What happened
On the night of 6 December 2007, a serious air proximity incident occurred at Amsterdam Schiphol Airport involving two commercial aircraft. An Airbus A318, operating flight AF3484, was on final approach to Runway 18C. Due to significant wind gusts reaching up to 35 knots, the aircraft drifted from the centerline, forcing the crew to initiate a go-around at a very low altitude, approximately 15 feet above the runway.
Simultably, a Boeing 737-900, operating flight KLM1027, had received clearance for takeoff from Runway 24. As the Airbus climbed following its missed approach, its flight path intersected with the departing Boeing. The two aircraft passed extremely close to one another, with the Airbus flying just behind the Boeing at nearly the same altitude. The separation between the aircraft was only about 460 metres at the moment their paths crossed, with a time interval of only seven seconds between them.
The investigation
Following the event, Air Traffic Control the Netherlands (LVNL) conducted an internal investigation, which was later reviewed by the Dutch Safety Board. The investigation examined the adherence to established Air Traffic Services (VDV) procedures, specifically regarding runway combinations used during night operations.
Investigators looked into the coordination between Runway Controller 1 and Runway Controller 2. It was noted that while a procedure existed to prevent departures from Runway 24 when an aircraft was within 3 NM of the Runway 18C threshold, this protocol was not followed. The investigation also scrutinized the 'mixed mode' configuration, where Runway 24 was being used for both departures and 'break-off' landings. Furthermore, the Board examined the quality of the oversight process, noting a lack of clarity regarding the boundaries between an air traffic controller's professional independence and the requirement to strictly adhere to established safety frameworks.