Klawock

The airline transport pilot was conducting a commercial visual flight rules (VFR) flight transporting 10 passengers from a remote fishing lodge. According to the pilot, while in level cruise flight about 1,100 ft mean sea level (msl) and as the flight progressed into a mountain pass, visibility decreased rapidly. In an attempt to turn around and return to VFR conditions, the pilot initiated a climbing right turn. Before completing the 180° right turn, he saw what he believed to be a body of water and became momentarily disoriented, so he leveled the wings. Shortly thereafter, he realized that the airplane was approaching an area of snow-covered mountainous terrain, so he applied full power and initiated a steep climb; the airspeed decayed, and the airplane collided with an area of rocky, rising terrain, which resulted in substantial damage to the wings and fuselage. The pilot reported no mechanical malfunctions or anomalies that would have precluded normal operation, and the examination of the airframe and engine revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation. The weather forecast at the accident time included scattered clouds at 2,500 ft msl, overcast clouds at 5,000 ft msl with cloud tops to 14,000 ft and clouds layered above that to flight level 250, and isolated broken clouds at 2,500 ft with light rain. AIRMET advisory SIERRA for "mountains obscured in clouds/precipitation" was valid at the time of the accident. Conditions were expected to deteriorate. Passenger interviews revealed that through the course of the flight, the airplane was operating in marginal visual meteorological conditions and occasional instrument meteorological conditions (IMC) with areas of precipitation, reduced visibility, obscuration, and, at times, little to no forward visibility. Thus, based on weather reports and forecasts, and the pilot's and passengers' statements, it is likely that the flight encountered IMC as it approached mountainous terrain and that the pilot then lost situational awareness. The airplane was equipped with a terrain awareness and warning system (TAWS); however, the alerts were inhibited at the time of the accident. Although the TAWS was required to be installed per Federal Aviation Administration (FAA) regulations, there is no requirement for it to be used. All company pilots interviewed stated that the TAWS inhibit switch remained in the inhibit position unless a controlled flight into terrain (CFIT) escape maneuver was being accomplished. However, the check airman who last administered the accident pilot's competency check stated that the TAWS inhibit switch was never moved, even during a CFIT escape maneuver. The unwritten company policy to leave the TAWS in the inhibit mode and the failure of the pilot to move the TAWS out of the inhibit mode when weather conditions began to deteriorate were inconsistent with the goal of providing the highest level of safety. However, if the pilot had been using TAWS, due to the fact that he was operating at a lower altitude and thus would have likely received numerous nuisance alerts, the investigation could not determine the extent to which TAWS would have impacted the pilot's actions. At the time of the accident, the director of operations (DO) for the company resided in another city and served as DO for another air carrier as well. He traveled to the company's main base of operation about once per month but was available via telephone. According to the chief pilot, he had assumed a large percentage of the DO's duties. The president of the company said that the chief pilot had taken over "officer of the deck" and "we're just basically using him [the DO] for his recordkeeping." The FAA was aware that the company's DO was also DO for another commuter operation. FAA Flight Standards District Office management and principal operations inspectors allowed him to continue to hold those positions, although it was contrary to the guidance provided in FAA Order 8900.1. The company's General Operations Manual (GOM) only listed the DO, the chief pilot, and the president by name as having the authority to exercise operational control. However, numerous company personnel stated that operational control could be and was routinely delegated to senior pilots. The GOM stated that the DO "routinely" delegated the duty of operational control to flight coordinators, but the flight coordinator on duty at the time of the accident stated that she did not have operational control. In addition, the investigation revealed numerous inadequate and missing operational control procedures and processes in company manuals and operations specifications. Based on the FAA's inappropriate approval of the DO, the insufficient company onsite management, the inadequate operational control procedures, and the exercise of operational control by unapproved persons likely resulted in a lack of oversight of flight operations, inattentive and distracted management personnel, and a loss of operational control within the air carrier. However, the investigation could not determine the extent to which any changes to operational control, company management, and FAA oversight would have influenced the pilot's decision to continue the VFR flight into IMC.

The pilot of the twin-engine airplane and the pilot-rated passenger reported that, during a missed approach in instrument meteorological conditions, at 2,000 ft mean sea level, the right engine seized. The pilot attempted to feather the right engine by pulling the propeller control to the feather position; however, the engine did not feather. The airplane would not maintain level flight, so the pilot navigated to a known airport, and the passenger made emergency communications with air traffic control. The pilot was unable to maintain visual reference with the ground until the airplane descended through about 100 to 200 ft and the visibility was 1 statute mile. The pilot stated that he was forced to ditch the airplane in the water about 5 miles short of the airport. The pilot and passenger egressed the airplane and swam ashore before it sank in about 89 ft of water. Both the pilot and passenger reported that there was postimpact fire on the surface of the water. The airplane was not recovered, which precluded a postaccident examination. Thus, the reason for the loss of engine power could not be determined.

After departing the floatplane base on a company VFR flight plan, the scheduled commuter flight proceeded northwest along a saltwater strait at a low altitude above water. Two miles northwest of the airport the aircraft entered a snow squall and the pilot attempted a steep turn to reverse course. During the turn the aircraft impacted and sank in 167 feet deep water. Search and rescue efforts were suspended after 4 days.

At 1236 the flight departed Ketchikan seaplane base with a special VFR clearance and at 1240 reported clear of the control zone. The next and last transmission by the pilot was made to the company via FM radio at about 1340. This report was issued in the vicinity of Happy Harbor (passing over Kasaan Island) and was the approximate mid-point of the flight to Craig. Witnesses reported seeing the aircraft flying southwest over Twelvemile arm toward Hollis. Upon reaching Hollis the flight would be expected to turn west and cross inland over Prince of Wales Island until reaching the west shoreline and thence directly to Craig. There was a fog bank about 2 miles prior to Hollis in Twelvemile arm and the aircraft was observed to reverse course as the weather was approached and proceed north. The aircraft was lost from sight due to trees and rapidly upsloping terrain. An increase in engine sound was heard prior to the crash. Witnesses described the clouds as essentially broken with bases at about 1,000 feet over the water and obstructing the tops of some of the higher islands. All eight occupants were killed in the crash.

The crew was transferring the aircraft to Vietnam. While approaching Klawock Airstrip located in south Alaska, the airplane crashed in unknown circumstances in a swampy area. There were no casualties but the aircraft was written off.