Aerosucre B732 at Puerto Carreno on Feb 3rd 2022, engine failure on takeoff
Last Update: April 10, 2023 / 17:59:20 GMT/Zulu time
Incident Facts
Date of incident
Feb 3, 2022
Classification
Incident
Airline
Aerosucre Colombia
Departure
Puerto Carreno, Colombia
Destination
Bogota, Colombia
Aircraft Registration
HK-5192
Aircraft Type
Boeing 737-200
ICAO Type Designator
B732
A video, that became viral, shows the aircraft a low height crossing just above the wires, treetops and roofs of houses about 250 meters/800 feet past the runway end. The trees immediately reacted to the aircraft's wake turbulence (however, no actual contact between aircraft and trees is visible) leading to claims the aircraft had hit the treetops, which dropped leaves as result.
Company pilots reported later, that one of the engines had overheated and power was lost from the engine, which climbed out at only 50% thrust available. The aircraft returned to Puerto Carreno for an emergency landing a few minutes later.
On Mar 4th 2022 Colombia's Aeronautica Civil reported the occurrence was rated a serious incident and is being investigated by Colombia's Direccion Tecnica de Investigacion de Accidentes (CDTIA). The CDTIA released their preliminary report in Spanish summarizing the sequence of events as follows:
The aircraft commenced takeoff on runway 07 at maximum takeoff power, winds from 060 degrees at 4 knots in daylight visual meteorologic conditions, V1 had been computed at 130 KIAS, Vr at 132 KIAS and V2 at 138 KIAS. According to the crew reports all parameters remained normal during the takeoff roll, the aircraft rotated and became airborne, the landing gear was selected up, while the gear was moving the aircraft struck the top of a tree. Immediately following this contact the left hand engine (JT8D) generator failed and the left hand engine lost power. The crew performed the related checklists and with the parameters present decided to restart the left hand engine. The engine started and stabilized, however indicated high temperatures. The aircraft climbed to 2500 feet, the crew decided to return to Puerto Carreno requesting ground support. The crew was unsure whether the landing gear had been compromised during the contact, the crew extended and retracted the landing gear with satisfactory results. The crew computed Vref at 135 KIAS with flaps at 40 degrees and landed safely on runway 07 about 20 minutes after departure. After landing the aircraft turned around to backtrack runway 07 back to the apron when emergency services reported smoke from the left hand engine, no fire was observed. The crew shut the engine down and taxied to the apron.
An inspection of the aircraft the following day revealed vegetation embedded in several joints of the slats, leading edge of the left wing and engine #1, ingestion of vegetation by the left hand engine was evident.
The tree struck at position N6.1902 W67.4836 was 14 meters (46 feet) high and located 295 meters past the runway end.
On Apr 10th 2023 Colombia's Aeronautica Civil released their final report in Spanish only (Editorial note: to serve the purpose of global prevention of the repeat of causes leading to an occurrence an additional timely release of all occurrence reports in the only world spanning aviation language English would be necessary, a Spanish only or no release does not achieve this purpose as set by ICAO annex 13 and just forces many aviators to waste much more time and effort each in trying to understand the circumstances leading to the occurrence. Aviators operating internationally are required to read/speak English besides their local language, investigators need to be able to read/write/speak English to communicate with their counterparts all around the globe).
The report concludes the probable causes of the serious incident were:
- Late Rotation caused by extreme conditions of aircraft weight and density altitude, that did not permit the aircraft to achieve a sufficient climb rate, climb angle and altitude to clear the obstacles in the takeoff trajectory
- takeoff with more aircraft weight than permitted by performance calculations. This weight together with the density altitude caused the aircraft to cover a longer takeoff roll distance consequently reducing the safety margin to avoid obstacles in the takeoff trajectory causing the aircraft to collide with a natural obstacle immediately after takeoff rotation and during initial climb.
Contributing factors were:
- Overconfidence by the crew assuming they would lose sufficient weight during taxi for departure rendering their gross weight within the performance calculations
- Low situational awareness by crew and dispatch which influenced the decision to continue the takeoff under limited performance conditions
- Weaknesses in the operational control and management by the operator's dispatch by not adequately briefing the crew to take into account the atmospheric conditions (ambient temperature, above all) would change at takeoff time and thus would affect the takeoff performance.
- Lack of risk management by the crew and the operator's Operational Safety to anticipate the conditions that would affect an aircraft's performance on a limited runway at high ambient temperatures.
The investigation analysed that the aircraft weighed an estimated 109,836 lbs (including 16,866 lbs of fuel) at the apron. According to the manual the aircraft's maximum takeoff weight was 109,000 lbs, the minimum fuel needed to Bogota was 15,970 lbs. The investigation found that the weight of three occupants of the aircraft was not included in the weight and balance computations.
Based on the assumed takeoff weight of 108,877 lbs the V speeds would have been: V1=128 KIAS, Vr=130 KIAS, V2=137 KIAS.
The aircraft actually took off at 108,577 lbs, however, due to the increased ambient temperature at 33.9 degrees C, 1.9 degrees above planned temperature, the maximum takeoff weight was 107,950 lbs, thus the aircraft was 606 lbs over weight.
The crew was aware that they were overweight for departure according to CVR transcript, the first officer annotated they were about 500 lbs over weight with 109,036 lbs of takeoff weight (compared to the limit of 108,500 lbs computed for a departure with 32 degrees C).
Despite that overweight, with both engines operating, the aircraft should have cleared the obstacle by 90 feet. There had been no engine failure on takeoff. Even IF an engine had failed, the aircraft should have cleared the runway end at 35 feet AGL and the aircraft should have cleared the obstacle by 60 feet.
During the takeoff run it was noticed that the captain pushed the yoke forward twice without a change in attitude of the aircraft, a backward pressure became visible only at 138 KIAS. However, the aircraft became airborne only at 151 KIAS. Immediately after the aircraft became airborne and established a positive rate of climb the #1 engine's EPR was lost, when the aircraft hit the tree. It thus is clear that upon applying back pressure there was no positive climb reponse of the aircraft until additional speed had been gained.
The first officer reported that he made the rotate call, but the captain did not immediately rotate, perhaps to get more speed for rotation.
The CVR revealed complacency by the crew, none of the crew members questioned the takeoff weight or the ambient temperature or suggested to wait until the temperature had dropped again.
The investigation analysed that there were surprising similiarities with the crash of another company Boeing 727-200 in the year 2016, see Crash: Aerosucre B722 at Puerto Carreno on Dec 20th 2016, overran runway on takeoff.
Incident Facts
Date of incident
Feb 3, 2022
Classification
Incident
Airline
Aerosucre Colombia
Departure
Puerto Carreno, Colombia
Destination
Bogota, Colombia
Aircraft Registration
HK-5192
Aircraft Type
Boeing 737-200
ICAO Type Designator
B732
This article is published under license from Avherald.com. © of text by Avherald.com.
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