Ground accident of a BAe 125-400B in Lanseria

Date & Time: Feb 12, 2002 at 0800 LT
Type of aircraft:
Operator:
Registration:
ZS-JBA
Flight Phase:
Survivors:
Yes
Schedule:
Lanseria – Blantyre
MSN:
25259
YOM:
1971
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
7881
Captain / Total hours on type:
64.00
Copilot / Total flying hours:
13500
Copilot / Total hours on type:
18
Circumstances:
The aircraft was parked on the international departures apron at FALA, ready for a flight from FALA to Blantyre. The pilot assumed that the engineer had pressurised the hydraulic accumulator and therefore did not inspect it himself. When the passengers arrived, the pilot got in the aircraft and began the internal pre-start checks. The co-pilot removed the chocks after boarding the passengers, closed the door and then started to brief the passengers. At that moment the pilot noticed that the aircraft was rolling forward. Attempts to stop the aircraft were unsuccessful, the aircraft rolled forward, narrowly missed a hangar and a parked Bell Long-ranger helicopter next to the hangar, crossed the taxiway and finally stopped when entering a ditch between the taxiway and the runway. The pilot was the holder of a valid transport pilot’s licence and had the type endorsed in his licence. The operation of the hydraulic system was found to be satisfactory. The hand pump was used to pressurise the system after which the brakes could be applied successfully.
Probable cause:
The hydraulic system was not pressurised during the pre-flight inspection of the aircraft. The chocks were therefore removed without adequate hydraulic system pressure available.
Final Report:

Crash of a Cessna F406 Caravan II in Johannesburg: 3 killed

Date & Time: Nov 2, 2001 at 0320 LT
Type of aircraft:
Registration:
ZS-OIG
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Johannesburg - Windhoek
MSN:
406-0041
YOM:
1989
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
3
Captain / Total flying hours:
1956
Captain / Total hours on type:
1001.00
Circumstances:
The aircraft departed Johannesburg International Airport at 0119Z on an international cargo flight to Eros, an aerodrome located on the outskirts of Windhoek the capital of Namibia. There were two pilots and a passenger onboard the aircraft as well a substantial amount of cargo, consisting mainly of express freight parcels and two heavy steel bars approximately 3 metres in length each. The aircraft crashed approximately 106 seconds after commencing its take-off roll, impacting the ground in a left wing low attitude approximately 700 metres South of the threshold of runway 03R at Johannesburg International Airport in a marshy area. All three occupants onboard were fatally injured and the aircraft was destroyed.
Probable cause:
The accident resulted due to a loss of control (aircraft becoming uncontrollable in the pitch and roll axis), which occurred approximately 35 to 40 seconds after lift-off/rotation. It was induced and aggravated by a 16% overload condition as well as the exceedance of the certified aft CG limitation of the aircraft. The investigation revealed that the aircraft was overloaded by approximately 16% 699.6kg). The cargo was not secured, nor was there a seat or a restraining device in the aircraft for the passenger that was onboard the ill-fated flight. The last Mandatory Periodic Inspection prior to the accident was certified on 30 May 2001 at 4 353.1 airframe hours, by AMO No. 273. Since the inspection was certified a further 96.6 hours were flown. The Certificate of Airworthiness for the aircraft was invalid at the time of the accident, as both engines have exceeded their TBO (time between overhaul) by approximately 185 hours.
Final Report:

Crash of a Beechcraft G18S in Lanseria

Date & Time: Mar 14, 2001 at 1240 LT
Type of aircraft:
Operator:
Registration:
ZS-OEP
Flight Type:
Survivors:
Yes
Schedule:
Lanseria - Lanseria
MSN:
BA-474
YOM:
1959
Country:
Region:
Crew on board:
4
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
19639
Captain / Total hours on type:
24.00
Aircraft flight hours:
671
Circumstances:
The instructor was accompanied by a trainee pilot and two passengers (also pilots) on a local training flight and was in the process of doing type conversion training when the accident happened. On the third circuit after a touch and go landing on runway 06L, the right-hand engine failed soon after take-off. The aircraft was flown at low altitude in a left-hand circuit in an attempt to land onto runway 17. During this circuit the left-hand engine also failed. The aircraft collided with, and severed, three 11kV electrical conductors and executed a forced landing with the gear retracted to the North of FALA approximately 1 km from threshold of runway 17. The pilot only sustained minor injuries with no one else injured. The initial on-site inspection revealed that both front tanks, which were selected at the fuel tank selector, were empty. The pilot who was undergoing conversion training refueled the aircraft prior to the accident and stated that 70 litres of fuel was uplifted into each "inboard auxiliary" tank and that what he presumed to be the "main" tanks were filled to capacity. The instructor stated that upon his arrival, the pilot who refueled the aircraft told him that he had filled the "mains" and that the "centre aux. tanks" were partially filled. The instructor further stated that the "main" tanks were selected for the duration of the flight. The aircraft is equipped with three fuel tanks in each wing. These tanks are: Front, Rear Auxiliary and Auxiliary tanks. Only one fuel quantity gauge is installed in the aircraft. A seven position selector knob above the fuel quantity gauge determines the tank to which the gauge is connected which then indicates the amount of fuel in that respective tank. The left and right front tanks were selected on the fuel gauge selector knob.
Probable cause:
Poor preflight inspection. Miscommunication between instructor and student pilot resulting in fuel mismanagement and depletion of the front tanks' fuel supply and subsequent engine failure. A contributory factor is that both the instructor and the student were relatively unfamiliar with the aircraft and its systems.

Crash of a Piper PA-31-350 Navajo Chieftain in Johannesburg: 10 killed

Date & Time: Dec 6, 1999 at 0706 LT
Registration:
ZS-OJY
Flight Phase:
Survivors:
No
Schedule:
Johannesburg - Oranjemund
MSN:
31-7405210
YOM:
1974
Flight number:
FC350
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
9
Pax fatalities:
Other fatalities:
Total fatalities:
10
Captain / Total flying hours:
1444
Captain / Total hours on type:
445.00
Aircraft flight hours:
8422
Circumstances:
The charter operator was involved in a weekly operation to transport computer programmers and training staff, from a Johannesburg company, from Rand Airport to Oranjemund in Namibia. The outward leg of the flights to Oranjemund took place on the Monday morning and the pilot and aircraft stayed at Oranjemund for the week. The return flight to Johannesburg usually took place on the Friday afternoon. On the morning of the accident flight the set time of departure was 0500z. The passengers were assisted through the process of passport control, boarding and settling in by the operator's staff. The baggage was put next to the aircraft. According to a witness the pilot carried out the loading of the baggage. An instrument flight plan was filed and the pilot obtained departure clearance before the aircraft was taxied to the holding point. According to the air traffic controller, the take-off run was normal for this type of aircraft. Shortly after take-off the pilot declared an engine failure and requested to be routed back to land on the runway. Seconds later the pilot communicated they were going to crash. Several witnesses stated that the aircraft was very low when it passed over the highway close to the accident site. One of the witnesses stated that he noticed the right-hand engine stopped and he could see the blades of the propeller. The fire fighting services were alerted. It was apparent by the smoke that the aircraft crashed on an extended line of Runway 29. The accident took place at 0506z in daylight conditions. All 10 occupants were killed.
Probable cause:
The following findings were identified:
- The precipitative cause of this accident was the failure of the exhaust pipe segment, which caused the right–hand engine to lose power/fail.
- The overloaded condition of the aircraft was thus a highly significant contributory factor.
- The pilot operating the aircraft in an overloaded condition is regarded as a significant contributing factor.
- The company’s lack of flight operations management experience, professional flight standards supervision and an operational safety management program are regarded as significant contributing factors.
- The anomalies noted in regulatory oversight of the operator (airworthiness and flight operations surveillance) by the CD:CAA and CAA are regarded as possible contributing factors.
Final Report:

Crash of a Piper PA-31-350 Navajo Chieftain in Johannesburg

Date & Time: Oct 21, 1998 at 0310 LT
Operator:
Registration:
ZS-NHM
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Johannesburg - Windhoek
MSN:
31-8052035
YOM:
1980
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
1020
Captain / Total hours on type:
350.00
Circumstances:
The aircraft was loaded with cargo intended for Namibia, early the morning of the accident. The pilot reported that the right-hand engine suffered a loss of power at the point where he rotated the aircraft for take-off. During the attempt to abort the take-off the aircraft skidded over the end of the runway and crashed down an embankment. The pilot and his passenger escaped with minor injuries, but the aircraft was subsequently destroyed by the post impact fire.
Probable cause:
During the investigation it was found that the aircraft was overloaded.
Final Report:

Crash of an AMI Turbo DC-3-65TP in Pretoria: 1 killed

Date & Time: Aug 24, 1998 at 1646 LT
Type of aircraft:
Operator:
Registration:
ZS-NKK
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Pretoria - Durban
MSN:
13143
YOM:
1944
Country:
Region:
Crew on board:
2
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
11691
Circumstances:
Final power assurance checks were carried out on the aircraft’s engines on the morning of the accident. The AME (Aircraft Maintenance Engineer) trimmed the elevator-trim tab to the Full Nose UP position in order to reduce the stick forces required to hold the tail down during the engine power checks, but he did not set the elevator trim back to the neutral position on completion of the checks. The AME was requested by the pilot(s) to remove the aileron and elevator external gust locks and the landing gear down lock pins. He left the rudder lock in place, which was later removed by one of the pilots. The pilot(s) did not carry out a pre-flight inspection. At approximately 1646 on 24 August 1998 the DC3TP, registration number ZS-NKK, crashed during take-off from runway 11 at Wonderboom Airport. The PIC (Pilot-in-Command), who did not wear a shoulder harness, sustained fatal injuries and the co-pilot, who did wear a shoulder harness, serious injures. The accident occurred on the first flight after the aircraft had undergone a maintenance inspection, which included power assurance checks of the engines. The co-pilot sat in the left-hand seat and while he started the engines, the PIC attended to the cockpit checklist.
Probable cause:
It would appear that the accident was as a result of the PIC taking-off with the elevator trim set to the full nose-up position. This resulted in the nose of the aircraft pitching up after rotation, causing the pilot to lose control of the aircraft.
Final Report:

Crash of a Cessna 421C Golden Eagle III in Lanseria

Date & Time: May 4, 1998
Operator:
Registration:
ZS-JRR
Flight Phase:
Survivors:
Yes
MSN:
421C-0141
YOM:
1976
Country:
Region:
Crew on board:
0
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
During the takeoff roll at Lanseria Airport, the crew encountered technical problems and elected to abort. Unable to stop within the remaining distance, the aircraft overran and came to rest, bursting into flames. There were no casualties.

Crash of an Ilyushin II-18V in Johannesburg

Date & Time: Dec 17, 1997 at 0620 LT
Type of aircraft:
Operator:
Registration:
RA-75554
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Johannesburg - Bujumbura
MSN:
185 0084 04
YOM:
1965
Flight number:
RMY202
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
0
Aircraft flight hours:
18766
Aircraft flight cycles:
7040
Circumstances:
During the takeoff roll un runway 03L at Johannesburg-Jan Smuts Airport, the pilot-in-command started the rotation but the aircraft failed to respond. The captain decided to reject takeoff and initiated an emergency braking procedure. Unable to stop within the remaining distance, the aircraft overran, struck a concrete block, rolled for 200 metres then lost its left main gear and engine n°1 before coming to rest. All four occupants escaped uninjured while the aircraft was damaged beyond repair.
Probable cause:
It was determined that the total weight of the aircraft was five tons above MTOW while the CofG was too far forward, out of the envelope. In such conditions, the aircraft was not properly configured and a takeoff was impossible.

Crash of a Piaggio P.166S Albatross in Johannesburg

Date & Time: Mar 1, 1997
Type of aircraft:
Registration:
ZS-NJR
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Johannesburg - Port Elizabeth
MSN:
455
YOM:
1973
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Circumstances:
Shortly after liftoff, while in initial climb, the twin engine aircraft stalled and crashed near the runway end. The pilot was injured and the aircraft was destroyed.
Probable cause:
Loss of control during initial following an engine failure for unknown reasons.

Crash of a Beechcraft C90-1 King Air in the Suikerbosrand Nature Reserve: 3 killed

Date & Time: Dec 13, 1996
Type of aircraft:
Registration:
ZS-NXY
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Heidelberg - Heidelberg
MSN:
LJ-1058
YOM:
1983
Country:
Region:
Crew on board:
3
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
3
Circumstances:
The twin engine aircraft departed Heidelberg Airport for a local training flight with three pilots on board. Ten minutes after takeoff, the aircraft entered an uncontrolled descent and crashed in hilly terrain located in the Suikerbosrand Nature Reserve. All three occupants were killed.