ASN logo
ASN Wikibase Occurrence # 190652
Last updated: 23 July 2017
This information is added by users of ASN. Neither ASN nor the Flight Safety Foundation are responsible for the completeness or correctness of this information. If you feel this information is incomplete or incorrect, you can submit corrected information.

Date:05-OCT-2016
Time:20:40
Type:Silhouette image of generic E190 model; specific model in this crash may look slightly different
Embraer ERJ-195LR (ERJ-190-200 LR)
Owner/operator:Air Dolomiti, opf Lufthansa
Registration: I-ADJO
C/n / msn: 19000280
Fatalities:Fatalities: 0 / Occupants: 67
Other fatalities:0
Airplane damage: None
Category:Serious incident
Location:Brussel-Zaventem Airport (BRU/EBBR) -   Belgium
Phase: Take off
Nature:International Scheduled Passenger
Departure airport:Brussel-Zaventem Airport (BRU/EBBR)
Destination airport:Munich Airport (MUC)
Investigating agency: Air Accident Investigation Unit (AAIU) - Belgium
Narrative:
An Air Dolomiti Embraer ERJ-195LR, operating Lufthansa flight LH2293 was involved in a runway incursion incident during takeoff from Brussel-Zaventem Airport.
LH2293 was slightly late and the crew, during push-back, requested to depart from the C5 intersection of runway 07R. The Ground controller responded by giving a taxi route leading to the C6 intersection. The crew did not immediately understand the taxi route received due to the speech rate of the controler and requested clarification.
The captain was Pilot Flying for the flight, while the first officer was Pilot Monitoring.
The first officer reported high work load during taxi operations due to the "unfriendly airport lay-out" and taking into account that it was night. Both captain and first officer were listening out the same radio frequency.
Upon reaching the C6 intersection, the airplane stopped before the stop bar that was lit. After switching to the Tower frequency, the crew received the instruction "line up and wait" for runway 07R and the first officer read back the instruction correctly. The stop bar lights dimmed, allowing the airplane to proceed.
Another airplane, an Airbus A320 operated by Aer Lingus as flight EI638 from Dublin, Ireland, was in final approach for landing on runway 01. It was cleared to land by Brussels Tower after LH2293 received the instruction for lining up on the crossing runway (07R).
The captain of LH2293 reported the taxiway centreline lights were not easy to follow from the intersection during line-up. When entering runway 07R, the captain was uncertain of their position and asked the first officer if they were on the runway. The crew looked to the left and right and reported no traffic in sight. During the line-up, the crew stated they had an good overview of runway 01 and again did not notice any landing lights.
Further, when aligned on runway 07R, the captain asked the first officer whether they received the take-off clearance to which the first officer answered positively.
The crew of LH2293 stated that they initiated the take-off run as soon as they were lined-up. They did not see EI638 approaching, being concentrated on the take-off from runway 07R in front of them.
The crew of EI638 noticed LH2293 starting to roll and was about to call ATC when the Tower controller, who had visual contact with both aircraft, promptly instructed EI638 to go around. EI638 responded immediately and eventually made an uneventful landing.

Cause:
The incident was caused by the take-off without clearance of an aircraft instructed to "line up and wait" on Runway 07R while an aircraft was in final approach of Runway 01.
Contributing factors:
- Not using a mnemonic and/or cross-check for the take-off clearance by the DLH4TX crew.
- Limited traffic information/situational awareness given when delivering ATC clearances.
- Inadequate doubt-clearing management in the cockpit.
- The unfamiliarity of the crew with the airport.
- Authorizing aircraft to line up on RWY 07R at a short distance from the intersection with RWY 01 without correlation with landing traffic on this latter.
- Intersection and status of RWY 01 not indicated on RWY 07R.
- The complex taxiway layout (junction connecting 6 taxiways right before C6, the oblique angled entry taxiway including a part of the taxiway centerline lights).

Sources:

http://www.hln.be/hln/nl/922/Nieuws/article/detail/2918881/2016/10/13/Botsing-tussen-twee-vliegtuigen-nipt-vermeden-op-Brussels-Airport.dhtml
https://www.flightradar24.com/2016-10-05/18:40/12x/DLH4TX/b381246
LiveATC

Safety recommendations:

Safety recommendation BE 2016-0018 issued 27 March 2017 by AAIU Belgium to Air Dolomiti
Safety recommendation BE 2016-0019 issued 27 March 2017 by AAIU Belgium to Belgocontrol
Safety recommendation BE 2016-0020 issued 27 March 2017 by AAIU Belgium to Brussels Airport Company
Safety recommendation BE 2016-0022 issued 27 March 2017 by AAIU Belgium to Brussels Airport Company

Accident investigation:
cover
investigating agency: Air Accident Investigation Unit (AAIU) - Belgium
status: Final
number: AAIU-2016-21
released:27 March 2017
duration: 173 days (6 months)
download report: AAIU-2016-21

Images:




Situation sketch (airplane represented not in scale) (AAIU)

Revision history:

Date/timeContributorUpdates
14-Oct-2016 07:42 harro Added
14-Oct-2016 07:52 harro Updated [Source, Narrative, Photo, ]
14-Oct-2016 07:54 harro Updated [Narrative]
05-Apr-2017 19:48 harro Updated [Total fatalities, Narrative]
05-Apr-2017 19:51 harro Updated [Photo, ]
05-Apr-2017 19:52 harro Updated [Photo, ]

Corrections or additions? ... Edit this accident description