Created Thursday, Aug 10th 2023 15:54Z, last updated Thursday, Apr 10th 2025 13:49Z
An Easyjet Airbus A320-200, registration G-EJCI performing flight
U2-8414 from Toulouse (France) to London Gatwick,EN (UK) with 176 passengers and 6 crew, lined up Toulouse's runway 32R via taxiway N4 (about 1,250 meters/4,100 feet down the runway) and commenced takeoff. The aircraft continued to London Gatwick for a safe landing.
On Aug 10th 2023 the British AAIB reported however, that the occurrence was rated a serious incident, the aircraft took off from the wrong intersection. An investigation has been opened.
On Apr 10th 2025 the AAIB released their final bulletin summarizing the sequence of events:
During pre-flight preparations, both pilots completed a takeoff performance calculation from intersection N2 of Runway 32R at Toulouse-Blagnac Airport in France. During taxi, the aircraft was cleared to line up and take off from intersection N2 with 2,300 m takeoff distance available. However, the crew entered the runway via the N4 intersection, reducing the takeoff distance available by approximately 500 m. The Tower Controller did not monitor the aircraft visually and did not notice the error. The aircraft rotated with 500 m of runway to go and passed the upwind end of the runway at a height of 180 ft.
The AAIB released this discussion:
Analysis of the serious incident at Toulouse-Blagnac Airport conducted by the DSNA and the operator revealed several interconnected factors that led to the crew initiating takeoff from an incorrect intersection. These factors can be broadly categorized into three main areas:
- High Workload and expeditious mindset.
- Limited attentional capacity and suboptimal situational awareness.
- Confirmation bias
The crew was operating with the background of a challenging operational environment for the operator which likely created an expeditious mindset. Perceived pressure to “keep the operation flowing” can leave crews vulnerable to incorrect management of priorities and task saturation, potentially causing task overload.
A high mental workload is a significant stressor in aviation that can negatively affect situational awareness through attentional tunnelling. When the volume of information and/or number of tasks becomes overwhelming, pilots may focus only on a subset of that information resulting in incomplete or erroneous perception and integration of information.
For the crew of G-EJCI, the high workload conditions led to limitations in attentional capacity, which in turn resulted in suboptimal situational awareness. This manifested as an inability to process all relevant environmental information and a failure to perceive and respond to external runway intersection signage. It is probable that the incomplete intersection information presented to the crew on the FlySmart+ app contributed to an inaccurate mental model of the runway layout.
The development of an inaccurate mental model, combined with high workload, made the crew vulnerable to confirmation bias. This bias was reinforced by the early takeoff clearance from ATC that was delivered at a point where it appeared consistent with their shared mental model of the location of the N2 intersection. It was therefore likely that the crew would focus on confirmatory information that aligned with their existing beliefs. Additionally, by ATC not visually monitoring the progress of the aircraft from the tower, an important barrier to prevent the aircraft from lining up at the wrong intersection was rendered ineffective.
Related Flight:
U28414,
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