Accident Boeing 737-81Q (WL) N732MA, Friday 3 May 2019
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Date:Friday 3 May 2019
Time:21:42
Type:Silhouette image of generic B738 model; specific model in this crash may look slightly different    
Boeing 737-81Q (WL)
Owner/operator:Miami Air International
Registration: N732MA
MSN: 30618/830
Year of manufacture:2001
Total airframe hrs:38928 hours
Cycles:15610 flights
Engine model:CFMI CFM56-7B26
Fatalities:Fatalities: 0 / Occupants: 143
Other fatalities:0
Aircraft damage: Substantial, written off
Category:Accident
Location:Jacksonville Naval Air Station, FL (NIP) -   United States of America
Phase: Landing
Nature:Passenger - Non-Scheduled/charter/Air Taxi
Departure airport:Guantánamo NAS (NBW/MUGM)
Destination airport:Jacksonville NAS, FL (NIP/KNIP)
Investigating agency: NTSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
A Miami Air Boeing 737-800, registration N732MA, operating as Flight 293 from Cuba’s Leeward Point Field at Guantánamo Bay experienced a runway overrun upon landing at Jacksonville Naval Air Station/Towers Field (KNIP), Florida. The airplane came to rest in the shallow waters of St. Johns River, sustaining substantial damage. The 143 passengers and crew survived.
The aircraft was engaged in a charter flight to bring military personnel and family members home. The No. 1 (left) thrust reverser was not operational and deferred for the flight in accordance with the airplane’s minimum equipment list. The captain was the pilot flying for the accident flight, and the first officer was the pilot monitoring. The captain was also performing check airman duties for the first officer who was in the process of completing operating experience training.
Flight 293 departed Guantánamo Bay at 23:19 UTC.
At 21:22 local time the pilot checked in with a Jacksonville approach (JAX) controller while level at 13,000 ft mean sea level and was provided the JAX altimeter setting; the controller advised the pilot to expect the RNAV runway 28 approach and moderate-to-heavy precipitation on the final approach to runway 28 (9000 ft/2743 m long).
At 21:23, the JAX controller advised the pilot that the winds at KNIP were from 350° at 4 knots; the pilot then asked if there was any chance of getting runway 10 because it looked a little better. The JAX controller responded that he was showing moderate-to-heavy precipitation building over runway 10 starting about 5 miles on final. The pilot acknowledged and said he would stick with runway 28. He was then instructed to descend and maintain 5,000 ft.
At 21:25, the controller provided additional weather information to the flight crew, stating that moderate-to-heavy precipitation was present east and west of the airport. The pilot elected to continue for an approach to runway 28.
At 21:30, the JAX controller advised the pilot that the flight was heading northbound and the precipitation was moving eastbound; the controller then asked the pilot if he would like to try runway 10 since it might be better. The pilot acknowledged "yeah go ahead, let’s do it." The controller then instructed the pilot to turn left to a heading of 270°, and the pilot acknowledged.
Over the next several minutes, the flight was vectored for the approach to runway 10. At 21:37, the JAX controller cleared the flight for the RNAV runway 10 approach, and the pilot acknowledged. Shortly after, the flight was transferred to the KNIP radar controller.
The pilot contacted the KNIP radar controller, and, at 21:39, the KNIP radar controller indicated the winds were from 240° at 10 knots; he then cleared the flight to land on runway 10.
As the airplane descended through 1,390 ft mean sea level (msl), the pilots configured it for landing with the flaps set at 30° and the landing gear extended; however, the speedbrake handle was not placed in the armed position as specified in the Landing checklist. At an altitude of about 1,100 ft msl and 2.8 nm from the runway, the airplane was slightly above the glidepath, and its airspeed was on target. Over the next minute, the indicated airspeed increased to 170 knots (17 knots above the target approach speed), and groundspeed reached 180 knots, including an estimated 7-knot tailwind.
At an altitude of about 680 ft msl and 1.6 nm from the threshold, the airplane deviated further above the 3° glidepath such that the precision approach path indicator (PAPI) lights would have appeared to the flight crew as four white lights and would retain that appearance throughout the rest of the approach. Eight seconds before touchdown, multiple enhanced ground proximity warning system alerts announced "sink rate" as the airplane’s descent rate peaked at 1,580 fpm. The airplane crossed the displaced threshold 120 ft above the runway and 17 knots above the target approach speed, with a groundspeed of 180 knots and a rate of descent about 1,450 ft per minute (fpm). The airplane touched down about 1,580 ft beyond the displaced threshold, which was 80 ft beyond the designated touchdown zone as specified in the operator’s standard operating procedures (SOP).
After touchdown, the captain deployed the No. 2 engine thrust reverser and began braking; he later reported, however, that he did not feel the aircraft decelerate and increased the brake pressure. The speedbrakes deployed about 4 seconds after touchdown, most likely triggered by the movement of the right throttle into the idle reverse thrust detent after main gear tire spinup.
The automatic deployment of the speedbrakes was likely delayed by about 3 seconds compared to the automatic deployment that could have been obtained by arming the speedbrakes before landing. The airplane crossed the end of the runway about 55 ft right of the centerline and impacted a seawall 90 ft to the right of the centerline, 9,170 ft beyond the displaced threshold, and 1,164 ft beyond the departure end of runway 10. After the airplane came to rest in St. Johns River, the flight crew began an emergency evacuation.
The airplane was mostly intact, but both main landing gear had separated from the airplane and were also located in the river.

Probable Cause and Findings
An extreme loss of braking friction due to heavy rain and the water depth on the ungrooved runway, which resulted in viscous hydroplaning. Contributing to the accident was the operator’s inadequate guidance for evaluating runway braking conditions and conducting en route landing distance assessments. Contributing to the continuation of an unstabilized approach were 1) the captain’s plan continuation bias and increased workload due to the weather and performing check airman duties and 2) the first officer’s lack of experience.

METAR:

01:05 UTC / 21:05 local time:
KNIP 040105Z COR 08003KT 10SM -TSRA SCT008 BKN030CB BKN045 BKN250 25/23 A2997 RMK AO2 TSB04 OCNL LTGIC VC W TS W MOV E T1 SET P0000 T02500228 $

01:22 UTC / 21:22 local time:
KNIP 040122Z 35004KT 5SM +TSRA BR SCT008 BKN018CB OVC030 24/22 A2998 RMK AO2 TSB04 FRQ LTGIC OHD TS OHD MOV E T1 SET P0010 T02440222 $

01:45 UTC / 21:45 local time:
KNIP 040145Z 29008G16KT 3SM +TSRA BR SCT008 BKN015CB OVC032 24/22 A2999 RMK AO2 TSB04 FRQ LTGIC OHD TS OHD MOV E T1 SET P0063 T02440222 $

01:53 UTC / 21:53 local time:
KNIP 040153Z 13003KT 2SM +TSRA BR SCT010 BKN021CB OVC035 23/21 A2998 RMK AO2 TSB04 SLP149 FRQ LTGIC OHD TS OHD MOV E T1 SET P0074 T02280206 $

Accident investigation:
cover
  
Investigating agency: NTSB
Report number: DCA19FA143
Status: Investigation completed
Duration: 2 years and 3 months
Download report: Final report

Sources:

Flightaware track
NTSB

History of this aircraft

Other occurrences involving this aircraft

27 September 2012 N732MA Miami Air International 0 Concord Regional Airport, NC (KJQF) non
Taxiway excursion

Location

Images:


photo (c) NTSB; Jacksonville Naval Air Station, FL (NIP); 04 May 2019; (publicdomain)


photo (c) NTSB; Jacksonville Naval Air Station, FL (NIP); 04 May 2019; (publicdomain)


photo (c) NTSB; Jacksonville Naval Air Station, FL (NIP); May 2019; (publicdomain)


photo (c) NTSB; Jacksonville Naval Air Station, FL (NIP); May 2019; (publicdomain)


photo (c) NTSB; Jacksonville Naval Air Station, FL (NIP); May 2019; (publicdomain)


photo (c) Jaime Escobar Corradine; Miami International Airport, FL (MIA/KMIA); 14 January 2011


photo (c) Victor Vu; Columbia Regional Airport, MO (COU/KCOU); 18 November 2016


photo (c) Harro Ranter/ASN; Amsterdam-Schiphol International Airport (AMS/EHAM); 30 August 2016

Revision history:

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