Ground fire of a Short 360-100 in Houston

Date & Time: May 17, 2012 at 0715 LT
Type of aircraft:
Operator:
Registration:
N617FB
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Houston – Austin
MSN:
3617
YOM:
1983
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
5348
Captain / Total hours on type:
2305.00
Copilot / Total flying hours:
832
Copilot / Total hours on type:
171
Aircraft flight hours:
27504
Circumstances:
The pilots reported that the cargo airplane was about 60 pounds over its maximum takeoff weight. Because their taxi to the assigned runway was long, they decided to reduce weight by using higher-than-normal engine power settings to burn fuel before takeoff while using the wheel brakes to control the airplane’s speed while taxiing. During the taxi, a fire ignited in the right wheel housing. The pilots brought the airplane to a stop on the taxiway, evacuated, and attempted to extinguish the fire with two handheld fire extinguishers. Airport firefighting personnel arrived on scene and extinguished the fire using foam suppressant. Although the fire damage was extensive, postaccident examination of the airplane did not show evidence of mechanical malfunctions or failures with the wheel and brake system that could have caused the fire. The right and left main landing gear tires deflated when the fusible plugs in the wheels blew due to overheating. The fusible plugs are designed to “fail” if the wheels overheat, and those plugs functioned as designed. The pilots stated that they had been trained to not ride the brakes while taxiing. However, the captain stated that he did not realize that he was in danger of blowing the tires much less causing a fire, otherwise he would not have attempted to bum off excess fuel while taxiing.
Probable cause:
The pilots’ improper decision to burn fuel during the taxi by operating the engines at a higher-than-normal power setting and using the wheel brakes to control taxi speed, which resulted in a wheel fire.
Final Report:

Crash of a Curtiss C-46F-1-CU Commando in Santa Cruz: 3 killed

Date & Time: Apr 21, 2012 at 0813 LT
Type of aircraft:
Operator:
Registration:
CP-1319
Flight Type:
Survivors:
Yes
Schedule:
Santa Cruz - Cobija
MSN:
22428
YOM:
1945
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
12500
Copilot / Total flying hours:
3219
Aircraft flight hours:
29080
Circumstances:
The crew departed Santa Cruz-Viru Viru Airport at 0807LT on a cargo flight to Cobija-E. Beltram Airport. Shortly after takeoff from runway 16, the crew informed ATC he was returning but did not give any details about his situation. On final approach, the aircraft adopted a high-nose attitude, climbed then stalled and crashed 200 metres short of runway, bursting into flames. The passenger was seriously injured and all three crew members were killed. The aircraft was totally destroyed by a post crash fire.
Probable cause:
The cause of the accident was that the aircraft, while on short finals and cleared to land, made an unusual flight maneuver by climbing almost vertically until a wing stall and plunging violently against the terrain, bursting into flames within the security area of the runway.
Final Report:

Crash of a Fokker F27 Friendship 500 in Yida

Date & Time: Apr 15, 2012 at 1321 LT
Type of aircraft:
Operator:
Registration:
5Y-SRJ
Flight Type:
Survivors:
Yes
Schedule:
Lokichogio - Yida
MSN:
10372
YOM:
1968
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The aircraft departed Lokichoggio Airport at 1103LT on a cargo flight to Yida, carrying three crew members and a load consisting of food. En route, while cruising at an altitude of 16,000 feet, the right engine failed. The crew was able to restart it but it failed again few minutes later. The crew started the approach on one engine and landed uneventfully. While decelerating, the nose gear collapsed and the aircraft came to rest. All three crew members escaped uninjured while the aircraft was damaged beyond repair. Both engines accumulated about 20 hours since the last overhaul and it is believed that the nose gear failed due to fatigue cracks.

Crash of an Avro 748-287-2B in Doro

Date & Time: Apr 2, 2012
Type of aircraft:
Registration:
5Y-BZR
Flight Type:
Survivors:
Yes
MSN:
1737
YOM:
1975
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On final approach to Doro Airport, while performing a cargo flight, the aircraft impacted ground short of runway and came to rest. All three crew members escaped uninjured while the aircraft was damaged beyond repair.

Ground accident of a Douglas C-54G Skymaster in San Juan

Date & Time: Mar 22, 2012 at 1915 LT
Type of aircraft:
Registration:
N406WA
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Christiansted – San Juan
MSN:
35944
YOM:
1945
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Following an uneventful cargo flight from Christiansted-Henry E. Rohlsen Airport, the crew completed the landing normally at San Juan-Luis Muñoz Marin Airport. While taxiing to the ramp, the nose gear collapsed and the aircraft came to rest. Both pilots escaped uninjured and the aircraft was damaged beyond repair.
Probable cause:
No investigations were conducted by the NTSB.

Crash of a Convair CV-440-38 in San Juan: 2 killed

Date & Time: Mar 15, 2012 at 0738 LT
Operator:
Registration:
N153JR
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
San Juan - Sint Marteen
MSN:
117
YOM:
1953
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
22586
Captain / Total hours on type:
9000.00
Copilot / Total flying hours:
2716
Copilot / Total hours on type:
700
Circumstances:
The airplane, operated by Fresh Air, Inc., crashed into a lagoon about 1 mile east of the departure end of runway 10 at Luis Muñoz Marín International Airport (SJU), San Juan, Puerto Rico. The two pilots died, and the airplane was destroyed by impact forces. The airplane was operated under the provisions of 14 Code of Federal Regulations (CFR) Part 1251 as a cargo flight. Visual meteorological conditions prevailed at the time of the accident, and a visual flight rules flight plan was filed. The flight had departed from runway 10 at SJU destined for Princess Juliana International Airport, St. Maarten. Shortly after takeoff, the first officer declared an emergency, and then the captain requested a left turn back to SJU and asked the local air traffic controllers if they could see smoke coming from the airplane (the two tower controllers noted in postaccident interviews that they did not see more smoke than usual coming from the airplane). The controllers cleared the flight to land on runway 28, but as the airplane began to align with the runway, it crashed into a nearby lagoon (Laguna La Torrecilla). Radar data shows that the airplane was heading south at an altitude of about 520 ft when it began a descending turn to the right to line up with runway 28. The airplane continued to bank to the right until radar contact was lost. The estimated airspeed at this point was only 88 knots, 9 knots below the published stall speed for level flight and close to the 87-knot air minimum control speed. However, minimum control speeds increase substantially for a turn into the inoperative engine as the accident crew did in the final seconds of the flight. As a result, the airplane was operating close to both stall and controllability limits when radar contact was lost. Pilots flying multiengine aircraft are generally trained to shut down the engine experiencing a problem and feather that propeller; thus, the flight crew likely intended to shut down the right engine by bringing the mixture control lever to the IDLE CUTOFF position and feathering the right propeller, as called out in the Engine Fire In Flight Checklist. This would have left the flight crew with the left engine operative to return to the airport. However, postaccident examinations revealed that the left propeller was found feathered at impact, with the left engine settings consistent with the engine at takeoff or climb setting. The right engine settings were generally consistent with the engine being shut down; however, the right propeller’s pitch was consistent with a high rotation/takeoff power setting. The accident airplane was not equipped with a flight data recorder or a cockpit voice recorder (nor was it required to be so equipped); hence, the investigation was unable to determine at what point in the accident sequence the flight crew shut down the right engine and at what point they feathered the left propeller, or why they would have done so. Post accident examination of the airplane revealed fire and thermal damage to the airframe on the airplane’s right wing rear spar, nacelle aft of the power section, and in the vicinity of the junction between the augmentor assemblies and the exhaust muffler assembly. While the investigation was unable to determine the exact location of the ignition source, it appears to have been aft of the engine in the vicinity of the junction between the augmentor assemblies and exhaust muffler assembly. The investigation identified no indication of a fire in the engine proper and no mechanical failures that would have prevented the normal operation of either engine.
Probable cause:
The flight crew's failure to maintain adequate airspeed after shutting down the right engine due to an in-flight fire in one of the right augmentors. The failure to maintain airspeed resulted in either an aerodynamic stall or a loss of directional control.
Final Report:

Crash of a Cessna 402B off Punto Fijo

Date & Time: Feb 9, 2012 at 1200 LT
Type of aircraft:
Operator:
Registration:
YV2663
Flight Type:
Survivors:
Yes
Schedule:
Valera - Punto Fijo
MSN:
402B-1024
YOM:
1975
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The twin engine aircraft was performing a cargo flight from Valera-Dr. Antonio Nicolás Briceño Airport to Punto Fijo, carrying one passenger, two pilots and a load consisting of valuables. On approach to Punto Fijo-Josefa Camejo Airport, the crew encountered technical problems and ditched the aircraft off the Amuay refinery. The aircraft sank in shallow water and all three occupants took refuge on the roof of the airplane before being rescued few minutes later.
Probable cause:
The failure of the seal of the balance tube on the left engine intake manifold, causing a loss of manifold pressure and then a loss of engine power.
Contributing Factor:
- Discrepancies found with the quality control of the maintenance services performed on the aircraft,
- The non-assertive decisions taken during the flight when the emergency occurred.

Crash of a PZL-Mielec AN-28 in Namoya: 3 killed

Date & Time: Jan 30, 2012 at 0845 LT
Type of aircraft:
Operator:
Registration:
9Q-CUN
Flight Type:
Survivors:
Yes
Schedule:
Bukavu – Namoya
MSN:
1AJ006-11
YOM:
1989
Location:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
3
Circumstances:
The twin engine aircraft departed Bukavu-Kavumu Airport at 0745LT for a one-hour cargo flight to Namoya. On approach, the crew encountered marginal weather conditions when the aircraft crashed in a dense wooded area located 10 km short of runway threshold. Two passengers among them a 60 years old women were seriously injured while three other occupants were killed, among them both pilots, a Russian captain and an Indian copilot.

Crash of a Beechcraft 65-80 Queen Air in Manila: 13 killed

Date & Time: Dec 10, 2011 at 1415 LT
Type of aircraft:
Registration:
RP-C824
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Manila - San Jose
MSN:
LD-21
YOM:
1962
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
13
Circumstances:
On December 10, 2011, BE-65-80QA (Queen Air) with Registry RP-C824 took off from RWY 13, Manila Domestic Airport on/or about 0610 UTC (1410H) southbound for San Jose, Mindoro. There were three (3) persons on board, the PIC and two (2) other persons; one was seated at the right-hand cockpit seat and the other one at the passenger seat. After airborne, the ATC gave instructions to the pilot o turn right and report five (5) miles out. After performing the right turn, the pilot requested for a reland which was duly acknowledged but the ATC with instructions to cross behind traffic on short final Rwy 06 (a perpendicular international runway) and to confirm if experiencing difficulty. However, there was no more response from the pilot. From a level flight southward at about 200 feet AGL, three (3) loud sputtering/burst sounds coming from the aircraft were heard (by people on the ground) then the aircraft was observed making a left turn that progressed into a steep bank and roll-over on a dive. After about one complete roll on a dive the aircraft hit ground at point of impact (Coordinates 14.48848 N 121.025811 E), a confined area beside a creek surrounded by shaties where several people were in a huddle. Upon impact, the aircraft exploded and fire immediately spread to surrounding shanties and a nearby elementary school building. The aircraft was almost burned into ashes and several shanties were severely burned by post-crash fire. A total of thirteen (13) persons were fatality injured composed of: the 3 aircraft occupants who died due to non survivable impact and charred by post-crash fire, and ten (10) other persons on the ground, all residents at vicinity of impact point, incurred non-fatal injuries and were rushed to a nearby hospital for medical treatment. About 20 houses near the impact point were completely burnt and the adjacent Elementary School building was severely affected by fire.
Probable cause:
The Aircraft Accident Investigation and Inquiry Board determined that the probable cause of this accident was:
- Immediate Cause:
(1) Pilot’s Lack of event proficiency in emergency procedures for one (1) engine in-operative condition after-off. Pilot Error (Human Factor)
While a one engine in-operative condition during take-off after V1 is a survivable emergency event during training, the pilot failed to effectively maintain aircraft control the aircraft due to inadequate event proficiency.
- Contributing Cause:
(1) Left engine failure during take-off after V1. (Material Factor)
The left engine failed due to oil starvation as indicated by the severely burnt item 7 crankshaft assembly and frozen connecting rods 5 & 6. This triggered the series of events that led to the failure of the pilot to manage a supposedly survivable emergency event.
- Underlying Causes:
(1) Inadequate Pilot Training for Emergency Procedure. Human Factor
Emergency event such as this (one engine inoperative event – twin engine aircraft) was not actually or properly performed (discussed only) in actual training flights/check-ride and neither provided with corresponding psycho-motor training on a simulator. Hence, pilot’s motor skill/judgment recall was not effective (not free-flowing) during actual emergency event.
(2) Inadequate engine overhaul capability of AMO. Human Factor
There was no document to prove that engine parts scheduled to be overhauled aboard were complied with or included in the overhaul activity. The presence unauthorized welding spot in the left-hand engine per teardown inspection report manifested substandard overhaul activity.
(3) Inadequate regulatory oversight (airworthiness inspection) on the overhaul activity of the AMO (on engine overhaul). Human Factor
The airworthiness inspection on this major maintenance activity (engine overhaul) failed to ensure integrity and quality of replacement parts and work done (presence of welding spots).
(4) Unnecessary Deviation by ATC from the AIP provision on Runway 13 Standard VFR Departure Southbound.
The initiative of the AY+TC for an early right turn southbound after airborne was not in accord with the standard departure in the AIP which provides the safest corridor for takeoff and the ample time to stabilize aircraft parameters in case of a one engine inoperative emergency event for a successful re-land or controlled emergency landing.
Final Report:

Crash of a Cessna 208B Grand Caravan in Bilogai-Sugapa: 1 killed

Date & Time: Nov 23, 2011 at 0942 LT
Type of aircraft:
Operator:
Registration:
PK-VVG
Flight Type:
Survivors:
Yes
Schedule:
Nabire - Bilogai-Sugapa
MSN:
208B-1308
YOM:
2007
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
1859
Captain / Total hours on type:
1550.00
Copilot / Total flying hours:
690
Copilot / Total hours on type:
231
Aircraft flight hours:
4331
Aircraft flight cycles:
5375
Circumstances:
The flight route was Nabire to Bilogai as an unscheduled cargo flight. There were two pilots on board and the freight load was a mixture of food, palm oil, and cement. The aircraft departed from Nabire at 2355 UTC (0855 LT), the estimate time of arrival of Bilogai was 0045 UTC. At 0042 UTC the aircraft was reported above touchdown zone and the altitude recorded of 6,960 feet, direction 277 degrees and air speed 94 knots. The aircraft executed a go around due to an unauthorized person entering the shoulder of the runway 27, the aircraft then continued to climb and headed left. It was reported while the aircraft initially was climbing with the nose up but following lost altitude. During go around manoeuvre the aircraft attitude was in high nose up position, caused the angle of attack was too high and beyond a stall margins caused the aircraft stall. The aircraft bank to the right and crashed on a corn farm at coordinate S 03 44.58 E 137 0.96 and altitude about 6,550 feet with heading about 260 degrees. The aircraft was destroyed on impact with the ground. The captain seriously injured and still on seat in the aircraft wearing the shoulder harness. The second in command was fatally injured outside of the aircraft at the crashed site.
Probable cause:
FINDINGS :
• The aircraft was airworthy prior the accident and there was no evidence of system malfunction during the flight.
• The crew had valid license and medical certificate.
• There were no fences at the airport perimeter.
• There was a local plantation area nearby the runway.
• Unauthorized person entering the shoulder of the runway 27.
• There was no warning signal to alert if unauthorized persons entering the runway, especially during any aircraft Takeoff and Landing.
• The valley (gap) on the south side of the runway was too narrow for successful go around manoeuvre by a caravan aircraft.
• The aircraft most probably stalled due to very high angle of attack, when the aircraft was manoeuvre to avoid the surrounding terrain and bank to the right.
• The communication of incoming and outgoing Susi Air aircraft from and to Bilogai was only to Susi Air ground handling Agent at Sugapa.
CAUSES :
The aircraft was executed a Go Around due to a unauthorized person entering the shoulder of the runway 27, after go around, crew tried to avoid terrain impact, increasing the aircraft attitude more pitching up caused the angle of attack was higher and beyond a stall margins , finally stall just before impact.
Final Report: