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28th of January 2017, Maintenance Procedures, Blog #636

With a crew of four onboard, a Boeing 737-476 (SF - Special Freighter) was operating a domestic cargo flight, in Colombia, between Bogotá-Eldorado Airport and Letcia-Alfredo Vásquez Cobo Aiport.

The aircraft shortly after the accident (Source; X/@AerocivilCol © Unknown)

The aircraft took off at 15:50 lt (local time) and set course for Letcia-Alfredo Vásquez Cobo Aiport. The weather at the destination was calm, although some drizzle came down;

  • Wind - 320º / 3 knots

  • Visibility - good

  • Clouds - Scattered 1000 feet / Broken 1500 feet

  • Temperature - 27 ºC

  • Dewpoint - 24 ºC

  • Barometer - 29.80 inHg / 1009 hPa


After an uneventful flight, the aircraft was cleared to land on runway 21, shortly before 17:00 lt, with ATC stating wind 350º at 04 knots. The aircraft touched down abeam Taxiway Alfa at 16:57 local time.

The aircraft shortly after the accident (Source; X/@AerocivilCol © Unknown)


With auto-brake selected, the crew selected reverse thrust. At that time an explosion-like sound was heard by the crew, and also by airport staff. The crew observed that the auto-brake system had not activated and started to apply manual braking. There was no response from the brakes on brake application from either pilot.

As the aircraft did not decelerate the commander increased reverse thrust. At that time 400 meters of runway remained. With insufficient distance remaining to stop the aircraft overran the runway safety zone and entered the soft ground, causing the aircraft to decelerate sharply and come to a stop approximately 20 meters from the threshold of runway 03, on a heading of 180º.

The crew immediately completed the required emergency checklist and evacuated the aircraft approximately one minute after the aircraft came to a stop. There were no injuries.

Airport rescue service attended to the accident, but there was no post-accident fire.

The aircraft shortly after the accident (Source; X/@AerocivilCol © Unknown)

Damage to the aircraft was substantial;

  • Lower fuselage damaged (skin & frames)

  • The right-hand main landing gear fractured

  • Nose landing gear doors damaged

  • Both engines ingested FOD and were damaged by FOD

  • Both reversers damaged

  • Slats and flaps damaged

The failed right-hand main landing gear (Source GRIAA & © Unknown)

The GRIAA (Grupo de Investiación de Accidentes Areos - Columbian Aviation Accident Investigation Group) was alerted, and an investigation was launched. After an investigation that lasted approximately 18 months, the GRIAA concluded that the accident occurred due to the following causal factors;

  • Deficient maintenance procedures, by not determining the root cause of failures

  • Tire #4 (right-hand outboard) burst due to repeated overinflation after repeated reports of low tire pressure, causing over-flexing of the tire

  • Brake failure caused by damaged hydraulic lines and harness as a result of the #4 tire failure


Contributing Factors were identified as;

  • Inadequate risk management by the operator, repeat defects on the #4 tire were not known or acted upon

  • Poor condition of the runway extension (uneven and flooded) and overrun area


Several safety recommendations were made to the operator and the Colombian Aviation Authorities. The investigation report (in Spanish) can be accessed by clicking on the .pdf file below;

28Jan2017 B737-400 Maintenance Procedures-Runway Overrun
.pdf
Download PDF • 1.16MB

** Editorial note **


V2 Aviation - Training & Maintenance has not been able to obtain an investigation report in English on this accident. This blog is therefore based on several internet sources. Should there be inconsistencies in the blog don't hesitate to get in touch with us. There are two possibilities to do that, via the comments function at the bottom of this page or the contact page of the website.


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