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The Australian Transport Safety Bureau (ATSB) is Australia’s national transport safety investigator. The ATSB is the federal government body responsible for investigating transport-related accidents and incidents within Australia. They have released this report today, involving a Jetstar Airways Airbus A320-232, registered VH-VGJ (VGJ), when it was taxiing for a scheduled passenger transport flight on 25 January 2017 from Newcastle to Brisbane. There were six crewmembers and 165 passengers on board.
The aircraft parked at bay 4, which was a ‘pushback’ bay, which means that when the aircraft is ready for departure, the aircraft is pushed backwards from the parking bay by a tug under the supervision of a dispatcher. Another operator’s aircraft was parked on bay 5, to the left of VGJ. Bay 5 was a ‘power-out’ bay which means that on departure, aircraft taxi from the bay under their own power by turning sharply away from the terminal.
At about 1836 crew of VGJ received a clearance from the surface movement controller to pushback, which placed VGJ to the right rear quarter of the aircraft parked on bay 5, and facing towards taxiway H (See Figure). The dispatcher was walking beside the aircraft and was connected to the nose of VGJ by a headset for communications with the flight crew. The flight crew started the engines during the pushback in accordance with standard procedures. After the pushback was completed, the flight crew set the brakes, the tug disconnected and the dispatcher removed the nose wheel steering pin. 2 The flight crew then started their ‘after start flows’. After the tug disconnected from VGJ, the tug driver moved it to a position adjacent to the left wingtip of VGJ, facing towards the aircraft on bay 5.
2 minutes after, the crew of the aircraft on bay 5 requested a clearance to taxi for departure. The surface movement controller questioned whether the aircraft could taxi to taxiway J and avoid VGJ.3 The flight crew responded that they could. At this stage, the flight crew on board VGJ interrupted their ‘after start flows’ to monitor the other aircraft. The captain, seated in the left seat of VGJ, did not believe there was sufficient clearance for the other aircraft to turn around for taxiway J without a collision. The aircraft started to taxi from bay 5 in a right power-out turn, but stopped within a few metres.
When the tug driver observed the aircraft on bay 5 move towards them, they moved the tug away from VGJ over to the terminal side of the apron, near bay 4, to remain clear of the other aircraft. Meanwhile the dispatcher assisting the aircraft on bay 5, had also moved from bay 5 towards bay 4 in order to monitor and signal wingtip clearance for the left wing of the aircraft conducting the power-out from bay 5.
Radio communications continued between air traffic control and the aircraft departing from bay 5, until it was confirmed that the aircraft would wait for VGJ before taxiing any further. The captain of VGJ, who was looking out the left window of the flight deck towards the bay 5 aircraft and the terminal, sighted their tug and a dispatcher near bay 4. They assumed that the dispatcher near bay 4 was their dispatcher, who had disconnected from their aircraft while they were monitoring the bay 5 aircraft movements and radio communications. At about 1840, the flight crew on board VGJ requested and received a clearance to taxi for runway 12 via taxiway H. The flight crew selected their taxi lights on, released the brakes and increased power.
The dispatcher for VGJ was still connected to the aircraft nose with their headset and waiting for their clearance from the flight crew to disconnect. The aircraft started to taxi and they immediately disconnected their headset from the aircraft and moved clear to the left of the aircraft towards the terminal with the headset and the nose wheel steering pin. Once the dispatcher was clear of the aircraft, they turned around to display the nose wheel steering pin to the flight crew, but the captain was not looking towards them.
Following this serious incident the captain reported that their most important lesson was distraction management. They considered either slowing down the ‘after start flows’ or re-starting the ‘flows’, before the ‘after start checklist’, as the most practical risk mitigation strategies.
