DH8D / P180, en-route, near Kelowna BC Canada, 2019
DH8D / P180, en-route, near Kelowna BC Canada, 2019
Summary
On 3 January 2019, prescribed vertical separation was lost between a Bombardier DHC8-400 and a Piaggio P180 on converging cruise tracks at FL 220 and only restored after a resulting TCAS RA was followed. The Investigation found both aircraft were being flown in accordance with their clearances and that the controller involved had not been aware of corresponding traffic and conflict alerting system activations. A specific traffic display fault which arose from failure to follow a routine software upgrade procedure correctly and the shift supervisor failing to recognise the need to act as controller when workload increased were assessed contributory.
Description
On 3 January 2019, a Bombardier DHC8-400 (C-FSWE) being operated by WestJet Encore on a scheduled domestic flight from Calgary to Nanaimo as WEN3109 and in the cruise at FL 220 lost prescribed separation in day VMC against a privately-operated Piaggio P180 (N990RS) flying from Spokane to Kamloops at the same level as their tracks converged. In the absence of any ATC intervention, the DHC8 received and actioned a resultant TCAS RA to DESCEND which subsequently restored the prescribed minimum separation between the two aircraft.
Investigation
An Investigation was carried out by the Canadian Transportation Safety Board (TSB). It was quickly apparent that the two aircraft involved had been flying in accordance with their respective clearances prior to the avoiding action taken in response to the TCAS RA which had been the sole action taken which resolved the loss of separation. Sufficient relevant recorded ATC data and testimony was available to enable a detailed reconstruction of the events leading up to the conflict so no recorded information or crew experience details were sought in respect of the two aircraft involved. Rather, the focus of the Investigation was on the failure of ATC to ensure that clearances which maintained prescribed separation were issued.
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