Hughes 269C, VH-THV, 31 km south-west of Hay Point, Queensland, on 30 August 1990

Summary

Circumstances:

The aircraft began the outbound flight with full tanks and an anticipated endurance of 312 minutes. On the return flight, at about 90 kilometres from the destination, the low fuel warning light illuminated. The pilot landed at a property close by and added 30 litres of fuel to the helicopter before continuing the flight. However, the engine failed due to fuel exhaustion some 20 kilometres from the destination. During the subsequent forced landing, which occurred 14 minutes after last light, the helicopter rolled over.

Significant Factors:

The following factors were considered relevant to the development of the accident:

1. The pilot miscalculated the fuel consumption rate.

2. The pilot did not land before last light.

3. He did not land before fuel was exhausted.

4. The engine failed due to fuel exhaustion.

5. A forced landing was conducted on unsuitable terrain.

Occurrence summary

Investigation number 199003097
Occurrence date 30/08/1990
Location 31 km south-west of Hay Point
State Queensland
Report release date 03/06/1991
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Hughes Helicopters
Model 269
Registration VH-THV
Serial number 880710
Sector Helicopter
Operation type Business
Departure point Peak Downs QLD
Destination Hay Point QLD
Damage Substantial

Cessna 182A, VH-WCG, Aratula (63 km SW Archerfield) QLD, 18 October 1987

Summary

This was to be the first time the pilot had flown an aircraft for the purpose of dropping parachutists. The right cabin door and all seats except the pilot's seat had been removed and a windblast deflector baffle had been fitted at the open doorway in preparation for the day's parachute drops. The aircraft was loaded with four parachutists. After the engine was started, the pilot completed an engine check and the pre-takeoff checks. However, the flap was inadvertently left in the fully retracted position. The pilot considered the strip fairly rough and raised the nosewheel early in the takeoff run, to save it from unnecessary stress. The aircraft became airborne at about 50 knots in an exaggerated nose high attitude. Almost immediately, the left wing dropped and the aircraft veered off the centre section of the strip. Several ground strikes occurred off the strip and the left aileron struck a post in the boundary fence. The aircraft continued at full power, occasionally flying in ground effect at low airspeed, until it struck a log in high grass well beyond the marked end of the strip. The takeoff attempt was continued until the aircraft struck another log and uprooted a large sapling before coming to rest, embedded in a large felled gum tree, 370 metres beyond the end of the strip. The investigation determined that the aircraft became airborne prematurely because the pilot overrotated on takeoff. An aft centre of gravity and lack of takeoff flap combined to make the elevator control very light and prone to overcontrol. Once airborne, the induced drag caused by the exaggerated nose high attitude, and the continual ground strikes prevented acceleration.

Occurrence summary

Investigation number 198703515
Occurrence date 18/10/1987
Location Aratula (63 km SW Archerfield)
Report release date 23/02/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Runway excursion
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Cessna Aircraft Company
Model 182
Registration VH-WCG
Serial number 51194
Operation type Private
Departure point Aratula QLD
Destination Aratula QLD
Damage Substantial

Hughes 269C, VH-SMQ, Yandiarra Station (100 km south of Port Headland), Western Australia, on 14 July 1990

Summary

Circumstances:

The pilot was attempting to prevent a herd of cattle from turning towards water by flying parallel to the cattle drive and between it and a creek bed. The aircraft was 10 feet above ground level and travelling at 10 knots when the tail boom and rotor collided with the top beam of a shed frame. The pilot was unable to retain control of the aircraft and it crashed next to the frame. The pilot was aware of the location of the rust coloured metal frame, however he had temporarily forgotten about it. The cattle drive had drawn his attention away from the aircraft's flight path and possible obstacles. A fine layer of dust covered the windscreen and with the setting sun, in front of the aircraft, visibility was reduced to the point where the pilot did not see the frame which blended into the rocky background.

Significant Factors:

The following factors were considered relevant to the development of the accident

1. The pilot forgot about the frame due to his concentrating on the cattle drive.

2. The pilot's visibility was impaired by the dusty windscreen, the setting sun and the lack of contrast between the frame and the background

Occurrence summary

Investigation number 199000093
Occurrence date 14/07/1990
Location Yandiarra Station (100 km south of Port Headland)
State Western Australia
Report release date 25/10/1990
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Hughes Helicopters
Model 269
Registration VH-SMQ
Serial number 1290876
Sector Helicopter
Operation type Aerial Work
Departure point Yandiarra Station WA
Destination Yandiarra Station WA
Damage Substantial

Cessna 182P, VH-AOB, Karratha Airport WA, 14 June 1989

Summary

The aircraft's engine performed normally during the run up, taxi and take-off. At approximately 200 feet, after take-off, the engine failed completely. The pilot attempted to land the aircraft in the remaining runway length, however, the aircraft touched down in the overrun, entered a muddy area and overturned. The aircraft was last refuelled two days before the accident. Heavy rain had fallen during the two days and the pilot found a significant quantity of water in the aircraft fuel system during his pre-flight fuel check on the morning of the accident. The pilot drained fuel from the system until no water was present in the fuel sample. The pilot was not aware that it is possible for water to accumulate in the fuel tank and not be cleared by the fuel drain. Consequently he did not 'rock' the aircraft, during his preflight, to ensure that all the water was clear. An inspection of the aircraft fuel system, following the accident, disclosed that the engine had stopped because the fuel supply to the carburettor had become contaminated with water. The fuel tank cap on one tank had a defective seal. This accident was not the subject of an on scene investigation.

Occurrence summary

Investigation number 198900239
Occurrence date 14/06/1989
Location Karratha Airport
Report release date 27/06/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Cessna Aircraft Company
Model 182
Registration VH-AOB
Serial number 18261772
Operation type Charter
Departure point Karratha WA
Destination Onslow WA
Damage Substantial

Hughes 269B, VH-XXM, Parafield SA, 18 March 1989

Summary

The pilot had only just taken delivery of the helicopter. After attending a party he invited an acquaintance to inspect the aircraft and listen to a compact disc player which was installed. The pilot stated that the helicopter battery did not seem to have much charge and since he knew the aircraft was to be used in the morning, he decided to start the engine. He believed that there was a note in the Flight Manual stating not to leave the engine running too long without engaging the main rotors. He therefore engaged the rotor and the next thing he could recall was that the helicopter was on its right side. The pilot, although the owner of the helicopter, was not qualified or authorised for night flying. He had consumed some alcohol at the party, and there is some doubt as to whether a takeoff had been intended. Nevertheless, by starting the engine and engaging the main rotor, the pilot should have been aware that an inadvertent takeoff was possible.

Occurrence summary

Investigation number 198900803
Occurrence date 18/03/1989
Location Parafield
Report release date 03/07/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Loss of control
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Hughes Helicopters
Model 269
Registration VH-XXM
Serial number 14-0014
Sector Helicopter
Operation type Private
Departure point Parafield SA
Destination Parafield SA
Damage Substantial

Cessna 414A, VH-SDV, 15 km north of Wonthaggi, Victoria, on 27 October 1989

Summary

Circumstances:

The pilot reported that whilst enroute from Essendon to Wonthaggi he descended to the lowest safe altitude of 3600 feet above sea level, lowered the landing gear, reduced power and airspeed to counter the effect of turbulence and entered a holding pattern to the south south west of the Wonthaggi navigation aid. During the holding pattern the aircraft descended until it collided with trees that were 865 feet above sea level. The weather at the time included gale force winds, rain, and low cloud. There were no thunderstorms or microbursts in the area, however, other aircraft reported a very low cloud base and severe turbulence. A few minutes prior to the accident ground witnesses, south south west of the accident site, reported an aircraft matching the description of VH-SDV, flying below a low, misty, ragged cloud base. There was no record of another aircraft in the area at the time. Information was available which indicated that the aircraft had descended below 3600 feet during the approach to Wonthaggi. The passengers reported that the pilot gave no indication of any problem or danger. Until the impact, they believed the aircraft was descending normally for a landing at Port Welshpool. No aircraft defects were found which may have been factors in the accident. The investigation indicates that the pilot attempted to fly under the low cloud base, in order to reach the Port Welshpool destination where weather conditions were earlier reported to have been partially sunny. Port Welshpool is not serviced by an approved navigation aid.

Significant Factors:

The following factors were considered relevant to the development of the accident:

1. The pilot attempted to descend below the cloud base, hoping to achieve visual flight conditions to continue to his destination.

Occurrence summary

Investigation number 198901558
Occurrence date 27/10/1989
Location 15 km north of Wonthaggi
State Victoria
Report release date 27/09/1990
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Cessna Aircraft Company
Model 414
Registration VH-SDV
Serial number 414A0261
Sector Piston
Operation type Charter
Departure point Essendon VIC
Destination Port Welshpool VIC
Damage Destroyed

Cessna 210L, VH-BBI, 2 km SW of Point Plomer NSW, 4 January 1988

Summary

The aircraft was cruising just inland of the beach at 1500 feet when the pilot noted smoke, accompanied by a strong burning smell entering the cabin from the lower right hand side air vent. Almost immediately the engine suffered a complete loss of power. The pilot carried out a successful wheels-up forced landing on the beach. A fire which had been burning in the nose wheelwell area had apparently been extinguished by seawater and wet sand during the landing slide. Inspection revealed that chaffing had occurred between an electric cable and hydraulic line situated in the wheelwell. Arcing from the electric cable burnt through the hydraulic line, and hydraulic oil under pressure escaped in a fine spray and was ignited by the arcing. This created a torching effect which was directed at the fuel strainer. The heat caused the fuel in the strainer to boil, developing a vapour lock and disrupting the fuel flow to the engine and causing the subsequent engine failure. The chaffing of the cable on the pipe was in such a location that it would have been difficult to see during normal periodic or pre-flight inspections.

Occurrence summary

Investigation number 198802338
Occurrence date 04/01/1988
Location 2 km SW of Point Plomer
Report release date 17/03/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Fire
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Cessna Aircraft Company
Model 210
Registration VH-BBI
Serial number 21060471
Operation type Private
Departure point Bankstown NSW
Destination Maryborough QLD
Damage Substantial

Cessna P206, VH-SIR, Bathurst Island Airport NT, 18 February 1989

Summary

A trench had been dug across the apron during the installation of aerodrome lighting. It had been back filled with earth. Whether the compacting was inadequate or whether the rain had been exceptionally heavy is not known, but heavy rain had made the earth fill very soft. The pilot landed just after a very heavy rain shower had passed through the area. There was about 2 cm of water covering the ground which made it near impossible to see the trench. When the aircraft's nosewheel entered the soft earth the aircraft veered sharply to the left and travelled about two metres before the nose gear hit a concrete pad and collapsed. Because the trench was almost impossible to see from the cockpit of the aircraft it is considered that it was a hidden hazard. The trench had not been marked by unserviceability cones. This accident was not the subject of an on-site investigation.

Occurrence summary

Investigation number 198900802
Occurrence date 18/02/1989
Location Bathurst Island Airport
Report release date 17/03/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Cessna Aircraft Company
Model 206
Registration VH-SIR
Serial number P2060108
Operation type Private
Departure point Pickertaramoor NT
Destination Bathurst Island NT
Damage Substantial

Cessna 207A, VH-MNN, 33 km south-south-east of Jabiru, Northern Territory, on 7 January 1991

Summary

Circumstances:

The aircraft was nearing the completion of a scenic flight, maintaining about 800 feet above ground level, when the engine power reduced to 20 inches hg manifold pressure. The engine continued to run smoothly but failed to respond when the pilot advanced the throttle. All other means attempted by the pilot to restore the lost power were unsuccessful. The aircraft, which had a full complement of persons on board, was too heavy to maintain height under these conditions. As it was flying over forest the pilot turned the aircraft towards the south-west where a more favourable open area, with a road and an airstrip, was available. This entailed having to cross an escarpment, but due to the aircraft's rate of descent insufficient height remained, committing the pilot to a forced landing in an unsuitable area. The pilot transmitted a distress call, gave the passengers a thorough briefing and prepared the aircraft for the forced landing. The aircraft was slowed down and allowed to sink slowly into the forest, contacting the first tree about seven metres above ground level. It then continued through the trees for 40 metres before coming to rest inverted on the forest floor. All passengers evacuated from the aircraft and were rescued by a helicopter which had responded to the distress call. Inspection of the engine determined that it was capable of developing full power at the time of the accident. The throttle cable was found to have separated from the cast bronze throttle control lever at the fuel/air metering unit on the intake manifold. The serrated steel bush in the throttle control lever at the cable attachment had become loose, causing the hole to wear elongated which reduced the edge distance from the hole to the end of the control lever sufficiently for it to fail when the throttle was opened. This probably occurred during the last take-off. During flight, the bush, which was still attached to the cable ball end by the bolt, was probably in such a position as to operate the lever when the throttle control was moved to reduce power for climb and cruise. As the flight progressed and the cable separated from the lever, in-flight movement and vibration would have moved the throttle towards the closed position, with the subsequent reduction in power. Further inspection found that the assembly of the cable to the lever was incorrect, with the washer from under the bolt head being omitted. This reduced the bearing area at the bolt head to the control lever, with the possibility that the bolt may have only been clamped to the bush assisting any movement of the bush in the lever. Once the steel bush started moving in the softer bronze material the rate of wear would have been rapid. The aircraft had flown 85 hours since the last periodic inspection, at which time it may have been possible to detect the first signs of wear between the bush and the control lever if information advising of this type of fault had been available.

Significant Factors:

The following factors were considered relevant to the development of the accident:

1. Incorrect assembly of the washers on the control cable attachment bolt may have allowed the bush to start moving in the lever.

2. The bush became loose in the control lever, with the subsequent wear elongating the hole allowing the control lever end to fail.

3. The throttle control cable separated from the throttle control lever.

4. The throttle closed sufficiently during flight to reduce engine power.

5. The aircraft was too heavy to maintain flight.

6. The aircraft was operating over an area unsuitable for a forced landing.

7. Wear between the bush and the lever may have been detectable during the previous periodic inspection if advisory information had been available.

Recommendations:

It is recommended that the Civil Aviation Authority consider issuing an Airworthiness Directive (or Advisory Letter) to all owners and operators of aircraft fitted with Teledyne Continental fuel injected engines:

1. Advising of the need for correct installation, assembly and attachment of fuel and mixture control rod end nuts, bolts, and the location of washers to control lever arms, and

2. Instruction for the critical repetitive visual inspection of the lever arm bolt holes and bushings for wear, and bushings for looseness, with the control rod bolt and washers disassembled.

Occurrence summary

Investigation number 199100511
Occurrence date 07/01/1991
Location 33 km south-south-east of Jabiru
State Northern Territory
Report release date 08/07/1991
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Cessna Aircraft Company
Model 207
Registration VH-MNN
Serial number 20700439
Sector Piston
Operation type Charter
Departure point Jabiru NT
Destination Jabiru NT
Damage Destroyed

Cessna 172M, VH-MOU, Moorooduc VIC, 29 January 1989

Summary

The pilot hired the aircraft to make a short local pleasure flight with some friends on board. The aircraft was parked at the southern end of the airfield, pointing north and aligned with the centre of the 1300 metre grass strip. The pilot reported that he started the engine and completed normal engine runup and pre-takeoff checks. He then manoeuvred the aircraft out of the parking position to check for other aircraft on final approach. A takeoff into the north was then commenced. After what the pilot considered was a normal ground roll, the aircraft became airborne. He initially allowed it to accelerate close to the ground before commencing to climb. At an altitude of about 100 feet above the ground and an airspeed of about 60 knots, the engine began to run very roughly. The pilot landed the aircraft back on the strip and commenced braking. He then became aware that the aircraft was not going to stop before the fence at the northern end of the strip. Accordingly, he applied power in an attempt to fly over the fence. This attempt was not successful. The aircraft hit the top wires of the fence and an adjacent gorse hedge, coming to rest 50 metres further on with the nose gear detached. An examination of the engine revealed a number of faulty spark plugs. An opinion was obtained from an engine specialist that the condition of the plugs was consistent with the rough running reported by the pilot. Weather conditions had not been conducive to the formation of carburettor icing.

Occurrence summary

Investigation number 198901532
Occurrence date 29/01/1989
Location Moorooduc
Report release date 16/03/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Cessna Aircraft Company
Model 172
Registration VH-MOU
Serial number 17264583
Operation type Private
Departure point Moorooduc VIC
Destination Moorooduc VIC
Damage Substantial