The pilot reported that he was conducting circuit practice. Another aircraft was also in the circuit and flew an unusually long and wide downwind and base leg pattern. This distracted the pilot, and he landed the aircraft with the landing gear retracted.

The Airbus A320 was enroute from Sydney to Perth when approximately 250 NM east of Perth, the co-pilot reported that he had a sudden onset of very strong cramp-like pain. He later reported that he had no prior discomfort or warning. The pain developed into very strong waves of lower stomach and right-side pain. As the pain intensity increased, the co-pilot could no longer remain seated and gained slight relief only by standing. The co-pilot was so incapacitated by the pain that he could not perform his duties. The crew decided not to divert to Kalgoorlie because it was an unfamiliar airfield and there would be increased workload for the pilot in command because of the lack of ATS facilities. Operations at Kalgoorlie are conducted under the mandatory broadcast zone (MBZ) procedures.

The pilot in command declared a medical emergency to Melbourne ATC and the aircraft was cleared for a direct track to Perth and received priority processing from Perth ATC. An ambulance was arranged to meet the aircraft on arrival. Because the co-pilot could neither sit or lie down, the crew decided that he would occupy the forward toilet compartment from the top of descent into Perth. The co-pilot used the handgrips and packing provided by the purser to support and brace himself during the descent and landing. The pilot in command engaged the autoland system and the aircraft landed without further incident. The co-pilot was transported to hospital by the waiting ambulance.

The co-pilot was later diagnosed as having kidney stones. He had no known previous history of the condition.

The pilot reported that during take-off, he opened the balloon's smart vent to reduce the rate of climb to ensure that the balloon remained clear of others in the near vicinity. He reported that the vent appeared to only partially open to approximately 6 inches. He had intended to vent for only 2 to 3 seconds. However, when he pulled on the line to close the vent, the vent would not close and reseal. Each time he pulled on the line the bottom sides of the envelope, where there are pulleys for the lines to run through, would draw to the centre of the balloon envelope. This indicated that there was a malfunction and the line was unable to freely move through the pulley.

The balloon continued to climb to approximately 55 ft where it levelled off. The pilot applied double burners for approximately 6 seconds but the balloon did not respond to the heating. The balloon began to descend and the pilot decided not to make any more burns. As the balloon accelerated towards the ground, he instructed his passengers to bend their knees and about 3 seconds after, the balloon landed heavily injuring some passengers.

When the balloon landed heavily, the smart vent closed. The vent was tested after the accident and was found to operate correctly. It has since continued to operate normally.

The operator reported that the smart vent was a relatively new invention and was still being developed. The operator also reported that there was an understanding within the company that the vent would not be operated until the balloon was landing.

The operator is amending the company's operating documentation to include a requirement that the smart vent not be operated unless the balloon is within 20 ft of the ground.

The pilot of the Piper Arrow reported that his approach to runway 23 at Coonamble, in a gusting 12 knot crosswind, was high and fast.

The aircraft initially touched down on the nosewheel and veered off the runway before he could regain directional control. However, he was unable to prevent the aircraft running into a ditch, resulting in the nose landing gear collapsing, and the propeller striking the ground. The pilot was uninjured in the accident.

The incident occurred on the morning Class E Radar airspace was introduced. Class E Radar airspace included defined airspace within radar coverage over NSW, from south of Ballina to north of Canberra from 8,500 ft to Flight Level (FL) 125. It excluded existing Class C, Class D and military restricted airspace. To operate in Class E Radar airspace, Instrument Flight Rules (IFR) flights required an airways clearance. Air traffic control provided separation from other IFR traffic.

VH-GKB, on an IFR flight, was cruising at 9,000 ft, and reported overhead Williamtown at 0731 ESuT, estimating Taree at 0754. VH-SMH, also on an IFR flight, departed Williamtown at 0732 tracking direct to Point Lookout, and climbing to planned level FL 250. At 0733.40, the flight service officer coordinated the departure of SMH to Brisbane Control. At 0734.28, the flight service officer instructed SMH to transfer to the Sector 15C frequency, and suggested that SMH maintain 8,000 ft due to IFR traffic at 9,000 ft. Sixteen seconds later, SMH contacted Brisbane Control, advising an altitude of 8,800 ft. The controller immediately advised the pilot that clearance was not available, and instructed him to descend to 8,000 ft. At this time, the indicated altitude of the aircraft on the controller's radar display was 8,700 ft. The horizontal distance between the aircraft was 4.7 NM. The minimum separation standard required was 5 NM horizontally, or 1,000 ft vertically.

The operator advised that the aircraft was operating at low weight. This resulted in a high rate of climb. The crew was aware of the lower limit of the Class E Radar airspace and expected to receive a clearance before the aircraft reached 8,500 ft. In the event, the expectation of a clearance combined with the high rate of climb of the aircraft resulted in insufficient anticipation being applied to level the aircraft at 8,500 ft. Replay of the recorded radio transmissions revealed that the transmission from the flight service officer suggesting that the aircraft maintain 8,000 ft was broken, incomplete and slightly garbled. Consequently, the crew did not hear the suggestion to maintain 8,000 ft.

Prior to the occurrence, company practice when climbing into controlled airspace had been to set the lower limit of the airspace (in this case 8,500 ft) pending receipt of an airways clearance. However, this provided only 500 ft separation from traffic cruising at 9,000 ft in Class E Radar airspace and advice from ATC was that traffic information is not passed in such situations. Based on this information, and the circumstances of the incident, company procedures were amended to set 8,000 ft in the assigned altitude indicator.

VH-HYG, an Airbus A320, was en route from Sydney to Perth at flight level (FL) 350. VH-TAG, a Boeing 737, was en route from Adelaide to Perth on the same route and was maintaining FL330. The aircraft position reports for FILET, a reporting point over the Great Australian Bight, revealed that there was a 6 minute interval between the aircraft with HYG in front. The crew of TAG requested approval to climb to FL350. The controller believed that the groundspeed of the aircraft over a 6 minute period would provide the necessary 30 NM longitudinal separation standard and instructed the crew to climb to FL350.

The controller requested both crews to report their distance from FLAKE, the reporting point west of FILET. The reports from the crews revealed that the distance between the aircraft was 16 NM. The required separation was either 30 NM or 2,000 ft vertically. There was a breakdown of separation standards. Subsequently, the controller instructed the crew of TAG to descend to FL330 to maintain separation. Controllers were required to check for distance standard between aircraft that had less than 10 minutes between their respective estimates. There was a considerable number of aircraft being managed by the controller at the time of the occurrence.

Following the occurrence the controller was replaced at the position. However, prior to the occurrence the controller had approved the crew of VH-HYE, an Airbus A320 en route from Perth to Adelaide, to climb from FL370 to FL390 but had not coordinated this change of level with the next control position. Additionally, the controller had not annotated the new level on the HYE flight progress strip for HYDRA. This flight progress strip would be used to coordinate the position of HYE with the next control position. A second handover/takeover was then conducted with a third controller assuming responsibility for the position. The crew of HYE reported at both the HITCH and HOLLA positions at FL390 while this controller was operating the position. The controller advised Adelaide Sector 4 of HYE's HYDRA estimate and level from the flight progress strips for that position. The crew of HYE reported to Adelaide Sector 4 at HYDRA at FL390.

The level was confirmed by Sector 4 from the radar display label. The investigation established that the first controller may have been distracted by aircraft radio transmissions and coordination calls from other control positions while he was endeavouring to annotate all flight progress strips for HYE with the new level. Consequently, he did not annotate the new level, of FL390, in the HYDRA flight progress strip. In relation to TAG, the investigation did not establish the reason for the controller not complying with the requirement to check the distance between aircraft. In both handover/takeovers it is probable that the on-coming controllers did not conduct an adequate review of the flight progress strips. To some degree they may have been limited in their ability to conduct a check of the FPSs because of the level and complexity of the traffic situation. This aspect may also be the reason for the third controller not establishing the difference between the levels provided in the two position reports and that annotated on the HYDRA flight progress strip which was subsequently used for the coordination with Adelaide.

The Cessna Citation (C550) was on climb to flight level 310 (FL310) but had been restricted to FL280 due to opposite direction traffic on descent to FL290. The Sector 16 controller had coordinated the planned flight level with the next sector and had notated the flight strip accordingly. A following Boeing 737 (B737) was on the same track and had planned to climb to FL350 but had also been restricted to FL280 due to the same conflicting traffic.

The controller had also coordinated this flight with the following sector and had notated the flight strip accordingly. The B737 reached FL280 first and began to increase speed as the aircraft maintained level flight. At this time the slower C550 was approximately 25 NM ahead of the B737, but still climbing. An opportunity to establish positive vertical separation was available at this time but the controller did not invoke separation assurance techniques. The controller had intended to climb both aircraft to their respective flight planned levels after they had passed the opposite direction traffic and expected to maintain the 5 NM radar separation standard prior to that event.

Changes to airspace procedures had taken place 3 days prior to the occurrence and it was the controller's first shift involving the new procedures since the introduction of Class "E" airspace. He had been on duty just 30 minutes when he received his first request for a clearance involving "E" airspace. This request resulted in him having to perform coordination tasks with both Flight Service and Sector 19. The consequent workload due to his unfamiliarity with the new procedures resulted in his attention being diverted from the radar display, as the B737 closed on the C550. The C550 subsequently levelled at FL280. A controller not performing tasks related to Sector 16 noticed the rate of closure between the C550 and the B737 and brought this to the attention of the Sector 16 controller who immediately issued a radar vector to the crew of the B737.

As the aircraft passed, the horizontal separation reduced to approximately 1/2 NM. The crew of the B737 did not sight the C550. Radar analysis indicated that the closing speed varied between 70 and 220 kts. It had been planned that all Sector 16 controllers were to have undergone 5 simulator exercises prior to the implementation of "E" airspace. However, due to time constraints and technical difficulties, only 4 exercises had been developed. An agreement had been reached for all Sector 16 controllers to receive those 4 exercises. However, the controller on duty had only experienced 2 complete and 1 "over the shoulder" simulator exercises at the time of implementation. Moreover, the changes issued by the Civil Aviation Safety Authority, 7 days prior to implementation, resulted in a new version of Local Instructions for Sector 16 only becoming available to the controller 4 days before the occurrence. This limited the time available for adequate training of air traffic controllers.

SAFETY ACTION

As a result of this occurrence, the Bureau of Air Safety Investigation is currently investigating a perceived safety deficiency. The deficiency identified relates to air traffic controller training. Any safety output issued as a result of this analysis will be published in the Bureau's Quarterly Safety Deficiency Report.

A Boeing 767 had just departed from Sydney runway 16R when, at a height of about 100ft, the crew reported hearing a series of loud bangs and the right engine exhaust gas temperature indicator rose rapidly into the red range. The right thrust lever was retarded to idle, resulting in the temperature indications returning to normal. ATC had also observed a series of explosions from the right engine as the aircraft departed and had declared a local emergency.

The crew requested a return to the field for a landing. Because of local weather conditions the aircraft was radar vectored for an ILS approach to runway 16R, where it landed without further incident. After vacating the runway, the aircraft was stopped on the taxiway, and the right engine shut down, before being inspected by the waiting fire services. As there was no evidence of fire the aircraft was taxied back to the terminal where the passengers disembarked normally.

A ground inspection of the engine revealed no external damage, however, an internal borescope inspection revealed extensive damage to blades of the thirteenth compressor stage. The engine was subsequently removed for further inspection, resulting in a replaceable 'phillips' bit from a screwdriver being found in the core of the engine. The operator reported that the incident occurred on the first flight after the aircraft had undergone an 'A' maintenance check. The 'phillips' bit had probably entered the engine through the variable bleed valves which are open when the engine is not operating.

The operator is investigating ways to preclude foreign objects entering the engine in this manner during ground maintenance.

A Twin Squirrel helicopter was approaching Sydney Airport on a St Peters 2 Inbound helicopter route. As the helicopter approached the airport maintenance area, the pilot advised the aerodrome controller that he had a hydraulic problem and requested a fire tender to meet him on arrival. As this was being arranged, the pilot further advised that there was now a strong smell of hydraulic fluid in the cabin and requested confirmation that a fire tender was awaiting his arrival. However, as the helicopter passed over runway 25, the pilot advised that he had lost hydraulic power to the tail rotor and was landing immediately. The helicopter landed safely on helipad 03. There was no fire or reported damage to the helicopter.

A ground inspection of the helicopter revealed that the right hydraulic system fluid reservoir outlet flange had cracked, resulting in loss of contents and subsequent loss of tail rotor control. The operator has submitted a Major Defect Report to the Civil Aviation Safety Authority.

The foreign Private Pilot was conducting a local flight in the Camden area, following a flight review three days earlier.

At the time of departure, the control tower was manned. Throughout the day the wind had been from the south-west, favouring runway 24. By the time aircraft returned for a landing the tower had closed down. The Camden ATIS, which had earlier nominated runway 24 for landing, had been changed on closedown to provide a standard message. This indicated that the control zone was reclassified as Class G airspace, and that Mandatory Broadcast Zone procedures applied. The preferred runway direction was 06. No wind information was provided.

The pilot said that he listened to the ATIS well before his return to Camden, to reduce his workload during the subsequent approach. He understood that runway 24 was still in use. Later, when he returned for a landing, he was unable to see the wind indicator and elected to make an approach to runway 24, using 10 degrees of flap.

Ground observers subsequently saw the aircraft travelling along runway 24 at a very low height, with the pilot apparently attempting to land. When it reached a position some 3/4 along the runway the observers saw the aircraft adopt a high nose attitude and attempt to climb away. The aircraft continued in a high nose attitude, at low forward speed, towards rising ground to the west of the aerodrome. It became apparent that the angle of climb was insufficient to overcome the terrain. The aircraft was then observed to strike trees and disappear.

The aircraft came to rest in the front yard of a house, after colliding with a number of trees. Both occupants were able to escape with minor injuries. A subsequent examination concluded that the aircraft had been capable of normal operation at the time of the accident.

An investigation found that in the 30 minutes after the tower closed down, there had been a significant wind shift. At 1600, the time of closedown, the recorded wind direction and velocity was 300/13 kt. The next reading at 1630 showed the wind had changed to 100/12 kt. The effect of that wind shift was to create a substantial downwind component on runway 24.

Witnesses indicated that the wind had changed shortly after 1600, just before the pilot attempted his landing approach. The description of the event provided by the pilot, and other observers, was consistent with the pilot attempting to land the aircraft on a runway with a substantial downwind component. The angle of climb during the subsequent go-around was also adversely affected by the downwind component, and was insufficient to overcome the rising terrain.