Aviation safety investigations & reports

Engine failure involving Saab 340B, VH-RXX, near Merimbula, New South Wales, on 29 August 2019

Investigation number:
AO-2019-046
Status: Completed
Investigation completed
Phase: Final report: Dissemination Read more information on this investigation phase

Final Report

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What happened

On the evening of 29 August 2019, a Regional Express Saab 340B, registered VH-RXX, departed Moruya, New South Wales. The aircraft was performing a scheduled passenger service to Merimbula, New South Wales. At the time, the aircraft’s right engine was being monitored for high oil consumption.

Soon after top of climb, the flight crew received an engine fire indication from the right engine. While conducting the engine fire checklist, the engine surged and then failed. A cabin crew member reported seeing a brief flash of light from the right side of the aircraft. The flight crew then shut the engine down.

Based on the close proximity to the destination, the flight crew decided to continue to Merimbula Airport. The aircraft landed without incident at about 1950.

What the ATSB found

The engine failed as a result of an internal oil fire, which weakened a turbine disk and resulted in turbine blades being released. The fire occurred when oil leaked from an oil sump due to carbon deposits, known as coking, within that oil sump. The coking was most likely due to either the component not being completely clean when installed at the last major overhaul and/or accelerated coking on the component.

What's been done as a result

The engine manufacturer has enhanced the troubleshooting procedures to identify internal engine oil leaks more effectively and developed enhancements to the overhaul facility cleaning procedure for the affected oil sump.

Safety message

This incident highlights the importance, when piloting multi-engine aircraft, of maintaining the ability to operate with one engine inoperative. Aircraft turbine engines are complex, and can fail for reasons that are rare and difficult to identify prior to the failure. In this occurrence, the maintainers had followed the correct troubleshooting procedure but were unable to determine the reason for the high oil consumption. The crew’s skill and knowledge, however, along with the built-in redundancies of the system ensured the overall safety of the flight.

Download final report
[Download  PDF: 481KB]
 
 
 

The occurrence

General details
Date: 29 August 2019   Investigation status: Completed  
Time: 2245 EST   Investigation level: Short - click for an explanation of investigation levels  
Location   (show map): 28 km north-east of Merimbula Airport   Investigation phase: Final report: Dissemination  
State: New South Wales   Occurrence type: Engine failure or malfunction  
Release date: 13 August 2020   Occurrence category: Incident  
Report status: Final   Highest injury level: None  

Aircraft details

Aircraft details
Aircraft manufacturer Saab Aircraft Co.  
Aircraft model 340B  
Aircraft registration VH-RXX  
Serial number 340B-209  
Operator Regional Express  
Type of operation Air Transport Low Capacity  
Sector Turboprop  
Damage to aircraft Minor  
Departure point Moruya, New South Wales  
Destination Merimbula, New South Wales  
Last update 26 August 2020