Arall DC3 at Puerto Gaitan on Apr 7th 2016, lost height after engine failure, RPMs inadvertently reduced on good engine
Last Update: April 29, 2020 / 20:34:36 GMT/Zulu time
Colombia's Aeronautica Civil reported the DC-3, registration HK-2663, plunged to ground a few minutes after takeoff at 06:25L (11:25Z), two crew members were injured and were taken to hospitals. Other than Colombian media reported (claiming the aircraft was carrying 14 passengers) the aircraft did not carry passengers. Investigators have been dispatched onto the accident site.
No weather data are available for Puerto Gaitan.
In their preliminary report in Spanish Colombia's Grupo de Investigación de Accidentes & Incidentes Aéreos de Colombia (GRIAA) reported that during the takeoff run from runway 22 the crew heard a sound similiar to an explosion and noticed the engine cover had separated and impacted the left hand propeller. The crew feathered the propeller, the aircraft however began to lose speed and height. The crew therefore decided to put the aircraft down in a field in sight, the aircraft contacted the field's fence, during contact with the ground both propellers and other parts of the aircraft detached, the aircraft came to a stop 1.37nm from the end of runway 22. The aircraft burst into flames, about 60% of the aircraft were consumed by the fire. Two of three occupants were injured, all left the aircraft.
The GRIAA reported that a runway inspection revealed fragments of the left engine's cylinders were found about 614 meters past the threshold runway 22. The examination of the engines is currently in process.
The GRIAA released their final report in Spanish (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 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 accident were:
Incorrect execution of the emergency procedure invoked by the failure of engine #1, when the RPMs of the #2 engine were accidentally reduced causing the right engine's BMEP (brake mean effective pressure) to be exceeded causing the right hand engine to stall, which rendered the aircraft impossible to fly resulting in the forced landing.
Contributing factors were:
- failure of the #1 engine caused by the detachment of a cylinder head duing takeoff.
- poor maintenance procedures that did not anticipate or prevent component failure.
The GRIAA reported the aircraft had diverted to Puerto Gaitan the day before due to weather at Villavicencio. The passengers and luggage were taken to Villavicencio by road. The next day the aircraft was to position to Villavicencio with captain, first officer and an engineer on board.
The captain (61, ATPL, 4,058 hours total, was pilot flying, the first officer (51, CPL, 7,934 hours total) was pilot monitoring, when the aircraft was accelerating for takeoff from Puerto Gaitan's runway 04. Just when the aircraft rotated to become airborne, an explosion was heard from the left hand engine. The captain called for the engine shutdown checklist, the aircraft was beginning to lose speed and height. The crew decided to perform an emergency landing in an open unprepared field with gear and flaps retracted. Upon ground contact the propellers and some other parts of the aircraft detached. The aircraft travelled about 103 meters on the ground before coming to a stop. After the aircraft stopped a fire broke out consuming most of the aircraft, which was fueled by fuel leaking from the left and right hand tanks. The engineer received minor injuries, both pilots remained uninjured. Fire fighters of Puerto Gaitan arrived at the aircraft about 45 minutes after the forced landing.
The GRIAA analysed the accident was caused by a simple chain of events. When the aircraft rotated from runway 04 the crew heard an explosion and felt vibrations from the left engine. The captain reported the engine bonnet detached and hit the propellers. After the crew had performed the checklist for shutting the #1 engine down, they noticed they could no longer maintain height and the speed was decreasing prompting the crew to performed a forced landing in the open field. Following the landing a fire broke out, the crew evacuated the aircraft, local fire services arrived on scene about 45 minutes after the forced landing.
During the field investigtion investigators noticed the position of the RPM levers were not in line with the emergency procedures, the left hand RPM lever was in the full forward position, the right hand RPM lever was in the aft position. The right RPM lever fully closed together with the power lever in the full forward position caused the right hand engine to exceed its operating limits (BMEP) and stall, most likely receiving severe damage in that process too. Quite possibly the crew inadvertently and accidentally closed the RPM lever #2 instead of the lever #1.
This article is published under license from Avherald.com. © of text by Avherald.com.
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