Crash of a Dornier DO228-202K in Viña del Mar: 2 killed

Date & Time: Sep 9, 2013 at 0950 LT
Type of aircraft:
Operator:
Registration:
CC-CNW
Flight Type:
Survivors:
No
Schedule:
Coquimbo - Viña del Mar
MSN:
8063
YOM:
1986
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
15537
Captain / Total hours on type:
12431.00
Copilot / Total flying hours:
10777
Aircraft flight hours:
25012
Circumstances:
The crew departed Coquimbo on a positioning flight to Viña del Mar to pick up passengers who need to fly to a mining area located in Los Perlambres. As the ILS system was inoperative, the crew was forced to complete a non-precision approach to runway 05. The visibility was poor due to foggy conditions. On final approach, while the aircraft was unstable, the crew descended below the MDA until the aircraft collided with power cables and crashed in an open field located about 1,8 km short of runway. The aircraft was destroyed upon impact and both pilots were killed.
Probable cause:
Controlled flight into terrain following the decision of the crew to continue the approach below the MDA without visual contact with the runway until the aircraft impacted ground.
The following contributing factors were identified:
- Failure to apply the concepts of Crew Resource Management (CRM).
- Failure to use checklists.
- Failure to brief the maneuvers to be executed.
- Loss of situational awareness of the crew.
- Failure to keep a sterile cockpit during approach.
- Complacency and overconfidence of the pilots.
- Unstabilized instrument approach.
- Lack and/or non-use of equipment and systems to support the flight.
Final Report:

Crash of an Airbus A330-321 in Bangkok

Date & Time: Sep 8, 2013 at 2326 LT
Type of aircraft:
Operator:
Registration:
HS-TEF
Survivors:
Yes
Schedule:
Guangzhou – Bangkok
MSN:
066
YOM:
1995
Flight number:
TG679
Country:
Region:
Crew on board:
14
Crew fatalities:
Pax on board:
288
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Following an uneventful night schedule service from Guangzhou, the crew was cleared for an ILS approach to runway 19L at Bangkok-Suvarnabhumi Airport. Following a smooth landing, the crew started the braking procedure when, after a course of about 1,000 metres, the aircraft deviated to the right then veered off runway. While contacting soft ground, the nose gear collapsed, the aircraft sank in earth and came to rest with both engines in flames. All 302 occupants were rescued, among them 14 passengers were injured. The aircraft was damaged beyond repair.
Probable cause:
Loss of control after landing after the right hand bogie beam broke due to fatigue cracks.

Crash of a Piper PA-31P Pressurized Navajo in Doylestown

Date & Time: Sep 8, 2013 at 1030 LT
Type of aircraft:
Registration:
N57JK
Flight Type:
Survivors:
Yes
Schedule:
Cambridge - Doylestown
MSN:
31-7530020
YOM:
1975
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1612
Captain / Total hours on type:
1054.00
Aircraft flight hours:
3952
Circumstances:
Following a normal landing, the pilot felt no wheel braking action on the left wheel, and the brake pedal went to the floor. The pilot attempted to maintain directional control; however, the airplane departed the right side of the runway and traveled into the grass. The landing gear collapsed, and the airplane came to a stop, sustaining structural damage to the left wing spar. Postaccident examination confirmed that the left brake was inoperative and revealed a small hydraulic fluid leak at the shaft of the parking brake valve in the pressurized section of the cabin. Air likely entered the brake line at the area of the leak while the cabin was pressurized, rendering the left brake inoperative.
Probable cause:
A leaking parking brake valve, which allowed air to enter the left brake line and resulted in the eventual failure of the left wheel brake during the landing roll.
Final Report:

Crash of a Canadair RegionalJet CRJ-200ER in Moscow

Date & Time: Sep 7, 2013 at 2115 LT
Operator:
Registration:
TC-EJA
Survivors:
Yes
Schedule:
Naples - Moscow
MSN:
7763
YOM:
2003
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
7
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Following an uneventful flight from Naples-Capodichino Airport, the crew started the descent to Moscow. On approach to Vnukovo Airport Runway 09, while completing the approach checklist and configuring the aircraft for landing, the crew noticed that both main landing gears remained stuck in their wheel well while the nose gear was lock down properly. The crew abandoned the approach and initiated a go-around. During a holding circuit, the crew attempted to troubleshoot the system and to deploy both main gears manually without success. The crew eventually decided to complete the landing in such configuration. The aircraft landed on runway 01 with both main gears retracted and the nose gear down, slid for few dozen metres and came to a halt. All 11 occupants evacuated safely and the aircraft was damaged beyond repair.

Crash of a Cessna T207 Turbo Skywagon in Colorado Springs

Date & Time: Sep 4, 2013 at 0758 LT
Registration:
N211AS
Flight Phase:
Survivors:
Yes
Schedule:
Colorado Springs – Lubbock
MSN:
207-0259
YOM:
1974
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
5200
Captain / Total hours on type:
18.00
Aircraft flight hours:
13482
Circumstances:
The pilot reported that he performed the takeoff with the airplane at gross weight and with the flaps up and the engine set for maximum power, which he verified by reading the instruments. During the takeoff, the airplane accelerated and achieved liftoff about 65 to 70 mph and then climbed a couple hundred feet before the pilot began to lower the nose to accelerate to normal climb speed (90 to 100 mph). The airplane then stopped climbing and would not accelerate more than 80 mph. While the pilot attempted to maintain altitude, the airplane decelerated to 70 mph with the engine still at the full-power setting. With insufficient runway remaining to land, the pilot made a shallow right turn toward lower terrain and subsequently made a hard landing in a field. The pilot likely allowed the airplane to climb out of ground effect before establishing a proper pitch attitude and airspeed for the climb, which resulted in the airplane inadvertently entering a “region of reversed command” at a low altitude. In this state, the airplane may be incapable of climbing and would require either more engine power or further lowering of the airplane’s nose to increase airspeed. Because engine power was already at its maximum and the airplane was at a low altitude, the pilot was unable to take remedial action to fly out of the region of reversed command.
Probable cause:
The pilot’s failure to establish the proper pitch attitude and airspeed during takeoff with the engine at maximum power, which resulted in the exceedance of the airplane’s climb performance capability.
Final Report:

Crash of a Cessna 421C Golden Eagle III in Paris: 1 killed

Date & Time: Aug 27, 2013 at 1120 LT
Operator:
Registration:
N229H
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Paris - Terre Haute
MSN:
421C-0088
YOM:
1976
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
8600
Captain / Total hours on type:
2000.00
Aircraft flight hours:
3000
Circumstances:
Company personnel reported that, in the weeks before the accident, the airplane's left engine had been experiencing a problem that prevented it from initially producing 100 percent power. The accident pilot and maintenance personnel attempted to correct the discrepancy; however, the discrepancy was not corrected before the accident flight, and company personnel had previously flown flights in the airplane with the known discrepancy. Witnesses reported observing a portion of the takeoff roll, which they described as slower than normal. However, the airplane was subsequently blocked from their view. Examination of the runway environment showed that, during the takeoff roll, the airplane traveled the entire length of the 4,501-ft runway, continued to travel through a 300-ft-long grassy area and a 300- ft-long soybean field, and then impacted the top of 10-ft-tall corn stalks for about 50 ft before it began to climb. About 1/2 mile from the airport, the airplane impacted several trees in a leftwing, nose-low attitude, consistent with the airplane being operated below the minimum controllable airspeed. The main wreckage was consumed by postimpact fire. Postaccident examinations revealed no evidence of mechanical anomalies with the airframe, right engine, or propellers that would have precluded normal operation. Given the left engine's preexisting condition, it is likely that its performance was degraded; however, postimpact damage and fire preluded a determination of the cause of the problem.
Probable cause:
The pilot's failure to abort the takeoff during the ground roll after detecting the airplane's degraded performance. Contributing to the accident was the pilot's decision to attempt a flight with a known problem with the left engine and the likely partial loss of left engine power for reasons that could not be determined during the postaccident examination of the engine.
Final Report:

Crash of an Antonov AN-26B-100 in Guriceel

Date & Time: Aug 25, 2013 at 1604 LT
Type of aircraft:
Operator:
Registration:
EK-26818
Survivors:
Yes
Schedule:
Mogadishu – Guriceel
MSN:
141 01
YOM:
1990
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
45
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The aircraft was performing a special flight from Mogadishu to Guriceel, carrying 5 crew members and 45 passengers, among them Hussein Ali Wehliye, the new governor of the Galguduud Province. Following an uneventful flight, the aircraft landed too far down the runway and was unable to stop within the remaining distance. It overran and hit a rock which caused the nose gear to collapse and to penetrated the cockpit floor, injuring a crew member. All 49 other occupants escaped uninjured and the aircraft was damaged beyond repair.
Probable cause:
It is believed that, following a wrong approach configuration, the aircraft landed too far down the runway, reducing the landing distance available. In such situation, the aircraft could not be brought to a safe halt. As the landing maneuver was obviously missed, the crew should initiate a go-around procedure. It was also reported that the aircraft CofA expired 31 May 2012 and that the aircraft was removed from the Armenian registered on 26 Oct 2012.

Crash of a Swearingen SA227DC Metro 23 in Sucre

Date & Time: Aug 20, 2013 at 0847 LT
Type of aircraft:
Operator:
Registration:
CP-2655
Survivors:
Yes
Schedule:
Potosí – Sucre
MSN:
DC-819B
YOM:
1993
Flight number:
AEK228
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
11073
Captain / Total hours on type:
806.00
Copilot / Total flying hours:
1553
Copilot / Total hours on type:
953
Aircraft flight hours:
34860
Circumstances:
Following an uneventful flight from Potosí, the crew started the descent to Sucre-Juana Azurduy de Padilla Airport Runway 05 in good weather conditions. After touchdown, at a speed of about 50 knots, the aircraft deviated to the left then pivoted 90° left, veered off runway and rolled for about 50 metres before coming to rest in a rocky ditch. There was no fire. All 10 occupants evacuated safely and the aircraft was damaged beyond repair.
Probable cause:
Loss of control after landing due to the failure of the nosewheel steering system.
Final Report:

Crash of a Douglas DC-3C in Yellowknife

Date & Time: Aug 19, 2013 at 1712 LT
Type of aircraft:
Operator:
Registration:
C-GWIR
Survivors:
Yes
Schedule:
Yellowknife - Hay River
MSN:
9371
YOM:
1943
Flight number:
BFL168
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
21
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
13000
Captain / Total hours on type:
4300.00
Copilot / Total flying hours:
500
Copilot / Total hours on type:
125
Circumstances:
On 19 August 2013, a Buffalo Airways Ltd. Douglas DC-3C (registration C-GWIR, serial number 9371) was operating as a scheduled passenger flight from Yellowknife, Northwest Territories, to Hay River, Northwest Territories. After lift-off from Runway 16 at 1708 Mountain Daylight Time, there was a fire in the right engine. The crew performed an emergency engine shutdown and made a low-altitude right turn towards Runway 10. The aircraft struck a stand of trees southwest of the threshold of Runway 10 and touched down south of the runway with the landing gear retracted. An aircraft evacuation was accomplished and there were no injuries to the 3 crew members or the 21 passengers. There was no post-impact fire and the 406 MHz emergency locator transmitter did not activate.
Probable cause:
Findings as to causes and contributing factors:
1. An accurate take-off weight and balance calculation was not completed prior to departure, resulting in an aircraft weight that exceeded its maximum certified takeoff weight.
2. The right engine number 1 cylinder failed during the take-off sequence due to a preexisting fatigue crack, resulting in an engine fire.
3. After the right propeller’s feathering mechanism was activated, the propeller never achieved a fully feathered condition likely due to a seized bearing in the feathering pump.
4. The windmilling right propeller caused an increase in drag which, combined with the overweight condition, contributed to the aircraft’s inability to maintain altitude, and the aircraft collided with terrain short of the runway.
5. The operator’s safety management system was ineffective at identifying and correcting unsafe operating practices.
6. Transport Canada’s surveillance activities did not identify the operator’s unsafe operating practices related to weight and balance and net take-off flight path calculations. Consequently, these unsafe practices persisted.
Findings as to risk:
1. If companies do not adhere to operational procedures in their operations manual, there is a risk that the safety of flight cannot be assured.
2. If Transport Canada does not adopt a balanced approach that combines inspections for compliance with audits of safety management processes, unsafe operating practices may not be identified, thereby increasing the risk of accidents.
3. If cockpit or data recordings are not available to an investigation, this may preclude the identification and communication of safety deficiencies to advance transportation safety.
Other findings:
1. Current Canadian Aviation Regulations permit a transport category piston-powered aircraft to carry passengers without a flight data recorder or cockpit voice recorder.
2. The crew resource management component of the flight attendant’s training had not been completed.
Final Report:

Crash of an Airbus A300-622R in Birmingham: 2 killed

Date & Time: Aug 14, 2013 at 0447 LT
Type of aircraft:
Operator:
Registration:
N155UP
Flight Type:
Survivors:
No
Schedule:
Louisville - Birmingham
MSN:
841
YOM:
2003
Flight number:
UPS1354
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
6406
Captain / Total hours on type:
3265.00
Copilot / Total flying hours:
4721
Copilot / Total hours on type:
403
Aircraft flight hours:
11000
Aircraft flight cycles:
6800
Circumstances:
On August 14, 2013, about 0447 central daylight time (CDT), UPS flight 1354, an Airbus A300-600, N155UP, crashed short of runway 18 during a localizer non precision approach to runway 18 at Birmingham-Shuttlesworth International Airport (BHM), Birmingham, Alabama. The captain and first officer were fatally injured, and the airplane was destroyed by impact forces and postcrash fire. The scheduled cargo flight was operating under the provisions of 14 Code of Federal Regulations Part 121 on an instrument flight rules flight plan, and dark night visual flight rules conditions prevailed at the airport; variable instrument meteorological conditions with a variable ceiling were present north of the airport on the approach course at the time of the accident. The flight originated from Louisville International Airport-Standiford Field, Louisville, Kentucky, about 0503 eastern daylight time. A notice to airmen in effect at the time of the accident indicated that runway 06/24, the longest runway available at the airport and the one with a precision approach, would be closed from 0400 to 0500 CDT. Because the flight's scheduled arrival time was 0451, only the shorter runway 18 with a non precision approach was available to the crew. Forecasted weather at BHM indicated that the low ceilings upon arrival required an alternate airport, but the dispatcher did not discuss the low ceilings, the single-approach option to the airport, or the reopening of runway 06/24 about 0500 with the flight crew. Further, during the flight, information about variable ceilings at the airport was not provided to the flight crew.
Probable cause:
The NTSB determined that the probable causes of the crash were:
- The crew continued an unstabilized approach into Birmingham Airport,
- The crew failed to monitor the altitude and inadvertently descended below the minimum descent altitude when the runway was not yet in sight.
Contributing factors were:
- The flight crew's failure to properly configure the on-board flight management computer,
- The first officer's failure to make required call-outs,
- The captain's decision to change the approach strategy without communicating his change to the first officer,
- Flight crew fatigue.
Final Report: