Crash of an Airbus A320-231 in Jaipur

Date & Time: Jan 5, 2014 at 2110 LT
Type of aircraft:
Operator:
Registration:
VT-ESH
Survivors:
Yes
Schedule:
Imphal – Guwahati – New Delhi
MSN:
469
YOM:
1994
Flight number:
AI890
Country:
Region:
Crew on board:
6
Crew fatalities:
Pax on board:
173
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
8322
Captain / Total hours on type:
5502.00
Copilot / Total flying hours:
2798
Copilot / Total hours on type:
2610
Aircraft flight hours:
55705
Circumstances:
On 05.01.2014, Air India Ltd. Airbus A-320-231 aircraft was scheduled to operate flight AI-889 (Delhi – Guwahati – Imphal) and return flight, AI-890 (Imphal – Guwahati – Delhi). Air India dispatch section at Delhi, which has received the roster of flight crew for the flights, had prepared the operational and ATC flight plans by using FWz flight planning software and taking into account the weight & weather (forecast winds). Same set of flight crew and cabin crew was rostered to operate the four sectors mentioned above. The flight was under Command of an ATPL holder with another ATPL holder as First Officer (FO) and 04 Cabin Crew members. The Commander was CAT III qualified and the FO was CAT I qualified. The FWz plan was prepared for VT-ESL, but later on the aircraft was changed to VT-ESH. As per the pilot in command as both the aircraft have bogie gear type of landing gear and the performance factor is also same for these aircraft, he had accepted the FWz plan of VT-ESL. As per the manager flight dispatch on duty, only first leg i.e. Delhi Guwahati was dispatched. Required fuel figures were informed to the engineering & commercial departments. Pilots were briefed with folders which in addition to flight plans contained current NOTAMs and meteorological information. The relevant information in these documents was highlighted for briefing to the flight crew. For the remaining sectors which were self briefing sectors flight plan and NOTAMs were given to the flight crew. As per the pre flight briefing register, both the crew members have visited the flight dispatch section for briefing and at around 10:40 hrs. IST have signed the dispatch register. The sectors Delhi – Guwahati – Imphal – Guwahati were as per schedule and were uneventful. As per the flight sector report, the transit time at Guwahati prior to Guwahati-Delhi sector was 50 minutes. The aircraft landed at Guwahati from Imphal at 11:15 hrs. UTC and 12.7 tons of fuel was uplifted. The filed alternates for the sector were Lucknow and Jaipur in that order. METARs of Delhi, Lucknow and Jaipur were provided at Guwahati. There was no specific briefing. Flight crew has taken the weather updates of destination and alternates before departure from Guwahati. Lucknow visibility at that time was 2000 meters with temperature and dew point of 18°C & 13°C respectively. The weather at Delhi (11:05 UTC) was RVR as 500 meters for runway 29, general visibility of 150 meters, with both temperature and dew point of 12°C. A speci was issued at 1130 UTC for Jaipur with winds 04 kts. visibility 3000m and haze. There was no significant clouding (NSC), temperature (T) 18°C & dew point (Dp) 13°C, QNH 1013. Pre flight walk around inspection was carried out by the crew at Guwahati and the aircraft was released by an Aircraft Maintenance Engineer which was accepted by the Pilot-in-command. There was no snag or technical problem with the aircraft. There was no component or system released under Minimum Equipment List (MEL). For its last leg, the aircraft departed Guwahati for Delhi at 1205 UTC with 173 passengers on board. The fuel requirement from Guwahati to Delhi with 179 persons on board was 12.2 tonnes. As per the commander of flight, additional 500 kgs of fuel was taken (total on board was 12.7 tonnes) considering the time of arrival in Delhi was that of traffic congestion and because of weather in Delhi. As per the Operational Flight Plan (OFP), there was 10 minutes of arrival delay at the destination. The aircraft was flown on managed speeds. Initially the flight was cleared by ATC for a lower level and was later on cleared to fly at cruising level of 340. The fuel was checked visually on the Flight Management System (FMS) and Fuel Page which was further cross checked with the OFP planned figures by the crew on way points but was not recorded on the Operational Flight Plan. As per the crew, the fuel consumed was marginally higher than planned. The time taken to reach the way points was also noted, which was almost the same as planned figures were. Enroute, there was no briefing about traffic congestion over Delhi by any of the ground stations of AAI. The crew, on reaching overhead Lucknow, has taken Lucknow weather and when the aircraft was in range of ATIS Delhi, Delhi ATIS weather was also copied. The aircraft was not equipped with Aircraft Communications Addressing and Reporting System (ACARS) but was provided with HF/VHF system. As per the flight crew no flight following was provided either by flight dispatch or the IOCC of Air India. Weather updates were not seeked by the crew from the flight dispatch nor were any updates provided by Flight dispatch to the aircraft during the flight except when crew had asked Delhi dispatch about Jaipur visibility before finally making the decision to divert to Jaipur. Flight crew did not seek any update of Delhi or Jaipur weather till the time the aircraft came in contact with Delhi ATC. While in contact with Delhi ATC, the flight was advised to join hold as Delhi visibility Runway 28 RVR had dropped to the lower end of CAT I operations at this point runway 29 was below minima. AI 890 was number 12 in sequence and continued to remain in the holding pattern for the next 20-25 minutes. During this period there was no attempt on the part of flight crew to seek Lucknow weather. Air India Flight dispatch has also not given any advice to the flight about Jaipur or Lucknow weather. The weather (visibility / RVR) reported on Runway 29 was below CAT I conditions so runway was not available for this flight at that moment as the First Officer was only Cat I qualified. As per commander of the flight, they did 03 holds each of 1.5 minutes leg and flew headings 360° and 180° before intercepting the localizer Runway 28 at 35 miles. RVR runway 28 also dropped below Cat. I minimas, therefore the crew discontinued approach and climbed to 8000 feet on runway heading before going on heading 180. As per the Commander, though the 1st planned diversion alternate was Lucknow which had visibility of 2000 m i.e. above minima, but change of diversion to Jaipur was made as after missed approach they were closer to Jaipur and they had inquired about the visibility from Dispatch for Jaipur, which was provided as 2000 m. At this stage the crew did not check complete weather of Jaipur. Minimum diversion fuel to Jaipur was 2.9 tonnes as per FWz CFP. AI-890 commenced diversion to Jaipur with ―Fuel on Board‖ of 3.1 tonnes. As per the Station Manager of Air India at Jaipur Airport, he received a call from their Executive Director, Northern Region at around 2040 hrs. IST on 05.01.2014 that due to Delhi weather, AI 890 had diverted to Jaipur. He then conveyed the same to the airport office and the concerned engineer. The aircraft came in contact with Jaipur for the first time when it was at 68 DME from Jaipur. At that time the crew came to know of the complete weather of Jaipur from ATIS as visibility of 900 m, Dew Point as 13°C, temperature as 13°C, and RVR of 1000m. At 60 miles and passing flight level 138, the crew intimated Jaipur that the aircraft is descending for flight level 100 as cleared by Delhi control, which was acknowledged by Jaipur ATC. The aircraft again informed Jaipur ATC its position at 55 miles, 50 miles and 42 miles from Jaipur which were also acknowledged by Jaipur ATC. During these contacts, weather of Jaipur was neither asked by the crew nor provided by the ATC. When the aircraft was at flight level 83, the crew asked ATC Jaipur to confirm that they can carry out ILS approach for runway 27 via 10 DME arc. While confirming the requested approach, Jaipur ATC has informed all the stations about the weather at that moment as visibility 400 m and RVR 1000 m. When the aircraft was at 30 miles from Jaipur, Jaipur ATC passed weather as visibility 400 m, RVR 1000 m and trend visibility becoming 350 m. The crew was asked to come overhead by Jaipur ATC. At 28 DME from Jaipur, the aircraft was maintaining 6000 feet and on request was cleared by Jaipur ATC to descend to 5000 feet. When the aircraft was at 25 DME, from Jaipur, ATC advised that the weather was deteriorating rapidly and visibility was 400 meters. The crew however intimated the ATC that they were committed to land at Jaipur due fuel. As per the crew the fuel on board at that point of time was 2.6 tonnes (approx.) and approach was commenced for Jaipur with a visibility of 500 m with trend reducing. The aircraft was no. 2 in approach at Jaipur and was cleared for VORDME arc ILS approach runway 27 at 25 nm. Crew had, as per them, checked Ahmedabad distance as 291 nm, with a fuel calculation of 2.7 tonnes and as sufficient fuel was not available for Ahmedabad so did not consider diverting to Ahmedabad at that moment. Crew has also stated that Udaipur watch hours were not available with them, Jodhpur is an Air Force field with restrictions and Delhi was packed so they continued approach to Jaipur knowing that visibility / RVR was rapidly deteriorating. Due to reducing visibility, Jaipur ATC asked all the aircraft inbound for Jaipur to come over head and join JJP hold. The crew of the subject flight asked for the weather which was provided as visibility 400 m & RVR 1000 m though RVR deteriorating to 550 m. The flight from the ―Arrival Route‖ flew the VORDME arc for ILS runway 27. The ATC had transmitted the RVR as 200 m and visibility as 50 m with trend reducing. Another scheduled flight ahead of AI-890 carried out a missed approach and diverted to Ahmedabad. When the aircraft was above MDA (1480 feet AGL), ATC reported RVR 50 m and cleared the aircraft to land subject to minima. Both the flight crew maintained that they had seen the runway lights. ILS approach was performed with dual AP until 200ft RALT. After descending below MDA on auto pilot, the commander disconnected the auto pilot. Captain performed the final approach manually. The aircraft deviated to the left of the runway centre line and touched down on soft ground (in kutcha) on the LH side of the runway. During touchdown and landing roll, the visibility was zero and crew were unable to see any of the reference cues. The crew had heard rumbling sound during landing roll. As per the commander, he did the manual landing as he was not sure if he could do auto-land on a ground facility which is CAT I certified airfield in actual zero visibility. The aircraft continued to roll/ skid on the unpaved surface and during this period the left wing impacted trees causing damage to the left wing. Thereafter aircraft turned right and entered the runway finally coming to a halt on the LH side of runway. There was no fire. ATC Jaipur informed the Airport Manager of the Airline at Jaipur that their flight AI-890 had blocked the runway and also requested them to send equipments / manpower to attend the aircraft and get the aircraft removed. The Station AME of the airline alongwith the Asst Officer (Comm.), who was at the tarmac were instructed by the Station Manager to move to the aircraft. As per the AME, the visibility was almost nil and they could not move without the help of ‗Follow Me‘ Jeep. The ATC was informed to arrange the jeep to escort the personnel upto the aircraft. The AME after reaching the aircraft observed that the no. 1 main wheel of the aircraft had decapped/ damaged and the port side wing was damaged. The fuel remaining on board was 2400 kgs. The disembarkation of passengers was carried out on the runway itself and passengers were sent to the terminal building. Since the aircraft was not in a position to be either taxied or towed to the parking bay, the baggage of passengers was offloaded at the runway itself and sent to the terminal. One passenger suffered minor bruise on the knuckle of his right hand middle finger. He was attended to by the cabin crew in the aircraft and also by the doctor at the airport. Medical check-up of all the crew members including breathanalyser (BA) test was done by the medical officer, M.I. room Jaipur airport. The BA test was negative for all the crew members with a reading of 00.00. Since the aircraft was obstructing the runway, the airport was shut down for any further flight operations till the runway could be cleared. A NOTAM was issued to this effect. The aircraft was towed the next day to parking bay no.5 at terminal-1 by 1200 hrs and was later repositioned on a non-operational remote bay.
Probable cause:
The cause below has been given considering events as a combination of organizational factors and human error.
- The flight crew made an erroneous decision of diverting & continuing to an airfield with reducing visibility.
- The flight crew attempted a manual landing in below minima conditions.
- Lack of operational supervision and desired ground support to flight.
- Internal quality assurance not capturing the hazards which slipped through due complacency.
- Lack of oversight of the flight operations.
Final Report:

Crash of a Canadair CL-601-3R Challenger in Aspen: 1 killed

Date & Time: Jan 5, 2014 at 1222 LT
Type of aircraft:
Registration:
N115WF
Flight Type:
Survivors:
Yes
Schedule:
Tucson - Aspen
MSN:
5153
YOM:
1994
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
17250
Captain / Total hours on type:
14.00
Copilot / Total flying hours:
20355
Copilot / Total hours on type:
14
Aircraft flight hours:
6750
Circumstances:
The airplane, with two flight crewmembers and a pilot-rated passenger on board, was on a cross-country flight. The departure and en route portions of the flight were uneventful. As the flight neared its destination, a high-altitude, terrain-limited airport, air traffic control (ATC) provided vectors to the localizer/distance measuring equipment (LOC/DME)-E approach to runway 15. About 1210, the local controller informed the flight crew that the wind was from 290º at 19 knots (kts) with gusts to 25 kts. About 1211, the flight crew reported that they were executing a missed approach and then requested vectors for a second approach. ATC vectored the airplane for a second LOC/DME-E approach to runway 15. About 1221, the local controller informed the flight crew that the wind was from 330° at 16 kts and the 1-minute average wind was from 320° at 14 kts gusting to 25 kts. The initial part of the airplane's second approach was as-expected for descent angle, flap setting, and spoilers. During the final minute of flight, the engines were advanced and retarded five times, and the airplane's airspeed varied between 135 kts and 150 kts. The final portion of the approach to the runway was not consistent with a stabilized approach. The airplane stayed nose down during its final descent and initial contact with the runway. The vertical acceleration and pitch parameters were consistent with the airplane pitch oscillating above the runway for a number of seconds before a hard runway contact, a gain in altitude, and a final impact into the runway at about 6 g. The weather at the time of the accident was near or in exceedance of the airplane's maximum tailwind and crosswind components for landing, as published in the airplane flight manual. Given the location of the airplane over the runway when the approach became unstabilized and terrain limitations of ASE, performance calculations were completed to determine if the airplane could successfully perform a go-around. Assuming the crew had control of the airplane, and that the engines were advanced to the appropriate climb setting, anti-ice was off, and tailwinds were less than a sustained 25 kts, the airplane had the capability to complete a go-around, clearing the local obstacles along that path.Both flight crewmembers had recently completed simulator training for a type rating in the CL600 airplane. The captain reported that he had a total of 12 to 14 hours of total flight time in the airplane type, including the time he trained in the simulator. The copilot would have had close to the same hours as the captain given that they attended flight training together. Neither flight crew member would have met the minimum flight time requirement of 25 hours to act as pilot-in-command under Part 135. The accident flight was conducted under Part 91, and therefore, the 25 hours requirement did not apply to this portion of their trip. Nevertheless, the additional flight time would have increased the crew's familiarity with the airplane and its limitation and likely improved their decision-making during the unstabilized approach. Further, the captain stated that he asked the passenger, an experienced CL-600-rated pilot. to accompany them on the trip to provide guidance during the approach to the destination airport. However, because the CL-600-rated pilot was in the jumpseat position and unable to reach the aircraft controls, he was unable to act as a qualified pilot-in-command.
Probable cause:
The flight crew's failure to maintain airplane control during landing following an unstabilized approach. Contributing to the accident were the flight crew's decision to land with a tailwind above the airplane's operating limitations and their failure not to conduct a go-around when the approach became unstabilized.
Final Report:

Crash of a Piper PA-31-310 Navajo in Port Raúl Marín Balmaceda

Date & Time: Dec 28, 2013 at 1000 LT
Type of aircraft:
Operator:
Registration:
CC-CMM
Flight Type:
Survivors:
Yes
Schedule:
Puerto Montt - Port Raúl Marín Balmaceda
MSN:
31-315
YOM:
1968
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
7480
Captain / Total hours on type:
3100.00
Circumstances:
The pilot departed Puerto Montt at 0900LT on a positioning flight to Port Raúl Marín Balmaceda to pick up five passengers. On approach, the pilot decided to complete a loss pass to evaluate the landing conditions and the wind component. Shortly later, the aircraft landed on its belly and slid for few dozen metres before coming to rest in a grassy area. The pilot was uninjured and the aircraft was damaged beyond repair.
Probable cause:
The pilot forgot to lower the landing gear prior to landing.
Final Report:

Crash of an Antonov AN-12B in Irkutsk: 9 killed

Date & Time: Dec 26, 2013 at 2101 LT
Type of aircraft:
Operator:
Registration:
12162
Flight Type:
Survivors:
No
Schedule:
Novosibirsk - Irkutsk
MSN:
3 3 415 09
YOM:
1963
Country:
Region:
Crew on board:
6
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
9
Circumstances:
The four engine aircraft departed Novosibirsk-Yeltsovka Airport on a cargo flight to Irkutsk, carrying three mechanics, six crew members and a load consisting of 1,5 tons of spare parts for the Irkut Group (Sukhoi, Beriev) based in Irkutsk. On approach to Irkust-2 Airport, the crew encountered marginal weather conditions with mist and limited visibility due to the night. On short final, the aircraft deviated to the right and descended too low until it impacted military vehicles and crashed onto several barracks of the 109th Arsenal of the Russian Army, coming to rest 770 metres short of runway 14 and about 90 metres to the right of its extended centerline. The aircraft was destroyed and all nine occupants were killed. There were no victims on the ground.
Probable cause:
The following findings were identified:
- The crew continued the descent below MDA without any visual contact with the ground, until the aircraft impacted obstacles and crashed,
- The flight manager was aware of the deterioration of the weather conditions at destination with a visibility that was below minimums, but failed to inform the crew accordingly,
- ATC at Irkutsk-2 Airport failed to inform the crew that he was deviating from the approach path on short final.

Ground accident of a Boeing 747-436 in Johannesburg

Date & Time: Dec 22, 2013 at 2243 LT
Type of aircraft:
Operator:
Registration:
G-BNLL
Flight Phase:
Survivors:
Yes
Schedule:
Johannesburg – London
MSN:
24054/794
YOM:
1990
Flight number:
BA034
Country:
Region:
Crew on board:
17
Crew fatalities:
Pax on board:
185
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
20050
Captain / Total hours on type:
12500.00
Copilot / Total flying hours:
5700
Copilot / Total hours on type:
1400
Aircraft flight hours:
110578
Aircraft flight cycles:
12832
Circumstances:
The British Airways aircraft B747-400, flight number BA034 with registration G-BNLL, was going to embark on a commercial international air transportation long haul flight from FAOR to EGLL. The ATC gave the crew instructions to push back, start and face south, then taxi using taxiway Bravo to the Category 2 holding point for Runway 03L. During the taxi, instead of turning to the left to follow Bravo, the crew continued straight ahead, crossing the intersection of taxiway Bravo and aircraft stand taxilane Mike. After crossing the intersection, still being on Mike, the aircraft collided with a building. An investigation was conducted and several causal factors were determined. Amongst others, it was determined that the crew erred in thinking they were still taxiing on Bravo while in fact they were taxiing on Mike. This mistake, coupled with other contributory factors such as the briefing information, taxi information, ground movement visual aids, confusion and loss of situational awareness led to the collision. All 202 occupants evacuated safely while four people in the building were injured. The aircraft was damaged beyond repair.
Probable cause:
The loss of situational awareness caused the crew to taxi straight ahead on the wrong path, crossing the intersection/junction of Bravo and Mike instead of following Bravo where it turns off to the right and leads to the Category 2 holding point. Following aircraft stand taxilane Mike; they collided with a building on the right-hand side of Mike.
Contributory Factors:
- Failure of the crew to carry out a briefing after they had received instruction from ATC that the taxi route would be taxiway Bravo.
- The lack of appropriate knowledge about the taxiway Bravo layout and relevant information (caution notes) on threats or risks to look out for while taxiing on taxiway Bravo en route to the Cat 2 holding point.
- The aerodrome infrastructure problems (i.e. ground movement navigation aids anomalies), which created a sense of confusion during the taxi.
- Loss of situation awareness inside the cockpit causing the crew not to detect critical cues of events as they were gradually unfolding in front of them.
- Failure of the other crew members to respond adequately when the Co-pilot was commenting on the cues (i.e. narrowness and proximity to the building).
- The intersection/junction of Bravo and Mike not being identified as a hotspot area on the charts.
Final Report:

Crash of a Beechcraft B90 King Air in Viña del Mar

Date & Time: Dec 19, 2013 at 2100 LT
Type of aircraft:
Operator:
Registration:
CC-CVZ
Flight Type:
Survivors:
Yes
Schedule:
Viña del Mar - Santiago de Chile
MSN:
LJ-441
YOM:
1969
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
15844
Captain / Total hours on type:
4000.00
Copilot / Total flying hours:
10367
Copilot / Total hours on type:
17
Aircraft flight hours:
8870
Circumstances:
The crew departed Viña del Mar-Torquemada Airport on a positioning flight to Santiago de Chile. Shortly after takeoff, the crew encountered technical problems and elected to return. On approach, both engines failed and on short final by night, the aircraft stalled and crashed 450 metres short of runway 05. Both pilots escaped uninjured and the aircraft was damaged beyond repair.
Probable cause:
Both engines stopped during flight due to fuel exhaustion as the main fuel tanks were empty. It was not possible for the crew to transfer fuel from the auxiliary tanks (wing tips) due to the intermittent function of the fuel pump.
Final Report:

Crash of a Raytheon 390 Premier I in Atlanta: 2 killed

Date & Time: Dec 17, 2013 at 1924 LT
Type of aircraft:
Operator:
Registration:
N50PM
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Atlanta - New Orleans
MSN:
RB-80
YOM:
2003
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
7200
Captain / Total hours on type:
1030.00
Aircraft flight hours:
713
Circumstances:
The pilot and passenger departed on a night personal flight. A review of the cockpit voice recorder (CVR) transcript revealed that, immediately after departure, the passenger asked the pilot if he had turned on the heat. The pilot subsequently informed the tower air traffic controller that he needed to return to the airport. The controller then cleared the airplane to land and asked the pilot if he needed assistance. The pilot replied "negative" and did not declare an emergency. The pilot acknowledged to the passenger that it was hot in the cabin. The CVR recorded the enhanced ground proximity warning system (EGPWS) issue 11 warnings, including obstacle, terrain, and stall warnings; these warnings occurred while the airplane was on the downwind leg for the airport. The airplane subsequently impacted trees and terrain and was consumed by postimpact fire. Postaccident examination of the airplane revealed no malfunctions or anomalies that would have precluded normal operation. During the attempted return to the airport, possibly to resolve a cabin heat problem, the pilot was operating in a high workload environment due to, in part, his maneuvering visually at low altitude in the traffic pattern at night, acquiring inbound traffic, and being distracted by the reported high cabin temperature and multiple EGPWS alerts. The passenger was seated in the right front seat and in the immediate vicinity of the flight controls, but no evidence was found indicating that she was operating the flight controls during the flight. Although the pilot had a history of coronary artery disease, the autopsy found no evidence of a recent cardiac event, and an analysis of the CVR data revealed that the pilot was awake, speaking, and not complaining of chest pain or shortness of breath; therefore, it is unlikely that the pilot's cardiac condition contributed to the accident. Toxicological testing detected several prescription medications in the pilot's blood, lung, and liver, including one to treat his heart disease; however, it is unlikely that any of these medications resulted in impairment. Although the testing revealed that the pilot had used marijuana at some time before the accident, insufficient evidence existed to determine whether the pilot was impaired by its use at the time of the accident. Toxicology testing also detected methylone in the pilot's blood. Methylone is a stimulant similar to cocaine and Ecstasy, and its effects can include relaxation, euphoria, and excited calm, and it can cause acute changes in cognitive performance and impair information processing. Given the level of methylone (0.34 ug/ml) detected in the pilot's blood, it is likely that the pilot was impaired at the time of the accident. The pilot's drug impairment likely contributed to his failure to maintain control of the airplane.
Probable cause:
The pilot's failure to maintain airplane control while maneuvering the airplane in the traffic pattern at night. Contributing to the accident was the pilot's impairment from the use of illicit drugs.
Final Report:

Crash of a Boeing 747-281BSF in Abuja

Date & Time: Dec 4, 2013 at 2119 LT
Type of aircraft:
Operator:
Registration:
EK-74798
Flight Type:
Survivors:
Yes
Schedule:
Jeddah - Abuja
MSN:
23698/667
YOM:
1986
Flight number:
SV6814
Country:
Region:
Crew on board:
6
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
23000
Captain / Total hours on type:
13000.00
Copilot / Total flying hours:
5731
Copilot / Total hours on type:
1296
Aircraft flight hours:
94330
Aircraft flight cycles:
15255
Circumstances:
Following an uneventful cargo flight from Jeddah, the crew completed the approach and landing procedures on runway 04 at Abuja-Nnamdi Azikiwe Airport. During the landing roll, the aircraft overran the displaced threshold then veered to the right and veered off runway. While contacting a grassy area, the aircraft collided with several parked excavator equipment and trucks. The aircraft came to a halt and was severely damaged to both wings and engines. All six occupants escaped uninjured while the aircraft was damaged beyond repair.
Probable cause:
The accident resulted as the crew was not updated on the information available on the reduced runway length.
The following contributing factors were identified:
1. Lack of briefing by Saudia dispatcher during pre-flight.
2. Runway status was missing from Abuja ATIS information.
3. Ineffective communication between crew and ATC on short finals.
4. The runway markings and lighting not depicting the displaced threshold.
5. The entire runway lighting was ON beyond the displaced threshold.
Final Report:

Crash of a Britten Norman BN-2A-3 Islander in Aldeia Pikany: 5 killed

Date & Time: Dec 4, 2013 at 1130 LT
Type of aircraft:
Operator:
Registration:
PT-WMY
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Aldeia Pikany – Novo Progresso
MSN:
314
YOM:
1974
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
5
Captain / Total flying hours:
530
Captain / Total hours on type:
58.00
Circumstances:
Shortly after takeoff from The Pikany Indian Reserve Airfield, while in initial climb, the twin engine aircraft lost height, collided with trees and crashed in a wooded area located on km from the airstrip. The aircraft was destroyed and all five occupants were killed, among them Indian Kayapo who were flying to Novo Progresso to have urgent care.
Probable cause:
The following factors were identified:
- The utilization of an aircraft not included in the Operating Specifications and of a runway neither registered nor approved, with a pilot who did not have the amount of hours necessary nor specific training, disclose a culture based on informal practices, which led to operation below the minimum safety requirements.
- It is possible that the pilot forgot to verify the quantity of fuel in the tanks of the aircraft before takeoff.
- The lack of specific training for the pilot and for the coordinator who, possibly, assumed the function of instructor may have compromised their operational performance during the preparation and conduction of the flight, since they were not effectively prepared for the activity.
- It is possible that the pilot failed to comply with the prescriptions of the legislation relatively to the minimum amount of fuel required for the flight leg. The operation of the aircraft by a pilot with expired qualifications and without the required training goes against the prescriptions at the time, but it was not determined whether this pilot (coordinator) was in the aircraft controls at the moment of the accident. The transport of a cylinder onboard the aircraft also configures flight indiscipline, since it goes against the legislation which prohibits the transport of such material.
- The lack of training of the differences may have contributed to the forgetting to verify the fuel tanks, a procedure that is prescribed in the aircraft manual. Likewise, lack of training may have deprived the pilots from acquiring proficiency for the operation of the aircraft in a single engine condition.
- The fact of conducting a flight to provide assistance in an emergency situation may have contributed to the pilot having forgotten to check safety parameters, such as the amount of fuel necessary.
- The pilot’s intention to earn his operational promotion may have stimulated him excessively, to the point of disregarding the minimum safety requirements for the operation. In addition, the emergency nature of the flight request possibly added to the motivation of the pilot and the coordinator.
- It is possible that, due to having little total experience either both of flight and in the aircraft, the pilot lost control of the aircraft when faced with the situation of in-flight engine failure after the takeoff.
- It is possible that the pilot and the coordinator prioritized the emergency requirement of the situation, failing to evaluate other aspects relevant for the safety of the flight, such as planning, for example.
- The lack of control on the part of the company’s management in relation to the flights operating outside of the main base allowed the pilot and the base manager to conduct a flight without the operating sector authorization. The lack of supervision of the air transport service provision by the contracting organizations allowed the company to provide services without the minimum conditions required by the legislation. Such conditions exposed the passengers to the risks of an irregular operation.
Final Report:

Crash of a Rockwell Grand Commander 680E in Crescent City

Date & Time: Dec 3, 2013 at 0937 LT
Registration:
N71DF
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Crescent City - Palatka
MSN:
680E-672-12
YOM:
1958
Crew on board:
1
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
15000
Captain / Total hours on type:
100.00
Aircraft flight hours:
8400
Circumstances:
The pilot reported that the airplane "hesitated" during the takeoff roll due to the added weight of the passengers on board and the grass surface of the departure airstrip (Jim Finlay Farm Airstrip). He said he then added "extra" engine power at rotation, and that the left engine accelerated more quickly than the right, which resulted in an adverse yaw to the right and collision with trees along the right side of the runway. The subsequent collision with trees and terrain resulted in substantial damage to the airframe. According to the pilot, there were no mechanical deficiencies with the airplane that would have prevented normal operation.
Probable cause:
The pilot's failure to maintain directional control during takeoff.
Final Report: