Descripción del Accidente ASN 08 NOV 2017 Avro RJ85 ZS-ASW - Limpopo province
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Estado:Accident investigation report completed and information captured
Fecha:mircoles 8 noviembre 2017
Tipo:Silhouette image of generic RJ85 model; specific model in this crash may look slightly different
Avro RJ85
Registración: ZS-ASW
Numéro de série: E2313
Año de Construcción: 1997-08-20 (20 years 3 months)
Horas Totales de la Célula:29636
Motores: 4 Lycoming LF507-1F
Tripulación:Fatalidades: 0 / Ocupantes: 4
Pasajeros:Fatalidades: 0 / Ocupantes: 34
Total:Fatalidades: 0 / Ocupantes: 38
Daños en la Aeronave: Considerable
Ubicación:sobre Limpopo province (   Sudáfrica)
Fase: En ruta (ENR)
Naturaleza:Vuelo Internacional Programado
Aeropuerto de Salida:Harare Airport (HRE/FVHA), Zimbabwe
Aeropuerto de Llegada:Johannesburg-O.R. Tambo International Airport (JNB/FAOR), Sudáfrica
Número de Vuelo:SA8103
Airlink flight 8103 took off from Harare International Airport (FVHA) in Zimbabwe on an international scheduled flight to from Johannesburg, South Africa.
The Avro RJ85 took off at about 18:45 hours local time. At approximately 19:38 during cruise flight at a height of 34000 ft (FL340) within South African airspace, a loud bang was heard on the flight deck and a subsequent right yaw was experienced. The crew observed an immediate visual indication on the cockpit engines instruments that engines no. 1 and 2 had experienced catastrophic failure. According to the flight recordings, the no. 1 engine failed first. This was due to damage to the full authority digital electronic control (FADEC) box, which had been struck by the turbine blades debris from engine no.2.
Following the incident, the crew declared a MAYDAY call due to the instant failure of the two engines on the port wing, and immediately followed emergency operating procedures. Contact was made with the operator's maintenance control centre (MCC) to report and discuss the situation. A decision was then made by the crew following considered assessment of the situation to continue with the flight to the destination, a distance of approximately 240 nm. The aircraft landed uneventfully on runway 21R at 20:39.

It was found that that fourth-stage Low Pressure turbine rotor disc of engine no.2 had failed. The fourth-stage disc assembly was fitted on 27 July 2017 as a repaired unit which had a total of 11885 hours and 9419 cycles. During this disc change a wrong procedure was followed: pre-SB (Service Bulletin) engine configuration type procedure was applied during a post SB engine configured installation. During replacement of the fourth-stage disc assembly, a retaining nut that had been fitted before was reused and a new locking cup was used.

Probable Cause:

Probable Cause:
The cause of the no2 engine uncontained failure was attributed to the LP turbine retaining nut becoming dislodged resulting on the fourth-stage turbine rotor disk disengaged from the LP turbine shaft. The fourth-stage turbine rotor disc compromised the turbine casing and turbine debris from the no. 2 engine struck the no. 1 engine, causing an un-commanded shutdown and leading to a catastrophic failure of both port-side engines.
Contributory factor:
1. The incorrect application of torque settings; or improper installation due to a possible mis-stacking of the over-speed ring during maintenance.

Accident investigation:

Investigating agency: CAA SouthAfrica
Status: Investigation completed
Duration: 1 year and 5 months
Accident number: CA18/3/2/1185
Download report: Final report

» Airlink

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CAA S.A. issued 1 Safety Recommendation

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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 Harare Airport to Johannesburg-O.R. Tambo International Airport as the crow flies is 955 km (597 miles).
Accident location: Approximate; accuracy within a few kilometers.

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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