ASN Aircraft accident Cessna 208 Caravan 675 C-GURL Addenbroke Island, BC
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Status:Accident investigation report completed and information captured
Date:Friday 26 July 2019
Time:11:02
Type:Silhouette image of generic C208 model; specific model in this crash may look slightly different
Cessna 208 Caravan 675
Operator:Seair Seaplanes
Registration: C-GURL
MSN: 20800501
First flight: 2008
Total airframe hrs:4576
Engines: 1 Pratt & Whitney Canada PT6A-114A
Crew:Fatalities: 1 / Occupants: 1
Passengers:Fatalities: 3 / Occupants: 8
Total:Fatalities: 4 / Occupants: 9
Aircraft damage: Destroyed
Aircraft fate: Written off (damaged beyond repair)
Location:Addenbroke Island, BC (   Canada)
Phase: En route (ENR)
Nature:Domestic Non Scheduled Passenger
Departure airport:Vancouver International Water Airport, BC, Canada
Destination airport:Hakai Pass Seaplane Base, BC (YHC), Canada
Narrative:
Seair Seaplanes was contracted by a remote fishing lodge on the central coast of British Columbia, Canada to provide seasonal transport of guests and supplies between Vancouver International Water Airport (CAM9), BC, and the lodge, which is located about 66 nautical miles north-northwest of Port Hardy Airport (CYZT), BC.
On the morning of the occurrence, four Seair visual flight rules (VFR) flights were scheduled to fly to the central coast of BC, all on float-equipped Cessna Caravan aircraft. The first 3 flights were direct flights to the fishing lodge. Because of poor weather conditions in the central coast region, however, all of the flights were delayed.
After the crews referred to weather cameras along the central coast region, the flights began to depart, but in a different order than originally scheduled. One of Seair’s senior operational staff (operations manager) departed CAM9 at 08:50 aboard C-FLAC. The occurrence aircraft departed at 09:32.
The pilot originally scheduled to fly C-GSAS declined the flight. This pilot had recently upgraded to the Caravan, had never flown to this destination before, and was concerned about the weather at the destination. When Seair’s chief pilot returned to CAM9 at 09:53 after a series of scheduled flights on a different type of aircraft, he assumed the last remaining flight to the lodge and C-GSAS departed CAM9 at 10:24.
After departing the Vancouver terminal control area, the occurrence aircraft climbed to 4500 feet above sea level (ASL) and remained at this altitude until 10:23, when a slow descent was initiated. The aircraft levelled off at approximately 1300 feet ASL at 10:44, when it was approximately 18 NM northeast of Port Hardy Airport (CYZT), BC, and 57 NM southeast of the destination.
At 10:50, the occurrence aircraft slowly descended again as the flight continued northbound. During this descent, the aircraft’s flaps were extended to the 10° position. At this point, the occurrence aircraft was 37 NM south-southeast of the fishing lodge. The aircraft continued to descend until it reached an altitude of approximately 330 feet ASL, at 10:56. By this point, the occurrence aircraft was being operated along the coastline, but over the ocean.
C-FLAC departed from the fishing lodge at 10:56 on the return flight to CAM9. C-FLAC flew into the Fitz Hugh Sound and proceeded southbound along the western shoreline. At approximately 11:00, it flew through an area of heavy rain where visibility was reduced to about 1 statute mile (SM). C-FLAC descended to about 170 feet ASL and maintained this altitude for the next 5 minutes before climbing to about 300 feet ASL.
As the southbound C-FLAC entered Fitz Hugh Sound from the north at Hecate Island, the occurrence aircraft entered Fitz Hugh Sound from the south, near the southern tip of Calvert Island. The occurrence aircraft then changed course from the western to the eastern shoreline, and descended again to about 230 feet ASL, while maintaining an airspeed of approximately 125 knots.
The two aircraft established 2-way radio contact. The pilot of C-FLAC indicated that Addenbroke Island was visible when he flew past it, and described the weather conditions in the Fitz Hugh Sound to the occurrence pilot as heavy rain showers and visibility of approximately 1 SM around Kelpie Point. The occurrence pilot then indicated that he would maintain a course along the eastern shoreline of the sound.
At 11:03, the two aircraft were separated by 2 NM and passed each other on reciprocal tracks, approximately 4 NM south of the accident site. The occurrence aircraft maintained a consistent track and altitude for the next 54 seconds, then slowly began a 25° change in track to the west (0.35 NM from the Addenbroke Island shoreline). Seven seconds after the turn started (0.12 NM from the island’s shoreline), the aircraft entered a shallow climb averaging 665 fpm.
At 11:04:55, the occurrence aircraft struck trees on Addenbroke Island at an altitude of approximately 490 feet ASL, at an airspeed of 114 knots, and in a relatively straight and level attitude. The aircraft then continued through the heavily forested hillside for approximately 450 feet, coming to rest at an elevation of 425 feet ASL, 9.7 NM east-southeast of the destination fishing lodge.
The aircraft was destroyed by the impact forces and the pilot and three of the eight passengers were killed.

Probable Cause:

Findings as to causes and contributing factors:
1. The flight departed Vancouver International Water Aerodrome even though the reported and forecast weather conditions in the vicinity of the destination were below visual flight rules minima; the decision to depart may have been influenced by the group dynamics of Seair pilots and senior staff at the flight planning stage.
2. The pilot continued flight in reduced visibility, without recognizing the proximity to terrain, and subsequently impacted the rising terrain of Addenbroke Island.
3. The configuration of the visual and aural alerting systems and the colouration ambiguity in the primary flight display of the Garmin G1000 was ineffective at alerting the occurrence pilot to the rising terrain ahead.
4. The occurrence pilot’s attention, vigilance, and general cognitive function were most likely influenced to some degree by fatigue.

Accident investigation:
cover
Investigating agency: TSB Canada
Status: Investigation completed
Duration: 1 year and 8 months
Accident number: A19P0112
Download report: Final report

Classification:
Insufficient rest / fatigue
VFR flight in IMC
Controlled Flight Into Terrain (CFIT) - Mountain

Sources:
» vancouverisland.ctvnews.ca
» thestar.com


Photos

photo of Cessna-208-Caravan-675-C-GURL
accident date: 26-07-2019
type: Cessna 208 Caravan 675
registration: C-GURL
photo of Cessna-208-Caravan-675-C-GURL
accident date: 26-07-2019
type: Cessna 208 Caravan 675
registration: C-GURL
photo of Cessna-208-Caravan-675-C-GURL
flight track
photo of Cessna-208-Caravan-675-C-GURL
accident date: 26-07-2019
type: Cessna 208 Caravan 675
registration: C-GURL
 

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 Vancouver International Water Airport, BC to Hakai Pass Seaplane Base, BC as the crow flies is 442 km (276 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.
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