Read and question: scenario #1

The idea is not to judge or mock, but to read through and put yourself into the situation as much as you can. Think through what you might do, if any threats or errors might be potentially present in your own operations and consider how you would deal with them.

Most importantly, try to learn from it to avoid similar errors and threats in your operation.

Phase I

On September 18, 2018, an Air Arabia flight ABY111 departed the gate at OMSJ/Sharjah International Airport, UAE to OOSA/Salalah International Airport, Oman.

A new and relatively inexperienced pilot is undergoing training and operating their first flight to OOSA/Salalah with an extremely experienced training Captain. The flight is expected to take around 1 hour 50 minutes. The flight preparation went normally, and there was no evidence of rushing the before start checklist. The take-off mass was well below the maximum, and the flight documents, including the weather report, operational flight plan (OFP), and departure procedures, were checked and discussed between both flight crew members before the flight.

A procedure at the airline is for one engine to be started on stand/during pushback and a second to be started during taxi to minimise fuel consumption, and to assist with brake temperatures on the taxi.

Based on the above information, discuss some of the following:

• Are there any threats you can identify?
• Are there any barriers you can think of at this point to avoid threats and errors?

Phase II

The Commander briefed the Second Officer for an intersection and rolling takeoff as part of her training subjects. The responsibility for engine start was the Commander’s, and he was pilot monitoring so also responsible for communications and all other actions, whilst the Second Officer managed the aircraft taxi.

The aircraft was cleared to taxi to runway 30 via B15, A, B14, and to contact the tower on reaching the holding point. This was a relatively short taxi, especially compared to the taxi time for B20 which was the ‘expected’ holding point. During the taxi, the Commander started the right hand (no2) engine and on reaching the holding point the crew then carried out the take-off checklist ‘down to the line’. Following this, auto brake max was selected.

When the Commander checked in with tower, they were cleared for departure. The commander read it back, but did not inform the tower of a rolling take off. The aircraft parking brake was selected off and the Second Officer requested the before takeoff checklist below the line items as the aircraft started moving towards runway 12/30 – initially with idle thrust, but then the Second Officer increased both engines’ thrust above idle power as they initiated a right turn from heading 30 degrees towards runway 12.

Based on the above information:

• Can you see any new threats or errors emerging?
• Do you have any techniques or methods to manage task fixation, capacity or workload management?
• What is your technique for lining up on the runway?
• Of the threats identified, how could you mitigate against these?

Phase III

While the Captain was heads down completely the before take off checklist, the Second Officer turned onto the runway, facing the wrong direction. The Second Officer continued to advance thrust for a rolling takeoff. At 20 knots groundsheet a nose down force was added on the side stick, and within 3 seconds takeoff thrust was selected.The Second Officer stated she was occupied with monitoring engine power and line-up. She then noticed and called out that the flight mode annunciator (FMA) was showing NAV instead of RWY.

The Captain stated he was still finishing the checklist and did not notice the incorrect turn onto the runway.

At around 60knots, the Captain identified that they were facing the wrong way on the runway.This was approximately6 seconds after the initiation of the take-off roll. The intersection provided approximately 1000m runway.

The Commander stated “I saw the end of runway coming” but determined there was insufficient runway left to stop. Instead, he took control and advanced the thrust levers to TOGA.

At 106 knots, Tower called to say the aircraft was rolling the wrong way. The crew did not respond, but a few seconds later the Captain selected Config2 Flaps. Throughout the roll the Co-Pilot maintained a use down force on the side stick, while the Captain applied a nose up force.

The aircraft was rotated at 122knots, and the flaps/slats reached config2 position at around 127knots, with an increase in pitch up angle. The aircraft lifted off approximately 30 metres beyond the runway-end safety area (stopway)/ end of runway 12 and impacted a runway approach light.

Based on the above information, consider the following:

• Do you think there was any resilience or robustness shown by either pilot?
• How do you think the startle affect impacted both pilots?
• What do you brief for an RTO, and in this situation what do you think you might have done?
• Do you think the Second Officer was incapacitated and if so, in what way?
• What barriers might be present to avoid similar events?
  

References

The full accident investigation report for this event can be read here.