Investigation number
200200035
Occurrence date
Location
9 km E Horn Island, Aero.
State
Queensland
Report release date
Report status
Final
Investigation type
Occurrence Investigation
Investigation status
Completed
Aviation occurrence category
Loss of control
Occurrence class
Accident
Highest injury level
Fatal

The pilot of a Cessna 206 (C206), departed from Badu Island, Qld at about 1210 Eastern Standard Time (EST) on a positioning flight to Horn Island, Qld in accordance with the visual flight rules (VFR). The aircraft had an estimated fuel endurance of 270 minutes. The pilot, who was the sole occupant, had been tasked to conduct a charter flight from Horn Island at 1330 with passengers who were reported as arriving on a scheduled flight from Cairns.

At about 1221 the pilot broadcast on the Torres Mandatory Broadcast Zone (MBZ) frequency that he was over Wednesday Island and tracking for a 3 NM final approach to runway 26 at Horn Island. A short time later he broadcast that he was holding until the weather over the runway cleared. At about 1238 the pilots of two aircraft in the Bamaga area reported hearing a MAYDAY broadcast from the pilot of the C206 on the MBZ frequency. The pilot did not describe the nature of the emergency. Further efforts by the pilots operating in the Bamaga area to contact the pilot of the C206 were unsuccessful and they advised air traffic services of the MAYDAY they had heard on the MBZ frequency.

An air and sea search was commenced. Later that day floating debris, identified as belonging to the C206, was located. The recovered items included the left main wheel and landing gear leg, the nose wheel and part of the nose gear landing leg and a seat. The following day divers located the aircraft approximately 3 NM east of Horn Island in 7 m of water but the pilot was not found.

The aircraft was recovered from the sea floor where it had been submerged for just over two days. It had been extensively damaged by impact forces. The nature of the recovery process resulted in further disruption of the wreckage. The outer left wing, left aileron and the engine cowls were not recovered. Salt-water corrosion had affected many of the aircraft components. The flaps were found in the retracted position and damage to the propeller blades was consistent with low engine power at the time of impact. Damage was consistent with the aircraft having struck the water at a moderate to high speed in a nose-down, left wing low attitude. The collision with the water was not survivable.

Examination of the damaged gyroscopic flight instruments did not reveal any indication of pre-impact malfunction. The vacuum pump was found in good condition and capable of normal operation. Although the aircraft was equipped with appropriate instrumentation for flight in instrument meteorological conditions (IMC) it was maintained to the VFR standard, as appropriate to the category of operation. Maintenance requirements were certified as having been performed and no evidence was found to indicate that the aircraft was other than serviceable prior to the flight. Analysis of recorded audio data determined that engine operation was normal during the pilot's radio transmissions.

The pilot was reported to have obtained a forecast from Airservices electronic briefing facility using the company computer terminal at Badu Island. That forecast predicted north-westerly stream weather characteristic of conditions normally experienced during the wet season in the Torres Strait area between October and April. The terminal area forecast for Horn Island, valid from 0600 to 1800, indicated light showers of rain and a visibility greater than 10 km. Throughout the forecast period, a temporary deterioration in conditions (up to 60 minutes) was forecast due to thunderstorms, with visibility reduced to 2000 m in rain and a cloud base of 800 ft. Approximately 40 minutes before he departed Badu Island, the pilot received a telephone call from the senior base pilot. The senior base pilot had flown from Badu Island to Horn Island that morning and advised him of the actual weather conditions he had encountered, including 20 minutes holding east of Horn Island while awaiting a rain shower to move from over the aerodrome.

Witnesses reported that the weather conditions at Horn Island aerodrome between 1230 and 1245 were less than visual meteorological conditions. Heavy rain had reduced visibility to less than 100 m. One witness reported seeing lightning to the north of the aerodrome. A Bureau of Meteorology assessment of weather conditions for the area east of Horn Island at the time of the occurrence indicated that the generally low overcast cloud contained embedded thunderstorm cells, with associated heavy rain and a cloud base less than 1,000 ft. The recorded rainfall intensity was heaviest between 1230 and 1300. Weather conditions at Horn Island at the time of the occurrence were described by witnesses as being the most severe seen that season.

The pilot held a Commercial Pilot (Aeroplane) Licence and a valid Class 1 medical certificate. He had obtained his commercial pilot licence in September 2000 and qualified for a command multi-engine instrument rating in April 2001. The pilot's logbook was not found. A compilation of flight time records showed that at the time of the occurrence the pilot had between 270 and 290 hours total flying experience that included approximately 45 hours on type. The company did not require the pilot to maintain IFR currency there was no evidence that the pilot had met recency requirements for instrument flight. The pilot was not reported to be suffering from any physiological condition that may have affected his capability as a pilot. He had been off duty for the two days prior to commencing duty on the morning of the accident.

In July 2001 the pilot moved to the Torres Strait area and gained some occasional flying experience with another operator. In November 2001 the pilot commenced employment with the operator he was working for at the time of the accident as a VFR charter pilot on C182 and C206 aircraft. On 19 November 2001, before commencing operational duties, the pilot had flown a familiarisation flight under supervision of the senior base pilot. On 27 November he had demonstrated proficiency on the C182 in normal and emergency procedures to an approved company check pilot. That flight of one and a half hours also incorporated a short area familiarisation. The pilot was then certified as competent to conduct company charter flights. On 1 December 2001 he flew the C206 while acting in-command under the supervision of the senior base pilot.

The flight was being conducted under the VFR, at an altitude that required the aircraft to remain clear of cloud, and with a minimum flight visibility of 5,000 m. The operator's operations manual instructed pilots to consider uplifting additional fuel for diverting or holding when the forecast indicated elements of weather below the minimum required for the flight. The pilot had departed with ample fuel reserves for holding or diverting. Company pilots reported that diversions and holding, due to rain showers and associated poor visibility, were not unusual during the wet season. The pilot had broadcast his intention to hold until weather conditions improved.

Although the pilot of the C206 had flown in IMC during his training he did not have any instrument flight recency and had very little exposure to tropical wet season weather conditions and its characteristic heavy rain shower activity.

The circumstances of the occurrence were consistent with a loss of control at low level and at an altitude from which recovery was not considered possible. Due to the limited information available to the investigation, the reason for the loss of control could not be determined. However, the circumstances were consistent with VFR flight into IMC.

Aircraft Details
Manufacturer
Cessna Aircraft Company
Model
206
Registration
VH-STL
Serial number
U20603389
Operation type
Charter
Sector
Piston
Departure point
Badu Island, QLD
Departure time
1210 hours EST
Destination
Horn Island, QLD
Damage
Destroyed