Inadequate preflight inspection of an un-refuelled aircraft resulted in a total loss of engine power due to fuel exhaustion and a dramatic emergency landing.
Fuel Exhaustion Causes EMB-110 Emergency Landing Read Post »
US HEMS Accident Rates 2006-2015 The safety of US Helicopter Emergency Medical Service (HEMS) operations has been a topic we have discussed previously. With HeliExpo approaching, when 10 years of the International Helicopter Safety Team (IHST) will be marked and with US NTSB Board Member Robert Sumwalt just publishing a HEMS article in Professional Pilot,
US HEMS Accident Rates 2006-2015 Read Post »
An ATSB report on a fatal man overboard incident questions if blindly valuing compliance may create a culture that actually undermines safety.
Culpable Culture of Compliance? Read Post »
Machining Defect Cause of V2500 Failure On 18 September 2014 JetBlue Airways Airbus A320-232 N656JB experienced a Number 2 IAE V2527-A5 engine failure and under-cowl fire during initial climb out from Long Beach, California. The US National Transportation Safety Board (NTSB) say in their report: The flightcrew shutdown the No. 2 engine, discharged both fire bottles, and
Machining Defect Cause of V2500 Failure Read Post »
Ignoring Corrosive Environment Brings Down B206 Helicopter An operator that ignored the Rolls-Royce M250-C20 Series Engine Operation and Maintenance Manual classification of their entire island operating location as a “severe corrosion operating environment” and failed to do the associated maintenance requirements suffered the loss of the their Bell 206B3. Emerald Pacific Airlines B206B3 B-31019 was hovering at
Ignoring Corrosive Environment Brings Down B206 Helicopter Read Post »
Finmeccanica Strives For Greater Gearbox Loss of Lube Capability Finmeccanica Helicopters (the recently rebranded AgustaWestland (UPDATE: and now Leonardo) is working to enhance the durability of helicopter Main Gear Boxes (MGBs) after a loss of lubrication. The company’s Marco Tamborini presented their approach at the European Aviation Safety Agency (EASA) 9th Rotorcraft Symposium held in Cologne in December
Leonardo Strives For Greater Gearbox Loss of Lube Capability Read Post »
The ASC Taiwan has issued their investigation report into the CFIT of a TransAsia ATR 72-500 on 23 July 2014 during an attempted landing in bad weather.
Safety Lessons from TransAsia ATR-72 Flight GE222 CFIT Read Post »
On the evening of 27 Jan 1986 a group were preparing for what we now know as one of the most infamous telecons in history. We look at lessons for all complex, high hazard industries.
NASA Challenger Launch Decision Read Post »
HEMS S-76C Night Approach Loss of Control – In-flight (LOC-I) Incident A Helicopter Emergency Medical Service (HEMS) Sikorsky S-76C+ C-GHHJ operated by Helijet on behalf of the BC Ambulance Service was on a VFR approach to the coastal Tofino/Long Beach Airport (CYAZ), British Columbia, Canada at 02:39 Local Time on the dark, moonless night of 15 November 2015. It suffered a Loss of Control
HEMS S-76C+ Night Approach LOC-I Incident Read Post »
CAP1145 Helicopter Water Impact Survivability Statistics – A Critique Eurocopter AS332L2 G-WNSB impacted the sea 1.5 nm west of Sumburgh Airport, Shetland Islands on 23 August 2013 (see the last AAIB Special Bulletin) with the loss of 4 lives. https://youtu.be/C_3xlunGUk0 Within weeks the UK Civil Aviation Authority (CAA) ordered a hurried safety review. This resulted in the CAP1145 report (‘Safety review of offshore public transport
CAP1145 Helicopter Water Impact Survivability Statistics – A Critique Read Post »
Maintenance Personnel Fatigue and Alertness Maintenance personnel fatigue and a consequential lack of alertness is regularly being identified as contributory, or potentially contributory, to maintenance related air accidents and serious incidents. We have covered three examples previously: Some involve poor shift patterns: Missing Igniters: Fatigue & Management of Change Shortcomings: The UAE GCAA investigation report explains most of the
Maintenance Personnel Fatigue and Alertness Read Post »
HUMS Vibration Health Monitoring Success Australia’s Civil Aviation Safety Authority (CASA) has published a Service Difficulty Report (SDR), dated 1 November 2015, that highlights a Health & Usage Monitoring System (HUMS) Vibration Health Monitoring (VHM) success. During investigation of a HUMS vibration alert, the main rotor head of an Airbus Helicopters EC225/H225 offshore helicopter was examined and wear was identified beyond the limits
HUMS Vibration Health Monitoring Success Read Post »
CSB: ‘Multiple Safety Deficiencies’ Led to ExxonMobil Refinery Explosion The US Chemical Safety Board (CSB) report that they have “uncovered multiple process safety management deficiencies” that led to the 18 February 2015, explosion at the ExxonMobil Torrance refinery, California and an associated serious near miss. The CSB explain: …two workers were injured when an explosion occurred in the
CSB: ‘Multiple Safety Deficiencies’ Led to ExxonMobil Refinery Explosion Read Post »
The Passengers Who ‘Caused’ a 737 Tail Strike On 12 January 2003 a serious incident occurred involving Transavia Boeing 737-800 PH-HZB at Rotterdam. The Dutch Safety Board (DSB) report says the aircraft: …pitched nose-up just after take -off thrust had been selected. The pitch up movement stopped when the aft fuselage and the tailskid assembly contacted the
The Passengers Who ‘Caused’ a 737 Tail Strike: Ground Handling Lessons Read Post »
Aerossurance Marks RAeS 150th Anniversary by Sponsoring Rotorcraft Automation Conference The Royal Aeronautical Society (RAeS) was founded on 12 January 1866, so is today celebrating its 150th anniversary (or sesquicentennial). To mark this significant milestone Aerossurance is pleased to be sponsoring the Society’s 2016 Rotorcraft Conference. This conference, to be held 6-7 July 2016 at the
Aerossurance Marks RAeS 150th Anniversary by Sponsoring Rotorcraft Automation Conference Read Post »
We look at the lessons on aerodrome lighting and charts from a UK bizjet take off accident. Mistaking edge lights for the centreline is not uncommon.
G-III Attempted Takeoff Using Runway Edge Lights as Centerline Read Post »
An inappropriate, undocumented practice, coupled with a failure to follow the checklist contributed to writing off an SF340 while taxying.
Procedural Drift at Saab 340 Operator Leads to Taxiway Excursion Read Post »
Aerossurance: Our Top 20 Articles of 2015 As we start the new year we look back on the 20 articles that proved most popular with our readers in 2015. In reverse order: Number 20: Building St Helena Airport – An Industrial Scale ‘Grand Design’ This started with the building of the first airport on the volcanic
Our Top 20 Articles of 2015 Read Post »
Dangers of Aircraft Tyre (US: Tire) Inflation The Royal Canadian Air Force are investigating two recent tyre inflation burst accidents. Both involve visiting aircraft using borrowed equipment: 25 August 2015 CT-114 Tutor CT114058 A Snowbird aircraft was diverted from the rest of the deployed team due to an in-flight emergency. The aircraft was repaired, including a successful
Dangers of Aircraft Tyre Inflation Read Post »
UK BOSIET/FOET Cat-A CA-EBS HUET Update Category A Compressed Air Emergency Breathing Systems (CA-EBS) were introduced for helicopter passengers flying offshore over the UK Continental Shelf in September 2014. This followed the UK Civil Aviation Authority (CAA) North Sea Review, which resulted in the CAP1145 report. Oil and Gas UK, Step Change in Safety, OPITO, the International Association of Drilling Contractors
UK BOSIET/FOET Cat-A CA-EBS HUET Update Read Post »
B1900C PSM+ICR Accident in Pakistan 2010 The Pakistan Civil Aviation Authority (CAA) has recently published the report into the loss of a Beechcraft B1900C in 2010. The aircraft, AP-BJD, was being operated by JS Air (as subsidiary of the JS Group) when it crashed on 5 November 2010, killing 21 people. The accident featured what a
B1900C PSM+ICR Accident in Pakistan 2010 Read Post »
Fatal Arctic Bo105 CFIT gives lessons on low level ops, compliance with mx data, cold water survivability, alerting, data recorders and regulatory oversight.
Canadian Coast Guard Helicopter Accident: CFIT, Survivability and More Read Post »
UK Offshore Helicopter Safety Action Group (OHSAG) October 2015 Minutes The UK Civil Aviation Authority (CAA) has just published the minutes of the 16 October 2015 meeting of the Offshore Helicopter Safety Action Group (OHSAG). This is the third and last of the year (compared to six in 2014), postponed from July 2015. The OHSAG was formed as a result of the ‘Civil
UK OHSAG Oct 2015 Minutes Read Post »
So You Think The Gulf of Mexico (GOM) is Non-Hostile? The Gulf of Mexico (GOM), off the coast of Mississippi, Louisiana and Texas in particular, remains a busy area for offshore helicopter operations with over 2 million passengers carried and nearly 300,000 flying hours last year (see our article: Helicopter Ops and Safety – Gulf Of
So You Think The GOM is Non-Hostile? Read Post »
We look at some of the problems of error management and ask if we are still making the error management mistakes James Reason warned of in 1997 (spoiler: some organisations are). We also look at drift and how some have failed to grasp its more than poor compliance.
Back to the Future: Error Management Read Post »
