Landing (descent or approach)

Flight Type:

Scheduled Revenue Flight

Survivors:

Site:

Makkah l-Mukarramah (مكة المكرمة)

Schedule:

Madinah - Dhaka

MSN:

437

YOM:

2001

Flight number:

SV3818

Location:

Jeddah-King Abdulaziz

Country:

Saudi Arabia

Region:

Asia

Crew on board:

Crew fatalities:

Pax on board:

142

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

The aircraft departed Madinah-Mohammad Bin Abdulazziz Airport at 1724LT on a schedule service to Dhaka with 142 passengers and 10 crew members on board. At 1746LT, while cruising at FL370, the crew informed ATC about a malfunction of the green hydraulic system followed by a 'green hydraulic system reservoir low level' warning. The crew decided to return to Madinah but this was not possible due to deteriorating weather conditions, so it was decided to divert to Jeddah-King Abdulazziz Airport. Several attempts to lower the nose gear were unsuccessful and only both main landing gear seemed to be down. After a circuit to burn fuel, the crew was cleared to descent and expected to make a low pass over runway 16C but neither the control tower nor ground staff were able to confirm the nose gear extension. Eventually, the crew was cleared to land on runway 34R with the nose gear retracted. The aircraft landed 700 metres past the runway threshold and the nose landed 1,350 metres further, causing both engine nacelles to hit the runway surface. The airplane slid for few hundred metres and came to rest 700 metres from the runway end. All 152 occupants evacuated safely and the aircraft was damaged beyond repair.

Crash of a Gulfstream G200 in Yangzhou

Date & Time: May 20, 2018 at 1507 LT

Type of aircraft:

Gulfstream G200

Operator:

Registration:

B-8129

Flight Phase:

Flight Type:

Training

Survivors:

Site:

Cessna 208B Grand Caravan

Schedule:

Yangzhou - Yangzhou

MSN:

134

YOM:

2006

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

16075

Captain / Total hours on type:

1181.00

Copilot / Total flying hours:

538

Copilot / Total hours on type:

246

Aircraft flight hours:

2235

Aircraft flight cycles:

1114

Circumstances:

The aircraft departed Yanzhou-Taizhou Airport runway 35 at 1359LT on a local training flight, carrying two pilots under supervision and one instructor. The crew completed six landings without any incidents. and then changed seats, the instructor seating in the left front seat and the pilot under training in the right front seat. On final approach to runway 35, at a height of about 50 feet, the aircraft followed a steep descent and landed 500 metres past the runway threshold to the right of the runway centerline with a 4,5° deviation to the right. The copilot elected to correct this when the aircraft veered to the left, exited the runway then deviated to the right and came back on the runway. Then it veered off runway to the right, lost its both main gears and came to rest in a grassy area. All thre crew members evacuated safely and the aircraft was damaged beyond repair.

Probable cause:

The accident was the consequence of a series of errors on part of the crew. The following findings were identified:
- The rate of descent on short final was escessive (sink rate),
- The aircraft landed to the right of the runway centerline with a 4,5° deviation to the right,
- The copilot actions were excessives and the aircraft veered to the left,
- The instructor did not intervene in due time to expect recovery.

Final Report:

Crash of a Cessna 208B Grand Caravan in Clonbullogue: 2 killed

Date & Time: May 13, 2018 at 1438 LT

Type of aircraft:

Operator:

Registration:

G-KNYS

Flight Phase:

Flight Type:

Skydiving / Paratroopers

Survivors:

Site:

Schedule:

Clonbullogue - Clonbullogue

MSN:

208B-1146

YOM:

2005

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

2157

Aircraft flight hours:

4670

Aircraft flight cycles:

6379

Circumstances:

The Cessna 208B aircraft took off from Runway 27 at Clonbullogue Airfield (EICL), Co. Offaly at approximately 13.14 hrs. On board were the Pilot and a Passenger (a child), who were seated in the cockpit, and 16 skydivers, who occupied the main cabin. The skydivers jumped from the aircraft, as planned, when the aircraft was overhead EICL at an altitude of approximately 13,000 feet. When the aircraft was returning to the airfield, the Pilot advised by radio that he was on ‘left base’ (the flight leg which precedes the approach leg and which is normally approximately perpendicular to the extended centreline of the runway). No further radio transmissions were received. A short while later, it was established that the aircraft had impacted nose-down into a forested peat bog at Ballaghassan, Co. Offaly, approximately 2.5 nautical miles (4.6 kilometres) to the north-west of EICL. The aircraft was destroyed. There was no fire. The Pilot and Passenger were fatally injured.

Probable cause:

Impact with terrain following a loss of control in a steeply banked left-hand turn. The following contributing factors were reported:
- The steeply banked nature of the turn being performed,
- Propeller torque reaction following a rapid and large increase in engine torque,
- The aircraft’s speed while manoeuvring during the steeply banked turn,
- Insufficient height above ground to effect a successful recovery.

Final Report:

Crash of an Embraer KC-390 in Gavião Peixoto

Date & Time: May 5, 2018 at 1110 LT

Type of aircraft:

Embraer KC-390

Operator:

Registration:

PT-ZNF

Flight Phase:

Flight Type:

Test

Survivors:

Site:

Gavião Peixoto-Embraer Unidade

Schedule:

Gavião Peixoto - Gavião Peixoto

MSN:

390-00001

YOM:

2015

Location:

São Paulo

Country:

Brazil

Region:

South America

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

The crew was completing a local test flight at Gavião Peixoto-Embraer Unidade Airport on this first prototype built in 2015 and flying under the Brazilian Air Force colour scheme. Following several circuits, the crew landed on runway 20. After touchdown, the airplane was unable to stop within the remaining distance and overran. While contacting soft ground, it lost its undercarriage and came to rest few dozen metres further. All three crew members escaped uninjured while the aircraft was considered as damaged beyond repair.

Probable cause:

Despite the fact that the aircraft sustained significant damage, CENIPA classified the event as an 'Incident' and on August 5, 2018, reported that closed the investigation with no final report being issued.

Crash of a Beechcraft C99 Airliner in Ibagué: 4 killed

Date & Time: May 2, 2018 at 1830 LT

Type of aircraft:

Beechcraft 99 Airliner

Operator:

Registration:

PNC-0203

Flight Phase:

Flight Type:

Training

Survivors:

Site:

Schedule:

Bogotá – Ibagué – Mariquita

MSN:

U-199

YOM:

1983

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

The crew departed Bogotá on a training flight to Mariquita with an intermediate stop at Ibagué-Perales Airport. While on approach by night, the twin engine aircraft went out of control and crashed in a field located few km from the airport, bursting into flames. The aircraft was totally destroyed by a post crash fire and all four crew members were killed.
Crew:
Maj Andrés Valbuena Cadena,
Lt Carlos Andrés León Caicedo,
Lt Juan Alcides Sosa Triana,
Sub John Wílfer Parra Solano.

Crash of a Pilatus PC-12/47E in Ubatuba

Date & Time: May 1, 2018 at 1743 LT

Type of aircraft:

Pilatus PC-12

Operator:

Registration:

PR-WBV

Flight Phase:

Flight Type:

Private

Survivors:

Site:

Schedule:

Angra dos Reis – Campo de Marte

MSN:

1129

YOM:

2009

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

4500

Captain / Total hours on type:

126.00

Copilot / Total flying hours:

3200

Copilot / Total hours on type:

120

Aircraft flight hours:

1361

Circumstances:

At the beginning of the descent to Campo de Marte Airport while on a flight from Angra dos Reis, the crew reported engine problems and diverted to Ubatuba Airport. After touchdown on runway 09 which is 940 metres long, a maneuver was performed aiming at exchanging speed for altitude, causing the airplane to veer off runway and to crash in a swampy area located in the left hand side of the overshoot area. The airplane struck several trees, lost its both wings and empennage and was destroyed. Both crew members and two passengers were injured while six other passengers escaped unhurt.

Probable cause:

At the beginning of the descent to Campo de Marte Airport, a failure occurred in the aircraft's propeller pitch control system, which tended to feather the engine.
The following findings were identified:
a) the pilots held valid Aeronautical Medical Certificates (CMA);
b) the PIC held valid Single-Engine Land Airplane (MNTE) and Airplane IFR Flight (IFRA) ratings;
c) the SIC held valid Single-Engine Land-Airplane (MNTE) and Multi-Engine LandAirplane (MLTE) ratings;
d) the pilots had qualification and experience in the type of flight;
e) the aircraft had a valid Airworthiness Certificate (CA);
f) the aircraft was within the prescribed weight and balance limits;
g) the records of the airframe, engine, and propeller logbooks were up to date;
h) the meteorological conditions were compatible with the conduction of the flight;
i) on 02Oct2017, a modification was made in the approved type-aircraft project;
j) on 06Mar2018, the engine of the aircraft was replaced with a rental engine, on account of damage caused by FOD;
k) the aircraft returned to the maintenance organization responsible for the engine replacement, due to recurrent episodes of Engine NP Warning Light illumination;
l) the maintenance organization inspected the powerplant, washed the compressor, and performed a pre-flight, after which the aircraft returned to operation;
m) the aircraft took off from SDAG, bound for SBMT;
n) between engine start-up and takeoff from SDAG, there were two drops of the propeller rotation (NP) to values below 950 RPM;
o) after taking off from SDAG, the aircraft climbed to, and maintained, FL145;
p) moments after the aircraft started descent, and upon reduction of the PCL, the propeller rotation began to drop quickly and continuously;
q) the adoption of the procedures prescribed for the situation “ENGINE NP - In flight, If propeller is below 1640” had no effect;
r) the NP dropped to a minimum value of 266 RPM;
s) the crew decision was to land in SDUB;
t) after the touchdown, a maneuver was performed aiming at exchanging speed for altitude, and deviation of the aircraft to a swampy area located in the left-hand side of the overshoot area;
u) in the functional tests of the engine performed after the occurrence, one verified normal operating conditions and full response to control demands;
v) upon examination of the propeller, and measurement of the beta ring distance, one verified that the ring displacement was outside the limits specified by the manufacturer;
w) it was not possible to identify whether such discrepancy had resulted from a maintenance procedure or from the impact during the emergency landing;
x) analysis of the propeller-governor revealed that the internal components were in operating condition;
y) the aircraft sustained substantial damage, and
z) the PIC suffered serious injuries, the SIC and two of the passengers were slightly injured, while the other six passengers were not hurt.

Contributing factors:
- Training – undetermined.
Even though the PIC had undergone simulator training less than a year before the occurrence, his difficulty perceiving the characteristics of the emergency experienced in order to frame it in accordance with his simulated practice suggests deficiencies in the processes related to qualification and training. The SIC, in turn, was not required to undergo that type of training, since the occurrence airplane had a Class-aircraft classification bestowed by the regulatory agency. The training and qualification process available to him in face of the circumstances may have contributed
to his lack of ability to recognize and participate in the management of the failure with due proficiency, when one also considers the selection of procedures and his assisting role in relation to the speeds and configuration of the aircraft.

- Instruction – a contributor.
As for the SIC, considering the fact that the aircraft classification did not require simulator sessions or other types of specific training, it was possible to note that he was not sufficiently familiar with emergencies and abnormal situations, something that prevented him from giving a better contribution to the management of the situation.

- Piloting judgment – a contributor.
There was inadequate assessment of the flight parameters on the final approach, something that made the landing in SDUB unfeasible, when one considers the 940 meters of available runway.

- Aircraft maintenance – undetermined.
During the measurement of the distance of the beta ring performed in the analysis of the propeller components, one verified that the displacement of the ring was outside the limits specified by the manufacturer. It was not possible to identify whether such displacement was due to a maintenance action or the result of a ring-assembly event at the time of propeller replacement. However, such discrepancy may have resulted from the impact of the propeller blades during the emergency landing. Furthermore, the aircraft was subject to inspection of the failure related to the ENGINE
NP warning light illumination prior to the accident. Given the fact that such illumination was intermittent, and the investigation could not identify the reasons for the warning, the aircraft was released for return to flight without in-depth investigation as to the root cause and possible implications of a failure related to the inadvertent drop in RPM.

- Memory – undetermined.
Although the PIC had undergone training in a class D aircraft-simulator certified by the manufacturer, it was not possible to verify the necessary association between the trained procedures and his performance in joining the traffic pattern and landing with a powerless aircraft in emergency. Furthermore, since the PIC frequently landed in the location selected for the emergency landing attempt, it is likely that he sought to match such emergency approach with those normally performed, in which he could count both on the “aerodynamic brake” condition with the propeller at IDLE and on the use of the reverse.

- Perception – a contributor / undetermined.
There was not adequate recognition, organization and understanding of the stimuli related to the condition of propeller feathering, which led to a lowering of the crew’s situational awareness.
Such reduction of the situational awareness made it difficult to assess the conditions under which the emergency could be managed, as the crew settled on the idea of landing in SDUB, without observing the condition of the airfield, meteorology, distance necessary for landing without control the engine, best glide speed, approach, and aircraft configuration.

- Decision-making process – a contributor / undetermined.
Since the first decisions made for identification of the emergency condition, it was not possible to verify the existence of a well-structured decision-making process contemplating appropriate assessment of the scenario and available alternatives. Objective aspects related to the SDUB runway, such as runway length and obstacles, the actual condition of the aircraft at that time, or contingencies, were not considered.

- Support systems – a contributor.
The Aircraft Manual and the QRH did not clearly contemplate the possibility of propeller feathering in flight, making it difficult for the pilots to identify the abnormal condition, and making it impossible for them to adopt appropriate and sufficient procedures for the correct management of the emergency. Considering the possibility that the application of the “ENGINE NP - In Flight”
emergency procedure prescribed by the QRH would not achieve the desired effect, there were no further instructions as to the next actions to be taken, leaving to the crew a possible
interpretation and selection of another procedure of the same publication.

- Managerial oversight – undetermined.
As for the maintenance workshop responsible for the tasks of engine replacement, together with adjustment of the propeller and its components: in the inspection at the request of the pilots after an event of ENGINE NP warning light illumination, the maintenance staff released the aircraft for return to operation. The investigation committee raised the possibility that the supervision of the services performed, by allowing the release of the aircraft, was not sufficient to guarantee mitigation of the risks related to the aircraft operation with the possibility of an intermittent recurrence of the failure.

Final Report:

Crash of a Cessna 402B in Tanner-Hiller

Date & Time: Apr 26, 2018 at 1715 LT

Type of aircraft:

Cessna 402

Operator:

AC Research Inc.

Registration:

N87266

Flight Phase:

Flight Type:

Private

Survivors:

Site:

Schedule:

Keene - Tanner-Hiller

MSN:

402B-1097

YOM:

1976

Location:

Tanner-Hiller

Massachusetts

Country:

United States of America

Region:

North America

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

330

Aircraft flight hours:

9193

Circumstances:

The private pilot was conducting a local, personal flight. The pilot reported that he checked the weather conditions at three local airports before the flight but stated that he did not trust the wind reports. He added that he did not get a preflight weather briefing. Once at the destination airport, he conducted two go-arounds due to gusting wind conditions. During the third attempted landing, he made a steep approach at a normal approach speed and flared the airplane about midway down the 3,000-ft-long runway. The airplane floated down the runway for much longer than the pilot expected before touching down. Despite applying maximum braking, there was insufficient remaining runway to stop, and the airplane skidded off the runway, impacted trees, and subsequently caught fire, which resulted in substantial damage to the airframe. The wind conditions reported at an airport located about 13 miles away included a tailwind of 16 knots, gusting to 27 knots. Given the tailwind conditions reported at this airport and the pilot's description of the approach and landing, it is likely that the pilot conducted the approach to the runway in a tailwind that significantly increased the airplane's groundspeed, which resulted in a touchdown with insufficient runway remaining to stop the airplane, even with maximum braking.

Probable cause:

The pilot's improper decision to land with a tailwind, which resulted in a touchdown with insufficient runway remaining to stop the airplane.

Final Report:

Crash of a McDonnell Douglas MD-83 in Alexandria

Date & Time: Apr 20, 2018 at 1420 LT

Type of aircraft:

McDonnell Douglas MD-83

Operator:

Registration:

N807WA

Flight Phase:

Charter/Taxi (Non Scheduled Revenue Flight)

Flight Type:

Survivors:

Site:

Schedule:

Chicago - Alexandria

MSN:

53093/2066

YOM:

1993

Flight number:

WAL708

Location:

Alexandria

Louisiana

Country:

United States of America

Region:

North America

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

13335

Captain / Total hours on type:

6466.00

Copilot / Total flying hours:

4590

Copilot / Total hours on type:

2474

Aircraft flight hours:

43724

Circumstances:

The airplane suffered a right main landing gear collapse during landing at the destination airport. The airplane sustained substantial damage to the right lower wing skin when it contacted the runway after the landing gear collapse. The crew stopped the airplane on the runway and an emergency evacuation was performed through three of the four doors on the airplane. The escape slide at the left forward door did not deploy or inflate due to the depletion of the gas charge in the reservoir. The reservoir depleted due to a leak in the valve assembly and was not caught during multiple inspections since installation of the slide assembly in the airplane. The landing gear cylinder fractured under normal landing loads due to the presence of a fatigue crack on the forward side of the cylinder in an area subject to an AD inspection for cracks. The most recent AD inspection of the cylinder was performed 218 landings prior when the fatigue crack was large enough to be detectable. A previous AD inspection performed 497 landings prior to the accident also did not detect the crack that would have been marginally detectable at the time.

Probable cause:

The failure of the right main landing gear under normal loads due to fatigue cracking in an area subject to an FAA Airworthiness Directive that was not adequately inspected.

Final Report:

Crash of an Antonov AN-74-200 in Akola

Date & Time: Apr 14, 2018

Type of aircraft:

Antonov AN-74

Operator:

Registration:

EK-74036

Flight Phase:

Flight Type:

Humanitarian

Survivors:

Site: