Mid-air collision Accident Beechcraft D95A Travel Air VH-AEM,
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ASN Wikibase Occurrence # 233074
 
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Date:Wednesday 19 February 2020
Time:c. 11:25
Type:Silhouette image of generic BE95 model; specific model in this crash may look slightly different    
Beechcraft D95A Travel Air
Owner/operator:Private
Registration: VH-AEM
MSN: TD-682
Year of manufacture:1966
Fatalities:Fatalities: 2 / Occupants: 2
Other fatalities:2
Aircraft damage: Destroyed
Category:Accident
Location:near Mangalore Airport, VIC (YMNG) -   Australia
Phase: En route
Nature:Training
Departure airport:Melbourne-Tyabb Airport, VIC (YTYA)
Destination airport:Mangalore Airport, VIC (YMNG)
Investigating agency: ATSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
A Piper PA-44-180 Seminole (VH-JQF) and a Beechcraft D95A Travel Air (VH-AEM) suffered a mid-air collision at about 4100 feet, east Mangalore Airport (YMNG), Victoria, Australia. Both occupants in each aircraft were killed and the aircraft were destroyed.
The Beech Travel Air had departed Melbourne-Tyabb Airport at 10:55 hours on a training flight to Shepparton via Mangalore, and return to Tyabb. On board were an instructor and student.
At 11:11, the pilot of the Seminole, contacted air traffic control (ATC) to advise that the aircraft was taxiing for departure from Mangalore Airport. The pilot had submitted a flight plan for a round-trip IFR flight for Mangalore via Essendon and Shepparton. Also on board was an authorised testing officer, who was testing the pilot for an instrument flight rating.
The Travel Air tracked as per the flight plan and, at 11:17, began a descent from 6,000 ft above mean sea level (AMSL) for airwork at Mangalore. Radio communication with ATC indicated the airwork was to occur between 4,000 ft and ground level.
At 11:19, the air traffic controller passed traffic information to VH-AEM about VH-JQF departing from Mangalore. At 11:22, VH-JQF made a departure call from Mangalore, advising ATC of a planned climb to 7,000 ft. ATC passed traffic information about VH-AEM to the Seminole crew.
At 11:24 the two aircraft collided approximately 8 km south of Mangalore Airport at approximately 4,100 ft. All four pilots were fatally injured in the accident, and both aircraft were destroyed.

Contributing factors:
- Following receipt of verbal traffic information, the pilots did not successfully manoeuvre or establish direct communications on the common traffic advisory frequency to maintain separation, probably due to the collision risk not being recognised.
- While it is probable that the aircraft were in instrument meteorological conditions, and could not visually separate to avoid the collision; the known limitations of the see-and-avoid principle meant that the pilots were unlikely to have seen each other in sufficient time to prevent the collision even in visual conditions.
- Following receipt of a short term conflict alert, the controller assessed it in accordance with the required procedure. After considering that the pilots had been passed mutual traffic information and were required to ensure their own separation in non‑controlled airspace, the controller did not intervene further.
- While the pilots were responsible for self-separation within the Mangalore common traffic advisory frequency area, they did not have access to the same surveillance data, including automatic dependant surveillance broadcast information available to air traffic control. As a result, the pilots were required to make timely decisions to avoid a collision without the best available information.

Other factors that increased risk
- The En-Route Supplement Australia included a requirement to add 1,000 ft to the prescribed practice instrument approach ‘altitude’ at Mangalore Airport. The procedure did not detail whether this height was to be applied to the minimum descent altitude or to all approach altitudes, resulting in varied application and an increased risk of traffic conflicts. (Safety issue)

Accident investigation:
cover
  
Investigating agency: ATSB
Report number: AO-2020-012
Status: Investigation completed
Duration: 2 years 1 month
Download report: Final report

Sources:

https://www.theguardian.com/australia-news/2020/feb/19/four-people-killed-in-mid-air-collision-between-two-aircraft-in-victoria
https://www.weeklytimesnow.com.au/deaths-feared-after-mangalore-plane-crash/news-story/625174c79beab77367fb4ab70892c16e
https://www.abc.net.au/news/2020-02-19/aircraft-incident-at-mangalore/11980244
https://www.news.com.au/travel/travel-updates/incidents/deaths-feared-after-mangalore-plane-crash/news-story/625174c79beab77367fb4ab70892c16e
https://www.theage.com.au/national/victoria/two-planes-involved-in-crash-in-central-victoria-20200219-p5429t.html
https://www.3aw.com.au/it-doesnt-look-good-planes-crash-near-seymour/
!1e3!4b1!4m5!3m4!1s0x6ad821e4a1cdae27:0x40579a430a07fa0!8m2!3d-36.8908218!4d145.164489?hl=en-us
https://flightaware.com/live/flight/VHAEM
https://www.atsb.gov.au/publications/investigation_reports/2020/aair/ao-2020-012/

https://imgproc.airliners.net/photos/airliners/0/0/8/0507800.jpg?v=v40 (photo)

History of this aircraft

Other occurrences involving this aircraft
31 May 1969 VH-AEM Growan Pty Ltd 0 Wanna Station, Mount Augustus, WA sub
19 January 1996 VH-AEM 0 Tyabb Airfield, Tyabb, VIC sub

Location

Images:


Flight track based on ADS-B data recorded by Flightaware

Media:

Revision history:

Date/timeContributorUpdates
19-Feb-2020 02:39 Geno Added
19-Feb-2020 04:29 RobertMB Updated [Time, Aircraft type, Registration, Cn, Operator, Total fatalities, Total occupants, Other fatalities, Location, Nature, Source, Damage, Narrative]
19-Feb-2020 04:31 RobertMB Updated [Source]
19-Feb-2020 04:41 RobertMB Updated [Total occupants, Phase, Departure airport, Source, Narrative]
19-Feb-2020 06:30 Bidgee Updated [Destination airport, Source]
19-Feb-2020 16:01 Anon. Updated [Destination airport]
19-Feb-2020 16:46 harro Updated [Narrative, Photo]
19-Feb-2020 16:53 harro Updated [Location]
23-Apr-2020 06:21 harro Updated [Nature, Source, Embed code, Narrative]
01-Apr-2022 12:59 harro Updated [Narrative, Accident report]

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