Crash of an Embraer EMB-121A1 Xingu II off Angra dos Reis: 3 killed

Date & Time: Jul 12, 2012 at 1715 LT
Type of aircraft:
Registration:
PT-MAB
Survivors:
No
Schedule:
Belo Horizonte - Angra dos Reis
MSN:
121-007
YOM:
1979
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
2735
Captain / Total hours on type:
2065.00
Copilot / Total flying hours:
1820
Copilot / Total hours on type:
1283
Circumstances:
The twin engine aircraft departed Belo Horizonte-Pampulha Airport on a charter flight to Angra dos Reis, carrying one passenger and two pilots. On approach to Angra dos Reis, the crew encountered poor weather conditions with a cold front approaching the area. On short final, while completing a right turn at low height, the right wing struck the water surface and the aircraft crashed in the sea, some 500 metres offshore. The wreckage was found 3 km from the airport. All three occupants were killed and aircraft was destroyed. Visibility was low at the time of the accident with heavy rain falls, low clouds and turbulences. The passenger was the local representative of the Mercedes Benz Group.
Probable cause:
The collision with water and the subsequent accident was the consequence of the decision of the crew to continue the approach at low altitude to maintain a visual contact with the ground. At the time of the accident, the visibility was limited and weather conditions were marginal.
Final Report:

Crash of a Grumman G-159 Gulfstream GI in Pweto

Date & Time: Jun 20, 2012
Type of aircraft:
Registration:
9Q-CIT
Survivors:
Yes
Schedule:
Lubumbashi - Pweto
MSN:
193
YOM:
1968
Location:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Following an uneventful charter flight from Lubumbashi-Lueno Airport, the crew made a steep approach followed by a hard landing. The aircraft bounced and climbed to a height of about 20 feet, landed again and went out of control. It veered off runway to the left, collided with a rocky embankment, lost its undercarriage and came to rest, broken in several pieces. All five occupants escaped uninjured while the airplane was destroyed.
Probable cause:
Wrong approach configuration after the crew made a sharp turn late on final to join the glide. The rate of descent was excessive during the last segment, causing the aircraft to land hard and to bounce. Due to excessive g-loads and aerodynamic forces, the airplane went out of control.

Crash of a De Havilland DHC-2 Beaver in Lillabelle Lake: 2 killed

Date & Time: May 25, 2012 at 1408 LT
Type of aircraft:
Operator:
Registration:
C-FGBF
Survivors:
Yes
Schedule:
Edgar Lake - Lillabelle Lake
MSN:
168
YOM:
1952
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
1100
Captain / Total hours on type:
300.00
Aircraft flight hours:
22000
Circumstances:
The Cochrane Air Service de Havilland DHC-2 Mk.1 Beaver floatplane (registration C-FGBF, serial number 168) departed Edgar Lake, Ontario, with 2 passengers and 300 pounds of cargo on board. The aircraft was destined for the company’s main base located on Lillabelle Lake, Ontario, approximately 77 miles to the south. On arrival, a southwest-bound landing was attempted across the narrow width of the lake, as the winds favoured this direction. The pilot was unable to land the aircraft in the distance available and executed a go-around. At 1408, Eastern Daylight Time, shortly after full power application, the aircraft rolled quickly to the left and struck the water in a partially inverted attitude. The aircraft came to rest on the muddy lake bottom, partially suspended by the undamaged floats. The passenger in the front seat was able to exit the aircraft and was subsequently rescued. The pilot and rear-seat passenger were not able to exit and drowned. The emergency locator transmitter activated on impact.
Probable cause:
Findings as to Causes and Contributing Factors:
1. On the windward side of the landing surface, there was significant mechanical turbulence and associated wind shear caused by the passage of strong gusty winds over surface obstructions.
2. During the attempted overshoot, the rapid application of full power caused the aircraft to yaw to the left, and a left roll quickly developed. This movement, in combination with a high angle of attack and low airspeed, likely caused the aircraft to stall. The altitude available to regain control before striking the water was insufficient.
3. The pilot survived the impact, but was unable to exit the aircraft, possibly due to difficulties finding or opening an exit. The pilot subsequently drowned.
4. The rear-seat passenger did not have a shoulder harness and was critically injured. The passenger’s head struck the pilot’s seat in front; this passenger did not exit the aircraft and drowned.
Findings as to Risk:
1. Without a full passenger safety briefing, there is increased risk that passengers may not use the available safety equipment or be able to perform necessary emergency functions in a timely manner to avoid injury or death.
2. Not wearing a shoulder harness can increase the risk of injury or death in an accident.
3. Not having a stall warning system increases the risk that the pilot may not be aware of an impending aerodynamic stall.
4. Commercial seaplane pilots who do not receive underwater egress training are at increased risk of being unable to exit the aircraft following a survivable impact with water.
Final Report:

Crash of a De Havilland DHC-2 Beaver near Niblack

Date & Time: Mar 13, 2012 at 1040 LT
Type of aircraft:
Operator:
Registration:
N82SF
Flight Phase:
Survivors:
Yes
Schedule:
Niblack - Ketchikan
MSN:
839
YOM:
1955
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
23000
Captain / Total hours on type:
12000.00
Aircraft flight hours:
17574
Circumstances:
The pilot departed from an off-airport site in marginal visual flight rules conditions. Shortly after departure, the weather worsened, and flight visibility dropped to near zero in heavy snow. He attempted to follow the shoreline at a low altitude but was unable to maintain visual contact with the ground. He stated that he saw trees immediately in front of the airplane and attempted a right turn toward what he thought was an open bay. During the turn, the right float contacted a rock outcrop, and the airplane impacted the water. The pilot did not report any mechanical anomalies that would have precluded normal operation.
Probable cause:
The pilot's decision to depart in marginal visual meteorological conditions, and his continued visual flight into instrument meteorological conditions.
Final Report:

Crash of a Beechcraft A100 King Air in Deadmans Cay

Date & Time: Mar 9, 2012 at 1410 LT
Type of aircraft:
Operator:
Registration:
N70JL
Survivors:
Yes
Schedule:
Nassau - Deadmans Cay
MSN:
B-87
YOM:
1971
Country:
Crew on board:
0
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The twin engine aircraft was operating a taxi flight from Nassau-Lynden Pindling Airport to Deadmans Cay, and departed Nassau around 1 pm. On approach to Deadmans Cay, the crew encountered technical problems and was unable to lower the gear. The captain decided to perform a belly landing. The aircraft skidded on runway for several yards then veered off runway before coming to rest. There was no fire. While all occupants escaped uninjured, the aircraft was damaged beyond repair.

Crash of a Rockwell Shrike Commander 500S in Plan de La Laguna: 2 killed

Date & Time: Mar 8, 2012 at 1125 LT
Operator:
Registration:
TG-JAB
Flight Phase:
Survivors:
No
Schedule:
San Pedro Sula - Tegucigalpa
MSN:
500-3303
YOM:
1977
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
For unknown reasons, the twin engine aircraft was flying low when it impacted tree tops and crashed in a wooded area located in Plan de La Laguna, in the Comayagua National Park. Both occupants were killed.

Crash of a Piper PA-31-325 Navajo C/R near Quellón: 8 killed

Date & Time: Mar 1, 2012 at 1215 LT
Type of aircraft:
Operator:
Registration:
CC-CYM
Flight Phase:
Survivors:
No
Site:
Schedule:
Melinka – Quellón
MSN:
31-8012016
YOM:
1980
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
7
Pax fatalities:
Other fatalities:
Total fatalities:
8
Captain / Total flying hours:
10508
Aircraft flight hours:
3406
Circumstances:
The twin engine aircraft departed Melinka Airport at 1200LT on a taxi flight to Quellón, carrying seven passengers and one pilot. Eight minutes later, the pilot reported his position at 6,500 feet some 20 NM south of the destination. Six minutes later, at 1214LT, he reported at 3,000 feet some 10 NM southwest of Quellón. Shortly later, radar and radio contacts were lost after the airplane impacted the slope of a mountain located in the Piedra Blanca Mountain Range. The wreckage was found 15 km southwest of Quellón. The aircraft was destroyed by impact forces and all eight occupants were killed. At the time of the accident, weather conditions were poor with rain, fog and strong winds.
Probable cause:
Controlled flight into terrain following the decision of the pilot to continue the flight under VFR mode in IMC conditions.
The following contributing factors were identified:
- Cloudy conditions affecting the area where the accident occurred,
- Entering IMC conditions without clearance,
- Not maintaining the flight under VFR.
Final Report:

Crash of a McDonnell Douglas MD-83 in Kandahar

Date & Time: Jan 24, 2012 at 0828 LT
Type of aircraft:
Operator:
Registration:
EC-JJS
Survivors:
Yes
Schedule:
Dubai - Kandahar
MSN:
49793/1656
YOM:
1989
Flight number:
SWT094
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
86
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
4946
Captain / Total hours on type:
3228.00
Copilot / Total flying hours:
2881
Copilot / Total hours on type:
2222
Circumstances:
On Tuesday, 24 January 2012, a McDonnell Douglas MD-83, registration EC-JJS and operated by Swiftair, took off from the Dubai Airport (United Arab Emirates) at 02:08 UTC on a scheduled flight to the Kandahar Airport (Afghanistan). Its callsign was SWT094 and there were 86 passengers (one of them a company mechanic), three flight attendants and two cockpit crew onboard. Swiftair, S.A. was operating this regularly scheduled passenger flight under an ACMI arrangement with the South African company Gryphon Airlines. The crew was picked up at its usual hotel in the emirate of Ras al-Khaimah (United Arab Emirates) at 21:00. The airplane was parked in the Ras al-Khaimah airport and had to be flown empty to the Dubai Airport. This flight departed at 00:20 UTC en route to Dubai. Once there, an agent for Gryphon Airlines gave the crew the documentation for the flight to Kandahar. They went through customs at the Dubai Airport, boarded the passengers and the cargo and refueled the airplane with enough fuel to make the return the flight, a typical practice so as to avoid refueling in Kandahar. The airplane took off from runway 30R at the Dubai Airport at 02:08 on standard instrument departure RIKET2D and climbed to flight level FL290. The first officer was the pilot flying. At 03:42, while over SERKA, they were transferred to Kabul control, which instructed them to descend to FL280. The crew reported its ISAF callsign (ISF39RT) to this ATS station, which allowed the aircraft to fly over Afghan airspace, and entered the new stipulated squawk code. Kabul Control instructed the crew to follow some radar vectors that took them to point SODAS, where they were transferred to Kandahar Control at 03:46. The crew reduced the airspeed to 250 kt above this point. Kandahar Control cleared them for an RNAV (GPS) approach to runway 05, providing a direct vector to point FALOD (the IAF), and to descend to 6,000 ft. The weather information provided on the ATIS “F” broadcast was runway in use 05, wind from 060º at 17 kt gusting to 24 kt, visibility 1,200 m, scattered clouds at 2,700 ft and broken clouds at 3,000 ft, temperature 1 ºC, dewpoint -7 ºC and QNH 30.06 in Hg (1,018 mbar). This information was practically the same as that radioed to the crew by the Kandahar control tower a few minutes before landing: wind from 060 at 15 kt gusting to 21 kt. They reached point FALOD (IAF) under cloud cover (and thus in IMC conditions). They did not exit the clouds until 1,500 ft before minimums which, for this approach, according to the associated chart, was an altitude of 3,700 ft, or 394 ft AGL. They established visual contact with the runway 500 ft above minimums and noted that they were a little right of the runway centerline. Since the captain had more operational experience at the destination airfield, he decided to take over the controls and fly the last phase of the approach maneuver. The PAPI was out of service, meaning that in final approach they only had visual references to the runway and over the ground. During short final they corrected the deviation from the runway centerline by adjusting their path from right to left. They landed at 03:58. During the flare, the crew noticed the airplane was shifting to the left, threatening to take them off the runway, as a result of which the captain applied a right roll angle. This caused the right wing tip to strike the ground before the wheels made contact with the ground. The captain regarded the maneuver as a hard landing, although the first officer thought they might have struck the runway. The autopilot was engaged until visual contact was established with the runway and the auto-throttle until the landing. On exiting the runway, the airport control tower personnel (who had witnessed the contact with the ground) ordered the crew to stop and informed them of the damage they had seen during the landing. They dispatched the emergency services (firefighters), which forced them to turn off their engines. Once it was confirmed that there was no fuel leak or damage to the wheels or brakes, they allowed the crew to restart the engines and proceed to the stand. The wing made contact with the ground some 20 m prior to the threshold, resulting in five threshold lights being destroyed by the aircraft and in damage to the aircraft’s right wing. According to the crew’s statement, the passengers were not really aware of the contact between the wing and the ground and they were subsequently disembarked normally.
Probable cause:
The accident was likely caused by the failure to observe the company's operating procedures and not executing a go-around when the approach was clearly not stabilized. Moreover, the operator lacked the authorization (and the crew the training) to carry out the RNAV (GPS) approach maneuver that was conducted at RWY 05 of the Kandahar Airport.
Contributing to the accident was:
The inoperable status of the PAPI at runway 05 of the Kandahar Airport, which was thus unable to aid the crew to establish the aircraft on the correct descent slope.
Final Report:

Crash of a Piper PA-31-350 Navajo Chieftain in North Spirit Lake: 4 killed

Date & Time: Jan 10, 2012 at 0957 LT
Operator:
Registration:
C-GOSU
Survivors:
Yes
Schedule:
Winnipeg - North Spirit Lake
MSN:
31-7752148
YOM:
1977
Flight number:
KEE213
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
4
Captain / Total flying hours:
2400
Captain / Total hours on type:
95.00
Circumstances:
The Piper PA31-350 Navajo Chieftain (registration C-GOSU, serial number 31-7752148), operating as Keystone Air Service Limited Flight 213, departed Winnipeg/James Armstrong Richardson International Airport, Manitoba, enroute to North Spirit Lake, Ontario, with 1 pilot and 4 passengers on board. At 0957 Central Standard Time, on approach to Runway 13 at North Spirit Lake, the aircraft struck the frozen lake surface 1.1 nautical miles from the threshold of Runway 13. The pilot and 3 passengers sustained fatal injuries. One passenger sustained serious injuries. The aircraft was destroyed by impact forces and a post-impact fire. After a short period of operation, the emergency locator transmitter stopped transmitting when the antenna wire was consumed by the fire.
Probable cause:
Findings as to causes and contributing factors:
1. The pilot's decision to conduct an approach to an aerodrome not serviced by an instrument flight rules approach in adverse weather conditions was likely the result of the pilot's inexperience, and may have been influenced by the pilot's desire to successfully complete the flight.
2. The pilot's decision to descend into cloud and continue in icing conditions was likely the result of inadequate awareness of the Piper PA31-350 aircraft's performance in icing conditions and of its de-icing capabilities.
3. While waiting for the runway to be cleared of snow, the aircraft held near North Spirit Lake (CKQ3) in icing conditions. The resulting ice accumulation on the aircraft's critical surfaces would have led to an increase in the aircraft's aerodynamic drag and stall speed, causing the aircraft to stall during final approach at an altitude from which recovery was not possible.
Findings as to risk:
1. Terminology contained in aircraft flight manuals and regulatory material regarding “known icing conditions,” “light to moderate icing conditions,” “flight in,” and “flight into” is inconsistent, and this inconsistency increases the risk of confusion as to the aircraft’s certification and capability in icing conditions.
2. If confusion and uncertainty exist as to the aircraft’s certification and capability in icing conditions, then there is increased risk that flights will dispatch into icing conditions that exceed the capability of the aircraft.
3. The lack of procedures and tools to assist pilots in the decision to self-dispatch leaves them at increased risk of dispatching into conditions beyond the capability of the aircraft.
4. When management involvement in the dispatch process results in pilots feeling pressure to complete flights in challenging conditions, there is increased risk that pilots may attempt flights beyond their competence.
5. Under current regulations, Canadian Aviation Regulations (CARs) 703 and 704 operators are not required to provide training in crew resource management / pilot decision-making or threat- and error-management. A breakdown in crew resource management / pilot decision-making may result in an increased risk when pilots are faced with adverse weather conditions.
6. Descending below the area minimum altitude while in instrument meteorological conditions without a published approach procedure increases the risk of collision with terrain.
7. If onboard flight recorders are not available to an investigation, this unavailability may preclude the identification and communication of safety deficiencies to advance transportation safety.
Final Report:

Crash of a PAC 750XL in Abmisibil: 2 killed

Date & Time: Dec 17, 2011 at 0740 LT
Operator:
Registration:
PK-RCD
Survivors:
Yes
Schedule:
Jayapura - Abmisibil
MSN:
149
YOM:
2009
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
After landing on a wet runway at Abmisibil Airport, the single engine aircraft went out of control, veered off runway and came to rest in a ravine, bursting into flames. The pilot was killed and a passenger died few hours later. All three other occupants were seriously injured and the aircraft was destroyed by impact forces and a post crash fire.