Was on a B767 departing Newark transatlantic. Takeoff was rejected probably very near V1. It IS rather exciting. Came to a stop about 50 yards short of the end of the runway. Taxi back to the gate and sit for 2 hours while maintenance looks things over. Faulty indicator. Taxi out to a dark corner of the airport for a thrust test, everyone still on board. Then we go back to the runway for another try. The hysterical thing was they did the safety briefing a second time. People had their safety cards out, REALLY paying attention this time. They fire it up and the woman I don't know next to me grabs my arm, took a few days for her fingerprints to go away. Once we got up about 1000' the cabin breaks out into noisy applause. Probably not a thing wrong with the plane. Memorable, though. Good times.
Did that once as a nonrev on a Continental DC-10 in HNL heading to EWR. The takeoff roll seemed to last forever and then we suddenly started braking. We were told one of the engines didn't respond the way the crew liked. An hour parked in front of the maintenance hangar and we went to try again. An RTO right before an ocean crossing is an interesting experience. This was one of the first times I could use the nonrev privileges completely on my own at age 18. I had read about UA232 so I was sure losing one engine would not matter, but the crew really didn't want to deal with that, so they must trust that the problem is solved.
Having Captained A330s into JFK for almost 20 years and having had the exact same clearance from T8 more than a few times and the same going to 31L, this intersection is nothing for the weak hearted, in rush hour, nighttime, snowing etc. It's tight, large aircraft in close proximity , a small stub way going to active runways both landing and take off .It is a hotspot that requires accurate briefing, read back and understanding of clearances, it doesn't take much to miss that stub way , there is a lot going on around you and as the taxing pilot you are really concentrating on not bending any metal, yours or others and a split second looking the wrong way would do it. ATC was up to the game, which they generally were in JFK and the other crew got it right as well. Human factors play a huge part in getting it all right on the day .For the 737 crew coming out of the dark end of 4L probably couldn't see the 777 until the abort call came and reacted without a flinch. I almost ran into the back of an 380 at night that I was following after it had been cleared to enter the ramp with a right turn at around November ,I looked left at a passing 747 and the 380 just stopped with its tail still over the taxi way, just noticed in a nick of time and had to jump on the brakes. The 380 crew got confused over to enter ramp clearance and just stopped, my FO was calling ramp control for our entry clearance, 8hr flight no 3rd man just little things that all sum up. The AA crew will be having a few bad weeks going over it all in their heads, but it could have happened to anyone, and we learn another lesson, this time thank god without loss of life..
In my 47 years as a Part 91 general aviation pilot that often operated IFR in and out of commercial service airports like ATL and DCA (pre-9/11), I was way more concerned about safely finding my way around the airport on the ground than I was a 3+ hours solid IFR flight. And night time and low IFR operations were not conducted without a second pilot.
Ever fly into O'Hare before the Modernization/Union dictated public works projects into infinity....LOL, when they had parallel as well as diagonal runways? There was a similar stub intersection there at the end of Runway 22R/4L called the Old Scenic/New Scenic taxiway juncture.....
Looking at my Jepp FD Pro this update has no circled Hot Spots, that seems like an oversight! Applicable Hot Spots would have been a required briefing item.😐
When I heard about this incident, I knew that you would release a perfect analyzes of the story. I didn't even bother to read or watch the news. You did a perfect job explaining everything. Thank you. HOPEFULLY you'll never have to do this type of video every again.
Came here to say the same thing. Never even bothered to pay attention to whatever half explanations news shows and other online sources were going to post.
FO did not read back runway assignment after initial contact with ground. Clearance was “taxi four left bravo hold short of kilo.” Ground did not question her read-back with no runway. Ground should have doubled down and insist she read back the runway assignment as is normal. Guessing they planned 31L and didn’t catch the change. Expectation bias is in play here. Complying with fast talking controllers can be a challenge.
Recency bias too, the last thing she said and everybody in the cockpit heard was “…(cross runway 31) LEFT AT KILO.” They then proceeded to turn “left at kilo” which they had ringing in their ears, instead of right as they were supposed to.
Disagree with your interpretation. The readback was perfectly correct. The final report will certainly indicate the complexities in this tight little corner of JFK airport, and there could be renaming and/or phraseology modifications in light of this. "Right on Kilo, cross runway three-one Left" might have been less ambiguous, so I agree with you there.
@@Roadhammer42 First off, "everytime" is not a word. It's two separate words "every" "time". Secondly, it's simply not true - If little mistakes and complacency killed "every time" there would be a hundred plane crashes every day. You think I'm nitpicking, but there's substance here. Rules and procedures for humans are not the same as computer code. There must be room for reasonable excursions or misinterpretations that do not automatically or irrevocally result in disaster. That's why this serious incident "could" result in some new rules in operations and phraseology at this particular (antiquated) airport. There is a cost though, any changes specific to this airport will require that it be considered a "special" airport, and require specific training and recency for pilots to fly in there. It is worth noting that no rule changes have been issued as a result of the Air Canada near disaster where the plane lined up to land on a busy taxiway, when SFO, far more than JFK, should be considered a "special" airport with specific recent experience requirements.
@@gregfaris6959 Sorry - you are incorrect. Check AIM 4-3-18.a.9(a) “When taxi instructions are received from the controller, pilots should always read back the runway assignment.” Also, see the example in paragraph ‘d’ in the same section. Regardless of whether the runway readback by the pilot would have made a difference, it is simply incorrect to call the AA readback “perfect.”
I was a passenger on a 737 that had a rejected take off from a hydraulic problem. It is impressive. The crew on my flight were great and informed us immediately about the problem. This event occurred just after you had done a video about hydraulic problems so it was a non-event for me. I remain in awe of the amount of knowledge that is required for commercial crews. I also realize that sometimes "stuff" happens. Thanks for going over this.
I was on a lightly loaded jumbo in Bahrain that aborted takeoff due to a U/C warning light in the cockpit. The deceleration was startling. We spent a couple of hours on a remote part of the apron while they checked out the tires and everything else before we eventually took off without incident.
Being a 23 year Boeing Airbus Delta pilot, Juan, you did an excellent forensic explanation of this potentially deadly event. At the airlines and military, we would have to wait 6 months for the review. You are right, we have to be 110% spot on while conducting any flying ops especially at airports like JKF. Thank you for providing such timely information to “us” professional pilots.
Did he? That statment assumes the pilots weren't looking or already reacting. It is good the controller made the radio call anyway as he couldn't know one way or the other, but you also can't know.
@@mytech6779 We need to wait for the investigation results. However, from the audio tapes, it is clear that the controller actions were pivotal and timely! I think that needs to be recognized as well!
Juan, your knowledge on aircraft systems, pilot training (the script) and the anomalies that can crop up, make you a prime candidate to join the NTSB or FAA educating pilots on how to make the right moves and aiding airlines when they need to improve their procedures. I've watched your channel for about 3 years. Your depth of knowledge of flying a wide variety of aircraft, is just spectacular and your including Pete in the mix when your home is wonderful. NTSB would be a nice retirement gig when the time comes.
As a retired thirty year air traffic controller, I can assure Juan that the bureaucracy and idiocy of any government institution is exactly where he DOESN’T want to retire to.
You three gentlemen do bring up a good point. I think where i'm going with this is the FAA needs people who can think through logically. There is a lot wrong with the airway system in the US and maybe, just maybe we get a few good people who understand how it really should work and they be given the authority to straighten it out sooner than later. Juan always shows deep intellect in analyzing these issues. Rest assured I don't want Juan to loose his time with Little Pete.
3 pilots, 3 iPads with the capability to display real time your aircraft position on the taxiway. I always made sure that all three of us in the cockpit agreed to any taxi instructions issued by ground control. Hard to believe all three did not notice they were headed to the wrong runway. Leave it to AA to try and save a buck by sending out a 35 page bulletin instead of properly training the pilots. It would be interesting to know how much time each one of those pilots had in the 777. Just an observation from a retired AA 777 Ca. Keep up the great reporting!
Verify every crossing "on the glass" 10-9 painted route,, MFD, FMS notepad, and "in the grass" twy and rwy signs and hold short markings. If only one pilot had done that prior to crossing it would have been any other day.
Sometimes too much information in front of you is worse than not enough. Most likely they where distracted. They should review CVR to learn more. Sterile flight deck under 10000?
I don't think you need a 35-page bulletin. These are common sense procedures for use with any airplane A simple radio call, by either AA pilot, before reaching the intersection, to confirm "are we cleared to cross 4L" would have alerted the crew they had the wrong runway. I never cross an active or inactive runway without a confirmation, even if it was cleared before. I agree, this looks like poor crew resource management, or someone said confirmation bias. Also, the I Pads can be a distraction.
Does the Ipad automaticaly highlight the cleared taxi route from ATC? If not, maybe that functionality could be added to help avoid this in the future.
Edit 1 -18-2023 ...Much respect to the flight crew (of the DL jet*) who stopped the takeoff as soon as possible. (*Please see Laura Savino's ( an actual passenger jet pilot) posts below-she corrected my credit to the flight controllers, asserting they were actually not aware or timely on their observations or reactions-that the DL flight crew showed truly professional flight awareness and averted a disaster all on their own - my thanks to Miss Savino for correcting me here)
@Laura Savino that DL already saw the issue and was aborting makes sense because the jet stopped short of the crossover. The five to ten seconds response time from a controllers call to just start the jet slowing down would have probably put them through the intersection....I will not repost what you said but you should definitely post it as a starter comment because there are a lot of people here with the same errors about the air control team being the reason this wasn't a disaster when it was all in the hands of the DL crew to save their own lives. In one day,I will delete my comment as it is clearly inaccurate. Thank you for your correction.
@Laura Savino but she did read back “cross 31L on Kilo…. Then let the Capt cross 4L causing DAL to reject. Th FO was not in the “ball game” as much as the Capt was not in the game either. Perhaps he thought they were taking off on another runway and talked the rest of the crew into his expectations. The big question will be what was initially loaded into the box, what performance data did they use for planning? Did they think they got a runway change during taxi? Lots of questions but the ultimate was they NEVER had a clearance to cross 4L in any way shape or form. I’m not bashing a fellow crew member just calling it like it was…
These breakdowns are why I became a Patron of this Channel. My knowledge and respect for all involved is aviation has grown so much. And WE were only hearing the calls to THOSE two aircraft, not the other 20-30 transmissions to and from the other aircraft moving on that field.
There was a queue behind the Delta flight and on the longer audio capture you can hear ATC telling the next jet in line that "This is going to take more than a minute and a half".
I'm stuck on why the American Captain continued the flight. My understanding is that it will record over the CVR. To me, that decision makes it hard to allow it to be a teaching moment and allow him or her to continue as a captain.
Enjoy your content. I’m a former A350 instructor and now Captain on the A320. This was a close call and will need to be investigated thoroughly. Listening to the ATC recordings you omitted one key transmission in your video from the ground controller that I believe also had a key part in this event. Another American Airlines flight, American 185 was cleared to line up and wait runway 31L at KE just after Delta 1943 had been cleared for takeoff on 4L. At this time American 106 heavy initiated the crossing of 4L. I wonder if the 106 crew had expectation bias on where their perceived takeoff point was with ATC instructions which led to them having the runway incursion. Very thankful for all the safety precautions that prevented this from being another Tenerife type of event. Thanks again for your breakdown of these aviation events.
This is why I love your channel Juan...taking the time to explain what's going on from an actual pilot with tons of experience. Thank You for all you do!
Delta supplied new underwear for all onboard after the violent rejected takeoff. Very close call, JFK has always scared me because of how busy it is and runway configuration. At night it's even more scary.
I imagine that the pilots had to go in the restroom of a change of their drawers. After they got to the destination they probably had a few drinks to settle down.
It’s better than LaGuardia! But in Nov 2019 flew into JFK over the water really fast and it was super windy outside. Felt like we were riding on a gravel roadway! And it was dark/night time! Scary. Then about 39 years ago, coming back home to Monterey, Ca from LasVegas via LA airport. Think it was a 737 or smaller jet? We were ready to touchdown when the piokwt pulled that jet almost straight up as I looked out the window saw a small plane under us on the left side. Yelled out( I know everyone heard me) there’s a plane underneath us. We climbed which was very scary as it felt like we were suspended and not moving. He leveled off and turned out over the ocean and made a wide turn and landed back again!! No one was smiling as we departed the plane. All the stewardess could do was nod their heads like yes we made it!
@@williamfenner9915 i think they returned to the gate after this occurred; possibly because the crew may have been close to time and would have timed out in flight because of delays from communicating with the company, updating flight plan, new clearance, then resetting the aircraft systems, reprogramming flight computers, taxi back, and the new departure slot time it would have been probably 30 to 45 minutes delay. Not to mention the DAL pilots were probably shaken up and heavily stressed due to the events and needed a bit to cool down, they were roughly 1000 ft, about 2 to 5 seconds at speed, from Tenerife in NY so I wouldn't blame them for needing a bit of time to process it and relax.
As a 30 year pilot and CFI, I know first hand how confusing airports can be. Just a few weeks ago, I did a flight review for another CFI and while taxing, we misinterpreted the call and got confused. It happens to everyone. We simply stopped the airplane and called for clarification. How three ATP’s screwed up this very simple taxi call to the point where they were flat out heading to the wrong runway (forget being on the wrong taxiway) is hard to fathom.
I was flying out of Chicago one time and had a rejected takeoff just before rotation. Just about had to pull my teeth out of the seat in front of me. This explains a lot, now I understand the pilot didn’t have any choice on how hard the breaking was.
Hi Juan. Jack here CFI at a large training school. Excellent reporting. Will show this episode to my students to emphasize that flight starts as soon as the engines are fired up and that vigilance and airmanship is paramount in all phases of flight. An avid follower. Thanks. Jack.
you should play the entire tape to your students, not just the redacted calls he plays in this video. Let them hear the Tower clear American 185 to takeoff 31L at KE right before 106 Heavy made the wrong turn to cross 4L on Juliet. I think that may have added to 106's confusion at the very time he entered that central intersection.
@@bradleys2320 Hi! Thanks for your comment! Yes, I'm giving a class this weekend and will play the excerpt. Wouldn't want to sound biased event though I also was an ATC for 15 years... 🙂
As a man named Jack, I've never met a man named Jacques who chooses to be called "Jack". I have much respect for you just based off of your decided nickname. It is a great nickname and it fits perfectly. :)
@@jacquesparadis6756 ATC for 15 years??? Holy cow. How did you manage to cope with that stress? ATC have one of the highest suicide rates in America because of the non-stop stress and absolute pristine attention and recognition required.
We experienced a rejected TO in a DC-10 at JFK back around 1986. It was an exciting stop for sure, but we did not go back to the gate to cool off the brakes. We went around and "tried it again." When we landed at Guadalupe (Virgin Islands), 4 or 5 tires were flat due to the blow out plugs letting loose in flight from the heat. We deplaned and went on our way to our resort. When we returned to the airport a week later, that DC-10 was still sitting there. We spoke with people who had been scheduled to continue on to Martinique but never left the ground. They said it took 2 days to fly spare tires in. Then the jack broke and damaged a landing gear. Some people got frustrated and hired another plane to get them to Martinique. Others just stayed on in a cheap hotel on Guadalupe with a wasted vacation. My father, a senior L-1011 captain, said if we had to reject TO the second time at JFK, they would have to come out in boats to pick us up.
Juan, time for a California drought and water update lake Shasta, Oroville, Folsom, Don Pedro are filling up fast from the storms. I find your channel very informative and non-bias. I started watching you because of the Oroville crisis. I also know a-lot about the weather. This could of been a disaster, also got my first solo done toward my PPL.
In my opinion a contributing factor to this event is how the US handles departure clearances. Nearly everywhere else in the world your departure clearance includes the runway you will depart from, however in the US (in my experience flying there) you only find out your departure runway after you pushback, taxi out from the ramp and call ground control. Changing your departure runway at this point requires recalculations, reprogramming of the FMC and revised briefings, all at a less than ideal time, especially when ATC want you to move. It's something I've experienced a few times now and I can see how something like this can happen. Confirmation bias also ties into this if they had planned to depart on 31L while still at the gate.
Zesiro: Altbough your point is well taken, it may not be practical at busier airports. Runway assignment is the result of many conditions and options. As an example, during my days as a journeyman Controller at KORD, if weather/wind conditions permitted, runway assignment was based on your direction of flight immediately after departure. Further the assignment was often impacted by the amount of departure traffic; e.g. if south and westbound departures might be assigned runway 27L, and north and eastbound traffic assigned runway 32R during the current airport configuration, if departing traffic on ruway 27L was backing up, at the discreation of the Ground Controller the westbound departures might to assigned runway 32R to expedite traffic. At a busier airport runway assignment is a dynamic situation. Simply an FYI for anyone interested.
@Zesiro & Rich P - both are valid points and the clear link between is the overwhelming choice to cram as much traffic as possible through the system for 4 reasons: - the entire business is populated with hyperactive, obsessive compulsive people - human arrogance - scheduling convenience for traveling public - greed For these reasons we are willing to risk hundreds of lives on a few sequential errors which all arise for the same reason - too much, too fast.
1/17/23; 2day your review of taxiway incident (near collision) at JFK was fantastic! Love your use of close up animated (earlier recorded real time) movements of a/c. Your presentation clearly shows a/c symbols moving around & your use of red & green colors linked to the a/c showing their movements on ATC assigned taxiways was perfect but made better when the ATC instructions were played real time as conflict developed...was caught in time to be effective & prevented a Tenneriffa type catastrophe. Juan, your channel, your experience, your use of available ATC recordings & many other visual/technical presentations is always wonderful education & valuable information for all YT viewers to consume. You are providing experience & education for public safety...sometimes your videos come from tragic aviation mistakes, but ultimately you are delivering factual information which in due course becomes changes for enhanced public safety. Bravo sir! Stay safe & carry on!👍👍👍👏👏😊
@James Cole : I really like your use of "near collision". It's actually a more accurate description than "near miss". A "near miss", at least in my mind, would actually be a collision, as the "vehicle/s" involved "almost missed" each other, or another object in their path.
Capt. Brown, I am a B767 Captain who flies in and out of JFK frequently. This event has certainly caught the attention of the public. Several friends (non flying and friends from the GA community) have been emailing and texting me seeking analysis of this event. As always, I’ve been looking for your input. Barring some as yet unrevealed information, I have found it challenging to explain how the AA crew made this error. Nonetheless having been a Central Air Safety Committee chairman and pilot rep on the ERC, I know that drawing conclusions before all the information is collected is not a valid approach. That said, I had a couple of questions about AA procedures. 1. I assume that somewhere in the pre-push phase, after having received the clearance that a taxi brief is required. Accordingly, the crew would have planned for and programmed 4L as the departure runway and seen that a turn would be required before reaching 4L. Thus, onto using to taxi to 31L should have triggered a “runway change” checklist - correct? 2. The FO (presumably) read back the clearance to cross 31L at K. Accordingly, the Captain continuing beyond K should have at least elicited a conversation and verification from ATC. 3. When they were crossing 4L, the DAL jet was on its takeoff roll (presumably) with it forward facing lights on. I am curious how the FO missed this when clearing the runway to cross. In 2001, I had an Air France 777 pull onto the runway I was taking off from as we accelerated through 120 knots. We departed the runway to avoid a collision. Needless to say, I am always very alert when entering/crossing runways. 4. These thoughts represent just a few layers of the Swiss Cheese that lined up here. So here is my AA procedure question - following an event like this, would the crew be required to notify the company before departing? If so, would this have necessarily required a CVR download? 5. Absent the implication of one or more of the “Big Five,” the crew will be covered by ASAP. However with the NTSB’s involvement, do you know whether the findings from the CVR (if available) could be used to determine inclusion/exclusion from ASAP? 6. As you said, anyone can make a mistake like this. We can all lose SA. Nonetheless, how three pilots lost SA to this degree is perplexing. Once the findings are complete, I think this event will be on tap for everyone’s recurrent for some time to come.
Avoided watching anything about this until you covered it, Juan! Man, I was in a 747 many years ago (Pan Am) that did a late rejected takeoff. Very violent indeed. Overhead compartments popping open and lots of noise and vibration. Wouldn’t care to repeat that!
Thank you Juan B for your succinct explanation of this incident. I was curious if you'd be allowed to post on this particular occurrence and I am grateful you were. I have seen other content on this incident but without your detailed map depiction, it was difficult to comprehend without PIC or FO exposure at a "hard surface facility." Cheers from Texas.
Clearly this event caused a huge emotional impact on you Juan...we can hear it in your voice. You did an excellent job describing the situation as it unfolded at JFK. For those of us who are avation-challenged you made it easy to understand. ✈✈ When your aircraft is CLEARED for take off you expect the runway to be CLEARED for a safe takeoff.
@@MeppyMan and the fact that they are fellow pilot employees at the same carrier. It's possible that Juan is personally acquainted with them and/or has flown with them, plus a little "There, but by the grace of God go I" thrown in for good measure?!
@@bearowen5480 also, I wonder if he will take any heat for reporting on certain airlines? Like 74gear, I wonder if the social media policy is different at SWA, Atlas, Kitilla, UAL or AA? The value of Juan’s reporting should earn him some respect. OTOH DTSB not so much.
At approximately 5:15 you state that, “Everyone should be on board that we’re going to runway 04L.” I did not hear the FO do a full read back of the taxi clearance in that runway 04L appears to be omitted. In addition, ATC does not correct the readback. This was an omission of a very important SOP and a missed opportunity by ATC to trap the error.
The FO on the initial contact with ground did not read back the departure runway. If the TPS listed 31L as the primary runway, and the departure briefing was given for 31L. And departing from 31L full length is not uncommon then we have a set up for expectation bias. With out a full read back of the initial clearance then the bias would not be broken. Just speculating here as to the setup of what could of caused this. Great video and analysis as alway Juan.
I’ve also been wondering about the “Takeoff Brief”, as well as what runway the station issued TPS for. Have had MANY instances where the EWBS close out comes with an incorrect runway, incorrect intersection (usually full length), incorrect winds, runway conditions, etc.. Personally, I refuse to brief a taxi route other than to say expected runway. I always state that we will follow ATC instructions to our assigned runway and that we WILL NOT cross any runway without a verified crossing clearance. Expectation bias is a VERY dangerous thing in our business. Even then, mistakes are so easy to make. Like when the FO goes “heads down” during taxi to send for new TPS due to weather changes, runway change, etc. Far be it for me to say why this happened. Way to many variables and lack if information at this point.
Yeah, I to am betting they set up and briefed 31L and had that set in their minds the entire time. I wonder if they got the memo about their TPS reports.
Great pickup that there was no read-back of the runway assignment to Ground. Still kind of curious that they read back "cross 31L at K" and they crossed 4L on J. Wonder how it's signposted, as Juan mentioned. I have wondered to myself why my local ground controller / tower have (even when I've read back the right runway, and the airport has been empty) had me re-acknowledge runway assignment. I'm now even more thankful for our local ATC controllers; knowing that being pedantic about the small things isn't necessarily about movement at our little GA airport, it's also about training pilots to be clear and avoid getting into situations like this one.
I was about to suggest the same thing. Maybe it’s the route they took last time further reinforcing the bias. Human factors means one of these is always going to slip through eventually. It’d be nice to think taxi instructions could be uplinked to aircraft but I guess it’s too cumbersome.
Great video, Juan. I've encountered professional pilots who seem to completely trust ATC and rarely look outside the cockpit. As a GA pilot, we're taught to spend as much time as possible outside the cockpit. I've gotten lost at a 'large' airport and stopped on the taxiway. Frequency was tied up by a student having trouble reading back his clearance. Sure enough, a SWA 737 pulled up behind me. I bailed to an open ramp nearby because I figured he knew where he was going. ATC thanked me. Super important to keep aware of your surroundings. If unsure of taxi, stop and ask.
I was waiting for you to do this one… I heard about it and was wondering if you were gonna cover it… love your channel Juan… I’m not a pilot but a truck driver I do enjoy aviation
I am also a truck driver and everything you said is on point with my own thoughts. I've been following Juan for approx 2 years and I've become so intrigued and fascinated by aviation because of it. I never realized how complex it truly is and how demanding it is for the pilots. So much respect and appreciation to them.....as well as ATC, ground crews, dispatch, flight attendants and everyone else involved.
I am also a truck driver. Not to discount any pilot's tremendous responsibilities along with the training that goes with it it, there's some similarities amongst GA, air transport, and commercial truck driving. For all of us drivers and pilots, concentration, sit awareness, alertness to the myriad of hazards, etc. are key to a successful flights and runs. When driving I'm relaxed but playing out "what if...? scenarios as I'm rolling down the road. An old veteran truckdriver was once quoted as saying: the most dangerous mile is the next one. BTW, thanks, Juan.
On both I-pads we have GPS on the Airport diagram, most Arlines have similar, some more complex than others. Someone was NOT paying attention to the clearance, and routing. At JFK particularly we, at EVERY junction, confirm left, right, straight or "Runway XX on the sign" clear to cross, clear right / left before entering EVERY time. There is NO valid excuse not to have both heads up and out, if only at the intersections, no checks should be done during the taxi period unless it is 100% safe.
Thank you Juan. When you show your passion for safety, it reinforces what I already know and tell others. Flying is the safest way to travel because of dedicated people like Juan Browne.
Outstanding breakdown and analysis Juan. Thank you. As a Part 121 pilot who regularly operates at JFK and as been at that very intersection countless times, this incident hits home on so many different levels. I really appreciated your comment of, “…it could happen to any of us.” That is 100% spot on. I really hope that no stone will be left unturned during the investigation so that we as an industry can learn (change our behavior) all that we can. Everyone remembers or has read about the mishap at Tenerife; we, as an industry, were a mere 1,000’ from another loss of hundreds of lives. Thank the Lord this was not the case on 13 Jan 2023.
An additional piece of information, pinned on the VASAviaton coverage of this event, is that AA106 was told to stop multiple times on the ground frequency and never responded. There were some huge holes in the Swiss cheese on this one!
@@dryan8377 the American Airlines flight had 3 pilots on the flight deck and was apparently not monitoring the ground freq before crossing the wrong runway. I am well aware of the hierarchy. They should have been monitoring ground and maintaining situational awareness instead of talking to company or whatever else they were doing. The Delta flight that actually was rejecting did manage to respond to the tower in the middle of their RTO...
When I was a tech working on the CP-140 Aurora (Canadian P-3) a pilot buddy had a rejected takeoff due to prop pitch-lock. They Flat-spotted the main tires, and when they taxied back to the ramp we immediately signaled "hot brakes" to the crew. While monitoring a small fire flared up, immediately put out. We earned our pay that day, as we had it back in rotation about 4 hours later. The prop issue was a pressure transmitter.
I just want to stress how important it is to understand how vulnerable we all are to these types of situations. In this case it took a quick acting Delta crew and a pair of very attentive controllers to avert an absolute tragedy. One day, hopefully never, we may all be the goat or the hero in this or a similar story. Please, be aware out there, this was way way too close.
Nice work Juan. I would just say as a ATC person, a good technique would have been to tell them to turn right on Kilo and cross 31L. While they didn’t do anything wrong with the instructions, I always preferred to give a positive instruction of turn right and cross so that there was less chance for misunderstanding. Especially with a complicated taxiway design of this airport. I am sure that’s a Hot Spot. Again thanks for your review.
That probably would have helped greatly in this situation. Not to say the ATC is at fault, but it's a team effort after all right? Maybe following this incident that kind of verbiage will become standardized, especially at busy airports. Maybe adds half a second to each transmission, but if it improves safety even a little bit that surely is/would be worth it. We'll see I guess.
Completely agree. Cleared to cross and taxi way K is a hard right, J is straight ahead and crossing a rwy, easy to go with straight ahead, taxi way signs are not always right in front of you or easy to see. And not one hotspot at JFK.
As a pilot I agree that your technique should be standard at ATC. "American 106 Heavy cross RWY 31L at Kilo" does not provide as much information as "...turn right on Kilo, cleared to cross RWY 31L." It's a heavy workload environment for both controllers and pilots alike and I certainly don't blame the controller for his clear and common verbiage, however, even a small phrase like "turn right" can provide a certain measure of clarity for pilots and prevent a potential disaster.
@@robertbutsch1802 Good point, Bob, ! I noticed that same point. In an accident's a priori sequence of events, the "Sweiss cheese" usually has a lot of holes in it!
As a B737 Capt. I always told my FO’s that “There are four “F’s” you want to never do: 1) Fire 2) Flight Control problems 3) Funnel Clouds And the 4) Five o,clock news I actually started with 5 F’s but I broke that one and ended up marrying a Flight Attendant😜
Great job Juan with the breakdown of what we know so far. I'm sure this one wasn't easy. Luckily no one was hurt. I'm sure many things aligned in the Swiss cheese model to allow this to happen. One thing I noticed on the audio is that the ground controller did not specify to turn right on kilo, then cross 31L. He only said to hold short of kilo initially, then extended the taxi with a crossing clearance. It's a small detail, but may have prompted conversation or drawn attention to the need for a right turn before crossing a runway. It's a good example of why proper radio etiquette is so important. This is something we all should do better on both sides of the radio.
Yep, I think you’re right about that clearance, I heard the same thing. ATC should’ve issued a right turn on K, then the crossing clearance. My guess is it’ll be a key ingredient to the confusion factor. Still, situational awareness is paramount. Didn’t get what the reported visibility was at the time. That’s another factor, if DAL couldn’t see the AA crossing down the runway during takeoff roll, they could’ve initiated the RTO themselves. Fly Safe.
Juan, a couple of questions come to mind. 1. For the DL crew and plane after the RTO why would ARFF not be dispatched to check on DL brakes? 2. Why was runway 4L and 31L not shut down for a safety check due to possible FOD from DL aircraft. Violent RTO braking can shake things loose from plane. 3. Why was the AA crew allowed to continue the flight? After being in a close call and getting grilled by ATC why would AA allow them to continue to fly? I wouldn't have wanted to be on that flight with a distraught crew. 3. Seems like the taxiways near 4L and 31L are poorly designed. Similar to an incursion at DTW between two NW aircraft that resulted in collision (1990's). Would love a followup video. Keep up the good work.
Agreed. I had a low speed RTO departing EGPF several years ago in a Falcon 900. After we cleared the runway, EGPF controllers closed the runway temporarily to conduct a FOD inspection.
I can't find anyone else asking this question so hope you don't mind me hitting replying under yours. My question is: is the poor audio quality of the readback by the FO of AA-106 at 5:24 indicative of the same poor audio quality Ground would have heard? I'm assuming not, but curious. Since *if* Ground didn't care to clarify a poorly transmitted readback of a mis-understood instruction that did not match the original Ground request, then that would also be a contributing factor to the near-hit.
I think it is important NOT to point fingers at anyone. Let’s have the report first and remember that there are always many aspects of case like this. Thanks for providing the basic facts.
We used to operate into KJFK occasionally and parked at the GA ramp. The taxi routes to 31L or 4L were common for us. Company SOP included taxi briefings once the runway was assigned and the heading bug set to departure runway. Perhaps the ground controller could have given a clearance that specified a right turn on “K” “cross 31L”. That may have alleviated the confusion. Agreed 110%, Juan on augmented flight crews. We flew with an augmented crew quite often on long haul international flights and per our SOP the third crew member was active crew on the jump seat until leaving 10,000’. Very fortunate that this did not end in tragedy. Good heads up by tower and Delta crew.
totally agree... ground controllers around the country should give a specific turn instruction before a crossing instruction (where the crossing isn't straight ahead). Sometimes ugly incidents like this are opportunities to locate weaknesses in the system.
@@bearowen5480 - Yeah it was a huge mistake. But this scary incident has revealed an opportunity for a key improvement in ground control phraseology. Can't forget there are lots of foreign crews operating out of JFK... anything to make things as extra clear as possible.
@@pdquestions7673 That would require changing the 7110.65 manual (written by lawyers) where specific phraseology is in place. Although a controller can deviate from phraseology if needed to make a command clear or issue safety alerts. Though Runway 4L, taxi via Bravo, Kilo, Hold short Runway 31L at Kilo seems pretty clear to me on where to go. Typical taxi instructions are Destination, route, hold instructions if needed. As a plane approaches a Runway to cross the Ground Controller has to request to cross the runway from the local controller. This is called coordination and happens at all airports. Once that coordination is set (with each controller using their two letter ID for the tapes) the ground controller can tell the the plane to continue, i.e. Aircraft, Cross Runway 31L at Kilo continue taxing. The pilot must confirm the taxi instructions and if they do not understand the taxi clearance SHOULD ask the controller for clarification. Pilots can also request progressive taxi if not familiar with the airport. Also with technology like Foreflight Pro taxi routes can be brought up on the screen giving you the route on a map.
I heard the call like AA did, the first time (but not familiar with the airport). Before what Juan played, there's a lot of fast calls, and hold shorts. That's a confusing jog there, too, over to 4L, but seems 1 of the 3 pilots would know it. I'm not a pilot, and most ATC is beyond me to hear/process, so grain of salt. The crew should have at least questioned the call, it seems. But why is ATC firing off so many taxi instructions in a row with little time for read back? I get that they're really busy, but slow things down a hair?
You and Victor (VASAviation) are my go-to for incidents like this. And I was especially interested in hearing from you since the aircraft that seems to have caused the problem was a 777. You would be able to explain procedures in the cockpit better than most other analysts. That there is a third pilot in the cockpit during takeoff whose only duties are to monitor things makes this potential deviation particularly troubling.
I can understand why DAL1943 delayed until the next day (even before you talked about how violent the stop would have been) because the pilot was probably still really shaken up. What I don't understand is why AA106 was allowed to continue after a half hour or so. If the crew made such a critical error to cause this, could they be trusted for the flight? I noticed that the ATC changed crews, presumably to give the involved controller a break, but also to investigate if he screwed up. Can you comment?
I was wondering the same thing. Hell, at places I’ve worked at if you hit something with a forklift you’ve gotta go take a pee test, nevertheless when you almost kill 100s of people.
@@almostthere100 has that been reported? 30 minutes would be a quick turnaround to find an entirely different flight crew and you would still overwrite the CVR.
Oh a different crew? But news said recorders only record 2 hours so that data and voice was overwritten. Still, readbacks were correct on tower tapes so at least they have that. Hope they weren't watching youtube while taxying...
There is no way I could understand how close this situation was by listening to, and watching the news reports. This episode clearly shows how close it was. Watching this literally takes my breath away. Thank you.
A number of years ago, I was in a maintenance crew that was taxiing an aircraft at ORD and we witnessed an incursion which was so scary, it was easily one of the most frightening things of my 20+ years there. Needless to say, so very glad this had a good ending.
Hey Juan, about that FB. I have been retired almost 15 years, but when I was at AA, the 777 guys used to complain that AA would schedule the London trips for 7:58, or so, in order to avoid having to pay for an FB on the trip. Do they still do that? Do you suppose this flight did not have an FB? Winter jet stream and all, perhaps there was no FB. Keep up the good work. Bob
"This could happen to any of us." - I tip my hat to you for that statement, sir. Life has taught me that the skilled professionals are very often the humble ones.
Juan is so good at these explanations. Initially thought he may not want to touch this one. (Two close to home). Last flight returning to "Fortress" Bragg, NC from Northern Greece after participating in the huge NATO exercise Deep Furrow '72. C-141A Starlifters lacked in-flight refueling capability, so we stopped for gas at Torrejon AFB in Spain. Our ride, affectionately known as "Stardrifters" by we paratroopers, blew a starboard side main gear tire on take-off roll. The blown tire proceeded to beating the wheel well and adjacent tires up resulted in loud bangs and considerable vibration. That RTO was a wild ride! Once stopped the Loadmasters threw the paratroop doors open and we bunny hopped into a huge slick of hydraulic fluid on the runway. (Starlifter decks were very low to the ground). Two things in our favor... The jet was set up with the backwards facing airliner style seats and, at that time, the runway at Torrejon was the longest in Europe. Today it is the ninth longest runway in Europe.
RTO arms at 90 knots on the 737-800. And it stops faster than standing on the brakes. Incomplete read back was the beginning of this incident. I’ve done the same taxi route several times and that part of the airport is very dark at night. ( black hole) Seems like they got in their heads where they were going and what to expect except it was the wrong runway. Easy mistake to make. Easy to fix. Remember boys and girls, questions are free.
I spent 12 years flying out of JFK. Up until May 2020, there was a signage issue at that exact intersection. We all know there are supposed to be signs when approaching a taxiway intersection, indicating what crossing taxiway one is approaching. I can testify from first-hand experience that there was no sign visible from taxiway bravo, when approaching taxiway kilo, indicating where kilo is. Nothing! I wonder if this fact will finally be addressed as a result of this incident?
Jaun. It seems that you are speechless. I am very impressed with your experience with flying aircraft of many different places, and type. I bet that you have never seen something like this in your life as a professional pilot. If I was getting into a plane I would love to have you as a captain of the plane. If I knew that you were behind that wheel I would be very comfortable. The sad part is that I know that you are reaching the time that you will passing along your experience with younger pilots. Keep up the great work 👍.
Thank you for helping with the background and technical detail on this issue, it really makes a difference and shows how professional and well trained everyone is. I hate to see that there was a near miss, I'm sure that the industry will take every opportunity to learn from this. Incredibly scary for everyone involved but I'm glad they are all okay.
Briefing the planned taxi route to the active Runway is basic procedure. All three should have been on the same page concerning where they were going. Following the continuous loop process, the FO and RO should have been informing the Captain of the next step of the Taxi route. When crossing an Active Runway, the FO should have been looking at the Departure end and confirming it was clear. Distractions, either internally or externally, are certainly a threat. Appears that their were a lot of links in the error chain in this event. Glad the Delta Crew and Tower were on top of things.
Excellent work JB, thank you. Just an FYI, when you played back the chat between ATC and aircraft, it was only on the right (audio) channel (which suggests you are working in stereo). Maybe check your settings, if you're playing back a mono audio track, maybe pan it centre.
Juan, quite emotional you appear when you report this. Understandable!! When I heard of this incident for the first time, I wondered if you were inside the cockpit of this jet. Luckily not! I still remember flying with you in a T-37 at Mather. Good memories. Keep on!
Funny how you described the fb’s job on takeoff, when I was in the Air Force I often rode in the instructor pilots seat aka jump seat during low level bomb runs as being a Gunner, I had little else to do, and my AC often wanted me there for safety reasons. One flight we were low in the mountains and at one point I noticed we were getting closer than usual to a upcoming mountain ridge, I looked at both pilots, and they were both looking at their checklists, I immediately asked who had the aircraft, and both their heads shot up and both reached for the throttles and Jamed them forward and started a rapid climb, that was far closer to a bad day then I ever want to be again.
As the FE in a B727 I had no charts, however looking over the F/O shoulder as he briefed the approach he read off the wrong MDA (lower than allowed) I corrected him and although he was embarrassed at the moment he and the captain thanked me later. Can not say that saved an accident but shows that three heads are better than two
There's additional audio that I didn't hear you play where the female controller tells 106 to hold position several times as they begin to cross 4L. Then the male controller tells Delta to cancel.
Thank you for explaining that departures sometimes take off from 31L at KE. Although I was aware that it is possible for ATC to do this, I was not aware that this was a common occurrence at some airports. Thank you for this informative video, as always
Juan, you may have mentioned it later on in this video; I haven't had the time yet to listen to the whole thing, but I will do so. I did notice, nonetheless, at about the 4:50 mark in the video that the FO of American's flight 106 read back the taxi instructions from the ground controller WITHOUT stating the takeoff runway in her reply. She did not say, "Runway 4L, taxi via Bravo, hold short of Kilo." She simply said, "Bravo, hold short of Kilo", or something to that effect... And the ground controller did not quiz her about it nor ask her to repeat the takeoff runway. Also, as an anecdote, the first time that I know of that an American Airlines pilot expressed heated frustration over the constant inordinate amount of Operations Manual changes was in 1939. It certainly looks like things in that department haven't changed at American. I don't miss working there...
Juan. I’m a retired engineer never had the opportunity to be a pilot but have had a life long love for aviation (flew a lot of RC). Thank you so much for your work and great well presented information that I could never get if it were not for you.
Juan Brown, it appears you're missing some audio. Please listen to the VASAviation audio around :26 and you will hear the controller say "American 185, runway 31 left at Kilo Echo, line up and wait.". According to the airport diagram you can't take Kilo Echo to line up and wait for runway 31L. The controller should have said " American 185, CROSS runway 31 left at Kilo Echo, FOR 4 LEFT, line up and wait". I think this situation is a great example. Why read back is important!! And not to get lazy with directions. Could the call to American 185 confused American 106. What are your thoughts??
Juan, given the serious nature of this incident, is it normal practice to allow those involved to continue their flights or should they have been stood down for an immediate debriefing? Was kinda shocked the AA flight left as little as 30mins later, whereas the Delta flight remained grounded for 15 hours (although presumably, they would've needed to check the aircraft given its abrupt stop).
@@Fitch93 AA didn't even return to the gate? They made the flight and then we're pulled from the return flight and deadheaded home. DL flight returned to gate.
The AA crew flew to LHR, as scheduled. They had a layover in London, but were removed from duty-working back to JFK. All three pilots instead, deadheaded (as passengers) back to JFK.
I read somewhere that the plane taking off was traveling at about 115mph at RTO. Few passengers have experienced max braking on any vehicle let alone an aircraft, so to be accelerating one second and then max braking the next has to be a surprise at best. That is why you have seatbelts! It is curious that the AA crew did not query their clearance to taxi - so my question is what was the readback before taxi? The chief pilot not knowing your name was a great line. Excellent analysis. Thank you.
Juan, I heard a different recording where after the Delta was cleared for take off there were 2 partial transmissions of swear words and then the controller first told American to stop (not stop short! possibly already on the runway) and then the transmission to Delta to reject takeoff. Did you just edit the recording or is that the only recording you heard?
36 year airline pilot here- V1 speed is determined mainly by how much the jet weighs at takeoff. A reject at V1, the jet will stop at the end of the balanced field length(this distance is calculated based mainly on weight again) and this is always shorter than the hard surface of the runway being used.
Nice analysis. In my FE days I remember doing an FCF on the 747 and we had to test MAX brakes on landing. It stopped us so fast the pilots didn't even have time to get the TRs out. It was impressive! Also, as the 3rd person like you said I would write down all clearances and follow along with the airport diagram. Good FE always backed up the pilots. Now I'm flying the CRJ and will say coming in and out of SFO makes me nervous because there's always planes crossing your runway.
Thank you Juan. Recent subscriber and a fellow commercial aviator here. I could tell you put quality content out there from watching literally just a couple of your videos. This event boggles my mind really, it should be an interesting investigation. It would seem there was a terrible and acute loss of situational awareness at some point... What really has me in awe is the Capt of the AA flight asking to confirm if they were cleared to cross in their last clearance...! You were cleared to cross, but you crossed a different runway and it seems like you probably didn't even notice. We'll see what comes out of this
Nice job Juan. I can appreciate the sensitivity covering this topic for you. A couple questions for future follow-up: (1) How did the controller recognize the conflict? simply visual? is there a ground radar that includes collision warnings that the controller would have access to? (2) what is likely to happen to the American pilots involved? Administrative leave? Suspension? Demotion? I would think the American Cockpit Voice Recorder would be important, but if the flight took off minutes later, does it get erased by the flight operation? Thank you for your great reporting!
Yeah, that recorder must be gone after a flight to London since they overwrite unless the 777 uploads them to a server or something. Seems a mistake to let them fly after that, since you would want to preserve the evidence and they had to be rattled knowing they nearly killed 100's of people and themselves.
Assuming it was an honest mistake, the American pilots will likely be protected from FAA enforcement by the ASAP program. And if they have a clean record, they will probably keep their jobs and get remedial training because of union protection. Lessons will be learned, procedures will be changed and disseminated to the entire pilot group to prevent this from happening again.
Juan-The fact that this incident gave you the willies is the best evidence of how close it really was. Another outstanding video from one of the true experts out there. Thank you.
Thank you Juan for your objective and clear analysis of this incident. I retired ten years ago from a 25 year career as a tower controller which included 22 years at a major west coast airport. I have to admit that I was involved in one way or another in more than one similar incident. This is why we have air traffic control and I really appreciate your covering of this event. Thank you and God Bless all those airmen involved!
Great analysis 👍 it’s a pity procedure for an incident like this doesn’t include a delay to the offending aircraft and pulling its CVR recording. It would have been interesting to hear what they were talking about before crossing 04L.
One wonders whether the AA captain, knowing that the CVR might reveal too much (like non-flight related chitchat on the flight deck), elected to depart on a flight that would guarantee the CVR was erased.
A couple of observations, having worked ATC under Canadian, ICAO (TCU and Approach Radar), UK and EASA (TWR and APR) regulations. It's a huge situational awareness issue that AAL106 taxied for the wrong runway. There should have been a couple of opportunities to catch that; issuance of SID, which should be runway specific (if it's a simple "climb straight ahead to 3,000ft" off every runway, I accept that safety net may not exist at JFK), and read back of taxi clearance. The latter sounded pretty garbled to me, and probably should have been challenged by GMC. The crossing clearance of an ACTIVE RUNWAY was issued by GMC; that would not be permitted where I work. Greater SA might have been available to all if crossings were issued on the tower frequency. The phraseology used by the tower controller to stop the B739 is not what we use here; "cancel T/O clearance" is for a stationary aircraft or non-urgent situation. To stop in that situation would have been "C/S STOP IMMEDIATELY, I SAY AGAIN C/S STOP IMMEDIATELY, ACKNOWLEDGE." The crew who stopped were clued-in enough that it probably wouldn't have altered their (excellent) reaction, but it is much more definite in intent. Finally; stop bars. At my current location they are in use H24 at all runway entry points including vehicle-only entry points. We call it the ring of red. You do NOT cross a red stop without specific clearance to do so and specific information that the stopbar is inoperable.
Are you sure they cleared crossing an active runway? At the time of this incident, both 4L and 31L SHORTENED were open for simultaneous takeoffs. It's a very common mode of operations at JFK. 31L SHORTENED doesn't include the runway part east of taxiway KE; taxiway K and runway 4L actually don't cross it.
For all pilots from student Cessna 150 to A380 Senior Captain, here's some advice. If in doubt, ask. If both crewmembers are not 100% sure of the instructions, ASK! I can assure you ATC would rather say "Afirmative, cleared to cross" than having a runway incursion. Cannot say this applies to this particular case, but good advice nonetheless for crossing runways, takeoff and landing clearances and many other situations.
Thanks a lot for the breakdown on this event! This is probably the worst kind of runway incursion that can happen. I’m thankful that it only resulted in some shaken passengers and an embarrassing call to the tower.
Thank You Jaun for an objective report on this incident. I am grateful no injuries occurred. I observed as you reported, your emotions/dedication to safety were evident. This incident also cost Delta Airlines some maintenance-money. Inspection of the aircraft and replacement of tires/brakes as needed. A Patreon and Luscombe pilot.
You just answered the question I had. Juan mentioned the Delta aircraft had to wait 15 hours for next take off. I thought it might have to do with impact rejected takeoff might have on the airplane but wasn’t sure if it was that or some other administrative reason.
As someone who has rejected his takeoff, I can add from this experience in my Airbus, that as the jet is providing maximum effort braking, it is not possible to disconnect the auto brakes by pressing the toe-brakes. Irrespective of how hard one presses, the brakes are already at max, therefore I could not provide a higher pressure to release them (I did try). I let the jet stop itself as it was programmed to, rather than attempt to deselect the auto brakes via the push button. The stop was as impressive as expected. Expect to see a strict focus from ATC on reading back the assigned runway.
As a former C-141flight engineer I use to enjoy sitting in the rickety jump seat on take of and landing if we only had two pilots on board and I was scanner. One night taking off we rejected for comp stalls on one of the engines. Sitting in the jump seat with only a lap belt I held on tight to bar across the top of the center console.
Thanks so much, Juan. I've been Great to see you, Juan! Water and Snow and Planes, OH MY! Excellent, EXCELLENT commentary. I always love the little tidbits, recounted from your long many years of impressive service. in addition to the major teachable moments you have now become, dare I say, downright famous for 🙏🏽! Please God, don't let me.......screw up! 🫡 You know, just thinking about all the good work pilots do every single day, with about 100,000 flights successfully traversing the globe daily..... well it always gives me a lil catch in my throat. Thank you to both air and ground crew, and an exemplary record. AND, since I haven't talked with you in ages, Happy New Year #2023! The best to you, Mrs. B, and the little 'Lirios for #2023 🫶 *And nope, no one EVER likes being advised to Grab A Pencil 🫣 !
Captain looks left: "Clear left." FO looks right: "Clear right." Captain and FO: "Clear to cross." A lot of lights flashing and shining out there at night can be somewhat confusing. Be careful out there boys. Glad we can talk about an incident and not an accident.
4L is undergoing upgrades as is the full airport. My understanding is the lighted hold bar (aka stop light) has not been upgraded. Nevertheless, there are runway marker signs the crew should have seen.
A couple of questions: (1) When given instructions to cross 31-Left at Kilo, why was the readback essentially inaudible? (2) Why does it seem in many examples the dialogue is always very fast pre-issue, but afterwards everything is slowed down to almost conversation speed? Thanks for great illustrations & explanations!
RWSL=RunWay Status Lights. Over running them would be a bust on a checkride even before you get to the runway. JFK airport notes indicate that they are in use. Also, What happened to “Clear left-Clear right”? Probably would have seen Delta landing lights coming at them. Lastly, keep in mind, this could happen to any of us.
Yeah with three in the cockpit too. Makes you wonder how sterile things were or if, like was mentioned in the video, the procedure changes distracted them and had a conversation going that diverted attention.
"on the job 110%"...I got my PPL late in life flying out of FRG in the busy NYC metro area. Bucket list thing. It can be stressful for a low time pilot, monitor the radio, gauges and instruments, constantly looking for traffic. It took a lot of FUN out of flying. I haven't flown in 2 years. Neither me or a seasoned airline pilot, you cannot let your guard down. I appreciate your videos-good reminder to stay focused-situational awareness.
I'm amazed that they let the AA crew fly that flight after the incident. The Delta crew was stood down because of the near death experience and the need to check the aircraft for damage but by letting the AA crew take off they lost their cockpit voice recorder since the fuse wasn't pulled. They can say whatever they want now and probably had a 12 hour flight to get their stories straight. Also, they would have been even more distracted during that flight than the Delta crew given not only did they nearly die but they nearly caused a major disaster.
I was thinking the same thing. Who would want to be on a 😊lane with a pilot who just had a near miss and may also be in trouble. How could the possibly be focused. Happy to hear there was an alternate crew for the flight.
Was on a B767 departing Newark transatlantic. Takeoff was rejected probably very near V1. It IS rather exciting. Came to a stop about 50 yards short of the end of the runway. Taxi back to the gate and sit for 2 hours while maintenance looks things over. Faulty indicator. Taxi out to a dark corner of the airport for a thrust test, everyone still on board. Then we go back to the runway for another try. The hysterical thing was they did the safety briefing a second time. People had their safety cards out, REALLY paying attention this time. They fire it up and the woman I don't know next to me grabs my arm, took a few days for her fingerprints to go away. Once we got up about 1000' the cabin breaks out into noisy applause. Probably not a thing wrong with the plane. Memorable, though. Good times.
Did that once as a nonrev on a Continental DC-10 in HNL heading to EWR. The takeoff roll seemed to last forever and then we suddenly started braking. We were told one of the engines didn't respond the way the crew liked. An hour parked in front of the maintenance hangar and we went to try again. An RTO right before an ocean crossing is an interesting experience.
This was one of the first times I could use the nonrev privileges completely on my own at age 18. I had read about UA232 so I was sure losing one engine would not matter, but the crew really didn't want to deal with that, so they must trust that the problem is solved.
Wow, that's different - applause after takeoff rather than after landing!
I am so relieved that you then had an eventless flight - because that is what it really comes down to: arriving safely.
Never been in an RTO, but did experience a go-around, and when the crew decides to act, boy do they act.
Funny how fear brings us together.😄
Having Captained A330s into JFK for almost 20 years and having had the exact same clearance from T8 more than a few times and the same going to 31L, this intersection is nothing for the weak hearted, in rush hour, nighttime, snowing etc. It's tight, large aircraft in close proximity , a small stub way going to active runways both landing and take off .It is a hotspot that requires accurate briefing, read back and understanding of clearances, it doesn't take much to miss that stub way , there is a lot going on around you and as the taxing pilot you are really concentrating on not bending any metal, yours or others and a split second looking the wrong way would do it. ATC was up to the game, which they generally were in JFK and the other crew got it right as well. Human factors play a huge part in getting it all right on the day .For the 737 crew coming out of the dark end of 4L probably couldn't see the 777 until the abort call came and reacted without a flinch. I almost ran into the back of an 380 at night that I was following after it had been cleared to enter the ramp with a right turn at around November ,I looked left at a passing 747 and the 380 just stopped with its tail still over the taxi way, just noticed in a nick of time and had to jump on the brakes. The 380 crew got confused over to enter ramp clearance and just stopped, my FO was calling ramp control for our entry clearance, 8hr flight no 3rd man just little things that all sum up. The AA crew will be having a few bad weeks going over it all in their heads, but it could have happened to anyone, and we learn another lesson, this time thank god without loss of life..
In my 47 years as a Part 91 general aviation pilot that often operated IFR in and out of commercial service airports like ATL and DCA (pre-9/11), I was way more concerned about safely finding my way around the airport on the ground than I was a 3+ hours solid IFR flight. And night time and low IFR operations were not conducted without a second pilot.
Ever fly into O'Hare before the Modernization/Union dictated public works projects into infinity....LOL, when they had parallel as well as diagonal runways? There was a similar stub intersection there at the end of Runway 22R/4L called the Old Scenic/New Scenic taxiway juncture.....
Great reply. Rip Gordon Cooper
Looking at my Jepp FD Pro this update has no circled Hot Spots, that seems like an oversight! Applicable Hot Spots would have been a required briefing item.😐
It couldn't of happened to anyone. It happened because the female FO was hugely incompetent. No part of what she did was right. Nothing.
When I heard about this incident, I knew that you would release a perfect analyzes of the story. I didn't even bother to read or watch the news. You did a perfect job explaining everything. Thank you. HOPEFULLY you'll never have to do this type of video every again.
YES YES YES !!!!!!!
I was waiting as well, thanks, Juan!
Came here to say the same thing. Never even bothered to pay attention to whatever half explanations news shows and other online sources were going to post.
Analysis*
Yep I pretty much ignored the news media waiting for this video
FO did not read back runway assignment after initial contact with ground. Clearance was “taxi four left bravo hold short of kilo.” Ground did not question her read-back with no runway. Ground should have doubled down and insist she read back the runway assignment as is normal. Guessing they planned 31L and didn’t catch the change. Expectation bias is in play here.
Complying with fast talking controllers can be a challenge.
Recency bias too, the last thing she said and everybody in the cockpit heard was “…(cross runway 31) LEFT AT KILO.” They then proceeded to turn “left at kilo” which they had ringing in their ears, instead of right as they were supposed to.
Typical woman pilot. Not doing the job correctly. She needs sacking immediately. Didn't read back then nearly kills 400 ppl
Disagree with your interpretation. The readback was perfectly correct.
The final report will certainly indicate the complexities in this tight little corner of JFK airport, and there could be renaming and/or phraseology modifications in light of this.
"Right on Kilo, cross runway three-one Left" might have been less ambiguous, so I agree with you there.
@@Roadhammer42 First off, "everytime" is not a word. It's two separate words "every" "time".
Secondly, it's simply not true - If little mistakes and complacency killed "every time" there would be a hundred plane crashes every day.
You think I'm nitpicking, but there's substance here. Rules and procedures for humans are not the same as computer code. There must be room for reasonable excursions or misinterpretations that do not automatically or irrevocally result in disaster.
That's why this serious incident "could" result in some new rules in operations and phraseology at this particular (antiquated) airport. There is a cost though, any changes specific to this airport will require that it be considered a "special" airport, and require specific training and recency for pilots to fly in there.
It is worth noting that no rule changes have been issued as a result of the Air Canada near disaster where the plane lined up to land on a busy taxiway, when SFO, far more than JFK, should be considered a "special" airport with specific recent experience requirements.
@@gregfaris6959 Sorry - you are incorrect.
Check AIM 4-3-18.a.9(a)
“When taxi instructions are received from the controller, pilots should always read back the runway assignment.”
Also, see the example in paragraph ‘d’ in the same section.
Regardless of whether the runway readback by the pilot would have made a difference, it is simply incorrect to call the AA readback “perfect.”
I was a passenger on a 737 that had a rejected take off from a hydraulic problem. It is impressive. The crew on my flight were great and informed us immediately about the problem. This event occurred just after you had done a video about hydraulic problems so it was a non-event for me. I remain in awe of the amount of knowledge that is required for commercial crews. I also realize that sometimes "stuff" happens. Thanks for going over this.
Well, slightly different from you, Forrest Gump would say, “Shit Happens”…
How hard was the deceleration?
That's what her girlfriends asked.
I was on a lightly loaded jumbo in Bahrain that aborted takeoff due to a U/C warning light in the cockpit. The deceleration was startling. We spent a couple of hours on a remote part of the apron while they checked out the tires and everything else before we eventually took off without incident.
@@Av-vd3wk Gotta remember that -;SHIT HAPPENS ,💀
Being a 23 year Boeing Airbus Delta pilot, Juan, you did an excellent forensic explanation of this potentially deadly event. At the airlines and military, we would have to wait 6 months for the review. You are right, we have to be 110% spot on while conducting any flying ops especially at airports like JKF. Thank you for providing such timely information to “us” professional pilots.
It's about time......
What does he mean by FB? First Officer B?
@@jaypiper2 yes, there are two first officers because of the long haul ocean crossing. FO-B would be sitting in the jumpseat for this takeoff.
Hahaha. 110% spot on at “JKF”.
Who wrote this comment....the Hallmark Channel ? Thank you...youre analysis is spot on...dork comments.
Kudos to the tower controller that caught this deviation just in time! He played a major role in preventing a tragedy!!
News said there is a warning system there. Stop lights at the crossings... which were apparently ignored!! Alarm went off for controller to know.
For sure
Absolutely the controller saved the accident , I’m not sure why this guy doesn’t mention anything about that .
Did he? That statment assumes the pilots weren't looking or already reacting. It is good the controller made the radio call anyway as he couldn't know one way or the other, but you also can't know.
@@mytech6779 We need to wait for the investigation results. However, from the audio tapes, it is clear that the controller actions were pivotal and timely! I think that needs to be recognized as well!
Juan, your knowledge on aircraft systems, pilot training (the script) and the anomalies that can crop up, make you a prime candidate to join the NTSB or FAA educating pilots on how to make the right moves and aiding airlines when they need to improve their procedures. I've watched your channel for about 3 years. Your depth of knowledge of flying a wide variety of aircraft, is just spectacular and your including Pete in the mix when your home is wonderful. NTSB would be a nice retirement gig when the time comes.
Why wouldn’t a retirement gig just be flying around in the bush plane with Pete? Why work MORE?
As a retired thirty year air traffic controller, I can assure Juan that the bureaucracy and idiocy of any government institution is exactly where he DOESN’T want to retire to.
never happen, makes too much good sense
You three gentlemen do bring up a good point. I think where i'm going with this is the FAA needs people who can think through logically. There is a lot wrong with the airway system in the US and maybe, just maybe we get a few good people who understand how it really should work and they be given the authority to straighten it out sooner than later. Juan always shows deep intellect in analyzing these issues. Rest assured I don't want Juan to loose his time with Little Pete.
3 pilots, 3 iPads with the capability to display real time your aircraft position on the taxiway. I always made sure that all three of us in the cockpit agreed to any taxi instructions issued by ground control. Hard to believe all three did not notice they were headed to the wrong runway.
Leave it to AA to try and save a buck by sending out a 35 page bulletin instead of properly training the pilots.
It would be interesting to know how much time each one of those pilots had in the 777.
Just an observation from a retired AA 777 Ca.
Keep up the great reporting!
Verify every crossing "on the glass" 10-9 painted route,, MFD, FMS notepad, and "in the grass" twy and rwy signs and hold short markings. If only one pilot had done that prior to crossing it would have been any other day.
Sometimes too much information in front of you is worse than not enough. Most likely they where distracted. They should review CVR to learn more. Sterile flight deck under 10000?
AA only runs 2 pilots on that run. 8.5 hour duty.
I don't think you need a 35-page bulletin. These are common sense procedures for use with any airplane A simple radio call, by either AA pilot, before reaching the intersection, to confirm "are we cleared to cross 4L" would have alerted the crew they had the wrong runway. I never cross an active or inactive runway without a confirmation, even if it was cleared before. I agree, this looks like poor crew resource management, or someone said confirmation bias. Also, the I Pads can be a distraction.
Does the Ipad automaticaly highlight the cleared taxi route from ATC? If not, maybe that functionality could be added to help avoid this in the future.
Edit 1 -18-2023 ...Much respect to the flight crew (of the DL jet*) who stopped the takeoff as soon as possible.
(*Please see Laura Savino's ( an actual passenger jet pilot) posts below-she corrected my credit to the flight controllers, asserting they were actually not aware or timely on their observations or reactions-that the DL flight crew showed truly professional flight awareness and averted a disaster all on their own - my thanks to Miss Savino for correcting me here)
@Laura Savino that DL already saw the issue and was aborting makes sense because the jet stopped short of the crossover. The five to ten seconds response time from a controllers call to just start the jet slowing down would have probably put them through the intersection....I will not repost what you said but you should definitely post it as a starter comment because there are a lot of people here with the same errors about the air control team being the reason this wasn't a disaster when it was all in the hands of the DL crew to save their own lives. In one day,I will delete my comment as it is clearly inaccurate. Thank you for your correction.
@Laura Savino but she did read back “cross 31L on Kilo…. Then let the Capt cross 4L causing DAL to reject. Th FO was not in the “ball game” as much as the Capt was not in the game either. Perhaps he thought they were taking off on another runway and talked the rest of the crew into his expectations. The big question will be what was initially loaded into the box, what performance data did they use for planning? Did they think they got a runway change during taxi? Lots of questions but the ultimate was they NEVER had a clearance to cross 4L in any way shape or form. I’m not bashing a fellow crew member just calling it like it was…
These breakdowns are why I became a Patron of this Channel.
My knowledge and respect for all involved is aviation has grown so much.
And WE were only hearing the calls to THOSE two aircraft, not the other 20-30 transmissions to and from the other aircraft moving on that field.
Me too!
There was a queue behind the Delta flight and on the longer audio capture you can hear ATC telling the next jet in line that "This is going to take more than a minute and a half".
I’m never surprised that Juan can explain exactly what his viewers need to know with such a concise and timely manner What a pro
I'm stuck on why the American Captain continued the flight. My understanding is that it will record over the CVR. To me, that decision makes it hard to allow it to be a teaching moment and allow him or her to continue as a captain.
Enjoy your content. I’m a former A350 instructor and now Captain on the A320. This was a close call and will need to be investigated thoroughly. Listening to the ATC recordings you omitted one key transmission in your video from the ground controller that I believe also had a key part in this event. Another American Airlines flight, American 185 was cleared to line up and wait runway 31L at KE just after Delta 1943 had been cleared for takeoff on 4L. At this time American 106 heavy initiated the crossing of 4L. I wonder if the 106 crew had expectation bias on where their perceived takeoff point was with ATC instructions which led to them having the runway incursion. Very thankful for all the safety precautions that prevented this from being another Tenerife type of event. Thanks again for your breakdown of these aviation events.
When aviation events occur, your videos are the ones I look forward to. Thanks for doing what you do!
This is why I love your channel Juan...taking the time to explain what's going on from an actual pilot with tons of experience. Thank You for all you do!
Delta supplied new underwear for all onboard after the violent rejected takeoff. Very close call, JFK has always scared me because of how busy it is and runway configuration. At night it's even more scary.
Definite a code brown.
I imagine that the pilots had to go in the restroom of a change of their drawers. After they got to the destination they probably had a few drinks to settle down.
It’s better than LaGuardia! But in Nov 2019 flew into JFK over the water really fast and it was super windy outside. Felt like we were riding on a gravel roadway! And it was dark/night time! Scary. Then about 39 years ago, coming back home to Monterey, Ca from LasVegas via LA airport. Think it was a 737 or smaller jet? We were ready to touchdown when the piokwt pulled that jet almost straight up as I looked out the window saw a small plane under us on the left side. Yelled out( I know everyone heard me) there’s a plane underneath us. We climbed which was very scary as it felt like we were suspended and not moving. He leveled off and turned out over the ocean and made a wide turn and landed back again!! No one was smiling as we departed the plane. All the stewardess could do was nod their heads like yes we made it!
@@patti3d wow. so glad they avoided the collision!!
@@williamfenner9915 i think they returned to the gate after this occurred; possibly because the crew may have been close to time and would have timed out in flight because of delays from communicating with the company, updating flight plan, new clearance, then resetting the aircraft systems, reprogramming flight computers, taxi back, and the new departure slot time it would have been probably 30 to 45 minutes delay. Not to mention the DAL pilots were probably shaken up and heavily stressed due to the events and needed a bit to cool down, they were roughly 1000 ft, about 2 to 5 seconds at speed, from Tenerife in NY so I wouldn't blame them for needing a bit of time to process it and relax.
As a 30 year pilot and CFI, I know first hand how confusing airports can be. Just a few weeks ago, I did a flight review for another CFI and while taxing, we misinterpreted the call and got confused. It happens to everyone. We simply stopped the airplane and called for clarification. How three ATP’s screwed up this very simple taxi call to the point where they were flat out heading to the wrong runway (forget being on the wrong taxiway) is hard to fathom.
I was flying out of Chicago one time and had a rejected takeoff just before rotation. Just about had to pull my teeth out of the seat in front of me. This explains a lot, now I understand the pilot didn’t have any choice on how hard the breaking was.
if they had hit the braking action would have been MUCH harder....
any time did an emergency brake on the Highway? they did what they had to.....
Hi Juan. Jack here CFI at a large training school. Excellent reporting. Will show this episode to my students to emphasize that flight starts as soon as the engines are fired up and that vigilance and airmanship is paramount in all phases of flight. An avid follower. Thanks. Jack.
you should play the entire tape to your students, not just the redacted calls he plays in this video. Let them hear the Tower clear American 185 to takeoff 31L at KE right before 106 Heavy made the wrong turn to cross 4L on Juliet. I think that may have added to 106's confusion at the very time he entered that central intersection.
@@bradleys2320 You're absolutely right! I had to listen to that part like 3 times to understand just what the hell was he saying to whom???
@@bradleys2320 Hi! Thanks for your comment! Yes, I'm giving a class this weekend and will play the excerpt. Wouldn't want to sound biased event though I also was an ATC for 15 years... 🙂
As a man named Jack, I've never met a man named Jacques who chooses to be called "Jack". I have much respect for you just based off of your decided nickname.
It is a great nickname and it fits perfectly. :)
@@jacquesparadis6756 ATC for 15 years??? Holy cow. How did you manage to cope with that stress? ATC have one of the highest suicide rates in America because of the non-stop stress and absolute pristine attention and recognition required.
Good morning Juan, thanks for keeping your audience updated and educated.
We experienced a rejected TO in a DC-10 at JFK back around 1986. It was an exciting stop for sure, but we did not go back to the gate to cool off the brakes. We went around and "tried it again." When we landed at Guadalupe (Virgin Islands), 4 or 5 tires were flat due to the blow out plugs letting loose in flight from the heat. We deplaned and went on our way to our resort. When we returned to the airport a week later, that DC-10 was still sitting there. We spoke with people who had been scheduled to continue on to Martinique but never left the ground. They said it took 2 days to fly spare tires in. Then the jack broke and damaged a landing gear. Some people got frustrated and hired another plane to get them to Martinique. Others just stayed on in a cheap hotel on Guadalupe with a wasted vacation.
My father, a senior L-1011 captain, said if we had to reject TO the second time at JFK, they would have to come out in boats to pick us up.
Juan, time for a California drought and water update lake Shasta, Oroville, Folsom, Don Pedro are filling up fast from the storms. I find your channel very informative and non-bias. I started watching you because of the Oroville crisis. I also know a-lot about the weather. This could of been a disaster, also got my first solo done toward my PPL.
I agree. It's good content.
I saw him while flying around the Lake Berryessa area a few days ago. I imagine theres one coming, at least I hope!
Will do!!
have
@@avocadoflight I grew up in Vacaville, so Lake Berryessa is my old stompin' grounds. Definitely want to see if the Glory Hole will spill over soon!
In my opinion a contributing factor to this event is how the US handles departure clearances. Nearly everywhere else in the world your departure clearance includes the runway you will depart from, however in the US (in my experience flying there) you only find out your departure runway after you pushback, taxi out from the ramp and call ground control. Changing your departure runway at this point requires recalculations, reprogramming of the FMC and revised briefings, all at a less than ideal time, especially when ATC want you to move. It's something I've experienced a few times now and I can see how something like this can happen.
Confirmation bias also ties into this if they had planned to depart on 31L while still at the gate.
Zesiro: Altbough your point is well taken, it may not be practical at busier airports. Runway assignment is the result of many conditions and options. As an example, during my days as a journeyman Controller at KORD, if weather/wind conditions permitted, runway assignment was based on your direction of flight immediately after departure. Further the assignment was often impacted by the amount of departure traffic; e.g. if south and westbound departures might be assigned runway 27L, and north and eastbound traffic assigned runway 32R during the current airport configuration, if departing traffic on ruway 27L was backing up, at the discreation of the Ground Controller the westbound departures might to assigned runway 32R to expedite traffic. At a busier airport runway assignment is a dynamic situation. Simply an FYI for anyone interested.
@Zesiro & Rich P - both are valid points and the clear link between is the overwhelming choice to cram as much traffic as possible through the system for 4 reasons:
- the entire business is populated with hyperactive, obsessive compulsive people
- human arrogance
- scheduling convenience for traveling public
- greed
For these reasons we are willing to risk hundreds of lives on a few sequential errors which all arise for the same reason - too much, too fast.
There are busier airports already doing it. "Busy" is not an excuse.
This is really like running a red light. No amount of technology, preparation and programming will help someone from running a red light.
That is totally not true. The departure runway is, at the very least, on the ATIS. It's far more complicated outside the US.
1/17/23; 2day your review of taxiway incident (near collision) at JFK was fantastic! Love your use of close up animated (earlier recorded real time) movements of a/c. Your presentation clearly shows a/c symbols moving around & your use of red & green colors linked to the a/c showing their movements on ATC assigned taxiways was perfect but made better when the ATC instructions were played real time as conflict developed...was caught in time to be effective & prevented a Tenneriffa type catastrophe.
Juan, your channel, your experience, your use of available ATC recordings & many other visual/technical presentations is always wonderful education & valuable information for all YT viewers to consume. You are providing experience & education for public safety...sometimes your videos come from tragic aviation mistakes, but ultimately you are delivering factual information which in due course becomes changes for enhanced public safety. Bravo sir! Stay safe & carry on!👍👍👍👏👏😊
YES!!!!
Juan provides the absolute best graphics and descriptions.
@James Cole :
I really like your use of "near collision".
It's actually a more accurate description than "near miss".
A "near miss", at least in my mind, would actually be a collision, as the "vehicle/s" involved "almost missed" each other, or another object in their path.
Capt. Brown,
I am a B767 Captain who flies in and out of JFK frequently. This event has certainly caught the attention of the public. Several friends (non flying and friends from the GA community) have been emailing and texting me seeking analysis of this event. As always, I’ve been looking for your input. Barring some as yet unrevealed information, I have found it challenging to explain how the AA crew made this error. Nonetheless having been a Central Air Safety Committee chairman and pilot rep on the ERC, I know that drawing conclusions before all the information is collected is not a valid approach. That said, I had a couple of questions about AA procedures.
1. I assume that somewhere in the pre-push phase, after having received the clearance that a taxi brief is required. Accordingly, the crew would have planned for and programmed 4L as the departure runway and seen that a turn would be required before reaching 4L. Thus, onto using to taxi to 31L should have triggered a “runway change” checklist - correct?
2. The FO (presumably) read back the clearance to cross 31L at K. Accordingly, the Captain continuing beyond K should have at least elicited a conversation and verification from ATC.
3. When they were crossing 4L, the DAL jet was on its takeoff roll (presumably) with it forward facing lights on. I am curious how the FO missed this when clearing the runway to cross. In 2001, I had an Air France 777 pull onto the runway I was taking off from as we accelerated through 120 knots. We departed the runway to avoid a collision. Needless to say, I am always very alert when entering/crossing runways.
4. These thoughts represent just a few layers of the Swiss Cheese that lined up here. So here is my AA procedure question - following an event like this, would the crew be required to notify the company before departing? If so, would this have necessarily required a CVR download?
5. Absent the implication of one or more of the “Big Five,” the crew will be covered by ASAP. However with the NTSB’s involvement, do you know whether the findings from the CVR (if available) could be used to determine inclusion/exclusion from ASAP?
6. As you said, anyone can make a mistake like this. We can all lose SA. Nonetheless, how three pilots lost SA to this degree is perplexing. Once the findings are complete, I think this event will be on tap for everyone’s recurrent for some time to come.
Avoided watching anything about this until you covered it, Juan! Man, I was in a 747 many years ago (Pan Am) that did a late rejected takeoff. Very violent indeed. Overhead compartments popping open and lots of noise and vibration. Wouldn’t care to repeat that!
Thank you Juan B for your succinct explanation of this incident. I was curious if you'd be allowed to post on this particular occurrence and I am grateful you were. I have seen other content on this incident but without your detailed map depiction, it was difficult to comprehend without PIC or FO exposure at a "hard surface facility." Cheers from Texas.
Clearly this event caused a huge emotional impact on you Juan...we can hear it in your voice. You did an excellent job describing the situation as it unfolded at JFK. For those of us who are avation-challenged you made it easy to understand. ✈✈ When your aircraft is CLEARED for take off you expect the runway to be CLEARED for a safe takeoff.
I think it’s a lot is due to him flying similar aircraft and understanding how close this really was.
It makes me shake just seeing how close this was. Angels in all the right places stopped this.
@@MeppyMan and the fact that they are fellow pilot employees at the same carrier. It's possible that Juan is personally acquainted with them and/or has flown with them, plus a little "There, but by the grace of God go I" thrown in for good measure?!
@@bearowen5480 also, I wonder if he will take any heat for reporting on certain airlines? Like 74gear, I wonder if the social media policy is different at SWA, Atlas, Kitilla, UAL or AA? The value of Juan’s reporting should earn him some respect. OTOH DTSB not so much.
@@Qrail I worked for UAL. We had to be VERY careful about what we put on social media.
At approximately 5:15 you state that, “Everyone should be on board that we’re going to runway 04L.” I did not hear the FO do a full read back of the taxi clearance in that runway 04L appears to be omitted. In addition, ATC does not correct the readback. This was an omission of a very important SOP and a missed opportunity by ATC to trap the error.
The FO on the initial contact with ground did not read back the departure runway. If the TPS listed 31L as the primary runway, and the departure briefing was given for 31L. And departing from 31L full length is not uncommon then we have a set up for expectation bias. With out a full read back of the initial clearance then the bias would not be broken. Just speculating here as to the setup of what could of caused this. Great video and analysis as alway Juan.
I’ve also been wondering about the “Takeoff Brief”, as well as what runway the station issued TPS for. Have had MANY instances where the EWBS close out comes with an incorrect runway, incorrect intersection (usually full length), incorrect winds, runway conditions, etc.. Personally, I refuse to brief a taxi route other than to say expected runway. I always state that we will follow ATC instructions to our assigned runway and that we WILL NOT cross any runway without a verified crossing clearance. Expectation bias is a VERY dangerous thing in our business. Even then, mistakes are so easy to make. Like when the FO goes “heads down” during taxi to send for new TPS due to weather changes, runway change, etc. Far be it for me to say why this happened. Way to many variables and lack if information at this point.
Yeah, I to am betting they set up and briefed 31L and had that set in their minds the entire time. I wonder if they got the memo about their TPS reports.
@@saxmanb777 Uh yeah...that would be great.
Great pickup that there was no read-back of the runway assignment to Ground. Still kind of curious that they read back "cross 31L at K" and they crossed 4L on J. Wonder how it's signposted, as Juan mentioned.
I have wondered to myself why my local ground controller / tower have (even when I've read back the right runway, and the airport has been empty) had me re-acknowledge runway assignment. I'm now even more thankful for our local ATC controllers; knowing that being pedantic about the small things isn't necessarily about movement at our little GA airport, it's also about training pilots to be clear and avoid getting into situations like this one.
I was about to suggest the same thing. Maybe it’s the route they took last time further reinforcing the bias. Human factors means one of these is always going to slip through eventually. It’d be nice to think taxi instructions could be uplinked to aircraft but I guess it’s too cumbersome.
Great video, Juan. I've encountered professional pilots who seem to completely trust ATC and rarely look outside the cockpit. As a GA pilot, we're taught to spend as much time as possible outside the cockpit. I've gotten lost at a 'large' airport and stopped on the taxiway. Frequency was tied up by a student having trouble reading back his clearance. Sure enough, a SWA 737 pulled up behind me. I bailed to an open ramp nearby because I figured he knew where he was going. ATC thanked me. Super important to keep aware of your surroundings. If unsure of taxi, stop and ask.
I was waiting for you to do this one… I heard about it and was wondering if you were gonna cover it… love your channel Juan… I’m not a pilot but a truck driver I do enjoy aviation
I am also a truck driver and everything you said is on point with my own thoughts. I've been following Juan for approx 2 years and I've become so intrigued and fascinated by aviation because of it. I never realized how complex it truly is and how demanding it is for the pilots. So much respect and appreciation to them.....as well as ATC, ground crews, dispatch, flight attendants and everyone else involved.
I am also a truck driver. Not to discount any pilot's tremendous responsibilities along with the training that goes with it it, there's some similarities amongst GA, air transport, and commercial truck driving. For all of us drivers and pilots, concentration, sit awareness, alertness to the myriad of hazards, etc. are key to a successful flights and runs. When driving I'm relaxed but playing out "what if...? scenarios as I'm rolling down the road. An old veteran truckdriver was once quoted as saying: the most dangerous mile is the next one. BTW, thanks, Juan.
On both I-pads we have GPS on the Airport diagram, most Arlines have similar, some more complex than others. Someone was NOT paying attention to the clearance, and routing. At JFK particularly we, at EVERY junction, confirm left, right, straight or "Runway XX on the sign" clear to cross, clear right / left before entering EVERY time. There is NO valid excuse not to have both heads up and out, if only at the intersections, no checks should be done during the taxi period unless it is 100% safe.
Thank you Juan. When you show your passion for safety, it reinforces what I already know and tell others. Flying is the safest way to travel because of dedicated people like Juan Browne.
Outstanding breakdown and analysis Juan. Thank you. As a Part 121 pilot who regularly operates at JFK and as been at that very intersection countless times, this incident hits home on so many different levels. I really appreciated your comment of, “…it could happen to any of us.” That is 100% spot on. I really hope that no stone will be left unturned during the investigation so that we as an industry can learn (change our behavior) all that we can. Everyone remembers or has read about the mishap at Tenerife; we, as an industry, were a mere 1,000’ from another loss of hundreds of lives. Thank the Lord this was not the case on 13 Jan 2023.
An additional piece of information, pinned on the VASAviaton coverage of this event, is that AA106 was told to stop multiple times on the ground frequency and never responded. There were some huge holes in the Swiss cheese on this one!
@@dryan8377 The AA777 was told to stop several times.
@@dryan8377 Delta was the one rejecting takeoff, not AA
@@dryan8377 the American Airlines flight had 3 pilots on the flight deck and was apparently not monitoring the ground freq before crossing the wrong runway. I am well aware of the hierarchy. They should have been monitoring ground and maintaining situational awareness instead of talking to company or whatever else they were doing.
The Delta flight that actually was rejecting did manage to respond to the tower in the middle of their RTO...
When I was a tech working on the CP-140 Aurora (Canadian P-3) a pilot buddy had a rejected takeoff due to prop pitch-lock. They Flat-spotted the main tires, and when they taxied back to the ramp we immediately signaled "hot brakes" to the crew. While monitoring a small fire flared up, immediately put out. We earned our pay that day, as we had it back in rotation about 4 hours later. The prop issue was a pressure transmitter.
Kennedy Steve retires, and the whole place goes to he||
Hahaha!!! Agreed. He is a legend. Always fun when he was on the other end of the freq.
I just want to stress how important it is to understand how vulnerable we all are to these types of situations. In this case it took a quick acting Delta crew and a pair of very attentive controllers to avert an absolute tragedy. One day, hopefully never, we may all be the goat or the hero in this or a similar story. Please, be aware out there, this was way way too close.
Nice work Juan. I would just say as a ATC person, a good technique would have been to tell them to turn right on Kilo and cross 31L. While they didn’t do anything wrong with the instructions, I always preferred to give a positive instruction of turn right and cross so that there was less chance for misunderstanding. Especially with a complicated taxiway design of this airport. I am sure that’s a Hot Spot. Again thanks for your review.
That probably would have helped greatly in this situation. Not to say the ATC is at fault, but it's a team effort after all right? Maybe following this incident that kind of verbiage will become standardized, especially at busy airports. Maybe adds half a second to each transmission, but if it improves safety even a little bit that surely is/would be worth it. We'll see I guess.
Completely agree. Cleared to cross and taxi way K is a hard right, J is straight ahead and crossing a rwy, easy to go with straight ahead, taxi way signs are not always right in front of you or easy to see. And not one hotspot at JFK.
As a pilot I agree that your technique should be standard at ATC. "American 106 Heavy cross RWY 31L at Kilo" does not provide as much information as "...turn right on Kilo, cleared to cross RWY 31L." It's a heavy workload environment for both controllers and pilots alike and I certainly don't blame the controller for his clear and common verbiage, however, even a small phrase like "turn right" can provide a certain measure of clarity for pilots and prevent a potential disaster.
@@allen-nl5idJ is a right turn off B just like K, just not as hard a right turn.
@@robertbutsch1802 Good point, Bob, ! I noticed that same point. In an accident's a priori sequence of events, the "Sweiss cheese" usually has a lot of holes in it!
As a B737 Capt. I always told my FO’s that “There are four “F’s” you want to never do:
1) Fire
2) Flight Control problems
3) Funnel Clouds
And the
4) Five o,clock news
I actually started with 5 F’s but I broke that one and ended up marrying a Flight Attendant😜
You'd have been better off breaking the other 4 - LOL Guess you never heard of the 3 Fs?
@@mountainflyhigh rent it lol!
@@mountainflyhigh😂
That was Alan Shepherd's prayer, but he said it over an open mic. It is still in use but said privately by the Astronauts.
Great job Juan with the breakdown of what we know so far. I'm sure this one wasn't easy. Luckily no one was hurt. I'm sure many things aligned in the Swiss cheese model to allow this to happen. One thing I noticed on the audio is that the ground controller did not specify to turn right on kilo, then cross 31L. He only said to hold short of kilo initially, then extended the taxi with a crossing clearance. It's a small detail, but may have prompted conversation or drawn attention to the need for a right turn before crossing a runway. It's a good example of why proper radio etiquette is so important. This is something we all should do better on both sides of the radio.
Yep, I think you’re right about that clearance, I heard the same thing. ATC should’ve issued a right turn on K, then the crossing clearance. My guess is it’ll be a key ingredient to the confusion factor. Still, situational awareness is paramount. Didn’t get what the reported visibility was at the time. That’s another factor, if DAL couldn’t see the AA crossing down the runway during takeoff roll, they could’ve initiated the RTO themselves. Fly Safe.
Juan, a couple of questions come to mind. 1. For the DL crew and plane after the RTO why would ARFF not be dispatched to check on DL brakes? 2. Why was runway 4L and 31L not shut down for a safety check due to possible FOD from DL aircraft. Violent RTO braking can shake things loose from plane. 3. Why was the AA crew allowed to continue the flight? After being in a close call and getting grilled by ATC why would AA allow them to continue to fly? I wouldn't have wanted to be on that flight with a distraught crew. 3. Seems like the taxiways near 4L and 31L are poorly designed. Similar to an incursion at DTW between two NW aircraft that resulted in collision (1990's). Would love a followup video. Keep up the good work.
Agreed. I had a low speed RTO departing EGPF several years ago in a Falcon 900. After we cleared the runway, EGPF controllers closed the runway temporarily to conduct a FOD inspection.
And I’d be even more uneasy if the AA crew *wasn’t* distraught
@@10RRASK the way the AA captain it seems like they were thinking they didnt do anything wrong
I can't find anyone else asking this question so hope you don't mind me hitting replying under yours. My question is: is the poor audio quality of the readback by the FO of AA-106 at 5:24 indicative of the same poor audio quality Ground would have heard? I'm assuming not, but curious. Since *if* Ground didn't care to clarify a poorly transmitted readback of a mis-understood instruction that did not match the original Ground request, then that would also be a contributing factor to the near-hit.
@@OutofDarkness_jik no it is not. I hear very poor audio quality listening on liveATC but in the cockpit it is super clear
I think it is important NOT to point fingers at anyone. Let’s have the report first and remember that there are always many aspects of case like this. Thanks for providing the basic facts.
We used to operate into KJFK occasionally and parked at the GA ramp. The taxi routes to 31L or 4L were common for us. Company SOP included taxi briefings once the runway was assigned and the heading bug set to departure runway. Perhaps the ground controller could have given a clearance that specified a right turn on “K” “cross 31L”. That may have alleviated the confusion.
Agreed 110%, Juan on augmented flight crews. We flew with an augmented crew quite often on long haul international flights and per our SOP the third crew member was active crew on the jump seat until leaving 10,000’.
Very fortunate that this did not end in tragedy. Good heads up by tower and Delta crew.
totally agree... ground controllers around the country should give a specific turn instruction before a crossing instruction (where the crossing isn't straight ahead). Sometimes ugly incidents like this are opportunities to locate weaknesses in the system.
@@pdquestions7673 I agree that Ground Control could have done a more thorough job, but the crew still dropped the ball big time!
@@bearowen5480 - Yeah it was a huge mistake. But this scary incident has revealed an opportunity for a key improvement in ground control phraseology. Can't forget there are lots of foreign crews operating out of JFK... anything to make things as extra clear as possible.
@@pdquestions7673 That would require changing the 7110.65 manual (written by lawyers) where specific phraseology is in place. Although a controller can deviate from phraseology if needed to make a command clear or issue safety alerts. Though Runway 4L, taxi via Bravo, Kilo, Hold short Runway 31L at Kilo seems pretty clear to me on where to go. Typical taxi instructions are Destination, route, hold instructions if needed. As a plane approaches a Runway to cross the Ground Controller has to request to cross the runway from the local controller. This is called coordination and happens at all airports. Once that coordination is set (with each controller using their two letter ID for the tapes) the ground controller can tell the the plane to continue, i.e. Aircraft, Cross Runway 31L at Kilo continue taxing. The pilot must confirm the taxi instructions and if they do not understand the taxi clearance SHOULD ask the controller for clarification. Pilots can also request progressive taxi if not familiar with the airport. Also with technology like Foreflight Pro taxi routes can be brought up on the screen giving you the route on a map.
I heard the call like AA did, the first time (but not familiar with the airport). Before what Juan played, there's a lot of fast calls, and hold shorts. That's a confusing jog there, too, over to 4L, but seems 1 of the 3 pilots would know it. I'm not a pilot, and most ATC is beyond me to hear/process, so grain of salt. The crew should have at least questioned the call, it seems. But why is ATC firing off so many taxi instructions in a row with little time for read back? I get that they're really busy, but slow things down a hair?
You and Victor (VASAviation) are my go-to for incidents like this. And I was especially interested in hearing from you since the aircraft that seems to have caused the problem was a 777. You would be able to explain procedures in the cockpit better than most other analysts. That there is a third pilot in the cockpit during takeoff whose only duties are to monitor things makes this potential deviation particularly troubling.
VAS gets the transcript wrong a lot, bur it's the best.
I can understand why DAL1943 delayed until the next day (even before you talked about how violent the stop would have been) because the pilot was probably still really shaken up. What I don't understand is why AA106 was allowed to continue after a half hour or so. If the crew made such a critical error to cause this, could they be trusted for the flight? I noticed that the ATC changed crews, presumably to give the involved controller a break, but also to investigate if he screwed up. Can you comment?
I was wondering the same thing. Hell, at places I’ve worked at if you hit something with a forklift you’ve gotta go take a pee test, nevertheless when you almost kill 100s of people.
Different AA crew flew it.
Delta plane had to get brakes looked at after the RTO. Like Juan said flew 15 hours later.
@@almostthere100 has that been reported? 30 minutes would be a quick turnaround to find an entirely different flight crew and you would still overwrite the CVR.
Oh a different crew? But news said recorders only record 2 hours so that data and voice was overwritten. Still, readbacks were correct on tower tapes so at least they have that. Hope they weren't watching youtube while taxying...
Juan, you're everyone's go-to guy for the best and most timely analysis of aviation incidents in the news.
There is no way I could understand how close this situation was by listening to, and watching the news reports. This episode clearly shows how close it was. Watching this literally takes my breath away. Thank you.
A number of years ago, I was in a maintenance crew that was taxiing an aircraft at ORD and we witnessed an incursion which was so scary, it was easily one of the most frightening things of my 20+ years there.
Needless to say, so very glad this had a good ending.
Good review. I will throw some kudos to the Air Traffic Controller for recognizing the situation and acting quickly to help avert a disaster.
Hey Juan, about that FB. I have been retired almost 15 years, but when I was at AA, the 777 guys used to complain that AA would schedule the London trips for 7:58, or so, in order to avoid having to pay for an FB on the trip. Do they still do that? Do you suppose this flight did not have an FB? Winter jet stream and all, perhaps there was no FB.
Keep up the good work. Bob
There was a FB on the flight deck! So, three pairs of eyes and ears.
"This could happen to any of us." - I tip my hat to you for that statement, sir. Life has taught me that the skilled professionals are very often the humble ones.
Juan is so good at these explanations. Initially thought he may not want to touch this one. (Two close to home).
Last flight returning to "Fortress" Bragg, NC from Northern Greece after participating in the huge NATO exercise Deep Furrow '72.
C-141A Starlifters lacked in-flight refueling capability, so we stopped for gas at Torrejon AFB in Spain.
Our ride, affectionately known as "Stardrifters" by we paratroopers, blew a starboard side main gear tire on take-off roll. The blown tire proceeded to beating the wheel well and adjacent tires up resulted in loud bangs and considerable vibration. That RTO was a wild ride!
Once stopped the Loadmasters threw the paratroop doors open and we bunny hopped into a huge slick of hydraulic fluid on the runway. (Starlifter decks were very low to the ground).
Two things in our favor... The jet was set up with the backwards facing airliner style seats and, at that time, the runway at Torrejon was the longest in Europe. Today it is the ninth longest runway in Europe.
RTO arms at 90 knots on the 737-800. And it stops faster than standing on the brakes.
Incomplete read back was the beginning of this incident. I’ve done the same taxi route several times and that part of the airport is very dark at night. ( black hole) Seems like they got in their heads where they were going and what to expect except it was the wrong runway. Easy mistake to make. Easy to fix.
Remember boys and girls, questions are free.
I spent 12 years flying out of JFK. Up until May 2020, there was a signage issue at that exact intersection. We all know there are supposed to be signs when approaching a taxiway intersection, indicating what crossing taxiway one is approaching. I can testify from first-hand experience that there was no sign visible from taxiway bravo, when approaching taxiway kilo, indicating where kilo is. Nothing! I wonder if this fact will finally be addressed as a result of this incident?
Highly relevant point right here. Take some actual physical real photographs of that part of the tarmac, and its signs, as soon as possible.
Jaun. It seems that you are speechless. I am very impressed with your experience with flying aircraft of many different places, and type. I bet that you have never seen something like this in your life as a professional pilot. If I was getting into a plane I would love to have you as a captain of the plane. If I knew that you were behind that wheel I would be very comfortable. The sad part is that I know that you are reaching the time that you will passing along your experience with younger pilots. Keep up the great work 👍.
Thank you for helping with the background and technical detail on this issue, it really makes a difference and shows how professional and well trained everyone is. I hate to see that there was a near miss, I'm sure that the industry will take every opportunity to learn from this. Incredibly scary for everyone involved but I'm glad they are all okay.
Briefing the planned taxi route to the active Runway is basic procedure.
All three should have been on the same page concerning where they were going.
Following the continuous loop process, the FO and RO should have been informing the Captain of the next step of the Taxi route.
When crossing an Active Runway, the FO should have been looking at the Departure end and confirming it was clear.
Distractions, either internally or externally, are certainly a threat.
Appears that their were a lot of links in the error chain in this event.
Glad the Delta Crew and Tower were on top of things.
Excellent work JB, thank you. Just an FYI, when you played back the chat between ATC and aircraft, it was only on the right (audio) channel (which suggests you are working in stereo). Maybe check your settings, if you're playing back a mono audio track, maybe pan it centre.
Juan, quite emotional you appear when you report this. Understandable!! When I heard of this incident for the first time, I wondered if you were inside the cockpit of this jet. Luckily not! I still remember flying with you in a T-37 at Mather. Good memories. Keep on!
Funny how you described the fb’s job on takeoff, when I was in the Air Force I often rode in the instructor pilots seat aka jump seat during low level bomb runs as being a Gunner, I had little else to do, and my AC often wanted me there for safety reasons.
One flight we were low in the mountains and at one point I noticed we were getting closer than usual to a upcoming mountain ridge, I looked at both pilots, and they were both looking at their checklists, I immediately asked who had the aircraft, and both their heads shot up and both reached for the throttles and Jamed them forward and started a rapid climb, that was far closer to a bad day then I ever want to be again.
Wow! Damn that's scary! Great job sir!
As the FE in a B727 I had no charts, however looking over the F/O shoulder as he briefed the approach he read off the wrong MDA (lower than allowed) I corrected him and although he was embarrassed at the moment he and the captain thanked me later. Can not say that saved an accident but shows that three heads are better than two
My wife is a Flight attendant and she told me from experience that rejected takeoffs can be pretty rough.
I want the aft facing seat, thank you.
There's additional audio that I didn't hear you play where the female controller tells 106 to hold position several times as they begin to cross 4L. Then the male controller tells Delta to cancel.
Thanks Juan. I was wondering if you were going to cover this one
Thank you for explaining that departures sometimes take off from 31L at KE. Although I was aware that it is possible for ATC to do this, I was not aware that this was a common occurrence at some airports. Thank you for this informative video, as always
Juan, you may have mentioned it later on in this video; I haven't had the time yet to listen to the whole thing, but I will do so. I did notice, nonetheless, at about the 4:50 mark in the video that the FO of American's flight 106 read back the taxi instructions from the ground controller WITHOUT stating the takeoff runway in her reply. She did not say, "Runway 4L, taxi via Bravo, hold short of Kilo." She simply said, "Bravo, hold short of Kilo", or something to that effect... And the ground controller did not quiz her about it nor ask her to repeat the takeoff runway. Also, as an anecdote, the first time that I know of that an American Airlines pilot expressed heated frustration over the constant inordinate amount of Operations Manual changes was in 1939. It certainly looks like things in that department haven't changed at American. I don't miss working there...
Juan. I’m a retired engineer never had the opportunity to be a pilot but have had a life long love for aviation (flew a lot of RC). Thank you so much for your work and great well presented information that I could never get if it were not for you.
Wow, didn’t think you would cover this. Glad to see you give us some insight.
Well Juan does work for one of the two companies talked about and that was involved in this incident so
Juan Brown, it appears you're missing some audio. Please listen to the VASAviation audio around :26 and you will hear the controller say "American 185, runway 31 left at Kilo Echo, line up and wait.". According to the airport diagram you can't take Kilo Echo to line up and wait for runway 31L. The controller should have said " American 185, CROSS runway 31 left at Kilo Echo, FOR 4 LEFT, line up and wait". I think this situation is a great example. Why read back is important!! And not to get lazy with directions. Could the call to American 185 confused American 106. What are your thoughts??
Juan, given the serious nature of this incident, is it normal practice to allow those involved to continue their flights or should they have been stood down for an immediate debriefing? Was kinda shocked the AA flight left as little as 30mins later, whereas the Delta flight remained grounded for 15 hours (although presumably, they would've needed to check the aircraft given its abrupt stop).
The AA crew were replaced for the trip.
@@Fitch93 AA didn't even return to the gate? They made the flight and then we're pulled from the return flight and deadheaded home. DL flight returned to gate.
The AA crew flew to LHR, as scheduled. They had a layover in London, but were removed from duty-working back to JFK. All three pilots instead, deadheaded (as passengers) back to JFK.
@@davidmangold1838 Thank you very much for the information.
@@davidmangold1838 I can imagine how they were able to focus on anything during their flight to London.
I read somewhere that the plane taking off was traveling at about 115mph at RTO. Few passengers have experienced max braking on any vehicle let alone an aircraft, so to be accelerating one second and then max braking the next has to be a surprise at best. That is why you have seatbelts! It is curious that the AA crew did not query their clearance to taxi - so my question is what was the readback before taxi? The chief pilot not knowing your name was a great line. Excellent analysis. Thank you.
Juan, I heard a different recording where after the Delta was cleared for take off there were 2 partial transmissions of swear words and then the controller first told American to stop (not stop short! possibly already on the runway) and then the transmission to Delta to reject takeoff.
Did you just edit the recording or is that the only recording you heard?
'It's not a Near Miss, it's a Near Hit.' - George Carlin ;)
36 year airline pilot here- V1 speed is determined mainly by how much the jet weighs at takeoff. A reject at V1, the jet will stop at the end of the balanced field length(this distance is calculated based mainly on weight again) and this is always shorter than the hard surface of the runway being used.
Nice analysis. In my FE days I remember doing an FCF on the 747 and we had to test MAX brakes on landing. It stopped us so fast the pilots didn't even have time to get the TRs out. It was impressive! Also, as the 3rd person like you said I would write down all clearances and follow along with the airport diagram. Good FE always backed up the pilots. Now I'm flying the CRJ and will say coming in and out of SFO makes me nervous because there's always planes crossing your runway.
Thank you Juan. Recent subscriber and a fellow commercial aviator here. I could tell you put quality content out there from watching literally just a couple of your videos. This event boggles my mind really, it should be an interesting investigation. It would seem there was a terrible and acute loss of situational awareness at some point... What really has me in awe is the Capt of the AA flight asking to confirm if they were cleared to cross in their last clearance...! You were cleared to cross, but you crossed a different runway and it seems like you probably didn't even notice. We'll see what comes out of this
Nice job Juan. I can appreciate the sensitivity covering this topic for you. A couple questions for future follow-up: (1) How did the controller recognize the conflict? simply visual? is there a ground radar that includes collision warnings that the controller would have access to? (2) what is likely to happen to the American pilots involved? Administrative leave? Suspension? Demotion? I would think the American Cockpit Voice Recorder would be important, but if the flight took off minutes later, does it get erased by the flight operation?
Thank you for your great reporting!
They would certainly have ASDE-X ground-based radar and would have generated an alarm at the controller's position.
Yeah, that recorder must be gone after a flight to London since they overwrite unless the 777 uploads them to a server or something. Seems a mistake to let them fly after that, since you would want to preserve the evidence and they had to be rattled knowing they nearly killed 100's of people and themselves.
Assuming it was an honest mistake, the American pilots will likely be protected from FAA enforcement by the ASAP program. And if they have a clean record, they will probably keep their jobs and get remedial training because of union protection. Lessons will be learned, procedures will be changed and disseminated to the entire pilot group to prevent this from happening again.
@@sharedsailing4787 Thank you! That's good to know.
@@douglashart5059 Good to know. Thanks!
Juan-The fact that this incident gave you the willies is the best evidence of how close it really was. Another outstanding video from one of the true experts out there. Thank you.
Thank you Juan for your objective and clear analysis of this incident. I retired ten years ago from a 25 year career as a tower controller which included 22 years at a major west coast airport. I have to admit that I was involved in one way or another in more than one similar incident. This is why we have air traffic control and I really appreciate your covering of this event. Thank you and God Bless all those airmen involved!
Great analysis 👍 it’s a pity procedure for an incident like this doesn’t include a delay to the offending aircraft and pulling its CVR recording. It would have been interesting to hear what they were talking about before crossing 04L.
One wonders whether the AA captain, knowing that the CVR might reveal too much (like non-flight related chitchat on the flight deck), elected to depart on a flight that would guarantee the CVR was erased.
@@thepaliogroup8126 👍
Started following your channel, few years ago, when you covered PIA in Karachi.
Thanks so much for these excellent analyses, always.
A couple of observations, having worked ATC under Canadian, ICAO (TCU and Approach Radar), UK and EASA (TWR and APR) regulations. It's a huge situational awareness issue that AAL106 taxied for the wrong runway. There should have been a couple of opportunities to catch that; issuance of SID, which should be runway specific (if it's a simple "climb straight ahead to 3,000ft" off every runway, I accept that safety net may not exist at JFK), and read back of taxi clearance. The latter sounded pretty garbled to me, and probably should have been challenged by GMC. The crossing clearance of an ACTIVE RUNWAY was issued by GMC; that would not be permitted where I work. Greater SA might have been available to all if crossings were issued on the tower frequency. The phraseology used by the tower controller to stop the B739 is not what we use here; "cancel T/O clearance" is for a stationary aircraft or non-urgent situation. To stop in that situation would have been "C/S STOP IMMEDIATELY, I SAY AGAIN C/S STOP IMMEDIATELY, ACKNOWLEDGE." The crew who stopped were clued-in enough that it probably wouldn't have altered their (excellent) reaction, but it is much more definite in intent. Finally; stop bars. At my current location they are in use H24 at all runway entry points including vehicle-only entry points. We call it the ring of red. You do NOT cross a red stop without specific clearance to do so and specific information that the stopbar is inoperable.
Are you sure they cleared crossing an active runway? At the time of this incident, both 4L and 31L SHORTENED were open for simultaneous takeoffs. It's a very common mode of operations at JFK. 31L SHORTENED doesn't include the runway part east of taxiway KE; taxiway K and runway 4L actually don't cross it.
Juan, I would think the cockpit voice recorder would be one of the first things invetigators would do.
AA 106 continued to destination... Is it overwritten? Or do the newer ones have longer record times?
For all pilots from student Cessna 150 to A380 Senior Captain, here's some advice. If in doubt, ask. If both crewmembers are not 100% sure of the instructions, ASK! I can assure you ATC would rather say "Afirmative, cleared to cross" than having a runway incursion. Cannot say this applies to this particular case, but good advice nonetheless for crossing runways, takeoff and landing clearances and many other situations.
See you here! Good work as always, Juan.
Thanks a lot for the breakdown on this event! This is probably the worst kind of runway incursion that can happen. I’m thankful that it only resulted in some shaken passengers and an embarrassing call to the tower.
Thank You Jaun for an objective report on this incident.
I am grateful no injuries occurred. I observed as you reported, your emotions/dedication to safety were evident.
This incident also cost Delta Airlines some maintenance-money. Inspection of the aircraft and replacement of tires/brakes as needed.
A Patreon and Luscombe pilot.
You just answered the question I had. Juan mentioned the Delta aircraft had to wait 15 hours for next take off. I thought it might have to do with impact rejected takeoff might have on the airplane but wasn’t sure if it was that or some other administrative reason.
As someone who has rejected his takeoff, I can add from this experience in my Airbus, that as the jet is providing maximum effort braking, it is not possible to disconnect the auto brakes by pressing the toe-brakes. Irrespective of how hard one presses, the brakes are already at max, therefore I could not provide a higher pressure to release them (I did try). I let the jet stop itself as it was programmed to, rather than attempt to deselect the auto brakes via the push button. The stop was as impressive as expected.
Expect to see a strict focus from ATC on reading back the assigned runway.
As a former C-141flight engineer I use to enjoy sitting in the rickety jump seat on take of and landing if we only had two pilots on board and I was scanner. One night taking off we rejected for comp stalls on one of the engines. Sitting in the jump seat with only a lap belt I held on tight to bar across the top of the center console.
Thank you for such a superb technical description of the event, without undue hyperbole
Thanks so much, Juan. I've been
Great to see you, Juan!
Water and Snow and Planes, OH MY!
Excellent, EXCELLENT commentary.
I always love the little tidbits, recounted from your long many years of impressive service.
in addition to the major teachable moments you have now become, dare I say, downright famous for 🙏🏽!
Please God, don't let me.......screw up! 🫡
You know, just thinking about all the good work pilots do every single day,
with about 100,000 flights successfully traversing the globe daily.....
well it always gives me a lil catch in my throat.
Thank you to both air and ground crew, and an exemplary record.
AND, since I haven't talked with you in ages, Happy New Year #2023!
The best to you, Mrs. B, and the little 'Lirios for #2023 🫶
*And nope, no one EVER likes being advised to Grab A Pencil 🫣 !
Captain looks left: "Clear left."
FO looks right: "Clear right."
Captain and FO: "Clear to cross."
A lot of lights flashing and shining out there at night can be somewhat confusing. Be careful out there boys. Glad we can talk about an incident and not an accident.
Surprised, you did not give kudos to ATC for keeping his eyes on the ball and preventing this accident. Stay safe.
I think they also have automated systems that warn of a potential conflict at JFK?
Yes on automated warning systems. But news also said they have stop lights at the crossings that the AA 777 apparently ignored !!!
4L is undergoing upgrades as is the full airport. My understanding is the lighted hold bar (aka stop light) has not been upgraded. Nevertheless, there are runway marker signs the crew should have seen.
A couple of questions: (1) When given instructions to cross 31-Left at Kilo, why was the readback essentially inaudible? (2) Why does it seem in many examples the dialogue is always very fast pre-issue, but afterwards everything is slowed down to almost conversation speed? Thanks for great illustrations & explanations!
RWSL=RunWay Status Lights. Over running them would be a bust on a checkride even before you get to the runway. JFK airport notes indicate that they are in use.
Also, What happened to “Clear left-Clear right”? Probably would have seen Delta landing lights coming at them.
Lastly, keep in mind, this could happen to any of us.
Yeah with three in the cockpit too. Makes you wonder how sterile things were or if, like was mentioned in the video, the procedure changes distracted them and had a conversation going that diverted attention.
"on the job 110%"...I got my PPL late in life flying out of FRG in the busy NYC metro area. Bucket list thing. It can be stressful for a low time pilot, monitor the radio, gauges and instruments, constantly looking for traffic. It took a lot of FUN out of flying. I haven't flown in 2 years. Neither me or a seasoned airline pilot, you cannot let your guard down. I appreciate your videos-good reminder to stay focused-situational awareness.
I'm amazed that they let the AA crew fly that flight after the incident. The Delta crew was stood down because of the near death experience and the need to check the aircraft for damage but by letting the AA crew take off they lost their cockpit voice recorder since the fuse wasn't pulled. They can say whatever they want now and probably had a 12 hour flight to get their stories straight. Also, they would have been even more distracted during that flight than the Delta crew given not only did they nearly die but they nearly caused a major disaster.
Somebody said a different crew flew that flight. But recorders only do 2 hours then overwrite.... so no audio to see what was said before and after.
Agreed!
I was thinking the same thing. Who would want to be on a 😊lane with a pilot who just had a near miss and may also be in trouble. How could the possibly be focused. Happy to hear there was an alternate crew for the flight.
Exactly
Who is “they?”