Crash of a Tupolev TU-154M in Burdakovka: 145 killed

Date & Time: Jul 4, 2001 at 0208 LT
Type of aircraft:
Operator:
Registration:
RA-85845
Survivors:
No
Schedule:
Yekaterinburg – Irkutsk – Vladivostok
MSN:
86A735
YOM:
1986
Flight number:
XF352
Country:
Region:
Crew on board:
9
Crew fatalities:
Pax on board:
136
Pax fatalities:
Other fatalities:
Total fatalities:
145
Aircraft flight hours:
20953
Aircraft flight cycles:
11387
Circumstances:
The airplane departed Yekaterinburg Airport on a regular schedule flight (XF352) to Vladivostok with an intermediate stop at Irkutsk. The flight departed Yekaterinburg at 1947LT and climbed to the assigned cruising altitude of 10,100 metres. Some three hours into the flight, at 0150LT, the crew started the descent to Irkutsk Intl Airport. The copilot was the pilot-in-command. At 0205LT, the crew reported at 2,100 metres with the runway in sight. At this time, the aircraft' speed was 540 km/h. The maximum speed at which the landing gear may be lowered was 400 km/h. At 0206:56 the airplane leveled off at 900 metres with an airspeed still at 420 km/h. The first officer asked for gear down and the speed further decreased to 395 km/h with engines at idle. When the gear was down and locked, the airplane entered a left bank angle of 20-23°. The airspeed continued to drop to 365 km/h while the recommended speed was 370 km/h at this stage of the flight. Power was added slowly. This was only just sufficient for maintaining an altitude of 850 metres at 355-360 km/h. At 0207:46, while still in the left hand turn, the angle of attack increased to 16,5° because the autopilot attempted to maintain altitude with a decreasing speed. An aural warning sounded, informing the crew about a high angle of attack. The first officer attempted to correct this by using the control column and disconnected the autopilot. Because he deflected the control column to the left, the left bank increased to the maximum permissible value of -30° to -44°, and then to -48°. In a nose down attitude, the speed increased to 400 km/h then the aircraft entered clouds. By night, the crew lost visual contact with the ground and was not able to observe the natural horizon. In such conditions, the captain took over controls but alternately deflected the steering wheel to the left and right. An intensive deflection of steering control to the right caused a positive angular acceleration of +4,4° per second. The captain reacted by deflecting the steering wheel to the left again. The first officer now realized that the airplane was in a severe left bank of -45° and indicated that they should be rolling to the right. Because of an increase in vertical descent rate of 20 metres per seconds, one of the crew members pulled the control column. The airplane pitched up rapidly then entered a stall and a subsequent flat spin before crashing in an open field 22 seconds later. The aircraft was totally destroyed by impact forces and a post crash fire and all 145 occupants were killed.
Probable cause:
The accident was the consequence of a wrong approach configuration on part of the flying crew. The following contributing factors were identified:
- Poor control actions on part of the crew, which caused the aircraft to enter a super critical angle of attack followed by a stall and a spin,
- Violation of interactions by the crew regarding the separation of responsibilities for piloting established by the pilot-in-command,
- Lack of proper control to maintain flight parameters during the approach, in reference to the TU-154 flight operations manual,
- Poor crew interactions.

Crash of an ATR42-320 in Tel Aviv

Date & Time: Jun 18, 2001
Type of aircraft:
Operator:
Registration:
4X-ATK
Survivors:
Yes
MSN:
073
YOM:
1987
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
39
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On approach to Tel Aviv-Ben Gurion Intl Airport, the right main gear remained stuck in its wheel well. The crew informed ATC about the situation and continued the approach. After touchdown, the aircraft slid for few dozen metres then veered off runway to the right and came to rest. All 42 occupants escaped uninjured while the aircraft was damaged beyond repair.

Crash of a Transall C-160NG in Jayapura: 1 killed

Date & Time: Jun 16, 2001 at 1430 LT
Type of aircraft:
Operator:
Registration:
PK-VTP
Survivors:
Yes
Schedule:
Jayapura – Wamena
MSN:
F234
YOM:
1985
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
16
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
After takeoff from Jayapura-Sentani Airport, while climbing, the crew informed ATC about engine problems and was cleared for an immediate return. Following a 180 turn, the crew initiated an approach to runway 30. After touchdown, the crew started the braking procedure and reduced the engine power when a technical problem occurred on the right engine. The aircraft went out of control, veered off runway to the left, collided with a drainage ditch and came to rest against palm trees located 72 metres to the left of the runway centerline and 1,050 metres from the runway threshold. 18 occupants were injured and a passenger was killed. The aircraft was written off.
Probable cause:
A technical failure occurred on the right engine whose rotation could not be reduced below 14,200 rpm after touchdown, for reasons unknown.

Crash of a De Havilland Dash-8-103 in Båtsfjord

Date & Time: Jun 14, 2001 at 1608 LT
Operator:
Registration:
LN-WIS
Survivors:
Yes
Schedule:
Alta – Båtsfjord
MSN:
247
YOM:
1990
Flight number:
WF954
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
24
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
21890
Captain / Total hours on type:
321.00
Copilot / Total flying hours:
3400
Copilot / Total hours on type:
1000
Aircraft flight hours:
23935
Aircraft flight cycles:
29469
Circumstances:
The twin engine aircraft departed Alta Airport at 1522LT on a regular schedule service to Båtsfjord, carrying 24 passengers and a crew of three. Following an uneventful flight, the crew started a LOC/DME approach to runway 21. Shortly after passing the missed approach point, the pilot-in-command lost visual contact with the runway so the captain took over controls and continued the approach. The airplane became unstable and the crew encountered control problems due to difficulties to disengage the autopilot system. This caused the aircraft to lose height during the last segment and it landed hard, causing the right main gear to collapse upon impact. The aircraft slid for few dozen metres then veered off runway to the right and came to rest in a grassy area 23 metres to the right of the runway. All 27 occupants evacuated safely while the aircraft was damaged beyond repair.
Probable cause:
The following factors were identified:
- The crew deviated from the prescribed procedure,
- The crew deviated from the company Standard Operating Procedure,
- The crew failed to comply with CRM requirements as described in the company Flight Operations Manual,
- The crew continued the approach after passing the minimum altitude without adequate visual reference with the runway,
- The crew did not consider 'go around' when passing Decision Point without adequate, visual references to the runway,
- The crew did not consider 'go around' during a landing with apparent flight control problems,
- The crew completed the landing despite the fact that the aircraft was not in a stabilised configuration,
- The non-stabilised landing with a high descent rate overloaded the right undercarriage fuse pin to a point at which it collapsed,
- The public address system did not function when used by the commander for evacuation.
Final Report:

Crash of a Fokker 100 in Dallas

Date & Time: May 23, 2001 at 1504 LT
Type of aircraft:
Operator:
Registration:
N1419D
Survivors:
Yes
Schedule:
Charlotte – Dallas
MSN:
11402
YOM:
1992
Flight number:
AA1107
Crew on board:
4
Crew fatalities:
Pax on board:
88
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
14000
Captain / Total hours on type:
3600.00
Copilot / Total flying hours:
6700
Copilot / Total hours on type:
302
Aircraft flight hours:
21589
Circumstances:
During landing touchdown, following a stabilized approach, the right main landing gear failed. The airplane remained controllable by the pilots and came to a stop on the runway, resting on its right wing. The DFW Fire Department arrived at the accident site in 35 seconds and, following communication between the airplane's Captain and Fire Department's Incident Commander, it was decided that an emergency evacuation of the airplane was not necessary. Examination revealed that the right main gear's outer cylinder had fractured allowing the lower portion of the gear (including the wheel assembly) to separate from the airplane. Research, examination & testing of the cylinder revealed that a forging fold was introduced into the material during the first stage of its forging process. The first stage is a hand operation, therefore the quality is highly dependent on the person performing the hand operation. Following the first landing, the forging fold became a surface breaking crack, due to the normal loads imposed during landing. Although growth of the fatigue crack was suppressed by crack blunting, high load landings resulted in growth of the fatigue crack. Subsequently, the landing gear failed when the crack had reached a critical length. Additionally, the airplane's maintenance records were reviewed and no anomalies were found.
Probable cause:
A forging fold that was introduced during the manufacture of the right main landing, which resulted in a fatigue crack in the right main landing gear cylinder, and its subsequent failure during landing.
Final Report:

Crash of a Boeing 737-210C in Yellowknife

Date & Time: May 22, 2001 at 1325 LT
Type of aircraft:
Operator:
Registration:
C-GNWI
Survivors:
Yes
Schedule:
Edmonton – Yellowknife
MSN:
21066
YOM:
1975
Flight number:
7F953
Country:
Crew on board:
6
Crew fatalities:
Pax on board:
98
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
16400
Captain / Total hours on type:
7000.00
Copilot / Total flying hours:
9500
Copilot / Total hours on type:
840
Circumstances:
First Air Flight 953, a Boeing 737-210C, serial number 21066, was on a scheduled flight from Edmonton, Alberta, to Yellowknife, Northwest Territories. On board were 2 flight crew, 4 cabin crew, and 98 passengers. The flight departed Edmonton at 1130 mountain daylight time, with an estimated time en route of 1 hour 35 minutes. As the aircraft approached Yellowknife, the spoilers were armed, and the aircraft was configured for a visual approach and landing on Runway 33. The computed Vref was 128 knots, and target speed was 133 knots. While in the landing flare, the aircraft entered a higher-than-normal sink rate, and the pilot flying (the first officer) corrected with engine power and nose-up pitch. The aircraft touched down on the main landing gear and bounced twice. While the aircraft was in the air, the captain took control and lowered the nose to minimize the bounce. The aircraft landed on its nose landing-gear, then on the main gear. The aircraft initially touched down about 1300 feet from the approach end of Runway 33. Numerous aircraft rubber scrub marks were present in this area and did not allow for an accurate measurement. During the third touchdown on the nose landing-gear, the left nose-tire burst, leaving a shimmy-like mark on the runway. The aircraft was taxied to the ramp and shut down. The aircraft was substantially damaged. There were no reported injuries to the crew or the passengers. The accident occurred at 1325, during the hours of daylight.
Probable cause:
Findings as to Causes and Contributing Factors:
1. Incorrect bounced landing recovery procedures were carried out when the captain pushed forward on the control column to prevent a further bounce, and the aircraft landed nosewheel first.
2. The high sink rate on the initial flare was not recognized and corrected in time to prevent a bounced landing and a subsequent bounced landing.
Other Findings:
1. The power increase during the flair resulted in the speedbrake/spoilers retracting.
2. The captain had not received a line check of at least three sectors before returning to flight duties, although this check was required to regain competency after pilot proficiency check expiry.
Final Report:

Crash of a De Havilland DHC-6 Twin Otter 300 in Saint-Barthélémy: 20 killed

Date & Time: Mar 24, 2001 at 1628 LT
Operator:
Registration:
F-OGES
Survivors:
No
Schedule:
Sint Maarten - Saint-Barthélemy
MSN:
254
YOM:
1969
Flight number:
TX1501
Crew on board:
2
Crew fatalities:
Pax on board:
17
Pax fatalities:
Other fatalities:
Total fatalities:
20
Captain / Total flying hours:
9864
Captain / Total hours on type:
5000.00
Copilot / Total flying hours:
670
Copilot / Total hours on type:
15
Aircraft flight hours:
35680
Aircraft flight cycles:
89331
Circumstances:
The aircraft departed Saint Maarten Airport on a flight to Saint-Barthélemy Airport under callsign TX1501, carrying 17 passengers and two pilots. The captain was pilot flying and the cruise level was 1,500 feet. The crew left the Sint Maarten Juliana aerodrome frequency when abeam of the island of Fourchue, the entry point of the aerodrome circuit located three nautical miles northwest of the island of Saint-Barthélemy. A few seconds later, they announced, on the Saint-Barthélemy Information frequency, that they were passing the 'Fourchue' reporting point. Shortly afterwards, they announced passing the 'Pain de Sucre' reporting point for a final approach to runway 10. That was their last communication. When the aircraft began its short final before the La Tourmente pass, several people, including the AFIS agent, saw it turn left which a steep bank angle then dive towards the ground. It crashed near a house and caught fire. All of the occupants perished, along with one person who was in the house.
Probable cause:
The accident appears to result from the Captain's use of the propellers in the reverse beta range, to improve control of his track on short final. A strong thrust asymmetry at the moment when coming out of the reverse beta range would have caused the loss of yaw control, then roll control of the aircraft. The investigation could not exclude three other hypotheses which can nevertheless be classified as quite unlikely:
- A loss of control during a go-around,
- A loss of control due to a stall,
- A loss of control due to sudden incapacitation of one of the pilots,
The Captain's lack of recent experience on this airplane type, the undeniable difficulty of conducting an approach to runway 10 at Saint-Barthélemy and the pressure of time during this flight were contributory factors. The low height at which the loss of control occurred was an aggravating factor.
Final Report:

Crash of a Beechcraft 1900C-1 in Lubango: 16 killed

Date & Time: Mar 17, 2001 at 0823 LT
Type of aircraft:
Operator:
Registration:
S9-CAE
Survivors:
Yes
Site:
Schedule:
Luanda – Lubango
MSN:
UC-142
YOM:
1991
Location:
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
15
Pax fatalities:
Other fatalities:
Total fatalities:
16
Circumstances:
While descending to Lubango Airport following an uneventful flight from Luanda, the crew encountered poor weather conditions with heavy rain falls and low ceiling. In such conditions, the aircraft struck the slope of a mountain located 16 km northwest of runway 10 threshold. One passenger survived while 16 other occupants were killed.
Probable cause:
A possible loss of control after the pilot-in-command suffered a spatial disorientation while descending in IMC conditions.

Ground explosion of a Boeing 737-4D7 in Bangkok: 1 killed

Date & Time: Mar 3, 2001 at 1448 LT
Type of aircraft:
Operator:
Registration:
HS-TDC
Flight Phase:
Survivors:
Yes
Schedule:
Bangkok – Chiang Mai
MSN:
25321
YOM:
1991
Flight number:
TG114
Country:
Region:
Crew on board:
8
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
While parked at gate 62 at Bangkok-Don Mueang Airport, the aircraft suffered an explosion and caught fire. On board were eight crew members awaiting 148 passengers to embark, among them Thaksin Shinawatra, Thai Prime Minister. Seven crew members were able to evacuate the cabin while the eighth crew member died. The aircraft was completely destroyed by fire. It was reported that the first explosion occurred in the center fuel tank, about 27 minutes prior to the expected takeoff time, followed by a second explosion in the right wing tank 18 minutes later.
Probable cause:
An explosion of the center wing tank resulting from ignition of the flammable fuel/air mixture in the tank. The source of the ignition energy for the explosion could not be determined with certainty, but the most likely source was an explosion originating at the center wing tank pump as a result of running the pump in the presence of metal shavings and a fuel/air mixture.

Crash of a GAF Nomad N.24A in Jacobkondre: 10 killed

Date & Time: Feb 10, 2001
Type of aircraft:
Operator:
Registration:
PZ-TBP
Survivors:
No
Schedule:
Paramaribo – Jacobkondre
MSN:
73
YOM:
1978
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
10
Circumstances:
On approach to Jacobkondre Airfield, the twin engine aircraft was too low. It collided with trees and crashed near the Salamacca River. The wreckage was found on a hill located about 3 km from the airfield. All 10 occupants were killed.