Re­port re­veals Air Canada jet was feet from his­toric disas­ter

The Standard (St. Catharines) - - Canada & World - DAVID KOENIG

Safety of­fi­cials say a near col­li­sion of air­lin­ers in San Fran­cisco last year was a few feet from be­com­ing the worst crash in avi­a­tion his­tory and un­der­scores the need for faster re­port­ing of dan­ger­ous in­ci­dents be­fore ev­i­dence is lost.

The Na­tional Trans­porta­tion Safety Board is­sued a fi­nal re­port Thurs­day on the in­ci­dent in which an Air Canada jet nearly crashed into planes lined up on the ground at San Fran­cisco In­ter­na­tional Air­port.

The pilots were slow to re­port the in­ci­dent to su­pe­ri­ors. By the time they did, the plane had made an­other flight and the cock­pit voice record­ing of the close call was recorded over.

The NTSB says the record­ing could have helped in­ves­ti­ga­tors un­der­stand why the Air Canada pilots missed the run­way and were about to land on a taxi­way where four other planes were idling be­fore the land­ing was aborted.

The Air Canada jet swooped to just 60 feet above the ground while pass­ing over other planes packed with pas­sen­gers wait­ing to take off shortly be­fore mid­night on July 7, 2017.

“Only a few feet of sep­a­ra­tion pre­vented this from pos­si­bly be­com­ing the worst avi­a­tion ac­ci­dent in his­tory,” NTSB vicechair Bruce Lands­berg said in a state­ment with the re­port.

An­other board mem­ber, Earl Weener, said the Air Canada plane came within feet of hit­ting an­other plane and col­lid­ing with sev­eral oth­ers.

“Over 1,000 peo­ple were at im­mi­nent risk of se­ri­ous in­jury or death,” he said.

The dead­li­est avi­a­tion ac­ci­dent oc­curred in 1977, when two Boe­ing 747 jets col­lided on a run­way in Tener­ife on the Ca­nary Is­lands, leav­ing 583 peo­ple dead.

The Air Canada cap­tain, iden­ti­fied in NTSB doc­u­ments as Dimitrios Kisses, was sup­posed to re­port the San Fran­cisco in­ci­dent to the air­line as soon as pos­si­ble but didn’t be­cause he was “very tired” and it was late. He waited un­til the next day. By that time, the plane was used for an­other flight, and the au­dio loop on the cock­pit voice recorder was taped over.

The NTSB did not al­lege that Kisses and co-pi­lot Matthew Dampier de­lib­er­ately de­layed re­port­ing the in­ci­dent, but it did say that in­ves­ti­ga­tors could have gained a bet­ter un­der­stand­ing of what the crew was do­ing be­fore the close call.

The NTSB is con­sid­er­ing rec­om­mend­ing that cock­pit recorders cap­ture the last 25 hours of fly­ing time, up from two hours un­der cur­rent rules.

Board mem­ber Weener also crit­i­cized the air­line in­dus­try’s re­liance on self-re­port­ing of safety is­sues, say­ing the in­dus­try and the Fed­eral Avi­a­tion Ad­min­is­tra­tion should con­sider stronger mea­sures to in­ter­vene af­ter a dan­ger­ous si­t­u­a­tion.

Weener noted that other pilots were alert enough to turn on lights to warn the off-course Air Canada jet.

Yet once the dan­ger passed, he said, they took no ac­tion to prompt “an in­ter­ven­tion and eval­u­a­tion of the Air Canada crew.”

The five-mem­ber board de­ter­mined last month that the in­ci­dent was caused by the Air Canada pilots be­ing con­fused be­cause one of two par­al­lel run­ways was closed that night.

The clo­sure was noted in a brief­ing, and nine other planes had made rou­tine land­ings af­ter the run­way was shut down.

The safety board also crit­i­cized the FAA for hav­ing just one con­troller on duty at the time of the in­ci­dent, and rec­om­mended bet­ter light­ing to tell pilots when a run­way is closed at night.

“It is note­wor­thy that the NTSB’s rec­om­men­da­tions were not di­rected at Air Canada specif­i­cally and ad­dress many ar­eas for im­prove­ment,” said Air Canada spokesper­son Pe­ter Fitz­patrick.

Air Canada told the NTSB it has taken steps to in­crease safety, in­clud­ing em­pha­siz­ing proper pro­ce­dures for land­ing ap­proaches and spe­cific train­ing to fa­mil­iar­ize pilots with the San Fran­cisco air­port.


San Fran­cisco air­port. U.S. of­fi­cials have is­sued a fi­nal re­port on the 2017 close call in which an Air Canada jet nearly crashed into planes lined up.

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