occurrence rated an incident.
On Feb 26th 2015 the ATSB released their brief final report releasing following safety message:
This incident highlights the importance of careful attention to the actions taken during flows and checks, particularly under circumstances where there is a change in plans, such as a changed departure runway. The incident also highlights the importance of careful attention to cross referencing calculated performance data and configuration with the inputted data and displayed configuration information. This is particularly important under circumstances where a crew may be susceptible to the effects of reduced vigilance, or where there is an increased risk of distraction. Under these circumstances, crew monitoring and cross-checking assume greater importance.
The ATSB reported that the aircraft had been assigned runway 16L for departure, which required a flap setting of 2. However, due to increasing tail winds ATC changed the active runways and assigned runway 34L for departure as result, this runway requiring the flaps at setting 1+F. The captain, pilot flying, who had computed the performance data for departure from runway 16L redid the computations and entered the new performance data into the FMGS, to relief some of the work load resulting from the runway change the first officer took over load sheet computations. The first officer subsequently computed the performance data, too, and cross checked the entries in the FMGS.
While executing the "After Start" checklists the first officer set the flaps to position 2 and verified the position with the ECAM finding the flaps had moved to position 2 indeed and satisfied believing they needed to set the flaps to position 2 as originally planned.
The first officer subsequently pressed the takeoff configuration push button to simulate a TOGA activation, so that the checks for proper aircraft configuration would occur. The ATSB annotated however that these checks do not compare the flap setting in the FMGS with the manually selected flaps position, hence the incorrect takeoff configuration was not detected by the automation.
After climbing to safety height of 800 feet the captain, pilot flying, began to accelerate the aircraft and only now noticed that the aircraft's speed was above the flap retraction speed. The crew now realised that the flaps had been incorrectly configured, set the flaps to 1+F and continued with a normal flight acceleration.
The ATSB reported that it was the 4th sector of the day for both crew, both crew "reported being tired at sign on; however, had judged themselves fit to fly" and further reported: "Although the checks had all been completed, the crew were briefly distracted by a new Cathay Pacific 747-800 departing." stating that this distraction prevented the captain (8,400 hours of total flying experience) to notice the incorrect flap setting.
The ATSB analysed: "Although the crew conducted the before take-off checklist they did not notice that the flap setting was incorrect. The decreased vigilance was most likely a result of the crew not operating at their optimum due to the continuous high workload and decreased level of operational capability at the start of duty."
Aircraft Registration Data
Incident Facts
Date of incident
Jul 28, 2014
Classification
Incident
Airline
Jetstar Airways
Flight number
JQ-766
Departure
Sydney, Australia
Destination
Adelaide, Australia
Aircraft Registration
VH-VFU
Aircraft Type
Airbus A320
ICAO Type Designator
A320
This article is published under license from Avherald.com. © of text by Avherald.com.
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