Rawlins

The air ambulance was dispatched from Steamboat Springs, Colorado (SBS), to pick up and transport a patient in serious condition from Rawlins Municipal Airport/Harvey Field (RWL) to Casper, Wyoming. Approaching RWL, the pilot initiated a right turn outbound to maneuver for the final approach course of the VOR/GPS approach to runway 22. On the inbound course to the airport, the airplane impacted mountainous terrain, approximately 2.5 nautical miles east-northeast of the airport. The airplane, configured for landing, struck the terrain wings level, in a 45-degree nose-down dive, consistent with impact following an aerodynamic stall. Approximately 5 minutes before the accident, RWL reported broken ceilings at 1,100 and 1,800 feet above ground level (agl), 3,100 feet agl overcast, visibility 2.5 statute miles with light snow and mist, temperature 33 degrees Fahrenheit (F), dew point 30 degrees F, winds 240 degrees at 3 knots, and altimeter 29.35 inches. Before departing SBS, the pilot received a weather briefing from Denver Flight Service. The briefer told the pilot that there was a band of light to moderate snow shower activity halfway between Rock Springs and Rawlins, spreading to the northeast. The briefer told the pilot there were adverse conditions and flight precautions along his route for occasional mountain or terrain obscurations. The pilot responded that he planned to fly instrument flight rules for the entire flight. The National Weather Service, Surface Analysis showed a north-south stationary front positioned along the front range of the Rocky Mountains beginning at the Wyoming/Montana border and extending south into north-central Colorado. Station plots indicated patchy snow over western Colorado and Wyoming. The most recent AIRMET reported, "Occasional moderate rime or mixed icing in clouds and precipitation between the freezing level and flight level 220." The freezing level for the area encompassing the route of flight began at the surface. Witnesses in the vicinity of RWL reported surface weather conditions varying from freezing rain to heavy snow. An examination of the airplane showed clear ice up to 1 ½ inches thick adhering to the vertical stabilizer, the left and right wings, the right main landing gear tire, and the right propeller. The airplane's aerodynamic performance was degraded due to the ice contamination, leading to a stall. An examination of the airplane's systems revealed no anomalies. A human factors review of interviews and other materials showed insufficient evidence that the company placed pressure on the pilot to take the flight; however, the review did not rule out the pilot inducing pressure on himself. FAA Advisory Circular (AC) 135-15, Emergency Medical Services/Airplane (EMS/A) addresses several subject areas not practiced by the operator, including, "Additional considerations when planning IFR flights include the following: (1) Avoid flight in icing weather whenever possible."

The captain said the airplane felt 'sluggish' during the takeoff roll. At V1/Vr, the airplane was rotated for liftoff. It climbed 10 feet, 'shuddered,' and sank. The captain elected to abort the takeoff. He landed the airplane on the runway, applied brakes and deployed the drag chute. The drag chute separated and the airplane went off the runway, down a hill, through a fence, across a road and grassy area, across another road, through a chain link fence, and collided with a power pole. The captain said they had calculated the takeoff performance using inappropriate tables, and failed to consider the wet runway and wind shift. The drag chute riser fractured at a point where it passed through a lightning hole. The lightning hole bore no evidence of a nylon grommet having been installed.

During the initial climb after takeoff, while executing a dark-night departure, the pilot failed to maintain clearance from rising terrain about one and one-quarter mile off the end of the runway. Operator records indicated that the pilot had flown out of this airport in the past, and that the aircraft was approximately 600 pounds below maximum certificated gross weight at the time of departure. A teardown inspection of both engines revealed no pre-impact anomalies, and visual and teardown inspections of the propellers showed damage signatures consistent with ground contact in a flat pitch under significant power.

The flight took off at 0500 hours in dark visual meteorological conditions. Radar data indicates that the flight was heading in an easterly direction, towards its destination and had climbed to and leveled off at 12,500 feet. Three minutes prior to the last identified radar target, the pilot obtained a partial weather briefing, for the destination airports, from the flight service station. The wreckage was located in an area of high mountainous terrain. Evidence indicated that the flight collided with a ridge line at the 12,400 foot level. The main wreckage was located on the east side of the ridge at 11,400 feet. During the post crash investigation, there was no evidence of a mechanical failure or malfunction. Both occupants were killed.

The approach to Denver-Stapleton was completed in poor weather conditions, below MDA for an ASR approach. At the decision height, the pilot-in-command was unable to locate the runway so he decided to initiate a go-around when the left engine failed. The airplane stalled and crashed short of runway threshold. Two passengers were seriously injured while five other occupants were killed.