Pobeda B737 crew temporarily loses control of aircraft during second go-around

Photo by © Aviation of Russia

Rosaviatsia has published its conclusions on the incident involving Pobeda’s Boeing 737-800 RA-73227 aircraft during its second go-around in Sochi with the landing gear not retracted. Information on the incident is contained in the Rosaviatsia report. The document is published in the telegram channel Aviatorshchina.

On 23 December 2023, the aircraft with 168 passengers on board was on flight DP338 from Kazan to Sochi. On landing, the aircraft encountered a thunderstorm front with strong gusts of wind and unstable approach conditions. As a result, the aircraft found itself in a difficult spatial situation and remained uncontrolled by the crew for some time due to pilot error.

The experts found that after the decision to make a second turn at an altitude of 300 metres, the pilot-in-command gave the copilot the command to retract the wing mechanics to the 1° position. The copilot delayed the command and only executed it after a second instruction. A few seconds later, the commander gave the command to fully retract the landing gear, but the pilot did not do so because he was engaged in radio communication with the dispatcher.

In both cases, the commander did not repeat the instruction and gave a new command to retract the landing gear, which the copilot did, but not to the required UP position, but to the intermediate OFF position – to relieve the hydraulic pressure in the landing gear struts. Both pilots were unaware that the landing gear had not been retracted and the aircraft continued to climb. The crew increased the pitch to 18° and began the first right turn with a roll of 33° in turbulent conditions with downward gusts of up to 5 m/s.

While retracting the flaps at an altitude of 1100 m, a low speed alarm went off in the cockpit, which led to the co-pilot realising the error and, without consulting the commander, correcting the situation by moving the landing gear lever to the UP position. However, the commander noticed this and asked why the landing gear had not been retracted. After regaining control of the aircraft, the crew failed to comply with the dispatcher’s instructions during the approach to the alternate aerodrome in Vladikavkaz and the aircraft crossed the state border by up to 1,400 metres.

Based on the results of the internal investigation, Pobeda Airlines came to the conclusion that during the second turn and before the departure to the alternate aerodrome, the main parameters of the aircraft’s movement were not properly controlled by either the commander or the co-pilot, due to limited physiological capabilities of information perception under excessive workload. In the course of the second round, the crew’s workload increased to such an extent that their ability to analyse and react to incoming information was completely lost.

The occurrence of excessive workload was blamed on the crew and their uneducated decisions in continuing the approach. Pobeda’s management decided to remove the commander from his post and transfer him to the position of co-pilot, without the possibility of holding the position of flight crew chief in the future. At the same time, the Rosaviatsia commission merely recommended that Pobeda inform the pilots in detail about the circumstances, causes and factors of the incident, and carry out corrective measures with the flight crew.