Crash of a Beechcraft G18S in Nome

Date & Time: Dec 18, 1995 at 1316 LT
Type of aircraft:
Operator:
Registration:
N340K
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Nome - Gambell
MSN:
BA-605
YOM:
1962
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
8500
Captain / Total hours on type:
450.00
Aircraft flight hours:
6886
Circumstances:
The pilot was attempting to transport by-pass mail from Nome to Gambell, Alaska. The pilot stated that the takeoff run was normal until he rotated the nose of the airplane to lift off. The pilot said the airplane pitched up and he had to apply full forward control yoke pressure while he adjusted the pitch trim to nose down. The airplane rolled to the left and the pilot used the rudders to level the wings prior to impact. The information provided by the company, the FAA, and the post office, indicate that the airplane weighed 10,114 pounds at the time of the takeoff. The certificated maximum gross weight was 10,100 pounds. A weight and balance calculation, based upon information obtained from the company and the placarded limits on the airplane, showed a center of gravity of 121.9 inches. The center of gravity limits shown in the airplane manual are 113 to 120.5 inches. The wreckage examination showed that the elevator trim indicator was indicating full nose up trim.
Probable cause:
The pilot exceeding the weight and balance limitations of the airplane and improperly utilizing the airplane's elevator trim by selecting full nose up trim.
Final Report:

Crash of a Piper PA-31-310 Navajo in Kamloops: 1 killed

Date & Time: Nov 22, 1995 at 1902 LT
Type of aircraft:
Operator:
Registration:
C-GKNB
Flight Type:
Survivors:
Yes
Schedule:
Williams Lake – Kamloops – Vancouver
MSN:
31-598
YOM:
1970
Flight number:
FCV705
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
The Navair Charter Piper PA-31, flight FCV705, a mail courier with a crew of two, was on a night, instrument flight rules (IFR) flight plan from Williams Lake, British Columbia, to Kamloops. While the crew was conducting an instrument procedure to the Kamloops airport, they flew into an area that was clear of cloud. The captain cancelled his IFR flight plan and descended for a visual flight rules (VFR) approach to the airport. At 1902 PST, the aircraft collided with trees at an elevation of 2,400 feet above sea level (asl), seven nautical miles (nm) east-southeast of the Kamloops airport. The captain was fatally injured on impact, and the first officer was seriously injured; the aircraft was destroyed during the crash and post-crash fire.
Probable cause:
The aircraft collided with trees during a night, VFR descent over mountainous terrain because the crew had inadequate visual cues to accurately determine their height above the ground. Contributing to this accident were the captain's decision to cancel his IFR flight plan and attempt a visual approach from well outside the published VFR circuit area, the inherent risks of VFR flight in mountainous regions, and a requirement by the crew to remain clear of departing IFR traffic from the Kamloops airport.
Final Report:

Crash of an IAI-1124 Westwind in Alice Springs: 3 killed

Date & Time: Apr 27, 1995 at 1957 LT
Type of aircraft:
Operator:
Registration:
VH-AJS
Flight Type:
Survivors:
No
Schedule:
Darwin – Katherine – Alice Springs – Adélaïde – Sydney
MSN:
221
YOM:
1978
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
10108
Captain / Total hours on type:
2530.00
Copilot / Total flying hours:
3747
Copilot / Total hours on type:
85
Aircraft flight hours:
11508
Circumstances:
The aircraft was on a scheduled freight service from Darwin via Tindal, Alice Springs, and Adelaide to Sydney under the IFR. The flight from Darwin to Tindal was apparently normal, and the aircraft departed Tindal slightly ahead of schedule at 1834 CST. The pilot in command occupied the left cockpit seat. At 1925, the aircraft reported at position DOLPI (200 miles north of Alice Springs) Flight Level 330, to Melbourne Control. Another Westwind aircraft was en route Darwin–Alice Springs and was more than 40 miles ahead of VH-AJS. Information from the aircraft cockpit voice recording confirmed that the pilot in command was flying the aircraft. At about 1929, he began issuing instructions to the co-pilot to program the aircraft navigation system in preparation for a locator/NDB approach to Alice Springs. The pilot in command asked the co-pilot to enter an offset position into the area navigation (RNAV) system for an 11-mile final for runway 12. The co-pilot entered the bearing as 292 degrees Alice Springs. (This was the outbound bearing from Alice Springs NDB to Simpson’s Gap locator indicated on the locator/NDB approach chart.) The pilot in command stated that he had wanted the bearing with respect to the runway, 296 degrees, entered but said that the setting could be left as 292 degrees. He then instructed the co-pilot to set Alice Springs NDB frequency on ADF 1, Simpson’s Gap locator on ADF 2, and to preset the Temple Bar locator frequency on ADF 2 so that it could be selected as soon as the aircraft passed overhead Simpson’s Gap. He indicated his intention to descend to 4,300 feet until overhead Simpson’s Gap, and said that the co-pilot should then set 3,450 feet on the altitude alert selector. On passing Temple Bar, the co-pilot was to set 2,780 feet on the altitude alert selector which the pilot in command said would be used as the minimum for the approach. At 1940, the co-pilot contacted Adelaide Flight Service (FIS) and was given the Alice Springs weather, including the local QNH. At 1945, he advised Adelaide FIS that the aircraft was leaving Flight Level 330 on descent. At about 30 miles from Alice Springs, the pilot in command turned the aircraft right to track for the offset RNAV position 292 degrees/11 miles Alice Springs. The crew set local QNH passing 16,000 feet and then completed the remaining transition altitude checks. These included selecting landing and taxi lights on. At 1949, the co-pilot advised Adelaide FIS that the aircraft was transferring frequency to the Alice Springs MTAF. At 1953, the aircraft passed Simpson’s Gap at about 4,300 feet and the copilot set 3,500 feet in the altitude alert selector. About 15 seconds later, the pilot in command told the co-pilot that, after the aircraft passed overhead the next locator, he was to set the ‘minima’ in the altitude alert selector. At 1954 , the pilot in command called that the aircraft was at 3,500 feet. A few seconds later, the co-pilot indicated that the aircraft was over the Temple Bar locator and that they could descend to 2,300 feet. The pilot in command repeated the 2,300 feet called by the co-pilot and asked him to select the landing gear down. The crew then completed the pre-landing checks. Eleven seconds later, the co-pilot reported that the aircraft was 300 feet above the minimum descent altitude. This was confirmed by the pilot in command. About 10 seconds later, there were two calls by the co-pilot to pull up. Immediately after the second call, the aircraft struck the top of the Ilparpa Range (approximately 9 kilometres north-west of Alice Springs Airport), while heading about 105 degrees at an altitude of about 2,250 feet in a very shallow climb. At approximately 1950, witnesses in a housing estate on the north-western side of the Ilparpa Range observed aircraft lights approaching from the north-west. They described the lights as appearing significantly lower than those of other aircraft they had observed approaching Alice Springs from the same direction. The lights illuminated buildings as the aircraft passed overhead and then they illuminated the northern escarpment of the range. This was followed almost immediately by fire/explosion at the top of the range.
Probable cause:
The following factors were considered significant in the accident sequence:
1. There were difficulties in the cockpit relationship between the pilot in command and the co-pilot.
2. The level of crew resource management demonstrated by both crew members during the flight was low.
3. The Alice Springs locator/NDB approach was unique.
4. The briefing for the approach conducted by the pilot in command was not adequate.
5. When asked for the ‘minima’ by the pilot in command, the co-pilot called, and the pilot in command accepted, an incorrect minimum altitude for the aircraft category and for the segment of the approach.
6. The technique employed by the pilot in command in flying the approach involved a high cockpit workload.
7. The crew did not use the radio altimeter during the approach.
Final Report:

Crash of a Beechcraft E18S in Kansas City: 1 killed

Date & Time: Dec 8, 1994 at 2038 LT
Type of aircraft:
Registration:
N5647D
Flight Type:
Survivors:
No
Schedule:
Sedalia - Kansas City
MSN:
BA-364
YOM:
1958
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
2523
Captain / Total hours on type:
500.00
Circumstances:
During arrival at night in fog and drizzle, the pilot was cleared for an ILS runway 1l approach. While on the approach, she reported encountering moderate rime ice. Radar data showed that the airplane continued inbound on the localizer until it neared the middle marker, then it deviated about 20° left and collided with the ground, about 300 feet short and 300 feet left of the threshold. According to witnesses, the airplane stopped its descent and slowed down, shortly before entering a steep descent and a spin. An on-scene investigation revealed no preimpact airframe, control system, or powerplant anomalies. The wings had 1/4 inch of ice on the leading edge and a 1/2 inch high ridge of ice, parallel to the deicing boots, about 3 inches aft of the boots. The cockpit and windshield heating system were found in the 'off' position. The pilot's logbook was not available for inspection. Company records showed she had passed a 14 cfr part 135 checkride on may 20, 1994. The faa checkride form was administered and signed by the chief pilot. However, other records/information showed the chief pilot would not have been able to have given the checkride on that date.
Probable cause:
Failure of the pilot to maintain adequate airspeed on final approach, which resulted in an inadvertent stall/spin. Factors related to the accident were: the adverse weather (icing) conditions, the accumulation of airframe/wing ice, the pilot's improper use of the anti-ice/deice equipment, inadequate training of the pilot concerning flight in icing conditions, and inadequate surveillance of the operation by the chief pilot (company/operator management).
Final Report:

Crash of a Convair CV-440 Metropolitan near Toluca

Date & Time: Nov 30, 1989
Registration:
XA-NAU
Flight Phase:
Flight Type:
Survivors:
Yes
MSN:
411
YOM:
1957
Location:
Country:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
An engine failed en route, forcing the crew to attempt an emergency landing. The aircraft crash landed in an open field near Toluca and was damaged beyond repair. Both occupants escaped uninjured. The exact date of the mishap remains unknown, somewhere in November 1989.
Probable cause:
Engine failure for unknown reasons.

Crash of a Mitsubishi MU-2B-60 Marquise off Orosei: 2 killed

Date & Time: Oct 24, 1989
Type of aircraft:
Registration:
I-IDMA
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Palermo - Olbia
MSN:
769
YOM:
1980
Location:
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
The twin engine aircraft was completing a mail flight from Palermo to Olbia with two pilots on board. While approaching Sardinia, the aircraft crashed in unknown circumstances in the Tyrrhenian Sea off Orosei. Both occupants were killed.

Crash of a Piper PA-31-350 Navajo Chieftain in Ontario: 1 killed

Date & Time: Sep 15, 1989 at 0652 LT
Operator:
Registration:
N70PE
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Ontario - Santa Barbara
MSN:
31-8052137
YOM:
1980
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
1916
Aircraft flight hours:
3118
Circumstances:
The propeller separated from the right engine during the initial climb. Examination of the wreckage revealed the propeller hub fracture resulted in one of the three propeller blades detaching from the hub. The rest of the propeller hub then separated striking the right front of the fuselage. Oil was spread across the aircraft nose and windshield. The fuselage right side damage increased aerodynamic drag. Witnesses reported the engine cowling was torn. The aircraft entered a right turn and dive. It impacted the ground in a near inverted attitude. Metallurgical examination of the failed prop hub revealed metal fatigue emanating from the threaded hole for the grease fitting. The threads had been deformed by shot peening, resulting in increased stress concentrations at the threads. The pilot, sole on board, was killed.
Probable cause:
Failure of the right propeller hub due to metal fatigue which resulted in catastrophic separation of the propeller. Contributing to the accident was damage done to the aircraft airframe in flight by the separating propeller making the aircraft uncontrollable.
Final Report:

Crash of a Cessna 208A Caravan I near Travis AFB: 1 killed

Date & Time: Oct 23, 1987 at 0423 LT
Type of aircraft:
Operator:
Registration:
N828FE
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Oakland - Reno
MSN:
208-0073
YOM:
1985
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
10495
Captain / Total hours on type:
642.00
Aircraft flight hours:
1721
Circumstances:
While cruising on a scheduled cargo flight in IMC the pilot encountered moderate to severe turbulence near an area where weather cells could have been observed on the aircraft's radar. The pilot reversed course, declared an emergency and lost control of the aircraft. The aircraft entered an uncontrolled descent, collided with terrain and was destroyed. The recently hired pilot had completed the FAA approved ground and flight training program in the aircraft. During the pilot's recent training, neither the FAA nor the operator required the pilot to demonstrate proficiency in unusual attitude recoveries or have knowledge in the operation of the aircraft's weather radar. Company employees, which included the pilot's husband, stated that the pilot had no previous experience with weather radar and did not understand the weather radar installed in this aircraft. They further stated that the pilot appeared to be tired. The pilot, sole on board, was killed.
Probable cause:
The National Transportation Safety Board determines the probable cause(s) of this accident to be:
Pilot's encounter with severe turbulence which precipitated a loss of Aircraft control.
Findings
Occurrence #1: in flight encounter with weather
Phase of operation: cruise - normal
Findings
1. Light condition - dark night
2. (f) weather condition - turbulence in clouds
3. (f) weather radar - not understood - pilot in command
4. (f) inadequate initial training - company/operator management
5. (f) inadequate initial training - faa (principal operations inspector)
6. (c) flight into known adverse weather - continued - pilot in command
----------
Occurrence #2: loss of control - in flight
Phase of operation: maneuvering - turn to reverse direction
Findings
7. (c) spiral - uncontrolled - pilot in command
8. (f) spatial disorientation - pilot in command
9. (f) fatigue (lack of sleep) - pilot in command
----------
Occurrence #3: in flight collision with terrain/water
Phase of operation: descent - uncontrolled
Final Report:

Crash of a Britten-Norman BN-2B-27 Islander in Ainsdale

Date & Time: Aug 21, 1987 at 0530 LT
Type of aircraft:
Operator:
Registration:
G-BLDX
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Manchester – Douglas
MSN:
2181
YOM:
1983
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
11792
Captain / Total hours on type:
17.00
Circumstances:
A Britten-Norman BN-2B-27 Islander sustained substantial damage in a forced landing on a Merseyside beach. The airplane was to carry mail on an early morning service from Manchester Airport (MAN) to Ronaldsway Airport, Isle of Man. The commander arrived at the aircraft at about 03:45 hrs in the morning. As it was dark, the internal checks were done in normal cockpit lighting and, having completed the usual preflight administration, he was ready to start engines at about 04:50 hrs. The aircraft took off at 05:09 hrs, on a Special Visual Flight Rules Clearance, turned right onto a northwesterly heading, and climbed to an initial cruising altitude of 1000 feet. Just prior to crossing the coast, as conditions were conducive to the formation of carburettor icing, the commander selected HOT air on both engines for 30 seconds. At this stage the aircraft was cruising at an altitude of 2000 feet at between 120 and 130 knots with both engines set at 24 inches manifold pressure and 2300 revolutions per minute. When the aircraft was about 2 nautical miles out to sea, the port engine appeared to surge and then stopped. Shortly afterwards, the starboard engine did the same thing. At 05:28 hrs the commander informed Liverpool Approach that he had a problem and was going to attempt a forced landing at Woodvale Airfield. Having turned back towards the shore, the commander selected the TIP/MAIN switch to TIP and reduced the indicated airspeed to about 65 kt in the descent. The aircraft did not reach Woodvale and a forced landing was carried out on the beach. It was while the commander was making the aircraft safe that he noticed that the main fuel cock selectors were positioned such that both engines had been feeding from the right fuel tank. Both fuel cocks were then selected to OFF and, when the shutdown had been completed, the commander vacated the aircraft uninjured. The aircraft had landed on flat sand, but had struck a soft patch; this had resulted in the collapse of the nose and right main undercarriage, and damage to the nose and the wing centre section. Recovery attempts by local services had severely damaged the tailplane and had probably caused the sideway failure of the left undercarriage. The aircraft was totally submerged during the subsequent high tide. Examination of the aircraft, before it was recovered from the beach, showed no evidence of any pre-impact failure in the engine or flying controls. The fuel state was approximately 289 litres with the right main tank empty.
Probable cause:
Double engine failure caused by a fuel exhaustion as the fuel selector was positioned on an empty tank. 289 liters of fuel remained in other tanks at the time of the accident.
Final Report:

Crash of a PZL-Mielec AN-2 in Kakvinskie Pechi

Date & Time: Jul 5, 1987
Type of aircraft:
Operator:
Registration:
CCCP-32402
Flight Phase:
Flight Type:
Schedule:
Sverdlovsk – Ivdel
MSN:
1G101-03
YOM:
1969
Country:
Region:
Crew on board:
0
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
While on a mail flight from Sverdlovsk to Ivdel, weather conditions deteriorated with low ceiling and precipitations. The crew decided to continue when the aircraft struck tree tops and crashed in a wooded area. The wreckage was found 25 km off course. Occupant fate unknown.