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Accidents · NTSB OPS15IA017 · Final report

Boeing 767 34AF and Cessna 750 incident near Miami, Florida, April 12, 2015

On April 12, 2015 at about 12:21 pm local time, 2 aircraft, Boeing 767 34AF (N342UP) and Cessna 750 (N900QS), were involved in the same incident near Miami, Florida (Miami Intl airport). The NTSB record does not give the injuries. The weather was visual conditions (good weather).

The NTSB's probable cause their words, unchanged

The controller's issuance of a landing clearance to an arriving aircraft while another aircraft was in position on the same runway. Contributing to the incident was the controller's non-compliance with traffic advisory procedures, and insufficient requirements for use of memory aids to track arrival and departure operations.
The controller's issuance of a landing clearance to an arriving aircraft while another aircraft was in position on the same runway. Contributing to the incident was the controller's non-compliance with traffic advisory procedures, and insufficient requirements for use of memory aids to track arrival and departure operations.

Source: NTSB aviation accident database, copy made November 2, 2026. Docket and reports at the NTSB.

What the record shows

Date
April 12, 2015 · about 12:21 pm local time · cases in 2015
Place
Miami, Florida · Miami Intl · cases near this airport · map
Type
Incident
Injuries
The NTSB record does not give the injuries.
Weather
visual conditions (good weather)
Aircraft 1
Boeing 767 34AF 34AF, built 2011 · all 767 34AFs on the register
Registration
N342UP · registry record · serial 37865
Damage
Not recorded
Flight
Flight · scheduled airline rules (Part 121)
Aircraft 2
Cessna 750 NO SERIES, built 2000 · all 750s on the register
Registration
N900QS · registry record · serial 750-0123
Damage
Not recorded
Flight
Flight · rules the NTSB did not record

The NTSB's narrative for the Boeing 767 34AF final · quoted from the NTSB record

This loss of required air traffic control separation resulted from the LN/LS controller issuing a landing clearance to UPS357 to a runway occupied by N900QS in position on the same runway. This resulted in UPS357 overflying N900QS by about 475 feet. Contributing to the error was the local controller's non-compliance with traffic advisory procedures, and insufficient requirements for use of memory aids to track arrival and departure operations. When issuing a landing clearance to UPS357, the local controller did not ensure the runway was clear as required by FAA Order 7110.65, Air Traffic Control, paragraph 3-10-3, Same Runway Separation and, the local controller did not advise UPS357 that an aircraft was in position on the landing runway as required by FAA Order 7110.65, paragraph 3-10-5c, Landing Clearance. Contributing to this incident was the lack of required memory aids for arrivals. Miami Air Traffic Control Tower procedures required controllers to use memory aids to indicate that an aircraft had been directed to line up and wait (LUAW), when an aircraft was issued a departure clearance, and to indicate that a runway was occupied by an airport vehicle. However, flight progress strips or memory aids were not required for arrivals and arrival flight progress strips were not used. The data available via the radar presentation on the tower display workstation (TDW) was the only information used for arrival sequencing. While the LUAW memory aide is beneficial to prevent a controller from issuing a takeoff clearance for a runway that is occupied by an aircraft in LUAW position, it did not prevent the controller from issuing a landing clearance to UPS357 nine seconds after he had directed N900QS to LUAW. There were no visual aids utilized to indicate an aircraft was on the runway to which an aircraft had also been cleared to land. According to controller interviews, the "rule of thumb" or unofficial procedure for arrivals to a runway occupied by an aircraft in position was that if the arrival reached two miles and the aircraft in position had not started departure roll, the arriving aircraft would be sent around. However, there were no visual clues or memory aids to remind the controller that an aircraft was in position on the runway except where a controller may decide to write down call-signs of arriving aircraft at the control position.

The complete narrative as the NTSB published it. The NTSB's docket holds the report as a PDF and any photographs, statements and other documents from the investigation.

The NTSB's narrative for the Cessna 750 final · quoted from the NTSB record

This loss of required air traffic control separation resulted from the LN/LS controller issuing a landing clearance to UPS357 to a runway occupied by N900QS in position on the same runway. This resulted in UPS357 overflying N900QS by about 475 feet. Contributing to the error was the local controller's non-compliance with traffic advisory procedures, and insufficient requirements for use of memory aids to track arrival and departure operations. When issuing a landing clearance to UPS357, the local controller did not ensure the runway was clear as required by FAA Order 7110.65, Air Traffic Control, paragraph 3-10-3, Same Runway Separation and, the local controller did not advise UPS357 that an aircraft was in position on the landing runway as required by FAA Order 7110.65, paragraph 3-10-5c, Landing Clearance. Contributing to this incident was the lack of required memory aids for arrivals. Miami Air Traffic Control Tower procedures required controllers to use memory aids to indicate that an aircraft had been directed to line up and wait (LUAW), when an aircraft was issued a departure clearance, and to indicate that a runway was occupied by an airport vehicle. However, flight progress strips or memory aids were not required for arrivals and arrival flight progress strips were not used. The data available via the radar presentation on the tower display workstation (TDW) was the only information used for arrival sequencing. While the LUAW memory aide is beneficial to prevent a controller from issuing a takeoff clearance for a runway that is occupied by an aircraft in LUAW position, it did not prevent the controller from issuing a landing clearance to UPS357 nine seconds after he had directed N900QS to LUAW. There were no visual aids utilized to indicate an aircraft was on the runway to which an aircraft had also been cleared to land. According to controller interviews, the "rule of thumb" or unofficial procedure for arrivals to a runway occupied by an aircraft in position was that if the arrival reached two miles and the aircraft in position had not started departure roll, the arriving aircraft would be sent around. However, there were no visual clues or memory aids to remind the controller that an aircraft was in position on the runway except where a controller may decide to write down call-signs of arriving aircraft at the control position.

The complete narrative as the NTSB published it. The NTSB's docket holds the report as a PDF and any photographs, statements and other documents from the investigation.

The factual record for the Boeing 767 34AF from the NTSB's investigation tables, in plain English

What happened, in order

  1. Near midair/TCAS alert/loss of separation during approach (IFR final approach) defining event

The NTSB's findings

  • cause Personnel issues › Action/decision › Info processing/decision › Identification/recognition › ATC personnel

The aircraft

  • Maximum gross weight: 400,998 lb
  • Landing gear: fixed
  • Engine 1: Ge CF6-80C2B6F (turbofan); 0 hours total
  • Engine 2: Ge CF6-80C2B6F (turbofan); 0 hours total

The flight

  • Departed from: MNMG Managua at 6:28 am
  • Destination: MIA Miami FL
  • Flight plan: IFR
  • Runway 8L, 8,600 ft by 150 ft
  • A second pilot was aboard

Weather at the time

  • Light: daylight
  • Wind: from 120° at 7 knots
  • Visibility: 10 statute miles
  • Sky: broken clouds at 25,000 ft; a few clouds at 2,300 ft
  • Temperature: 79°F (26°C), dew point 72°F (22°C)
  • Altimeter: 30.09 inHg
  • Observation at 11:53 am from mia

The factual record for the Cessna 750 from the NTSB's investigation tables, in plain English

What happened, in order

  1. Runway incursion veh/AC/person during taxi (into takeoff position) defining event

The NTSB's findings

  • cause Personnel issues › Action/decision › Info processing/decision › Identification/recognition › ATC personnel

The aircraft

  • Landing gear: fixed
  • Operator: Netjets Sales INC

The flight

  • Departed from: MIA Miami FL at 12:22 pm
  • Destination: MYBC Chub Cay
  • Flight plan: IFR
  • Runway 08L, 8,600 ft by 150 ft
  • A second pilot was aboard

Documents from the investigation the NTSB's docket: the evidence folder behind the report

The NTSB has not released the docket for this case yet. The docket, the folder of records gathered during an investigation (maintenance records, photographs, witness statements, examinations), is usually released when the investigation is nearly complete, and the list here is refreshed when it appears. Check at the NTSB.

Connections how this case links to the rest of the register

Aircraft
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Analytics

The whole map of how records connect · these connections as data: /graph/accident/OPS15IA017.json.

The bigger picture in Aviation Analytics: accidents over time since 1982, by model, by phase of flight and conditions, by place and on the map.

Everything on this page comes from the NTSB's public records. The narrative, probable cause and findings are the NTSB's own words; the coded tables behind the report are written out in plain English, with pilots' ages, home towns and medical details left out. The documents and photographs are the NTSB's docket, shown as the NTSB released them. This site's own text does not name anyone involved, its policy at this time. A preliminary report can change; the final report usually follows one to two years later, and the page is refreshed when it does.