Modern aviation safety heavily depends on human performance and system reliability. This study aims to analyze the causal factors of a serious incident involving Batik Air flight ID-6723 (January 25, 2024), during which both the pilot and co-pilot fell asleep simultaneously for approximately 28 minutes. The research employed a qualitative descriptive method with a case study approach, utilizing secondary data from the National Transportation Safety Committee (KNKT) investigation report. Analysis was conducted using the Human Factors Analysis and Classification System (HFACS) framework. The findings indicate that the incident was primarily triggered by a failure at the Preconditions for Unsafe Acts level, specifically due to the pilots’ physiological condition (acute fatigue) resulting from domestic sleep quality disruption. Furthermore, weaknesses were identified in the implementation of the Safety Management System (SMS), particularly concerning Controlled Rest procedures and cabin supervision. This study recommends strengthening the Fatigue Risk Management System (FRMS) and establishing more stringent cockpit monitoring mechanisms to prevent similar occurrences in the future.
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