Microlights

1 June       

Pegasus Quik:     G-CCPC:    East Fortune Airfield, East Lothian, Scotland
AAIB Synopsis: During start up, the engine suddenly went to a high rpm. The aircraft accelerated over the ground and became airborne with the base bar attached to the front strut. It struck the ground in a field adjacent to the airfield and the pilot died from head injuries eight days later.  It is likely that the pilot started the engine with the hand throttle open and did not free the base bar, reduce the rpm or stop the engine before the aircraft became airborne. The pilot might have survived if he had been wearing his shoulder (diagonal) harness and his helmet had been designed to protect him from rotational head injuries. Four Safety Recommendations are made in this report. Two to the CAA to mandate the embodiment of a starter inhibitor switch on the hand throttle, and to review the exception for a shoulder strap not to be worn. Two to the British Standards Institute regarding the design of helmets used for airborne sports. Safety Actions were also taken by the BMAA, Microlight Panel of Examiners and the pilot’s flying club.  The 60 year old pilot had flown 155hrs with six on type. (AAIB Bulletin 1/2004).

24 March  

Flight Design CT2K:  G-CBDJ:   Beccles Aerodrome, Suffolk
AAIB Summary: The aircraft was on a flight from Temple Bruer airstrip, Lincolnshire to Beccles Aerodrome, Suffolk. The approach was described as “unstable”. The aircraft bounced on landing and probably stalled. The pilot was fatally injured when the aircraft subsequently struck the ground.

The pilot was familiar with his aircraft and in recent practice, but the landing diverged from his intended plan. Given that he was 87 years old and recognised that he would likely have to stop flying in the near future, it is possible that some age-related deterioration in human performance was a factor in this accident. The investigation highlighted a lack of medical guidance for both pilots and medical professionals, as well as a cohort of private pilots who are not subject to an independent professional assessment of age-related deterioration in piloting ability. Four Safety Recommendations have been made to the CAA, three about the Pilot Medical Declaration and one about the revalidation of ratings.  (The pilot held a PPL with 2,677 hrs and 1,621 on type.  (AAIB Bulletin 6/2023). 

Helicopters

20 June          

Guimbal Cabri G2: G-CJEK : Nr Burton in Lonsdale, N. Yorks
AAIB Synopsis: The helicopter departed a private site with the intention of flying a local experience flight. As the helicopter returned to land at the departure point, it made a left turn away from the landing site and began a shallow climb. It began to yaw to the left, initially with a normal attitude before the nose dropped. The helicopter continued to yaw to the left, the nose dropped further and it rapidly descended into a tree. There was an intense post-crash fire. Both occupants were fatally injured. Due to the damage sustained and lack of available evidence, the investigation was not able to reach a definitive conclusion, but a number of possible causes have been identified.  The 66 year old pilot held a PPL (H) and had flown 538 hours with 258 on type.  (AAIB Bulletin 7/2023).

Aeroplanes

26 August

Pitts S-1S:      G-BOXV:  Shobdon Airfield, Herefordshire        

AAIB Summary: During an aerobatic practice flight, G-BOXV was seen to enter a climbing vertical rolling manoeuvre from approximately 420 ft agl. The aircraft yawed right at the top of the manoeuvre which apexed at approximately 1,100 ft agl. During the right yaw, an un-commanded autorotative right roll developed and the aircraft entered a steep nose-down spiral dive. As the pilot attempted to pull out of the ensuing dive, the aircraft experienced an accelerated stall and a rolling departure to the right. At that point there was insufficient height remaining in which to effect a safe recovery and the aircraft struck the ground. The pilot was fatally injured in the accident.  No causal or contributory technical issues were identified during the post-accident examination of the aircraft.
The investigation found that the entry conditions to the initial climbing manoeuvre gave little or no safety margin when the aircraft began to dynamically diverge from the expected flight path at the apex. Entering the manoeuvre with more height and/or speed would likely have increased the pilot’s chances of avoiding the loss of control and/or being able to recover from it safely.  Generic guidance for aerobatic pilots is contained in CAA Safety Sense Leaflet 19 – ‘Aerobatics’.  The 59 year old pilot held a CPL and had flown a total of 1,978 hrs with 530 on type.  (AAIB Bulletin 6/2023).  

19 July  

Aeroprakt A32 Vixxen:  G-ENVV:     Nr Newtownards Airfield, Co. Down, N. Ireland
AAIB Summary: On the evening of 19 July 2022, two pilots were flying circuits around Newtownards Airport in G-ENVV an Aeroprakt Vixxen. After approximately 20 mins of circuits they flew a low pass parallel to Runway 03 followed by a steep right turn passing over several people on the ground. Recorded data showed the aircraft passed over the people with 70° angle of bank at 72 ft above the ground. During this turn the aircraft was seen to descend and hit the ground.
The investigation could not determine exactly why the aircraft descended in the turn but no defects could be found with the aircraft or engine. There was evidence that the aircraft’s electronic displays lost power before the accident and this could have caused a distraction. However, it was being flown in a manner that exposed the aircraft, the occupants and the people on the ground to a high risk of an accident.  The investigation identified several shortcomings in the build process and the registration of the ballistic parachute recovery system, which did not contribute to the outcome. The LAA and CAA have taken action to address these.  During an inspection carried out immediately before the accident the CAA identified shortcomings in the aerodrome’s safety management system, which the CAA stated have now been addressed.  The 44 year old female pilot held a PPL with Night Rating and had flown a recorded 204.6 hrs with a further unrecorded 12.1 hrs.  (AIB Bulletin: 6/2023). 

29 June

Piper PA-28-161:  G-BORL:   Blackpool Airport, Lancs
AAIB Summary: A flying instructor, who held a Class 1 Medical, died inflight whilst flying with a qualified pilot. The pilot was able to land the aircraft safely. A post-mortem concluded that the instructor died from acute cardiac failure. The CAA intends to review the circumstance of this incident to determine if anything can be learnt and if any changes should be made to the current guidance.
The circumstances surrounding the occurrence did not fall within the definitions of an accident or serious incident as defined in ICAO Annex 13, however, the Chief Inspector, in exercise of his powers under the Civil Aviation (Investigation of Air Accidents and Incidents) Regulations 2018, initiated an investigation, treating the occurrence as an incident. The 57year old pilot held a CPL and had flown a total of 8,876 hrs. (AAIB Bulletin 2/2023)

2 April
Piper PA-28R-200: Cherokee Arrow: G-EGVA: 12 nm W of  Le Touquet, France

AAIB Summary: G-EGVA was one of seven aircraft taking part in a club ‘fly-out’ from Wellesbourne Mountford Aerodrome to Le Touquet in France. A line of highly convective cloud was forecast on the intended route in the English Channel. As G-EGVA approached the middle of the Channel, one of its two occupants, who were both pilots, reported to London Information that they were in cloud. The aircraft was operating under visual flight rules and neither of the pilots was qualified to fly in cloud. Shortly after this transmission the aircraft disappeared from radar. An extensive search of the area was coordinated by the UK and French Aeronautical Rescue Coordination Centres but neither the aircraft nor its occupants were found.  It is likely control of the aircraft was lost when the aircraft entered the convective cloud.  The CAA has published an animation and podcast reinforcing the safety messages highlighted in AAIB Special Bulletin S1/2022.  The 69 year old pilot held a PPL and had flown 200 hrs with 4.7 on type.  (AAIB Bulletin 12/2022).

Gliders

24th Sept  

Schlelcher ASW20L:        G-CFRW:         Nr Pulborough, West Sussex
AAIB Synopsis: Shortly after an aerotow takeoff and during a noise abatement turn to the left, the glider released the tow at approximately 300 ft agl. The glider then pitched down rapidly and struck the ground in a nose low attitude at high speed. The pilot was ejected from the aircraft during the accident sequence and was found approximately 26 m from the aircraft. He sustained fatal injuries.
An on-site inspection of the aircraft revealed that the elevator was not connected to the elevator control rod. Two Safety Recommendations have been made; the first to mandate Positive Control Checks and the second to amend the Flight and Operations Manual to include relevant information on the limitations of pitch control using flaps.  The 21 year old pilot had flown 454 hrs with 201 on type.  (AAIB Bulletin 10/2023).




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