Aviation safety investigations & reports

Collision with terrain involving DHC-1, 'Chipmunk' VH-UPD near Coffs Harbour, NSW on 29 June 2014

Investigation number:
AO-2014-114
Status: Completed
Investigation completed

Final Report

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What happened

On the morning of 29 June 2014, the pilot of a de Havilland Canada DHC-1 T Mk 10 Chipmunk aircraft, registered VH-UPD, was taking a passenger for a brief, private flight over Coffs Harbour Regional Airport, New South Wales.

According to pilot and passenger reports, after conducting a series of aerobatic manoeuvres, the pilot climbed to about 3,800 ft and accelerated to about 85 kt. The pilot then made a short dive to build up speed to about 120 kt before commencing a loop.

At the top of the loop, the aircraft stalled while inverted, most likely as the result of excessive elevator input. The aircraft rolled and entered an upright spin, which became flatter as it developed. Later, the pilot reported that attempts to recover were unsuccessful. The spin continued until the aircraft impacted terrain. The pilot and passenger sustained serious injuries and the aircraft was seriously damaged. There was no fire.

What the ATSB found

The pilot reported undertaking training to conduct loops, but there was no record of an endorsement and the instructor did not recall approving the pilot to conduct loops. As a result, at the time of the accident, the pilot likely did not possess the necessary skills and judgement to conduct the manoeuvre safely and consistently.

The pilot probably did not apply and maintain the spin recovery control inputs appropriate for a fully-developed spin in a Chipmunk aircraft. Furthermore, the pilot was taught a spin recovery method that was not effective for recovering from such spins in the aircraft.

In addition, the accident aircraft’s flight manual had not been approved by the Civil Aviation Safety Authority and did not include advice on spin recovery. The mandatory, Civil Aviation Safety Authority-approved flight manual contained spin recovery advice.

What's been done as a result

The flying school that provided the pilot’s aerobatic training reported that a briefing process was undertaken with all current aerobatic instructors to ensure that consistent terminology is used to describe and teach aerobatic manoeuvres. It also reported that a programme of standardisation flights for all current aerobatic instructors will include the training of spin and unusual attitude recovery for aerobatic students.

Safety message

Pilots and instructors, particularly those intending to conduct or teach aerobatic manoeuvres, should be familiar with any special handling requirements for a particular aircraft type as well as recovery from both incipient and developed spins. Furthermore, they should ensure that they hold the appropriate aerobatic endorsement before attempting a manoeuvre.

VH-UPD accident site

VH-UPD accident site

Source: ATSB

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The occurrence

Context

Safety analysis

Findings

Safety issues and actions

Sources and submissions

Appendices

Photos

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General details
Date: 29 June 2014   Investigation status: Completed  
Time: 1136 EST    
Location   (show map): Coffs Harbour Airport, SE 1 km   Investigation type: Occurrence Investigation  
State: New South Wales   Occurrence type: Collision with terrain  
Release date: 04 February 2016   Occurrence class: Operational  
Report status: Final   Occurrence category: Accident  
  Highest injury level: Serious  

Aircraft details

Aircraft details
Aircraft manufacturer de Havilland Canada  
Aircraft model DHC-1 T MK 10  
Aircraft registration VH-UPD  
Serial number C1/0111  
Type of operation Private  
Sector Piston  
Damage to aircraft Substantial  
Departure point Coffs Harbour, NSW  
Destination Coffs Harbour, NSW  
Last update 14 November 2018