What happened
On September 15, 2022, at approximately 12:50 UTC, a traffic conflict occurred near the Senador Petronio Portella Airport (SBTE) in Teresina, Brazil. The incident involved two aircraft: a Brazilian Air Force EMB-550 (registration FAB 3604) performing a flight instruction mission, and a private C90A (registration PP-ASD) operating a private flight.
During a missed approach procedure by the FAB 3HD4 crew, the aircraft experienced a loss of separation below the regulatory minimums. The crew of the EMB-550 initially received a Traffic Advisory (TA) via the Traffic Collision Avoidance System (TCAS). Following the pilot's flight maneuvers, the system issued a Resolution Advisory (RA), necessitating an evasive maneuver. There were no injuries to the four crew members on the military aircraft or the three occupants of the private aircraft, and no damage was sustained by either airframe.
The investigation
CENIPA's investigation focused on the coordination between the Teresina Approach Control (APP-TE) and the Teresina Tower (TWR-TE). Investigators examined the flight paths, the use of radar surveillance tools, and the communication between air traffic controllers. The investigation also reviewed the flight maneuvers performed by the pilot flying of the EMB-550 following the TCAS alerts.
Findings
- Inadequate ATC Coordination: There was a failure to transfer traffic management from Approach Control to the Tower Control once the aircraft entered the Tower's airspace. This was compounded by non-assertive communication between the two controllers.
- Pilot Maneuvering: The pilot flying of the EMB-550 performed a maneuver—increasing the rate of climb and turning left—that contradicted the aircraft's operations manual and directly contributed to the escalation from a Traffic Advisory to a Resolution Advisory.
- Surveillance and Planning: Air traffic controllers did not adequately utilize available radar surveillance information (TARIS) to ensure separation. Furthermore, the information provided to the pilot of the PP-ASD lacked critical details regarding the approaching military traffic, reducing situational awareness.
- Training Deficiencies: A lack of simulator training regarding TCAS RA scenarios was identified as a factor that may have led to suboptimal performance during the event.