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Accidents: October 2017
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Preliminary, final and factual reports
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Preliminary, final and factual reports
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PRELIMINARY REPORTS


Lancair EVOT Windshield Fails at Altitude


Lancair Evolution, May 15, 2017, Firebaugh, Calif.—A private pilot and his family sustained only minor injuries when their homebuilt single-engine turboprop Lancair Evolution EVOT was substantially damaged during a forced landing attempt after the windshield failed at altitude. The pilot landed gear-up at Firebaugh Airport (F34), in Firebaugh, Calif., and the airplane slid off the runway and through a fence, crossing a road before coming to rest in a field. The private pilot and one rear-seat passenger did not sustain any injuries. A front-seat passenger and two rear-seat passengers received minor injuries.


The IFR cross-country flight departed Livermore Municipal Airport (KLVK), Livermore, Calif., for Marana Regional Airport (KAVQ), Marana, Ari. At 25,000 feet msl the windshield "exploded" without warning, according to the pilot. The airplane instantly lost cabin pressure, so he activated the ancillary oxygen and donned his oxygen mask. During his subsequent steep descent, the pilot found a nearby airport with the requisite landing distance. At 12,000 feet, he leveled off and saw the airport. His headset had departed the airplane after the windshield failure.


The pilot stated that he was unable to locate the airport's windsock during the descent, but chose to land on Runway 12. While on the downwind leg, the pilot deployed one notch of flaps and attempted to maintain 110 knots. After turning final, the pilot deployed the landing gear but the left main landing gear did not show a green indication. The pilot recycled the landing gear, but received the same indication. He then decided to land with the gear retracted. According to his recount the touchdown was smooth and level.


Post-accident examination by an FAA inspector revealed substantial damage to both wings. The wreckage was retained for further examination. Lancair Evolution turboprops are amateur-built, most being constructed at the kit manufacturer’s authorized builder assist centers, of which there are seven around the U.S.


R66 Hits Hard on Landing, Chopping Tailboom


Robinson R66, May 20, 2017, Canon City, Colo.—A commercial pilot with four passengers lost control on the approach to landing near Canon City, Colo., resulting in a hard landing on the rear of the skids, and subsequent loss of the tailboom from a main rotor chop. No one was injured, but the helicopter sustained substantial damage. The helicopter was on a Part 91 local air-tour flight in VFR conditions. The flight originated from a private helipad near Canon City.


The pilot reported to the NTSB investigator-in-charge that after completing the local air-tour flight he approached the helipad at between 50 and 60 knots, and then began to arrest the descent. At 200 feet agl, he started a left turn and the helicopter began an uncommanded descent. The pilot applied power to stop the descent, but the helicopter continued sinking for unknown reasons. The pilot then committed to land and leveled the helicopter, realizing he could not get power. During the landing, the back of the landing gear skids struck the ground hard, causing the main rotor blades to contact and subsequently sever the tail boom. The helicopter came to rest upright and the occupants exited.


Indonesian King Air 350i Departs Runway


Beechcraft King Air 350i, May 31, 2017, Ambon-Pattimura Airport, Indonesia—A King Air 350i registered to Badan Kalibrasi Fasilitas Penerbangan (BKFP), a flight calibration and inspection services company, ran off the runway at Ambon-Pattimura Airport  (AMQ) in Ambon, Maluku, Indonesia. The aircraft came to rest with the right main gear in the grass, off the right side of Runway 4 some 3,000 feet from the threshold, collapsing the nose gear, which resulted in significant damage to both engine propellers from contact with the ground while under power.


Wind was light and variable with some thunderstorms in the vicinity at the time of the accident; however, marginal VFR conditions prevailed.








FINAL REPORTS














Mexican Hawker 400XP Hit Snow Plow


Beechcraft Hawker 400XP, Dec. 23, 2015, Telluride, Colo.—A Hawker 400XP air-taxi charter from Mexico carrying two ATP-rated pilots and five passengers collided with a snow plow while landing at Telluride Regional Airport (KTEX) in Telluride, Color. No one, including the snowplow operator, was injured, but the airplane was substantially damaged during the accident.


The IFR flight departed Monterrey, Mexico, stopping in El Paso, Texas, en route to Telluride. As the flight neared the destination, the crew was in contact with a Denver controller. The crew also listened to Telluride's automated weather observation station (Awos) broadcast.


At 1:48 p.m., the controller asked the pilots to advise him when they had the weather and Notams for KTEX, adding that another airplane just attempted an approach into KTEX but had to execute a missed approach. The pilot reported that they received the weather information and planned to make the approach. The controller responded by giving the flight a heading, saying this would be for the descent and sequence into the airport. At 1:50 p.m., the airport operator entered a Notam via computer closing the runway (effective 1:50 p.m.) for snow removal, and the airport operator proceeded onto the runway. At 1:58 p.m., the controller cleared the Hawker for the approach to the airport. The pilot then canceled his flight plan at 2:02 p.m.with the airport in sight. The crew did not change radio frequencies to the CTAF for the airport, and never received the Notam. The crew said they did not see the snowplow on the runway until it was too late to avoid a collision.




TBM 700 Lost After VFR Approach into IMC


Daher TBM 700B, April 26, 2013, Bötersen, Germany—All four souls were lost when a Daher TBM 700B attempting to land in fog at Rotenburg (Wümme) Airfield (EDXQ), near Bötersen, Germany, hit terrain 1.25 nm short of the threshold of Runway 8 and 1,700 feet to the left of the extended runway centerline. The German Federal Bureau of Aircraft Accident Investigation (BFU) attributed the accident to the pilots’ decision to continue the flight VFR into IMC conditions, combined with a lack of both vertical and lateral situational awareness.


A witness said that before departure the person in the right seat of the aircraft phoned Rotenburg (Wümme) three times asking about the weather conditions, twice asking a passenger waiting at the airfield about the weather, and once asking the Flugleiter (aperson required by German regulation at nontower airports to provide airport information service to pilots). The aircraft then departed Kiel-Holtenau Airport (EDHK) in IMC on an IFR flight plan.


When the aircraft was eight nautical miles north of the destination at about 4,000 feet msl the pilots were told that at the airfield visibility was 1.25 miles and the cloud base was at 500 feet. Minimum landing conditions for EDXQ are visibility of at least five miles above 2,500 feet agl and a minimum cloud clearance of one mile lateral and 1,000 feet vertical. Below 2,500 feet agl visibility shall not be less than one mile.


According to the radar data the pilots continued to 1,400 feet msl. At 9:15 a.m. they executed a left turn to the final approach heading of 090 degrees. A minute later they began final descent. The glideslope was three degrees over a distance of 1.5 nm and until about 800 feet amsl.


Below 800 feet and 2.5 nm short of the runway threshold the aircraft’s rate of descent increased, reaching nearly 1,400 fpm at the last radar scan, which was recorded with an altitude of 100 feet msl.


The airplane was consumed in a post-accident fire. According to police data, ground visibility at the accident site at about 9:40 a.m.was between 1,500 and 2,100 feet. The weather conditions were described as misty, temporary drizzle and slight wind.


Investigators determined that the engine was functioning normally when the aircraft hit the ground. The post-crash fire made it difficult to assess the condition of the two Garmin GPS units on board.


Subsequent interviews and research revealed that both pilots had been aware of the marginal weather conditions at EDXQ. The flight plan listed Bremen Airport as an alternate airport, but an alternate was never mentioned in the phone calls with the waiting passengers before the flight.


Investigators found no indication that the crew accessed weather information via the Deutsche Wetterdienst before takeoff, and the Meteorological Briefing Centre did not record an individual weather briefing for this flight. There was no evidence that either of the pilots accessed weather data through any information source at the departure airport.


King Air Low Pass Ended on the Ground


Beechcraft King Air B200, Aug. 5, 2013, Akureyri, Iceland—A pilot’s attempt at a fly-by of a racetrack went wrong, killing the captain and the paramedic on board the Beech King Air B200 and seriously injuring the copilot. The Icelandic Transportation Safety Board (ITSB) cited human factors as playing a major role in this accident. Inadequate collaboration and planning of the flyover amongst the flight crew indicated a failure of crew resource management (CRM) that caused the flight crew to be less able to make timely corrections, according to the ITSB.


The medical transport King Air B200 with two flight crewmembers and a paramedic on board was heading back to home base at Akureyri Airport (BIAR), after completing an ambulance flight from Höfn (BIHN) to Reykjavik Airport (BIRK) when the captain requested to overfly the town of Akureyri before landing. As the aircraft approached the racetrack area, it entered a steep left turn and, in line with the racetrack, struck the ground.


During cruise, the flight crew discussed the captain’s desire to deviate from the planned route to BIAR to fly over a racetrack area near the airport, where a race was about to start. The captain told the copilot that he planned to visit the racetrack area after landing.


The investigation concluded that the flyby/low pass was poorly planned and outside the scope of company SOPs. The pass was made at such a low altitude and steep bank that a loss of control was inevitable; the aircraft struck the racetrack and both wings separated. The fuselage broke into three main pieces (cockpit, cabin and empennage).


Three videos that captured the aircraft during its last phase of flight were used in the investigation. One of the videos was from a CCTV camera ona building near the accident site, which captured the aircraft before the left turn. The second video, from a personal video camera mounted on a race vehicle, captured the aircraft in the left turn. The third video, from a personal camera mounted on the same race vehicle (facing forward), captured the aircraft during the last phase of the flight and when it hit the ground. Investigators were also provided with a video taken from the racetrack’s audience stand.


By calculating the speed from the photogrammetric analysis, investigators determined the aircraft was doing 240 to 260 knots during the turn and close to 275 knots when it hit the ground. At the midpoint of the flight path the bank angle increased to 72.9 degrees from 54.2.


The area of the accident was the hometown of the captain and he had flown over the racetrack before, but from the southwest with no steep turn. He had also deviated from normal procedures before, performing low passes and for flight crew sightseeing on the way back from ambulance flights.


After the accident, the operator started an internal investigation and as a result standardized normal, abnormal and emergency operating procedures. Standardization was emphasized in training, both ground training and simulator. Management clearly communicated that individuality in procedural adherence is 
not acceptable. 
Finally, the operator updated its Aerial Work and VFR/IFR Policy. 


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004AccidentsAINOct17
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