Crash of a Socata TBM-700 in Moulins

Date & Time: May 13, 2002 at 1538 LT
Type of aircraft:
Operator:
Registration:
N700AR
Flight Type:
Survivors:
Yes
Schedule:
Clermont-Ferrand - Moulins
MSN:
023
YOM:
1991
Location:
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
2100
Captain / Total hours on type:
35.00
Circumstances:
The single engine aircraft was completing an aerial photography flight from Clermont-Ferrand, carrying one passenger and one pilot. On final approach to Moulins-Montbeugny Airport runway 08, at a speed of 85 knots, the pilot estimated that the nose-up attitude of the aircraft was excessive and increased engine power. The aircraft rolled to the left, causing the left wing tip to struck the runway surface. Out of control, the aircraft impacted the ground, lost its undercarriage and slid fo 95 metres before coming to rest, bursting into flames. Both occupants escaped uninjured and fire brigade arrived 15 minutes later. The aircraft was destroyed by fire.
Probable cause:
It was reported that the approach was completed with the engine at reduced power. It was not possible to determine if the engine was running at 'full reduced power' or at a minimum of 10% of torque as preconized by the manufacturer. During an approach completed with an engine at 'full reduced power', the full power can be obtained only after a period of five seconds.
Final Report:

Crash of an Embraer EMB-820C Navajo in Brasília: 1 killed

Date & Time: Nov 23, 2001 at 1645 LT
Type of aircraft:
Operator:
Registration:
PT-RAZ
Flight Type:
Survivors:
Yes
Schedule:
Bom Jesus da Lapa – Brasília
MSN:
820-114
YOM:
1980
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
3000
Captain / Total hours on type:
2700.00
Aircraft flight hours:
2633
Circumstances:
Following an uneventful flight from Bom Jesus da Lapa, the pilot started the descent to Brasília Airport runway 29. On final approach, in a gear and flaps down configuration, the aircraft suffered an engine failure. The pilot elected to restart the engine when the aircraft deviated from the approach path to the right, lost height and struck a promontory located 61 metres from the runway threshold. Both occupants were seriously injured and the aircraft was damaged beyond repair. 23 days later, the passenger died from his injuries.
Probable cause:
No technical anomalies were found on both engines. The fuel selector was positioned on the auxiliary tanks who had sufficient fuel at the time of the accident. It was reported that the pilot elected to continue the approach on one engine, letting himself be carried away by the luck factor that he benefited in the past in other similar situations.
Final Report:

Crash of a Britten-Norman BN-2A-27 in Bujari

Date & Time: Sep 22, 2001 at 1207 LT
Type of aircraft:
Operator:
Registration:
PT-KTQ
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Rio Branco - Rio Branco
MSN:
493
YOM:
1976
Location:
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
12000
Captain / Total hours on type:
300.00
Circumstances:
The twin engine aircraft departed Rio Branco with four passengers and one pilot on board. The goal of the flight was to carry four Japanese journalists who wanted to perform aerial views from various tribes located in the region of Santa Rosa do Purus. About 30 minutes into the flight, an oil leak occurred on the left engine that lost power. The pilot reduced his altitude and attempted an emergency landing when the aircraft crashed near Bujari, about 39 km from Rio Branco. The wreckage was found near motorway BR364 and all five occupants were slightly injured.
Probable cause:
The following findings were identified:
- It is likely that the pilot did not use the controls properly to maintain an adequate control of the airplane in a single-engine configuration while the airplane was operated within weight and balance limits,
- The left propeller retainer had been replaced by similar but not original equipment, using glue to ensure its tightness, which was non compliant with the engine manufacturer's procedures,
- The aircraft maintenance documents were not kept up to date by the operator,
- Poor flight preparation on the part of the pilot who did not notice that the maintenance documents were not up to date,
- The operator was not compliant with the current Brazilian Civil Aviation Authority legislation.
Final Report:

Crash of a De Havilland DHC-2 Beaver in Port Blakely

Date & Time: Oct 1, 1999 at 1445 LT
Type of aircraft:
Operator:
Registration:
N9766Z
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Seattle - Seattle
MSN:
504
YOM:
1953
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1829
Captain / Total hours on type:
240.00
Aircraft flight hours:
30792
Circumstances:
The pilot-in-command (PIC) departed Lake Union seaplane base with four British Broadcasting Company passengers aboard the De Havilland DHC-2 'Beaver.' The passengers were engaged in aerial videography of an east/west geological fault line crossing from south Seattle through Blakely Harbor near the south end of Bainbridge Island. An onboard video recorder captured a voice instructing 'Keep as low as you can and slow as you can while we're doing this please... .' The PIC's first pass over the south end of Bainbridge Island was uneventful and the aircraft was maneuvered for a second pass. The PIC reported that approaching the upsloping, tree covered terrain he applied climb flaps and power but shortly thereafter realized the climb rate was less than he expected. He attempted a shallow left turn towards down sloping terrain and then leveled the wings as the aircraft descended into the treetops. The scenario was corroborated by two onboard video recordings. The pilot reported no powerplant or control system malfunction during the accident flight. He also reported encountering a downdraft condition over the tree covered terrain. Winds remained below 12 knots throughout the day at reporting stations near the accident site, and the video recordings showed no wind streaking and only sporadic whitecaps on the surface of Puget Sound during the transit from Seattle to the south end of Bainbridge Island.
Probable cause:
The pilot-in-command's failure to maintain adequate clearance from trees/terrain. Contributing factors were rising terrain and trees.
Final Report:

Crash of a Piper PA-31-310 Navajo Chieftain in San Diego: 3 killed

Date & Time: Jun 20, 1997 at 1231 LT
Type of aircraft:
Operator:
Registration:
N266MM
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
San Diego - San Diego
MSN:
31-140
YOM:
1968
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
10041
Captain / Total hours on type:
1586.00
Aircraft flight hours:
8473
Circumstances:
The aircraft concluded an aerial survey and landed at Brown Field to clear U.S. Customs. On restart, as the left engine began running, a witness noticed two short, yellow flame bursts exit the exhaust. During taxi, the witness heard a popping sound coming from the aircraft. As power was applied to cross runway 26L, the sound went away. The aircraft stopped for a few seconds prior to pulling onto the runway; the witness did not observe or hear a run-up. Witnesses reported hearing a series of popping sounds similar to automatic gunfire and observed the aircraft between 600 and 1,000 feet above the ground with wings level and the landing gear up. The aircraft was observed to make an abrupt, 45-degree banked, left turn as the nose dipped down. Witnesses reported the nose of the aircraft then raised up toward the horizon. This was followed by the aircraft turning to the left and becoming inverted in an estimated 30-degree nose low attitude. With the nose still low, the aircraft continued around to an upright position and appeared to be in a shallow right bank. Witnesses then lost sight of the aircraft due to buildings and terrain. A May 20, 1997, work order indicated the left manifold pressure fluctuated in flight. Both wastegates were lubricated and a test flight revealed the left engine manifold pressure lagged behind the right engine manifold pressure. On June 18, 1997, the left engine differential pressure controller was noted to have been removed and replaced. This was the corrective action for a discrepancy write up that the left engine manifold pressure fluctuated up and down 2 inHg and the rpm varied by 100 in cruise. A test flight that afternoon by the accident pilot indicated the discrepancy still occurred at cruise power settings, but the engine operated normally at high and low power settings. Post accident functional checks were performed on various components. No discrepancies were noted for the left governor. The left engine differential pressure controller was damaged and results varied on each test. The left density controller was too damaged to test. The right engine density and differential pressure controllers tested satisfactory. The left and right fuel pumps operated within specifications. Both fuel servos were damaged. One injection nozzle on the left engine was partially plugged; all others flow tested within specifications.
Probable cause:
The loss of power in the left engine for undetermined reasons and the pilot's subsequent failure to maintain minimum single-engine control airspeed. A contributing factor was the pilot's decision to fly with known deficiencies in the equipment.
Final Report:

Crash of a Basler BT-67 in Newton: 2 killed

Date & Time: Mar 15, 1997 at 1528 LT
Type of aircraft:
Operator:
Registration:
TZ-389
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Oshkosh - Newton
MSN:
26002
YOM:
1943
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
5350
Captain / Total hours on type:
3775.00
Aircraft flight hours:
17616
Circumstances:
At 1400 cst, modified Douglas DC-3C/BT-67R, TZ-389, and Beech A36, N3657A, began formation flight to get DC-3 flying time and for the 2nd occupant of the A36 to get aerial photos of the DC-3. A witness saw the airplanes at 500 feet to 700 feet agl, "flying close together heading north." He said "the big plane (DC-3) was flying straight and level. The little plane (A36) was just to the west of the big plane. The little plane then hit the big plane near the middle." After impact, pieces of acft were seen falling. Another witness saw the DC-3 heading north and the A36 circling it above and below. On its last pass, the A36 circled behind the DC-3, then crossed over the top and hitting the top of the DC-3. About 5 seconds after impact, the DC-3 gently rolled/turned westbound (apparently descending and gaining airspeed); the left wing then came off, followed by the right wing about 2 seconds later. Parts of the A36 empennage were found 3590 to 4,910 feet from the main wreckage. There was evidence that during impact, the DC-3 elevator and rudder controls were severed. No preimpact anomalies were found. At 1445 cst, an AIRMET had been issued, forecasting light to moderate turbulence below 8,000 feet msl. Toxicology tests of the DC-3 copilot's blood showed 0.127 mcg/ml amitriptyline (a prescription antidepressant with sedative side effects), 0.039 mcg/ml nortriptyline (metabolite of amitriptyline), and an undetermined amount of ephedrine and phenylpropanolamine (over-the-counter medications used in cold preparations, diet aids and stimulants).
Probable cause:
Failure of the Beech A36 pilot to maintain clearance from the modified Douglas DC-3, while positioning the A36 for photography of the DC-3.
Final Report:

Crash of a Tupolev TU-134AK in Samoylikha: 8 killed

Date & Time: Sep 9, 1994 at 1107 LT
Type of aircraft:
Operator:
Registration:
RA-65760
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Moscow - Moscow
MSN:
62187
YOM:
1979
Country:
Region:
Crew on board:
5
Crew fatalities:
Pax on board:
3
Pax fatalities:
Other fatalities:
Total fatalities:
8
Circumstances:
The aircraft was engaged in an aerial photography mission, carrying three passengers and a crew of five. While cruising at an altitude of 3,000 metres parallel to a Tupolev TU-22M3, both crews agreed to close each other about 10-15 metres when the TU-22 struck the tail of the TU-134. While the crew of the TU-22 was able to return to Moscow-Zhukovsky Airport for an emergency landing, the TU-134 entered an uncontrolled descent and crashed in a wooded area located in Samoylikha, about 140 km southeast of Moscow. The aircraft was totally destroyed and all eight occupants were killed.
Probable cause:
Failure of both crews to observe a minimum safe separation between both aircraft while flying in formation and poor judgment.

Crash of a Cessna T207A Skywagon in Banning: 2 killed

Date & Time: Jun 9, 1994 at 1630 LT
Registration:
N6383H
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Burbank - San Diego
MSN:
207-0504
YOM:
1979
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
5032
Captain / Total hours on type:
1160.00
Circumstances:
The PA-28, N4512Z, was westbound in level flight about 1,000 feet agl, about 2 miles north of an airport at which an intermediate stop was planned. The Cessna T207A, N6383H, was maneuvering in left turns while conducting aerial photography, and had just initiated a turn toward the east. The left wings of each aircraft were struck by the other airplane. Witnesses indicated that about 2 seconds before impact, the PA-28 attempted to avoid a collision by beginning a climbing right turn. Each aircraft continued past the other and then both spiraled to the ground. The weather conditions were clear, visibility 3 miles in haze. Neither airplane was in radar or voice contact with any FAA facility. All three occupants in both aircraft were killed.
Probable cause:
The failure of both pilots to see and avoid each other. The haze was a factor.
Final Report:

Crash of a Piper PA-46-310P Malibu in Boulder: 1 killed

Date & Time: Jul 26, 1986 at 0740 LT
Operator:
Registration:
N4346L
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Boulder - Boulder
MSN:
46-8408038
YOM:
1984
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
1255
Captain / Total hours on type:
83.00
Aircraft flight hours:
382
Circumstances:
The purpose of the flight for both aircraft was an aerial photo mission. N5113S was used as the camera platform. The pilots of N5113S and N4346L discussed prior to takeoff the procedures of the flight. Both aircraft departed and flew a course to position the airplanes on a southerly heading. N5113S was to the east and slightly above and ahead of N4346L. The photographer shot one roll of film and reloaded. He was ready to begin shooting when N4346L began to close in on N5113S. The pilot of N5113S felt two 'bumps' as N4346L closed, and did not see the aircraft pass under. The pilot of N5113S maneuvered his aircraft to determine controllability and saw N4346L spiralling to the ground. Examination of N4346L revealed the vertical stab and rudder had separated in-flight. There were numerous paint smears found on the right side on N5113S. The pilot, sole on board, was killed.
Probable cause:
Occurrence #1: midair collision
Phase of operation: maneuvering
Findings
1. (f) in-flight planning/decision - inadequate - pilot in command
2. (c) altitude - misjudged - pilot in command
3. (c) distance - misjudged - pilot in command
4. (c) clearance - not maintained - pilot in command
5. (f) overconfidence in personal ability - pilot in command
----------
Occurrence #2: airframe/component/system failure/malfunction
Phase of operation: maneuvering
Findings
6. Vertical stabilizer surface - separation
7. Flight control, rudder - separation
----------
Occurrence #3: in flight collision with terrain/water
Phase of operation: descent - uncontrolled
Findings
8. Object - vehicle
9. Object - none suitable
Final Report:

Crash of a Consolidated PBY-6A Catalina off Port Isabel: 7 killed

Date & Time: Oct 13, 1984 at 0803 LT
Operator:
Registration:
N16KL
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Harlingen - Harlingen
MSN:
2068
YOM:
1944
Crew on board:
3
Crew fatalities:
Pax on board:
7
Pax fatalities:
Other fatalities:
Total fatalities:
7
Captain / Total flying hours:
8695
Captain / Total hours on type:
70.00
Aircraft flight hours:
6457
Circumstances:
Aerial photos were being taken of the mishap aircraft. Mission called for a simulated water landing (actual water landing prohibited) by flying as close as possible to water. Copilot at controls descended aircraft to about 6 feet, then gradually reduced clearance to 6-12 inches above water, airspeed 105 mph. Copilot inadvertently allowed aircraft to touch water. On touchdown, aircraft decelerated violently and broke up, ejecting several of the occupants and coming to rest inverted. Examination of aerial photos shows aircraft hull at touchdown was slightly nose down vice normal landing attitude; water contact made at location of nose landing gear doors. Photos show outward rupturing of forward hull structure, nose gear doors missing. Hull at rear of step showed two parallel, 3-feet long by 2-in wide, fore-to-aft and outboard-to-inboard penetrations. Floor of shallow lagoon known to have scattered debris from petroleum explorations; however, no positive determination of aircraft contact with submerged object could be made. Seven occupants were killed while three others were injured.
Probable cause:
Occurrence #1: in flight collision with terrain/water
Phase of operation: maneuvering
Findings
1. (f) terrain condition - water, glassy
2. (c) clearance - misjudged - copilot/second pilot
3. (c) supervision - inadequate - pilot in command
4. (c) door, landing gear - overload
5. (c) door, landing gear - separation
Final Report: