Crash of a Cessna 208B Super Cargomaster on Lummi Island: 1 killed

Date & Time: Oct 9, 2000 at 0951 LT
Type of aircraft:
Operator:
Registration:
N941FE
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Bellingham – Eastsound
MSN:
208B-0192
YOM:
1989
Flight number:
FDX665
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
8705
Captain / Total hours on type:
4500.00
Aircraft flight hours:
3526
Circumstances:
With a reported ceiling of 500 feet and visibility of 2 miles, the pilot requested and received a Special Visual Flight Rules (VFR) clearance to depart the Bellingham airport. He then took off and called clear of Bellingham's Class D airspace. A witness reported seeing the aircraft flying very low over water near the accident site, appearing to go in and out of clouds, and subsequently seeing it turn toward rising wooded terrain and disappear into the clouds. The aircraft crashed shortly thereafter. Witnesses reported very low ceilings and fog in the accident area at the time. Pieces of the aircraft's left wing and left horizontal stabilizer, along with a felled treetop, were found between the location of the witness's sighting and the main crash site, on or near the crest of a hill about 1/4 mile from the main crash site. These pieces exhibited leading-edge and primary structure damage, and leading-edge-embedded plant material, consistent with the pieces separating from the aircraft upon contact with trees. Wreckage and impact signatures at the main crash site were indicative of an uncontrolled impact with the ground. Investigators found no evidence of any aircraft malfunctions or cargo anomalies occurring prior to the apparent tree strikes.
Probable cause:
The pilot's attempted flight into known adverse weather conditions, and his subsequent failure to maintain altitude above, or clearance with, trees. Factors contributing to the accident included low ceilings, fog, the pilot's low-altitude flight, rising terrain, and trees.
Final Report:

Crash of a Cessna 208B Super Cargomaster in Greenville

Date & Time: Sep 23, 2000 at 1950 LT
Type of aircraft:
Operator:
Registration:
N590TA
Flight Type:
Survivors:
Yes
Schedule:
Bangor - Greenville
MSN:
208B-0590
YOM:
1997
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
5350
Captain / Total hours on type:
2000.00
Aircraft flight hours:
2671
Circumstances:
According to the pilot, he was conducting a GPS approach during occasional low ceilings, reduced visibility and rain. At the minimum descent altitude, the ground was 'occasionally' visible through fog and rain. Near the missed approach point, the runway lights were visible, so he continued the descent. He lost visual contact with the runway, and began a missed approach, but collided with trees. The accident site was 2 miles prior to the runway, on rising terrain, 200 feet below the runway elevation. The missed approach point was over the approach end of the runway.
Probable cause:
The pilot's improper in-flight decision to continue his descent without visual contact with the runway, and his inattention to his altitude, in relation to the airport elevation.
Final Report:

Crash of a Cessna 208B Grand Caravan on Mt Arenal: 10 killed

Date & Time: Aug 26, 2000 at 1210 LT
Type of aircraft:
Operator:
Registration:
HP-1357APP
Flight Phase:
Survivors:
No
Site:
Schedule:
San Juan – La Fortuna – Tamarindo
MSN:
208-0709
YOM:
1998
Flight number:
RZ1644
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
10
Captain / Total flying hours:
2354
Copilot / Total flying hours:
350
Aircraft flight hours:
792
Circumstances:
The single engine airplane departed San Juan Airport at 1138LT on a flight to Tamarindo with an intermediate stop in La Fortuna on behalf of SANSA - Servicios Aéreos Nacionales. At La Fortuna Airport, a Japanese tourist was drop off and the aircraft took off at 1205LT. About five minutes after takeoff, while cruising in IMC conditions at an altitude of 5,380 feet, the aircraft struck the slope of the Arenal Volcano. The wreckage was found about 200 metres below the summit and all 10 occupants were killed.
Crew:
Karl Acevedo Neverman, pilot,
William Badilla Salazar, copilot.
Passengers:
Terry Pratt,
Silvia Rhissiner,
Catherine Shoep,
Steven Bohmer,
Helena Gutierrez-Bohmer,
Frank Consolazio,
Yudi Consolazio,
Cristopher Damia.
Probable cause:
Controlled flight into terrain after the crew continued under VFR mode in IMC conditions. The following findings were identified:
- The pilot's unsafe flying and failure to maintain adequate separation (vertical and horizontal) with mountainous terrain and not remain in VMC. Moreover, lack of timely corrective action by the crew allowed the aircraft to fly in a controlled manner and unnoticed into the ground.
- Loss of situational awareness and attention from the crew.
- Inadequate monitoring and enforcement by the pilot not flying.
- Lack of application or adherence to standard operating procedures established by SANSA.
- Using flight procedures not written or approved.
- Lack of culture regarding operational safety.

Crash of a Cessna 208B Grand Caravan near Bukavu: 2 killed

Date & Time: Apr 19, 2000
Type of aircraft:
Operator:
Registration:
ZS-ONT
Flight Phase:
Survivors:
No
MSN:
208B-0220
YOM:
1990
Location:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
Crashed in unknown circumstances in the Kahuzi-Biega National Park near Bukavu, killing both occupants.

Crash of a Cessna 208B Grand Caravan near Adjuntas

Date & Time: Dec 23, 1999 at 1600 LT
Type of aircraft:
Registration:
N1315A
Flight Phase:
Survivors:
Yes
Site:
Schedule:
Ponce - Aguadilla
MSN:
208B-0655
YOM:
1998
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1985
Captain / Total hours on type:
550.00
Aircraft flight hours:
1427
Circumstances:
While en route to the first schedule stop, the pilot heard a radio transmission that weather conditions in the vicinity of his next destination were 'bad.' Upon arriving, the pilot attempted to telephone Flight Service for a weather briefing and to file a flight plan. After efforts to contact Flight Service failed, the pilot elected to takeoff without a filing a flight plan. A few minutes into the flight, the pilot decided to return to the departure airport after the flight encountered deteriorating weather conditions that included heavy turbulence, and low ceilings. The airplane collided with trees as the pilot maneuvered the airplane. The post-accident examination of the airplane failed to disclose a mechanical malfunction or a component failure. The pilot did not report a mechanical problem with the airplane. A review of the en route flight charts disclosed that the terrain elevation at the departure point was approximately 24 feet. The terrain elevation at the approximate location of the accident site was 2,500 feet.
Probable cause:
The pilot continued flight into adverse weather conditions that included low ceiling and turbulence. Factors to the accident were trees.
Final Report:

Crash of a Cessna 208B Super Cargomaster in Ranger Lake

Date & Time: Oct 15, 1999 at 1225 LT
Type of aircraft:
Operator:
Registration:
C-FKSL
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Deer Lake - Red Lake
MSN:
208B-0129
YOM:
1988
Flight number:
WSG126
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
While holding outside the control zone at Red Lake (YRL) pending a special VFR clearance, the pilot made a descending turn to avoid a flock of large birds. The right wing struck the water of Ranger Lake and the Cessna overturned. A military DHC-8 diverted to Red Lake and located the Cessna on the west side of Ranger Lake. The airplane was partially submerged and the pilot was on the wing. A floatplane (C-FVTU) subsequently picked up the pilot and returned him to Red Lake. The pilot suffered shoulder injuries, arm injuries, facial injuries and hypothermia.

Crash of a Cessna 208B Grand Caravan in Lerwick

Date & Time: Sep 6, 1999 at 1034 LT
Type of aircraft:
Registration:
LN-PBB
Flight Type:
Survivors:
Yes
Schedule:
Kirkwall - Lerwick
MSN:
208B-0302
YOM:
1992
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1780
Captain / Total hours on type:
500.00
Circumstances:
The operating company were involved in a Royal Mail contract to deliver mail from Aberdeen to Shetland Islands each day. The crew involved in the accident had flown LN-PBB from Stauning Airport in Denmark to Aberdeen in preparation for a two week period of duty delivering the mail; they arrived at Aberdeen at 1700 hrs on 5 September 1999. The next morning, the crew arrived for duty at approximately 0540 hrs and completed their normal checks of LN-PBB. Shortly after this, the mail arrived and was escorted to the aircraft by the company ground crew. The mail bags were sorted and loaded into the aircraft by the flight and ground crew under the supervision of the commander; the mail had been weighed by Royal Mail and the commander was given written confirmation of the total weight of 1,196 kg. At the completion of the loading, the commander was satisfied that the load was secure and correctly distributed. Prior to departure for Sumburgh Airport, the commander had checked the weather and was aware that it was 'poor' at Sumburgh but the indications were that it would improve; additionally, the weather at Kirkwall Airport was clear if they needed to divert. The aircraft appeared fully serviceable during start, taxi and take off from Aberdeen at 0640 hrs; for the flight to Sumburgh, the commander was the handling pilot. Cruise was at Flight Level (FL)90and, about half way to Sumburgh, ATC advised the crew of the latest weather at Sumburgh which indicated that they would not be able to land there. However, there was a preceding aircraft heading for the same destination and the commander elected to continue towards Sumburgh. Then, once the preceding aircraft crew had declared that they were diverting to Aberdeen, the commander decided to divert to Kirkwall. The diversion was uneventful and the aircraft landed at 0807 hrs. At Kirkwall, the crew uplifted sufficient fuel to bring the total up to the same with which they had left Aberdeen (1,200lb) and waited for a weather improvement at Sumburgh. By approximately 0930hrs, the crew were advised by Kirkwall ATC that the weather had improved at Sumburgh and they prepared the aircraft for departure. Take off was at 0950 hrs with the co-pilot as handling pilot. Cruise was at FL 70 and was uneventful up to the approach and landing. The airport was using Runway 27 as that is the only runway with full ILS. The ATIS information at 1020 hrs was broadcasting the following information: surface wind 340°/07 kt; 9,000 metres in rain; cloud few at 300 feet, scattered at 1,000 feet and broken at 1,600 feet; temperature 12°, dew point 12°; tempo cloud broken 1,500 feet with a wet runway. In accordance with ATC instructions, the crew commenced their descent to 2,000 feet amsl where they were instructed to intercept the ILS from a heading of 300°. Once fully established on the ILS, the commander noted that the co-pilot was having a little difficulty maintaining the aircraft on both the localizer and glide slope. The co-pilot was not sure of the height at which they broke cloud but the commander estimated that they were at 500 feet agl. At this point, the co-pilot considered that they were slightly high and fast; subsequently, the commander estimated the aircraft airspeed as 140 kt as they became visual with the runway. During the final approach, the air traffic controller gave three separate wind reports of 010°/11 kt, 010°/11 kt and010°/10 kt; these reports were based on the two minute mean surface winds. As the aircraft crossed the runway threshold, the co-pilot called out that he had too much speed and that "it wasn't going to work". With no reply from the commander, the co-pilot took this lack of response as an indication that the commander was content. For his part, the commander was concentrating on the runway aspect and, although he heard a comment from the co-pilot, did not make any response. The crew considered that touchdown was approximately halfway down the runway and the co-pilot was aware of the aircraft bouncing before a second touchdown; neither pilot could recall the speed at touchdown. Both pilots applied full foot braking but with little apparent result in retardation. Then, as the aircraft approached the end of the runway, the commander took control and applied full power; this was because he was aware of the concrete blocks positioned off the end of the runway as a sea defence and wished to clear them. The aircraft was now yawed slightly left and positioned to the left of the runway centreline. It left the runway surface, travelled across grass and a public road and came to rest on the concrete blocks.
Probable cause:
The aircraft overran the end of Runway 27 at Sumburgh following a touchdown which was too fast and well down the runway. There was insufficient runway remaining for the aircraft to stop. The landing resulted from a poor approach and no apparent co-operation between the crew. A positive decision from the co-pilot, or better monitoring and an active input from the commander, should have resulted in a go-around and a further approach or a diversion. While this crew may be unusual, it would be appropriate for the operating company to review their procedures to ensure that their crews are operating in a safe manner. The investigation also reviewed the rules under which the flight was conducted. Examination of the weather information available to the crew indicate doubts as to whether the flight could have been completed within the limitations contained within company manuals. Additionally, Article 32A of the UK ANO is not clear; it could be interpreted as only prohibiting flights when the weather conditions are not met at all of the relevant aerodromes. It would be appropriate for the CAA to review the content of Article 32A to ensure that the intent is clear.
Final Report: