Status: | Accident investigation report completed and information captured |
Date: | Tuesday 18 December 2018 |
Time: | 19:53 |
Type: |  Dornier 228-201 |
Operator: | Africa's Connection STP |
Registration: | S9-AUN |
MSN: | 8076 |
First flight: | 1985-10-23 (33 years 2 months) |
Total airframe hrs: | 13026 |
Cycles: | 14222 |
Engines: | 2 Garrett TPE331-5-252D |
Crew: | Fatalities: 0 / Occupants: 3 |
Passengers: | Fatalities: 0 / Occupants: 7 |
Total: | Fatalities: 0 / Occupants: 10 |
Aircraft damage: | Substantial |
Location: | São Tomé Island Airport (TMS) ( São Tomé and Príncipe)
|
Phase: | Landing (LDG) |
Nature: | Int'l Non Scheduled Passenger |
Departure airport: | São Tomé Island Airport (TMS/FPST), São Tomé and Príncipe |
Destination airport: | Douala Airport (DLA/FKKD), Cameroon |
Narrative:The Dornier 228-201 took off from São Tomé Island Airport at 15:16 hours local time to Douala, Cameroon.
After take off from Sao Tomé the crew noticed that with gear retraction the transition light did not go off and was on throughout the flight. During the approach to Douala and having selected the landing gear down, the crew realized that the nose gear was not down and only the main gear was extended and locked. The crew recycled the landing gear but to no avail. With this abnormal condition the crew decided to return to home base at São Tomé Airport.
At 19:53 a forced nose gear-up landing was performed, resulting in substantial damage to the aircraft's nose area.
Probable Cause:
Causal Factors:
The investigation determines that the cause of this accident as:
During towing of the aircraft, the pin for towing came out and at time of turning it damaged the nose landing gear torque link affecting the alignment and centering of the nose wheel.
After take off and selecting landing gear up, the nose gear was stuck in the nose compartment due to 15° off deflection from centre point.
Nose wheel could not be extended because it was stuck in the nose compartment.
Contributory Factors:
1 Inadequate tow bar.
2 Inadequate aircraft tow tractor.
3 Aircraft tow tractor was technically faulty.
4 Lack of appropriate training for ground personnel on aircraft towing.
5 Undocumented ground personnel discharging maintenance duties.
6 Roughness and degradation of taxiway surface.
7 No action was taken for specific inspection on the nose landing gear for any damage caused during towing the aircraft.
8 No compliance with Service Bulletin no. SI-228-036 issued by the manufacturer on 28th April 1989.
Accident investigation:
|
Investigating agency: | CNIPAIA  |
Status: | Investigation completed |
Duration: | 1 year and 4 months | Accident number: | AC/18/12/2018/RF | Download report: | Final report
|
|
Classification:
Gear-up landing
Forced landing on runway
Sources:
» BFU18-1804-DX
»
telanon.info
Follow-up / safety actions
issued 7 Safety Recommendations
Issued: -- | To: CAA São Tomé and Príncipe | 01/2018 |
Civil Aviation Authority of São Tomé and Príncipe should intensify its surveillance and monitoring on all validation of maintenance technician and ground personnel certificates. |
Issued: -- | To: CAA São Tomé and Príncipe | 02/2018 |
Civil Aviation Authority should not permit undocumented personnel to carry out maintenance duties. |
Issued: -- | To: CAA São Tomé and Príncipe | 03/2018 |
Civil Aviation Authority should establish contact with homologous Authorities of countries which are manufacturers of aircraft registered in São Tomé and Príncipe regarding Service Bulletins and other related Airworthiness Directives (AD) with aim of creating safety in the aviation industry. |
Issued: -- | To: Africa Connection | 04/2018 |
Africa Connection as the operator should monitor the validity of maintenance technician licences and ground personnel certificates. |
Issued: -- | To: Africa Connection | 05/2018 |
Africa Connection should lay down procedures to improve maintenance work and upgrade training for the ground staff. |
Issued: -- | To: Africa Connection | 06/2018 |
Africa Connection should make acquisition of a new and appropriate tow bar. |
Issued: -- | To: ENASA | 07/2018 |
National Airports and Safety Corporation (ENASA) should make necessary effort to repair the taxiway surface. |
Show all...
Photos
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 São Tomé Island Airport to Douala Airport as the crow flies is 521 km (326 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.