Crash of a Socata TBM-700 in Gaithersburg

Date & Time: Mar 1, 2010 at 1715 LT
Type of aircraft:
Operator:
Registration:
N700ZR
Flight Type:
Survivors:
Yes
Schedule:
Chapel Hill - Gaithersburg
MSN:
87
YOM:
1993
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
4215
Captain / Total hours on type:
1240.00
Circumstances:
The pilot of the single-engine turboprop was on an instrument flight rules (IFR) flight and cancelled his IFR flight plan after being cleared for a visual approach to the destination airport. He flew a left traffic pattern for runway 32, a 4,202-foot-long, 75-foot-wide, asphalt runway. The pilot reported that the airplane crossed the runway threshold at 81 knots and touched down normally, with the stall warning horn sounding. The airplane subsequently drifted left and the pilot attempted to correct with right rudder input; however, the airplane continued to drift to the left side of the runway. The pilot then initiated a go-around and cognizant of risk of torque roll at low speeds did not apply full power. The airplane climbed to about 10 feet above the ground. At that time, the airplane was in a 20-degree left bank and the pilot applied full right aileron input to correct. The airplane then descended in a left turn, the pilot retarded the throttle, and braced for impact. A Federal Aviation Administration inspector reported that the airplane traveled about 100 feet off the left side of the runway, nosed down in mud, and came to rest in trees. Examination of the wreckage by the inspector did not reveal any preimpact mechanical malfunctions, nor did the pilot report any. The reported wind, about the time of the accident, was from 310 degrees at 10 knots, gusting to 15 knots.
Probable cause:
The pilot’s failure to maintain aircraft control while performing a go-around.
Final Report:

Crash of an Airbus A300B4-203F at Bagram AFB

Date & Time: Mar 1, 2010 at 1210 LT
Type of aircraft:
Operator:
Registration:
TC-ACB
Flight Type:
Survivors:
Yes
Schedule:
Bahrain - Bagram AFB
MSN:
121
YOM:
1980
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
12923
Captain / Total hours on type:
8000.00
Aircraft flight hours:
25300
Aircraft flight cycles:
46516
Circumstances:
While approaching Bagram AFB, the crew did not obtain the three green lights when the undercarriage were lowered. The left main gear signal appears to remain red. The captain obtained the authorization to make two low passes over the airport then ATC confirmed that all three gears were down. The final approach was completed at low speed and after touchdown, while braking, the left main gear collapsed. The aircraft veered off runway to the left and came to rest some 2 km past the runway threshold. All five crewmen were unhurt while the aircraft was damaged beyond repair.
Probable cause:
Cracks as result of fatigue caused the fracture of the hinge arm of the left main gear strut. The cracking most likely occurred as result of corrosion that remained undetected during the last maintenance inspection. The origin of pitting could not be identified, the investigation however identified deficiencies in the maintenance task conducted during last overhaul of the gear strut. Incomplete maintenance documentation and tools available during overhaul contributed to the accident.
Final Report:

Crash of a Boeing 737-247 in Mwanza

Date & Time: Mar 1, 2010 at 0745 LT
Type of aircraft:
Operator:
Registration:
5H-MVZ
Survivors:
Yes
Schedule:
Dar es-Salaam - Mwanza
MSN:
23602/1347
YOM:
1987
Flight number:
ACT100
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
76
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
After landing at Mwanza Airport, the crew encountered control problems. The aircraft deviated to the left then veered off runway. While contacting soft ground, the nose gear collapsed and the aircraft came to rest near a taxiway. All 80 occupants escaped uninjured while the aircraft was damaged beyond repair.

Crash of a Piper PA-46-350P Malibu Mirage in Saint Louis: 2 killed

Date & Time: Feb 21, 2010 at 1826 LT
Registration:
N350WF
Flight Type:
Survivors:
No
Schedule:
Vero Beach – Saint Louis
MSN:
46-22082
YOM:
1989
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
1750
Aircraft flight hours:
3209
Circumstances:
The airplane was on an instrument flight in night instrument meteorological conditions approaching the destination airport. The pilot contacted the approach control facility by radio and was subsequently cleared for an instrument landing system (ILS) approach to the destination airport. During the approach, the air traffic approach controller advised the pilot twice that the airplane was to the right of the approach course. The controller suggested a left turn of 5 to 7 degrees to the pilot. Once the airplane was back on the inbound course, the approach controller instructed the pilot to contact a tower controller. The pilot never contacted the tower controller, but later reestablished contact with the approach controller, who provided radar vectors for a second attempt at the ILS approach. During the second approach, the controller again advised the pilot that the airplane was to the right of the approach course and provided the pilot a low altitude alert. The airplane then started a climb and a turn back toward the inbound course. The controller advised the pilot that the airplane would intercept the inbound course at the locator outer marker (LOM) for the approach and asked if the pilot would like to abort the approach and try again. The pilot declined and responded that he would continue the approach. No further transmissions were received from the pilot. The airplane impacted a building about 0.4 nautical miles from the LOM. The building and airplane were almost completely consumed by the postimpact fire. A postaccident examination revealed no evidence of mechanical malfunction or failure. The airplane's turning ground track and the challenging visibility conditions were conducive to the onset of pilot spatial disorientation.
Probable cause:
The pilot’s spatial disorientation and subsequent failure to maintain airplane control during the instrument approach.
Final Report:

Crash of a PAC 750XL in Cascais: 1 killed

Date & Time: Feb 12, 2010 at 1700 LT
Operator:
Registration:
D-FGOJ
Survivors:
Yes
Schedule:
Évora - Cascais
MSN:
139
YOM:
2008
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The aircraft departed Evora Airport in the afternoon for a local flight with two skydivers, one photographer and a pilot on board. Few minutes after take off, the photographer output a weapon and ordered both skydivers to jump. After they left the cabin, the photographer then threatened the pilot and ordered him to divert to Cascais-Tires Airport. After landing, the aircraft veered off runway, lost its undercarriage and came to rest in a grassy area near the apron. The pilot was able to escape while the photographer shot himself and died. Aircraft was damaged beyond repair, both wings being partially sheared off.
Probable cause:
Aircraft and crew hijacked in flight by a 'photographer'.
Final Report:

Crash of a Piper PA-31T-620 Cheyenne II in Forest City: 1 killed

Date & Time: Feb 12, 2010 at 1355 LT
Type of aircraft:
Operator:
Registration:
N250TT
Flight Type:
Survivors:
No
Schedule:
Chesterfield – Forest City
MSN:
31-7820050
YOM:
1978
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
10352
Aircraft flight hours:
9048
Circumstances:
A witness reported that the multi-engine turboprop airplane was on final approach to land when it suddenly veered to the left and entered a rapid descent. The witness stated that he heard the "whine of the engines" before the airplane impacted terrain about 1/2 mile south of the runway threshold. In the days preceding the accident flight, the airplane had been at a maintenance facility to resolve a vibration in the rudder system while the autopilot system was engaged. There were no anomalies reported with the autopilot system during a test flight completed immediately before the accident flight. However, anomalies with the rate gyro were noted by a mechanic who recommended replacing it, but the pilot departed on the accident flight without the recommended repair having been completed. Further, examination of the autopilot annunciator panel indicated that the autopilot was likely not engaged at the time of impact, likely because the airplane was on a short final approach for landing. Accordingly, any existing autopilot faults would not have affected the flight as the autopilot system was likely not in use. There were no failures identified with the primary flight controls, engines, or propellers that would have prevented the pilot from maintaining control of the airplane manually. Toxicological testing revealed the presence of Zolpidem in the pilot's blood (Zolpidem, the trade name for Ambien, is used for short-term treatment of insomnia); however, the reported levels would likely not have resulted in any impairment.
Probable cause:
The pilot's failure to maintain airplane control during final approach.
Final Report:

Crash of a Beechcraft 65 Queen Air in Lawrenceville: 1 killed

Date & Time: Feb 8, 2010 at 1705 LT
Type of aircraft:
Registration:
N130SP
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Lawrenceville - Lawrenceville
MSN:
LF-17
YOM:
1960
Crew on board:
1
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
10099
Captain / Total hours on type:
1332.00
Aircraft flight hours:
9234
Circumstances:
During the preflight inspection, some water was present in the fuel sample; it was drained until a clear sample was observed. Subsequently, the fuel tanks were topped off, and the remaining preflight inspection revealed no other anomalies. The pilot initiated a takeoff and upon reaching rotation speed, the airplane became airborne and the landing gear was retracted. The right engine immediately lost power, and the pilot feathered the engine and attempted to return to the airport. Shortly thereafter, the left engine lost power. The pilot informed the air traffic controller that the airplane had lost all power. The airplane subsequently collided with trees and terrain and a post crash fire ensued. A postaccident examination of the airframe and engine revealed no mechanical malfunctions or failures that would have precluded normal operation. Examination of fuel retrieved from the right main fuel tank, as well as fuel from the fixed base operator, revealed no anomalies. The left fuel selector valve was observed in the plugged port (no fluid flow) position, but it was most likely moved to that position during the accident sequence. The right fuel selector valve was partially aligned with the main fuel passageway and was unobstructed. The reason for the loss of engine power to both engines was not determined.
Probable cause:
The failure of both engines for undetermined reasons.
Final Report:

Crash of a Cessna 425 Conquest I in Munich

Date & Time: Feb 2, 2010 at 0210 LT
Type of aircraft:
Operator:
Registration:
D-IAWF
Flight Type:
Survivors:
Yes
Schedule:
Hanover - Munich
MSN:
425-0222
YOM:
1985
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3600
Captain / Total hours on type:
400.00
Copilot / Total flying hours:
5200
Copilot / Total hours on type:
300
Aircraft flight hours:
5836
Aircraft flight cycles:
4376
Circumstances:
The aircraft took off at 0041 hrs from Hanover (EDDV) for a positioning flight to Munich (EDDM) with a crew of two pilots. The intention was to make a subsequent air ambulance flight from Munich to Kiel. During the climb the crew received the instruction for a direct flight to Munich and the clearance for a climb to Flight Level (FL) 230. The radar data showed that the aircraft turned south-east and climbed to FL230 after take-off. At 0123:45 hrs the crew made radio contact with Munich Radar. About five minutes later, the controller advised the crew that both runways were closed for snow removal, but that the southern runway would re-open in about 25-30 minutes. In response, the crew advised they would reduce the speed somewhat. The crew stated that the temperature in flight altitude had been -40 °C. At 0133:58 hrs the controller issued descent clearance to FL110. According to crew statements in this phase there were problems with the left engine. A system check indicated that the engine’s Interstage Turbine Temperature (ITT) had exceeded 900°C and the torque had reduced to zero. The crew then first worked through the memory items before "beginning with the engine failure checklist". In the presence of the BFU the crew gave their reasons for the shut-off of the engine as being the fast increase of the ITT and the decrease of the torque to zero. The crew could not give any other engine parameters like Ng per cent RPM, propeller RPM, fuel flow, oil pressure or oil temperature. The co-pilot reported via radio: "… we request to maintain FL150 … we have engine failure on the left side, call you back." At that time, the radar data showed the aircraft at FL214. As the controller asked at 0138:15 hrs if a frequency change to approach control were possible, the co-pilot answered: "... give us a minute, please, and then we report back, until we have everything secured ..." At 0143:22 hrs the co-pilot advised the controller that the engine had been "secured" and a frequency change was now possible. The crew subsequently reported that, three to five minutes later there had been brief, strong vibrations in the right engine. The crew could not state which actions they had carried out after the descent clearance and during shut-off and securing of the left engine. Both pilots stated that there was no attempt to re-start the left engine. After changing frequency to Munich Approach Control the crew was advised that runway 26L was available. The co-pilot declared emergency at 0143:48 hrs, about 25 NM away from the airport of destination, mentioning again the failure of the left engine. The controller responded by asking the crew what assistance they would require, and asked if a ten-mile approach would be acceptable. This was affirmed. At 0149:28 hrs the controller gave clearance for an ILS approach to runway 26L. At that time the radar data showed the airplane in FL78 flying with a ground speed of 210 kt to the south-east. The aircraft turned right towards the final approach and at 0151:53 hrs it reached the extended runway centre line about 17 NM prior to the runway threshold in 5,400 ft AMSL with a ground speed of 120 kt. At 0154:12 hrs the controller said: "… observe you a quarter mile south of the centre line." According to the radar data the aircraft was in 5,000 ft AMSL with a ground speed of 90 kt at that time. The co-pilot answered: "Ja, we are intercepting…". Twenty seconds later the controller gave clearance to land on runway 26L. Up until about 0157:30 hrs the ground speed varied between 80 and 90 kt. From 0157:43 hrs on, within about 80 seconds, the speed increased from 100 kt to 120 kt. Thereby, the airplane had come within 5.5 NM of the threshold of runway 26L. Up until 0200:53 hrs the airplane flew with a ground speed of 100 - 110 kt. At 0201:32 hrs ground speed decreased to 80 kt. At that time, the airplane was in 1,900 ft AMSL and about 1.5 NM away from the threshold. Up until the last radar recording at 0202:27 hrs the ground speed remained at 80 kt. The crew stated the approach was flown with Blue Line Speed. During the final approach the aircraft veered slightly to the left and tended to sink below the glidepath. Approximately 3 NM from the threshold the approach lights had become visible and the flaps and the landing gear were extended. Then the airplane veered to the left and sank below the glidepath. The co-pilot stated a decision for a go-around was made. When an attempt was made to increase power from the right engine, no additional power was available. The aircraft had lost speed and to counteract it the elevator control horn was pushed. Prior to the landing, rescue and fire fighting vehicles were positioned at readiness in the vicinity of the airport’s southern fire station. The weather was described as very windy with a light snow flurry. The fire fighters subsequently reported they had seen two white landing lights and the dim outline of an approaching aircraft. The aircraft’s bank attitude was seen to alter a number of times. Shortly before landing, the landing lights suddenly disappeared and the aircraft was no longer visible. The aircraft impacted the ground about 100 metres prior to the threshold of runway 26L. The crew turned off all the electrical systems and left the aircraft unaided. During the initial interviews by BFU and police the co-pilot repeatedly talked about a go-around the crew had intended and he had, therefore, pushed the power lever for the right engine forward. In later statements he stated that the engine power was to be increased. A few days after the accident, the BFU asked both pilots for a detailed written statement concerning the course of events. The BFU received documents with a short description of the accident in note form. The statements of the two pilots were almost identical in content and format.
Probable cause:
The following findings were identified:
- When the left engine was shut down, the propeller was not feathered,
- During the final approach, the speed for an approach with one shut-off engine was lower than the reference speed,
- The airplane veered to the left during power increase and became uncontrollable due to the lack of rudder effectiveness,
- Non-adherence to checklists during the shut-off of the engine and,
- Poor crew coordination.
Final Report:

Crash of a Yakovlev Yak-40 in Luanda

Date & Time: Jan 31, 2010 at 1513 LT
Type of aircraft:
Operator:
Registration:
D2-FES
Survivors:
Yes
Schedule:
Cabinda – Luanda
MSN:
9341431
YOM:
1973
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
34
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Following an uneventful flight from Cabinda, the aircraft landed on runway 25 when all three gears collapsed. The aircraft slid on its belly for few dozen metres before coming to rest by taxiway Bravo. While all 37 occupants were uninjured, the aircraft was damaged beyond repair.

Crash of an Embraer EMB-110C Bandeirante in Senador José Porfirio: 2 killed

Date & Time: Jan 25, 2010 at 1320 LT
Operator:
Registration:
PT-TAF
Survivors:
Yes
Schedule:
Belém - Senador José Porfirio
MSN:
110-103
YOM:
1976
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
12350
Captain / Total hours on type:
3887.00
Copilot / Total flying hours:
701
Copilot / Total hours on type:
265
Circumstances:
Following an uneventful flight from Belém, the crew started the descent to Senador José Porfirio-Wilma Rebelo Airport in marginal weather conditions. On approach, the crew noticed an elevation of the left engine turbine temperature. The captain reduced the power on both engines and elected to make an emergency landing when the aircraft stalled and crashed in an open field located 4 km short of runway. The captain and a passenger were killed. All eight other occupants were killed, three seriously. The aircraft was destroyed.
Probable cause:
The following findings were identified:
- Weather conditions made it difficult for the crew to locate the runway;
- The crew failed to follow the emergency procedures and was unable to keep the aircraft level;
- The captain did not feather the left propeller, which resulted in increased drag and reduced aircraft speed;
- The engine maintenance did not meet the engine manufacturer's requirements;
- No technical overhaul of the left engine had been carried out despite the fact that the 12-year calendar limit set by the manufacturer had been exceeded;
- A nipple mounted on the left propeller governor was not intended for aeronautical use;
- The poor seal caused by the improper connection allowed the pressure to drop, resulting in a loss of power on the left engine;
- Poor organizational culture by the operator, which compromised the safety of the operation;
- The company did not have an effective supervision program;
- Poor judgment on part of the captain;
- Poor aircraft maintenance.
Final Report: