| Date: | Friday 10 February 2023 |
| Time: | 14:27 LT |
| Type: | Embraer EMB-505 Phenom 300 |
| Owner/operator: | NetJets Europe |
| Registration: | CS-PHM |
| MSN: | 50500471 |
| Fatalities: | Fatalities: 0 / Occupants: 2 |
| Other fatalities: | 0 |
| Aircraft damage: | None |
| Category: | Serious incident |
| Location: | 3 NM W of St. Gallen-Altenrhein -
Switzerland
|
| Phase: | Approach |
| Nature: | Private |
| Departure airport: | Bad Windsheim Airfield (EDQB) |
| Destination airport: | St. Gallen-Altenrhein Airport (ACH/LSZR) |
| Investigating agency: | STSB |
| Confidence Rating: | Accident investigation report completed and information captured |
Narrative:An Embraer EMB-505 Phenom 300 (CS-PHM) and a Diamond DA 40 (HB-SHB) were involved in a serious airprox incident 3 NM west of St. Gallen-Altenrhein Airport.
The Phenom jet was on an instrument approach to runway 10 and the DA 40 aircraft had taken off from runway 28 under visual flight rules.
In Class D airspace, in which the aircraft were located, collision avoidance is fundamentally ensured by the principle of "see and avoid." The operational procedures applied at St. Gallen-Altenrhein (LSZR) can lead to conflict situations depending on the sequence of events between IFR approaches to runway 10 and aircraft taking off from runway 28 in the opposite direction. In this case, there was a potential conflict between the HB-SHB departing westward from runway 28 and the CS-PHM approaching runway 10.
After taking off, the pilot of the HB-SHB was absorbed with aircraft control procedures and continued to fly straight ahead, contrary to the procedures published on the visual flight chart, thus putting himself on a collision course with the oncoming Phenom jet, leading to an airprox. The fact that the pilot responded to the repeated calls of the air traffic controller (ATC) with only his call sign or not at all suggests a severely limited capacity to respond during this phase.
The crew of the CS-PHM was informed by the ATC about the aircraft taking off from runway 28. After sighting the other aircraft, they performed an evasive maneuver. Simultaneously, the TCAS (Traffic Collision Avoidance System) acted as a safety net as intended.
The serious incident, in which a single-engine aircraft flying by visual flight rules from runway 28 came dangerously close to a business travel aircraft approaching runway 10 by instrument flight rules, was caused by the pilot of the light aircraft maintaining his course after takeoff and not initiating a right turn into the cross-departure route as published.
The operational procedures applied at St. Gallen-Altenrhein (LSZR), which regularly lead to take-offs and landings in opposite directions, contributed to the occurrence of the serious incident and thus represent a safety deficit.
Accident investigation:
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| | |
| Investigating agency: | STSB |
| Report number: | |
| Status: | Preliminary report |
| Duration: | 1 year and 11 months |
| Download report: | Preliminary report
|
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Sources:
STSB
Revision history:
| Date/time | Contributor | Updates |
| 01-May-2023 09:02 |
harro |
Added |
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