AIB Recommends Review of Aero Safety Management System

The Accident Investigation Bureau (AIB) has recommended that Aero should review its Safety Management System (SMS) to ensure that all safety critical staff are aware of their responsibilities to alert the system whenever signs of stress, fatigue or disorderly behaviours are noticed in any operating flight crew members.
This is just as the body stated that fatigue on the part of the captain contributed to the incident.
AIB’s recommendation is contained in the final report of the Aero’s Boeing 737-500 series aircraft with registration number5N-BLE that had serious incident at runway 28 Yakubu Gowon Airport, Jos, on August 21, 2010.
Apart from that, AIB also recommended that Aero should re-emphasise adherence to safety and company operating procedures by flight crew members and for captains to take over control of the aircraft promptly whenever critical operational deviations are noticed during flight in adverse weather conditions.
The above recommendation was based on the agency’s findings that the first officer (second- in -command) was the pilot flying at the time of the incident.
The air accident and incident investigating body explained that the recommendations in its report were addressed to the regulatory authorities of the state (NCAA), adding that it is for this authority to ensure enforcement.
Also, AIB stated that its investigation into the incident revealed that the faulty runway lighting system on runway 28 was rectified shortly after the incident occurred.
The investigation also showed that runway surface friction assessment had never been carried out and that there was no record of the current friction level to enable Air Traffic Controller (ATC) advice pilots in wet runway condition.
The agency’s findings revealed that the Non Directional Beacon (NDB) was unserviceable and Notice To Air Men (NOTAM) was issued and that the crew did not carry out emergency evacuation.
It added that there was no evidence to confirm that approach briefing was carried out and that the crew did not execute a go-around procedure following an un-stabilised approach.
The captain, the agency said was not the rostered pilot initially for the flight.
According to AIB, “the captain was tired based on the duty schedule of the day, which involves three training sessions as check airman”.
AIB stated in its final report that causal factor that led to the incident was the decision of the crew to continue the approach in an un-stabilised condition, coupled with the Captain inappropriate attempt to take over control of the aircraft.
The body gave the contributory factors in its findings to include: fatigue, which according to AIB impaired the captain’s performance and reflected the effects of a long, demanding duty day associated with check airman functions, poor Crew Resource Management (CRM) and the prevailing weather condition.
It could be recalled that Aero Flight 210, a Boeing 737-500, registered 5N-BLE that departed Lagos on August 21, 2010, skidded off the threshold of Runway 28 while landing on approach into Yakubu Gowon Airport, Jos.
Culled from Daily Independent

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