Aviation safety investigations & reports

Incorrect aircraft configuration - Airbus A320-232, VH-VQA, Melbourne Airport, 28 July 2011

Investigation number:
AO-2011-089
Status: Completed
Investigation completed

Summary

Download Final Report - Bulletin
[Download  PDF: 5.43MB]
 

On 28 July 2011, a Jetstar Airways, Airbus A320-232 aircraft, registered VH-VQA, departed Newcastle, New South Wales on a scheduled passenger service to Melbourne, Victoria. The First Officer (FO) was designated as the pilot flying.

While on approach to runway 34 at Melbourne, at about 245 ft (radio altitude), the Captain realised that the landing checklist had not been completed. At the same time, the crew received a 'TOO LOW FLAP' aural and visual warning from the aircraft's enhanced ground proximity warning system (EGPWS). The Captain identified that the aircraft was not in the landing configuration, immediately called for a go-around which the FO initiated. Prior to establishing a positive rate of climb, the crew received a second 'TOO LOW FLAP' warning.

The operator conducted an investigation and determined that the following factors had contributed to the incident: incomplete approach brief, loss of situation awareness, improper coaching techniques and cognitive overload. As a result, the operator intends to:

  • provide the Captain and FO with a remedial training and coaching program
  • conduct a review of their command upgrade training to ensure it focuses on the development of a positive cockpit authority gradient, and the command of flight capabilities
  • incorporate this incident into the command upgrade training course as a case study
  • conduct a review of their recurrent human factors training.
Download Final Report - Bulletin
[Download  PDF: 5.43MB]
 
 
 
General details
Date: 28 July 2011   Investigation status: Completed  
Time: 2000 EST    
Location   (show map): Melbourne Airport   Investigation type: Occurrence Investigation  
State: Victoria   Occurrence type: Incorrect configuration  
Release date: 12 December 2011   Occurrence class: Operational  
Report status: Final   Occurrence category: Incident  
  Highest injury level: None  

Aircraft details

Aircraft details
Aircraft manufacturer Airbus Industrie  
Aircraft model A320  
Aircraft registration VH-VQA  
Serial number 3783  
Operator Jetstar  
Type of operation Air Transport High Capacity  
Damage to aircraft Nil  
Destination Melbourne, Vic.  
Last update 14 November 2018