Aviation safety investigations & reports

Depressurisation event involving a Metro 3, VH-SEF, 93 km SSE Narrabri Airport, 23 September 2012

Investigation number:
AO-2012-127
Status: Completed
Investigation completed

Summary

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On 23 September 2012 at 1855 Eastern Standard Time, a Metro 3 aircraft registered VH-SEF (SEF) and operated by Brindabella Airlines, departed Narrabri on a scheduled passenger flight to Sydney, New South Wales. On board were seven passengers and two flight crew.

Passing through 10,000 ft, the Captain asked the First Officer (FO) for the transition checks which included a check of the cabin altitude by the FO. The transition checks were completed with no abnormalities found. During the climb, the Captain began to feel progressively worse and asked the FO to recheck the cabin altitude.  Before the FO could respond, the cabin altitude warning light illuminated at a cabin altitude of 17,000 ft. An emergency descent to 10,000 ft was performed.

As a result of this occurrence, the operator amended their standard operating procedures in regard to; the transition checks, maintenance schedule for the cabin altitude warning system and the re‑currency simulator training syllabus.

Flight crew are reminded of the dangers of hypoxia and the need to put oxygen masks on without delay if hypoxia is suspected.

Aviation Short Investigation Bulletin – Issue 14

Download Final Report
[Download  PDF: 289KB]
 
 
Alternate: [Download  DOC: 7.32MB]
 
General details
Date: 23 September 2012   Investigation status: Completed  
Time: 1855 EST   Investigation level: Short - click for an explanation of investigation levels  
Location   (show map): 93 km SSE Narrabri Airport    
State: New South Wales   Occurrence type: Air/pressurisation  
Release date: 20 December 2012   Occurrence category: Serious Incident  
Report status: Final   Highest injury level: None  

Aircraft details

Aircraft details
Aircraft manufacturer Fairchild Industries Inc  
Aircraft model SA227  
Aircraft registration VH-SEF  
Serial number AC-641  
Operator Brindabella Airlines  
Type of operation Air Transport Low Capacity  
Damage to aircraft Nil  
Departure point Narrabri, NSW  
Destination Sydney, NSW  
Last update 14 November 2018