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  • A319, Rio de Janeiro Galeão Brazil, 2017 (Synopsis: On 19 July 2017, an Airbus A319 crew ignored the prescribed non-precision approach procedure for which they were cleared at Rio de Janeiro Galeão in favour of an unstabilised “dive and drive” technique in which descent was then continued for almost 200 feet below the applicable MDA and led to an EGPWS terrain proximity warning as a go around was finally commenced in IMC with a minimum recorded terrain clearance of 162 feet. The Investigation noted the comprehensive fight crew non-compliance with a series of applicable SOPs and an operational context which was conducive to this although not explicitly causal.)
  • A319, Santiago de Compostela Spain, 2016 (Synopsis: On 10 October 2016, an Airbus 319 was cleared to divert to its first alternate after failing to land off its Cat II ILS approach at Porto and obliged to land at its second alternate with less than final reserve fuel after the first alternate declined acceptance due to lack of parking capacity. The Investigation concluded that adjacent ATC Unit coordination in respect of multiple diversions was inadequate and also found that the crew had failed to adequately appraise ATC of their fuel status. It also noted that the unsuccessful approach at the intended destination had violated approach ban visibility conditions.)
  • A320 / B738 Barcelona Spain, 2012 (Synopsis: On 27 May 2012, an Airbus A320 departing Barcelona was cleared by GND to taxi across an active runway on which a Boeing 737-800 was about to land. Whilst still moving but before entering the runway, the A320 crew, aware of the aircraft on approach, queried their crossing clearance but the instruction to stop was given too late to stop before crossing the unlit stop bar. The 737 was instructed to go around and there was no actual risk of collision. The Investigation attributed the controller error to lack of familiarisation with the routine runway configuration change in progress.)
  • A320 / B738, vicinity Delhi India, 2016 (Synopsis: On 30 January 2016, an Airbus A320 crew cleared for an ILS approach to runway 11 at Delhi reported established on the runway 11 LLZ but were actually on the runway 09 LLZ in error and continued on that ILS finally crossing in front of a Boeing 737-800 on the ILS for runway 10. The Investigation found that the A320 crew had not noticed they had the wrong ILS frequency set and that conflict with the 737 occurred because Approach transferred the A320 to TWR whilst a conflict alert was active and without confirming it was complying with its clearance.)
  • A320 / B738, vicinity Launceston Australia, 2008 (Synopsis: On 1 May 2008 an Airbus A320-200 being operated by JetStar on a scheduled passenger flight from Melbourne to Launceston, Tasmania was making a missed approach from runway 32L when it came into close proximity in night VMC with a Boeing 737-800 being operated by Virgin Blue and also inbound to Launceston from Melbourne which was manoeuvring about 5nm north west of the airport after carrying out a similar missed approach. Minimum separation was 3 nm at the same altitude and the situation was fully resolved by the A320 climbing to 4000 feet.)
  • A320 / B789 / A343, San Francisco CA USA, 2017 (Synopsis: On 7 July 2017 the crew of an Airbus A320, cleared for an approach and landing on runway 28R at San Francisco in night VMC, lined up for the visual approach for which it had been cleared on the occupied parallel taxiway instead of the runway extended centreline and only commenced a go-around at the very last minute, having descended to about 60 feet agl whilst flying over two of the four aircraft on the taxiway. The Investigation determined that the sole direct cause of the event was the poor performance of the A320 flight crew.)