South America

Loss of directional control of the aircraft and a subsequent Runway Excursion, resulting from a combination of errors in takeoff planning and execution, incorrect configuration of the RPM throttles levers, failure to comply with standard procedures and poor cockpit resource management (CRM).
The following contributing factors were identified:
- The inappropriate decision to abort takeoff at a speed higher than that described in the performance tables significantly increased the required braking distance.
- Ineffective communication between flight crew members, especially during the critical takeoff phase, creating confusion and incorrect decision-making.
- The ASDA (Accelerate-Stop Distance Available) and takeoff speed calculations used by the crew were significantly higher, increasing the distance and speed required for a safe takeoff.

During the climb, immediately after takeoff, the aircraft rolled to the left, stabilized momentarily, and then rolled again to the same side. The second roll caused excessive bank, resulting in localized lift loss on the left wing, which led to a loss of altitude until impact with the ground. Information obtained during the investigation suggests that the aileron interconnection cable was disconnected at the time of the accident. Disconnection of the aileron interconnection cable causes a loss of synchronization between the left (pilot) and right (copilot) controls, allowing only right turns from the left control and left turns from the right control. This disconnection likely generated asymmetrical responses in the control inputs, making it difficult to control the aircraft and contributing to the loss of control. Cockpit conversations suggest that the copilot, seated on the right, began the takeoff run and, after the second left bank, transferred control to the pilot, seated on the left. At low altitude, the attempt to correct the left wing tilt, once in a stall situation, proved ineffective. According to the aircraft's maintenance records, the last replacement of the aileron interconnection cable was performed at 13,217.5 total flight hours July 18, 2016. The procedure for replacing the aileron interconnection cable did not clearly establish the removal and installation of the locking clips. The procedure for checking the tension of the aileron system cables, carried out on February 28, 2020, at 13,695.7 flight hours, did not clearly establish the installation of the locking clips. It is reasonable to conclude that the cable became disconnected due to the absence of the locking clips, which would have allowed the tensioner to gradually unscrew under the dynamic loads resulting from successive flights. The conclusion that the cable detachment was due to the absence of the locking clip suggests shortcomings in the training of the personnel responsible for inspecting the aircraft, as well as in the supervision of maintenance tasks by the maintenance manager. No evidence of failure of other flight control components that could have contributed to the accident was found.

Contributing factors:
- Training – undetermined.
The frequent and improper use of the EPL (Emergency Power Lever) during emergency landing training throughout the aircraft’s operation may have contributed to engine degradation.
- Work-group culture – undetermined.
The recurring improper use of the EPL by multiple pilots during the operation of the aircraft may have contributed to engine degradation.
- Handling of aircraft flight controls – undetermined.
It is possible that the pilot's use of the aircraft’s EPL was inappropriate and contributed to the severity of the accident.
- Aircraft maintenance – a contributor.
Given the large number of seat belts that detached as a result of the shearing of their floor attachment brackets and their corroded condition, it was determined that the maintenance actions were not effective in ensuring the integrity and reliability of these materials, which contributed to the injuries sustained by the parachutists during the emergency landing.
- Managerial oversight – a contributor.
The oversight of the operational procedures related to the use of the EPL was not effective in identifying the risks associated with its use in disagreement with the aircraft manufacturer’s specifications.

Progressive loss of engine power due to the malfunction of the combustion system from the beginning of the takeoff, which significantly compromised the aircraft's performance in flight, as it was unable to maintain the proper speed and altitude to return to the airport, entering into a sudden loss of lift and the subsequent collision with ground.

Contributing factors:
- Adverse meteorological conditions – a contributor.
The significant weather, indicated with the proximity qualifier “vicinity” in the METAR for SBBR, encompassed the SSGP region and affected the aircraft’s stability on short final, requiring the pilot to perform additional control inputs compared to normal operating
conditions.
- Handling of aircraft flight controls – a contributor.
The improper use of flight controls during heading correction on final approach - due to wind gusts - and the failure to effectively neutralize the aircraft’s rolling tendency during the go-around maneuver contributed to destabilization on final and to the unsuccessful go around.
- Piloting judgment – a contributor.
The application of rudder to correct for lateral wind deviation, based on the belief that using aileron would result in loss of lift, reflected an inadequate assessment.
- Perception – undetermined.
It is possible that situational awareness was reduced due to the wind gust occurring near touchdown, where increased workload may have led to delayed or selective perception of the required action, in this case, the go-around procedure.
- Decision-making process – a contributor.
The decision to continue the approach, followed by exposure to another wind gust during a critical phase (low altitude and left of runway centerline), resulted in a delayed execution of the go-around procedure, highlighting difficulty in perceiving, analyzing, and
selecting appropriate alternatives for the situation encountered.