Occurrence Briefs are concise reports that detail the facts surrounding a transport safety occurrence, as received in the initial notification and any follow-up enquiries. They provide an opportunity to share safety messages in the absence of an investigation.
On 28 August 2019 at about 1045 Eastern Standard Time, a Kawasaki BK117 helicopter was conducting a medical retrieval from a suburban park in Pendle Hill, New South Wales. The crew consisted of the pilot in the front right seat, an additional crew member in the front left seat and a paramedic and doctor in the rear of the helicopter.
During normal operations, the paramedics are trained to open both rear doors and provide clearances and guidance into the hover. To enable movement between the doors they have a harness attached to a wander strap to allow for better visibility.
As the helicopter approached the intended landing spot, the paramedic observed a small two-strand wire running from a light pole across the approach path. The paramedic alerted the pilot of the hazard and the landing was aborted. At the time the landing was aborted, the wire was approximately 30 metres in front of the helicopter and below skid height. The helicopter subsequently made an approach to an open area clear of the wire.
Source: Google Earth, annotated by ATSB
The operator has well-defined standard operating procedures that apply to unknown landing site operations and training is provided to all members of the crew to be able to contribute to safe operations. In this instance, the following factors worked as designed to prevent a potentially major accident:
- Crew resource management:
The presence of a healthy ‘challenge and response’ environment is regularly reinforced and encouraged by the air crew with the medical crew.
- Wire awareness:
When operating into unknown landing sites, wire hazard awareness is kept top-of-mind.
- Approach power margin:
The requirement to have the power margin to enable a slow approach, allowing for careful scanning for obstacles/hazards and consideration of an immediate abort of the approach if required.
- Approach type:
A steep angle of approach with a limited rate of descent, meaning power was applied early in the approach. In the event there is a need to arrest the descent and climb or go-around, this transition can be accomplished quickly and with only a modest additional power application.
The training provided to all medical crew members emphasises wire awareness as a major threat, and ensures that paramedics achieve the ability to be able to visualise the approach path of the helicopter and scan this path for hazards.
This incident highlights the importance of having clear standard operating procedures and a mature crew resource management culture. In this instance, the crew were disciplined and used the correct, defined approach profile which resulted in the paramedic having sufficient time and opportunity to detect the wire and manage the threat. Appropriate training enabled all involved parties to become valuable contributors to safe operations.
About this report
Decisions regarding whether to conduct an investigation, and the scope of an investigation, are based on many factors, including the level of safety benefit likely to be obtained from an investigation. For this occurrence, no investigation has been conducted and the ATSB did not verify the accuracy of the information. A brief description has been written using information supplied in the notification and any follow-up information in order to produce a short summary report, and allow for greater industry awareness of potential safety issues and possible safety actions.
|Date:||28 August 2019||Investigation status:||Completed|
|State:||New South Wales|
|Release Date:||02 October 2019||Occurrence category:||Incident|
|Report status:||Final||Highest injury level:||None|
|Aircraft manufacturer||Kawasaki Heavy Industries|
|Type of operation||Aerial Work|
|Damage to aircraft||Nil|
|Destination||Suburban park in Pendle Hill, New South Wales|