01 октября  Боинг-737-300 EI-DON

Accident date01.10.2008
Investigation status
Aircraft registration numberEI-DON
Place of aircraft departure
Airport of departure
Intended destination
Intended Airport of arrival
Accident siteа/п Калининград
Latitude
Longitude
Aircraft type
Serial №
Aircraft operator
Aircraft ownerОАО «КД авиа» Северо-Западного управления государственного авиационного надзора Минтранса РФ
The date of the completion of the investigation (report)
Number of fatalities0
Victims accuracy
Degree of aircraft destruction
Report
Aviation type
Works type
Note

03 september 2009

     Investigation team of the Interstate Aviation Committee which includes official representatives of FATA and Rostransnadzor has completed the investigation of the crash with Boeing 737-300 EI-DON aircraft operated by KD Avia Airlines JSC occurred on October 1, 2008 at Kaliningrad Airport (RF).
      According to the Investigation team's conclusion:
        The crash was caused by aircraft landing with not extended landing gear that resulted in aircraft structure and engines damage and it was caused by combination of the following adverse factors: 
      - erroneous deactivation of GPWS gear warning (voice) system that was caused by failure to perform QRH recommendations on flaps warning deactivation during their asymetrical extension;   
      - presence of QRH manual on board of Boeing-737-300 EI-DON aircraft containing in Additional Deferred Item clause of Trailing Edge Flap Asymmetry chapter recommendation to the crew which are not specialized for the board configuration; 
      - violation of the "Crew operating procedure of Boeing-737-300 aircraft" and non-compliance with QRH recommendations («LANDING CHECKLIST» section) with the result that the crew did not extend landing gear and did not monitor their position; 
      - stereotyping on actuation of Landing Gear Warning Horn aural warning during approach as a result of which the crew deactivated it repeatedly without monitoring of landing gear position; 
      - inadequate coordination of the crew resulted in lack of monitoring of compliance with FCOM and QRH requirements at occurrence and development of abnormal situation; 
        Appropriate safety recommendations based on the investigation results were developed.