High pilot workload prior to misaligned take-off

A number of runway edge lights were damaged during a night-time take-off roll when a pilot misaligned their Piper Chieftain aircraft with the runway edge lighting, an ATSB investigation details.

At about 1:20 in the morning of 21 July 2023, the Piper PA-31-350 Navajo Chieftain with a single pilot on board was taxiing for departure for a freight charter flight from Essendon to Bankstown.

After commencing the take-off run, the pilot heard multiple loud noises, and they rejected the take-off at a speed of 77 kt. As the aircraft’s speed reduced, the pilot felt abnormal braking pressure on the right main landing gear and the aircraft subsequently veered to the left.

The pilot continued the aircraft-induced left turn to complete a full 360° turn before exiting the runway at taxiway Hotel. The aircraft then returned to the airport’s southern apron.

Subsequent inspection of the runway revealed a number of runway edge lights had been damaged, while inspection of the aircraft identified a damaged main landing gear tyre and brake caliper damage, consistent with striking the lights.

ATSB Director Transport Safety Stuart Macleod said the incident highlighted the importance of reducing distractions during critical stages of flight, and to consider having a sterile cockpit rule at those times.

“During the 10-minute taxi, the pilot conducted pre-departure checklists and engine run-up checks, and obtained an airways clearance,” Mr Macleod noted.

“Then as they entered the runway, the pilot completed the departure flight logs, read back departure instructions to ATC, and conducted the line-up checklist.”

The ATSB concluded the aircraft was misaligned with the runway edge lighting during a period of high pilot workload.

The investigation’s analysis found it unlikely the pilot was experiencing a level of fatigue known to have an effect on performance, but the ATSB acknowledges the operator’s proactive safety actions, which include a review of its fatigue management policies.

The operator has also reviewed its night proficiency checks for pilots and how regularly they occur, as well as airport familiarisation processes, and its simulator set-up.

You can find here the final report: Misaligned take-off involving Piper PA-31-350 VH-XMM at Essendon Aerodrome, Victoria on 21 July 2023.

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