[SystemSafety] Chicago controller halts Delta jet's near-miss on takeoff: '1328, stop, stop stop!'

Matthew Squair mattsquair at gmail.com
Fri Jun 19 00:53:01 CEST 2015


A historical note, at Tenerife one of the causal factors was also dual
transmissions obscuring what was being said.

Matthew Squair

MIEAust, CPEng
Mob: +61 488770655
Email; Mattsquair at gmail.com
Web: http://criticaluncertainties.com

On 19 Jun 2015, at 4:58 am, Christopher Johnson <
Christopher.Johnson at glasgow.ac.uk> wrote:

Call sign confusion is not a black swan event.  Eurocontrol have a working
group addressing the issue for several years now.
The aim was to reach agreement so that callsigns should be ³maximally²
easy to distinguish rather than the ad hoc approach that
applies now (ad hoc from a human factors perspective).

All the best,
Chris

On 18/06/2015 19:12, "systemsafety-bounces at lists.techfak.uni-bielefeld.de
on behalf of Steve Tockey"
<systemsafety-bounces at lists.techfak.uni-bielefeld.de on behalf of
Steve.Tockey at construx.com> wrote:


I can see how "3828" can be possibly confused with "1328". But ATC never

uses flight numbers alone. One flight would be "Cactus 3828" and the other

"Delta 1328". Unless the DL pilot used to work for SW, how could s/he not

recognize the company part of the call sign?





-----Original Message-----

From: <Smith>, "Brian E.   (ARC-TH)" <brian.e.smith at nasa.gov>

Date: Thursday, June 18, 2015 11:02 AM

To: Peter Wilkinson <Peter.Wilkinson at noeticgroup.com>, Simon Whiteley

<simon at whiteley-safety.co.uk>,

"systemsafety at lists.techfak.uni-bielefeld.de"

<systemsafety at lists.techfak.uni-bielefeld.de>

Subject: Re: [SystemSafety] Chicago controller halts Delta jet's near-miss

on takeoff: '1328, stop, stop stop!'


Agree.  Perhaps it is more properly termed a rare coincidence of call sign

similarity.


On 6/18/15, 10:59 AM, "Peter Wilkinson" <Peter.Wilkinson at noeticgroup.com>

wrote:


I wonder if it is rarely a Black Swan event. If these are defined (at

least in part) as unforeseen events - I don't think it qualifies as a

Black Swan. As Peter has pointed out - a known problem regards

Pete w


-----Original Message-----

From: systemsafety-bounces at lists.techfak.uni-bielefeld.de

[mailto:systemsafety-bounces at lists.techfak.uni-bielefeld.de
<systemsafety-bounces at lists.techfak.uni-bielefeld.de>] On Behalf Of

Smith, Brian E. (ARC-TH)

Sent: Friday, 19 June 2015 3:44 AM

To: Simon Whiteley; systemsafety at lists.techfak.uni-bielefeld.de

Subject: Re: [SystemSafety] Chicago controller halts Delta jet's

near-miss on takeoff: '1328, stop, stop stop!'


As observed by Peter, this may have been caused by confusion between the

Call Signs of the aircraft.  One of those rare, Black Swan events.


From:

http://www.chicagotribune.com/news/local/breaking/ct-midway-airport-close

-

c

all-20150617-story.html#


Before the incident, a Midway ground controller had notified both pilots

about the similar and potentially confusing flight numbers of the

 [comment: good job!]

two planes waiting to depart, and he advised the pilots to listen

carefully to radio calls, according to tapes of the incident, which are

on http://www.LiveATC.net


On the transmission, the tower controller is heard clearing Southwest

Flight 3828 for takeoff. But when the Southwest pilot radios back

confirmation, his voice is obscured, or "stepped on," by a dual

transmission, apparently from Delta Flight 1328. During a dual

transmission, each pilot hears only some of what is being communicated.


A second dual transmission then occurs, and seconds later, as the

Southwest plane is accelerating down runway 31 Center, the Delta plane is

also on a takeoff roll on intersecting runway 4 Right, sources said.


A controller abruptly yells, "Stop, stop, stop, stop!" A pilot says,

"Aborting," and another pilot announces, "SWA stopping."







On 6/18/15, 10:27 AM, "Simon Whiteley" <simon at whiteley-safety.co.uk>

wrote:


http://www.nola.com/business/index.ssf/2015/06/chicago_controller_preve

nts

_de.html


FYI


- Two passenger jets began to take off at the same time on intersecting

runways at Chicago's Midway International Airport, prompting a

controller to shout over the radio for one of the pilots to halt to

avoid a collision.




Wow! Just wow!

-SPPW


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