Piper PA28-140, VH-CNL, Cessnock NSW, 9 October 1987

Summary

Following a normal approach for landing during a period of solo circuits, the aircraft touched down heavily and bounced. Attempts by the pilot to recover from the bounced landing resulted in a second more accentuated bounce. Recovery from the second bounce was not effected and the aircraft impacted the runway in a nose low attitude. No pre-existing defects were found which could have contributed to this occurrence.

Occurrence summary

Investigation number 198702429
Occurrence date 09/10/1987
Location Cessnock
Report release date 03/12/1987
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Hard landing
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Piper Aircraft Corp
Model PA-28
Registration VH-CNL
Serial number 76-25254
Operation type Flying Training
Departure point Cessnock NSW
Destination Cessnock NSW
Damage Substantial

Kavanagh D-105, VH-OBF, 5 km S Walkamin QLD, 15 September 1987

Summary

The pilot obtained a weather forecast that indicated that the wind at 2000 feet, in the area of the proposed flight, would be a south-easterly at 20 knots, although the surface wind was a light southerly. After receiving a favourable wind report from the launch site, the pilot and passengers proceeded there, and the pilot carried out two helium balloon flights to check the conditions. Having satisfied himself that the conditions were suitable the passengers were briefed and the balloon was launched. After about twenty minutes the wind strength increased and the pilot decided to land the balloon. The passengers were rebriefed on the landing procedures and the burner pilot light was turned off in preparation for landing. On touchdown, in an estimated 20 knot wind, the basket tipped over and was dragged along the ground for 90 metres before coming to rest. Two of the occupants let go of the grab ropes on touchdown and were thrown from the basket on initial ground impact. During the ground slide two other passengers also let go of the grab ropes, the pilot managed to restrain one and keep her within the basket, however, the other passenger was thrown out of the basket.

Occurrence summary

Investigation number 198703504
Occurrence date 15/09/1987
Location 5 km S Walkamin
Report release date 22/12/1987
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Hard landing
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Kavanagh Balloons
Model D
Registration VH-OBF
Serial number KB034
Operation type Ballooning
Departure point Yungaburra QLD
Destination N/K
Damage Minor

Fokker F27-600, VH-TQS, Roma QLD, 27 July 1986

Summary

The aircraft was scheduled to complete a flight from Brisbane to Townsville with intermediate stops at Blackall, Longreach, Winton, Richmond and Hughenden. The weather forecasts received by the pilot indicated that an alternate destination would be required for Blackall and Longreach. Charleville was suitable as an alternate, however, the terminal weather forecast required the carriage of an additional 30 minutes holding fuel for aircraft planning to land there and the pilot flight planned accordingly. While the aircraft was enroute to Blackall, the weather forecast for Charleville was amended to require the carriage of 60 minutes holding fuel. The amended forecast also rendered Charleville unsuitable as an alternate after 1130 hours. This forecast was not passed to the pilot by either of the two Flight Service Units (FSU) concerned with providing information to the aircraft. The pilot was thus unaware of the change in forecast weather at Charleville. However, prior to landing at Blackall at 0944 hours, the pilot requested and received actual weather reports from both Longreach and Charleville. These reports indicated that Longreach was still available as a destination and Charleville was still suitable as an alternate destination. After departing Blackall the aircraft proceeded to Longreach. The Automatic Terminal Information Service (ATIS) at that station gave the the cloud base as 400 feet and the pilot attempted two instrument approaches. Both of these approaches were unsuccessful and the aircraft was diverted to the alternate, Charleville. Reports of the actual weather at Charleville, which were passed to the pilot before his decision to divert, confirmed that Charleville was a suitable alternate destination. Some 32 minutes later, while enroute to Charleville, the pilot received a report from Charleville FSU that the present weather at that station was a cloud base of 1000 feet, with some lower patches and the visibility to the north was two kilometres in rain. When the aircraft arrived overhead Charleville at the published minima, the pilot reported that it was between cloud layers with about seven eighths of cloud below. He immediately commenced a diversion to Roma and gave the total fuel endurance as 60 minutes. He was then advised that the aircraft had been sighted from the ground as it flew overhead. Prior to his decision to divert, the pilot had been advised that the pilot of another Fokker F27 aircraft, which had just landed at Roma, reported that the weather conditions there were fluctuating about the minima. While the aircraft was enroute, attempts by Charleville FSU to find a more suitable landing point were unsuccessful. Arrangements were then made with an aircraft charter operator at Roma to advise the pilot on the method of approach most likely to achieve a landing. The aircraft subsequently landed at 1227 hours after being forced to descend below the published instrument approach minima. After landing the remaining fuel endurance of the aircraft was approximately 15 minutes. At 1244 hours, another F27 aircraft diverted to Brisbane from overhead Charleville after two missed instrument approaches.

Occurrence summary

Investigation number 198602894
Occurrence date 27/07/1986
Location Roma
Report release date 19/12/1986
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Incident
Highest injury level None

Aircraft details

Manufacturer Fokker B.V.
Model F27
Registration VH-TQS
Operation type Air Transport High Capacity
Departure point Blackall QLD
Destination Longreach QLD
Damage Nil

Boeing 727-276, VH-TBO, Cairns QLD, 18 May 1985

Summary

Twenty-eight nautical miles (nm) west of Cairns the aircraft contacted Cairns Tower and was cleared down to 7600 feet. At 8 nm the aircraft was further cleared to 4400 feet and to carry out a VOR (Visual Omni Range) approach. Further communications with the aircraft alerted the Cairns Tower Controller to the fact that the aircraft was not carrying out the prescribed procedure. The controller then directed the aircraft so as to ensure clearance from terrain and other traffic. A visual approach and landing was then carried out without further difficulty. An investigation was initiated, following a report received six weeks after the event. Readout of the aircraft flight data recorder and the Tower communications recording established that the initial patterns flown were oriented North-South and similar to that required for a VOR approach at Coolangatta rather than the North East-South west configuration of the Cairns VOR pattern. Further enquiry revealed that the flight crew had anticipated carrying out a visual approach and did not become aware of the requirement for a VOR approach until a short time before the aircraft first arrived over the VOR. An incorrect Instrument Approach and Landing chart was then employed because the normal approach briefing and cross-check of charts was not carried out.

Occurrence summary

Investigation number 198503821
Occurrence date 18/05/1985
Location Cairns
Report release date 01/12/1986
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Miscellaneous - Other
Occurrence class Incident
Highest injury level None

Aircraft details

Manufacturer The Boeing Company
Model 727
Registration VH-TBO
Operation type Air Transport High Capacity
Departure point Mount Isa QLD
Destination Cairns QLD
Damage Nil

Piper PA28-235, VH-FAR, Kulpra Station NSW,(38 km SE of Mildura) VIC, 11 September 1987

Summary

The purpose of the flight was to return to Underbool after visiting friends and relatives at Kulpra Station. On DEPARTURE from Underbool the aircraft carried 136 litres of fuel, 68 litres in each main tank, the tip tanks were empty. The flight to Kulpra was conducted using fuel from the right main tank. The pilot stated that at an altitude of about ten feet after lift-off, the engine failed. The aircraft was landed back on the strip, heavily on the nosewheel, and the nosegear subsequently collapsed. The pilot reported that on inspection the fuel tank selector was positioned to draw fuel from the empty left wingtip tank instead of the left main tank.

Occurrence summary

Investigation number 198702418
Occurrence date 11/09/1987
Location Kulpra Station NSW,(38 km SE of Mildura) VIC
Report release date 15/12/1987
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Piper Aircraft Corp
Model PA-28
Registration VH-FAR
Serial number 28-10210
Operation type Private
Departure point Kulpra Station NSW
Destination Underbool VIC
Damage Substantial

Waggon und Maschinenbau AG Phoebus B1, VH-GYC, 13 km SSW Maryborough QLD, 14 January 1987

Summary

The pilot was returning to land after a period of thermalling flight, when severe turbulence was encountered. The pilot's head hit and broke the canopy, and he then had problems with his vision. Heavy sink was also experienced. The pilot stated his last recollection of events was making a left turn towards the airfield at about 150 feet above the ground, and then regaining consciousness in the wreckage. Investigation revealed that the glider had touched down on a 5 metre wide strip between areas of cane growing to about 1.7 metres in height. The left wing caught in the cane and the aircraft slewed violently before coming to rest with the wing completely torn out of the fuselage.

Occurrence summary

Investigation number 198703456
Occurrence date 14/01/1987
Location 13 km SSW Maryborough
Report release date 23/12/1987
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Collision with terrain
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Bolkow-Apparaterbao GmbH
Model Phoebus
Registration VH-GYC
Operation type Gliding
Departure point Glenorchy QLD
Destination Glenorchy (15 km SSW Maryborough) QLD
Damage Substantial

Bergfalke Mk 4, VH-GZM, Lochiel SA, 26 December 1988

Summary

The instructor reported that he was conducting circuits and landings with a student. Several circuits had been completed satisfactorily but on this particular occasion the student delayed making the flare for landing. The instructor was unable to prevent a heavy touchdown which fractured the main skid.

Occurrence summary

Investigation number 198800742
Occurrence date 26/12/1988
Location Lochiel
Report release date 17/04/1989
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Hard landing
Occurrence class Accident
Highest injury level None

Aircraft details

Manufacturer Scheibe Flugzeugbau GmbH
Model Bergfalke
Registration VH-GZM
Serial number N/K
Operation type Gliding
Departure point Lochiel SA
Destination Lochiel SA
Damage Substantial

Grumman American Aviation G44A Widgeon, VH-WET, Daintree, 74km NW of Cairns QLD, 14 December 1987

Summary

Two photographers chartered the aircraft to fly them to a white tropical beach. Enroute to Hope Island, the passengers asked the pilot to land near a beach at the mouth of the Daintree River. After making a water landing on the river, the pilot found that he could not get his passengers and their photographic equipment to the shore because the hull of the aircraft grounded on a sandbank, some 50 Metres from the beach. A decision was then made to takeoff from the water and land on the beach. During the landing , the pilot lost control of the aircraft when one of the mainwheels ran through shallow water. The aircraft nosed over and came to rest inverted.

Occurrence summary

Investigation number 198703526
Occurrence date 14/12/1987
Location Daintree, 74km NW of Cairns
Report release date 04/03/1988
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 Minor

Aircraft details

Manufacturer Grumman American Aviation Corp
Model G-44
Registration VH-WET
Serial number 1466
Operation type Charter
Departure point Cairns QLD
Destination Hope Island QLD
Damage Substantial

Australian Ultralight Industries Bunyip, Needle Creek, (approx 10 km north-east of Jundah), Queensland, on 9 October 1990

Summary

Circumstances:

The pilot was conducting cattle spotting operations, operating from an area of flood plain on the property. After take-off on the accident flight, a right turn was commenced when the aircraft reached about 250 feet above ground level. At the completion of the turn the nose dropped but the pilot was not initially concerned due to the prevailing turbulence. He soon found that he could not raise the nose by use of elevator control. Witnesses saw the aircraft commence to dive, and the attitude of the aircraft change until it was inverted. It remained in this attitude until ground impact. On this aircraft type, the horizontal stabiliser is attached to the fuselage beam by two 5/16-inch diameter rose joints mounted vertically. The all-flying stabiliser is operated by a push-pull rod from the control column. One of the rose joints apparently failed during the flight, causing the pilot to lose control of the horizontal stabiliser.

Occurrence summary

Investigation number 199003130
Occurrence date 09/10/1990
Location Needle Creek, (approx 10 km north-east of Jundah)
State Queensland
Report release date 10/04/1991
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Airframe - Other
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer AW & WE Peters Pty Ltd
Model Bunyip
Registration Unknown
Sector Piston
Operation type Sports Aviation
Departure point Needle Creek QLD
Destination Needle Creek QLD
Damage Substantial

Kavanagh D105 Hot Air Balloon, VH-HUZ, Bullengarook, Victoria, on 7 October 1989

Summary

Circumstances:

The balloon was one of two launched from Sidonia. The operator's Senior Pilot, who was the pilot of the second balloon, obtained a general Area Forecast and a Melbourne Terminal Area forecast by telephone from the Melbourne Flight Service Centre prior to the accident flight. The forecasts, which indicated that conditions would be suitable until an upper ridge passed through the area, were passed to the pilot of VH-HUZ. Conditions were forecast to deteriorate gradually after 0700. The Senior Pilot also contacted a resident in the local area who reported that conditions were clear and there was no wind. A number of weather observation balloons were released and observed by the two pilots, and these confirmed their view that the weather was suitable for flight. The passengers were briefed on the flight including which landing positions to adopt however, some of the passengers have indicated that they were not clear about the contents of the briefing. Both balloons successfully completed one flight of approximately 40 minutes before landing. One of VH-HUZ's gas cylinders was changed and new passengers boarded for a second flight. After take-off, the balloon drifted slowly to the south west for approximately 10 kilometres. The pilot increased altitude to pick up an easterly drift in order to avoid flight over a forest and to drift in the general direction of suitable landing areas. At the completion of the manoeuvre the pilot noticed the ground speed had increased and the balloon was encountering turbulence. Some passengers noticed the trees below were "boiling". The pilot continued towards his selected landing site, which was the last suitable area prior to the balloon crossing thickly wooded countryside, and he advised the passengers to expect a hard landing. The pilot aimed to land beyond a fence line on the up slope of one of two clear hills. The landing area was acceptable and had been used on previous occasions. During the descent, the pilot was forced to change his approach technique because of a powerline in the area. Turbulence on the final approach caused the balloon to lose height more rapidly then expected and it touched down hard 90 metres short of the fence. The basket skipped up the hill as the pilot pulled the parachute vent rip cord in an attempt to spill hot air, deflate the envelope and bring the balloon to a stop. The balloon collided with a fence strainer post, and the pilot was knocked unconscious by the post before he could complete his task. The balloon continued up the hill, struck a second fence, continued down the lee side of the hill and stopped when it became entangled in a large tree approximately 787 metres beyond the initial touchdown point. The forecast wind speed at 2000 feet, at the time of the first flights, was 35 knots and subsequent observations indicate that the forecast was essentially correct. The weather observation balloons did not indicate a high upper wind speed to the pilot although one of the passengers observed a balloon "whip" away once it had reached 1500 to 2000 feet. A weather observation balloon was not released prior to the second take-off. When the passengers were advised by the pilot to prepare for a hard landing, they adopted a squat position rather than the correct position of standing with their knees flexed or bent. The pilot was carrying a portable radio which was thrown from the basket during the landing. There was a delay in activating rescue procedures when the radio could not be located.

Significant Factors:

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

1. The forecast change in the wind and turbulence occurred more rapidly than the pilot had anticipated. The pilot's incorrect expectations partly resulted from his using incomplete weather information. Additional information would have been available had the pilot or his representative contacted the Duty Forecaster and obtained an up-to-date weather assessment prior to the flight.

2. A weather observation balloon was not released prior to DEPARTURE of the second flight although the forecast indicated that significant changes would occur after that time. Had a weather balloon been launched it is possible that the pilot of VH-HUZ would have become aware of the changes and cancelled the flight.

3. During the final stage of the landing the balloon was affected by turbulence, and the pilot was unable to prevent a premature touchdown.

4. Although the passengers had been briefed on the correct landing position not all of them understood the briefing and in the rush of the landing, they adopted a squat position which research indicates can lead to more serious injury.

5. The pilot's attempt to complete the landing sequence was terminated when he was knocked unconscious by a post.

6. The balloon's landing continued unattended until it became entangled in a tree.

Recommendations:

1. The CAA should remind commercial balloon operators to ensure that their pilots take advantage of all the weather forecasting facilities that are available including a briefing from an officer of the Bureau of Meteorology prior to undertaking a commercial flight. Consideration should be given to launching additional weather observation balloons, between flights, if the forecast indicates that significant weather changes are likely to occur during the period of the next flight.

2. The CAA should remind commercial balloon operators to ensure that passengers have a clear understanding of the safety procedures covered during the briefing.

3. The CAA should examine the crashworthiness and survivability aspects of high-speed balloon landings with special emphasis on the positioning and stance of passengers in such a landing.

4. The CAA should examine the need to develop regulations to require radio transceivers carried as mandatory equipment on commercial balloon flights to be secured so as to ensure availability at all times.

Occurrence summary

Investigation number 198901556
Occurrence date 07/10/1989
Location Bullengarook
State Victoria
Report release date 28/11/1990
Report status Final
Investigation type Occurrence Investigation
Investigation status Completed
Mode of transport Aviation
Aviation occurrence category Hard landing
Occurrence class Accident
Highest injury level Serious

Aircraft details

Manufacturer Kavanagh Balloons
Model D
Registration VH-HUZ
Serial number KB074
Sector Balloon
Operation type Charter
Departure point Sidonia VIC
Destination Woodend VIC
Damage Substantial