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Air crashes: Flight crew ignored cockpit danger warnings –AIB

 

The Accident Investigation Bureau (AIB) has released six final accident and serious incident reports that occurred in the Nigeria’s aviation industry between 2009 and 2014.

 

The most striking of the crashes was the Associated Airline carrying the remains of former Minister of Aviation and former Governor of Ondo State, Dr. Olusegun Agagu, which occurred less than one minute after take-off at the Murtala Muhammed Airport, Lagos on October 3, 2013 near aviation fuel dump.

 

The report equally identified inadequate regulatory oversight as the airplane did not go through the mandatory maintenance checks.

 

There was also poor Crew Resource Management (CRM) as the Captain of the ill-fated aircraft and his First Officer and entire crew worked at cross purposes before and during take-off of the aircraft.

 

The aircraft came down at 118 meters after take-off, killing all on board with the exception of four people who sustained major injuries.

 

The AIB report stated that take-off should have been aborted when the crew noticed defects with the airplane, but decided to continue with the flight.

 

The report indicated that the Pilot Flying (PF) and the entire crew ignored all signs on their equipment, Emnraer120ER, registration 5N-BJY, a charter flight, scheduled to depart Lagos to Akure on an Instrument Flight Rules (IFR).

 

According to the report released by AIB Commissioner, Akin Olateru, an aircraft engineer, “The Captain was the Pilot Flying (PF) and the First Officer was the Pilot Monitoring (PM). The aircraft departed with No. 1 Engine torque indicator stuck at 76 per cent. A crew-derived non-standard procedure was used to set the No. 1 Engine take-off power, as the torque indicator is the primary gauge for setting power.

 

“After take-off power was set, a take-off flap configuration aural warning came on, indicating that the flap position did not agree with the selection.”

 

The report equally cited Associated’s crash causal factor on the decision of the crew to continue the take-off despite the abnormal number two propeller indication warning and the low altitude stall as a result of low thrust at start of roll for take-off from number two engine caused by an undetermined malfunction of the propeller control unit.

 

On the contributory factor, the AIB’s release fingered the aircraft being rotated before attaining V1, the decision to continue the take-off with flap configuration warning and auto-feather warning at low speed, poor professional conduct of the flight crew, inadequate application of Crew Resource Management (CRM) principles, poor company culture and inadequate regulatory oversight.

 

Among the six reports released were two accidents and four serious incidents.

 

Another accident report released was that of Westlink Airlines Limited Piper Aztec 23-250 aircraft with the registration number 5N-BGZ, which occurred at Matseri Village, Bunza Local Government Area of Kebbi State on August 11, 2014.

 

The serious incidents were Aero Contractor’s DHC-8-400 aircraft incident with registration 5N-BPT, with the Nigerian Aviation Handling Company (NAHCO) baggage loader on April 29, 2014 and another incident involving two Bristow Helicopters aircraft, Bell 412 helicopters with registration numbers 5N-BGS, and 5N-BDD, at the Addax Base Helipad, Calabar, Cross River State, Nigeria on 12th November, 2009.

 

Also covered were the serious incidents involving two aircraft belonging to Nigerian College of Aviation Technology (NCAT). They were the Tampico Club TB9 with the registration number 5N-CBE, which serious incident occurred at Zaria Aerodrome, Kaduna State on October 4, 2012 and another serious incident involving Tampico TB–9 Aircraft with registration number 5N-CBI that occurred at the same Zaria Aerodrome on May 23, 2012.

 

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