News & Comment

T-Bolt Trouble: Unrecorded Maintenance on US HEMS BK117C2/H145 and Loss of TR Pitch Control

Posted by on 2:58 pm in Accidents & Incidents, Helicopters, Human Factors / Performance, Maintenance / Continuing Airworthiness / CAMOs, Safety Management, Special Mission Aircraft

T-Bolt Trouble: Unrecorded Maintenance on US HEMS BK117C2/H145 and Loss of Tail Rotor Pitch Control (Metro Aviation N191LL) On 6 March 2024 Metro Aviation Airbus BK117C2 / H145 helicopter air ambulance N191LL was damaged at Purdue University Airport (LAF), West Lafayette, Indiana. The three occupants were uninjured. On 24 April 2025 the US National Transportation Safety Board (NTSB) released their safety investigation report, in a creditable 14 months. The Accident Flight The pilot reported that, while in a hover taxi to accelerate for takeoff, he felt a force against his feet from the pedals. The helicopter yawed to the right, so he applied full left pedal, but when the pedal was depressed, there was no resistance and no effect on the helicopter’s yaw. The helicopter landed hard came to rest and rest upright, with damage to “the fuselage, tailboom, vertical fin, horizontal stabilizer, tail rotor assembly, and one main rotor blade”.  The Safety Investigation – The Accident Sequence The T-bolt and its attachment bolts, which connect the pitch change bellcrank to the pitch change slider was found to have become disconnected. Investigators concluded that the T-bolt attachment bolts had been installed but not torqued and lock wired, allowing them to back out while rotors running. Once the attachment bolts backed out, the T-bolt also backed out resulting in a loss of tail rotor pitch control. The T-bolt then likely impacted and damaged a tail rotor blade. The subsequent imbalance led to the overload separation of the upper vertical fin.  One attachment bolt was found on the ramp after the accident, and the other was “lodged into a honeycomb panel at the aft-lower area of the fuselage, adjacent to the fuel cell.” The Safety Investigation – The Maintenance History During maintenance a few days prior, the T-bolt and its attachment bolts were removed by a mechanic at the direction of a lead mechanic to facilitate troubleshooting of adjacent components for the tail rotor control system. As the T-bolt’s removal was temporary and quick, the mechanic crucially choose not to record the removal in the Work Order’s Discrepancy Sheet.  The T-bolt attachment bolts were then subsequently temporarily installed “finger-tight’ by a second mechanic to assist a third mechanic who was installing the tail rotor blade mounting forks and pitch change links. According to the NTSB “the first mechanic [sic] was tasked to another company helicopter shortly after”.  The NTSB state that “while he stated he relayed to the other mechanics that the T-bolt attachment bolts were finger-tight, no one followed up on the installation of the T-bolt attachment bolts”.  This part of the NTSB report is rather ambiguous but it seems likely the NTSB mean the mechanic tasked to another job was the second mechanic, who reinstalled the bolts finger tight, rather than the first mechanic who did the unrecorded removal. Without a maintenance discrepancy entry for the removal of the T-bolt, there was no open task to verify T-bolt installation was complete. Furthermore, no one identified that lock wire was missing from these bolts during the final checks before the helicopter was released to service. NTSB Probable Cause The failure of maintenance personnel to properly install the tail rotor pitch change slider attachment hardware (T-bolt), which led to the disconnection of the pitch change slider, a loss of tail rotor control, and subsequent...

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Three Fatalities When US Air Ambulance Helicopter Struck Goose at Night

Posted by on 4:20 pm in Accidents & Incidents, Helicopters, Safety Management, Special Mission Aircraft

Three Fatalities When US Air Ambulance Helicopter Struck Goose at Night (Air Evac B206L3+ N295AE) On 20 January 2024, at 23:23 Local Time, Bell 206L3+ air ambulance N295AE of Air Evac Lifeteam was destroyed in an accident near Hydro, Oklahoma. The three occupants, the pilot, flight nurse, and flight paramedic were all fatally injured. The US National Transportation Safety Board (NTSB) stated in their safety investigation report, issued on 19 March 2025, that having dropped off a patient at the Mercy Health Center Heliport, Oklahoma City, Oklahoma: The helicopter was en route back to the crew’s home airfield [Weatherford, Oklahoma] when it encountered a flock of geese during the night flight. The helicopter was in cruise flight about 500-600 ft above ground level and at 110 knots groundspeed when the encounter occurred. The bird strike resulted in an inflight breakup of the helicopter and subsequent impact with terrain.  The debris field was about 265 yards long and 455 yards wide. Bird remains were recovered from the area of the cockpit, tail rotor and pitch links.  Samples were sent to the Smithsonian Institution’s Feather Identification Laboratory. These were identified as cackling goose (Branta hutchinsii), which until 2004 was treated as a subset of the canada goose family (at which time the four smallest sub-species were reclassified).  DNA testing confirmed the remains were consistent with female cackling geese, which have an average mass of 2 kg.  At least two birds were involved (as three feet were found within the debris). Following the accident, the operator revised their General Operational Manual and pre flight risk assessment form: They encouraged all pilots to review bird migration tracking websites before flight, increased the recommended cruise altitude to 2,500 ft above ground level in areas of potential bird activity, and moved the recommended approach to land/descent airspeed to around 80-90 knots versus descending at cruise airspeed. Interestingly, despite encouraging use of bird migration data, NTSB also reported that: Preflight mission planning for the flight would likely not have detected a risk for a bird strike. A review of military and civilian bird hazard websites showed that at the time of the accident, the probability of bird strike in that area was deemed to be low. In addition, historic migration data also estimated the probability of a bird strike at the time of the accident as low. Our Safety Observations The actions taken after the accident all appear to be foreseeable safety improvements that have been foreshadowed by prior bird strike accidents.   NTSB do however note that to the operator’s credit the helicopter had been modified via a Supplemental Type Certificate to replace the pilot-side windshield with a polycarbonate kit “that offered increased resistance to windshield penetration by a bird strike”.  The specific product is not identified but an example can be found here.  NTSB do not comment further but the STC windscreens would be unlikely to be cleared for a 2 kg bird like a female crackling goose as even FAR 29.631 for the windscreens of larger rotorcraft is only a 1 kg test requirement. Safety Resources On 3 October 2023, the FAA released Special Airworthiness Information Bulletin (SAIB) AIR-21-17R1 Rotorcraft Bird Strike Protection and Mitigation, to inform pilots about the risk of bird strikes. The European Safety Promotion Network Rotorcraft (ESPN-R) has a helicopter safety discussion...

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Engine & Emergency Flotation Failures – Greenland B206L4 Ditching

Posted by on 6:31 am in Accidents & Incidents, Crises / Emergency Response / SAR, Design & Certification, Helicopters, Maintenance / Continuing Airworthiness / CAMOs, Offshore, Safety Management, Survivability / Ditching

Engine & Emergency Flotation Failures – Greenland B206L4 Ditching (Sermeq Helicopters OY-HIO) On 28 February 2024 Bell 206L4 OY-HIO Sermeq Helicopters ditched in Tunulliarfik Fjord (the inner section of Skovfjord) near Qaqortoq in southern Greenland.  Although the Emergency Flotation System (EFS) was activated, it malfunctioned and the helicopter rolled over.  The pilot, the sole occupant, escaped unharmed. Greenland is an autonomous territory within the Kingdom of Denmark and so the Accident Investigation Board (AIB) Denmark (Danish: Havarikommissionen for Civil Luftfart og Jernbane or HCLJ) investigated this accident.  They released their safety investigation report on 5 March 2025. The Accident Flight Th helicopter was making a VFR positioning flight from Narsarsuaq (BGBW) to Qaqortoq (BGJH) cruising at 1500 ft when… …the engine chip detector light illuminated on the caution and warning panel, and a few seconds later, the engine low oil pressure light started illuminating. Engine oil pressure indicated zero and indicated oil temperature decreased.  Moments after: The N1 (Gas Producer Turbine rotations per minute) indication was zero, and both the engine-out warning light and horn activated. However, the engine still produced power with a normal N2 (Power Turbine rotations per minute) indication. Consequently the pilot selected a narrow sand bar alongside the steep southern cliffs of the fjord and initiated a powered descent.    The engine however stopped and the pilot was forced to complete an autorotation, activating the EFS.  The helicopter ditched a few meters from the sand bar.  While the rotors were still turning the helicopter started slowly rolling onto its left hand side in a water depth of approximately 0.5 m.  The helicopter’s fixed Emergency Locator Transmitter (ELT) was mounted just below the instrument panel and fortuitously remained above the waterline.  It activated automatically, tiggering the tasking of a Search and Rescue (SAR) helicopter by Joint Arctic Command. At 17:17 an Air Greenland H225 SAR helicopter arrived on scene and located the accident site at 17:29.  The pilot, who was wearing “ordinary clothing” and whose legs had gotten wet was found conscious but with a low body temperature, having sat outside in -5 °C for c75 minutes. He was kept in hospital overnight. Safety Investigation – Survivability The investigators note that the SAR operation was “effective and positively impacted the chance of survival in a hostile area”. Though not legally required, in the opinion of the AIB, a survival suit in a hostile area would most likely have reduced the risk of hypothermia. Safety Investigation – Engine Following examination of the Rolls-Royce 250C30 engine the investigators concluded that the engine power loss was due to the following sequence of events: The bearing no. 8 thrust plate anti-rotation tab separated from the thrust plate ringand travelled with the engine oil to the scavenge side of the oil pump.  Debris from the anti-rotation tab triggered the engine chip detector light. Parts of the anti-rotation tab got trapped between a scavenge pump gear and the wall of the scavenge pump housing. The oil pressure pump and scavenge pump stopped. The drive shaft coupling from the fuel control gearshaft to the oil pump gearshaft fractured. There was no oil pressure and no N1 indication. The gas producer turbine and power turbine were still running. A stopped scavenge pump resulted in no warm engine oil flowing from the engine to the airframe oil tank, where the engine oil...

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EC135P2+ Air Ambulance Fatal Accident Mississippi 10 March 2025

Posted by on 9:37 am in Accidents & Incidents, Helicopters, Safety Management, Special Mission Aircraft

EC135P2+ Air Ambulance Fatal Accident Mississippi 10 March 2025 (Med-Trans AirCare 3 N835CS) On 10 March 2025 Airbus Helicopters EC135P2+ air ambulance N835CS, operated by Med-Trans Corporation (part of Global Medical Response) as AirCare 3, was destroyed in an accident near Canton, Mississippi. The pilot (who had 10,644 hours total time), the flight paramedic and flight nurse were fatally injured.  The US National Transportation Safety Board (NTSB) issued a preliminary report on 4 April 2025. The Accident Flight – Preliminary Details The helicopter was repositioning day VFR to its home base, Golden Triangle Regional Airport (GTR), Columbus, Mississippi, after transporting a patient to the St Dominic-Jackson Memorial Hospital Heliport (MS46), Jackson, Mississippi. According to the NTSB: A preliminary review of automatic dependent surveillance-broadcast (ADS-B) data showed the helicopter departed from MS46 and began to climb to the northeast. The helicopter flew over the Ross R. Barnett Reservoir, and the flightpath remained south of the Natchez Trace Parkway. The helicopter eventually reached an altitude of about 2,500 ft above mean sea level (msl).  Shortly after the helicopter flew over the Pearl River State Wildlife Management Area, it began to descend. Shortly after the helicopter flew over the Pearl River State Wildlife Management Area, it began to descend. About halfway through the descent, the flight nurse transmitted over the radio to the UMMC MED-COM, “we’ve got a major problem, we are having an emergency landing in a field right now, ops are not good, controls are giving us a lot of trouble, coming in fast.” No further radio transmissions were recorded from the helicopter from either the UMMC MEDCOM or ATC. During the descent, the helicopter turned to the north. It impacted multiple trees just to the south of a flat grass field 1/4 mile southwest of the Turcotte Fish Hatchery.  There was a postimpact fire that burned for about 3 hours, due to the remote location.  The Turcotte Fish Hatchery manager was inside his truck near the hatchery ponds at the time, 700 yards from the accident site: He heard a “boom” or an “explosion,” which is what first drew his attention to the helicopter. He looked toward the hatchery and saw the helicopter while it was airborne.  He…could not recall hearing any engine sound after the “boom,” and the helicopter sound was not noticeable to him. The helicopter… …did not change course and was pointed straight at him before it turned north and descended “at a pretty good rate.” It appeared to him that the pilot was “having trouble controlling” the helicopter. The witness reported that he did not see any smoke or fire from the helicopter. The helicopter was… …descending at a pretty good rate, which he estimated as a 40° to 45° descent angle. He said the helicopter’s estimated nose down attitude was about 30°. He said there was “a little wobble” of the nose from left to right. The helicopter was rolling “just a little bit.” He said the time from the “boom” to helicopter’s impact with the ground spanned no more than about 15 seconds. NTSB report that the helicopter had undergone its most recent inspection 2.7 flying hours before the accident.  The NTSB do not comment on what inspection this was.  A review of data on FlightAware indicated that the aircraft was on the ground at Key...

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UK CAA HOFO ACAS Rulemaking 2025 & a 2004 Tornado / AS332L Airprox

Posted by on 12:17 pm in Accidents & Incidents, Air Traffic Management / Airspace, Design & Certification, Fixed Wing, Helicopters, Military / Defence, Offshore, Oil & Gas / IOGP / Energy, Regulation, Safety Management

UK CAA HOFO ACAS Rulemaking 2025 & a 2004 Tornado / AS332L Airprox UK CAA Rulemaking 2025 The UK Civil Aviation Authority (UK CAA) has recently consulted on a general update to the Air Operating Regulations for offshore helicopters (Subpart K: Helicopter Offshore Operations).  This included introduction of Aircraft Collision Avoidance System (ACAS) requirements. The UK CAA wrote that: An internal CAA study produced in 2005 cited flight in uncontrolled airspace and mixing of civilian and military air traffic as two of the single largest factors associated with risk bearing Airproxes (during the 2001-2004 study period). The majority of offshore helicopter operations take place off the north-east coast of the UK where both of these factors prevail. It is therefore proposed to add a requirement for ACAS II to the Air Operating Regulations in order to reduce the risk of MAC… Wording similar to the CAT.IDE.A.155 requirement for aeroplanes will be [sic] proposed for addition to SPA.HOFO.160 (new para. (d)) in order to ‘future proof’ the requirement. A two-year period is proposed to allow time for all aircraft to be upgraded and to allow the costs to be spread. In there consultation, UK CAA note: Following a high profile very near miss between a military aircraft and an offshore helicopter in February 2004, all helicopters currently used for UK offshore operations are voluntarily equipped with ACAS, mostly ACAS II. Some aircraft are equipped with ACAS I, about half of which are already scheduled to be upgraded to ACAS II.  We will examine that 2004 incident next. RAF Tornado F3 / Bristow AS332L Airprox 5 February 2004 The UK Airprox Board (UKAB) published its analysis of this incident: The RAF Panavia Tornado F3 from RAF Leuchars was tasked as the target aircraft in an exercise and “required to simulate an aircraft flying a 20nm square search pattern between 250-1000ft asl” for two other Tornadoes.  The fighter’s… …AI [Airborne Interception] radar [GEC AI.24 Foxhunter] was serviceable and they were squawking with Mode C selected on. They were receiving an Air Defence Information Service (ADIS) from the Control and Reporting Centre (CRC) at RAF Neatishead, Norfolk. The surface wind was westerly at about 35kt, with the 2000ft wind registering at 50kt; the weather was slightly hazy at low level with an in-flight visibility of about 8km and no cloud to affect the flight. The Bristow AS332L was returning to Aberdeen in VMC along the Helicopter Main Route (HMR) 117 from the Auk A installation (then operated by Shell) in the Central North Sea at 09:07.  They were receiving a NATS offshore Flight Information Service (FIS) and were squawking the assigned code with Mode C.  The helicopter was en route at 1000 ft rather than the more usual 2000 ft because of a 55 knot headwind, as they were entitled to do in Class G airspace. Neither aircraft was equipped with any form of ACAS.  Both were operating in uncontrolled Class G airspace, and beyond radar cover at that time (multilateration was not introduced until 2010). Neither NATS nor Neatishead were aware of the other traffic, undermining their ability to provide a useful information service. After about 20 nm on the HMR and approaching 119 nm range from the ADN [Aberdeen North] VOR at 125kt with the autopilot engaged, when the helicopter crew… …suddenly became aware...

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AS365 Crewman Dragged from Boat During SAR Training

Posted by on 7:37 am in Accidents & Incidents, Crises / Emergency Response / SAR, Helicopters, Human Factors / Performance, Offshore, Safety Management, Special Mission Aircraft

AS365 Crewman Dragged from Boat During SAR Training (Western Australia Police Air Wing Airbus AS365N3 VH‑WPX) On 29 September 2020 Western Australia Police Air Wing Airbus AS365N3 VH‑WPX was conducting SAR training exercises near Swanbourne, Western Australia. While conducting an exercise with a small vessel, a rescue crewman attached to the hoist cable was pulled overboard and dragged through the water. The crewman was recovered uninjured. The Australian Transport Safety Bureau (ATSB) issued their safety investigation report on 22 September 2021. The Day’s Training & Incident Flight The crew commenced duty at 07:00 Local Time at their Jandakot base.  They departed at 09:33 for a staging area at Rous Head, Fremantle, landing at about 09:50.   The crew for the exercises comprised of the pilot, four tactical flight officers (TFOs) and one TFO instructor. It involved the TFOs rotating through the roles of winch operator, rescue crewman and diver.  They conducted the first training exercise of the day at a nearby beach.  The following exercises involved training with the 40 ft volunteer rescue vessel, Stacy Hall c 1-2 km offshore Swanbourne.   The aim was to conduct an initial vessel winching Operator Proficiency Check for one TFO and recency flights for two other crewmembers.  At the time of this incident the three key crew members were: The pilot:  joined the Australian Army as a Blackhawk pilot in 2008 and then the WA Police in Sept 2019.  They had 3,566 flying hours of experience, 320 on type. The hoist operator: who had served in the WA Police Air Wing since 2010, and had 1,596 hours of experience, including 110 cycles of water winching. The rescue crewman: who been with the Air Wing as a helicopter crewman  since mid 2018 and had 864 hours, including 74 cycles as a rescue crewman. The weather was overcast with clear visibility. The temperature was about 19°C with wind from the north‑west at 21 km/h (11 kt) gusting to 30 km/h (16 kt).  Sea state was forecast to increase to 1.5 to 2 m during the morning. After the first training it was decided only to conduct further operational recency training for the already qualified TFOs due to the sea state. At 11:31, they departed from Rous Head for the third training sortie. During a dummy run to the vessel the winch operator observed that the Stacy Hall was bouncing in the waves, so the crew requested…course and speed changes. …as the rescue crewman was winched clear of the deck, they swung towards the canopy on the forward end of the deck and required the use of their arms to fend off…with the winch operator commenting to the crew that the sequence ‘…was pretty hairy’. Further hoist training with the vessel and a helocast (free drop) / wet hoisting recovery exercise were conducted without issue, before a further return to Rous Head.  This suggests relatively low concern about the sea state. At 12:10 the helicopter departed to rendezvous with the Stacy Hall 1-2 km off Swanbourne for the fourth exercise. After take-off, the crew completed fly‑away checks, pre-landing checks, pilot brief and winch checks. The pilot brief confirmed the crew would undertake two hoist cycles to the vessel, which would be travelling on a course of 300° at a speed of 12 kt. The helicopter approached the Stacy Hall and...

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Firefighting Bucket Snags Trees During Autorotation

Posted by on 1:55 pm in Accidents & Incidents, Helicopters, Human Factors / Performance, Safety Management, Special Mission Aircraft

Firefighting Bucket Snags Trees During Autorotation (Valhalla Helicopters Bell 205 C-GRUV) On 19 July 2023, Valhalla Helicopters Bell 205A-1 C-GRUV crashed while conducting firefighting in northern Alberta.  The pilot died of his injuries. The Transportation Safety Board of Canada (TSB) published their safety investigation report on 27 February 2025. The Accident Flight At 1803 Local Time, 9 minutes after being tasked, the helicopter departed Haig Lake firebase, Alberta, on a VFR flight to a forest fire located approximately 15 NM northeast of Peace River Aerodrome Alberta.  The helicopter had an empty firefighting bucket, a1230 l SEI Industries Bambi Bucket BB2732, on a 150-foot longline. The pilot had 8711 flying hours total time, 3286 on type and a further 2048 on the B212. The helicopter was powered by an Ozark Aeroworks (formerly Honeywell) T5317B. Very shortly after departure, after reaching 1400 ft AGL, the helicopter experienced an engine failure. The helicopter began a 180° turn to the right, to a heading of approximately 025° magnetic, during which it continued to lose altitude. The helicopter then experienced a complete loss of engine power and the pilot began to autorotate into a section of muskeg to the west of his current location. During the subsequent autorotation the water bucket became entangled in trees. The helicopter consequently impacted the ground in a nose-down, left-banked attitude.  The main rotor struck the tail boom.  The damage indicated low rotor rpm at the time of impact.  There was no post-impact fire. The pilot survived the initial impact and was able to egress from the helicopter but later died of his injuries. The Safety Investigation The helicopter was not equipped with a flight data recorder or a cockpit voice recorder.  Neither were required by regulation.  The helicopter’s Garmin GPSMAP 496 provided the investigation with information about its flight path. A teardown of the T53 engine determined that a failure of the engine air diffuser’s No. 2 bearing support cone brazing resulted in the compressor rotor making contact with the power shaft, resulting in a high level of damage and vibration.  The failure of the brazing was due to an undetermined manufacturing defect that created a localized stress concentration that, over time, resulted in the progressive failure of the braze bond. The helicopter was equipped with an Onboard Systems keeperless cargo hook kit rated for loads up to 5000 lbs.  Investigators found the longline wrapped around treetops in the vicinity of the impact site. The snagged water bucket resulted in forward momentum being translated to a circular acceleration vector toward the ground, increasing the helicopter’s rate of descent. To counteract this, the pilot likely pulled aft on the cyclic and increased the collective to arrest the descent. With the engine no longer producing power, these actions would have led to a decay in main rotor rpm in the final moments of flight. The main rotor blades slowed to the point that the main rotor rpm would not have been recoverable. As the main rotor slowed, the retreating blade (left side) would have stalled, causing a roll to the left and a pitch forward in the final seconds before impact. For unknown reasons, the pilot did not jettison the external load using either the electrical or the manual release methods at the beginning of the autorotation. The pilot could have...

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Passenger Struck by Tail Rotor While Unloading at a Hunting Camp

Posted by on 8:53 am in Accidents & Incidents, Helicopters, Human Factors / Performance, Safety Management

Passenger Struck by Tail Rotor While Unloading at a Hunting Camp (Heli Explore Airbus AS350BA C-GWMO) On 21 April 2024, Airbus AS350BA C-GWMO of Heli Explore Inc, was conducting a series of VFR flights from Attawapiskat Airport, Ontario.  These were to various hunting camps in support of the annual ‘Goose Break‘ hunt.  A passenger fatality occurred unload after the 9th flight of the day.  The Transportation Safety Board of Canada (TSB) published their safety investigation report on 12 February 2025. The Accident Flight The helicopter had picked up one passenger at Attawapiskat Airport for Camp 17 on Akimiski Island, Nunavut, 15 minutes flying away.  The passenger had participated in the loading of the helicopter, under the supervision of a maintenance engineer.  Hunting equipment was being carried in panniers and pods on either side of the helicopter. The pilot landed facing the northeast, where he could see the trail leading to the camp. He left the engine running and rotors turning and his hands remained on the controls. This technique was often used during ground handling (passenger and cargo loading and off loading) to allow for a swift reaction if the helicopter were to shift or become unstable on the landing area. An individual on a snowmobile towing a sled arrived to help unload the helicopter. He waited off to the left side of the helicopter, in view of the pilot, until the pilot gave a signal that he could move closer. The pilot told the passenger he could get out of the helicopter and signalled to the snowmobile driver that he could approach the helicopter. The snowmobile and sled were parked near the external cargo basket on the left side, facing the same direction as the helicopter, where it remained throughout the occurrence. The passenger exited the helicopter and began unloading cargo from the left hand side with the snowmobile driver. As the passenger completed unloading the cargo pod, the snowmobile driver walked around the front of the helicopter to unload the right-side pod. Crucially: Once the passenger emptied the cargo pod, he secured its door and started walking toward the tail of the helicopter.  The snowmobile driver saw that the passenger was approaching the back of the helicopter, and tried to warn him by yelling and gesturing for him to stay away from the back of the helicopter. The passenger continued along the left side of the tail boom toward the back of the helicopter, past 4 antennas mounted below the tail boom, and past the left-side horizontal stabilizer.  He then ducked under the tail boom, aft of the horizontal stabilizer, but forward of the tail’s vertical fin. As he crossed to the right side, he was struck by the spinning tail rotor and was fatally injured. The impact caused the tail rotor and most of the tail rotor gearbox to detach from the helicopter. Safety Investigation In previous years at Attawapiskat, a person employed by Heli Explore Inc arranged passenger bookings and provided safety briefings to passengers. This documented that passengers had received a safety briefing, helped as some passengers only spoke Cree and “helped speed up the process of moving many passengers to the various camps”. However in 2024… …a new individual from the community was selected to arrange the passenger bookings in Attawapiskat. This individual...

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S-76D Loss of Control on Approach to an Indian Drilling Rig

Posted by on 12:30 pm in Accidents & Incidents, Crises / Emergency Response / SAR, Design & Certification, Helicopters, Human Factors / Performance, Offshore, Oil & Gas / IOGP / Energy, Regulation, Safety Culture, Safety Management, Survivability / Ditching

Pawan Hans Sikorsky S-76D Loss of Control on Approach to an Indian Drilling Rig (VT-PWI) On 28 June 2022 Pawan Hans Sikorsky S-76D VT-PWI, contracted by ONGC, impacted the sea on approach to the Sagar Kiran jack-up drilling rig in the Arabian Sea.  The helicopter capsized and while all 9 occupants egressed the helicopter, four passengers died in the water before they were rescued.  Two passengers suffered serious injuries.  Another passenger and the two flight crew escaped with minor injuries. The Indian Aircraft Accident Investigation Bureau (AAIB) published their safety investigation report in August 2023. ONGC, Pawan Hans and the Introduction of the S-76D in India State owned ONGC is the largest oil and gas company in India.  As is also common in Mexico and Brazil, the state oil company is the main customer for offshore helicopters in their domestic market. Pawan Hans (PHL) was formed in 1985.  ONGC owns 49% of the company, with the Government of India holding the majority stake. The Government has made 4 attempts to sell off their stake in the last 8 years.  Privately owned competitors to Pawan Hans include Global Vectra and Heligo. Pawan Hans operated 44 helicopters of 7 helicopter types at the time of the accident.  Offshore operations were their largest operating sector.  For many years the Airbus AS365 family had been their prime offshore type, with 31 in their fleet in 2022.   According to the in the AAIB report: ONGC…had put the criteria that aircraft being made available for operations should not be more than 7 years old [presumably for the commencement of new tenders]. Pawan Hans was not in a position to meet the customer demand without induction of newer aircraft in its fleet. Thereby, PHL’s top management decided to go for induction of new helicopters through leasing option. An attempt to lease S-76D and S-76C++ helicopters from a leasing company was made earlier but could not fructify. Hence, alternate leasing options were explored and PHL processed for leasing seven S-76D helicopters with planned induction in 2019-2020. These aircraft, formerly operated by Thai Aviation Services, were being replaced by Leonardo AW139s. After disruptions and delays owing to Covid-19, a master lease agreement was signed with lessor in October 2020. Pawan Hans was required to comply with provisions contained in the Air Operators Certification Procedure CAP 3400 for induction of new helicopter in its fleet.  Pawan Hans submitted request for pre-application meeting to [Directorate General of Civil Aviation] DGCA on 10 Nov 2020. Pawan Hans thus became the only operator of the S-76D in India.  The aircraft was leased by Milestone Aviation company Vertical Aviation No1 Ltd to Pawan Hans though to 17 February 2028. The aircraft arrived at Pawan Hans on 26 Aug 2021 in disassembled condition. Aircraft had 4636:42 hrs at the time of delivery to Pawan Hans. Aircraft was assembled and ground run was carried out on 23 Oct 2021.  The test flight for issue of ARC was carried out on 11 Jan 2022, and Certificate of Airworthiness and ARC was issued by DGCA on 28 Mar 2022. Pawan Hans has a Safety Management System (SMS), accepted by DGAC.  Pawan Hans hadidentified various risk mitigations for the S-76D introduction, including: Experienced offshore S-76D, TREs/TRIs to be recruited S-76D offshore experienced PIC will be hired/deployed in initial stages Existing Pawan...

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Two Rescuers Fell When Hoist Cable Damaged After a Loss of Hover Reference

Posted by on 1:39 pm in Accidents & Incidents, Crises / Emergency Response / SAR, Helicopters, Human Factors / Performance, Offshore, Safety Management, Special Mission Aircraft

Two Rescuers Fell When Hoist Cable Damaged After a Loss of Hover Reference (Australian Helicopters Bell 412 VH‑EMZ) On 9 November 2009 Australian Helicopters Bell 412 VH‑EMZ was involved in a hosting accident that left two crew members seriously injured. The Australian Transport Safety Bureau (ATSB) issued their safety investigation report on 21 January 2011. Preparations for the Medevac Flight The helicopter, call sign ‘Rescue 700’, based at Horn Island Aerodrome, Queensland was tasked to rendezvous with a 281m container ship Maersk Duffield located about 132 km west of Horn Island. The flight was to medevac an ill crew member to hospital. On board were to be four crew: On board the helicopter were the pilot, who was seated in the front right seat; an air crew officer (ACO), who was seated in the front left seat; and a rescue crew officer (RCO) and paramedic, who were seated in the rear cabin. The ACO “generally occupied the front left seat and relocated into the rear cabin” when required to operate the hoist.  The RCO’s role was to accompany the paramedic during hoisting. The pilot had c 8000 hours of flying experience, 2000 on type in command.  The ACO had 7 years of experience with about about 690 hours of operational experience, but just 25 hoist sorties of which only 8 had been involved ships.  No experience details were provided for the RCO or paramedic. Before departure, the crew had been advised that the patient would need to be hoisted from the ship’s forecastle.  This area was ahead of the 16.2 m high forward mast with c 8-9 m horizontal clearance.  The crew were provided with photos. The decision to undertake the winch to the forecastle was made by the master. The other options available for consideration were the ship’s bridge wings, the monkey island; or the top of the containers on the deck. The bridge wings and monkey island were considered unsuitable because of the number of aerials and other obstructions present, and the height of the containers above the deck meant that they were not accessible by the ship’s crew.  While awaiting the arrival of the paramedic, the pilots AO and RCO developed a plan.  They would… …request the ship to manoeuvre to provide a relative wind that was about 30° off the starboard side in order to provide the pilot with a visual reference of the ship. [In] order to reduce the overall time required to conduct the retrieval, the RCO suggested that he and the paramedic be winched together directly onto the forecastle. The suitability of the plan was to be confirmed on arrival overhead. The Accident Flight The helicopter departed Horn Island at 15:00 local time, arriving on scene at about 15:38. The pilot conducted a number of orbits of the ship to assess the proposed winching area and the relative wind via smoke from the ship’s funnel. Following that reconnaissance, the pilot requested that the ship’s master change the ship’s heading and reduce speed in order to obtain the originally planned relative wind. There was no restriction to the manoeuvring of the ship in preparation for the winch.  While the ship altered its heading, the helicopter conducted a final orbit and the crew confirmed they were were ready to commence hoisting. The ship’s master...

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