Narrative:An Embraer ERJ145 sustained substantial damage in a runway excursion accident at Vitória da Conquista Airport, BA (VDC).
On the final segment of a VFR approach to runway 15, the main landing gear and the underside of the aircraft hit a small mound located short of the runway threshold. The aircraft skidded for 300 meters and ended up exiting the runway via its left side. It came to rest at approximately 35 meters from the runway. The aircraft sustained substantial damage.
Probable Cause:
Contributing factors.
- Attention - a contributor.
During the approach, the flight crew's attention was focused on the characteristics of the geographical relief and presence of birds, reducing their awareness as to the maintenance of the approach slope.
- Work-group culture - a contributor.
The group culture of maintaining a low angle of approach led the crew to choose the runway aspect instead of the VASIS as a reference for the approach, making them susceptible to various types of spatial illusion.
- Handling of aircraft flight controls - undetermined.
Taking into account copilot's report that he was not succeeding in correcting the aircraft glide path relative to the runway, one may suppose that he was not applying the appropriate amplitude for such correction.
- Visual illusions - a contributor.
The physical characteristics of the runway 15 (the active one) contributed to a wrong perception of the ideal glide path. The pronounced acclivity of the runway, its width (narrower than the runways on which the crew was accustomed to operate), and the low terrain near the threshold, caused in the pilots a perception that they were above the ideal approach slope, leading them to seek correction, which resulted in an angle of approach below the ideal one.
- Management planning - undetermined.
For the flight in question, the company chose two pilots who had never operated in SBQV. A crewmember with previous experience in the locality would have a higher level of awareness in relation to the specific characteristics of the aerodrome.
- Support systems - a contributor.
No company publications were found that could provide the pilots with guidance on the specifics of SBQV, capable of helping with the management of the risks associated with the operation in that aerodrome.
Accident investigation:
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Investigating agency: | CENIPA Brazil |
Status: | Investigation completed |
Duration: | 6 years and 9 months | Accident number: | A - 512/CENIPA/2016 | Download report: | Final report
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Classification:
Runway excursion (veer-off)
Sources:
» Avião faz pouso de barriga na Bahia (Midiacon, 25-8-2010)
METAR Weather report:
17:00 UTC / 14:00 local time:
SBQV 251700Z 09011KT 9999 FEW010 BKN015 23/18 Q1022=18:00 UTC / 15:00 local time:
SBQV 251800Z 08015KT 9999 SCT015 22/17 Q1021=
Follow-up / safety actions
CENIPA issued 3 Safety Recommendations
Issued: 26-MAY-2017 | To: ANAC | A-512/CENIPA/2016 - 01 |
Take the necessary measures before Passaredo Linhas Aéreas, in order to guarantee company\'s adoption of risk assessment mechanisms for new operations, with subsequent issuance of mitigating measures to ensure operation within acceptable margins of risk. |
Issued: 26-MAY-2017 | To: ANAC | A-512/CENIPA/2016 - 02 |
Take the necessary measures before Passaredo Linhas Aéreas, in order to guarantee that the training delivered by the company includes the transmission of knowledge on how to identify visual illusions, and also that their crews be alerted when a locality susceptible to the occurrence of such phenomenon is identified. |
Issued: 26-MAY-2017 | To: ANAC | A-512/CENIPA/2016 - 03 |
Take the necessary measures before Passaredo Linhas Aéreas, in order to guarantee the adoption of procedures for the identification of possible deficiencies in the professional formation of its pilots, such as on how to interpret and utilize landing aid systems (VASIS, PAPI, etc.). |
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Photos
accident date:
25-08-2010type: Embraer EMB-145LU
registration: HB-JAI
Map
This map shows the airport of departure and the intended destination of the flight. The line between the airports does
not display the exact flight path.
Distance from São Paulo-Guarulhos International Airport, SP to Vitória da Conquista Airport, BA as the crow flies is 1116 km (697 miles).
Accident location: Exact; deduced from official accident report.
This information is not presented as the Flight Safety Foundation or the Aviation Safety Network’s opinion as to the cause of the accident. It is preliminary and is based on the facts as they are known at this time.