Incident Overview

Date: Sunday 3 March 2019
Aircraft Type: Airbus A320-214 (WL)
Owner/operator: Avianca Brasil
Registration Number: PR-OCW
Location: Rio de Janeiro/Gale?o-Antonio Carlos Jobim International Airport, RJ – ÿ Brazil
Phase of Flight: Landing
Status: Substantial, repaired
Casualties: Fatalities: 0 / Occupants: 168
Component Affected: Airbus A320-200 Flight O66227 ? Specifically, the aircraft?s flight control system, landing gear, and navigational systems.Airbus A320-200 Flight O66227 ? Specifically, the aircraft?s flight control system, landing gear, and navigational systems.
Investigating Agency: CENIPACENIPA
Category: Accident
An Airbus A320-200 flight O66227 experienced a significant landing deviation near Rio de Janeiro/Gale?o Airport due to challenging weather conditions. The pilot, responding to unfavorable wind and rain, initiated a maneuver to correct the aircraft?s lateral drift, but this was insufficient to stabilize the flight. Contributing factors included adverse meteorological conditions, pilot communication errors, and a compromised assessment of the aircraft?s flight state, ultimately leading to a landing outside the runway?s designated limits.An Airbus A320-200 flight O66227 experienced a significant landing deviation near Rio de Janeiro/Gale?o Airport due to challenging weather conditions. The pilot, responding to unfavorable wind and rain, initiated a maneuver to correct the aircraft?s lateral drift, but this was insufficient to stabilize the flight. Contributing factors included adverse meteorological conditions, pilot communication errors, and a compromised assessment of the aircraft?s flight state, ultimately leading to a landing outside the runway?s designated limits.

Description

Avianca Brasil flight O66227, an Airbus A320-200, touched down partially outside the runway while landing in heavy rainfall on runway 15 at Rio de Janeiro/Gale?o Airport, Brazil. The landing of the aircraft occurred under unfavorable weather conditions caused by heavy rain over the airfield and sudden variation in the direction and intensity of the surface wind. At the exact moment of the touch down, the wind was from a direction of 057ø at 19kts. The contact of the aircraft with the ground occurred about 916m beyond the threshold of runway 15 with the right main landing gear completely outside the lateral limits of the runway, at a speed of 121kts. After landing, the aircraft traveled 668m outside the runway. The pilot regained control of the aircraft and returned it to runway 15. Contributing factors. – Control skills – a contributor. The corrections applied to the flight commands, in order to control the tendency of the aircraft to laterally deviate to the right in relation to the center of SBGL runway 15, were not sufficient to stop this movement, nor to redirect the aircraft to the central axis of flight. Consequently, the aircraft touched the ground with the right main landing gear outside the runway’s lateral limits. – Organizational climate – undetermined. When considering the organizational climate present in the company at the time of the occurrence, it is possible that this scenario has influenced the assessments and, consequently, the crew’s decision to proceed with the landing, despite the adverse conditions encountered. – Adverse meteorological conditions – a contributor. The significant change in the direction and intensity of the wind in the final approach, which started to blow from the left abeam, and the increase in the intensity of the rain on the Aerodrome, which impaired the pilots’ peripheral vision and compromised the exact notion of depth of the aircraft in relation to the runway, contributed to the drifting movement of the aircraft to the right side of the SBGL runway 15. – Crew Resource Management – a contributor. When the aircraft was flying below 100ft height, the copilot conducted several callouts stating that the aircraft was off the runway axis. The commander collated the first ones, however, after a certain moment; he no longer properly responded to the copilot’s callouts and proceeded to land, despite the repeated alerts received. The copilot, even realizing that the commander’s corrections were not enough to control the aircraft and return it to the central axis of the runway, did not ask the commander, more assertively, to execute a go-around procedure in flight. This showed that the crewmembers had enough information to discontinue the landing, but they chose not to use this feature, which contributed to the occurrence. – Piloting judgment – a contributor. There was an incomplete assessment of the aircraft’s flight conditions. Once the tendency of lateral deviation to the right of the central axis of the runway was detected, the pilots thought it possible to correct this tendency in time to make the landing safely, which contributed to the outcome of the occurrence. – Perception – a contributor. The maintenance of the focus on the lateral deviation of the aircraft interfered in the identification of other variables present, such as the condition of destabilization and low visibility, which could affect the landing in a safe way. Thus, this selective perception, reinforced by the expectation of completing the landing at the destination, contributed to the outcome of this occurrence. – Management planning – undetermined. All crewmembers on flight O66227 were called for the mission in accordance with the on notice roster. The calling of the copilot and the flight chief did not adhere to the established in the company’s MGO; consequently, both were late to present themselves for the aircraft commander. Flight O66227 took off 30 minutes after the scheduled time. It is possible to consider that the delayed takeoff from Salvador to Rio de Janeiro had a negative influence on the assessments and the decision of the crewmembers to proceed with the execution of the landing. – Decision-making process – a contributor. There was a compromised analysis of the information available to the crew, so that the aircraft’s destabilization condition was not considered, as well as the meteorological degradation in the final approach, culminating in the decision to try to correct the aircraft until the last moment, even if unanswered, and proceed with the landing on SBGL.

Primary Cause

Adverse meteorological conditions, particularly the significant change in wind direction and intensity during the final approach, combined with impaired peripheral vision and a lack of sufficient information regarding the aircraft?s flight condition.Adverse meteorological conditions, particularly the significant change in wind direction and intensity during the final approach, combined with impaired peripheral vision and a lack of sufficient information regarding the aircraft?s flight condition.

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