Loss of Control in Final Approach – Investigation Feedback

ATR provided feedback on the 9N-ANC Loss of Control during final approach investigation.

Q&A:

If the crew had detected the mistake, would they have had any chance to recover power?

When putting back CLs on auto position the power would have come back quickly without any engine parameters exceedance.
Is it the first reported case of mist match between flaps and condition lever?

ATR event database contains no other undue movement of condition levers.
What are the actions taken by the company to improve their safety?

The safety actions are well detailed in the report, and are directly addressing the aviation safety system (better planning, control and airport procedure opening).
Do ATR consider to change the FCTM procedure to extend the flaps 30 earlier (not on final), which may reduce risk and have enough altitude.

No ATR procedure change are planned in light of this event.
From the video “[[SET]] Flaps 30” was not in line with FCTM 2022 “Flaps 30”, are you going to change to add the “SET” word in the future revision?

The FCTM will not be updated since SET is only used for autopilot settings. The film will be updated accordingly.
Was the Nepal aircraft fully serviceable at dispatch?

Yes, the aircraft was reported serviceable.
What could be the possible reasons for the reduction in power when flaps30 was called by PF and set by PM?

As explained in the report, the most probable scenario is a cockpit control confusion due to overload in short final.

1 file(s) 3.29 MB

Download