Crash of a Beechcraft B100 King Air in Abbotsford

Date & Time: Feb 23, 2018 at 1204 LT
Type of aircraft:
Operator:
Registration:
C-GIAE
Flight Phase:
Survivors:
Yes
Schedule:
Abbotsford - San Bernardino
MSN:
BE-8
YOM:
1976
Flight number:
IAX640
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
9
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
10000
Captain / Total hours on type:
800.00
Aircraft flight hours:
10580
Circumstances:
Weather conditions at Abbotsford at the time of departure consisted of a temperature of -2°C in moderate to heavy snowfall with winds of approximately 10 knots. Prior to the departure, the fuel tanks were filled to capacity and the pilot and passengers boarded the aircraft inside the operator's heated hangar. The aircraft was towed outside of the hangar without being treated with anti-ice fluid, and taxied for the departure on runway 07. Due to an inbound arrival at Abbotsford, C-GIAE was delayed for departure. Once cleared for takeoff, the aircraft had been exposed to snow and freezing conditions for approximately 14 minutes. After becoming airborne, the aircraft experienced power and control issues shortly after the landing gear was retracted. The aircraft collided with terrain within the airport perimeter. Four passengers and the pilot sustained serious injuries as a result of the accident which destroyed the aircraft.
Probable cause:
The accident was the consequence of the combination of the following findings:
- The occurrence aircraft exited a warm hangar and was exposed to 14 minutes of heavy snow in below-freezing conditions. This resulted in a condition highly conducive to severe ground icing,
- As the aircraft climbed out of ground effect on takeoff, it experienced an aerodynamic stall as a result of wing contamination,
- The pilot’s decision making was affected by continuation bias, which resulted in the pilot attempting a takeoff with an aircraft contaminated with ice and snow adhering to its critical surfaces,
- The pilot and the passenger seated in the right-hand crew seat were not wearing the available shoulder harnesses. As a result, they sustained serious head injuries during the impact sequence,
- During the impact sequence, the cargo restraint system used to secure the baggage in the rear baggage compartment failed, causing some of the baggage to injure passengers seated in the rear of the aircraft cabin,
- The aircraft was not airworthy at the time of the occurrence as a result of an incomplete airworthiness directive.
Final Report:

Crash of a Socata TBM-700 in Evanston: 2 killed

Date & Time: Feb 18, 2018 at 1505 LT
Type of aircraft:
Registration:
N700VX
Flight Type:
Survivors:
No
Schedule:
Tulsa – Evanston
MSN:
118
YOM:
1997
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
4154
Captain / Total hours on type:
100.00
Aircraft flight hours:
3966
Circumstances:
The commercial pilot was conducting an instrument approach following a 3.5-hour cross-country instrument flight rules (IFR) flight in a single-engine turboprop airplane. About 1.6 miles from the runway threshold, the airplane began a climb consistent with the published missed approach procedure; however, rather than completing the slight left climbing turn toward the designated holding point, the airplane continued in an approximate 270° left turn, during which the airplane's altitude varied, before entering a descending right turn and impacting terrain. Tree and ground impact signatures were consistent with a 60° nose-low attitude at the time of impact. No distress calls were received or recorded from the accident flight. A postimpact fire consumed a majority of the cockpit and fuselage. Weather information for the time of the accident revealed that the pilot was operating in IFR to low IFR conditions with gusting surface winds, light to heavy snow, mist, cloud ceilings between 700 and 1,400 ft above ground level with clouds extending through 18,500 ft, and the potential for low-level wind shear and clear air turbulence. The area of the accident site was under AIRMETs for IFR conditions, mountain obscuration, moderate icing below 20,000 ft, and moderate turbulence below 18,000 ft. In addition, a winter storm warning was issued about 6 hours before the flight departed. Although the pilot received a weather briefing about 17 hours before the accident, there was no indication that he obtained updated weather information before departure or during the accident flight. Examination of the airframe and engine did not reveal any preimpact anomalies that would have precluded normal operation; however, the extent of the fire damage precluded examination of the avionics system. The airplane was equipped with standby flight instruments. An acquaintance of the pilot reported that the pilot had experienced an avionics malfunction several months before the accident during which the airplane's flight display went blank while flying an instrument approach. During that occurrence, the pilot used ForeFlight on his iPad to maneuver back to the northeast and fly the approach again using his own navigation. During the accident flight, the airplane appeared to go missed approach, but rather than fly the published missed approach procedure, the airplane also turned left towards to northeast. However, it could not be determined if the pilot's actions were an attempt to fly the approach using his own navigation or if he was experiencing spatial disorientation. The restricted visibility and turbulence present at the time of the accident provided conditions conducive to the development of spatial disorientation. Additionally, the airplane's turning flight track and steep descent profile are consistent with the known effects of spatial disorientation.
Probable cause:
The pilot's loss of control due to spatial disorientation.
Final Report:

Crash of a Gulfstream G200 in Abuja

Date & Time: Jan 29, 2018 at 1520 LT
Type of aircraft:
Operator:
Registration:
5N-BTF
Survivors:
Yes
Schedule:
Lagos - Abuja
MSN:
180
YOM:
2007
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
5300
Captain / Total hours on type:
280.00
Copilot / Total flying hours:
5700
Copilot / Total hours on type:
93
Aircraft flight hours:
1421
Aircraft flight cycles:
921
Circumstances:
On 25th January 2018 at 14:28 h, a Gulfstream 200 (G200) aircraft with nationality and registration marks 5N-BTF operated by Nestoil Plc, departed Murtala Mohammed International Airport, Lagos (DNMM) as a charter flight to Nnamdi Azikiwe International Airport, Abuja (DNAA) on an Instrument Flight Rules (IFR) flight plan. Onboard were four passengers and three flight crew members. The Pilot in command (PIC) was the Pilot Monitoring (PM) and the Co-pilot was the Pilot Flying (PF). The departure, cruise and approach to Nnamdi Azikiwe International Airport were normal. At 14:45 h, 5N-BTF contacted Abuja radar and was subsequently cleared for Radar vectors ILS approach Runway 22. Abuja Airport Automatic Terminal Information Service (ATIS) Papa for time 14:20 h was monitored as follows; “Main landing runway 22, wind 110/07 kt, Visibility 3,500 m in Haze, No Significant Clouds, Temperature/Dew point 33/- 01°C, QNH 1010 hPa, Trend No Significant Change, End of Information Papa”. At 15:17 h, 5N-BTF reported 4 NM on Instrument approach (ILS) and was requested to report 2 NM because there was a preceding aircraft (Gulfstream 5) on landing roll. Thereafter, 5N-BTF was cleared to land runway 22 with reported wind of 070°/07 kt. At 15:18 h, the aircraft touched down slightly left of the runway centre line. According to the PF, in the process of controlling the aircraft to the centre line, the aircraft skidded left and right and eventually went partly off the runway to the right where it came to a stop. In his report, the PM stated that on touchdown, he noticed the aircraft oscillating left and right as brakes were applied. The oscillation continued to increase and [the aircraft] eventually went off the runway to the right where the aircraft came to a stop, partially on the runway. During the post-crash inspection, the investigation determined that the skid marks on the runway indicated that the aircraft steered in an S-pattern continuously with increasing amplitude, down the runway. On the last right turn, the aircraft exited the right shoulderof the runway, the right main wheel went into the grass and on the final left turn, the right main landing gear strut detached from its main attachment point after which the aircraft finally came to a complete stop on a magnetic heading of 160°. The ATC immediately notified the Aircraft Rescue and Fire Fighting Services (ARFFS), Approach Radar Control, and other relevant agencies about the occurrence. All persons on board disembarked with no injuries. Instrument Meteorological Conditions (IMC) prevailed at the time of the occurrence. The serious incident occcurred in daylight.
Probable cause:
Causal Factor:
The use of improper directional control techniques to maintain the aircraft on the runway.
Contributory Factor:
Improper coordination in taking over control of the aircraft by the PM which was inconsistent with Nestoil SOP.
Final Report:

Crash of a Boeing 737-82R in Trabzon

Date & Time: Jan 13, 2018 at 2325 LT
Type of aircraft:
Operator:
Registration:
TC-CPF
Survivors:
Yes
Schedule:
Ankara – Trabzon
MSN:
40879/4267
YOM:
2012
Flight number:
PC8622
Country:
Region:
Crew on board:
6
Crew fatalities:
Pax on board:
162
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The airplane departed Ankara-Esenboğa Airport at 2233LT bound for Trabzon. Following an uneventful flight, the crew started the approach by night to runway 11 and the landing was completed in heavy rain falls at 2325LT. After touchdown at a speed of 143 knots, the airplane rolled for about 2,400 metres then veered off runway to the left, went through a grassy area then down a steep slope. It lost its right engine and came to rest few metres above the sea. All 168 occupants evacuated safely. The right engine was sheared off and fell into the sea. According to first report, it is believed something went wrong with the right engine after touchdown (unintentional forward thrust and asymmetrical thrust).

Crash of a Cessna 208B Grand Caravan in Akobo: 1 killed

Date & Time: Jan 7, 2018 at 1645 LT
Type of aircraft:
Operator:
Registration:
5Y-FDC
Flight Phase:
Survivors:
Yes
Schedule:
Akobo – Juba
MSN:
208B-1280
YOM:
2007
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
9
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
In unclear circumstances, the single engine aircraft crashed while taking off from Akobo Airstrip. It struck a house and several cows before coming to rest, bursting into flames. One person on the ground was killed while all 11 occupants escaped uninjured. The aircraft was totally destroyed by a post crash fire.

Crash of a PZL-Mielec AN-2TP in La Paragua

Date & Time: Jan 6, 2018
Type of aircraft:
Operator:
Registration:
YV1944
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
La Paragua - Canaima
MSN:
1G185-58
YOM:
1980
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Shortly after takeoff, while in initial climb, the single engine aircraft stalled and crashed in a prairie, bursting into flames. Both pilots were seriously injured and the aircraft was totally destroyed by a post crash fire.

Crash of a Cessna (DMI) Falcon 402 on Bazaruto Island

Date & Time: Jan 2, 2018 at 1145 LT
Type of aircraft:
Operator:
Registration:
ZU-MDI
Flight Phase:
Survivors:
Yes
Schedule:
Bazaruto Island - Vilanculos
MSN:
402B-0207
YOM:
1972
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
6
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3291
Captain / Total hours on type:
215.00
Aircraft flight hours:
1068
Circumstances:
The single engine airplane was departing Bazaruto Island on a flight to Vilanculos, carrying six passengers and one pilot. During the takeoff roll on runway 20, after a course of about 400 metres, the aircraft started to veer to the left, departed the runway despite successive attempt to correct the flight trajectory. The aircraft crashed into bushed and came to rest in the opposite direction of the takeoff, some 60 metres from the runway centerline.
Probable cause:
The most likely cause of this accident was human failure. The following contributing factors were identified:
- The fact that the pilot has exceeded the aircraft's capacity from 8 (1+7) to 10 (1+9), associated with prevailing meteorological conditions, may have influenced the attitude of the aircraft during take-off.
- The fact that the pilot did not properly follow the pre-flight procedures, given the hurry he showed at departure and being distracted at the time of the pre-flight inspection may have contributed to forgetting to remove the lock) of the Vertical Stabilizer.
- The fact that the pilot probably did not remove the Lock of the Vertical Stabilizer caused it to remain fixed in its position and could not give the directional control to the aircraft.
Final Report:

Crash of a Cessna 208B Grand Caravan in Punta Islita: 12 killed

Date & Time: Dec 31, 2017 at 1216 LT
Type of aircraft:
Operator:
Registration:
TI-BEI
Flight Phase:
Survivors:
No
Schedule:
Punta Islita – San José
MSN:
208B-0900
YOM:
2001
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
10
Pax fatalities:
Other fatalities:
Total fatalities:
12
Captain / Total flying hours:
14508
Captain / Total hours on type:
11587.00
Copilot / Total flying hours:
453
Aircraft flight hours:
12073
Circumstances:
The two pilots were conducting a commercial charter flight to take 10 passengers to an international airport for connecting flights. The flight departed a nontower-controlled airport that was in a valley surrounded on all sides by rising terrain, with the exception of the area beyond the departure end of runway 21, which led directly toward the Pacific Ocean. The accident airplane was the second of a flight of two; the first airplane departed runway 3 about 15 minutes before the accident airplane and made an immediate right turn to the east/southeast after takeoff, following a pass in the hills over lower terrain that provided time for the airplane to climb over the mountains. Both a witness and surveillance video footage from the airport indicated that, 15 minutes later, the accident airplane also departed from runway 3 but instead continued on runway heading, then entered a left turn and descended into terrain. Analysis of the video determined that the airplane reached a maximum bank angle of about 75° and an airspeed below the airplane's published aerodynamic stall speed before impact. Examination of the airplane was limited due to impact and postcrash fire damage; however, no defects consistent with a preimpact failure or malfunction were observed, and the engine exhibited signatures consistent with production of power during impact. The captain was appropriately rated and had extensive experience in the accident airplane make and model. He had been employed by the accident operator for about a year in 2006 and had recently been re-hired by the operator; however, records provided by the operator did not indicate that he had completed all of the training and check flights required by the operator's General Operations Manual (GOM). The first officer was appropriately rated but had little experience in the accident airplane. The GOM also stated that pilots would receive additional, airport-specific training before operating to or from airports with special characteristics; however, the operator provided no listing of such airports, including the airport from which the accident flight departed. The pilots' experience at the departure airport could not be determined. It is possible the psychiatric diagnoses in 2011 were correct and the pilot suffered from a number of conditions which can cause a variety of symptoms. However, given the extremely limited information, what his symptoms were around the time of the accident, whether they were being addressed or effectively treated, and what his mental state was at the time could not be determined from the available information. Therefore, whether or not the pilot's medical or psychological conditions or their treatment played a role in the accident circumstances could not be determined by this investigation. There were no weather reporting facilities in the vicinity of the airport. Although the airport was equipped with two frames for windsocks, no windsocks were installed at the time of the accident to aid pilots in determining wind direction and intensity. Although a takeoff from runway 21 afforded the most favorable terrain since the airplane would fly over lower terrain to the ocean, it is possible that a significant enough tailwind existed for runway 21 that the pilots believed the airplane's maximum tailwind takeoff limitation may be exceeded and chose to depart from runway 3 in the absence of any information regarding the wind velocity. Performance calculations showed that the airplane would have been able to take off with up to a 10-kt tailwind, which was the manufacturer limitation for tailwind takeoffs. The witness who saw the accident reported that he spoke with the pilots of both airplanes before the flights departed and that the pilots acknowledged the need to use the eastern pass in order to clear terrain when departing from runway 3. The reason that the flight crew of the accident airplane failed to use this path after takeoff could not be determined. It is likely that, after entering the valley ahead of the runway, with rising terrain and peaks that likely exceeded the climb capability of the airplane, they attempted to execute a left turn to exit the valley toward lower terrain. During the steep turn, the pilots failed to maintain adequate airspeed and exceeded the airplane's critical angle of attack, which resulted in an aerodynamic stall and impact with terrain. Performance calculations using weights that would allow the airplane to operate within manufacturer weight and balance limitations at the time of the accident indicated that it was unlikely that the airplane would have had sufficient climb performance to clear the terrain north of the airport. However, the airplane would likely have had sufficient climb performance to clear terrain east of the airport had the crew performed a right turn immediately after takeoff like the previous airplane.
Probable cause:
The flight crew's failure to maintain airspeed while maneuvering to exit an area of rising terrain, which resulted in an exceedance of the airplane's critical angle of attack and an aerodynamic stall. Contributing to the accident was the flight crew's decision to continue the takeoff toward rising terrain that likely exceeded the airplane's climb capability, the lack of adequate weather reporting available for wind determination, and the lack of documented training for an airport requiring a non-standard departure.
Final Report:

Crash of a Cessna 525A CitationJet CJ2 in Michigan City

Date & Time: Dec 27, 2017 at 0650 LT
Type of aircraft:
Operator:
Registration:
N525KT
Flight Type:
Survivors:
Yes
Schedule:
DuPage - Michigan City
MSN:
525A-0058
YOM:
2002
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3200
Captain / Total hours on type:
300.00
Copilot / Total flying hours:
2020
Copilot / Total hours on type:
81
Aircraft flight hours:
2681
Circumstances:
The pilot reported that, during the approach following a positioning flight, he saw that the runway had a light dusting of snow on it and that the airplane touched down on speed in the first 1,000 ft of the 4,100- ft-long runway. The copilot, who was the pilot flying, applied heavy braking, but there appeared to be no braking effectiveness, and the airplane did not slow down as expected. The pilot added that, when the airplane reached about two-thirds of the way down the runway, he knew that it was going to overrun the runway due to the loss of only half of its airspeed. He thought that if he aborted the landing, there was a small chance the airplane could become airborne within the remaining runway. The copilot added engine power to abort the landing, and the nose landing gear lifted off, but insufficient runway was remaining to take off. The copilot reduced the engine power to idle, and the airplane overran the runway and went through the airport fence and a guardrail, across a highway, and into a field. Postaccident examination revealed no flat spots or evidence of skidding on the landing gear tires. The flaps were found in the “ground flaps” position, which is not allowed for takeoff. No evidence of any pre-accident mechanical malfunctions or failures were found with the airplane that would have precluded normal operation. Based on an airplane weight of 11,000 lbs, the airplane’s stopping distance would have been about 4,400
ft. The flight crew’s improper decision to land on a snow-covered runway that was too short to accommodate the landing in such conditions led to a runway overrun and impact with obstacles.
Probable cause:
The flight crew's improper decision to land on a snow-covered runway that had insufficient runway distance for the airplane to land with the contamination, which resulted in a runway overrun and impact with obstacles.
Final Report:

Crash of a Cessna 340 in Bartow: 5 killed

Date & Time: Dec 24, 2017 at 0717 LT
Type of aircraft:
Registration:
N247AT
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Bartow – Key West
MSN:
340-0214
YOM:
1973
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
5
Captain / Total flying hours:
1600
Aircraft flight hours:
1607
Circumstances:
The instrument-rated private pilot and four passengers boarded the multiengine airplane inside a hangar. The pilot then requested that the airplane be towed from the hangar to the ramp, since he did not want to hit anything on the ramp while taxiing in the dense fog. Witnesses heard the pre-takeoff engine run-up toward the end of the runway but could not see the airplane as it departed; the engines sounded normal during the run-up and takeoff. A witness video recorded the takeoff but the airplane was not visible due to the dense fog. During the takeoff roll the airplane's tires chirped, which is consistent with the wheels touching down on the runway with a side load. The video ended before the accident occurred. The witnesses stated that the takeoff continued and then they heard the airplane impact the ground and saw an explosion. The weather conditions at the time of the accident included visibility less than 1/4 mile in fog and an overcast ceiling at 300 ft above ground level. The airplane's weight at the time of the accident was about 105 lbs over the maximum takeoff weight, which exceeded the center of gravity moment envelope. The excess weight would have likely extended the takeoff roll, decreased the climb rate, and increased the amount of elevator pressure required to lift off of the runway. A majority of the airplane was consumed by postcrash fire. The ground impact marks and wreckage distribution were consistent with the airplane rolling left over the departure end of the runway and impacting the ground inverted in a nearly vertical, nose-low attitude. Examination of the engines revealed operating signatures consistent with takeoff power at the time of impact. The elevator trim tab and actuator were found beyond their full up travel limits and the trim cable exhibited tension overload separations near the actuator. It is likely that, when the cable separated in overload, the chain turned the sprocket and extended the actuator rod beyond full travel. No anomalies were observed with the airframe, engines, or cockpit instrumentation that would have precluded normal operation. The investigation was unable to determine the status of the autopilot during the accident takeoff. Based on the evidence it's likely that when the airplane entered instrument meteorological conditions the pilot experienced spatial disorientation, which resulted in a loss of control and descent into terrain.
Probable cause:
The pilot's loss of control due to spatial disorientation during takeoff in instrument meteorological conditions.
Final Report: