Crash of a Beechcraft C90GT King Air near Caieiras: 1 killed

Date & Time: Dec 2, 2019 at 0602 LT
Type of aircraft:
Registration:
PP-BSS
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Jundiaí – Campo de Marte
MSN:
LJ-1839
YOM:
2008
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
6000
Captain / Total hours on type:
211.00
Circumstances:
The pilot departed Jundiaí-Comandante Rolim Adolfo Amaro Airport at 0550LT on a short transfer flight to Campo de Marte, São Paulo. While descending to Campo de Marte Airport, he encountered poor weather conditions and was instructed by ATC to return to Jundiaí. Few minutes later, while flying in limited visibility, the twin engine airplane impacted trees and crashed in a wooded area located in Mt Cantareira, near Caieiras. The aircraft was destroyed by impact forces and a post crash fire and the pilot, sole on board, was killed.
Probable cause:
The accident was the consequence of the combination of the following factors:
- Attention – undetermined.
It is likely that the pilot has experienced a lowering of his attention in relation to the available information and the stimuli of that operational context in face of the adverse conditions faced.
- Attitude – a contributor.
It was concluded that there was no reaction to the warnings of proximity to the ground (Caution Terrain) and evasive action to avoid collision (Pull Up), a fact that revealed difficulties in thinking and acting in the face of an imminent collision condition, in which the aircraft was found.
- Adverse meteorological conditions – a contributor.
The clouds height and visibility conditions did not allow the flight to be conducted, up to SBMT, under VFR rules.
- Piloting judgment – a contributor.
The attempt to continue with the visual flight, without the minimum conditions for such, revealed an inadequate assessment, by the pilot, of parameters related to the operation of the aircraft, even though he was qualified to operate it.
- Perception – a contributor
The ability to recognize and project hazards related to continuing flight under visual rules, in marginal ceiling conditions and forward visibility, was impaired, resulting in reduced pilot situational awareness, probable geographic disorientation, and the phenomenon known as " tunnel vision''.
- Decision-making process – a contributor.
The impairment of the pilot's perception in relation to the risks related to the continuation of the flight in marginal safety conditions negatively affected his ability to perceive, analyze, choose alternatives and act appropriately due to inadequate judgments and the apparent fixation on keeping the flight under visual rules, which also contributed to this occurrence.
Final Report:

Crash of a Beechcraft 65-A90 King Air in Dillingham: 11 killed

Date & Time: Jun 21, 2019 at 1822 LT
Type of aircraft:
Operator:
Registration:
N256TA
Flight Phase:
Survivors:
No
Schedule:
Dillingham - Dillingham
MSN:
LJ-256
YOM:
1967
Crew on board:
1
Crew fatalities:
Pax on board:
10
Pax fatalities:
Other fatalities:
Total fatalities:
11
Captain / Total flying hours:
1086
Captain / Total hours on type:
214.00
Aircraft flight hours:
15104
Aircraft flight cycles:
24569
Circumstances:
On June 21, 2019, about 1822 Hawaii-Aleutian standard time, a Beech King Air 65-A90 airplane, N256TA, impacted terrain after takeoff from Dillingham Airfield (HDH), Mokuleia, Hawaii. The pilot and 10 passengers were fatally injured, and the airplane was destroyed. The airplane was owned by N80896 LLC and was operated by Oahu Parachute Center (OPC) LLC under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91 as a local parachute jump (skydiving) flight. Visual meteorological conditions prevailed at the time of the accident. OPC had scheduled five parachute jump flights on the day of the accident and referred to the third through fifth flights of the day as “sunset” flights because they occurred during the late afternoon and early evening. The accident occurred during the fourth flight. The accident pilot was the pilot-in-command (PIC) for each of the OPC flights that departed on the day of the accident. The pilot and 8 of the 10 passengers initially boarded the airplane. These eight passengers comprised three OPC tandem parachute instructors, three passenger parachutists, and two OPC parachutists performing camera operator functions. The pilot began to taxi the airplane from OPC’s location on the airport. According to a witness (an OPC tandem instructor who was not aboard the accident flight), the two other passengers—solo parachutists who had been on the previous skydiving flight and were late additions to the accident flight—“ran out to the airplane and were loaded up at the last minute.” The pilot taxied the airplane to runway 8 about 1820, and the airplane departed about 1822. According to multiple witnesses, after the airplane lifted off, it banked to the left, rolled inverted, and descended to the ground. One witness stated that, before impact, the airplane appeared to be intact and that there were no unusual noises or smoke coming from the airplane. A security camera video showed that the airplane was inverted in a 45° nose-down attitude at the time of impact. The airplane impacted a grass and dirt area about 630 ft northeast of the departure end of the runway, and a postcrash fire ensued. The airplane was not equipped, and was not required to be equipped, with a cockpit voice recorder or a flight data recorder. The accident flight was not detected by radar at the Federal Aviation Administration’s (FAA) Hawaii Control Facility, which was the air traffic control (ATC) facility with jurisdiction of the airspace over HDH. The FAA found no audio communications between the accident airplane and ATC on the day of the accident.
Probable cause:
The National Transportation Safety Board determines that the probable cause of this accident was the pilot’s aggressive takeoff maneuver, which resulted in an accelerated stall and subsequent loss of control at an altitude that was too low for recovery.
Contributing to the accident were
1) the operation of the airplane near its aft center of gravity limit and the pilot’s lack of training and experience with the handling qualities of the airplane in this flight regime;
2) the failure of Oahu Parachute Center and its contract mechanic to maintain the airplane in an airworthy condition and to detect and repair the airplane’s twisted left wing, which reduced the airplane’s stall margin; and
3) the Federal Aviation Administration’s (FAA) insufficient regulatory framework for overseeing parachute jump operations. Contributing to the pilot’s training deficiencies was the FAA’s lack of awareness that the pilot’s flight instructor was providing substandard training.
Final Report:

Crash of a Beechcraft C90B King Air in Ipumirim: 1 killed

Date & Time: Sep 15, 2018 at 1200 LT
Type of aircraft:
Operator:
Registration:
PR-RFB
Flight Phase:
Survivors:
No
Schedule:
Florianópolis – Chapecó
MSN:
LJ-1546
YOM:
1999
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The pilot departed Florianópolis-Hercílio Luz Airport at 1100LT on a flight to Chapecó. Following an uneventful flight, the pilot initiated the descent to Chapecó-Serafim Enoss Bertasco Airport but encountered marginal weather conditions with limited visibility. While descending under VFR mode, the aircraft collided with trees and crashed in a dense wooded area located in Ipumirim, some 50 km east of Chapecó Airport, bursting into flames. The aircraft was destroyed by impact forces and a post crash fire and the pilot, sole occupant, was killed.
Probable cause:
Controlled flight into terrain.
Contributing factors.
- Attitude - contributed
The fact that the pilot continued the descent visually, not performing the instrument approach according to the IFR flight plan, denoted disregard of the real risks of this action. Thus, his attitude contributed to the inappropriate approach that culminated in the collision with the ground.
- Adverse weather conditions - contributed
Despite the aerodrome presenting ceiling and visibility conditions favorable for visual flight at the time of the accident, it was verified that there was dense fog covering the entire region near the impact site and, therefore, the IFR rules, which determined a minimum altitude of 5,000 ft, should have been observed.
- Emotional state - undetermined
Some events in the pilot's personal life were negatively affecting his emotional state. In addition, the pilot appeared to be more introspective in the period leading up to the accident.
Thus, it is possible that his performance was impaired due to his emotional state.
- External influences - undetermined
The pilot was possibly experiencing difficult events in his personal life. These events could have negatively affected his emotional state.
Thus, the pilot's way of thinking, reacting and performance at work may have been impacted by factors external to work.
- Motivation - undetermined
The pilot intended to return home because he would be celebrating his birthday and that of his stepdaughter.
The audio recording of the pilot's telephony with the GND-FL, shows that he insisted to accelerate his take-off, denoting a possible high motivation focused on fulfilling his eagerness to accomplish the flight. This condition may have influenced the flight performance.
- Decision making process - contributed
The choice to continue the descent without considering the IFR rules, based on an inadequate judgment of the meteorological conditions, revealed the pilot's difficulties to perceive, analyze, choose alternatives and act adequately in that situation.
Final Report:

Crash of a Beechcraft C90GTi King Air in Vila Rica

Date & Time: Sep 5, 2018 at 1120 LT
Type of aircraft:
Registration:
PR-GVJ
Flight Type:
Survivors:
Yes
Schedule:
Belo Horizonte – Confresa
MSN:
LJ-2145
YOM:
2017
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The twin engine airplane departed Belo Horizonte-Pampulha-Carlos Drummond de Andrade Airport at 0820LT on a private flight to Confresa, carrying five passenger and one pilot. While descending to Confresa, the pilot decided to fly directly to the farm of the owner (Fazenda Angola) located in Vila Rica, about 80 km northeast of Confresa Airport. On final approach, the aircraft was too low when it struck the surface of a lake then its bank. On impact, the undercarriage were torn off and the aircraft crash landed and came to rest on its belly. There was no fire. All six occupants were injured, one seriously. The aircraft was damaged beyond repair.
Probable cause:
The pilot descended too low on approach to an umprepared terrain.
Contributing Factors:
- Attitude,
- Command application,
- Pilot judgment,
- Decision making process,
- Lack of adherence to regulations established by the authority of Brazilian civil aviation.
Final Report:

Crash of a Beechcraft C90GTi King Air in Campo de Marte: 1 killed

Date & Time: Jul 29, 2018 at 1810 LT
Type of aircraft:
Operator:
Registration:
PP-SZN
Survivors:
Yes
Schedule:
Videira – Campo de Marte
MSN:
LJ-1910
YOM:
2008
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
5
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
While approaching Campo de Marte Airport by night following an uneventful flight from Videira, the crew encountered technical problems with the landing gear and was cleared to complete two low passes over the runway to confirm visually the problem. While performing a third approach, the twin engine airplane rolled to the left then overturned and crashed inverted about 100 metres to the left of runway 30, bursting into flames. Six occupants were injured and one pilot was killed.

Crash of a Beechcraft C90A King Air in Mumbai: 5 killed

Date & Time: Jun 28, 2018 at 1315 LT
Type of aircraft:
Operator:
Registration:
VT-UPZ
Flight Type:
Survivors:
No
Site:
Schedule:
Juhu - Juhu
MSN:
LJ-1400
YOM:
1995
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
5
Circumstances:
Following a technical maintenance, a test flight was scheduled with two engineers and two pilots. The twin engine airplane departed Mumbai-Juhu Airport and the crew completed several manoeuvres over the city before returning. On approach in heavy rain falls, the aircraft went out of control and crashed at the bottom of a building under construction located in the Ghatkopar West district, some 3 km east from Mumbai Intl Airport, bursting into flames. The aircraft was destroyed by impact forces and a post crash fire and all four occupants were killed as well as one people on the ground.

Crash of a Beechcraft C90 King Air in Lake Harney: 3 killed

Date & Time: Dec 8, 2017 at 1115 LT
Type of aircraft:
Operator:
Registration:
N19LW
Flight Type:
Survivors:
No
Schedule:
Sanford - Sanford
MSN:
LJ-991
YOM:
1981
Flight number:
CONN900
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
243
Captain / Total hours on type:
0.00
Copilot / Total flying hours:
4800
Copilot / Total hours on type:
357
Aircraft flight hours:
10571
Circumstances:
The flight instructor, commercial pilot receiving instruction, and commercial pilot-rated passenger were conducting an instructional flight in the multi-engine airplane during instrument meteorological conditions. After performing a practice instrument approach, the flight was cleared for a second approach; however, the landing runway changed, and the controller vectored the airplane for an approach to the new runway. The pilot was instructed to turn to a southwesterly heading and maintain 1,600 ft until established on the localizer. Radar information revealed that the airplane turned to a southwesterly heading on a course to intercept the localizer and remained at 1,600 ft for about 1 minute 39 seconds before beginning a descending right turn to 1,400 ft. The descent continued to 1,100 ft; at which time the air traffic control controller issued a low altitude alert. Over the following 10 seconds, the airplane continued to descend at a rate in excess of 4,800 ft per minute (fpm). The controller issued a second low altitude alert to the crew with instructions to climb to 1,600 ft immediately. The pilot responded about 5 seconds later, "yeah I am sir, I am, I am." The airplane then climbed 1,400 ft over 13 seconds, resulting in a climb rate in excess of 6,700 fpm, followed by a descent to 1,400 ft over 5 seconds, resulting in a 1,500-fpm descent before radar contact was lost in the vicinity of the accident site. Radar data following the initial instrument approach indicated that the airplane was flying a relatively smooth and consistent flightpath with altitude and heading changes that were indicative of autopilot use until the final turn to intercept the localizer course. Maneuvering the airplane in restricted visibility placed the pilot in conditions conducive to the development of spatial disorientation. The accident circumstances, including altitude and course deviations and the subsequent high-energy impact, are consistent with the known effects of spatial disorientation. Additionally, examination of the airframe, engines, and propellers revealed no evidence of any preexisting anomalies that would have precludednormal operation. Therefore, it is likely that the pilot receiving instruction was experiencing the effects of spatial disorientation when the accident occurred. Toxicology testing of the flight instructor identified significant amounts of oxycodone as well as its active metabolite, oxymorphone, in liver tissue; oxycodone was also found in muscle. Oxycodone is an opioid pain medication available by prescription that may impair mental and/or physical ability required for the performance of potentially hazardous tasks. The flight instructor's tissue levels of oxycodone suggest that his blood level at the time of the accident was high enough to have had psychoactive effects, and his failure to recognize and mitigate the pilot's spatial disorientation and impending loss of control further suggest that the flight instructor was impaired by the effects of oxycodone. Toxicology testing of all three pilots identified ethanol in body tissues; however, given the varying amounts and distribution, it is likely that the identified ethanol was from postmortem production rather than ingestion.
Probable cause:
The pilot's loss of airplane control due to spatial disorientation during an instrument approach in instrument meteorological conditions, and the flight instructor's delayed remedial action. Contributing to the accident was the flight instructor's impairment from the use of prescription pain medication.
Final Report: