Status: | Accident investigation report completed and information captured |
Datum: | Mittwoch 1 Dezember 1993 |
Zeit: | 19:50 |
Flugzeugtyp: | British Aerospace 3101 Jetstream 31 |
Operated by: | Express Airlines I |
On behalf of: | Northwest Airlink |
Kennzeichen: | N334PX |
Werknummer: | 706 |
Baujahr: | 1986 |
Betriebsstunden: | 17156 |
Anzahl Zyklen der Zelle: | 21593 |
Triebwerk: | 2 Garrett TPE331-10 |
Besatzung: | Todesopfer: 2 / Insassen: 2 |
Fluggäste: | Todesopfer: 16 / Insassen: 16 |
Gesamt: | Todesopfer: 18 / Insassen: 18 |
Sachschaden: | Zerstört |
Konsequenzen: | Written off (damaged beyond repair) |
Unfallort: | 5,4 km (3.4 Meilen) NW of Hibbing-Chisholm Airport, MN (HIB) ( USA)
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Flugphase: | Annäherung (APR) |
Betriebsart: | Inländischer planmäßiger Passagierflug |
Flug von: | Minneapolis-St. Paul International Airport, MN (MSP/KMSP), USA |
Flug nach: | Hibbing-Chisholm Airport, MN (HIB/KHIB), USA |
Flugnummer: | 5719 |
Unfallbericht:Flight 5719 departed Minneapolis at 8:52, 42 minutes late. The delay was due to the late arrival of the aircraft, replacement of the landing light bulbs, and removal of a passenger because the aircraft was 130 pounds over the MTOW.
The flight was cleared for a runway 31 ILS approach, but the flight crew requested (and were cleared for) a localizer back course approach to runway 13 because there was a tailwind on the approach to runway 31 and the runway was covered with precipitation. The flight crew initiated the approach procedure by joining the HIB 20 DME arc from the HIB VOR and intercepting the localizer at 8000 feet msl. The delayed the start of the descent, possibly prompted by a desire to minimize time in icing conditions. This subsequently required an excessive rate of descent to reach the final approach fix and minimum descent height for the nonprecision approach. The aircraft descended at 2250 ft/min and was 1200 feet above the minimum altitude when overhead the KINNY final approach fix (at 14 DME). The aircraft continued its descent and descended through the 2040 feet step down altitude from 14 to 10 DME at around 2500 feet/min. The aircraft finally struck the top of a tree, continued and struck a group of aspen trees 634 feet later. The plane struck two ridges and came to rest inverted and lying on its right side.
Probable Cause:
PROBABLE CAUSE: " The captain's actions that led to a breakdown in crew coordination and the loss of altitude awareness by the flight crew during an unstabilized approach in night instrument meteorological conditions. Contributing to the accident were: the failure of the company management to adequately address the previously identified deficiencies in airmanship and crew resource management of the captain; the failure of the company to identify and correct a widespread, unapproved practice during instrument approach procedures; and the Federal Aviation Administration's inadequate surveillance and oversight of the air carrier."
Accident investigation:
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Investigating agency: | NTSB |
Status: | Investigation completed |
Duration: | 174 days (6 months) | Accident number: | NTSB/AAR-94-05 | Download report: | Final report
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Informationsquelle:
» NTSB Safety Recommendations A-94-113/117
» NTSB/AAR-94/05
Sicherheitsempfehlungen
NTSB issued 5 Safety Recommendations
Issued: 13-JUN-1994 | To: FAA | A-94-113 |
DEVELOP SPECIFIC GUIDANCE FOR THE EVALUATION AND OVERSIGHT OF CONTRACT TRAINING PROGRAMS USED BY AIR CARRIERS AND INCORPORATE SUCH GUIDANCE INTO FAA ORDER 8400.10 FOR FAA PRINCIPAL INSPECTORS TO USE IN APPROVING TRAINING PROGRAMS. (Closed - Acceptable Action) |
Issued: 13-JUN-1994 | To: FAA | A-94-114 |
ISSUE AN AIR CARRIER OPERATIONS BULLETIN DIRECTING PRINCIPAL OPERATIONS INSPECTORS TO ADVISE AIR CARRIERS TO REEMPHASIZE IN PILOT TRAINING MATERIALS THE NECESSITY FOR ADHERING TO THE MAXIMUM DESCENT RATE OF 1,000 FEET PER MINUTE AFTER PASSING THE FINAL APPROACH FIX, REGARDLESS OF THE EXISTENCE OF ICING CONDITIONS. (Closed - Acceptable Action) |
Issued: 13-JUN-1994 | To: FAA | A-94-115 |
BASED ON THE CIRCUMSTANCES AND FINDINGS OF THE INVESTIGATION OF THE EXPRESS II AIRLINES ACCIDENT AT HIBBING, MINNESOTA, ON DECEMBER 1, 1993, DEVELOP A CLEAR AND SPECIFIC DIRECTIVE TO FLIGHT STANDARDS INSPECTORS AND MANAGERS THAT EMPHASIZES THE NEED FOR COMPLIANCE WITH EXISTING FAA ORDERS, DIRECTIVES, AND OTHER GUIDANCE MATERIAL DURING THE CERTIFICATION AND SURVEILLANCE OF COMMUTER AIR CARRIERS. (Closed - Acceptable Alternate Action) |
Issued: 13-JUN-1994 | To: FAA | A-94-116 |
ISSUE AN AIRWORTHINESS DIRECTIVE REQUIRING OPERATORS OF TWO PILOT AIRPLANES, INCLUDING THE JETSTREAM 3100/3200, PRESENTLY EQUIPPED WITH ONLY THE LEFT WING ICE OBSERVATION LIGHT TO INSTALL A RIGHT WING ICE OBSERVATION LIGHT. (Closed - Unacceptable Action) |
Issued: 13-JUN-1994 | To: FAA | A-94-117 |
AMEND 14 CFR PART 23.1419, SECTION (D), TO REQUIRE THAT AIRPLANES CERTIFICATED FOR TWO-PILOT OPERATION BE CONFIGURED WITH ICE OBSERVATION LIGHTS ILLUMINATING BOTH WINGS. (Closed - Unacceptable Action) |
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Fotos
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 Minneapolis-St. Paul International Airport, MN to Hibbing-Chisholm Airport, MN as the crow flies is 278 km (174 miles).
Accident location: Exact; as reported in the 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.