A Chain of Failures Leads to a Near-Disaster in Hayden, Colorado: The JetBlue Incident

The 22nd of January, 2022, began as a calm and clear day in Hayden, Colorado. The sun had cleared up any lingering clouds, and the winds were calm, making it an ideal day for flying, especially for the small, regional Yampa Valley Airport. 

At over 6,600 feet above sea level, the airport is located near the stunning Rocky Mountains and is known for its proximity to several natural parks. However, while the weather may have been good for recreational flights, a series of miscommunications and missteps at the airport would soon lead to a catastrophic near-miss, causing a life-threatening situation for the passengers and crew aboard a JetBlue flight.

This near disaster was the result of a series of failures, where each one built upon the previous one, culminating in a situation where two planes nearly collided while the JetBlue flight was attempting to take off and another aircraft, a King Air, was making its approach to land. It was a complex series of events, each seemingly small but with huge implications.

What is so striking about this story is that despite the multiple failures, both from the pilots, air traffic controllers, and ground staff, no lives were lost, and the situation was averted—at the last possible second.

Hayden Airport, being relatively small, lacks a control tower and relies heavily on a common traffic advisory frequency (CTAF) for communication between aircraft and an unicom operator, who provides weather information and traffic updates. However, this system can lead to confusion, particularly with high-density traffic or multiple aircraft operating on the same frequency.

Yampa Valley Airport was also a hub for not just small general aviation flights but also commercial airliners, and on this particular day, JetBlue was operating a seasonal service into the airport. JetBlue Flight 1748, a commercial flight from Fort Lauderdale, was scheduled to depart Hayden back to Florida.

The two pilots, one a 45-year-old captain and the other a 40-year-old first officer, were well-trained and experienced, having completed the flight planning, briefing, and airport familiarization beforehand.

The pilots were aware that Hayden had specific operational quirks due to its high altitude, challenging terrain, and the frequent use of opposing runways. This was especially important because of the airport’s lack of a control tower, which meant that communication was key to ensuring safe operations. While preparing for the return flight, the pilots followed procedures as prescribed by their airline.

The first officer handled the walk-around inspection while the captain prepared the cockpit. The flight itself had no issues, and the weather was not a factor. The crew set the correct takeoff weights, calculated the necessary speeds, and began their final preparations for departure.

At the same time, however, another aircraft, a 28-year-old Beechcraft King Air, was descending towards Hayden Airport, intending to land on runway 10, the same runway that JetBlue Flight 1748 was preparing to use for takeoff. The Beechcraft, flown by a male pilot and his wife, was also on an instrument flight plan, and the crew had been communicating with air traffic control. As the two aircraft were now on the same runway, the controllers and pilots failed to properly manage the traffic flow.

The critical mistake that triggered the incident occurred when the Beechcraft pilot switched from an instrument flight plan (IFR) to a visual flight plan (VFR) as the aircraft descended. The decision to switch to visual conditions should have raised a red flag, but the pilots of the JetBlue aircraft did not fully grasp the significance of this decision.

A series of radio calls ensued, with the Beechcraft pilot reporting his position and intentions, but because the JetBlue pilots were busy preparing for their departure and managing their own checklist, they missed key information from the King Air pilot. The confusion was compounded by the fact that the King Air pilot failed to use the word "runway" in his calls, instead saying he was "on final for 28."

This lack of clarity, coupled with the JetBlue pilots' expectation that all inbound aircraft were on runway 10, led to a dangerous miscommunication.

At the same time, the JetBlue flight crew, who were focused on their departure procedures, did not fully grasp the position of the King Air, and even though the pilot of the King Air had reported being on final approach for runway 28, the message failed to register. The expectation bias was strong—both pilots of JetBlue assumed that the King Air was lining up for runway 10, and as a result, they did not immediately notice the looming danger ahead of them.

Just as JetBlue began its takeoff roll on runway 10, the King Air was on final approach for runway 28. The two aircraft were now on a collision course, with the JetBlue Airbus accelerating down the runway toward the oncoming King Air.

In the final seconds, the King Air pilot, aware of the situation, tried to make an evasive call, but the JetBlue pilots were slow to respond. They were still trying to process the situation and, by the time they realized what was happening, the Airbus was already too close to avoid a collision. The first officer attempted to alert the captain, but the captain, overwhelmed by the sudden realization, struggled to make the necessary decision to abort the takeoff.

In a last-ditch effort to avoid disaster, the JetBlue pilots tried to rotate the aircraft too early, resulting in a tail strike. The aircraft slammed into the runway with such force that it bounced back into the air before crashing down again.

The impact tore up the aircraft’s nose wheel assembly, knocking out the electrical systems, and leaving the aircraft without power. The Airbus began sliding uncontrollably along the runway with full engine thrust, ultimately skidding off the end of the runway and crashing into the surrounding field. Miraculously, despite the violence of the crash, most passengers survived. However, 44 were injured, and the aircraft was severely damaged.

The investigation into the crash revealed that a series of failures led to the disastrous event. The uncoordinated communication, the missed radio calls, the confusion regarding the runways, and the failure to recognize critical information contributed to the near-collision.

However, the most alarming finding was the psychological impact on the pilots. Expectation bias, fatigue, and a failure to use structured decision-making models exacerbated the situation and clouded the pilots' judgment in critical moments.

The JetBlue flight crew had been working under immense pressure, not only dealing with adverse weather conditions but also managing fuel levels and the desire to avoid having to divert to another airport. Their failure to properly assess the situation was not due to negligence or incompetence but rather a series of compounded errors and lapses in judgment.

The event served as a stark reminder of the importance of effective communication, rigorous decision-making processes, and strict adherence to procedures, especially in high-pressure and high-traffic environments.

The aftermath of the incident prompted changes in how untowered airports manage air traffic, with a focus on improving communication protocols, especially when multiple aircraft are on the same frequency.

The incident also led to a renewed focus on decision-making training, particularly on managing expectation bias and making clear, decisive actions in the face of uncertainty. Despite the terrifying circumstances, the passengers on board JetBlue Flight 1748 were lucky that the situation didn’t escalate into a fatal disaster, thanks to the actions of the crew who managed to prevent the worst-case scenario.

This incident highlights how a series of small, seemingly inconsequential errors can snowball into a major disaster. It also shows that even highly experienced pilots can be affected by psychological factors, leading to mistakes that could otherwise be avoided. In aviation, as in life, one failure often leads to another, and it’s the careful, methodical approach to each step that ensures the safety of all involved. For JetBlue and its crew, this was a wake-up call—a reminder that even in the most routine flights, the smallest detail must be carefully considered to ensure the safety of everyone on board.