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-   -   AA 106 @ JFK (13 Jan 23) (https://www.pprune.org/accidents-close-calls/650801-aa-106-jfk-13-jan-23-a.html)

SWBKCB 20th Jan 2023 08:38


Another Swiss cheese hole is when the AA crew were holding and expecting to cross the runway ahead of them ATC said "Cross runway 31L at Kilo"

If ATC had said to them, "Turn right on Kilo and cross 31L" I do not think the incident would have happened as the instruction to turn right would have been different to what they were expecting and would have made them realise.
Isn't the key bit here "Cross runway 31L"? Even at the little puddle jumper airports I fly into there are big red signs telling you what the ahead runway is and the holding point.

Surely you would want to visually confirm the identity of any active runway you are about to enter?

ATC Watcher 20th Jan 2023 09:05


Originally Posted by draglift (Post 11369674)
If ATC had said to them, "Turn right on Kilo and cross 31L" I do not think the incident would have happened as the instruction to turn right would have been different to what they were expecting and would have made them realise.

Do not try to shift or dilute the errors made by the AAL crew . There are long established taxi procedures, and they work 99.999% of the time . Instructing pilots to turn right or left from 3 Km away will create far more possibilities for confusion and errors than anything else.
Whether the stop bars were on or not is the thing I would like to know though.
I know from an IFALPA/IFATCA survey many years ago asking which airports pilots were routinely instructed by ATC to cross illuminated red bars that there were quite a few at the time . I thought the problem was solved. Or does any of you here still experience this somewhere today ?

punkalouver 20th Jan 2023 11:52

A good reason why I write down the clearances as they are given. In this case, 04L would have been right there in front of them as a reminder in case they had accidentally gotten 31L in their mind for departure.

It is not always realistic but for those not intimately familiar with the airport, it can be useful to stop after getting the clearance(or already be stopped prior to getting it) and review it with map to get the picture in mind(much more effective than doing this while taxiing). One can also review the names of the cross-taxiways that precede kilo so that they are better prepared to be aware when they are getting close to Kilo.

Obviously, if very familiar with the route/airport, one will likely be comfortable with taxiing while getting the clearance, like many of us do at a home base complicated airport(no guarantee that these two pilots had operated out of JFK for a long time).

But having that runway written down may pay off 5 minutes later when you quickly look at your piece of paper and discover that you have the wrong runway in mind. It may sound unnecessary to write it down but the runway to be used is usually at the beginning of the clearance and if a lot is added on to the transmission or something else is distracting, you may have forgotten what runway was given and then made an incorrect assumption, but pen mark on paper will not erase and should trigger one to question, if it is noticed.

Of course, the concept of not crossing an illuminated stop bar even if proper clearance is given is important as is a good look down the runway and perhaps questioning takeoff lights illuminated instead of assuming that the other aircraft is holding in position.

In addition, read the runway ID signs before crossing the runway. When you finish you acknowledgement to ATC to cross 31L, say out loud ‘cleared to cross 31L” to the other pilot and look for the sign or runway marking with that number and say it out loud. If you find yourself saying ‘cleared to cross 31L’ then discover yourself saying ‘04L’, you know it is time to stop.


250 kts 20th Jan 2023 12:46


Originally Posted by skydler (Post 11367209)
ATC audio:


Are we all comfortable with the quality of the "slurred" ATC as AAL106 is cleared to taxi? I had to listen to it 3 times to actually decipher that 4Left is mentioned, and even then it's only knowing he said 4L that it is a bit clearer.

Uplinker 20th Jan 2023 12:46

+1 punkalouver

I am sure most write down taxi instructions? I do in short-hand, so I can read them back correctly and to have the clearance in front of me if I should forget some of the details.

If it is a "simple airfield" with few taxiways, I might use the MCDU scratch-pad

The quality and delivery of speech from ATC at JFK has been noted - always my least favourite part of a long-haul trip !

100Series 20th Jan 2023 14:39

Departing JFK many years ago the cleance could include almost a full route as far as the ocean,read at lightning speed. Smart FOs would write down the flight plan in advance so they could read it back as fast as it was given. Extra points were earnt by replying for him, if the captain was doing the rt, didn't expect the torrent of words, and would need a repeat.
My favourite though was the southern U.S. captain who, after have had two repeats, drawlled "You'all hear how fast I speak, well that's how fast I write. Say again,"

(and don't get me started on "Climb to and maintain". Extra verbiage and a superfluous, possibly confusing, to)

WillowRun 6-3 20th Jan 2023 18:06

Sorry about having to bump into the thread here, but noticed a news article this afternoon which, to my merely SLF/attorney knowledge, seems quite pertinent.

Forbes reporting that the 106 FO, on first flight on 777 type (after experience on 737 and type training), was busy with new procedures, including making a p.a. announcement about imminent departure (article says "takeoff", but departure is the correct term, isn't it?). Article refers to input from an unnamed AA source; quoting, "she had just read the 35-page bulletin that changes procedures." Some content too about whether the changes in procedures were quite alright or not; per article, Allied Pilots Ass'n had initiated an "appeal" of their implementation.

Article notes also there was a third pilot on the 106 flight deck; that neither the PIC nor 3rd aviator saw the "stop bar lights on the runway"; and that AA 106 had just switched from company frequency to Tower frequency. AA 106 did not know the seriousness of the incursion until they arrived in London, per Forbes article. "Delta was cleared for takeoff before they switched over" to the tower frequency, the article quotes the source as saying.

An aviator active on Twitter, Kelly Lepley, posted the Forbes article. The American source it claims to rely on is identified as a "pilot" but not otherwise. [@kclepley - iirc, a UPS 747 captain]

Apologies twice for barging in on the aviator discussion.

wiggy 20th Jan 2023 18:10


Originally Posted by 250 kts (Post 11370253)
Are we all comfortable with the quality of the "slurred" ATC as AAL106 is cleared to taxi? I had to listen to it 3 times to actually decipher that 4Left is mentioned, and even then it's only knowing he said 4L that it is a bit clearer.

TBF we'd need to hear the original to judge if that was a factor but it sounds fairly normal for JFK (not that I go there anymore)

I think the one issue with the controller that appears to be a foul was that it appears (from the recording) that he didn't challenge the lack of runway assignment in the crew readback.

Other than that I'm afraid I am agree to some degree with ATC watcher's opening comment a few posts upthread and the comment very early on by a poster about the crew and expectation...

BFSGrad 20th Jan 2023 18:20


Originally Posted by WillowRun 6-3 (Post 11370457)
An aviator active on Twitter, Kelly Lepley, posted the Forbes article. The American source it claims to rely on is identified as a "pilot" but not otherwise. [@kclepley - iirc, a UPS 747 captain]

Here's the referenced Forbes article:

First Officer On American JFK Runway Incursion Flight Had Added Task At Departure, Source Says

Not convinced this narrative reflects actual events.

DaveReidUK 20th Jan 2023 18:29


Originally Posted by WillowRun 6-3 (Post 11370457)
Forbes reporting that the 106 FO, on first flight on 777 type (after experience on 737 and type training), was busy with new procedures, including making a p.a. announcement about imminent departure (article says "takeoff", but departure is the correct term, isn't it?).

No, the terminology in Forbes is correct.

"Departure" is the process that starts with pushback (hence an on-time pushback = an on-time departure). A PA announcement about imminent pushback would be unlikely to be a factor in a runway incursion, for obvious reasons.

blind pew 21st Jan 2023 13:46

Reading the Forbes article it would appear that some soul decided to interfere with what should be a sterile phase of the flight in that the monitoring pilot had a series of tasks which could and should have been carried out when the aircraft was stationary. Especially relevant as the copilot was new on type.
It isn’t the first time that I’ve seen ill thought procedure changes which left no one monitoring.
Since the tasks involved checking take off performance then Pm wouldn’t have been looking outside.
Perhaps it’s also about time that the 30 mins CVR rule is changed - after all it was introduced 50 years ago.
(I was on BALPA tech committee in the early 70s tasked with airfield lighting amongst other things - operated a heavy in 1978 into JFK and know how difficult RT and taxying can be without unnecessary distractions).

ATC Watcher 21st Jan 2023 14:33

A sentence in the article is intriguing : it says both the captain , who was taxying ,and the supernumerary crew on the jumpset COULD not see the stopbars . Using "could" instead of "did" would indicate that either they physically from their seats could not see them perhaps because of the turns they were performing , or that they were not on.
But that could be just a journalist interpretation , who also apparently was wrong when he says that the crew did not know they were involved an incident until they reached London. , the ATC audio clearly shows otherwise. That they did not realise the seriousness of it, that I can believe, but they were informed they did not follow the taxi instructions.

MarkerInbound 21st Jan 2023 16:42


Originally Posted by blind pew (Post 11370895)
Perhaps it’s also about time that the 30 mins CVR rule is changed - after all it was introduced 50 years ago.

It’s now 2 hours in the FAA world. I’ve heard EASA has gone to 25 hours. I know the NTSB is pushing for 25 hours and have a list of investigations that have been hindered by lack of CVR records. I’m sure this event will be added to that list.

Lake1952 22nd Jan 2023 00:24


Originally Posted by ATC Watcher (Post 11370915)
That could be just a journalist interpretation , who also apparently was wrong when he says that the crew did not know they were involved an incident until they reached London. , the ATC audio clearly shows otherwise. That they did not realise the seriousness of it, that I can believe, but they were informed they did not follow the taxi instructions.

The AA crew was informed there was a deviation and told to make a phone call. The male pilot, presumably the Captain, intimated they were cleared to cross 4L when their instructions were to cross 31L at Kilo. Tower controller was remarkably calm, said we will listen to the tapes, but that they were using 4L for departures. I haven't seen any report on the length of the "phone call " or what was said. But AA 106 sat at the end of 31L for about 30 minutes. While they may not have realized how close they were to disaster, or how much notoriety was in store, they had to know they screwed up.

tdracer 22nd Jan 2023 00:41


Originally Posted by MarkerInbound (Post 11370965)
It’s now 2 hours in the FAA world. I’ve heard EASA has gone to 25 hours. I know the NTSB is pushing for 25 hours and have a list of investigations that have been hindered by lack of CVR records. I’m sure this event will be added to that list.

Problem is, the rule would probably only apply to 'new build' aircraft. Although it's gotten cheaper and easier to retrofit CVR boxes since everything's gone digital, it's still expensive.
There are still lots of aircraft out there flying around with tape based CVR/FDR equipment.

Chiefttp 22nd Jan 2023 13:06

Unquestionably the AA crew knew the implications of their incursion. It’s bad enough to have a runway incursion, it’s really bad to cause another aircraft to reject due to said incursion. As far as JFK ATC high speed delivery, I’m a native New Yorker and that’s the way we talk..I do agree it doesn’t lend itself well to ATC and aviation ops in general and I predict one of the big outcomes from this incident will be a slower, paced delivery by ATC at JFK. I will always warn any new F/O’s to write down everything and listen carefully when we’re at JFK.
Willow 6-3,
The fact that the F/O was new to the jet has little bearing in my opinion. You said you were an Attorney, so If you decide to trade in your Mercedes for a BMW, would that be a valid excuse to run a red light in your new BMW? Also as far as the jumpseater, 3rd crewmember. If he was a jumpseater, (hitching a ride) they will usually try to not get in the way, outside of checking for anything major (Flap settings etc), unless the Captain briefs him to do otherwise. In my Air Force days, we had a taxi incident in Africa. The AF decided that at all times while taxiing, all crew members would scan outside and clear our routing. So we normally had at least 3 or 4 crewmember scanning outside and backing us up.I predict another takeaway from this incident will be sterile cockpit while taxiing.

Bergerie1 22nd Jan 2023 14:06

Chiefttp, I know you all talk like that but my question is, with so many foreign pilots flying into JFK, would it not be wiser, for safety's sake, to try to accomodate them? Even though this incident did not involve foreign pilots, neverthless, a slightly slower delivery would benefit everyone.

Seaking74 22nd Jan 2023 15:56

I tuned into JFK ATC last night, as I do most nights, and my favourite controller was on, he has a broad, thick NY accent (think "cwoffee"). It was noticeable that he was speaking more clearly last night, especially to foreign flight crew, as was the female controller who took over from him. Did a memo go around already perhaps?

Chiefttp 22nd Jan 2023 16:17


Originally Posted by Bergerie1 (Post 11371465)
Chiefttp, I know you all talk like that but my question is, with so many foreign pilots flying into JFK, would it not be wiser, for safety's sake, to try to accomodate them? Even though this incident did not involve foreign pilots, neverthless, a slightly slower delivery would benefit everyone.

I agree with you 100%, what I meant by my comment is sometimes New Yorkers don’t realize how fast they speak naturally. It’s not necessarily intentional. Trust me I’m in awe of foreign crews who have to communicate in rapid fire English when it’s not their native tongue.

Uplinker 22nd Jan 2023 17:20

Yep. And nothing is gained by speaking so quickly. It's one thing doing so in a shop or a bar in New York city, but at a large, complex, busy airfield; where safety is critical, and many foreign crews operate; speaking slowly and clearly is very much a good idea.

You want everyone to clearly hear and understand, (and write down) clearances. There is no need to speak so fast, (and risk misunderstandings or having to repeat). It sometimes seems to me to be the oral equivalent of driving with one hand on the wheel and one arm leaning on the window ledge - it might look flash but it is less safe. :sad:


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