Transbrasil

Flight Type:

Cargo

Survivors:

Site:

City

Schedule:

Manaus – São Paulo

MSN:

19354

YOM:

1966

Flight number:

TR801

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Captain / Total flying hours:

10731

Captain / Total hours on type:

1458.00

Copilot / Total flying hours:

2265

Copilot / Total hours on type:

Aircraft flight hours:

61053

Circumstances:

The crew (one captain under training, one instructor and one flight engineer) was completing a cargo flight from Manaus to São Paulo and the aircraft was carrying a load of 26 tons of electronic equipments. Initially cleared for an approach to runway 09L, the crew was instructed to change to runway 09R as runway 09L was blocked by an aircraft. The crew was aware of a notam saying that runway 09R would be closed to all traffic starting 1200LT due to maintenance. In such conditions, the instructor rushed the approach procedure, interrupted the instruction to the captain under supervision and commanded flaps and speed brake at the same time, causing the aircraft to descend. The left wing struck the roof of a house then crashed in a residential area located about 2,7 km short of runway, bursting into flames. All three crew members and 22 people on the ground were killed. 47 other people on the ground were seriously injured.

Probable cause:

The accident was the consequence of the combination of the following factors (findings):
- The imminent interruption of operations in the aerodrome that would be used for landing the aircraft (closure of runway 09R due to works) stimulated the instructor to make a hurried descent, characterizing a potential state of anxiety,
- Probable crew fatigue,
- The instruction given to the pilot was discontinued and the local flight did not comply with the minima provided in RAC 3211,
- The failures found in the instruction were due to poor supervision of the Company's operations sector,
- Poor crew coordination,
- During the descent procedure when working checklist, the instructor broke the sequence of standardized procedures, thus stopping the instruction and consequently, the student's core handling of the flight,
- The instructor, without the student being informed beforehand, commanded the flaps together with the speed brakes. This action configured an abnormal attitude that contributed, without the pilots identifying, to the loss of control of the aircraft,
- The flight engineer also failed to meet the checklist items,
- The instructor did not follow the standardization of the instruction, when he executed a decision in a hurry,
- The crew did not respond to the sinking and pull up warnings,
- Error in the application of flight controls,
- The crew did not operate in accordance with the operational standard issued by the manufacturer and endorsed by the company,
- The air traffic controller contributed to the increase of the crew anxiety level by using non standard phraseology.

Final Report:

Crash of a Boeing 707-330C in Manaus

Date & Time: Apr 11, 1987

Type of aircraft:

Boeing 707

Operator:

Registration:

PT-TCO

Flight Phase:

Flight Type:

Cargo

Survivors:

Site:

MSN:

18932

YOM:

1966

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

The approach to Manaus-Eduardo Gomes Airport was completed in poor weather conditions with limited visibility due to heavy rain falls. On final, the crew failed to realize that the airplane was not properly aligned with the runway centerline. The aircraft landed to the right of the centerline, causing the right main gear to collapse after it struck runway lights and an electric box. The aircraft slid for few hundred meters before coming to rest. All seven occupants escaped uninjured.

Crash of a Boeing 727-27C near Florianópolis: 55 killed

Date & Time: Apr 12, 1980 at 2038 LT

Type of aircraft:

Boeing 727-100

Operator:

Registration:

PT-TYS

Flight Phase:

Flight Type:

Survivors:

Site:

Mountains

Schedule:

Fortaleza - Sao Paulo - Florianópolis - Porto Alegre

MSN:

19111

YOM:

1966

Flight number:

TR303

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

On approach to Florianópolis-Hercílio Luz Airport, the crew encountered poor weather conditions with thunderstorm activity and heavy rain falls. The approach was abandoned and the captain initiated a go-around. Few minutes later, while completing a second attempt to land, the crew failed to realize that the airplane was not properly aligned. At a higher speed than prescribed, the airplane struck the top of a hill and crashed in flames about 26 km from the airport. Three passengers were rescued while 55 other occupants were killed. At the time of the accident, the airplane was approaching the airport below the glideslope and off course. It appears that an inspector pilot was at control at the time of the accident.

Probable cause:

The crew misjudged distance, speed and altitude during an approach completed in marginal weather conditions. The following contributing factors were reported:
- Lack of flight supervision,
- Lack of crew coordination,
- Improper use of engines,
- The pilot-in-command failed to initiate a second go-around,
- Lack of visibility due to poor weather conditions.

Crash of a BAc 111-520FN in Campinas

Date & Time: Jan 4, 1977 at 2230 LT

Type of aircraft:

BAc 111

Operator:

Registration:

PP-SDS

Flight Phase:

Flight Type:

Survivors:

Site:

Embraer EMB-110 Bandeirante

Schedule:

Vitória – Rio de Janeiro – Campinas

MSN:

236

YOM:

1971

Flight number:

TR203

Location:

Country:

Region:

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Circumstances:

The approach to Campinas-Viracopos Airport was completed in heavy rain falls. After touchdown on runway 32, a tire burst. The airplane went out of control, veered off runway to the left and came to rest in a muddy ground about 360 metres further. All 43 occupants were evacuated safely while the aircraft was damaged beyond repair.

Crash of an Embraer EMB-110C Bandeirante in Chapecó: 7 killed

Date & Time: Jan 22, 1976

Type of aircraft:

Operator:

Registration:

PT-TBD

Flight Phase:

Takeoff (climb)

Flight Type:

Survivors:

Site:

Chapecó-Serafim Enoss Bertaso

Schedule:

Chapecó – Erechim – Porto Alegre

MSN:

110-011

YOM:

1973

Flight number:

TR107

Location:

Santa Catarina

Country:

Brazil

Region:

South America

Crew on board:

Crew fatalities:

Pax on board:

Pax fatalities:

Other fatalities:

Total fatalities:

Aircraft flight hours:

20659

Circumstances:

Crashed while taking off from Chapecó-Serafim Enoss Bertaso Airport for unknown reasons. Both pilots and five passengers were killed while two other passengers were rescued.

Crash of a BAc 111-520FN in São Paulo

Date & Time: Feb 2, 1974

Type of aircraft:

BAc 111

Operator:

Registration:

PP-SDQ

Flight Phase:

Flight Type:

Survivors:

Site: