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Accidents: June 2019
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Preliminary and final reports
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Preliminary and final reports
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Preliminary Reports


Three Die in Mississippi Sabreliner Crash


Rockwell International NA-265-65, April 13, 2019, New Albany, Mississippi—Two commercial pilots and their sole passenger were killed when the 1980-model corporate jet disappeared from radar less than two minutes after the crew advised air traffic control of electrical problems. The airplane was operating in an area of moderate to heavy precipitation and presumed to be in instrument meteorological conditions on an IFR flight from Mississippi’s University-Oxford airport to the Marion County-Rankin Fite Airport in Georgia.


Initial voice and radar contact were made at 3:06 p.m. as the jet climbed through 1,300 feet. Two minutes later, its transponder stopped transmitting altitude data, so radar track data for the remainder of the flight includes airspeeds and headings but no altitude information. At about that time, the crew reported climbing through 9,000 feet to their cleared altitude of 11,000.


Four minutes later, ATC asked whether they were having navigational difficulties or deviating for weather. They responded that they were deviating but also reported having “AC voltage problems.”  At 3:13 they acknowledged a heading assignment of 095 degrees and began a right turn that continued until the airplane disappeared from radar on a roughly 270-degree heading.  The wreckage was oriented along a 005-degree heading in a forested rural area. Broken trees suggested impact occurred in a 20-degree nose-low attitude with a 50-degree right bank.


The NTSB’s preliminary report describes the wreckage as “highly fragmented and spread over an area about 800 feet wide and 1,500 feet long." The cockpit voice recorder has been recovered and sent to the NTSB recorder lab.


No Injuries After Emergency Autorotation onto Hawaiian Mountainside


MD Helicopter MD369E, April 16, 2019, Hau’ula, Oahu, Hawaii—A helicopter flown under contract to the Hawaiian Department of Land and Natural Resources’ Division of Forestry and Wildlife made an emergency autorotation into the forest canopy after losing engine power over Sacred Falls State Park. The aircraft came to rest inverted in a gully with both main and tail rotors separated, but all four on board escaped without injury and were able to hike out. 


In addition to the pilot, the helicopter was transporting one DOFAW employee and two representatives of Pacific Rim Conservation to place seabird song meters in support of ongoing population studies. The state employee credited the pilot with “extraordinary skill in bringing the aircraft down and avoiding serious injury,” adding that the helicopter nearly reached a clear, flat area that would have been a suitable landing zone.


Three Survive Night Ditching Off New Zealand


Eurocopter BK 117, April 22, 2019, off Yule Island, New Zealand—Thorough training and appropriate equipment, including survival suits, life vests, and helicopter emergency egress devices, are credited with saving the lives of the three crewmen on a medevac helicopter that went down in sub-Antarctic ocean waters two minutes short of its intended landing site on remote Enderby Island. The accident occurred in darkness at about 7:37 p.m. local time. Water temperatures were reported as 11 degrees Celsius (54 Fahrenheit).


According to press reports, the winchman in the rear of the helicopter was knocked unconscious. The pilot and medic in the front seats were able to extricate him and swim to the shore of Yule Island in near-total darkness. The aircraft was reported overdue at 8:15 p.m. and search-and-rescue efforts initiated immediately. The men were located at 11:45 the next morning, some 16 hours after the ditching.


The crew was positioning the helicopter to evacuate a crewman from a fishing trawler the following morning. At press time, New Zealand’s Transport Accident Investigation Commission had not yet announced a decision as to whether or not to attempt to retrieve the wreckage, reported to be about 65 feet underwater. Yule Island is 465 km (290 miles) south of the city of Bluff at the southern end of South Island.


Fuel Exhaustion Suspected in Downing of Air Ambulance


Beechcraft King Air B200, April 24, 2019, Gilliam, Manitoba, Canada—A Super King Air on a positioning flight lost power in both engines and came up short of the runway after declaring an emergency and diverting to the Gillam airport. The two pilots and two flight nurses on board were not injured. Both engines flamed out during descent and the pilots attempted a forced landing to Gillam’s Runway 23 but instead landed gear-down on the frozen surface of Stevens Lake underneath the final approach course. The airplane continued until it hit the rock berm at the foot of the runway, causing “substantial damage to the landing gear, fuselage, wings, and a propeller.” Photographs of the accident site show both sets of main landing gear wheels detached from the wreckage.


The flight was en route from Winnipeg to Churchill when the crew reported a fuel issue, declared an emergency, and requested a diversion to Gillam. Reports of evidence that the King Air departed without sufficient fuel for the flight have not been confirmed by the Transportation Safety Board, which had not issued an initial statement by press time.


Undershoot Ends German Training Flight


Cessna 551 SP, April 24, 2019, Siegen-Siegerland Airport, Germany—A Cessna Citation II struck the ground short of the threshold of Runway 13 while practicing takeoffs and landings, collapsing the main gear and causing a fuel leak. The resulting fire was quickly brought under control but consumed most of the airplane’s left wing. The jet’s two occupants, described as a student and instructor, escaped without injury.


Final Reports


Pilot Decision-making Faulted in Brazil Crash


Hawker Beechcraft King Air C90GTI, Jan. 3, 2016, Paraty, Rio de Janeiro, Brazil—Brazil’s Aeronautical Accident Investigation and Prevention Center (CENIPA) has attributed the fatal crash of a King Air C90GTI to the pilot’s decision to make repeated attempts to land at the VFR-only Paraty Airport in unstable, rainy weather with ceilings as low as 400 feet. Overconfidence and a competitive attitude toward landing in unfavorable conditions were cited as contributing factors. The twin-engine turboprop crashed into Corumbé Hill attempting a second go-around. The 802-hour pilot and 159-hour copilot were killed.


The positioning flight departed from Campo de Marte at 4:24 p.m. local time. Both pilots held commercial licenses with multiengine and instrument ratings and current medical certificates, but the copilot did not hold a BE 90 type rating and had no documented make-and-model experience. The pilot, however, was type-rated, and the airplane was certified for single-pilot operation. The cockpit voice recorder captured the copilot’s voice reading checklists and handling en route communications with air traffic control; the pilot explained details of aircraft operation and described the approach into Paraty. He had substantial experience flying into that airport, located in a region of Rio de Janeiro state known for its unstable weather.


The pilot departed VFR on a mixed VFR/IFR flight plan, then obtained an IFR clearance during climb. He resumed VFR crossing the DORLU fix and turned east to descend over Paraty Bay to attempt an unobstructed overwater approach to Runway 28. After his first attempt ended in a go-around, the pilot transmitted that he would hold over the bay at 900 feet while waiting for conditions to improve. The second approach began after another pilot reported having landed, albeit in poor visibility under ceilings estimated at 400 to 500 feet. Conditions deteriorated during the approach and the pilot initiated a second go-around but crashed into a hillside 3.9 nautical miles north of the runway threshold at an elevation of 1,800 feet. Examination of the wreckage and analysis of the CVR recording determined that the engines were producing full power at impact, but the landing gear was still extended.


Power Loss Attributed to Low Fuel Level in Nose-high Attitude


Hughes 369, June 23, 2017, Dennis, West Virginia—A loss of power during a long-line flight was caused by the combination of minimum fuel and a nose-high attitude that allowed the engine’s fuel pickup to become unported, according to the NTSB's finding of probable cause. The pilot made an emergency autorotation and escaped uninjured, but the helicopter’s main rotor severed its tailboom during the landing,  


Inspectors found about seven gallons in each of the two interconnected fuel tanks. The engine was successfully test-run with the fuselage in a level attitude, but the low fuel warning light illuminated when the nose was raised with only the remaining fuel on board. The report notes that the two tanks are interconnected with internal baffles. The only fuel pickup is located in the right front area of the left tank.


Following the accident, the operator revised its procedures to require the same fuel load for long-line as for side-pull operations: full tanks (64 gallons) with a maximum of one hour of flight time before refueling, leaving a 37-gallon reserve. Procedures in effect at the time required only a 100-pound reserve (14.7 gallons) upon landing for all operations other than side pulls.


Loose Clipboard Fouls Antitorque Pedals


Bell 206B, June 26, 2017, Entiat, Washington—A loss of tail rotor authority during low-altitude maneuvering was traced to an unsecured clipboard that became wedged beneath the antitorque pedals. Unable to free the clipboard in flight, the pilot attempted a precautionary landing but lost tail rotor effectiveness five to 10 feet above the ground. The helicopter completed two rotations to the right before touching down hard, folding the stinger into the tail rotor.  The pilot was not injured.


Spatial Disorientation Confirmed in Fatal Nebraska Crash


Mitsubishi MU 2B-40, Sept. 23, 2017, Ainsworth, Nebraska—The NTSB has formally attributed the fatal accident to spatial disorientation, without further comment on possible causes. The Board’s factual report noted that the pilot filed an IFR flight plan but never picked up his clearance before taking off into a 500-foot overcast. He had told his airplane partner and their avionics shop about a “transient flag” on its Chelton air data attitude and heading reference system, but the extent of impact damage to that system precluded functional testing.

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