Aviation safety investigations & reports
Operational event - Airbus A380, VH-OQE, Los Angeles International Airport, USA, 8 October 2011
AO-2011-151

Summary
What happened
On 8 October 2011, the flight crew of an Airbus A380-800, registered VH-OQE, was preparing for departure from Los Angeles International Airport, United States of America.
Prior to takeoff, the captain changed the departure runway that was entered in the aircraft's flight management system. The procedure for completing that task was not followed exactly, resulting in the take-off speeds not being displayed on the flight instruments.
During the take-off roll, the flight crew, becoming aware that the take-off speeds were not displayed, called out the speeds from their notes instead and proceeded with the takeoff.
What the ATSB found
The ATSB found that the captain was distracted from initially updating the runway change in the aircraft's navigation systems prior to the aircraft taxiing for the runway. Twice prior to takeoff the aircraft's systems displayed a message to check take-off data. The first officer cleared the first message on the understanding that the take-off data would be checked and in the second instance, believing that it had been checked. There were no other warnings in place to alert the crew that they were commencing the takeoff without the take-off speeds in the aircraft's navigation systems.
What has been done as a result
Qantas has advised that the aircraft manufacturer has updated the aircraft's warning systems as part of a planned upgrade program. This upgrade will issue a warning if takeoff is commenced without the take-off speeds having been entered into the aircraft's systems. They also advised that their standard operating procedures have been updated to avoid any misinterpretation regarding the required actions in the case of a runway change.
Safety message
This incident highlights the problem of distraction during critical stages of flight preparation. It also highlights the importance of good flight crew communication to ensure a shared understanding of the aircraft's systems status.
General details
Date: | 08 October 2011 | Investigation status: | Completed | ||
Time: | 0712 UTC | Investigation level: | Systemic - click for an explanation of investigation levels | ||
Location (show map): | Los Angeles International Airport, USA | ||||
State: | International | Occurrence type: | Aircraft Separation | ||
Release date: | 08 August 2012 | Occurrence category: | Incident | ||
Report status: | Final | Highest injury level: | None |
Aircraft details
Aircraft manufacturer | Airbus Industrie | |
---|---|---|
Aircraft model | A380 | |
Aircraft registration | VH-OQE | |
Serial number | 27 | |
Operator | Qantas | |
Type of operation | Air Transport High Capacity | |
Damage to aircraft | Nil | |
Departure point | Los Angeles, USA | |
Destination | Melbourne, Vic. |