AA106 - Incident: American B772 at New York on Jan 13th 2023

An American Airlines Boeing 777-200, registration N754AN performing flight AA-106 from New York JFK,NY (USA) to London Heathrow,EN (UK) with 137 passengers and 12 crew, was taxiing on taxiway B for departure from runway 04L being cleared to cross runway 31L on taxiway K, the aircraft however continued straight on, joined taxiway J and crossed runway 04L at taxiway J about 1200 meters/4000 feet down runway 04L.

At that very moment a Delta Airlines Boeing 737-900, registration N914DU performing flight DL-1943 from New York JFK,NY (USA) to Santo Domingo (Dominican Republic) with 153 passengers and 6 crew, was cleared for takeoff from runway 04L and was accelerating when tower noticed the conflict and instructed DL-1943 to cancel takeoff clearance with quite agitated voice, repeating that instruction a few seconds later until the crew reported they were rejecting takeoff. The Delta crew subsequently, in the voice of their transmissions to tower and "Uch!", indicated this became quite close. The aircraft vacated the runway to the left via taxiway J.

Tower subsequently instructed AA-106 to call a phone number due to pilot deviation.

After the phone call with tower AA-106 departed from runway 31L about 30 minutes later. DL-1943 returned to the apron, the aircraft remained on the ground for about 15 hours, then departed for the flight DL-1943 and reached Santo Domingo with a delay of about 14.5 hours.

The FAA reported according to preliminary analysis the 737 stopped about 1000 feet short of the intersection with taxiway J, where the 777 had crossed the runway. The FAA opened an investigation.

On Jan 15th 2023 the NTSB announced they have opened an investigation into the occurrence.

On Feb 10th 2023 the NTSB released their preliminary report stating that DL-1943 rejected takeoff at about 100 KIAS and came to a stop about 500 feet short of taxiway J and added: "The closest point between the two aircraft was about 1400 feet and occurred as DAL 1943 decelerated past taxiway K4 and AA106 exited the runway at taxiway J."

The NTSB reported further:

On February 1, 2023, NTSB conducted ATC interviews, which were audio recorded for transcription. Recorder data from both aircraft were obtained. Cockpit voice recorder data were both overwritten. Flight crew statements were received. In addition to the crew statements, NTSB attempted to interview the American Airlines flight crew three different times. American Airlines cleared the flight crew’s schedule to ensure their availability; however, the flight crew refused to be interviewed on the basis that their statements would be audio recorded for transcription. On behalf of the crew, the APA party representative informed the NTSB that the crew would not consent to participate in audio recorded interviews in any manner. NTSB has determined that this investigation requires that the flight crew interviews be audio recorded and transcribed by a court reporter to ensure the highest degree of accuracy, completeness, and efficiency. As a result of the flight crew’s repeated unwillingness to proceed with a recorded interview, subpoenas for their testimony have been issued.

On Jan 29th 2024 the NTSB opened their investigation docket.

On Jun 5th 2024 the NTSB reported in a press release (the final report is not yet published):

The NTSB determines that the probable cause of this incident was:

the American Airlines flight 106 (AAL106) crew’s surface navigation error due to distractions caused by their performance of concurrent operational tasks during taxi, which resulted in a loss of situational awareness.

Contributing to the incident was:

- the air traffic control tower team’s nondetection of the AAL106 crew’s deviation from taxi instructions while performing concurrent operational tasks;
- the timing of the runway status light system, which activated too late to prevent the AAL106 crew from crossing the runway hold short line;
- and American Airlines’ lack of adequate risk controls to prevent concurrent flight crew tasks from leading to distraction, loss of situational awareness, and deviation from an authorized taxi clearance.

Reducing the severity of the incident, and likely preventing an accident, was the activation of the ASDE-X warning in the air traffic control tower and the local controller’s prompt cancellation of DAL1943’s takeoff clearance.

On Jun 13th 2024 the NTSB released their final report concluding the probable causes of the incident were:

The American Airlines flight 106 (AAL106) crew’s surface navigation error due to distractions caused by their performance of concurrent operational tasks during taxi, which resulted in a loss of situational awareness. Contributing to the incident was the air traffic control tower team’s nondetection of the AAL106 crew’s deviation from taxi instructions while performing concurrent operational tasks; the timing of the runway status light system, which activated too late to prevent the AAL106 crew from crossing the runway hold short line; and American Airlines’ lack of adequate risk controls to prevent concurrent flight crew tasks from leading to distraction, loss of situational awareness, and deviation from an authorized taxi clearance. Reducing the severity of the incident, and likely preventing an accident, was the activation of the ASDE-X warning in the air traffic control tower and the local controller’s prompt cancellation of DAL1943’s takeoff clearance.

Excerpt of Aerodrome Chart, red: actual taxi path, green: cleared taxi path (Graphics: AVH/FAA):

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