Crash of a Beechcraft B90 King Air in Laguna del Sauce: 10 killed

Date & Time: Mar 19, 2015 at 2038 LT
Type of aircraft:
Operator:
Registration:
LV-CEO
Flight Phase:
Survivors:
No
Schedule:
Laguna del Sauce – San Fernando
MSN:
LJ-454
YOM:
1969
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
10
Captain / Total flying hours:
9348
Copilot / Total flying hours:
5095
Aircraft flight hours:
10319
Circumstances:
The twin engine airplane departed Laguna del Sauce Airport on a charter flight to San Fernando Airport near Buenos Aires, carrying eight passengers and two pilots. Shortly after a night takeoff from Laguna del Sauce Airport runway 01, the aircraft entered a controlled descent and crashed in shallow water some 2 km northwest of the airport, bursting into flames. The aircraft was destroyed by a post crash fire and all 10 occupants were killed.
Probable cause:
The accident resulted from impact with the ground without loss of control due to the combination of the following factors:
- The aircraft's climb profile did not meet the manufacturer's recommendations for speed and rate of climb,
- The center of gravity was outside the flight envelope,
- The total weight of the aircraft at the time of the accident was 124 kilos above the MTOW,
- Both pilots were tired due to a lack of rest time and a shift of more than 18 hours,
- The captain did not fly this type of aircraft since 1997 and was used to flying jets,
- The copilot had no experience on this type of aircraft despite being in possession of a valid license,
- The pilots' knowledge and understanding of the aircraft's systems and operation was inadequate,
- The operational checklists found on board the aircraft were not up to date,
- The pilots flew for the first time at night on this aircraft and for the second time together,
- The aircraft was operated under commercial rules on behalf of a travel agency while it could only fly privately,
- The instructor in charge of the training of both pilots and the person in charge of scheduling the flight refused to be questioned by the board of inquiry,
- An excessive workload for the crew and a lack of rest contributed to the pilots' loss of situational awareness,
- Both engines' compressors were running at low speed on impact,
- Both engines' propellers were turning at a speed close to low pitch,
- No mechanical anomalies were found on the engines and their components,
- Insufficient qualifications of the crew to fly on this type of aircraft,
- Pressure from the aircraft's owner to complete the flight,
- Crew fatigue and stress,
- Inadequate maintenance of the aircraft.
Final Report:

Crash of a Beechcraft B200 Super King Air near Carmelo: 5 killed

Date & Time: May 27, 2014 at 1240 LT
Operator:
Registration:
LV-CNT
Survivors:
Yes
Schedule:
San Fernando - Carmelo
MSN:
BB-1367
YOM:
1990
Location:
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
5
Captain / Total flying hours:
8039
Captain / Total hours on type:
478.00
Aircraft flight hours:
4616
Aircraft flight cycles:
4490
Circumstances:
Owned by Grupo Kowzef (Federico Alejandro Bonomi), the twin engine aircraft departed San Fernando (Buenos Aires) at 1222LT on an executive flight to Carmelo, Uruguay. On approach to Carmelo-Zagarzazú Airport runway 35, the pilot encountered marginal weather conditions and initiated a go-around procedure. Few minutes later, he attempted a second approach under VFR mode. While completing a slight turn to the left in descent, the aircraft impacted the surface of the Río de la Plata and came to rest in shallow water some 10 km southwest of Carmelo Airport. The pilot and four passengers were killed and four other occupants were injured. The aircraft was destroyed.
Probable cause:
The accident was the consequence of a controlled flight into terrain after the pilot suffered a loss of situational awareness due to a poor evaluation of the flight conditions upon arrival. The following contributing factors were identified:
- The pilot failed to return to his departure airport or to divert to the alternate airport due to poor weather conditions at the destination airport,
- The pilot continued the approach under VFR mode in IMC conditions with visibility below minimums,
- Poor evaluation of the flight conditions at destination on part of the pilot due to the combination of psychological and physiological factors.
Final Report:

Crash of a Swearingen SA227AC Metro III off Montevideo: 2 killed

Date & Time: Jun 6, 2012 at 1955 LT
Type of aircraft:
Operator:
Registration:
CX-LAS
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Montevideo - Buenos Aires
MSN:
AC-482
YOM:
1982
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
16177
Copilot / Total flying hours:
406
Aircraft flight hours:
26158
Circumstances:
The crew was performing a cargo flight from Montevideo to Buenos Aires on behalf of DHL. The aircraft departed runway 24 at Montevideo-Carrasco Airport at 1945LT and the crew was cleared to climb to FL080. While reaching a height of 4,500 feet, the aircraft entered an uncontrolled descent and crashed in the sea at a speed of 570 knots which caused its disintegration off Flores Island. Few debris were found the following day floating on water but the main wreckage was localized two weeks later about one NM south of Flores Island. The CVR was found on 02AUG2012 but was unreadable as the content was concerning the last 30 minutes of the precedent flight. On 11FEB2013, fishermen found the cargo door in their fishnet. No trace of the cargo nor the crew was ever found.
Probable cause:
Investigations determined that both engines were running normally at impact, that no propeller blades were lost during descent, that fuel was not contaminated and that no problems occurred on the on electrical system. Meteorological Office confirmed that severe icing conditions prevailed at the time of the accident between FL010 and FL150. The loss of control was the consequence of erroneous indications of the flight instruments, associated with the possible formation of crystalline ice on the aircraft' structure, causing a loss of situational awareness of the crew.
Final Report:

Crash of a Fokker F27 Friendship 500 in Melo

Date & Time: Apr 27, 2004 at 0415 LT
Type of aircraft:
Operator:
Registration:
N715FE
Flight Type:
Survivors:
Yes
Schedule:
Buenos Aires – Porto Alegre – Campinas
MSN:
10468
YOM:
1971
Flight number:
FDX7145
Country:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
The crew departed Buenos Aires-Ezeiza-Ministro Pistarini Airport on a night cargo service to Campinas-Viracopos with an intermediate stop in Porto Alegre. While cruising at an altitude of 17,000 feet, smoke was detected in the cargo compartment. The crew elected to extinguish the fire but without success. The crew contacted ATC, declared an emergency and attempted to divert to Montevideo Airport but ATC suggested the crew to divert to Melo which was the nearest airport. As this airfield was closed to traffic at this time, ATC contacted a night guard who switched on the runway lights and alerted the local emergency services. The aircraft landed 340 metres past the runway 07 threshold and stopped 640 metres further. The crew evacuated via the cockpit windows and was uninjured. The aircraft was damaged beyond repair.
Probable cause:
Numerous oil samples, plant tissues, and several animals that were transported, would have reacted on contact with an exothermic chemical reaction and associated combustion. The event originated with the spilling of liquid from containers not suitable for differential pressure, with little excess capacity for expansion and filled with indiscriminate materials. Low stringency in filling forms for description of product delivered for shipment in company offices and little control or careless handling of the load would have contributed to the occurrence of the accident.

Crash of a Piper PA-42 Cheyenne III in Treinta y Tres

Date & Time: Mar 20, 1998 at 1315 LT
Type of aircraft:
Operator:
Registration:
CX-ROU
Flight Phase:
Survivors:
Yes
Schedule:
Treinta y Tres - Montevideo
MSN:
42-8001074
YOM:
1982
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
During the takeoff roll, at a speed of 90 knots, the captain decided to abort. Unable to stop within the remaining distance, the aircraft overran and came to rest 270 metres further against an earth mound. All six occupants escaped with minor injuries and the aircraft was damaged beyond repair. The grassy runway used by the crew is 1,008 metres long and the last portion of 300 metres was waterlogged.

Crash of a Douglas DC-9-32 near Nuevo Berlin: 74 killed

Date & Time: Oct 10, 1997 at 2210 LT
Type of aircraft:
Operator:
Registration:
LV-WEG
Flight Phase:
Survivors:
No
Schedule:
Posadas - Buenos Aires
MSN:
47446
YOM:
1969
Flight number:
AU2553
Country:
Crew on board:
5
Crew fatalities:
Pax on board:
69
Pax fatalities:
Other fatalities:
Total fatalities:
74
Captain / Total flying hours:
9238
Captain / Total hours on type:
177.00
Copilot / Total flying hours:
2910
Copilot / Total hours on type:
1384
Aircraft flight hours:
56854
Aircraft flight cycles:
54800
Circumstances:
The aircraft departed Posadas-Libertador General José de San Martín Airport at 2118LT on a regular scheduled flight to Buenos Aires, carrying 69 passengers and five crew members. While cruising at an altitude of 35,000 feet, weather conditions deteriorated with cumulonimbus reported till 49,000 feet, stormy weather, icing conditions and severe turbulences with winds up to 80 km/h and an OAT of -59° C. The crew modified his route and entered the Montevideo FIR without contacting Montevideo ATC. At 2204LT, the aircraft entered an area with severe icing conditions and three minutes later, the copilot (pilot-in-command) initiated a descent without prior permission. Meanwhile, the captain contacted Ezeiza Control, requesting permission to descend. Ezeiza Control radioed that the flight was over Uruguay territory and that they needed to contact Montevideo Control for permission. At 2209:17, Montevideo ATC cleared the crew to descend to FL257, an altitude reached at 2210:25. During the descent the first officer complained that his airspeed indicator did not seem to be working correctly. Descending through FL300, the first officer extended the slats. The pilots were trained to extend slats when recovering from approach to stall situations at 10,000 - 12,000 feet. However, the actual airspeed at the time of extension was higher than permitted. This exceeded the design limit, causing an asymmetry. The aircraft entered an uncontrolled descent and crashed in a near vertical attitude in an open field located about 21 km east of Nuevo Berlin. The aircraft disintegrated on impact and all 74 occupants were killed. At the point of impact, a cratere of 10 metres deep by 30 metres wide was found. The accident was not survivable. It was reported that that the airspeed suddenly increased from 200 knots to 450 knots in four seconds, probably after the Pitot tubes got iced.
Probable cause:
The immediate cause of the accident was likely that at an altitude of 30,000 feet, the first officer, who was the pilot-in-command, found himself in flight conditions which induced him to extend the slats. This manoeuvre was completed at a speed much higher than the limit of the structural design of the slats, and their extension caused an asymmetry and a subsequent loss of control from which a recovery was not possible. The copilot's interpretation as to the need to extend the slats would have been a result of erroneous indications of low speed (IAS), caused by blockage of the Pitot tubes which resulted from icing conditions while cruising in clouds with an extreme OAT of -59° C. It was not possible to determine if the obstruction was caused by the crew by not activating the heating system via the selector switch, or failure of that system.
The following contributing factors were identified:
a) No indication of Mach number on the speed indicators installed in the accident aircraft within its flight envelope, with air speeds below 250 KIAS.
b) Lack of crew training in flight instrument failures and upset recovery.
c) Lack of crew training in the recovery of approach to stall in the DC-9 aircraft in "clean configuration" in accordance with the procedures specified in the FCOM, section 5, 10-0-0, code 30.
d) Lack of instruction and pilot training in crew resource management (CRM).
e) Absence of a warning light Pitot/Stall-Heater OFF on the annunciator panel.
f) Deficiency in operational procedures.
Final Report:

Crash of an Embraer EMB-110C Bandeirante near Montevideo

Date & Time: Feb 25, 1991
Operator:
Registration:
T-581
Flight Type:
Survivors:
Yes
MSN:
110-079
YOM:
1975
Country:
Crew on board:
0
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
While descending to Montevideo-Carrasco Airport, both engines failed simultaneously. The crew completed an emergency landing in an open field located 11 km from the airport. All occupants escaped uninjured while the aircraft was damaged beyond repair. The aircraft had the dual registration CX-BJK (civil) and T-581 (military).
Probable cause:
Double engine failure on approach due to fuel exhaustion.

Crash of a Piper PA-31-325 Navajo C/R in Montevideo: 2 killed

Date & Time: Aug 19, 1980
Type of aircraft:
Registration:
CX-BMT
Survivors:
No
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
On approach to Montevideo-Carrasco Airport, the pilot passed out. The pilot elected to take control of the aircraft that lost height and crashed. Both occupants were killed. The passenger was not familiar with piloting techniques.

Crash of a Canadair CL-44-6 in Montevideo

Date & Time: Oct 10, 1979
Type of aircraft:
Registration:
CX-BKD
Flight Type:
Survivors:
Yes
MSN:
8
YOM:
1960
Country:
Crew on board:
4
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
On approach to Montevideo-Carrasco Airport, the crew encountered technical difficulties with the right main gear that would not deploy. The gear was recycled manually and all three green lights came on in the cockpit, indicating that all three landing gears were down and locked. Upon touchdown, the right main gear collapsed, causing the right wing to struck the runway surface. Out of control, the airplane veered off runway to the right and came to rest in a grassy area. All six occupants escaped uninjured while the aircraft was damaged beyond repair.
Probable cause:
The cause of the landing gear collapse could not be determined.

Crash of a Douglas C-47A-75-DL in Artigas: 44 killed

Date & Time: Feb 10, 1978 at 1120 LT
Operator:
Registration:
T-511
Survivors:
No
Schedule:
Artigas - Montevideo
MSN:
19301
YOM:
1943
Flight number:
Uruguay 511
Location:
Country:
Crew on board:
4
Crew fatalities:
Pax on board:
40
Pax fatalities:
Other fatalities:
Total fatalities:
44
Circumstances:
After takeoff from Artigas, while on a flight to Montevideo with 40 civilian passengers on board, the pilot contacted ATC and reported engine problems. He was cleared to complete a turn to join the approach path when the airplane stalled and crashed in flames. All 44 occupants were killed. The exact cause of the engine problem remains unknown. The airplane had dual military (T-511) and civil (CX-BJH) registrations.