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 Beechcraft C90 King Air in Islip

Date & Time: May 18, 2001 at 1725 LT
Type of aircraft:
Operator:
Registration:
N270TC
Flight Type:
Survivors:
Yes
Schedule:
East Hampton - Ronkonkoma
MSN:
LJ-858
YOM:
1979
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
2439
Captain / Total hours on type:
98.00
Copilot / Total flying hours:
1613
Copilot / Total hours on type:
114
Aircraft flight hours:
6581
Circumstances:
After about a 20 minute flight, while on final approach for landing, the airplane experienced a loss of engine power on both engines, and the pilot-in-command (PIC) performed a forced landing into trees about 1/2 mile from the airport. The left and right boost pumps and the left and right transfer pumps, were observed in the "OFF" position. According to the PIC, after he exited the airplane, he returned to the cockpit and "shut off the fuel panel. The fuel quantity indicator toggle switch was observed in the "TOTAL" position. Examination of the fuel system revealed both engine nacelle tanks, both wing center section tanks, and the right wing fuel tanks were not compromised. About 1 quart of fuel was drained from the left and right engine nacelle tanks, respectively. Less than a quart of fuel was drained from the right wing tanks. The left wing tanks were compromised during the accident; however there was and no evidence of a fuel spill. Examination of the left and right wing center tanks revealed approximately 27 gallons (approximately 181 lbs) of fuel present in each tank. Battery power was connected to the airplane, and when the fuel transfer pump switches were turned to the "ON" position, fuel was observed being pumped from the left and right wing center tanks to their respective nacelle tanks. The accident flight was the third flight of the day for the flight crew and airplane. According to a flight log located in the cockpit, the flight crew indicated 750 lbs of fuel remained at the time of the takeoff. According to the airplane flight manual (AFM),"Fuel for each engine is supplied from a nacelle tank and four interconnected wing tanks...The outboard wing tanks supply the center section wing tank by gravity flow. The nacelle tank draws its fuel supply from the center section tank. Since the center section tank is lower than the other wing tanks and the nacelle tank, the fuel is transferred to the nacelle tank by the fuel transfer pump in the low spot of the center section tank...." Additionally, with the transfer pumps inoperative, all wing fuel except 28 gallons from each wing will transfer to the nacelle tank through gravity feed.
Probable cause:
The pilot’s failure to activate the fuel transfer pumps in accordance with the checklist, which resulted in fuel exhaustion.
Final Report:

Crash of a Casa-Nurtanio CN235-100M (IPTN) in Ankara: 4 killed

Date & Time: May 18, 2001
Operator:
Registration:
TCSG-552
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Ankara - Ankara
MSN:
C-153
YOM:
2000
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
4
Circumstances:
The crew was engaged in a local test flight at Ankara-Mürted AFB. Shortly after takeoff, while climbing to a height of about 100 feet, the aircraft went out of control and crashed, bursting into flames. All four crew members were killed. According to Turkish Authorities, this aircraft was the last of a series of eight CN-235 intended for the Turkish Navy and was still operated under the Turkish Coast Guard, taking part to a certification program. Several modifications have been made on this model by technicians from Turkish Aerospace Industries (TAI) and the crew consisted of four pilots, one Turkish and three Spanish from the Casa/EADS Consortium.
Probable cause:
In a report published at the end of June 2001, the Turkish and Spanish Authorities confirmed that despite the care taken in the quality control systems, the Turkish engineers were unable to detect a malfunction of the aileron control system probably stemming from an error made during the mounting. Despite the fact that the accident was attributable to the negligence of engineers at Turkish Aerospace Industries (TAI), investigators believe that the three accidents involving Casa CN-235s in Turkey in five months are likely to have resulted from three different causes.

Crash of a Fokker F27 Friendship 400M in Mendoza: 5 killed

Date & Time: May 17, 2001 at 1220 LT
Type of aircraft:
Operator:
Registration:
TC-76
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Mendoza – Paraná
MSN:
10412
YOM:
1969
Country:
Crew on board:
5
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
5
Circumstances:
After takeoff from Mendoza-El Plumerillo Airport, while climbing to a height of about 50 metres, the right engine lost power. The crew declared an emergency and initiated a left turn to return to the airport when control was lost. The aircraft stalled and crashed 300 metres past the runway end, bursting into flames. All five crew members were killed. They were completing a training flight to Paraná.

Crash of a BAe 125-600B in Lagos

Date & Time: May 15, 2001
Type of aircraft:
Operator:
Registration:
5N-RNO
Survivors:
Yes
Schedule:
Yola – Lagos
MSN:
256054
YOM:
1975
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On final approach to Lagos-Murtala Muhammed Airport, both engines failed simultaneously due to fuel exhaustion. The aircraft lost height, collided with approach lights and crashed short of runway threshold. All four occupants escaped with minor injuries while the aircraft was damaged beyond repair. The exact date of the mishap remains unknown, somewhere in May 2001.
Probable cause:
Double engine failure on final approach due to fuel exhaustion. Poor flight preparation.

Crash of a Boeing 727-44F in Nzagi

Date & Time: May 10, 2001
Type of aircraft:
Operator:
Registration:
D2-FCK
Flight Type:
Survivors:
Yes
Schedule:
Luanda – Nzagi
MSN:
18892
YOM:
1965
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
6
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On final approach to runway 08 at Nzagi Airport, the aircraft was too low, causing the right main gear to struck an earth mound located about 100 metres short of runway threshold. Upon touchdown, the right main gear collapsed and the aircraft came to rest partially on its belly. All 11 occupants escaped uninjured while the aircraft was damaged beyond repair. It was reported that the copilot was the pilot-in-command at the time of the accident. Wind was from 130 at 12-15 knots.

Crash of a Piper PA-42-1000 Cheyenne 400LS in Nuremberg: 1 killed

Date & Time: May 5, 2001 at 1631 LT
Type of aircraft:
Operator:
Registration:
D-IMAY
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Nuremberg – Zurich
MSN:
42-5527024
YOM:
1985
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The twin engine aircraft departed Nuremberg Airport runway 10 at 1628LT on a private flight to Zurich. During initial climb, at a height of 2,000 feet, the pilot was cleared to climb to 13,000 feet at his discretion. While climbing to a height of 4,500 feet, the aircraft stalled but quickly climbed again to 4,700 feet. Suddenly, control was lost and the aircraft entered a dive before crashing in a wooded area located along the motorway A3. The accident occurred three minutes after takeoff and the wreckage was found about 3,5 km east of the airport. The aircraft was destroyed and the pilot, sole on board, was killed. At the time of the accident, weather conditions were good with a 10 km visibility and a wind from 010 at 10 knots.
Probable cause:
No technical anomalies were found on the aircraft, the instruments and the engines. The aircraft' speed increased to 280 knots during the dive. The assumption that the pilot suffered a heart attack was not ruled out.

Crash of a Cessna 208B Super Cargomaster in Steamboat Springs: 1 killed

Date & Time: May 5, 2001 at 0858 LT
Type of aircraft:
Operator:
Registration:
N948FE
Flight Type:
Survivors:
No
Schedule:
Casper – Steamboat Springs
MSN:
208B-0052
YOM:
1987
Flight number:
FDX8810
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
2916
Captain / Total hours on type:
43.00
Aircraft flight hours:
8690
Circumstances:
The pilot obtained a weather briefing, filed an IFR flight plan, and departed on a nonscheduled domestic cargo flight, carrying 270 pounds of freight. The flight proceeded uneventfully until it was established on the VOR/DME-C approach. Radar data indicates that after turning inbound towards the VORTAC from the DME arc, the airplane began its descent from 10,600 feet to the VOR crossing altitude of 9,200 feet. Enlargement of the radar track showed the airplane correcting slightly to the left as it proceeded inbound to the VORTAC at 9,400 feet. Shortly thereafter, aircraft track and altitude deviated 0.75 miles northwest and 9,700 feet, 0.5 miles southeast and 9,600 feet, and 0.5 miles northwest and 9,400 feet before disappearing from radar. Witnesses said the weather at the time of the accident was 600 foot overcast, 1.5 miles visibility in "misting" rain that became "almost slushy on the ground," and a temperature of 36 degrees Fahrenheit. One weather study indicated "an icing potential greater than 50% and visible moisture" in the accident area. Another report said "icing conditions were likely present in the area of the accident." The airplane was equipped and certified for flight into known icing conditions. The wreckage was found in a closely area. There was no evidence of pre-impact airframe, engine, or propeller malfunction/failure. The pilot was properly certificated, but his flight time in aircraft make/model was only 38 hours. He had previously recorded 16 icing encounters, totaling 11.2 hours in actual meteorological conditions. He recorded no ice encounters and only 1.0 hour of simulated (hooded) instrument time in the Cessna 208. Microscopic examination of annunciator light bulbs revealed the GENERATOR OFF light was illuminated. This condition indicates a generator disconnection due to a line surge, tripped circuit breaker, or inadvertent switch operation. The operator's chief pilot agreed, noting that one of the items on the Before Landing Checklist requires the IGNITION SWITCH be placed in the ON position. The START SWITCH is located next to the IGNITION SWITCH. Inadvertently moving the START SWITCH to the ON position would cause the generator to disconnect and the GENERATOR OFF annunciator light to illuminate. He said this would be distracting to the pilot.
Probable cause:
An inadvertent stall during an instrument approach, which resulted in a loss of control. Contributing factors were the pilot's attention being diverted by an abnormal indication, conditions conducive to airframe icing, and the pilot's lack of total experience in the type of operation (icing conditions) in aircraft make/model.
Final Report:

Crash of a Cessna 208B Super Cargomaster in Plattsburgh

Date & Time: Apr 26, 2001 at 1945 LT
Type of aircraft:
Operator:
Registration:
N974FE
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Plattsburgh – Albany
MSN:
208B-0099
YOM:
1988
Flight number:
FDX7417
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
9144
Captain / Total hours on type:
137.00
Aircraft flight hours:
5993
Circumstances:
The pilot said the preflight, engine start, run-up, taxi and takeoff were "normal". The pilot said that during the climb after takeoff, approximately 1,000 to 1,500 feet above the ground, the airplane's engine "spooled down, slowly and smoothly, like a loss of torque or the propeller going to feather." The pilot performed a forced landing to a field, where the airplane nosed over, and came to rest inverted. Examination of the engine and propeller revealed that the propeller-reversing lever was installed on the wrong side of the reversing lever guide pin, and that the reversing linkage carbon block was no longer installed, and had departed the airplane. Examination of the airplane's maintenance records revealed that the carbon block was replaced during a 100-hour maintenance inspection, 5 hours prior to the accident. Installation of the reversing lever on the incorrect side of the guide pin resulted in improper seating and premature wear of the carbon block. According to the engine manufacturer, any disconnection in operation of the propeller control linkage will cause the propeller governor beta control valve to extend, and drive the propeller into feather.
Probable cause:
The incorrect installation of the propeller reversing lever and carbon block assembly, which resulted in a loss of propeller thrust.
Final Report:

Crash of a Cessna 402B in Del Rio: 1 killed

Date & Time: Apr 26, 2001 at 0830 LT
Type of aircraft:
Registration:
N80Q
Flight Type:
Survivors:
No
Schedule:
San Antonio – Del Rio
MSN:
402B-1384
YOM:
1978
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
1140
Captain / Total hours on type:
70.00
Aircraft flight hours:
19279
Circumstances:
Upon arrival at the destination airport, the commercial pilot of the Part 135 cargo flight reported to the tower that he was 7 miles to the east, intending to land on runway 13. Subsequently, the pilot reported that he would circle the airport a few times "because he was having trouble with his autopilot." After circling, the pilot positioned the airplane on final approach to runway 13. The pilot of another airplane in the traffic pattern observed the accident airplane on a "one to two mile final, in a normal flight attitude but possibly a little low." After looking at her instruments for several seconds, she made visual contact again and observed the airplane impact the ground with the "tail of the aircraft falling forward on top of a fence." She further stated that all of the radio transmissions from the accident airplane were "calm and completely un-alarmed prior to the accident." Another witness, who was located at a fixed base operator at the airport, observed the airplane turn onto final. He stated that the airplane "suddenly stalled and slammed into the ground from about two hundred feet." The 1,140 hour pilot had accumulated a total of 70 hours in the Cessna 402. The airplane was found to be within its prescribed weight and balance limitations at the time of the accident. Ground impressions and airframe deformations indicated that the impact angle was approximately 25 degrees nose down on a magnetic heading of 155 degrees with the landing gear extended and the flaps partially extended. A post-impact fire destroyed the airplane. Flight control continuity was established from the aft section of the cockpit to the rudder and elevator flight control surfaces. The elevator trim tab (located on the right elevator) was measured with a protractor and found to be in the 28 degrees tab-up position (aircraft nose down). According to the airplane manufacturer's specifications, the maximum tab-up travel limit (when connected) is 5 degrees. The trim tab would not move freely by hand forces and appeared to be jammed. The elevator skin was cut open (top side) to observe the trim tab connecting hardware. It was observed that the clevis end of the trim tab actuator rod was wedged against the front spar of the elevator's internal structure. Additionally, the bolt which connected the clevis end of the tab actuator rod to the actuator screw, was missing. After further inspection, neither the bolt nor the nut were found in the cavity of the elevator structure or the surrounding area. The clevis end of the actuator rod and the actuator screw were not damaged, and no impact damage was apparent on the trim tab. The operator's maintenance records showed that the right elevator had been replaced 10 flight hours prior to the accident.
Probable cause:
The loss of control due to a jammed trim tab, which resulted from the failure of maintenance personnel to properly secure the trim tab actuator rod when installing a replacement elevator.
Final Report: