Ambulance

The aircraft was engaged in an ambulance flight from Sangar to Segyan-Kyuel and back. Because of poor weather the flight was delayed a couple of hours. At ETD, weather conditions at Sangar Airport was as follows: visibility more than 10 km, scattered clouds at 800 metres, overcast at 3,000 metres, temperature -22° C, dewpoint -23° C, pressure 765 mm Hg. Weather forecast en route included a few stratocumulus clouds between 1,400 and 1,700 metres, significant altostratus clouds between 2,700 and 3,500 metres. The mountainous area over which the Antonov was to fly moderate orographic turbulence was present in the layer from 900 to 1,700 meters, and possible downdrafts on the lee side of ridge in the same altitude range. These conditions were not reported to the crew. Then medical equipment with a weight of 400 kg and passengers arrived at the airport by ambulances. The captain expected seven passengers, but three additional passengers had arrived, without having tickets. The names were added to the passenger list and the copilot arranged the payment of the fare. No seats were available for two passengers, so they had to sit on some hand luggage in the aisle. At 04:46 UTC the aircraft departed from Sangar and climbed towards the mountainous terrain. The highest point along the route was at an elevation of 1,976 metres. The minimum safe altitude was 2,515 metres. The pilot climbed VFR and maintained visual separation from the snow-covered mountains. At an altitude of 1,300 metres the Antonov entered an area with strong turbulence. The aircraft was caught in a downdraft. In an attempt to stop the plane from descending further, power was added to nominal, then to the takeoff power. With rising terrain it was impossible to continue. The pilot decided to carry out a 180° turn to the left over downsloping terrain. This brought the plane downwind with a 30° bank instead of the recommended 20°. As a result, the rate of descent increased and after it rolled to an angle of 120°, the left lower wing contacted a cliff. The aircraft lost speed and crashed on the snow covered mountain. All 12 occupants were rescued, among them four were seriously injured. The aircraft was destroyed.

A witness saw the airplane approach from the east. She said that the airplane came in "pretty fast" and touched down "approximately half way down the runway." The witness said, "The nose was down. He hit the ground and within 3 seconds he was off the runway and gone. Then all you saw was smoke." The witness said when the airplane hit "the front end shook. It wobbled like a kid on a tricycle. When it shook, it kind of looked like it [the airplane] bounced. Then it was gone." The control tower operator said he heard the captain say something over the radio, which caused him to look in the direction of the airplane. The tower operator saw the airplane off the runway, the main landing gear came off behind the airplane, and the airplane caught fire. The tower operator said he saw four people get out of the airplane. The airplane came to rest in a shallow ravine approximately 331 feet north of the runway. An examination of the airplane showed impact damage to the nose gear and nose gear wheel well. An examination of the airplane's systems revealed no anomalies.

The Glasgow based Islander aircraft was engaged on an air ambulance task for the Scottish Ambulance Service when the accident occurred. The pilot allocated to the flight had not flown for 32 days; he was therefore required to complete a short flight at Glasgow to regain currency before landing to collect a paramedic for the flight to Campbeltown Airport on the Kintyre Peninsula. Poor weather at Campbeltown Airport necessitated an instrument approach. There was neither radar nor Air Traffic Control Service at the airport, so the pilot was receiving a Flight Information Service from a Flight Information Service Officer in accordance with authorised procedures. After arriving overhead Campbeltown Airport, the aircraft flew outbound on the approach procedure for Runway 11 and began a descent. The pilot next transmitted that he had completed the ‘base turn’, indicating that he was inbound to the airport and commencing an approach. Nothing more was seen or heard of the aircraft and further attempts at radio contact were unsuccessful. The emergency services were alerted and an extensive search operation was mounted in an area based on the pilot’s last transmission. The aircraft wreckage was subsequently located on the sea bed 7.7 nm west-north-west of the airport; there were no survivors.

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."

On October 24, 2004, about 0025 Pacific daylight time, a Learjet 35A twin-turbofan airplane, N30DK, registered to and operated by Med Flight Air Ambulance, Inc. (MFAA), collided into mountainous terrain shortly after takeoff from Brown Field Municipal Airport (SDM), near San Diego, California. The captain, the copilot, and the three medical crewmembers received fatal injuries, and the airplane was destroyed. The repositioning flight was operated under the provisions of 14 Code of Federal Regulations (CFR) Part 91 with an instrument flight rules (IFR) flight plan filed. Night visual meteorological conditions prevailed. The flight, which was the fourth and final leg of a trip that originated the previous day, departed SDM at 0023.

The flightcrew stated that approximately 8 miles out on a visual approach for runway 10 they requested winds and altimeter setting from the control tower. They received altimeter setting 29.95 inches Hg., and winds from 090 degrees at 20 knots. About 5 miles out, in full landing configuration, they checked wind conditions again, and were told 090 at 16 knots. They were holding Vref of 125 knots plus 10 knots on final. The approach was normal until they got a downdraft on short final. The airplane sank and they reacted by immediately adding engine power and increasing pitch, but the airplane continued to sink. The airplane's main landing gear came in contact with the top of the barbwire fencing at the approach end of the runway. The airplane landed short of the threshold. The airplane was under control during the roll out and they taxied to the ramp. A special weather observation was taken at the Vance W. Amory International Airport at 1930, 10 minutes after the accident. The special weather observation was winds 090 at 15 knots, visibility 10 statute miles, scattered clouds at 2,000, temperature 27 degrees centigrade, dewpoint temperature 23 degrees centigrade, altimeter setting 29.95 inches hg.

Crew twin engine aircraft was performing an ambulance flight from Grande Prairie to his base in Fort Vermilion with one patient, one doctor, one accompanist and two pilots on board. On final approach, the aircraft was too high and eventually landed hard. Upon touchdown, the right main gear collapsed and the aircraft veered off runway to the right and and came to rest. All five occupants escaped uninjured while the aircraft was damaged beyond repair.

On July 2, 2004, at 1338 eastern standard time, a U.S. registered Westwind model 1124 corporate jet, N280AT, operated by Air Trek, Inc., as a Part 135 commercial air ambulance flight, impacted terrain and crashed into a building after departing from the Tocumen International Airport (MPTY), Tocumen, Panama. The airplane was destroyed by impact forces and post-crash fire. All six occupants on the airplane were fatally injured. A seventh person was also fatally injured on the ground. Visual meteorological conditions prevailed, and an instrument flight rules (IFR) flight plan was filed. The flight originated from Quito, Ecuador, and stopped in Tocumen for fuel. The flight was destined for Milan, Italy, via another fuel and crew-change stop at the Dulles International Airport, near Washington, DC. According to the operator, the airplane was flown with the two pilots and two flight nurses from Punta Gorda, Florida, to Guayaquil, Ecuador, on July 1, 2004. The airplane was refueled with 450 gallons of Jet A upon arrival, and remained overnight. On July 2, 2004, the airplane was fueled with an additional 150 gallons of Jet A, and subsequently departed for Quito, Ecuador. Upon arriving in Quito, two passengers were boarded, and the flight departed for Panama, where it would be refueled. The airplane was not fueled during the stop in Quito. According to the Panama Autoridad Aeronautica Civil, the flight landed in Panama uneventfully, and proceeded to the north ramp at the main terminal. The flightcrew requested from ground service personnel that the airplane be refueled with 600 gallons of Jet A. The flightcrew specifically requested that 500 gallons of fuel be added utilizing the pressure point fueling station, and 100 gallons be added to the auxiliary tank, utilizing a gravity filler port. After refueling, the airplane was started and taxied to runway 03L. An air traffic controller observed the airplane as it began to takeoff. He recalled that, "It pitched up vertically, the nose then lowered, and the wings rocked side to side. The airplane then veered to the right and descended out of view." A witness, who was located north of the accident site, observed the airplane veering to the right, before descending from his view. The airplane impacted the ground on taxiway Hotel, north of taxiway Bravo, and a fire ensued. The right wing and right engine separated from the fuselage and fragmented into multiple pieces. The vertical stabilizer impacted the ground, and separated from the fuselage. The main fuselage, left wing, and left engine continued across a grass field, where it struck an airport worker, and impacted a concrete wall. The airplane continued through the wall, and came to rest inverted inside a building. Airport crash fire and rescue responded to the accident, and contained the post crash fire within 3 minutes. The wreckage path was oriented on a heading of about 80 degrees. Ground scars on the taxiway were consistent with the right wing tip tank impacting the taxiway surface with the airplane in a nose high attitude, banked 90 degrees to the horizon. The scars continued forward, with the airplane rolling onto its back, collapsing the vertical stabilizer. About 35 feet beyond the vertical stabilizer impact point, scars were observed from the left tip tank. Debris from the cockpit and forward cabin area was observed in the grass area along the wreckage path. Airport personnel tested the fuel truck used to refuel the airplane for contamination after the accident. No abnormalities were noted. The cockpit voice recorder (CVR) was forwarded to the National Transportation Safety Board, Washington, D.C. for further review. The left and right engines, the horizontal stabilizer trim actuator, and the airplane's annunciator warning panel, were also retained for further examination.

The aircraft departed Rome-Ciampino Airport on an ambulance flight to Cagliari, carrying three pilots, three doctors and a cooler containing a heart for a patient. The descent to Cagliari-Elmas Airport was initiated by night under VFR mode. After the crew was cleared to descend to 2,500 feet, ATC reported runway 32 in use and asked the crew to report on short final. About two minutes later, at an altitude of 3,333 feet, the aircraft struck the slope of Mt Su Baccu Malu located 32 km northeast of Cagliari Airport. The aircraft was totally destroyed by impact forces and all six occupants were killed.

The captain and first officer were conducting a CFR Part 135 on-demand charter flight, returning two passengers to the accident airplane's base airport. The multi-destination flight originated from the accident airport, about 16 hours before the accident. On the final leg of the flight, the flight encountered stronger than anticipated headwinds, and the first officer voiced his concern several times about the airplane's remaining fuel. As the flight approached the destination airport, the captain became concerned about having to fly an extended downwind leg, and told the ATCT specialist the flight was low on fuel. The ATCT specialist then cleared the accident airplane for a priority landing. According to cockpit voice recorder (CVR) data, while the crew was attempting to lower the airplane's wing flaps in preparation for landing, they discovered that the flaps would not extend beyond 8 degrees. After the landing gear was lowered, the captain told the first officer, in part: "The gear doors are stuck down.... no hydraulics." The captain told the first officer: "Okay, so we're gonna do, this is gonna be a ref and twenty...All right, probably not going to have any brakes..." According to a ATCT specialist in the control tower, the airplane touched down about midway on the 6001-foot long, dry runway. It continued to the end of the runway, entered the overrun area, struck a chain link fence, crossed a road, and struck a building. During a postaccident interview, the captain reported that during the landing roll the first officer was unable to deploy the airplane's emergency drag chute. He said that neither he nor the first officer attempted to activate the nitrogen-charged emergency brake system. The accident airplane was not equipped with thrust reversers. A postaccident examination of the accident airplane's hydraulic pressure relief valve and hydraulic pressure regulator assembly revealed numerous indentations and small gouges on the exterior portions of both components, consistent with being repeatedly struck with a tool. When the hydraulic pressure relief valve was tested and disassembled, it was discovered that the valve piston was stuck open. The emergency drag chute release handle has two safety latches that must be depressed simultaneously before the parachute will activate. An inspection of the emergency drag chute system and release handle disclosed no pre accident mechanical anomalies.