Country
code

Channel Islands

Crash of a Piper PA-46-310P Malibu off Guernsey: 2 killed

Date & Time: Jan 21, 2019 at 2016 LT
Operator:
Registration:
N264DB
Flight Phase:
Survivors:
No
Schedule:
Nantes - Cardiff
MSN:
46-8408037
YOM:
1984
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
3500
Captain / Total hours on type:
30.00
Aircraft flight hours:
6636
Circumstances:
The pilot of N264DB flew the aircraft and the passenger from Cardiff Airport to Nantes Airport on 19 January 2019 with a return flight scheduled for 21 January 2019. The pilot arrived at the airport in Nantes at 1246 hrs on 21 January to refuel and prepare the aircraft for the flight. At 1836 hrs the passenger arrived at airport security, and the aircraft taxied out for departure at 1906 hrs with the passenger sitting in one of the rear, forward-facing passenger seats. Figure 1 shows the aircraft on the ground before departure. The pilot’s planned route would take the aircraft on an almost direct track from Nantes to Cardiff, flying overhead Guernsey en route (Figure 2). The Visual Flight Rules (VFR) flight plan indicated a planned cruise altitude of 6,000 ft amsl and distance of 265 nm. The aircraft took off from Runway 03 at Nantes Airport at 1915 hrs, and the pilot asked Air Traffic Control (ATC) for clearance to climb to 5,500 ft. The climb was approved by Nantes Approach Control and the flight plan was activated. The aircraft flew on its planned route towards Cardiff until it was approximately 13 nm south of Guernsey when the pilot requested and was given a descent clearance to remain in Visual Meteorological Conditions (VMC). Figure 3 shows the aircraft’s subsequent track. The last radio contact with the aircraft was with Jersey ATC at 2012 hrs, when the pilot asked for a further descent. The aircraft’s last recorded secondary radar point was at 2016:34 hrs, although two further primary returns were recorded after this. The pilot made no distress call that was recorded by ATC. On February 4, 2019, the wreckage (relatively intact) was found at a depth of 63 meters few km north of the island of Guernsey. On February 6, a dead body was found in the cabin and recovered. It was later confirmed this was the Argentine footballer Emiliano Sala. The pilot's body was not recovered.
Probable cause:
Causal factors
1. The pilot lost control of the aircraft during a manually-flown turn, which was probably initiated to remain in or regain VMC.
2. The aircraft subsequently suffered an in-flight break-up while manoeuvring at an airspeed significantly in excess of its design manoeuvring speed.
3. The pilot was probably affected by CO poisoning.
Contributory factors
1. A loss of control was made more likely because the flight was not conducted in accordance with safety standards applicable to commercial operations. This manifested itself in the flight being operated under VFR at night in poor weather conditions despite the pilot having no training in night flying and a lack of recent practice in instrument flying.
2. In-service inspections of exhaust systems do not eliminate the risk of CO poisoning.
3. There was no CO detector with an active warning in the aircraft which might have alerted the pilot to the presence of CO in time for him to take mitigating action.
Final Report:

Crash of a Britten Norman BN-2B-21 Islander in Devil's Hole

Date & Time: Nov 3, 2013 at 1020 LT
Type of aircraft:
Operator:
Registration:
G-CIAS
Flight Phase:
Survivors:
Yes
Schedule:
Guernsey - Guernsey
MSN:
2162
YOM:
1982
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
25200
Captain / Total hours on type:
60.00
Circumstances:
At approximately 1830 hrs on 3 November 2013 the operator’s duty pilot received a request that the aircraft should be dispatched to carry out a search. The volunteer crew-members were alerted and made their way to the airport. Weather conditions in the Channel Islands were poor, with a southerly wind gusting up to 41 kt, turbulence, rain, cloud below 1,000 ft aal, and visibility of 3 to 6 km. On arrival at the aircraft’s hangar, the crew was established, consisting of a pilot, search director, and three observers. They donned immersion suits and life jackets and prepared for flight. The search director obtained details of the search request, which was to search for two fishermen near Les Écréhous (a group of rocks in the English Channel approximately 5 nm north-east of the north-eastern corner of Jersey). Some evidence suggested the men were in a small dinghy; other information was that they were in the water. The men were reported to be alive and communicating by mobile telephone. One crew-member carried out pre-flight preparations, although he did not check the fuel quantities or carry out a water drain check. When interviewed, he recalled having reported to the pilot that he had not checked the fuel. The aircraft was then pulled out of its hangar and the search director explained the details of the search request to the pilot and other crew-members. Bearing in mind the weather, the fact that it was dark, and the fishermen’s predicament, the pilot recognized the need for “a lot of urgency” about the task. In the context of the operation, he regarded the task as being routine, but the weather not so. The pilot “walked round” the aircraft, though he did not carry out a formal pre-flight inspection; it was the organization’s custom to ensure that the aircraft was ready for flight at all times. The technical log showed that the aircraft was serviceable, with no deferred defects, and that the wing tanks contained 55 USG each side and the tip tanks, 18 USG each side. The search director recalled asking the pilot whether he was content to fly in the prevailing conditions, and that the pilot stated that he was willing to fly. The crew boarded the aircraft. The observer in the front right-hand seat had recently obtained a Private Pilot’s Licence and this influenced the decision for him to be placed next to the pilot. The pilot reported that he carried out a “fairly rapid” start, although the normal pre-departure sequence was interrupted while a problem with switch selections, affecting the functioning of the search equipment in the aircraft’s cabin, was resolved. The pilot obtained clearance from ATC to taxi, enter the runway, and take off when ready. He described that he carried out engine power checks during a brief back-track, checking the magnetos and propeller controls at 2,100 rpm, before carrying out pre-takeoff checks. He did not refer to the written checklists provided in the aircraft but executed a generic set of checks from memory. Following an unremarkable takeoff, in the strong crosswind , the pilot corrected for drift and established a climb towards a cruising altitude of 900 ft. When interviewed, he described the conditions as being “awful” and “ghastly”, with turbulence from the cliffs contributing to occasional activation of the stall warner, even though the speed was “probably 100 plus knots” . At 900 ft, the aircraft was “in the bottom” of the cloud, which was unhelpful for the observers, so the pilot descended the aircraft to cruise at 500 or 600 ft, flying by reference to the artificial horizon, and making constant control inputs to maintain straight and level flight. He stated that, although he would normally have begun checking fuel flow, mixture settings, etc, shortly after establishing in the cruise, he found that the conditions required him to devote his full attention to flying the aircraft. As the aircraft passed north abeam the western end of Jersey, the rain and low cloud continued and the turbulence worsened, The pilot gained sight of red obstacle lights on a television mast on the north side of the island but had few other visual references. The pilot noticed a change in an engine note. He immediately “reached down to put the hot air on” which made little difference; the observer recalled that the pilot checked that the mixtures were fully rich at this time. The right-hand engine rpm then began surging. The pilot made a quick check of the engine instruments, before applying full throttle on both engines, setting both propellers to maximum rpm and beginning a climb. The observer noticed that the fuel pressure gauge for the right-hand engine was “going up and down” but did not mention this to the pilot; the pilot did not see the gauge indication fluctuating. Around this time the pilot switched the electric fuel pumps on. The pilot turned the aircraft towards Jersey and made a MAYDAY call to ATC; the search director made a similar call on the appropriate maritime frequency. These calls were acknowledged, and a life boat, on its way to Les Écréhous, altered course towards the aircraft’s position. Although the pilot was “amazed” at how few lights he could see on the ground, he perceived what he thought was the runway at Jersey Airport, and flew towards it. The aircraft reached approximately 1,100 ft amsl. The right-hand engine then stopped. The pilot carried out the shut-down checks, feathering the propeller as he did so. The aircraft carried on tracking towards Jersey Airport, descending towards the north side of the island. Some moments later, the left-hand engine’s rpm began to fluctuate briefly before it also stopped. The pilot later recalled being “fairly certain” that he “was trying to change tanks” but acknowledged that he could not recall events with certainty. He trimmed the aircraft for a glide, still heading towards the airport at Jersey, but with very limited visual references outside the cockpit. The crew-members prepared the cabin for a ditching or off-airport landing; the observers in the rear-most seats considered how they might deploy the aircraft’s life raft (stored behind their seats) should a ditching occur. The pilot’s next recollection was that the automated decision height voice call-out activated (he had selected it to announce at 200 ft radio height). He switched the landing lights on and maintained a “reasonable speed” in anticipation of landing or ditching. One crew-member recalled the pilot calling “brace, brace, brace”, while another recalled being instructed to tighten seat belts and brace. No brace position had been set out in the operations manual, or rehearsed in training, and the responses of the crew-members to this instruction varied. The pilot glimpsed something green in front of the aircraft, and flared for landing. The aircraft touched down and decelerated, sliding downhill and passing through a hedge. With the aircraft now sliding somewhat sideways, it came to a halt when its nose lodged against a tree, with significant airframe damage. The pilot made various cockpit selections safe and all the occupants vacated the aircraft, with some difficulty. The search director became entangled in his headset lead as he egressed but freed himself. The front seat occupants experienced difficulty because their door could not be opened. They climbed over the search director’s desk and vacated the aircraft via the door adjacent to the search director’s position (the rear-row observers simultaneously opened the pilot’s door from the outside). The pilot and crew made their way to nearby habitation where they were subsequently assessed by an ambulance crew; none were injured. The search director returned to the aircraft with fire-fighters, to ensure that pyrotechnics and the self-inflating life raft on board the aircraft did not pose a hazard. In his very frank account of the flight, the pilot acknowledged that a decision to turn back soon after departure would have been justified by the weather conditions. He added that before the engine power changed, his workload was already very high, on account of the task and conditions.
Probable cause:
The inspection of the aircraft at the accident site, combined with the crew accounts gathered early in the AAIB accident investigation, indicated that no mechanical or electrical defect had been a factor in the accident. The evidence indicated that the fuel supply to the right-hand engine, and then the left-hand engine, had become exhausted in flight and the engines ceased producing power approximately 15 minutes after the aircraft became airborne. The fuel selector was found in the 'tip tank' position. It appears that the tip tanks had been selected on a flight the previous day and the selection had not been changed. At the commencement of the accident flight, each tip tank contained approximately 5-6 USG.
Final Report:

Crash of a Cessna T303 Crusader off Jersey: 2 killed

Date & Time: Sep 4, 2013 at 1013 LT
Type of aircraft:
Operator:
Registration:
N289CW
Flight Type:
Survivors:
No
Schedule:
Dinan - Jersey
MSN:
303-00032
YOM:
1981
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
524
Captain / Total hours on type:
319.00
Circumstances:
The aircraft was on a VFR flight from Dinan, France, to Jersey, Channel Islands and had joined the circuit on right base for Runway 09 at Jersey Airport. The aircraft turned onto the runway heading and was slightly left of the runway centreline. It commenced a descent and a left turn, with the descent continuing to 100 ft. The pilot made a short radio transmission during the turn and then the aircraft’s altitude increased rapidly to 600 ft before it descended and disappeared from the radar. The aircraft probably stalled in the final pull-up manoeuvre, leading to loss of control and impact with the sea, fatally injuring those on board, Carl Whiteley and his wife.
Probable cause:
The accident was probably as a result of the pilot’s attempt to recover to normal flight following a stall or significant loss of airspeed at a low height, after a rapid climb manoeuvre having become disoriented during the approach in fog.
Final Report:

Crash of an ATR42-320 in Jersey

Date & Time: Jun 16, 2012 at 0823 LT
Type of aircraft:
Operator:
Registration:
G-DRFC
Survivors:
Yes
Schedule:
Guernsey - Jersey
MSN:
007
YOM:
1986
Flight number:
BCI308
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
40
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
6106
Captain / Total hours on type:
1255.00
Circumstances:
The crew, comprising a commander, co-pilot and cabin crewmember, reported for duty at 0620 hrs at Guernsey Airport. The commander was conducting line training of the co-pilot, a first officer who had recently joined the companyThe first sector was to be from Guernsey to Jersey. No problems were identified during the pre-flight preparation and the aircraft departed on time at 0705 hrs, with the commander acting as handling pilot. The short flight was without incident and the weather for landing was reported as good, with the wind from 210° at 16 kt, FEW cloud at 2,000 ft and visibility in excess of 10 km. The commander elected to carry out a visual approach to Runway 27 at Jersey, using a planned approach speed of 107 kt and flap 30 selected for landing. During the approach, the gear was selected down and the flight crew confirmed the three green ‘gear safe’ indication lights were illuminated, indicating that the gear was locked in the down position. The commander reported that both the approach and touchdown seemed normal, with the crosswind from the left resulting in the left main gear touching first. Just after touchdown both pilots heard a noise and the commander stated the aircraft appeared to settle slightly differently from usual. This made him believe that a tyre had burst. The cabin crew member also heard a noise after touchdown which she too thought was from a tyre bursting. The commander selected ground idle and partial reverse pitch and, as the aircraft decelerated through 70 kt, the co-pilot took over control of the ailerons, as per standard procedures, to allow the commander to take control of the steering tiller. The co-pilot reported that despite applying corrective inputs the aircraft continued rolling to the left. A member of ground operations staff, situated at Holding Point E, reported to the tower controller that the left landing gear leg of the aircraft did not appear to be down properly as it passed him. The aircraft continued to quickly roll to the left until the left wingtip and propeller contacted the runway. The aircraft remained on the runway, rapidly coming to a halt to the left of the centreline, approximately abeam Holding Point D. Both propellers continued to rotate and the commander selected the condition levers to the fuel shutoff position and pulled the fire handles to shut both engines down. The tower controller, seeing the incident, pressed the crash alarm and airfield emergency services were quickly in attendance.
Probable cause:
The recorded data indicates that the rate of descent during the final approach phase was not excessive and remained low through the period of the touchdown. Although the registered vertical acceleration at ground contact was high, this is not consistent with the recorded descent rate and is believed to have been the effect of the close physical proximity of the accelerometer to the location of the fractured side brace. It is reasonable to assume that the release of strain energy during the fracturing process produced an instant shock load recorded as a 3 g spike.The general nature of the failure mechanism precipitating the collapse of the landing gear is clear. A fatigue crack propagated through most of the cross-section of one side of an attachment lug of the left main landing gear side brace upper arm. This continued as a final region of ductile cracking until complete failure occurred. The increased loading, during normal operation, on other elements of the twin lugs, once the initial crack was large or had passed completely through the section, led to overloading in the other section of the forward lug and both sections of the aft lug. This caused rapid onset of three small areas of fatigue damage followed by ductile overload failure of both lugs. The failure rendered the side brace ineffective and the unrestrained main trunnion continued to translate outboard leading to the collapse of the gear. The aluminium was found to be within the specifications to which it was made. The initial fatigue crack emanated from a feature which was inter-granular and high in titanium content, which was probably a TiB2 particle introduced during grain refining. This was surrounded by an area consistent with static loading before propagating a crack in fatigue. Given that there was not a measurable effect on the fatigue life of the material with the feature, and that an area of static overload was evident immediately surrounding the TiB2 particle, it is therefore concluded that at some time during the life of the side brace component it probably suffered a single loading event sufficient to exploit the presence of the origin, initiating a crack that remained undetectable until failure.
Final Report:

Crash of a Fokker F27 Friendship 600 in Saint Peter: 2 killed

Date & Time: Jan 12, 1999 at 1706 LT
Type of aircraft:
Operator:
Registration:
G-CHNL
Flight Type:
Survivors:
No
Schedule:
Luton - Saint Peter
MSN:
10508
YOM:
1975
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
3930
Captain / Total hours on type:
750.00
Copilot / Total flying hours:
958
Copilot / Total hours on type:
317
Circumstances:
The Fokker F27 was operating on a cargo flight to Guernsey, carrying newspapers. The aircraft departed Luton at 16:14. and climbed to cruising altitude FL150/160). The descent was begun at about 60 miles from Guernsey Airport and the aircraft was vectored onto final approach by Jersey Radar. The approach checklist was actioned and the flaps were lowered to 16° just before the aircraft was turned to intercept the ILS localizer. With less than six miles to run to the threshold the commander told the first officer that he could see the runway and was content to continue the approach visually. The first officer informed ATC that they wished to continue the approach visually; they were given the appropriate clearance and control of the aircraft was then handed over to Guernsey Tower. Initially the aerodrome controller cleared the aircraft to continue the approach (there was departing traffic on the runway) and the commander called for flaps to 26° followed by the landing checklist. About one minute later the commander said "three whites" (meaning that he was aware that the aircraft was slightly high on the glide path indicated by the precision approach path indicator lights) which the first officer acknowledged. The commander then said "ok the decision is to land, speed below one four four, flaps forty". The first officer acknowledged the instruction to select flaps to 40° and announced "running". There followed a pause of about five seconds before the first officer said, "flaps forty gear and clearance you have - oops". The commander then said, in an anxious tone of voice "ok flaps twenty six" and the engines could be heard accelerating on the cockpit voice recording. There then followed a number of expletives from the commander interspersed with some loud clicks as controls or switches were operated and the sound of a warning horn which stopped before the end of the recording. On approach the aircraft had lost control, attaining a nose-high attitude. The plane stalled, clipped a house on Forest Road with its left wing and ploughed into a field short of the runway.
Probable cause:
The investigation identified the following causal factors:
(i) The aircraft was operated outside the load and balance limitations;
(ii) Loading distribution errors went undetected because the load sheet signatories did not reconcile the cargo distribution in the aircraft with the load and balance sheet;
(iii) The crew received insufficient formal training in load management.
Final Report:

Crash of a Piper PA-31-350 Navajo Chieftain off Jersey: 1 killed

Date & Time: Jun 12, 1998 at 1842 LT
Operator:
Registration:
CN-TFP
Flight Type:
Survivors:
No
Schedule:
Tangier - Saint Peter
MSN:
31-7552086
YOM:
1975
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
9100
Aircraft flight hours:
5253
Circumstances:
The pilot, sole on board, departed Tangier on a delivery flight to Saint Peter-La Villiaze, Guernsey Island, where the aircraft should be taken over by another crew to be ferried to Iceland. While approaching the Channel Islands, the pilot informed ATC about technical problems and elected to divert to Jersey Airport. Shortly later, after both engines stopped due to a fuel exhaustion, the plane lost height and crashed in the sea about 3 nm northwest of Jersey Island. The aircraft was destroyed and the pilot was killed.
Probable cause:
The following causal factors were identified:
- The commander had not made an appropriate allowance for adverse headwind components before or during the flight.
- The aircraft was not carrying sufficient fuel for the intended flight.
- The commander apparently ignored pre-flight and in-flight indications that he should land and refuel in France.
- The commander's chances of survival were adversely affected by not adopting the optimum configuration and heading for ditching.
Final Report:

Crash of a Fokker F27 Friendship 500F in Saint Pierre

Date & Time: Dec 7, 1997 at 1818 LT
Type of aircraft:
Operator:
Registration:
G-BNCY
Survivors:
Yes
Schedule:
Southampton - Saint Pierre
MSN:
10558
YOM:
1977
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
50
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
14000
Captain / Total hours on type:
2865.00
Copilot / Total flying hours:
2150
Copilot / Total hours on type:
320
Aircraft flight hours:
44877
Aircraft flight cycles:
53639
Circumstances:
During his pre-flight preparation the commander noted that the crosswind at Guernsey would need close monitoring throughout the day as it would be close to the aircraft's crosswind limits. The aircraft departed from Guernsey at 16:10 for the first sector to Southampton, with the first officer acting as pilot flying (PF). On departure the first officer stated that the aircraft was 'difficult to keep straight' on the runway and moderate turbulence were encountered after takeoff between 500 to 1,000 feet agl but the remainder of the flight was uneventful. The aircraft departed again from Southampton at 17:23, with 50 passengers and 2 kg of freight on board, with the commander as the PF and the first officer as the pilot not flying (PNF). During the cruise the first officer obtained the latest weather for Guernsey: surface wind as 170°/19 gusting to 32 kt, visibility 5 km in rain, cloud scattered at 600 feet, broken at 800 feet, temperature 11°C, dew point 9°C, QNH of 1004 mb with turbulence and windshear below 200 feet agl. The commander briefed the first officer that he intended to carryout a 'radar vectored' ILS approach to runway 27 using 26.5° of flap, instead of the usual 40°, for greater aileron control in the crosswind conditions during the landing. He also intended to add 10 kt to the target threshold speed (TTS). In the final stages of the approach the aircraft experienced a drift angle of 25° to 30° in turbulent conditions. The aircraft was slightly above the prescribed glide path, as it crossed the threshold and the commander stated that when over the runway it was obvious to him that the aircraft would touchdown beyond the normal landing area. He therefore decided to initiate a go-around. Full power was applied and, when established with a positive rate of climb, the landing gear was selected up and the flaps retracted to 16°. The aircraft climbed to 1,500 feet, the flaps were retracted and the crew were given radar vectors for a second ILS approach to runway 27. The commander described the second approach as being more stable and on the correct 3° glide path throughout. The drift angle this time was between 30° and 40° from the inbound track. The crew had correctly calculated the TTS as 96 kt with 40° of flap and 106 kt when using 26.5° of flap. The 40° flap TTS of 96 kt was displayed on the landing data card on the flight deck. The aircraft was cleared to land by ATC approximately three minutes before the actual touchdown. The surface wind was passed as '180°/18 kt with the runway surface wet'. Nineteen seconds before touchdown ATC transmitted the surface wind as '190°/20 kt". The first officer stated that the indicated airspeed (IAS) had been 120 kt 'down the slope' and 110 kt as the aircraft crossed the threshold. The commander stated that the aircraft crossed the threshold, with 26.5° of flap selected, at the correct height with the projected touchdown point in the normal position. Both pilots stated that during the flare, at a height estimated by the commander to be between 10 to 15 feet above the runway, the aircraft appeared to float. The commander reduced the engine torques to zero. The aircraft then continued to descend and touched down, according to the commander, 'a little beyond the normal point, left main wheel first followed by the right and then the nose wheel'. Several fireman however, who were on standby in their vehicles at the airport fire station, saw the aircraft touch down. They described the touchdown point as being opposite the runway fire access road, i.e. with 750 meters to 900 meters of runway remaining. After touchdown the commander selected ground fine pitch on both engines but neither the first officer, the No 1 cabin attendant, who was seated at the rear of the aircraft, nor several of the passengers were aware of the normal aerodynamic braking noise from the propellers. The first officer selected the flaps up and, with the commander having called 'your stick', applied full left (into wind) aileron. It is normal for the PNF to then call '5 lights (indicating that both propellers were in ground fine pitch), TGTs (turbine gas temperatures) stable and flaps traveling'. The first officer can recall seeing five lights but stated that he did not make the normal call. The commander applied full right rudder and braking; applying maximum braking on the right side to keep the aircraft straight. The first officer described the commander as 'standing up in his seat' whilst applying full right rudder. As the aircraft traveled down the runway it felt to the crew as if it was 'skidding or floating with ineffective brakes'. The first officer did not assist with the braking. Sixteen seconds into the ground roll the aircraft started to turn uncontrollably to the left. Realizing that the aircraft would leave the paved surface the commander instructed the first officer to transmit a 'Mayday' message. The aircraft overran the end of the runway and entered the grass to the left of the extended center-line at a speed estimated by the crew to be 60 kt. It then impacted and crossed a narrow earth bank before stopping in an adjacent field.
Probable cause:
The following causal factors were identified:
- The commander decided to continue with the landing knowing that touchdown was beyond the normal point,
- The commander was not aware at touchdown that the crosswind component of the surface wind affecting the aircraft exceeded the Flight Manual limit,
- The commander could not apply maximum braking to both main landing gear brakes at the same time as maintaining directional control through differential braking and full rudder application.
Final Report: