Crash of a Raytheon 390 Premier I in Johannesburg

Date & Time: Nov 22, 2017 at 1623 LT
Type of aircraft:
Registration:
ZS-CBI
Flight Type:
Survivors:
Yes
Schedule:
Cape Town - Johannesburg
MSN:
RB-214
YOM:
2007
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3048
Captain / Total hours on type:
649.00
Copilot / Total flying hours:
4718
Copilot / Total hours on type:
305
Aircraft flight hours:
963
Circumstances:
On 22 November 2017, the pilot-in-command (PIC) accompanied by the first officer (FO) took off from the Cape Town International Airport (FACT) on a private flight to the Rand Airport (FAGM). The flight was conducted under instrument flight rules (IFR) by day and the approach was conducted under visual flight rules (VFR). The PIC was the pilot flying (PF) and was seated on the left seat and the FO was occupying the right seat. The air traffic controller (ATC) on duty at FAGM tower stated that the FO reported in-bound for a fullstop landing at FAGM. The last wind direction data for Runway 29 was transmitted to the FO as 230°/11 knots (kts) and Query Nautical Height (QNH): 1021. The FO acknowledged the transmission and the crew elected to land on Runway 11. The PIC stated that the approach for landing was stable and that the touchdown was near the first taxiway exit point. According to the FO, the aircraft floated for a while before touchdown. This was confirmed during the investigation. During the landing rollout, the PIC applied the brakes and the brakes responded for a short while, however, the aircraft continued to roll without slowing down. At approximately 300 metres (m) beyond the intersection of Runway 35 and Runway 11, the PIC requested the FO to apply emergency brakes. The FO applied the emergency brakes gradually and the aircraft continued to roll before the brakes locked and the tyres burst. The aircraft skidded on the main wheels and continued for approximately 180m until it overshot the runway. The undercarriage went over a ditch of approximately 200 millimetres in depth at the end of the runway into the soft ground and the aircraft came to a stop approximately 10m from the threshold facing slightly left off the extended centre line Runway 11. The aircraft was substantially damaged during the impact sequence and none of the occupants sustained injuries. The crash alarm was activated by the tower and the fire services responded to the scene.
Probable cause:
The investigation revealed that the aircraft was unstable on approach (hot and high), resulting in deep landing, probably near the second exit point, leading to a runway excursion. Contributing factors were attributed to the lift dumps not being deployed and the incorrect application of the emergency brakes.
Final Report:

Crash of an Eclipse EA500 near Swellendam: 1 killed

Date & Time: Dec 7, 2015 at 1057 LT
Type of aircraft:
Registration:
ZS-DKS
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Lanseria - Cape Town
MSN:
142
YOM:
2008
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
2977
Captain / Total hours on type:
506.00
Aircraft flight hours:
714
Circumstances:
The aircraft had taken off on a private flight with the pilot being the sole occupant on board. The pilot had filed an IFR flight plan and had informed air traffic control (ATC) at FALA that the aircraft had a fuel endurance of 4 hours and his estimated flying time to FACT was approximately 2 hours and 30 minutes. After take-off the aircraft climbed to its cruising altitude of 36 000 feet (FL360) as was seen on the radar recordings. The pilot maintained communication with ATC until overhead Kimberley. Shortly thereafter the aircraft was observed to change course, turning slightly left before the town of Douglas. The aircraft remained at FL360 and was observed to fly south towards the waypoint OKTED, which was a substantial distance to the east of FACT. FACT could not get communication with the aircraft and the aeronautical rescue co-ordination centre (ARCC) was advised of the situation. The aircraft was kept under constant radar surveillance. The ARCC requested assistance from the South African Air Force (SAAF) and a Gripen (military jet) from Air Force Base Overberg (FAOB) was dispatched to intercept the aircraft. The pilot of the Gripen intercepted the aircraft approximately 3 minutes before it impacted the terrain. The Gripen pilot was unable to get close enough to the aircraft as it was flying very erratically, and he could therefore not see whether the pilot was conscious or not. The aircraft was observed entering a left spiral and continue spiraling down until it impacted the ground. The pilot was fatally injured and the aircraft was destroyed during the impact sequence.
Probable cause:
The investigation revealed no anomalies on the part of the aircraft and all damage was attributed to the impact with the ground. The fatal injuries sustained by the pilot made it impossible to determine if the pilot was incapacitated or not. It was observed that the aircraft performed a series of unexplainable as well as erratic flying manoeuvres, which resulted in a loss of control and the aircraft to enter into a spiral dive, which was observed by the Gripen pilot before colliding with the ground.
Final Report:

Crash of a Cessna 441 Conquest II in Cape Town: 5 killed

Date & Time: Aug 16, 2015 at 0629 LT
Type of aircraft:
Operator:
Registration:
V5-NRS
Flight Type:
Survivors:
No
Site:
Schedule:
Oranjemund - Cape Town
MSN:
441-0288
YOM:
1983
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
5
Captain / Total flying hours:
6353
Captain / Total hours on type:
1357.00
Copilot / Total flying hours:
1394
Copilot / Total hours on type:
1
Aircraft flight hours:
7605
Circumstances:
On 15 August 2015 at 2351Z a Cessna 441 aeroplane, with two crew and a paramedic on board took off from Eros Airport (FYWE) on a medical evacuation flight with their intended final destination Cape Town International Airport (FACT). The aircraft landed at Oranjemund (FYOG) to pick up a male patient and his daughter. At 0206Z the aircraft departed from FYOG on a mercy flight to FACT. At 0343Z the aircraft made the first contact with FACT area and the aircraft was put under radar control. At 0355Z, area control advised the crew that there was a complete radar failure. The aircraft was on a descent to 6500 ft when approach advised them to prepare for a VOR approach for runway 19. At 0429Z, while on approach for landing at FACT, all contact was lost with the aircraft. At approximately 0556Z the aircraft’s wreckage was located approximately 8 nm to the north of FACT. All five occupants on board were fatally injured and the aircraft was destroyed by impact and post impact fire. The investigation revealed the aircraft collided with terrain during instrument meteorological condition (IMC) conditions while on the VOR approach for Runway 19 at FACT. At the time the ILS was working, however the approach controller offered a VOR approach for separation with an outbound aircraft as the radar was unserviceable.
Probable cause:
The aircraft collided with terrain during instrument meteorological flight conditions while on the VOR approach Runway 19.
Final Report:

Crash of a Piper PA-46-310P Malibu near Niekerkshoop: 2 killed

Date & Time: Apr 22, 2014 at 1121 LT
Operator:
Registration:
ZS-LLD
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Cape Town – Swartwater
MSN:
46-8408063
YOM:
1984
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
1569
Captain / Total hours on type:
163.00
Aircraft flight hours:
2029
Circumstances:
On 22 April 2014 at approximately 0716Z the Commercial pilot accompanied by a passenger departed Cape Town International Airport (FACT) on an IFR flight to Swartwater in the Limpopo Province. Approximately 16 minutes after take-off with the aircraft climbing through an altitude of 13500 feet to 17000 feet, the Air Traffic Controller advised the pilot that the aircraft’s Mode C transponder started transmitting erroneous altitude data and indicating that the aircraft was descending whereas the pilot thought he was ascending. The pilot notified the ATC that the aircraft was not descending and attempted to rectify the problem by recycling the Mode C transponder that however didn’t resolve the problem. As the transponder information was intermittent during the IFR flight to Swartwater, the ATC requested the pilot to descent to the VFR flight level FL 135. The pilot then requested Area West for approval to ascent to flight level (FL 195) which was approved. It appears that the pilot was unaware that the pitot static tube system that supplies both pitot and static air pressure for the airspeed indicator, altimeter and triple indicator was most probably blocked by dust or sand. The aircraft exceeded the Maximum Structural Air Speed (VNO) of the aircraft and the VNE air speed of 1 hour 44 minutes and 9 minutes respectively. The VNO of 173 airspeed and VNE of 203 airspeed exceedance resulted in the catastrophic inflight breakup of the aircraft. The wreckage was found scattered in a 1.58km path in mountainous terrain. Both occupants on board the aircraft sustained fatal injuries.
Probable cause:
The aircraft exceeded the Maximum Structural Cruising Speed (VNO) and Calibrated Never Exceed Speed VNE airspeed due to the fact that erroneous airspeed and altitude data information indicated on the cockpit instruments as a result of blockage of the pitot tube by dust and sand. The fact that the pilot switched off the transponder was considered as a contributory factor.
Final Report:

Crash of an Embraer 135 in George

Date & Time: Dec 7, 2009 at 1101 LT
Type of aircraft:
Operator:
Registration:
ZS-SJW
Survivors:
Yes
Schedule:
Cape Town - George
MSN:
145-423
YOM:
2001
Flight number:
SA8625
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
32
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
11973
Captain / Total hours on type:
2905.00
Copilot / Total flying hours:
2336
Copilot / Total hours on type:
864
Aircraft flight hours:
21291
Aircraft flight cycles:
17003
Circumstances:
Flight SA8625 departed from Cape Town International Airport on a domestic scheduled flight to George Airport (FAGG) with three crew members and 32 passengers on board. The weather at FAGG was overcast with light rain, and the aircraft was cleared for an instrument landing system approach for runway 11. It touched down between the third and fourth landing marker. According to the air traffic controller, the landing itself appeared normal, but the aircraft did not vacate the runway to the left as it should have. Instead, it veered to the right, overran the runway and rolled on past the ILS localiser. Realising that something was wrong, he activated the crash alarm. The cockpit crew did not broadcast any messages to indicate that they were experiencing a problem. The aircraft collided with eleven approach lights before bursting through the aerodrome perimeter fence and coming to rest in a nose-down attitude on the R404 public road. Several motorists stopped and helped the passengers, who evacuated the aircraft through the service door (right front) and left mid-fuselage emergency exit. The aerodrome fire and rescue personnel arrived within minutes and assisted with the evacuation of the cockpit crew, who were trapped in the cockpit. Ten occupants were admitted to a local hospital for a check-up and released after a few hours. No serious injuries were reported.
Probable cause:
The crew were unable to decelerate the aircraft to a safe stop due to ineffective braking of the aircraft on a wet runway surface, resulting in an overrun.
Contributory factors:
- The aircraft crossed the runway threshold at 50 ft AGL at 143 KIAS, which was 15 kt above the calculated VREF speed.
- Although the aircraft initially touched down within the touchdown zone the transition back into air mode of 1.5 seconds followed by a 4 second delay in applying the brakes after the aircraft remained in permanent ground mode should be considered as a significant contributory factor to this accident as it was imperative to decelerate the aircraft as soon as possible.
- Two of the four main tyres displayed limited to no tyre tread. This was considered to have degraded the displacement of water from the tyre footprint, which had a significant effect on the braking effectiveness of the aircraft during the landing rollout on the wet runway surface.
Several non-compliance procedures were not followed.
Final Report:

Crash of a Cessna 402B in Cape Town: 7 killed

Date & Time: Jun 5, 1983 at 1323 LT
Type of aircraft:
Operator:
Registration:
ZS-KVG
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Cape Town - Lanseria
MSN:
402B-1094
YOM:
1976
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
7
Circumstances:
The pilot, Lorance Weinberg, had a history of logging hours on aircraft he had not been trained to fly as well as logging hours on aircraft in which he had only traveled as a passenger. On 4 June 1983 he booked a Cessna 402 under false pretenses to fly to Durban, but in fact took a party of 9 to Cape Town for a wedding. The following day he filed an IFR flight plan to return to Johannesburg when he was not IFR rated, but had trouble filling in the forms. He took off just before 13:00 in deteriorating weather with his 8 passengers and immediately ran into trouble. He did not follow any instructions from air traffic control and evaded their questions when they decided it would be best to bring him back for landing. It was noted on radar that he was flying in ever decreasing circles until the aircraft finally crashed onto the Polkadraai Road running between Kuils River and Stellenbosch. Weinberg, five adult passengers and a baby were killed, but two adults survived.
Source: Fields of Air by James Byrom.
Probable cause:
The CAA determined that the pilot had undertaken a flight for which he was not qualified, or trained, to act as pilot in command. He took off in instrument meteorological conditions when he was not instrument rated and suffered from spatial disorientation and because of a lack of training flew into the ground.

Crash of a Hawker-Siddeley HS.125-400B Mercurius on Devil's Peak: 3 killed

Date & Time: May 26, 1971 at 1500 LT
Type of aircraft:
Operator:
Registration:
03
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Cape Town - Cape Town
MSN:
25182
YOM:
1969
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
3
Circumstances:
The crew was engaged in a local demonstration flight at Cape Town Airport, taking part to an airshow. With two other similar aircraft in a V formation, the Mercurius completed a low pass over Cape Town Airport then proceeded to the west. Shortly later, all three aircraft struck simultaneously the slope of the Devil's Peak shrouded in clouds and located about 15 km west of Cape Town Airport. All three aircraft were totally destroyed and all 11 crew members were killed.
Probable cause:
Controlled flight into terrain.

Crash of a Hawker-Siddeley HS.125-400B Mercurius on Devil's Peak: 4 killed

Date & Time: May 26, 1971 at 1500 LT
Type of aircraft:
Operator:
Registration:
02
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Cape Town - Cape Town
MSN:
25177
YOM:
1969
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
4
Circumstances:
The crew was engaged in a local demonstration flight at Cape Town Airport, taking part to an airshow. With two other similar aircraft in a V formation, the Mercurius completed a low pass over Cape Town Airport then proceeded to the west. Shortly later, all three aircraft struck simultaneously the slope of the Devil's Peak shrouded in clouds and located about 15 km west of Cape Town Airport. All three aircraft were totally destroyed and all 11 crew members were killed.
Probable cause:
Controlled flight into terrain.

Crash of a Hawker-Siddeley HS.125-400B Mercurius on Devil's Peak: 4 killed

Date & Time: May 26, 1971 at 1500 LT
Type of aircraft:
Operator:
Registration:
01
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Cape Town - Cape Town
MSN:
25181
YOM:
1969
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
4
Circumstances:
The crew was engaged in a local demonstration flight at Cape Town Airport, taking part to an airshow. With two other similar aircraft in a V formation, the Mercurius completed a low pass over Cape Town Airport then proceeded to the west. Shortly later, all three aircraft struck simultaneously the slope of the Devil's Peak shrouded in clouds and located about 15 km west of Cape Town Airport. All three aircraft were totally destroyed and all 11 crew members were killed.
Probable cause:
Controlled flight into terrain.

Crash of an Avro 696 Shackleton MR.3 near Stettynskloof: 13 killed

Date & Time: Aug 8, 1963 at 1525 LT
Type of aircraft:
Operator:
Registration:
1718
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Cape Town - Cape Town
MSN:
1528
YOM:
1957
Country:
Region:
Crew on board:
13
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
13
Aircraft flight hours:
777
Circumstances:
The tactical submarine phase of Operation CAPEX (Cape Exercise), a joint training exercise involving elements of Britain's Royal Navy and both the SA Navy and Air Force, commenced on August 7, 1963. During this phase, the Royal Navy submarine, HMS Alliance, would relocate from her existing position south of Port Elizabeth to a position further west, from where she would take part in further exercises with the SA Navy. During this transitional phase of the submarine, Shackleton 1718 was tasked by Maritime Group to conduct a CAPEX A exercise with the submarine. Although 35 Squadron was based at the military section of DF Malan International Airport in Cape Town, the unit's headquarters was at nearby Air Force Station (AFS) Ysterplaat and it was at this latter facility that the flight crew of Shackleton 1718 received a full briefing at 12H30 on August 8, 1963. During this briefing, the Operations Officer on duty advised the Shackleton aircrew to head out over False Bay after takeoff and to transit seawards towards the exercise area. He warned them that the direct overland route to Port Elizabeth should be avoided due to anticipated high icing levels on this route. Forecast weather for the route over False Bay and then southwards was poor. Heavy icing conditions could be expected between 1 220 and 1 829 m ( 4,000 and 6,000 ft) above mean sea level (AMSL) and consequently the flight crew were further briefed that Maritime Group had granted them special clearance to transit to the exercise area under 915 m (3,000 ft) AMSL. A 244 m (800 ft) AMSL cloud base would exist with tops up to 6 707 m (22,000 ft). Heavy air turbulence could be expected with cumulonimbus clouds, hail and heavy rain throughout. Surface wind was 42 km/h (26 mph) at 340° and 92 km/h (57 mph) at 340° and 1 524 m (5,000 ft). Even though the forecast weather over the eastern overland route was no better, at least the seaward route would eliminate the risk of the aircraft accidentally flying into high ground in the conditions of much reduced visibility. The aircraft commander, captain (Capt) TH Sivertsen, when giving his own briefing, confirmed his route as south over False Bay and then seawards towards the exercise area. The flight had been authorised by Maritime Group to provide the Shackleton crew with training in the radar detection of a submarine. No special instructions were issued. Shackleton 1718 was fully serviceable for flight even though the compasses had not been swung on their normal expiry date of July 19, 1963. Maritime Group gave authorisation for a month's extension provided that no major part of the aircraft was replaced. The compasses were therefore considered serviceable. The Flight Office at Ysterplaat was uncomfortable about the weather conditions and telephoned the Maritime Group Operations Centre thrice prior to the departure of the Shackleton, in an effort to get the flight cancelled, but this request was not forthcoming. Just minutes before takeoff, Capt Sivertsen, notwithstanding his briefing instructions, informed Air Traffic Control (ATC) that he would climb to 2 896 m (9,500 ft) AMSL and head overland towards Port Elizabeth. The aircraft lifted off Runway 34 at 15H06 and turned right on 350° for the climb out. Moments later, ATC informed the commander to come to 330° so as to safely avoid Tiger Mountain. Capt Sivertsen acknowledged this transmission and did accordingly. After the lapse of about a minute, he requested clearance to resume his original course of 350°. This was the last radio transmission received from Shackleton 1718. At about 15H20 the radar technician at DF Malan requested permission to deactivate the radar for about ten minutes due to flooding of the radar installation on account of the heavy rain. This permission was granted, but before the radar was deactivated, 1718's location was given as a distance on the radar screen of about 40 km (25 miles) on a course of 100°. The ground course was about 145°. Although the evidence suggested that the airplane had crashed, most likely in the Stettynskloof/Wemmershoek Mountains area, the adverse weather conditions, combined with the lateness of the hour, precluded any meaningful attempt at a search and rescue effort being mounted until the following day, August 9. At 10H00 and again at 13H30 on August 9, helicopters were sent out to the Wemmershoek area to report on the weather, which remained completely adverse. Following a report of an aircraft having been heard, a further helicopter was despatched at 15H00 to search the mountains south of Simonstown. On August 10, another helicopter continued the search at Simonstown from 08H15, while a second aircraft was sent to report back on the weather in the Wemmershoek area. Here, the weather was still closed in, but hinted at the first signs of improvement. At 09H00 at aircraft was sent to fly high over the Wemmershoek Mountains to report on the cloud coverage. At 11H00 two aircraft continued a search in the same mountains and at 13H15 they were joined by a further pair of rotorcraft. The wreck was finally discovered from the air at 17H18 just over two days following the accident. It was evident from the almost complete destruction of the aircraft that nobody aboard could possibly have survived the crash. The crash occurred about 25.8 km (16 miles from the nearest town, Worcester, in the Stettynskloof valley between Paarl and Stellenbosch. After inspecting the crash scene, the 35 Squadron Engineering Officer, Capt WJ Stiglingh decided to investigate the failures apparent on the port elevator and the upper section of the starboard rudder, both of which detached in flight, although the Board of Inquiry (BOI) officially convened to investigate the cause of the accident, was unable to establish which broke off first. The section of the starboard rudder was found 1 620 m (5,314 ft) and the port elevator 1 250 m (4,100 ft) from the impact point. Following the disintegration of these two flight control surfaces, the aircraft would have been rendered uncontrollable. At this point (about 15H25) the pilot was heard to make his final radio transmission: “Mayday. Mayday,” but this was not recognised as such by the ATC. The timing of the transmission coincides exactly with the crash time. At the same time that the starboard rudder and port elevator detached in flight, the port fuel tip tank also broke away removing a section of the port wing and both outer elevators. The outer most starboard elevator was found further forward than the impact point of the port tip tank. Clearly, it broke away shortly after the tip tank. The port elevator, which was complete, showed relatively little damage. Most of the damage sustained was consistent with it having fallen on to its inboard end and then on to some rocks. Signs were found, however, of excessive downward movement of this elevator to the extent that the hinges had damaged the steel spar, more so at the outboard hinge where the hinge arm had actually cut into the spar. It was official opinion that pilot applied force could not have caused this damage since the control column movement in restricted by stops strong enough to resist human force. It is considered that at the time of the excessive downward movement of the elevator, the force, mainly due to leverage over the spar, was sufficient to cause failure of the hinge bolts in tension. Failure of the spar attachment upper lug clearly indicated that the outboard end of the elevator broke away first in a rearward direction. No evidence was found to suggest that this port elevator was attached to the airframe at the time of impact. Examination of the starboard elevator indicated that its upward travel had been exceeded; this and other damage to this elevator being consistent with crash damage. Regarding the section of the upper starboard rudder, the outboard skin at the break had failed in tension and the inboard skin was torn away from the front rearwards, this indicating that the broken off portion was first bent inwards and then backwards. Furthermore, apart from damage at the upper leading edge, which was inflicted when the rudder struck the ground, this portion of rudder was altogether undamaged. The rudder was probably detached from the aircraft before the point of impact. As for the lower portion of the starboard rudder, failures on the outboard and inboard skins correspond to failure on the upper section. Damage on this section would appear to indicate that it did not strike the ground at the point of impact, but that it was flung forwards and carried further assisted by the strong winds prevailing at the time. Considerable violence coupled with exceptionally strong winds and/or air turbulence was necessary to carry the port and starboard fin, port tailplane and several other pieces of empennage to their final positions. None of these parts, except the starboard fin, displayed any damage that could have occurred at the point if impact. The port tailplane front spar had pulled out along its length, shearing all its rivets. Examination of the main impact zone indicated that the fuselage struck at right angles to the main mark down the slope and the sideways cartwheel or flick might have thrown empennage parts in to the air forward of, and to the right of, the impact area. Examination of the point of impact of the port wingtip fuel tank indicated that the angle that the tank struck the ground was such that, had the tank been attached to the aircraft, the empennage should then have hit the ground. The tank was therefore most probably detached from the aircraft while still in the air. Positions of the No. 3 and 4 ailerons and part of the port wing support this reasoning. The dump valves of both port and starboard tip tanks were found in the fully open position. As these valves are electromechanically driven, they were probably intentionally open and most likely before the port tip tank impact since this tank still had a considerable amount of fuel left over in it, judging by the flash fire area. The forward portion of the starboard tip tank, on the other hand, showed no signs of flash fire or explosion, indicating that its fuel content at the time of impact must have been low. The open dump valves appear to suggest that the pilot must have been busy dumping fuel in order to reduce the load on the airframe when it experienced the heavy turbulence and just before the aircraft began disintegrating. The aircraft weighed about 43 213 kg (95,242 lb) at the time of the accident. In an attempt to reconstruct the events leading up to the crash, another Shackleton of the same weight and load as Shackleton 1718, took off from Runway 34 at DF Malan on August 22, 1963 to attempt to emulate as closely as possible the course and climb tempo of the stricken aircraft. Based on this emulation, it was ascertained that Shackleton 1718 was either at or very close to its intended cruise altitude of 2 896 m (9,500 ft) AMSL. Instrument Flight Rules (IFR) flight had been authorised and the aircraft had been operating under IFR conditions at the time of its demise. The Board was satisfied that the flight crew were under all circumstances both qualified and capable of performing the mission with which they had been tasked. The accident occurred over State ground; property of the Department of Forestry. The terrain was unplanted, deforested and in its natural state. No claim could thus be made by the Department. There was no damage to private or other military property. Shackleton 1718 was manufactured in August 1957. Although possessing a maximum takeoff weight of 45 372 kg (100,000 lb), for its final flight it lifted off at 43 938 kg (96,840 lb). Since the aircraft was heavily laden with its maximum weight point close to the rearmost limit, the pilots would have experienced some instability in the yawing (left/right) plane.

Crew:
Cpt Thomas Howard Sivertsen, pilot,
2nd Lt Charles Alwyn du Plooy, copilot,
Cpt Jacques Guillaume Labuschagne, pilot,
Lt Abraham Gert Willem Coetzee, navigator,
2nd Lt George James Smith, navigator,
C/O Derek Ian Strauss, navigator,
WO2 Sydney Shields Scully, flight engineer,
L/Cpl Marthienus Christoffel Vorster, flight engineer,
Sgt David Hope Sheasby, signaller,
L/Cpl Charl Paul Viljoen, radio operator,
L/Cpl Matthys Johannes Taljaard, radio operator,
L/Cpl Michel Adolf Brodreiss, radio operator,
A/M Johannes Chamberlain, radio operator.

Source: ASN
Probable cause:
The Board established that the impact speed of the aircraft was high and that this, combined with the resulting fire following the crash, caused almost complete destruction of the aircraft. There was no attempt by the crew to use parachutes and all aboard are assumed to have perished in the high G impact. The Board established that the atrocious weather was a significant contributory factor in this accident. Wind was about 148 km/h (92 mph) due to the unstable air mass forming convection currents. Cloud cover extended from 305 m (1,000 ft) to 8 841 m (29,000 ft) AMSL with associated heavy precipitation. Due to the turbulence, the moist unstable air mass and low icing height resulted in unusually high icing conditions from 1 220 m to 1 829 m (4,000 ft-6,000 ft). Air Force headquarters telephonically informed the Board that the maximum acceleration permitted on the Shackleton airframe was 2.4 G. It was thus theoretically possible to easily exceed this low limitation, especially under conditions of unusually high turbulence as in this case. Although it cannot be proved, it is not impossible that the pilot in control could have over controlled the aircraft on at least one occasion in response to the unusually heavy turbulence. This could have placed an additional load on the airframe. It was considered a possibility that, due to the turbulence, the pilot found himself unwittingly between the mountain peaks and that either one wingtip or one of the tail surfaces skimmed the side of one of the mountains, the impact causing the aircraft to disintegrate in flight and causing the pilot to lose control. The Board, however, considered this scenario unlikely given the fact that the ATC heard the pilot's Mayday transmission clearly and the aircraft must have thus been flying above the mountain peaks under normal circumstances when the radio call was put out. Additionally, the fact that the dump valves were open does not correspond with a collision against a mountain. The Board found Capt Sivertsen solely responsible for the accident. He displayed a complete lack of discipline by disobeying a direct order to rather route south over False Bay and instead routed over land, where the mountainous terrain exacerbated the already foul weather conditions. The aerodynamic effect of heavy icing, strong and turbulent winds, the heavy weight of the aircraft combined with the possible over control by the pilot in control, placed an unusually high loading on the airframe. This resulted in the airframe exceeding its design limits and initiated disintegration, leading to the loss of control and the consequent fatal crash. The accident was classed as an avoidable major flying accident. All the evidence submitted by all the witnesses interviewed was considered credible by the Board. Shackleton 1718 was delivered new to the SAAF valued at R 417 250.00. At the time of its demise it had completed 775.15 total airframe hours and, with depreciation, was valued with engines and propellers at R 266 109.45. The Rolls-Royce Griffon Mk 57A piston engines, like the airframe, were all classified as having sustained Category IIIa (write-off damage with no salvageable content). Engine numbers were 64411, 64412, 64416 and 64445. This was the only Shackleton to be written off in 27 years of SAAF service from 1957 to 1984. The Group Commander remarked that the ultimate load factor was 4 G. This figure suggests that the airframe was considerably stronger than the BOI was made to believe when they made their investigation. This information was, however, not available to the Board at the time. The only flight crew member of the 13 that perished on board to have received any honours or awards was WO2 (Warrant Officer Class 2) Scully, recipient of the Africa Star with Clasp and the Union Medal (No. 285).