[Peetwo]

AO-2022-046 (Occurrence Investigation) - Final Report

From DTS for this week Dr Godlike...

Islander forced landing accident likely the result of fuel starvation



A twin piston-engined charter aircraft’s forced landing on an island in the Torres Strait was likely the result of fuel starvation, an Australian Transport Safety Bureau final report details.

On 3 October 2022, a Torres Strait Air Britten-Norman BN-2 Islander with a pilot and six passengers on board was operating a flight from Saibai Island to Horn Island.

While in the cruise at about 6,000 ft, the aircraft’s engines began to surge. The pilot diverted towards Kubin Airport on Moa Island, but was unable to reach the runway and was forced to land on a road.

During the landing the aircraft impacted the ground heavily, with the rear fuselage and tail breaking away, but fortunately, there were no reported injuries.

The ATSB’s subsequent transport safety investigation found the dual engine speed fluctuations and associated power loss was probably the result of fuel starvation.

“Fuel records from earlier flights showed the pilot was using the wing tip tanks when fuel remained in the aircraft’s main tanks, which was not in accordance with the flight manual,” ATSB Director Transport Safety Dr Stuart Godley said.

“In addition, the configuration and location of the aircraft’s fuel controls and gauges were probably not conducive to rapid and accurate interpretation, with the main tank gauges and cocks located overhead the windscreen centre post and the wing tip tank contents indicators on the right side of the cockpit.”

The ATSB considered that both of these factors increased the likelihood of the wing tip tanks being inadvertently selected during part or all of the round trip, leading to the exhaustion of the wing tip tanks.

Dr Godley noted accidents involving fuel mismanagement are an ongoing safety concern to the ATSB.
“Pilots are reminded of the importance of understanding an aircraft’s fuel supply system and being familiar and proficient in its use,” he said.

“Adhering to procedures, maintaining an accurate fuel record, and ensuring appropriate tank selections are made for the phase of flight will lessen the likelihood of fuel starvation.”

Dr Godley noted that prior to the accident, in June 2022, Britten-Norman released service letter 145, which detailed an optional modification for Islander aircraft with wing tip tanks.

“The service letter details an optional modification that centralises the fuel system controls, specifically relocating the wing tip tank indicators to the overhead panel adjacent to the main tank fuel indicators, with the fuel selection switches mounted between the indicators,” he said.

“We would encourage Islander aircraft operators to consider actioning this service letter for their aircraft.”

Read the report: Fuel starvation and forced landing involving Pilatus Britten-Norman Islander BN2A, registration VH-WQA, Moa Island, Queensland on 3 October 2022

Publication Date
05/10/2023

'Tongue in cheek comment': Again no idea why Dr Godlike needs to put in his 2 bob's worth but I do wonder about how many fuel starvation events have occurred with C208 LCRPT operations in the Torres Strait?? -    

Ref: Su_Spence to the rescue on Torres airfield embargo?? - Yeah right! 



MTF...P2