Tuesday, May 6, 2014

2009 plane crash in Kingston, Jamaica could have been avoided - report

KINGSTON, Jamaica: 

 A report on the 2009 crash of an American Airlines plane in Kingston says the accident could have been avoided if the flight crew had not ignored certain precautions and if the pilots had received adequate training in tailwind landing.

Some 148 passengers narrowly escaped death on December 22, 2009 when American Airlines Flight 331, flying from Miami to Kingston, overshot the runway at the Norman Manley International Airport and came to a stop inches from the sea just off the Port Royal main road.

Almost five years later, the Jamaica Civil Aviation Authority has released the report on the investigation into the incident.

Almost five years after the incident, the report has documented a wide range of issues that it says contributed to the crash on a wet and rainy night.

According to the report, the flight crew did not make themselves familiar with all the available information before departing Miami.

It says the flight crew did not give any consideration to the expected landing conditions in Kingston before departing from Miami.

The report says there is no evidence that the flight crew showed any concern about the runway conditions until just before landing.

The report concludes that this shows that the flight crew’s Situational Awareness before departure was incomplete, partly due to the inaccurate information given to them.

In aviation, situational awareness is a term used to describe a person’s awareness of their surroundings, the meaning of these surroundings, a prediction of what these surroundings will mean in the future, and then using this information to act.

However, the report says this awareness was low and as a result, the crew could not accurately predict possible landing conditions and make the appropriate adjustments.

Meanwhile, the report notes that information relayed to the flight crew informing of the adverse weather and that the runway at the Normal Manley International airport was wet were not acted on.

The report has revealed that the flight crew were focused on several other issues including getting the plane within the approved landing weight requirement during what it calls the late stage of the immediate approach.

According to the report, until the air traffic controllers indicated to the pilots that the runway was wet, they were proceeding as if the runway was dry and using autobrakes.

Even with this, the crew reportedly was not concerned since there were no reports on any action taken.

The report said the crew was proceeding with some level of complacency, landing in rain with a tailwind.

Story and comments/reaction:  http://jamaica-gleaner.com

 
 NTSB Identification: DCA10RA017
Accident occurred Tuesday, December 22, 2009 in Kingston, Jamaica
Aircraft: BOEING 737, registration: N977AN
Injuries: 15 Minor,139 Uninjured.

This is preliminary information, subject to change, and may contain errors. The foreign authority was the source of this information.

On December 22, 2009, about 2222 eastern standard time, a Boeing 737-823, N977AN, registered to Wells Fargo Bank Northwest N.A. Trustee, and operated by American Airlines as flight 331 a Title 14 CFR Part 121 international passenger flight from Miami, Florida, to Kingston, Jamaica, overran runway 12 while landing at the Norman Manley International Airport. Instrument meteorological conditions prevailed in the area, with reportedly heavy rain at the time, and an instrument flight rules flight plan was filed. There were 154 persons onboard, including the pilot, co-pilot, four flight attendants and 148 passengers. Numerous injuries were reported. The flight originated at Miami International Airport, Miami, Florida, about 2022.

This accident investigation is under the jurisdiction of the Government of Jamaica. Any further information pertaining to this accident may be obtained from:

Jamaican Civil Aviation Authority
4 Winchester Road
Kingston 10
Jamaica W.I
Telephone: (876)960-3948
Facsimile: (876)960-1637

This report is for informational purposes only, and contains only information obtained for or released by the Government of Jamaica.

Mass casualty plane crash exercise scheduled in Colorado Springs on Thursday

The Colorado Springs Airport and Office of Emergency Management will conduct a mass casualty exercise involving a simulated aircraft crash on Thursday to test response procedures.

More than 1,000 participants from 46 agencies will take part, including Colorado Springs police and fire, El Paso County Sheriff's Office, Fort Carson and Peterson Air Force Base.

Cresterra Parkway will be closed from 1 a.m. to 4 p.m. from Embraer Heights to Powers Boulevard, according to a city news release.

The Federal Aviation Administration requires all airports with scheduled air carrier service to conduct a full-scale emergency exercise every three years and tabletop exercises all other years, the release read.

Memorial Hospital Central and North campuses, Penrose Hospital, St. Francis Medical Center and Evans Army Community Hospital will take part in the exercise.

Source:   http://gazette.com

Federal Aviation Administration says former air traffic controller associated with 2009 crash does not direct traffic at Newport News/Williamsburg International Airport (KPHF) - Official said FAA employee is assigned to staff duties

An investigative story by WPIX television in New York City states that an air traffic controller cited in association with an August 2009 crash over the Hudson River now works at Newport News-Williamsburg International Airport.

But a Federal Aviation Administration official on Tuesday said the employee does not direct traffic at the Newport News airport. He is assigned to staff specialist duties, the official said.

The WPIX story looked into Federal Aviation Administration employees who had been cited in deadly crashes, but remained employed by the agency at its towers and control centers.

One of the employees investigated was Carlyle Turner, who was named in a National Transportation Safety Board report in connection with the Aug. 8, 2009 collision between a sightseeing plane and a helicopter. Nine people died. The WPIX story said the NTSB report alleges a phone conversation by Turner may have been a factor in the crash.

WPIX reported Turner lives in Chesapeake.

Newport News airport Executive Director Ken Spirito declined to comment on the story, noting Turner is a federal, not an airport employee.

FAA spokesman Jim Peters declined to discuss Turner, saying, “Federal privacy laws preclude the FAA from disclosing personnel information about specific employees.”

Peters provided an official FAA statement in response to questions about Turner:

“The Federal Aviation Administration (FAA) operates the safest aviation system in the world. The FAA achieves that record by investigating every accident and incident that occurs in the system to determine whether it could pursue further improvements to continue to enhance aviation safety. Non-punitive safety reporting systems also encourage controllers and other aviation professionals to report safety incidents so the FAA can fully understand what happened and implement any necessary corrective actions. If the FAA determines an act a controller committed that led to an incident or accident was intentional or grossly negligent, the controller is excluded from using those non-punitive systems. However, controllers have the same due-process rights as other federal employees and also are covered by the provisions of the National Air Traffic Controllers Association contract.”


Visit the WPIX website to read its story.

Source:   http://www.dailypress.com

Eurocopter AS 350BA, Liberty Helicopter Sightseeing Tours, N401LH and Piper PA-32R-300, LCA Partnership, N71MC: Accident occurred August 08, 2009 in Hoboken, New Jersey

 http://www.ntsb.gov/doclib/reports/2010/AAR1005.pdf

NTSB Identification: ERA09MA447A
14 CFR Part 91: General Aviation
Accident occurred Saturday, August 08, 2009 in Hoboken, NJ
Probable Cause Approval Date: 10/25/2010
Aircraft: PIPER PA-32R-300, registration: N71MC
Injuries: 9 Fatal.

NTSB Identification: ERA09MA447B
Nonscheduled 14 CFR Part 135: Air Taxi & Commuter
Accident occurred Saturday, August 08, 2009 in Hoboken, NJ
Probable Cause Approval Date: 10/25/2010
Aircraft: EUROCOPTER AS 350 BA, registration: N401LH
Injuries: 9 Fatal.

NTSB investigators traveled in support of this investigation and used data obtained from various sources to prepare this aircraft accident report.

The Safety Board’s full report is available at http://www.ntsb.gov/publictn/2010/AAR1005.htm

The Aircraft Accident Report number is NTSB/AAR-10/05.

On August 8, 2009, at 1153:14 eastern daylight time, a Piper PA-32R-300 airplane, N71MC, and a Eurocopter AS350BA helicopter, N401LH, operated by Liberty Helicopters, collided over the Hudson River near Hoboken, New Jersey. The pilot and two passengers aboard the airplane and the pilot and five passengers aboard the helicopter were killed, and both aircraft received substantial damage from the impact. The airplane flight was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 91, and the helicopter flight was operating under the provisions of 14 CFR Parts 135 and 136. No flight plans were filed or were required for either flight, and visual meteorological conditions prevailed at the time of the accident.

The National Transportation Safety Board determines the probable cause(s) of this accident to be:
(1) the inherent limitations of the see-and-avoid concept, which made it difficult for the airplane pilot to see the helicopter until the final seconds before the collision, and (2) the Teterboro Airport local controller’s nonpertinent telephone conversation, which distracted him from his air traffic control (ATC) duties, including correcting the airplane pilot’s read back of the Newark Liberty International Airport (EWR) tower frequency and the timely transfer of communications for the accident airplane to the EWR tower. Contributing to this accident were (1) both pilots’ ineffective use of available information from their aircraft’s electronic traffic advisory system to maintain awareness of nearby aircraft, (2) inadequate Federal Aviation Administration (FAA) procedures for transfer of communications among ATC facilities near the Hudson River Class B exclusion area; and (3) FAA regulations that did not provide adequate vertical separation for aircraft operating in the Hudson River Class B exclusion area.

Air-Safety Regulators Want Better Plane-Tracking Kit Installed Sooner; European Agency Calls For Longer-Life, Longer-Range Beacons By 2018, 2019

The Wall Street Journal

By Robert Wall


May 6, 2014 7:57 a.m. ET
 

European aviation safety regulators want to hasten the introduction of improved "black boxes" on commercial airliners after the fruitless search so far for Malaysia Airlines  Flight 370 has highlighted shortcomings with the existing technology.

The mandatory operational life of beacons attached to flight-data recorders should be extended to 90 days from 30 days two years earlier than initially planned, the Cologne-based European Aviation Safety Agency said today. Airplanes traversing oceans should also carry beacons with greater range, EASA said.

"The proposed changes are expected to increase safety by facilitating the recovery of information by safety investigation authorities," EASA Executive Director Patrick Ky said. "The tragic flight of Malaysia Airlines MH370 demonstrates that safety can never be taken for granted."

Authorities have been searching without success for the wreckage of the Malaysia Airlines Boeing 777-200ER that vanished en route to Beijing from Kuala Lumpur on March 8 with 239 people on board. Lapses in coordination among countries and companies trying to find the plane have repeatedly hobbled the two-month-old search.

The flight-data recorders that store information vital to crash investigations come with beacons designed to aid search teams trying to locate the devices.

In its latest opinion, which is not yet a binding requirement for the industry, EASA said it wants aircraft to feature beacons with a 90-day minimum transmission to give search teams more time to recover the devices. The technology should be introduced by 2018 rather than by 2020 as previously planned.

The beacons on the Malaysia Airlines flight had a 30-day transmission life so search teams had only a few days to locate the short-range signal after delays in narrowing the area where the plane is suspected to have crashed.

EASA also wants airliners flying more than 180 nautical miles over water to have an additional beacon transmitting at a different frequency with greater detection range from 2019. An alternative is to equip the aircraft with other technology to pinpoint the location of a crash site to within 6 nautical miles, the agency said.

The regulator also is requiring that cockpit voice recorders be upgraded to store 20 hours of conversation, rather than just two hours as is currently the case.

EASA had already proposed an increase to 15 hours, but has extended the storage requirement to capture the entire duration of long-range flights. It is giving industry an extra year to comply with the stricter standard that should now lead to the installation of such recorders on planes from 2020.


 Source:  http://online.wsj.com

New Zealand: Queenstown airport to turn on lights - Night flights to tourism gateway become possible as aviation officials give safety clearance



Airlines have welcomed the prospect of flying into Queenstown after dark now the resort's airport has safety clearance for night flights. 

Pilots say a new range of safety measures that would have to be implemented would improve safety at what is a "challenging airport".

The airport is allowed flights until 10pm, but evening flights could occur only in summer as aircraft were restricted to flying in daylight hours.

Queenstown Airport and tourism authorities say the possibility of extended operating hours could boost visitor numbers during the winter peak when the window for using the airport is at its narrowest.

Airlines are now assessing the commercial case, and if they commit to after-dark flying the airport will have to spend up to $10 million on lighting and widening the runway.

Queenstown Airport Corporation chief executive Scott Paterson said the decision by the Civil Aviation Authority and Australian Civil Aviation Safety Authority was a "potential game-changer" for Queenstown.

He said advanced navigation technology now in use in Queenstown was the key to enabling night flying.

The CAA's general manager for air transport and airworthiness, Stephen Hunt, said the approval process had taken two years to work through.

Sixty-six safety changes would be made, the most important being extra lighting and widening the runway from 30m to 45m.

"At night you don't have visual cues, so the crux is a lighting package with adequate cues and references."

The lighting changes would include a short set of lights leading into the runway, a line of lights down the centre, lights on the side of the approach end to give indications of whether the approach angle was correct and lights marking the latest point at which an aircraft could touch down.

"These are really significant changes but the biggest change will be the widening of the runway," said Hunt.

Satellite navigation in the area enabled aircraft to weave their way around mountains with a high degree of accuracy.

"The CAA doesn't rank airports' difficulty, what we do is look at is the complexity to fly in there and the aggregate of the risk," he said.

"In Queenstown there is terrain and wind issues but those are present in many airfields."

Air New Zealand chief flight operations and safety officer David Morgan said the green light was a welcome development.

"It's now up to each airline to consider the viability of operating outside of daylight hours at Queenstown and we will do that in due course as the airport company progresses the infrastructure upgrades."

Qantas Regional's general manager for New Zealand and Pacific Islands, Igor Kwiatkowski, said allowing after-dark flights would give greater flexibility to its Queenstown flying.

The airline would now assess the need for evening flights from a commercial and operational perspective.

Subsidiary Jetstar, which flies domestic and transtasman flights into Queenstown, said flight time flexibility was important to Jetstar and the approval by the CAA and its Australian counterpart was an important first step. It, too, would assess the case for evening flights.

Paterson said the airport had a clear idea of the technology, infrastructure and operational steps required but evening flights wouldn't be introduced before winter 2016.

"Winter is our peak and they [flights] have to be squeezed into a very small window, particularly the transtasman ones given the time difference with Australia.

"When they arrive in Queenstown in the mid-afternoon they are scrambling to turn that plane around and get out again," he said.

"For leisure travellers it would make weekend holidays from Auckland and Australia possible year-round. It would also give business people more flexibility with their travel plans and allow people to base themselves in Queenstown and commute to other main centres for work."

The New Zealand Airline Pilots Association said Queenstown's location and changeable weather made it challenging and the associated package of safety improvements was welcomed.

Once implemented these would improve safety at what was one of New Zealand's most challenging airports for pilots in terms of airline operations, because of its geographic location and changeable weather. 


Before after-dark flights can start:


• Airlines must assess the operational and commercial case.
• Airport runway will have to be widened from 30m to 45m.
• Comprehensive aeronautical lighting must be installed.
• Customised crew selection and training will be needed.
• Full capability of navigation technology must be used.
• On-board flight procedures will change to reduce pilot workload on final approach.
• Individual airline will have to apply for night-flight approval.

Story, video and photo:  http://www.nzherald.co.nz

Piper PA-32R-300 Cherokee Lance, N8700E: Accident occurred April 27, 2014 in Highmore, South Dakota

NTSB Identification: CEN14FA224
14 CFR Part 91: General Aviation
Accident occurred Sunday, April 27, 2014 in Highmore, SD
Probable Cause Approval Date: 04/27/2015
Aircraft: PIPER PA 32R-300, registration: N8700E
Injuries: 4 Fatal.

NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

During a dark night cross-country flight, the instrument-rated pilot was approaching the intended airport for landing when the airplane collided with the blades of a wind turbine tower. The weather had started to deteriorate and precipitation echoes were observed on radar. Witnesses in the area described low clouds, windy conditions, and precipitation. In addition, weather briefing records and statements made to a witness indicate that the pilot was aware of the current and forecast weather conditions for the route of flight. Investigators were unable to determine why the airplane was operating at a low altitude; however, the pilot was likely attempting to remain clear of the clouds even though both the pilot and the airplane were capable of flying in instrument meteorological conditions. An examination of the airplane, systems, and engine revealed no anomalies that would have precluded normal operation. Toxicology findings revealed a small amount of ethanol in the pilot’s blood, which was unlikely due to ingestion since no ethanol was found in liver or muscle tissue. The investigation revealed that the wind turbine farm was not marked on either sectional chart covering the accident location; however, the pilot was familiar with the area and with the wind turbine farm. Investigators were not able to determine what the pilot was using for navigation just before the accident. The light on the wind turbine tower that was struck was not operational at the time of the accident, and the outage was not documented in a notice to airmen. The wind turbine that was struck was the 5th tower in a string of towers oriented east to west, then the string continued south and southwest with an additional 13 towers. If the pilot observed the lights from the surrounding wind turbines, it is possible that he perceived a break in the light string between the wind turbines as an obstacle-free zone.

The National Transportation Safety Board determines the probable cause(s) of this accident as follows:
The pilot's decision to continue the flight into known deteriorating weather conditions at a low altitude and his subsequent failure to remain clear of an unlit wind turbine. Contributing to the accident was the inoperative obstruction light on the wind turbine, which prevented the pilot from visually identifying the wind turbine.

HISTORY OF FLIGHT

On April 27, 2014, about 2116 central daylight time (CDT), a Piper PA-32R-300 airplane, N8700E, was destroyed during an impact with the blades of a wind turbine tower 10 miles south of Highmore, South Dakota. The commercial pilot and three passengers were fatally injured. The airplane was registered to and operated by a private individual under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Dark night instrument meteorological conditions prevailed for the flight, which operated without a flight plan. The flight originated from Hereford Municipal Airport (KHRX), Hereford, Texas, approximately 1700, and was en route to Highmore Municipal Airport (9D0), Highmore, South Dakota.

According to family members, the pilot and three passengers had been in Texas for business. The pilot's family reported that they had intended to leave earlier in the day, on the day of the accident, but elected to delay, and subsequently left later than they had planned. The family stated that most likely, the flight was going to stop at 9D0 to drop off one passenger before continuing to Gettysburg Municipal Airport (0D8), Gettysburg, South Dakota.

A fixed base operator employee at KHRX witnessed the pilot fuel the accident airplane at the self-serve fuel pump just prior to the accident flight. He reported that the fuel batch report showed 82.59 gallons of fuel had been dispensed. The pilot commented to the employee that he was going to "top it off" as he had "pushed his luck on the trip down." The pilot also discussed the weather conditions in South Dakota, noting that it was raining there. The pilot also added that the only reason they were leaving was because one of the passengers was anxious to get home.

The pilot contacted the Fort Worth Lockheed Martin Contract Flight Service Station at 1711 when the airplane was 38 miles west of Borger, Texas, on a direct flight to North Platte, Nebraska. The pilot requested and obtained an abbreviated weather briefing. During this briefing, winds aloft and weather advisories for the reported route of flight were provided. The pilot also provided a pilot report for his position.

At 1812 the pilot sent a text stating that they were "Into KS aways" (sic). At 1923 he sent a text stating that they were "into NE". At 2054 he stated that they were flying by Chamberlain, South Dakota.

Several witnesses in the area reported seeing an airplane fly over their homes the evening of the accident. The first witness, located near the shore of the Missouri River, near Fort Thompson, South Dakota, reported seeing an airplane about 200 feet above the ground, flying to the northeast, about 2045. He stated that the airplane was low and was moving quickly. The second witness, located a few miles southwest of the accident site, reported seeing an airplane flying at a very low altitude, headed north, about 2115. Neither witness reported hearing problems with the engine.

According to the Federal Aviation Administration (FAA), the airplane was reported missing by a concerned family member when the airplane did not arrive in Gettysburg, South Dakota, on the evening of April 27, 2014. The wreckage of the airplane was located by members of the Hyde County Fire Department and the Hyde County Sheriff's department around 0330 on the morning of April 28, 2014. The pilot was not communicating with air traffic control at the time of the accident and radar data for the accident flight was not available.

OTHER DAMAGE

Wind turbine tower #14, part of the South Dakota Wind Energy Center owned by NextEra Energy Resources, was damaged during the accident sequence. One of the three blades was fragmented into several large pieces. One large piece remained partially attached to a more inboard section of the turbine blade. The inboard piece of this same turbine blade remained attached at the hub to the nacelle. The outboard fragmented pieces of the wind turbine blade were located in a radius surrounding the base of the wind turbine tower. The other two wind turbine blades exhibited impact damage along the leading edges and faces of the blades.

PERSONNEL INFORMATION

The pilot, age 30, held a commercial pilot certificate with airplane single engine land, multiengine land, and instrument ratings. He was issued a second class airman medical certificate without limitations on January 19, 2014. The pilot was a professional agricultural pilot and had flown agricultural airplanes in the area for several seasons.

The family provided investigators the pilot's flight logbook. The logbook covered a period between April 22, 2010, and April 20, 2014. He had logged no less than 3,895.8 hours total time; 100.7 hours of which were in the make and model of the accident airplane and 95.1 hours of which were in the accident airplane. This time included 76.2 hours at night, 1.1 hours of which had been recorded within the previous 90 days. The pilot was current for flight with passengers at night. He successfully completed the requirements of a flight review on January 18, 2013. He successfully completed an instrument proficiency check in a PA-32R on February 7, 2014.

According to the FAA, the pilot was familiar with the accident area. Specifically, the pilot was familiar with the wind turbine farm and had expressed his concern about the wind turbine farm to the FAA Flight Standards District Office in Rapid City, South Dakota. The details of his concerns were not available.

AIRCRAFT INFORMATION

The accident airplane, a Piper PA-32R-300 (serial number 32R-7680159), was manufactured in 1976. It was registered with the FAA on a standard airworthiness certificate for normal operations. A Lycoming IO-540-K1G5D engine rated at 300 horsepower at 2,700 rpm powered the airplane. The engine was equipped with a 2-blade Hartzell propeller. The airplane was equipped and certified for flight in instrument meteorological conditions.

The airplane was maintained under an annual inspection program. A review of the maintenance records indicated that an annual inspection had been completed on April 17, 2013, at an airframe total time of 4,766 hours.

METEOROLOGICAL INFORMATION

The closest official weather observation station was Pierre Regional Airport (KPIR), Pierre, South Dakota, located 35 miles west of the accident location. The elevation of the weather observation station was 1,744 feet mean sea level (msl). The routine aviation weather report (METAR) for KPIR, issued at 2124, reported wind from 010 degrees at 19 knots, visibility 10 miles, light rain, sky condition broken clouds at 1,000 feet, overcast at 1,600 feet, temperature 6 degrees Celsius (C), dew point temperature 5 degrees C, altimeter 29.37 inches, remarks ceiling variable between 800 and 1,200 feet.

The METAR issued at 2139 for KPIR reported wind from 070 degrees at 19 knots, visibility 4 miles, rain, mist, sky condition ceiling overcast clouds at 800 feet, temperature 6 degrees C, dew point temperature 5 degrees C, altimeter 29.37 inches, remarks ceiling variable between 600 and 1,300 feet.

Huron Regional Airport (KHON) in Huron, South Dakota, was located 53 miles to the east of the accident site at an elevation of 1,289 feet. The METAR issued at 2055 for KHON reported wind from 100 degrees at 20 knots, gusting to 27 knots, visibility 10 miles, sky condition ceiling overcast at 1,000 feet, temperature 9 degrees C, dew point temperature 7 degrees C, altimeter 29.36 inches, remarks peak wind of 29 knots from 090 degrees at 2015, rain began at 1956 and ended at 2006.

The National Weather Service (NWS) Surface Analysis Chart for 2200 CDT depicted a low-pressure center in southern Nebraska, with an occluded front extending into northeastern Kansas. A stationary front extended from northeastern Nebraska southeast through southern Iowa. Surface wind east of the accident location was generally easterly, with surface wind to the west of the accident location generally northerly. Station models across the state of South Dakota depicted overcast skies, with temperatures ranging from the high 30's Fahrenheit (F) to the mid-50's F. Rain and haze were depicted across the state.

A regional Next-Generation Radar (NEXRAD) mosaic obtained from the National Climatic Data Center (NCDC) for 2115 identified a large portion of South Dakota under light to moderate values of reflectivity, including the region surrounding the accident site. WSR-88D Level II radar data obtained at 2114 from Aberdeen, South Dakota, (KABR), depicted altitudes between 5,460 and 13,200 feet at the accident site. The KABR data identified an area of light reflectivity coincident with the accident location approximately two minutes prior to the accident time.

Advanced Very High Resolution Radiometer (AVHRR) data from the NOAA-16 satellite data were obtained from the National Oceanic and Atmospheric Administration and identified cloudy conditions at or near the accident site. Cloud-top temperatures in the region varied between -53 degrees C and 6 degrees C. The temperature of -53 degrees C corresponded to heights of approximately 35,000 feet. Due to a temperature inversion in the ABR sounding near 4,000 feet, the temperature of 6 degrees C may correspond to various cloud heights ranging from at or very near the surface to between 3,500 and 6,500 feet.

An Area Forecast that included South Dakota was issued at 2045 CDT. The portion of the Area Forecast directed toward the eastern two-thirds of South Dakota forecasted for the accident time: ceiling overcast at 3,000 feet msl with cloud tops to flight level (FL)180, widely scattered light rain showers, and wind from the east at 20 knots with gusts to 30 knots. Prior to the 2045 CDT Area Forecast, another Area Forecast that included South Dakota was issued at 1345 CDT. The portion of the Area Forecast directed toward the central and eastern portions of South Dakota forecasted for the accident time: ceiling overcast at 3,000 feet msl with clouds layered up to FL300, scattered thunderstorms with light rain, cumulonimbus cloud tops to FL400, wind from the southeast at 20 knots with gusts to 35 knots.

Airmen's Meteorological Information (AIRMET) SIERRA for IFR conditions was issued at 1959 CDT for a region that included the accident location. AIRMET TANGO for moderate turbulence for altitudes below 15,000 feet was issued at 1545 CDT for a region that included the accident location. The AIRMET also addressed strong surface winds for a region that did not include the accident location. AIRMET ZULU for moderate ice for altitudes between the freezing level and FL200 was issued at 1545 CDT for a region that included the accident location.

There were no non-convective Significant Meteorological Information (SIGMET) advisories active for the accident location at the accident time. There were two Convective SIGMETs issued for convection close to the accident location in the two hours prior to the accident time

According to the United States Naval Observatory, Astronomical Applications Department Sun and Moon Data, the sunset was recorded at 2037 and the end of civil twilight was 2109. The moon rose at 0615 on the following day.

At the time of the accident the wind turbine tower #14 recorded the wind velocity at 9.7 meters per second or 21 miles per hour and the ambient temperature was 7 degrees C.

The pilot logged on to the CSC DUAT System on April 26, 2014, at 2141:36 and requested a low altitude weather briefing quick path service. The pilot identified the route of flight as a direct flight between KHRX and 0D8, at an altitude of 8,500 feet.

AIDS TO NAVIAGATION

The FAA Twin Cities Sectional Chart 87th edition, dated 9 January, 2014, through 26 June, 2014, depicted the city of Highmore, South Dakota, and the Highmore Airport on the southern edge of the chart boundary. The city of Highmore and the airport were both within the same boundary box with a maximum elevation figure of 24 or 2,400 feet msl. The maximum elevation figure immediately south of Highmore was 27 or 2,700 feet msl. An obstacle at an elevation of 276 feet above ground level (agl) and 2,180 feet msl was depicted immediately south of the city of Highmore. A wind farm was depicted south and east of Ree Heights, South Dakota – this wind farm was at an elevation of 420 feet agl and 2,447 feet msl. The wind farm involved in this accident was not depicted on this sectional chart.

The FAA Omaha Sectional Chart 89th edition, dated 6 February, 2014, through 24 July, 2014, depicted the city of Highmore, South Dakota, and the Highmore Airport on the northern edge of the chart boundary. The city of Highmore and the airport were both within the same boundary box with a maximum elevation figure of 24 or 2,400 feet msl. The maximum elevation figure immediately south of Highmore was 27 or 2,700 feet msl. A wind farm was depicted south and east of Ree Heights, South Dakota – this wind farm was at an elevation of 420 feet agl and 2,447 feet msl and 420 feet agl and 2,500 feet msl.

A single obstruction was depicted on the chart about 7 miles south of the city of Highmore, just to the east of highway 57. The obstruction was at an elevation of 215 feet agl and 2,335 feet msl. A group of obstructions was depicted on the chart about 9 miles south of the city of Highmore, just to the west of highway 57. The obstructions were at an elevation of 316 feet agl and 2,496 feet msl. The wind farm involved in this accident was not depicted on this sectional chart as a wind farm.

According to the FAA, the 90th edition of the Omaha Sectional Chart, effective from 24 July, 2014, through 5 February, 2015, added the depiction of the accident wind farm just south of the city of Highmore. This depicted the wind farm west and southwest of highway 57 at an elevation of 2,515 feet msl. In addition, an unlit obstruction at an elevation of 415 feet agl and 2,597 feet msl was depicted just south of the wind farm boundary.

There are no instrument approach procedures into 9D0. There are two RNAV (GPS) approaches, runway 13 and runway 31, into 0D8.

FLIGHT RECORDERS

The accident airplane was equipped with an Apollo GX-50 panel-mount 8-channel GPS receiver. The unit includes a waypoint database with information about airports, VOR, NDB, en route intersections, and special use airspace. Up to 500 custom user-defined waypoints may be stored, as well. The GX-50 is a TSO-C129a class unit capable of supporting IFR non-precision approach operations. Thirty flight plans composed of a linked list of waypoints may be defined and stored. The real-time navigation display can be configured to show: latitude/longitude, bearing, distance to target, ground speed, track angle, desired track, distance, and an internal course deviation indicator (CDI). The unit stores historical position information in volatile memory; however, by design there is no method to download this information.

The unit was sent to the NTSB Vehicle Recorders Lab in Washington D.C. for download. Upon arrival at the Vehicle Recorders Laboratory, an exterior examination revealed the unit had sustained significant structural damage. An internal inspection revealed most internal components, including the battery, were dislodged. Since the internal battery was dislodged and the unit relied upon volatile memory to record information, no further recovery efforts were attempted.

WRECKAGE AND IMPACT INFORMATION

The accident scene was located in level, vegetated terrain, in the middle of a wind turbine farm, about 10 miles south of Highmore, South Dakota. The terrain was vegetated with short and medium grass. The wreckage of the airplane was fragmented and scattered in a radius to the north, through to the west, and then through the south, surrounding the base of wind turbine tower #14. The fragmented pieces of the fuselage, empennage, engine and propeller assembly, and both wings were accounted for in the field of debris.

MEDICAL AND PATHOLOGICAL INFORMATION

The autopsy was performed by the Sanford Health Pathology Clinic on April 29, 2014, as authorized by the Hyde County Coroner's office. The autopsy concluded that the cause of death was multiple blunt force injuries and the report listed the specific injuries.

The FAA's Civil Aerospace Medical Institute (CAMI), Bioaeronautical Sciences Research Laboratory, Oklahoma City, Oklahoma, performed toxicological tests on specimens that were collected during the autopsy (CAMI Reference #201400071001). Results were negative for all carbon monoxide and drugs. Testing of the blood detected 11 mg/dL ethanol; however, none was detected in the muscle or liver. Tests for cyanide were not conducted.

TESTS AND RESEARCH

Wreckage Examination

The wreckage was recovered and relocated to a hangar in Greeley, Colorado, for further examination. The wreckage was examined by investigators from the National Transportation Safety Board, Piper Aircraft, and Lycoming Engines.

The left wing separated from the fuselage and was fragmented. The fuel tanks were impact damaged and the left main landing gear separated from the wing assembly. The aileron and the flap separated from the wing assembly and were impact damaged.

The right wing separated from the fuselage and was fragmented. The fuel tanks were impact damaged. The right main landing gear was extended and remained attached to the right wing spar. The aileron and the flap separated from the wing assembly and were impact damaged.

The fuel selector valve was impact damaged. The position of the selector handle was at the left main fuel tank. Disassembly of the valve found the selector in an intermediate position between off and the left main tank. The fuel screen was clear of debris.

The instrument panel was fragmented and many of the instruments, radios, and gauges were destroyed. The ADI case and the directional gyro exhibited signatures of rotational scoring. The tachometer exhibited a reading of 2,400 to 2,500 rpm. The altimeter was broken and the needles separated. The Kollsman window was set at 29.27 inches. The airspeed indicator exhibited a reading of 235 miles per hour.

The pitot static system was impact damage and fragmented. The pitot tube and static port were clear and free of debris or mechanical blockage. Due to the damage, the system could not be functionally tested.

The empennage separated from the fuselage and was impact damaged. The aft portion of the vertical stabilizer was impact damaged and remained partially attached to the rudder at the hinge points. The stabilator was impact damaged and fragmented.

Flight control continuity to the ailerons, stabilator, and rudder could not be confirmed. The flight control cables were fractured in overload in multiple locations. The position of the flaps and landing gear could not be determined due to impact damage.

The engine was impact damaged impeding examination and testing for functionality. The spark plugs exhibited worn out normal signatures when compared to the Champion Aviation Check-A-Plug chart. The fuel injectors for the 1, 3, and 5 cylinders were clear of debris. The fuel injectors for the 2, 4, and 6 cylinders were impact damaged. The oil pick-up screen was clear of debris. The fuel servo and fuel pump were impact damaged and could not be functionally tested. The fuel flow divider was clear of debris. The vacuum pump case was bent and exhibited internal scoring consistent with operation at the time of the accident.

The propeller separated from the engine at the propeller flange. One blade exhibited S-bending, a curled tip, chord-wise scratches, and nicks and gouges along the leading edge of the propeller blade. The second blade exhibited chord-wise scratches, nicks and gouges along the leading edge of the propeller blade, and grey angular pain transfer near the tip of the propeller blade.

Wind Turbine Tower #14 Obstruction Light Power Supply, Flash Head, and Photocell Examination

The obstruction light, which included the power supply, flash head, and photocell (44812A), was removed from wind turbine tower #14 by an employee of ESI at the request of the wind turbine company. All of the components were shipped to Hughey & Phillips for further examination.

During the examination the following observations were made:

The flash head gasket was broken into 5 pieces. The day lens was crazed and a screw was loose in flash head.
The photocell which was in the container is an aftermarket unit and not as supplied by Hughey & Phillips.
An aftermarket transformer was added to the power supply above the TB1 terminal block. This was not wired into the power supply and two wires hung from the transformer.

The power supply was placed on test jig and the power supply and flash head were connected via a 7-wire power cable, 7 feet in length, provided by Hughey & Phillips. When power was applied to the unit the flash head did not work - the red lamp attempted to flash and the white lamp did not flash.

The lower flash tube was black consistent with age/use
The power supply - capacitor C3 – was bulged at the top consistent with a bad capacitor

The capacitor was replaced and the red lamp functioned as designed. The white lamp did not function. The white flash tube was replaced with a new flash tube.

When it was in day mode the white light activated
When in night mode the red light activated
When in auto mode, light was applied to the photocell sensor and after 30 seconds it switched from night to day mode. When light was removed and the sensor was covered to remove light, it switched back to night mode after 30 seconds.

The photocell was placed in a test chamber. When all light was removed, one light bulb illuminated. When 5 candelas was applied there was no change. The candelas were increased incrementally to 30 with no change. When the candelas were increased to 50, the test chamber switched to night mode within a minute or more.

The flash rate of the unit was tested.
The red lamp tested at a rate of 25 flashed per minute – This is within the FAA specifications for the L-864 fixture, 20 to 40 flashes per minute.
The white lamp tested at a rate of 40 flashes per minute- This is within the FAA specifications for the L-865 fixture, 40 flashes per minute.

The alarm function tested as designed.

The entire system operated normally with basic replacement of the flashtube and capacitor. The system was not operational in its as removed state.

ADDITIONAL INFORMATION

Wind Turbine

The wind turbine farm south of Highmore, South Dakota, was constructed in 2003. There are 27 towers in the entire farm oriented from east to west across highway 57. It was reported to the NTSB, on scene, that each turbine tower is about 213 feet tall (from the ground to the center of the hub) and the blade length is 100 feet long. Each tower is equipped with three blades and FAA approved lighting. The blades are constructed from carbon fiber.

On June 2, 2003, the FAA issued a Determination of No Hazard to Air Navigation, regarding the installment of wind turbine tower #14 near Highmore, South Dakota. The document identified that the wind turbines would be 330 feet agl and 2,515 feet msl. A condition to the determination included that the structure be marked and/or lighted in accordance with FAA Advisory Circular 70/7460-1K Change 1.

The wind turbine tower #14 was located to the west of highway 57, and was the 5th wind turbine tower in a string of wind turbine towers, oriented from east to west. Wind turbine tower #14 was 0.3 miles to the west of the 4th wind turbine tower and 0.5 miles to the west of the 3rd wind turbine tower. The string of wind turbine towers changed direction after wind turbine tower #14 and continued to the south and south west for about 2 additional miles with 13 additional wind turbine towers in the string. The next closest wind turbine tower to #14 was 0.5 miles south.

The wind turbine tower #14 recorded an alert in the system when the airplane and the turbine blade collided and the turbine went offline. The impact was recorded at 2116:33. The blades were pitched at -0.5 degrees and the nacelle was at 112 degrees yaw angle (not a compass heading, rather nacelle rotation). There were no employees at the wind farm maintenance facility when the accident occurred. The NextEra control center in Juno Beach, Florida, received an immediate alert when the collision occurred. The company response would have been to send an employee to the wind turbine the next morning to determine why the turbine had gone offline.

Maintenance records for wind turbine tower #14, for 5 years prior to the accident, were submitted to the NTSB investigator in charge for review. These records included major and minor inspection sheets for 2010 and 2011 in addition to work management records for general maintenance, repairs, and fault troubleshooting that occurred between June 2010, and October of 2014 (after the accident). The major and minor inspection sheets for 2010 and 2011 indicated that the FAA lighting was inspected and found to be "normal" or "OK." No other maintenance records were provided which illustrated maintenance that was conducted or performed on the FAA lighting system between 2010 and the accident.

It was reported to the NTSB IIC that the light on tower #14 was not functioning at the time of the accident and had been inoperative for an undefined period. The actual witness to the inoperative light did not return telephone calls in attempt to confirm or verify this observation.

FAA Lighting Requirements

The US Department of Transportation – FAA issued Advisory Circular AC 70/7460-1K Obstruction Marking and Lighting on February 1, 2007.

Section 23. Light Failure Notification states in part that "…conspicuity is achieved only when all recommended lights are working. Partial equipment outages decrease the margin of safety. Any outage should be corrected as soon as possible. Failure of a steady burning side or intermediate light should be corrected as soon as possible, but notification is not required. B. Any failure or malfunction that lasts more than thirty (3) minutes and affects a top light or flashing obstruction light, regardless of its position, should be reported immediately to the appropriate flight service station (FSS) so a Notice to Airmen (NOTAM) can be issued."

Section 44. Inspection, Repair, and Maintenance states in part that "Lamps should be replaced after being operated for not more than 75 percent of their rated life or immediately upon failure. Flashtubes in alight unit should be replaced immediately upon failure, when the peak effective intensity falls below specification limits or when the fixture begins skipping flashes, or at the manufacturer's recommended intervals. Due to the effects of harsh environments, beacon lenses should be visually inspected for ultraviolet damage, cracks, crazing, dirt, build up, etc., to insure that the certified light output has not deteriorated."

Section 47. Monitoring Obstruction Light stated in part that "Obstruction lighting systems should be closely monitored by visual or automatic means. It is extremely important to visually inspect obstruction lighting in all operating intensities at least once every 24 hours on systems without automatic monitoring."

Chapter 13, Sections 130 through 134, addressed Marking and Lighting Wind Turbine Farms. Wind turbine farms are defined as "a wind turbine development that contains more than three (3) turbines of heights over 200 feet above ground level." In addition, a linear configuration in a wind farm is "a line-like arrangement… The line may be ragged in shape or be periodically broke, and may vary in size from just a few turbines up to 20 miles long."

Section 131. General Standards states in part that "Not all wind turbine units within an installation or farm need to be lighted." "Definition of the periphery of the installation is essential; however, lighting of interior wind turbines is of lesser importance…" "Obstruction lights within a group of wind turbines should have unlighted separations or gaps of no more than ½ statute mile if the integrity of the group appearance is to be maintained."

Section 134. Lighting Standards states in part that "Obstruction lights should have unlighted separations or gaps of no more than ½ mile. Lights should flash simultaneously. Should the synchronization of the lighting system fail, a lighting outage report should be made in accordance with paragraph 23 of this advisory circular." Section c. Linear Turbine Configuration states in part "Place a light on each turbine positioned at each end of the line or string of turbines. Lights should be no more than ½ statute mile, or 2,640 feet from the last lit turbine."


AIRCRAFT STRUCK A WIND TOWER AND CRASHED, THE 4 PERSONS ON BOARD WERE FATALLY INJURED, SUBJECT OF AN ALERT NOTICE, WRECKAGE LOCATED 10 MILES FROM HIGHMORE, SD 

 http://registry.faa.gov/N8700E

NTSB Identification: CEN14FA224 
14 CFR Part 91: General Aviation
Accident occurred Sunday, April 27, 2014 in Highmore, SD
Aircraft: PIPER PA 32R-300, registration: N8700E
Injuries: 4 Fatal.

This is preliminary information, subject to change, and may contain errors. Any errors in this report will be corrected when the final report has been completed. NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

On April 27, 2014, at 2116 central daylight time, a Piper PA-32R-300 airplane, N8700E, was destroyed when it impacted the blade of a wind turbine 11 miles south of Highmore, South Dakota. The commercial pilot and three passengers were fatally injured. The airplane was registered to and operated by a private individual under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Instrument meteorological conditions prevailed for the flight, which operated without a flight plan. The flight originated from Hereford Municipal Airport (KHRX), Hereford, Texas, approximately 1700.

According to officials with the Federal Aviation Administration, the airplane was reported missing by a concerned family member when the airplane did not arrive in Gettysburg, South Dakota, on the evening of April 27, 2014. The wreckage of the airplane was located by members of the Hyde County Fire Department and the Hyde County Sheriff's department around 0330 on the morning of April 28, 2014.

The wreckage of the airplane was scattered in a radius surrounding the base of a wind turbine. The airplane was fragmented. One turbine blade exhibited impact damage and was broken into several large pieces, several of which remained attached to the turbine nacelle. The remaining two turbine blades exhibited impact damage.

The closest official weather observation station was Pierre Regional Airport (KPIR), Pierre, South Dakota, located 37 miles west of the accident location. The routine aviation weather report (METAR) for KPIR, issued at 2124, reported wind 010 degrees at 19 knots, visibility 10 miles, sky condition broken clouds at 1,000 feet, overcast at 1,600 feet, temperature 06 degrees Celsius (C), dew point temperature 05 degrees C, altimeter 29.37 inches, remarks, ceiling variable between 800 and 1,200 feet.


 Fears have re-ignited in southwestern Ontario after a fatal plane crash involving a wind turbine in South Dakota that left four people dead. 


Garry Sheperd has been flying for over 30 years. He's a seasoned pilot, and he's not pleased about the wind turbines he's now sharing the skies with.

"The ones we've got coming to our backyards here are 400 feet at present, but the new generation are 500 feet. In Europe they're over 700 feet and it's just a matter of time before there's a conflict."

 Four men were killed in April after their plane apparently collided with a wind turbine in South Dakota during foggy weather.

And Sheperd fears that he and his fellow pilots are just as at risk, especially those flying in and out of the Kincardine Municipal Airport, where 10 of 92 soon-to-be-built turbines in the Armow Wind farm could be flight risks.

"We pilots have been adamant that these aircraft and these turbines don't mix."

But the company disagrees, Jody Law of Pattern Energy says, "At Armow, we have worked closely with the federal regulatory agencies to ensure that the project will be in complete compliance with all safety regulations and standards."

In fact, the Armow Wind farm has been approved by all provincial and federal bodies.

But it's not just the size or the fact they are spinning that concerns pilots. Sheperd explains it's an invisible force unique to turbines that can cause problems flying past.

"As the blades turn there are vortices that come off them and rotate downwind...so we're climbing up through that invisible hazard and we shouldn't have to do that."

Eight turbines near the Chatham airport were ordered removed by Transport Canada last June for safety issues, but remain standing.

Story, photos and video:    http://london.ctvnews

Several oppose potential closure of Cuero Municipal Airport (T71) at council meeting

The City of Cuero council met for their regular meeting April 22 at the City Hall Council Chambers.

Talk about the airport picked up again at the April 22 city council meeting. Several people asked to speak before the council regarding the potential closure of the city’s existing airport.

City manager Raymie Zella said he spoke to TxDOT Aviation representative Michelle Hannah, who told him the first step in closing the airport was to submit a form to TxDOT inquiring if the city owed any debts. Zella said he submitted the form but had not heard back from TxDOT at the time of the meeting.

Seven men, including Bill Blackwell, Jimmy Gips, Hershal Ferguson, Bobby Lee Hranicky, Rick Doak, Michael Cavanaugh, and Mike Burris, asked to speak before the council. All men asked the council to at least consider keeping the airport open, if not to consider the building of a replacement airport.
 

Cuero Airport Supporters: https://www.facebook.com/CueroAirportSupporters 

Read more in this week's edition of the Record. 

Walter Hiebert YVR lawsuit reminiscent of Dziekanksi case: Vancouver Airport Authority has launched its own investigation into the incident

Seven years after the death of Robert Dziekanski, Vancouver International Airport is facing a lawsuit after a man became so disoriented and frustrated at the lack of help offered, he tried to climb over a wall, fracturing his hip in the process.

In October, 2007, Dziekanski, 40, who did not speak English, became agitated after spending more than nine hours wandering in the airport arrivals area, before being confronted by four Mounties who stunned him several times with a Taser.

In a recently filed statement of claim, Walter Hiebert says he suffered a stroke some years earlier that left him with impaired speech and an awkward gait. 

Hiebert says he was disembarked via wheelchair from a China Airlines flight from Taipei, in May 2012, transferred to a golf cart and left unattended for approximately 15 minutes, then offered a walker and given cursory directions. 

Where was security? 

The New Westminster man (then, 57) was left to wander the hallways of the airport unassisted for twenty minutes, before opening a set of alarmed doors — an act of desperation, his statement claims — in the hope security would arrive.

But no one came.

A video, held by the Airport Authority, but made available to Hiebert's lawyer, Paul Warnett, apparently shows his client stuck in the restricted area for six minutes, before being asked by staff to show his passport through a glass wall. The staff member then left without comment.

Frustrated at the situation, Hiebert used his wheelchair to boost himself over a wall, falling and fracturing his hip.

Hiebert's suit makes claim against several organizations, including the Vancouver Airport Authority, China Airlines Limited and Canada Border Services Agency.


'The airport should be prepared'

"These sorts of things happen to people. And one of the allegations we're making is that the airport should be prepared to handle these situations," Warnett told CBC.

"You would expect that someone is watching to make sure that you make your way down to where you're supposed to go," he said. "And we know that his movements were captured on video for approximately a half hour before he has his fall and injures himself."

In an email, the Vancouver Airport Authority expressed regret at the concern the incident caused Hiebert.

"We recognized a breakdown in customer care and immediately commenced an investigation involving personnel from the airline and other organizations at the airport," the email reads.

The email also said the VAA is yet to be served with court documents.

Hiebert's statement of claim only represents one side of a civil argument. None of his claims have yet been proven in court.


Source:   http://www.cbc.ca

Belize: Edmond Castro Faces Challenge In Court

In January, news broke about the Belize Airport Authority checks  approved for Edmond Castro, the Belize Rural North area rep. The result of that revelation was that the BBA's Board was required to resign, and the Department of Civil Aviation was removed from Castro's ministerial portfolio. 
 
Well, Belize Rural North resident Trevor Vernon believed that wasn't enough, and so he filed a civil suit against Castro claiming that he breeched the code of conduct given to Ministers under the Belize Constitution. The Chief Justice heard the application to bring that lawsuit, and both Vernon and Castro were in court today.

After the hearing, we spoke to attorneys on both sides about the arguments as to why the Chief Justice should or shouldn't allow the full case to be heard. Here's how they explained it:

Denys Barrow, attorney for Edmund Castro
"It is under the rules of court under which the case was brought. They brought it under a particular provision which deals with administrative law applications, constitutional relief, judicial review and claims for a declaration. But the particular rule is very clear as to when you can get a declaration and it is you can get a declaration against the state, against a tribunal, against a court or against another public body. Mr. Castro is not the state, he is not a tribunal, he is not a public body therefore this claim simply cannot be brought against him."

Phillip Palacio, attorney for Trevor Vernon

"What we essentially submitted to the court was that the points brought up by learned senior counsel they were all technical objections and when you look at technical objections that would more to the form of the claim and not the substance of the claim. We were saying and we had used authorities actually coming out of Belize to say that this is a very important claim which needs to be heard. Whenever you hear of misconduct or malfeasants by public offices specifically ministers - we are saying that this claim needs to proceed and what the Chief Justice should do he should amend the claim and allow it to proceed. That is the strategy that we had used. Instead of striking out for him to use all the alternatives available to him in order for this matter to be heard."

Chief Justice Kenneth Benjamin will deliver his decision on whether or not the case will be heard on May 19 at 9:30 a.m.


Source:   http://www.7newsbelize.com

Piper PA-31-350 Navajo Chieftain, Maui Island Air, N483VA: Accident occurred February 26, 2014 in Lanai City, Hawaii

NTSB Identification: WPR14FA124 
Nonscheduled 14 CFR Part 135: Air Taxi & Commuter
Accident occurred Wednesday, February 26, 2014 in Lanai City, HI
Probable Cause Approval Date: 10/21/2015
Aircraft: PIPER PA31, registration: N483VA
Injuries: 3 Fatal, 3 Serious.

NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

The airplane departed during dark (moonless) night conditions over remote terrain with few ground-based light sources to provide visual cues. Weather reports indicated strong gusting wind from the northeast. According to a surviving passenger, shortly after takeoff, the pilot started a right turn; the bank angle continued to increase, and the airplane impacted terrain in a steep right bank. The accident site was about 1 mile from the airport at a location consistent with the airplane departing to the northeast and turning right about 180 degrees before ground impact. The operator’s chief pilot reported that the pilot likely turned right after takeoff to fly direct to the navigational aid located southwest of the airport in order to escape the terrain-induced turbulence (downdrafts) near the mountain range northeast of the airport. Examination of the airplane wreckage revealed damage and ground scars consistent with a high-energy, low-angle impact during a right turn. No evidence was found of preimpact mechanical malfunctions or failures that would have precluded normal operation. It is likely that the pilot became spatially disoriented during the right turn. Although visual meteorological conditions prevailed, no natural horizon and few external visual references were available during the departure. This increased the importance for the pilot to monitor the airplane’s flight instruments to maintain awareness of its attitude and altitude. During the turn, the pilot was likely performing the additional task of engaging the autopilot, which was located on the center console below the throttle quadrant. The combination of conducting a turn with few visual references in gusting wind conditions while engaging the autopilot left the pilot vulnerable to visual and vestibular illusions and reduced his awareness of the airplane’s attitude, altitude, and trajectory. Based on toxicology findings, the pilot most likely had symptoms of an upper respiratory infection but the investigation was unable to determine what effects these symptoms may have had on his performance. A therapeutic level of doxylamine, a sedating antihistamine, was detected, and impairment by doxylamine most likely contributed to the development of spatial disorientation.

The National Transportation Safety Board determines the probable cause(s) of this accident as follows:
The pilot’s spatial disorientation while turning during flight in dark night conditions and terrain-induced turbulence, which resulted in controlled flight into terrain. Contributing to the accident was the pilot’s impairment from a sedating antihistamine.

HISTORY OF FLIGHT

On February 26, 2014, about 2130 Hawaii standard time, a Piper PA-31-350, N483VA, collided with terrain shortly after departure from the Lanai Airport (PHNY), Lanai City, Hawaii. The commercial pilot and two passengers were fatally injured, and three other passengers were seriously injured. The airplane was substantially damaged and was partially consumed by postimpact fire. The airplane was registered to Maui Aircraft Leasing, LLC, and operated by Maui Island Air under the provisions of 14 Code of Federal Regulations Part 135 on demand air taxi flight. Visual meteorological conditions prevailed for the flight, which operated on a visual flight rules flight plan. The flight had a planned destination of Kahului Airport, Kahului, Hawaii.

The National Transportation Safety Board (NTSB) investigator-in-charge (IIC) interviewed one of the survivors 6 days after the accident. The survivor reported that after the airplane departed the runway, he could see the lights of Lanai City and the Big Dipper star constellation off the left side of the airplane as it started its right banking turn. As he pointed out the constellation to the passenger seated to his right, he felt the sensation of G-loading in his seat. Shortly after, he said simultaneously his legs were forced towards the left side of the airplane and his upper body towards the isle. While trying to regain his position, he said he looked up, and saw the pilot leaning his upper body towards the right; it appeared that he was looking to the right, as if out the forward right cabin window. He said the airplane was in a steep right bank when he saw the ground impact the forward side of the airplane. He recalls that there was no realization that there was an emergency situation and that he had flown rougher [turbulent] flights before in this airplane.

PERSONNEL INFORMATION

A review of Federal Aviation Administration (FAA) airman records revealed that the 66-year-old-pilot held a commercial pilot certificate with ratings for airplane multiengine land and instrument airplane, and private privileges for airplane single-engine land. His second-class medical certificate was issued in March of 2013, with the limitation that he must wear corrective lenses for near and distant vision.

According to the pilot's last medical application, the pilot reported a total flight experience of 4,570 total hours, and 1 hour in the last six months.

The passengers onboard were Maui County employees on a business trip.

AIRCRAFT INFORMATION

The 10-seat, low-wing, retractable-gear airplane, serial number 31-7552124, was manufactured in 1975. It was powered by Lycoming model TIO-540-J2BD and LTIO-540-J2BD engines. The airplane was also equipped with Hartzell model HC-E3YR-2ALTF and HC-E3YR-2ATF constant speed propellers. The airplane was on an FAA Approved Aircraft Inspection Program (AAIP). Review of the maintenance logbook records showed an inspection [event inspection number #3] was completed December 1, 2013, at a total airplane time of 12,172.4 hours. A total airplane time at the accident site was undetermined due to damage.

Fueling records at Air Service Hawaii established that the airplane was last fueled on February 26, 2014, at 1559, with the addition of 27 gallons of 100LL-octane aviation fuel.

METEOROLOGICAL INFORMATION

A review of recorded data from PHNY, automated weather observation station revealed at 2056 conditions were wind 050 degrees at 21 knots, with gusts to 25 knots, visibility 10 statute miles, clear sky, temperature 18 degrees C, dew point 16 degrees C, and an altimeter setting of 30.03 inches of mercury.

According to the Astronomical Applications Department at the United States Naval Observatory, the official moonset was at 1611, and the official end of civil twilight was at 1853. The phase of the moon on the day of the accident was waning crescent, with 9 percent of the moon's visible disk illuminated.

COMMUNICATIONS

A VFR flight plan was filed, and no ATC communications took place.

AIRPORT INFORMATION

The FAA Digital Airport/Facility Directory indicated that PHNY Airport had an Automated Surface Observation System (ASOS), which broadcast on frequency 118.375.

The FAA Digital Airport/Facility Directory indicated that runway 03 was 5,001 feet long, 150 feet wide, and the runway surface was asphalt. The airport has an instrument landing system (ILS), and distance measuring equipment (DME) instrument approaches.

WRECKAGE AND IMPACT INFORMATION

An initial examination of the accident site by the IIC, revealed that the airplane impacted terrain southeast of the airport, about 1 mile perpendicular to the arrival end of runway 03. The debris field was about a 640-foot-long, and stretched from the first identified point contact (FIPC) to an engine component near the main wreckage. The FIPC was a ground scar that stretched about 160-feet-in-length and about 1-foot in width. Charring vegetation was observed about 100 feet down the ground scar from the FIPC, and fanned out on either side of the debris path for about 260 feet; it was about 50 feet in width at its widest point. The majority of the wreckage debris was found in the last 2/3 of the debris field. The main wreckage was mostly consumed by postimpact fire. Both wings separated from the main wreckage outboard of the engine nacelles. The tail section including the left and right side elevators; the rudder surface and vertical stabilator remained attached to the empennage.

A follow-up examination of the accident site was conducted on May 13, 2014, due to additional ground scars found in an aerial photograph of the accident site. During the follow-up examination, an FAA inspector and the IIC found the additional ground scar, which was about 360 feet in length about 270 feet, east-northeast from the original FIPC and was consistent with a right wing impact. Wing tip fairing sections and wing tip light assembly components were found near the mid-section of the ground scar. A plexiglas light cover was found near the east-north east end of the ground scar. The debris field had a total length of 1,270 feet with a magnetic heading of 250 degrees. See the Wreckage Diagram in the docket of this accident for further information.

The examination of the recovered airframe and flight control system components revealed no evidence of preimpact mechanical malfunction. Examination of the engines and propellers revealed that they separated from their nacelles with sections of the engine mounting assembly bent and attached. The propellers remained attached to the engines. Examination of both recovered engines and system components revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation.

The attitude indicator was found onsite after the initial examination of the accident site. An examination of the recovered attitude indicator revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation. The attitude indicator had minor damage to its housing, and the instrument face indication would not move freely when the instrument was tumbled by hand. The instrument was disassembled, and the gyro and surrounding housing revealed no mechanical rubbing.

MEDICAL AND PATHOLOGICAL INFORMATION

An autopsy of the pilot was conducted by the Maui Memorial Medical Center, Wailuku, Hawaii. According to the autopsy report, the cause of death was multiple blunt force injuries sustained in an aircraft crash.

Toxicology testing was performed at the request of the coroner by NMS laboratories identified caffeine, dextromethorphan and its metabolite dextrorphan, pseudoephedrine and its metabolite norpseudoephedrine, as well as doxylamine in the pilot's blood.

Toxicology testing was also performed on specimens from the pilot by the FAA Forensic Toxicology Research Team, Oklahoma City, Oklahoma. The toxicology report was negative for carbon monoxide, cyanide, and ethanol. The toxicology report identified dextromethorphan, its metabolite dextrorphan, pseudoephedrine, ephedrine, trimethoprim, doxylamine, and montelukast in blood and liver.

Review of the FAA medical certification file, autopsy report and toxicology tests, was conducted by the NTSB Medical Officer. Documents revealed that the pilot reported to the FAA that he had hay fever and childhood asthma. At the time of the accident, the pilot's medical certificate was limited by the need for corrective lenses. Mild enlargement of the heart and mild coronary artery disease was identified on autopsy. Postaccident toxicology testing in two laboratories identified caffeine, dextromethorphan and its metabolite dextrorphan, pseudoephedrine and its metabolite norpseudoephedrine, ephedrine, trimethoprim, doxylamine, and montelukast. The doxylamine was quantified at 120 and 62 ng/ml in the two laboratories.

For further information, see the Medical Factual Report within the public docket for this accident.

TEST AND RESEARCH

Spatial Disorientation

According to the FAA Airplane Flying Handbook (FAA-H-8083-3), "Night flying is very different from day flying and demands more attention of the pilot. The most noticeable difference is the limited availability of outside visual references. Therefore, flight instruments should be used to a greater degree.… Generally, at night it is difficult to see clouds and restrictions to visibility, particularly on dark nights or under overcast. The pilot flying under VFR must exercise caution to avoid flying into clouds or a layer of fog." The handbook described some hazards associated with flying in airplanes under VFR when visual references, such as the ground or horizon, are obscured. "The vestibular sense (motion sensing by the inner ear) in particular tends to confuse the pilot. Because of inertia, the sensory areas of the inner ear cannot detect slight changes in the attitude of the airplane, nor can they accurately sense attitude changes that occur at a uniform rate over a period of time. On the other hand, false sensations are often generated; leading the pilot to believe the attitude of the airplane has changed when in fact, it has not. These false sensations result in the pilot experiencing spatial disorientation."

According to the FAA Instrument Flying Handbook (FAA-H-8083-15), a rapid acceleration "...stimulates the otolith organs in the same way as tilting the head backwards. This action creates the somatogravic illusion of being in a nose-up attitude, especially in situations without good visual references. The disoriented pilot may push the aircraft into a nose-low or dive attitude." The FAA publication Medical Facts for Pilots (AM-400-03/1), described several vestibular illusions associated with the operation of aircraft in low visibility conditions. Somatogyral illusions, those involving the semicircular canals of the vestibular system, were generally placed into one of four categories, one of which was the "graveyard spiral." According to the text, the graveyard spiral, "…is associated with a return to level flight following an intentional or unintentional prolonged bank turn. For example, a pilot who enters a banking turn to the left will initially have a sensation of a turn in the same direction. If the left turn continues (~20 seconds or more), the pilot will experience the sensation that the airplane is no longer turning to the left. At this point, if the pilot attempts to level the wings this action will produce a sensation that the airplane is turning and banking in the opposite direction (to the right). If the pilot believes the illusion of a right turn (which can be very compelling), he/she will reenter the original left turn in an attempt to counteract the sensation of a right turn. Unfortunately, while this is happening, the airplane is still turning to the left and losing altitude. Pulling the control yoke/stick and applying power while turning would not be a good idea–because it would only make the left turn tighter. If the pilot fails to recognize the illusion and does not level the wings, the airplane will continue turning left and losing altitude until it impacts the ground."

ADDITIONAL INFORMATION

During a conversation with the NTSB IIC, the Chief Pilot of Maui Island Air reported that when they normally depart from runway 3 at PHNY, "it's like flying into a black hole" with no distant lights for situational awareness. He thought that the airplane could have hit down drafts off the mountain north of the airport during the right turn, and more than likely the pilot would have gone direct to the VHF omni directional radio range and a tactical air navigation system (VORTAC) located 1.6 miles southwest of the PHNY to escape the downdrafts. He stated that he would normally engage the autopilot once the airplane was established at 3,500 feet mean sea level (msl). He explained by leaning slightly to the right and reaching down with his right hand where the autopilot would be located as if positioned in the pilot seat. The autopilot unit is located below the throttle quadrant.


MAUI AIRCRAFT LEASING LLC:  http://registry.faa.gov/N483VA

NTSB Identification: WPR14FA124
Nonscheduled 14 CFR Part 135: Air Taxi & Commuter
Accident occurred Wednesday, February 26, 2014 in Lanai City, HI
Aircraft: PIPER PA 31-350, registration: N483VA
Injuries: 3 Fatal,3 Serious.

This is preliminary information, subject to change, and may contain errors. Any errors in this report will be corrected when the final report has been completed. NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

On February 26, 2014, about 2130 Hawaii standard time, a Piper PA-31-350, N483VA, collided with terrain shortly after departure from the Lanai Airport, Lanai City, Hawaii. The certified commercial pilot and two passengers were fatally injured and three other passengers were seriously injured. The airplane was substantially damaged and was partially consumed by postimpact fire. The airplane was registered to Maui Aircraft Leasing, LLC and operated by Maui Island Air under the provisions of 14 Code of Federal Regulations Part 135 on demand air taxi flight. Visual meteorological conditions prevailed for the flight, which operated on a visual flight rules flight plan. The flight had a planned destination of Kahului Airport, Kahului, Hawaii.

An initial examination of the accident site by the National Transportation Safety Board, investigator-in-charge, revealed about a 640-foot-long debris field that stretched from the first identified point of contact (FIPC) to an engine component near the main wreckage. The FIPC was a ground scar that stretched about 160-feet-in-length and about 1-foot in width. Charring vegetation was observed about 100 feet down the ground scar from the FIPC and fanned out on either side of the debris path for about 260 feet; it was about 50 feet in width at its widest point. The majority of the wreckage debris was found in the last 2/3 of the debris field. The main wreckage was mostly consumed by postimpact fire.

The airplane was recovered to a secure location for further examination.



HONOLULU —A fiery plane crash on Lanai that killed two Maui County workers and pilot Richard Rooney has resulted in a civil lawsuit by one of the victims' relatives.

Honolulu attorney Rick Fried filed the lawsuit Friday on behalf of Heather Shannon, the sister of 50-year-old Kathleen Kern, who was among those killed when a twin-engine airplane went down shortly after takeoff from Lanai City at 9:20 p.m. on Feb. 26.

The suit alleges negligence on the part of Rooney, 66, even though the National Transportation Safety Board is still months away from determining the official cause of the crash. The lawsuit also names both of Rooney's companies, Maui Island Air Inc. and Maui Aircraft Leasing LLC.

In a news conference Monday, Fried told reporters the lawsuit allows him to pursue possible evidence as well as depositions with survivors and witnesses.

"We will have to sort of take a backseat to the NTSB, but we do have contacts that hopefully can get us in the loop as soon as there's anything to report," he said.

Fried hopes to interview Maui County Deputy Corporation Counsel James Giroux, one of three people who survived the crash. In a statement to Maui police Giroux said the plane made an extreme bank to the right that was hard enough to feel the G-force.

The lawsuit hopes to recover damages for pain and suffering, funeral expenses and future earnings Kern would have received from Maui County. Kern was among a group of five Department of Planning workers who traveled to Lanai City for a community meeting. The workers usually return to Maui by ferry, but were forced to use the chartered flight after the meeting ended late.

Maui Island Air did not return a phone call Monday seeking comment about the lawsuit. Fried said the company has ceased operations since Rooney was the only person certified by the Federal Aviation Administration as a "chief pilot."

Story photo and comments/reaction:  http://www.kitv.com