Media Release
ATSB action to be taken against accident operator for failing to report safety incidents
01 December 2006
The ATSB has announced that it will refer Lessbrook Pty Ltd to
the Director of Public Prosecutions for its failure over several
years to report aviation safety occurrences to the bureau as
required by legislation.
Lessbrook Pty Ltd operates under the name Transair and was the
operator of the aircraft in which two pilots and 13 passengers lost
their lives on 7 May 2005. Despite the accident, it is only in
recent weeks that Lessbrook has provided the Australian Transport
Safety Bureau with evidence which our analysis has shown includes
25 safety incidents which should have been reported immediately or
within 72 hours depending on their severity.
The unreported occurrences include 7 immediately reportable
matters (IRMs) that occurred between 1 July 2003 and the accident.
They include a gear failure on departure from Bamaga, a cabin
pressurisation warning near Cairns, a burning smell near Inverell,
and a problem with flaps leading to a flapless takeoff and
associated flight issues from Gunnedah to Sydney.
Under the Transport Safety Investigation Act 2003 (TSI
Act) and Regulations such IRMs must be reported immediately by
responsible persons (eg the airline operator) in accordance with
the regulations and failure to do so has a maximum penalty of
imprisonment for six months (Section 18 of the TSI Act). Failure to
report the more routine matters or to make a written report of IRMs
carries a maximum penalty of 60 penalty units, a very steep
fine.
While in accordance with international requirements and domestic
law, ATSB investigations do not seek to assign blame or liability,
a serious breach of the TSI Act with respect to the investigations
or reporting requires action to deter people from failing to comply
with its safety objectives.
The failure to report these occurrences, which were reported by
relevant pilots to the operator, is indicative of a poor safety
culture and poor safety system within the operator. However, the
reports are a separate safety issue compared with the fatal
accident.
Despite the difficulties the ATSB has had in obtaining timely
and complete information for its investigation, a draft of the
final report is planned to be released to directly involved parties
on 15 December. This is to enable checking of factual accuracy and
to ensure natural justice. There are 60 days to comment before the
ATSB finalises the report for public release.
This media release constitutes a report released under Section
25 of the TSI Act.
Media Contact: 1800 020 616