Crash of an Avro 748 in George: 3 killed

Date & Time: Jun 1, 2002 at 0715 LT
Type of aircraft:
Operator:
Registration:
ZS-OJU
Flight Type:
Survivors:
No
Site:
Schedule:
Bloemfontein - George
MSN:
1782
YOM:
1980
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
20963
Captain / Total hours on type:
1819.00
Copilot / Total flying hours:
1099
Copilot / Total hours on type:
518
Aircraft flight hours:
14226
Aircraft flight cycles:
19789
Circumstances:
The aircraft was on a scheduled freight flight from Bloemfontein to George. Poor weather conditions prevailed over the George area and the pilots had to execute an instrument guided approach for the landing. The ground based Instrument Landing System (ILS) on Runway 29 at George Aerodrome was intermittently unreliable during the approach. The pilots decided to execute a missed approach. During the missed approach the pilots did not comply with the published missed approach procedure and with a combination of strong winds and possible erroneous heading indications they lost situational awareness. They flew the aircraft into a valley and crashed into the side of the mountains North-East of the George Aerodrome. The passenger was Hansie Cronje, a former South African cricket captain who had missed a South African Airlines flight.
Probable cause:
The crew deviated from the prescribed missed approach procedure during an attempted Instrument Landing System landing on Runway 29 at George in Instrument Meteorological Conditions and lost situational awareness aggravated by the presence of strong upper SouthWesterly winds. They allowed the aircraft to drift off course resulting in a controlled impact with terrain 6.7 nm North-East of the aerodrome. Contributing factors to the probable cause were the weather conditions, the intermittent unreliability of the Instrument Landing System, the serviceability of the directional gyro and the uncleared defects.
Final Report:

Crash of an Avro 748-372-2B in Sun City

Date & Time: Apr 16, 2002 at 1334 LT
Type of aircraft:
Operator:
Registration:
ZS-OLE
Survivors:
Yes
Schedule:
Skukuza - Sun City
MSN:
1796
YOM:
1982
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
42
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3846
Captain / Total hours on type:
755.00
Circumstances:
During the flight from Skukuza to Pilanesberg the aircraft developed a hydraulic problem, resulting in a complete hydraulic failure. However, a safe landing was carried out at Pilanesberg on Runway 23. Shortly after the landing the pilot shut down both engines, but maintained the runway heading for approximately 2000m, before the aircraft veered off to the left of the runway where it entered a ditch, 75m from the runway edge, where it finally stopped. There were no injuries, but the aircraft sustained extensive damage and substantial damage was caused to the perimeter fence around the airport. Both the pilot and the co-pilot were correctly licenced and type rated on the aircraft. Apart from the CVR, which was inoperative at the time of the accident and a leaking L/H hydraulic pump, it would appear that the aircraft was correctly maintained. Fine weather conditions prevailed at the time of the accident. The pilot informed Pilanesberg ATC of a complete hydraulic failure, but did not declare an emergency. The pilot failed to switch off the Nose Wheel Steering after touchdown and also shut down both hydraulic cut-off switches. The Emergency Checklist does not provide for a complete hydraulic failure.
Probable cause:
The accident resulted from a complete hydraulic failure, probably as a result of a leak on the L/H engine pump, which was not dealt with properly. Contributing to this was an incomplete emergency checklist.
Final Report:

Ground accident of a BAe 125-400B in Lanseria

Date & Time: Feb 12, 2002 at 0800 LT
Type of aircraft:
Operator:
Registration:
ZS-JBA
Flight Phase:
Survivors:
Yes
Schedule:
Lanseria – Blantyre
MSN:
25259
YOM:
1971
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
7881
Captain / Total hours on type:
64.00
Copilot / Total flying hours:
13500
Copilot / Total hours on type:
18
Circumstances:
The aircraft was parked on the international departures apron at FALA, ready for a flight from FALA to Blantyre. The pilot assumed that the engineer had pressurised the hydraulic accumulator and therefore did not inspect it himself. When the passengers arrived, the pilot got in the aircraft and began the internal pre-start checks. The co-pilot removed the chocks after boarding the passengers, closed the door and then started to brief the passengers. At that moment the pilot noticed that the aircraft was rolling forward. Attempts to stop the aircraft were unsuccessful, the aircraft rolled forward, narrowly missed a hangar and a parked Bell Long-ranger helicopter next to the hangar, crossed the taxiway and finally stopped when entering a ditch between the taxiway and the runway. The pilot was the holder of a valid transport pilot’s licence and had the type endorsed in his licence. The operation of the hydraulic system was found to be satisfactory. The hand pump was used to pressurise the system after which the brakes could be applied successfully.
Probable cause:
The hydraulic system was not pressurised during the pre-flight inspection of the aircraft. The chocks were therefore removed without adequate hydraulic system pressure available.
Final Report:

Crash of a Beechcraft C90 King Air in Cradock

Date & Time: Dec 23, 2001 at 1630 LT
Type of aircraft:
Operator:
Registration:
ZS-INN
Flight Type:
Survivors:
Yes
Schedule:
Port Elizabeth - Cradock
MSN:
LJ-523
YOM:
1971
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3599
Captain / Total hours on type:
118.00
Circumstances:
The private pilot was accompanied by his wife and his two daughters on a flight from Port Elizabeth to his farm in the Cradock district. On arrival at Cradock, the pilot apparently over-flew the runway for inspection and was on the downwind leg when the aircraft started to roll and yaw to the left. All engine indications were normal and the pilot had to decrease power on the right-hand engine in order to maintain control of the aircraft. With the reduction in power of the right-hand engine, the pilot was unable to maintain height and executed a forced landing on an open field. The aircraft was extensively damaged during the forced landing but no injuries were sustained. An on-site investigation was carried out on 24 December 2000 after which the aircraft was recovered to Lanseria aerodrome for further inspection. On inspection of the Left-hand propeller it was noted that the carbon block of the low pitch proximity sensor, which normally runs inside the Low-Pitch stop collar, was bent down at an angle, which would have rendered the secondary Low-Pitch stop inoperative. Due to the fact that the aircraft sustained damage to it's electronic circuitry it was not possible to verify the proper operation of the propeller pitch control system.
Probable cause:
Due to damage sustained during the accident, the proper operation of the propeller pitch control system could not be verified. The cause of the accident therefore remains undetermined.

Crash of a Cessna F406 Caravan II in Johannesburg: 3 killed

Date & Time: Nov 2, 2001 at 0320 LT
Type of aircraft:
Registration:
ZS-OIG
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Johannesburg - Windhoek
MSN:
406-0041
YOM:
1989
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
1956
Captain / Total hours on type:
1001.00
Circumstances:
The aircraft departed Johannesburg International Airport at 0119Z on an international cargo flight to Eros, an aerodrome located on the outskirts of Windhoek the capital of Namibia. There were two pilots and a passenger onboard the aircraft as well a substantial amount of cargo, consisting mainly of express freight parcels and two heavy steel bars approximately 3 metres in length each. The aircraft crashed approximately 106 seconds after commencing its take-off roll, impacting the ground in a left wing low attitude approximately 700 metres South of the threshold of runway 03R at Johannesburg International Airport in a marshy area. All three occupants onboard were fatally injured and the aircraft was destroyed.
Probable cause:
The accident resulted due to a loss of control (aircraft becoming uncontrollable in the pitch and roll axis), which occurred approximately 35 to 40 seconds after lift-off/rotation. It was induced and aggravated by a 16% overload condition as well as the exceedance of the certified aft CG limitation of the aircraft. The investigation revealed that the aircraft was overloaded by approximately 16% 699.6kg). The cargo was not secured, nor was there a seat or a restraining device in the aircraft for the passenger that was onboard the ill-fated flight. The last Mandatory Periodic Inspection prior to the accident was certified on 30 May 2001 at 4 353.1 airframe hours, by AMO No. 273. Since the inspection was certified a further 96.6 hours were flown. The Certificate of Airworthiness for the aircraft was invalid at the time of the accident, as both engines have exceeded their TBO (time between overhaul) by approximately 185 hours.
Final Report:

Crash of a Beechcraft G18S in Lanseria

Date & Time: Mar 14, 2001 at 1240 LT
Type of aircraft:
Operator:
Registration:
ZS-OEP
Flight Type:
Survivors:
Yes
Schedule:
Lanseria - Lanseria
MSN:
BA-474
YOM:
1959
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
19639
Captain / Total hours on type:
24.00
Aircraft flight hours:
671
Circumstances:
The instructor was accompanied by a trainee pilot and two passengers (also pilots) on a local training flight and was in the process of doing type conversion training when the accident happened. On the third circuit after a touch and go landing on runway 06L, the right-hand engine failed soon after take-off. The aircraft was flown at low altitude in a left-hand circuit in an attempt to land onto runway 17. During this circuit the left-hand engine also failed. The aircraft collided with, and severed, three 11kV electrical conductors and executed a forced landing with the gear retracted to the North of FALA approximately 1 km from threshold of runway 17. The pilot only sustained minor injuries with no one else injured. The initial on-site inspection revealed that both front tanks, which were selected at the fuel tank selector, were empty. The pilot who was undergoing conversion training refueled the aircraft prior to the accident and stated that 70 litres of fuel was uplifted into each "inboard auxiliary" tank and that what he presumed to be the "main" tanks were filled to capacity. The instructor stated that upon his arrival, the pilot who refueled the aircraft told him that he had filled the "mains" and that the "centre aux. tanks" were partially filled. The instructor further stated that the "main" tanks were selected for the duration of the flight. The aircraft is equipped with three fuel tanks in each wing. These tanks are: Front, Rear Auxiliary and Auxiliary tanks. Only one fuel quantity gauge is installed in the aircraft. A seven position selector knob above the fuel quantity gauge determines the tank to which the gauge is connected which then indicates the amount of fuel in that respective tank. The left and right front tanks were selected on the fuel gauge selector knob.
Probable cause:
Poor preflight inspection. Miscommunication between instructor and student pilot resulting in fuel mismanagement and depletion of the front tanks' fuel supply and subsequent engine failure. A contributory factor is that both the instructor and the student were relatively unfamiliar with the aircraft and its systems.

Crash of a Piper PA-31-350 Navajo Chieftain in Johannesburg: 10 killed

Date & Time: Dec 6, 1999 at 0706 LT
Registration:
ZS-OJY
Flight Phase:
Survivors:
No
Schedule:
Johannesburg - Oranjemund
MSN:
31-7405210
YOM:
1974
Flight number:
FC350
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
9
Pax fatalities:
Other fatalities:
Total fatalities:
10
Captain / Total flying hours:
1444
Captain / Total hours on type:
445.00
Aircraft flight hours:
8422
Circumstances:
The charter operator was involved in a weekly operation to transport computer programmers and training staff, from a Johannesburg company, from Rand Airport to Oranjemund in Namibia. The outward leg of the flights to Oranjemund took place on the Monday morning and the pilot and aircraft stayed at Oranjemund for the week. The return flight to Johannesburg usually took place on the Friday afternoon. On the morning of the accident flight the set time of departure was 0500z. The passengers were assisted through the process of passport control, boarding and settling in by the operator's staff. The baggage was put next to the aircraft. According to a witness the pilot carried out the loading of the baggage. An instrument flight plan was filed and the pilot obtained departure clearance before the aircraft was taxied to the holding point. According to the air traffic controller, the take-off run was normal for this type of aircraft. Shortly after take-off the pilot declared an engine failure and requested to be routed back to land on the runway. Seconds later the pilot communicated they were going to crash. Several witnesses stated that the aircraft was very low when it passed over the highway close to the accident site. One of the witnesses stated that he noticed the right-hand engine stopped and he could see the blades of the propeller. The fire fighting services were alerted. It was apparent by the smoke that the aircraft crashed on an extended line of Runway 29. The accident took place at 0506z in daylight conditions. All 10 occupants were killed.
Probable cause:
The following findings were identified:
- The precipitative cause of this accident was the failure of the exhaust pipe segment, which caused the right–hand engine to lose power/fail.
- The overloaded condition of the aircraft was thus a highly significant contributory factor.
- The pilot operating the aircraft in an overloaded condition is regarded as a significant contributing factor.
- The company’s lack of flight operations management experience, professional flight standards supervision and an operational safety management program are regarded as significant contributing factors.
- The anomalies noted in regulatory oversight of the operator (airworthiness and flight operations surveillance) by the CD:CAA and CAA are regarded as possible contributing factors.
Final Report:

Crash of a Piper PA-31-350 Navajo Chieftain in Johannesburg

Date & Time: Oct 21, 1998 at 0310 LT
Operator:
Registration:
ZS-NHM
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Johannesburg - Windhoek
MSN:
31-8052035
YOM:
1980
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1020
Captain / Total hours on type:
350.00
Circumstances:
The aircraft was loaded with cargo intended for Namibia, early the morning of the accident. The pilot reported that the right-hand engine suffered a loss of power at the point where he rotated the aircraft for take-off. During the attempt to abort the take-off the aircraft skidded over the end of the runway and crashed down an embankment. The pilot and his passenger escaped with minor injuries, but the aircraft was subsequently destroyed by the post impact fire.
Probable cause:
During the investigation it was found that the aircraft was overloaded.
Final Report:

Crash of an AMI Turbo DC-3-65TP in Pretoria: 1 killed

Date & Time: Aug 24, 1998 at 1646 LT
Type of aircraft:
Operator:
Registration:
ZS-NKK
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Pretoria - Durban
MSN:
13143
YOM:
1944
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
11691
Circumstances:
Final power assurance checks were carried out on the aircraft’s engines on the morning of the accident. The AME (Aircraft Maintenance Engineer) trimmed the elevator-trim tab to the Full Nose UP position in order to reduce the stick forces required to hold the tail down during the engine power checks, but he did not set the elevator trim back to the neutral position on completion of the checks. The AME was requested by the pilot(s) to remove the aileron and elevator external gust locks and the landing gear down lock pins. He left the rudder lock in place, which was later removed by one of the pilots. The pilot(s) did not carry out a pre-flight inspection. At approximately 1646 on 24 August 1998 the DC3TP, registration number ZS-NKK, crashed during take-off from runway 11 at Wonderboom Airport. The PIC (Pilot-in-Command), who did not wear a shoulder harness, sustained fatal injuries and the co-pilot, who did wear a shoulder harness, serious injures. The accident occurred on the first flight after the aircraft had undergone a maintenance inspection, which included power assurance checks of the engines. The co-pilot sat in the left-hand seat and while he started the engines, the PIC attended to the cockpit checklist.
Probable cause:
It would appear that the accident was as a result of the PIC taking-off with the elevator trim set to the full nose-up position. This resulted in the nose of the aircraft pitching up after rotation, causing the pilot to lose control of the aircraft.
Final Report:

Crash of an Antonov AN-32B in Vaalwater

Date & Time: May 7, 1998 at 0830 LT
Type of aircraft:
Operator:
Registration:
3D-DRV
Flight Type:
Survivors:
Yes
Schedule:
Durban – Bulawayo – Harare
MSN:
2302
YOM:
1990
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
While cruising at the altitude of 13,000 feet on the leg from Durban to Bulawayo, the crew informed ATC about smoke spreading in the cockpit and was cleared to reduce his altitude. Shortly later, while flying at low altitude, the pilots open the cockpit windows to allow the smoke to evacuate and elected to make an emergency landing at Vaalwater Aerodrome which offers a grassy runway of 780 metres long and 10 metres wide. After touchdown, the aircraft struck a tree on the left side of the runway, cartwheeled, lost a landing gear and came to rest. All four occupants escaped uninjured while the aircraft was damaged beyond repair.
Probable cause:
The smoke that spread in the cockpit was coming from behind the captain's seat as a result of a short circuit in the electrical system supplying the weather radar.