Aviation safety investigations & reports

Loss of control and collision with water involving Bell UH-1H, VH-UVC, 5 km south-west of Anna Bay, New South Wales, on 6 September 2019

Investigation number:
AO-2019-050
Status: Completed
Investigation completed
Phase: Final report: Dissemination Read more information on this investigation phase

Final report

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What happened

On 6 September 2019, at 1430 Eastern Standard Time,[1] the pilot of a Bell Helicopter Company UH-1H helicopter registered VH‑UVC (UVC) departed Archerfield Airport, Queensland, on a private flight with four passengers for Bankstown, New South Wales.

Following a refuelling stop at Coffs Harbour, New South Wales, the pilot made contact with Williamtown air traffic control (ATC), while north-east of Broughton Island and requested clearance to track south via the visual flight rules (VFR) coastal route. The initial radio calls between the pilot and Williamtown ATC, occurred about 6 minutes prior to the published time of last light. The radio calls indicated that the helicopter was being affected by turbulence and as a result the pilot was having difficulty maintaining a constant altitude. In response, the controller issued a clearance for the aircraft to operate between 2,400 and 3,500 ft.

Once past Anna Bay, and about 11 minutes past published last light, UVC was observed on Williamtown ATC radar to make a left turn to the south, depart the coastal route and head offshore, on a direct track to Bankstown Airport. The turn likely resulted in the pilot losing visual cues and encountering dark night conditions.

The helicopter continued to track offshore to the south-west for about 90 seconds, maintaining between about 2,500 and 3,200 ft before commencing a rapidly descending, left spiral turn. It disappeared from Williamtown radar coverage about 12 minutes after published last light. Attempts by the controller to contact the pilot were unsuccessful and authorities were subsequently advised of a missing helicopter.

On 25 September 2019, wreckage from the destroyed helicopter was located in about 30 m of water, 5 km south‑west of Anna Bay. Two of the five persons on board the helicopter were confirmed to have received fatal injuries. The bodies of the pilot and two of the passengers were not found but they were presumed to have similarly not survived the accident.

What the ATSB found

The ATSB found that the pilot continued to fly after last light without the appropriate training and qualifications, and then into dark night conditions that provided no visual cues. That significantly reduced the pilot's ability to maintain control of the helicopter, which was not equipped for night flight.

Once visual references were lost, the pilot likely became spatially disorientated and lost control of the helicopter, resulting in a collision with water.

Further, the pilot did not disclose on-going medical treatment for significant health issues to the Civil Aviation Safety Authority. That prevented specialist consideration and management of the on‑going flight safety risk the medical conditions and prescribed medications posed.

Safety message

Various ATSB research and investigation reports refer to the dangers of flying after last light without the appropriate qualifications and experience. The ATSB report, Avoidable Accidents No. 7, highlights the risks of visual flight at night. Risks include, reduced visual cues, increased likelihood of perceptual illusions, and spatial disorientation.

A VFR flight in dark night conditions should only be conducted by a pilot with instrument flying proficiency as there is a significant risk of losing control if attempting to fly visually in such conditions. If day VFR‑rated pilots find themselves in a situation where last light is likely to occur before the planned destination is reached, a diversion or precautionary landing is probably the safest option. Air traffic control assistance with available landing options is also available.

This accident also highlights the importance of aviation medical certificate holders reporting relevant conditions and medications to their Designated Aviation Medical Examiner. A full understanding by the Civil Aviation Safety Authority’s aviation medical specialists of a pilot’s medical conditions, and use of medications, enables management of the risk for both the individual and flight safety overall.

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  1. Eastern Standard Time (EST): Coordinated Universal Time (UTC) +10 hours.
Download Final report
[Download  PDF: 4.82MB]
 
 
 

The occurrence

Context

Safety analysis

Findings

Sources and submissions

General details
Date: 06 September 2019   Investigation status: Completed  
Time: 1813 EST   Investigation level: Defined - click for an explanation of investigation levels  
Location   (show map): 5 km south-west of Anna Bay, New South Wales   Investigation phase: Final report: Dissemination  
State: New South Wales   Occurrence type: Collision with terrain  
Release date: 23 June 2021   Occurrence category: Accident  
Report status: Final   Highest injury level: Fatal  

Aircraft details

Aircraft details
Aircraft manufacturer Bell Helicopter Co  
Aircraft model UH-1H  
Aircraft registration VH-UVC  
Serial number 5144  
Operator Brisbane Helicopters  
Type of operation Private  
Sector Helicopter  
Damage to aircraft Destroyed  
Departure point Coffs Harbour, NSW  
Last update 23 June 2021