Alliance F50 at Adelaide on Aug 17th 2016, runway incursion
Last Update: November 22, 2016 / 18:03:43 GMT/Zulu time
Incident Facts
Date of incident
Aug 17, 2016
Classification
Incident
Cause
Runway incursion
Airline
Alliance Air
Flight number
QQ-3201
Departure
Olympic Dam, Australia
Destination
Adelaide, Australia
Aircraft Registration
VH-FKV
Aircraft Type
Fokker 50
ICAO Type Designator
F50
Airport ICAO Code
YPAD
A Jetstar Airways Airbus A320-200, registration VH-VGI performing flight JQ-774 from Melbourne,VI to Adelaide,SA (Autralia), was on very short final to Adelaide's runway 23 below 100 feet AGL at 09:28L (23:58Z Aug 16th) when the Jetstar crew decided to go around after getting sight of the Fokker 50 entering their landing runway. The aircraft climbed 3500 feet, positioned for another approach and landed safely on runway 23 about 16 minutes after the go around.
Australia's TSB reported on Aug 19th 2016, that the occurrence was rated an incident, an investigation has been opened. The Fokker crew misunderstood an ATC instruction and as result entered runway 23 without clearance.
On Nov 22nd 2016 the ATSB released their final report releasing following ATSB comment regarding the probable causes of the incident:
The A320 crew are to be commended for their actions in preventing a potentially more serious incident occurring.
The flight crew of FKV thought they were cleared to cross the runway probably because of the bay allocation at the end of the hold short instruction. An effective sighting of the aircraft on final approach may have led them to query their understood instruction to cross the runway.
The SMC (Surface Movement Controller) heard one word in response and mis-heard it as ‘short’ rather than ‘cross’ and that assumed ‘hold’ had been clipped from the transmission. The SMC did not question the pilots about the missing word as they had some previous experiences of the beginning of transmissions being clipped. As there was a ‘quiet tower’ communications system, there was no opportunity for the ADC (Aerodrome Controller) to hear this pilot read-back to the SMC and notice the misunderstandings before the runway incursion.
The ADC was in the process of handover/takeover and was not watching the landing A320 or the runway as they assumed FKV would hold short and that the runway was clear.
The ATSB described the events:
On 17 August 2016, at about 0926 Central Standard Time (CST), an Alliance Airlines Fokker F27 MK 50 aircraft (Fokker 50), registered VH-FKV (FKV), and operating with callsign ‘Unity 3201’, landed on runway 12 at Adelaide Airport, South Australia (SA) after a flight from Olympic Dam, SA. The flight crew consisted of a captain seated in the left seat and a check captain seated in the right seat acting as the first officer. Also on board were two cabin crewmembers and 49 passengers.
Air traffic control (ATC) audio recordings showed that at 0926:53, after FKV had rolled through the intersection with runway 23, the aerodrome controller (ADC) cleared an aircraft for take-off on runway 23 (Figure 1).
At the end of runway 12, FKV then exited runway 12 onto taxiway D2. After vacating the runway, the check captain switched the aircraft radio from the ATC Tower frequency to Ground frequency and reconfigured the aircraft in accordance with standard operating procedures after landing. The check captain was unable to immediately contact the surface movement controller (SMC) due to congestion on the Ground frequency. The SMC position had combined SMC and airways clearance1 delivery responsibility.
At 0927:46, the ADC cleared a Jetstar Airbus A320 aircraft, registered VH-VGI (VGI), to land on runway 23. At that stage, the ADC sighted the A320 about 3 NM away on final approach. The flight crew of FKV did not hear that clearance.
Shortly after entering taxiway D2, the check captain, seated on the right of FKV looked outside and sighted an aircraft in the take-off roll on runway 23 and also sighted the A320 on final approach. They estimated that the A320 was 5 to 6 NM away. Based on that estimate, the check captain assessed that they would probably be cleared to cross runway 23 behind the departing aircraft and in front of the landing A320, and then turned their attention inside the cockpit to complete their after-landing checks.
As FKV approached holding point D2, the flight crew had not received an ATC clearance to cross runway 23, and the flight crew therefore assumed they were going to stop at the holding point. The check captain was still waiting for a break in transmissions to make their initial contact with the SMC to advise ‘Adelaide Ground, Unity 3201 for bay 50 golf’.
The SMC was issuing a clearance to another aircraft when they sighted FKV taxiing on taxiway D2 towards the direction the controller was facing. At 0927:49, the SMC told the flight crew of an aircraft awaiting an airways clearance to standby, then immediately said ‘Unity 3201 hold short of runway 23, I’ve got you going to 50 golf’.
The check captain of FKV reported that the start of the transmission from the SMC was over-transmitted and what they heard was ‘runway 23 and I’ve got you for bay 50 golf’. As the instruction included the parking bay, the check captain thought the SMC had instructed them to ‘cross runway 23…’ and read back ‘cross runway 23 to 50 golf, Unity 3201’. The SMC thought the pilot read back ‘short runway 23...’ and assumed that the word ‘hold’ had been ‘clipped’. Both flight crewmembers of FKV thought they had received a clearance to cross runway 23.
The ADC sighted FKV on taxiway D2 and heard the SMC say ‘hold short’, but did not hear the response from the flight crew. The ADC scanned runway 23 to check it was still clear for the landing A320, which was then over buildings and less than 30 seconds from touchdown, and then commenced a handover of the ADC position to another controller.
At 0928:10, the SMC coordinated with the ADC and cleared a vehicle to cross runway 12.
The captain (in the left seat) of FKV then looked to their left and stated ‘clear left’ and taxied the aircraft onto runway 23 to cross. The check captain then looked to their right and sighted the A320 and reported that it was a lot closer than they had expected.
The SMC had looked down at their screen to check the flight strip for the aircraft awaiting a clearance. As the controller looked up, they saw FKV crossing the holding point.
At 0928:21, the SMC called ‘hold short’ and immediately realising that was not the correct instruction, said ‘Unity expedite expedite Unity’. The SMC could then see the A320 in the go-around. The ADC heard the SMC call ‘expedite’ and looked up to see the A320 about 100 ft above the runway – already in the go-around. At 0928:25, the ADC directed the A320 crew to go around.
The captain of FKV continued to taxi the aircraft across the runway and onto taxiway D1 and did not sight the A320 at any time. The A320 (VGI) returned to land without further incident.
Metars:
YPAD 170200Z 05007KT 9999 FEW024 19/08 Q1021 NOSIG
YPAD 170130Z 03007KT 9999 FEW022 18/08 Q1021 NOSIG
YPAD 170100Z 11002KT 9999 FEW022 17/09 Q1022 NOSIG
YPAD 170030Z 00000KT 9999 FEW022 16/09 Q1022 NOSIG
YPAD 170000Z 00000KT 9999 FEW020 15/09 Q1022 NOSIG
YPAD 162330Z 08003KT 9999 FEW020 13/09 Q1022 NOSIG
YPAD 162300Z 00000KT 9999 FEW018 12/09 Q1022 NOSIG
YPAD 162230Z 00000KT 9999 FEW018 10/09 Q1022 NOSIG
YPAD 162200Z 00000KT 9999 FEW018 08/08 Q1022 NOSIG
YPAD 162130Z 08005KT 9999 MIFG FEW020 07/07 Q1022 FM2300 VRB05KT CAVOK
YPAD 162100Z 00000KT 9999 MIFG FEW018 08/07 Q1021 FM2300 VRB05KT CAVOK
YPAD 162030Z 10001KT 9999 MIFG NSC 08/07 Q1021 FM2300 VRB05KT CAVOK
YPAD 162000Z 00000KT 9999 MIFG NSC 08/07 Q1021 NOSIG
Aircraft Registration Data
Incident Facts
Date of incident
Aug 17, 2016
Classification
Incident
Cause
Runway incursion
Airline
Alliance Air
Flight number
QQ-3201
Departure
Olympic Dam, Australia
Destination
Adelaide, Australia
Aircraft Registration
VH-FKV
Aircraft Type
Fokker 50
ICAO Type Designator
F50
Airport ICAO Code
YPAD
This article is published under license from Avherald.com. © of text by Avherald.com.
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