Andrew Miller, Piper Seneca V, OO-TML, in-flight breakup - September 2009 Portugal.

[wunfoDREW]

On 15 September 2009, our wonderful son Andrew, 21, a student of the NLS (a Dutch ATPL training school) was killed – together with another student and instructor – during an IFR night navigation flight just north of XAPAS in southern Portugal.
Although we have some theories as to what may have happened, we would welcome any information, tips, advice which would help us find the cause and possibly prevent any such accident occurring in the future.

[wunfoDREW]

Thank you - we have the initial report

[GobonaStick]

It's only an observation, but the report says the wreckage was spread over a "very large area".

The Seneca is a fairly small aircraft, and while I don't have a sense of scale from the map on page 8, it does cause me to wonder whether the distribution is evidence of an in-flight break-up.

The report also says Faro radar lost transponder data about 40 seconds before all other information.

I don't know whether the trail direction is consistent with winds at the time.

Just my humble opinion.

[wunfoDREW]

Thank you - we believe that it was an in flight break up. The prevailing wind was NW

[OD100]

Dear Mrs. and Mr. Miller. I am so sorry for your loss. No parent should ever have to bury one of their own.....

In looking at the preliminary report, I did a rough estimate in googlemaps, and would agree with others that an in-flight break up did occur. The wreckage by my rough calculation is spread over approximately 1000 meters or or more.

With just the factual data contained in the report and a review of the pictures, I would suspect that it is possible the pilot and instruction loss situational awareness at night, possible some spatial disorientation, that led to an unusual attitude, from which recovery was not possible.

With wreckage spread over such a large area, it is possible that a very high rate of speed occurred in a spatial-disorientation scenario, leading to the breakup.

The factual data indicating the gear(lever) being in the DOWN position could be consistent with an attempt to recover from a very high rate of indicated airspeed.

Engine lever control positions would seem to be consistent with normal engine operation.

I am at loss as to what events may have proceeded such a scenario, as the instructor was reasonably experienced. The PF also seemed to have a bit of flight time as well.

Again, I am only speculating. Aircraft just don't come apart...a series of events leads to in-flight breakups, and the common theme is that an over-stress condition be met....a severe overspeed and/or an inappropriate recovery to lead to this.

I'll be interested in reading more data....

I am again so sorry for your loss......

[GobonaStick]

I wouldn't wish to pre-empt an official inquiry, and forgive me if I appear to be stating the obvious.

But if the evidence points to an in-flight break-up, and the weather appears - as the report states - suitable for training, then I imagine the only other reasonable conclusion is that the airframe suffered a catastrophic failure.

Only the official investigation will be able to determine whether or not the aircraft was structurally sound.

I do know, however, of one in-flight break-up of a Seneca in 2002 which was attributed to pilot disorientation, and subsequent excessive manoeuvres. I mention this only because the accident about which you are inquiring occurred at night, over what appears to be featureless and unlit terrain, an environment which can test even highly-experienced crews.

[White Knight]

Engine 2 looks like the prop is feathered, even though the prop lever on the quadrant is in a 'normal' position!

[wunfoDREW]

Thank you for your replies.

As far as situational awareness is concerned, it was planned to be a use of "autopilot and flight director" IFR training flight, which was made in excellent weather conditions on a straight airway. The area, whilst being sparsely populated, does have a number of villages and small towns, which should have been clearly visible.

Both propellers - according to preliminary report type MC Cauley 3AF32C522/82 NJA-6 - appear feathered. That the cockpit controls do not confirm this is interesting.

Does anyone have any opinion as to why the left engine has no cowlings at all and the right one does?

We value your continued input.

[OD100]

I took another look at the pictures....and yes, both engine propellers appear to be feathered. Very interesting.

It's highly unlikely the props feathered without being commanded. Prop levers are full-forward. It's possible G-force or blunt force from impact pushed the levers back forward. So difficult to say. But examination of the cable positions will determine that.

A more likely scenario is that the props feathered as the engines separated from the aircraft, as the cable on the prop governor pulled away from the airframe.

This would be consistent with prop lever position and the inflight break-up.

[BoeingMEL]

Mr and Mrs Miller, Like many others I find myself with feelings of unspeakable sadness at your loss. I am a retired airline pilot but with a lot of Seneca time in my log-boks.

Firstly, I agree with previous views that both propellors appear to be feathered.

You may or may not appreciate that one would normally only feather a propellor in flight following an engine failure (Feathering significantly reduces the drag and therefore permits improved performance when flying on the remaining engine or - heaven forbid - when gliding if you've lost both engines.)

As a result of mass and inertia (those air-cooled 6-cylinder engines are pretty heavy), it is quite common for engines to seperate from the wing in the event of impact or in-flight break-up. Among the many cables, wires, tubes etc connecting the engine to the wing is the propellor control cable which invariably breaks under tension when the engine assembly departs.

Mine is only one opinion and the grey-matter isn't what it once was but I agree that the propellors went into the fully-feathered position as a result of control-cable breakage when the engine seperated. Incidentally, I can think of no reason why the undercarriage was found to be in the "down" position.

Finally, on the limited amount of evidence about the debris-field, I too would consider this to be an in-flight break-up. I send mylove and best wishes and hope that you find some comfort in the knowledge that your beloved son died doing something that he loved. Regards, Mel

[Karl Bamforth]

With reference to the landing gear.

The throttles and plastic coaming have been bent and distorted towards the gear selector. It is possible that during the impact the gear selector was forced to the down position by the throttles.

[BoeingMEL]

but if the u/c switch was knocked to the "down" position at the point of impact, there would be no power or time for the wheels to extend. IMHO.

[smandkjc]

Was wondering why this thread was moved from Rumors and News and would like to point out it was initiated by a KLM 777 Captain who would really appreciate any input that can throw any light on the cause of this accident.

[wunfoDREW]

We are heartened by your responses - thank you.

As for our thread being moved - we were informed by the administrator that this was done because we had asked 2 questions and that by doing so, our post had to be under 'questions' which is under ' ground and other ops'. We don't agree, but perhaps we could rephrase our post to have it placed to a higher profile forum - after all, three people have died.

[GlueBall]

I speculate in line with OD100's probable theory. Mainly because the Piper Seneca has proven to be a rugged, reliable airframe, produced since 1971, and used in many countries as a multi engine trainer.

Notwithstanding some sort of gross maintenance/overhaul negligence, it is least likely for the airframe to have suffered catastrophic failure on its own.

Catastrophic airframe falure can occur rapidly in any airplane with improper control inputs, especially when exceeding airspeed limitations. Operating limitations can be exceeded in seconds from a resulting dive, spiral or spin without immediate corrective control inputs.

Even without flight data recorders, trained accident investigators can usually trace the probable inflight break-up sequence by studying the metallurgy, ripped airframe parts, deformations and by correlating the debris pattern.

[Akrapovic]

Even without flight data recorders, trained accident investigators can usually trace the probable inflight break-up sequence by studying the metallurgy, ripped airframe parts, deformations and by correlating the debris pattern.

Precisely.
Best left to the experts - not the 'armchair' experts . . .
Anything else is pure speculation.

[wunfoDREW]

Thank you all for your input.
To gain as much information as possible is the least we can do for our son and the other two pilots who have lost their lives in this tragic accident.
We continue to welcome further input, including any lateral thinking.

[smandkjc]

Akrapovic
Quote:
Precisely.
Best left to the experts - not the 'armchair' experts . . .
Anything else is pure speculation.

Not necessarily, have you never heard of TE901 and UA811.
I think it is misguided to believe that Airlines and Manufacturers can investigate themselves and every time come up with the answers that will make your job safer.

[Akrapovic]

I think it is misguided to believe that Airlines and Manufacturers can investigate themselves and every time come up with the answers that will make your job safer.

Don't recall mentioning Airlines and Manufacturers??

I was referring to trained accident investigators as mentioned previous.
If you're going to make a point I suggest you at least quote correctly!

[no sig]

The responsibility for air accident investigation, within ICAO, rests with the State where the accident occurred, and usually with the support of the country of registration, the airframe and engine manufacturer and the operator. One sincerely hopes they will come up with an unbiased, unfettered and comprehensive report as to the causes of the accident. Though it is often a long and arduous process.

Although, I have to agree with Akrapovic- anything posted here is going to be in absence of the material evidence and formal investigation and is at best, informed speculation. That said, following the AF447 discussion here on Pprune, I felt some serious professionals engaged their collective knowledge on the issue and I did wonder if those looking into the accident wouldn't have benefited from reading some of the theories considered there. So perhaps, something of value to the bereaved may come forth here. I hope so.

[smandkjc]

As no sig points out accident investigators work in concert with manufacturers and airlines who have a vested interest in the outcome of any investigation.
We also found that in major investigations investigators work only within their field of expertise and can fail to see the overall picture.
In both the investigations I quoted it took people outside the establishment to ascertain the true cause.

[wunfoDREW]

This forum reaches a vast group of professionals, experts and enthusiasts in the aviation industry. Their opinions are valued and should be encouraged. We must not forget what the parents of a victim of UA811 were able to achieve.

[Karl Bamforth]

BoeingMEL,

I didn't see any pictures of the landing gear being down, only reference to it being (apparently) selected down.

But on most small Pipers the landing gear is held in the UP position by hydraulic pressure alone. No locks. Loss of Hyd pressure will cause the gear to freefall down.

During the break up the hyd lines will have failed causing loss of pressure and subsequent free fall of the gear.

[wunfoDREW]

We would like to open up discussion on the radar data supplied on page 5 of the Preliminary Report - see link below. Surely, certain scenarios could be discounted based on this information and others not. We are interested as to why there was a loss of transponder information in such a short space of time after what appears to be level flight at a constant ground speed.

http://www.gpiaa.gov.pt/tempfiles/20...22331moptc.pdf (http://redirectingat.com/?id=42X487496&url=http%3A%2F%2Fwww.gpiaa.gov.pt%2Ftempfiles%2F200910261223 31moptc.pdf)

[PH-SCP]

As far as situational awareness is concerned, it was planned to be a use of "autopilot and flight director" IFR training flight, which was made in excellent weather conditions on a straight airway. The area, whilst being sparsely populated, does have a number of villages and small towns, which should have been clearly visible.

This tragic accident reminds me of the loss of an NLS Piper Seneca back in 1994 in which an instructor and two students lost their lives. This particular aircraft (registered PH-SNA) was enroute from Stuttgart to Maastricht on an IFR training flight using autopilot and flight director. In the descend from FL100 to FL60 the aircraft broke up in flight. Circumstances and similarities are scaringly similar allthough I am not implying in any way that the causes of both accidents are the same.

A report of the accident of PH-SNA is available via the BFU website;
http://www.bfu-web.de/cln_005/nn_223970/DE/Publikationen/Untersuchungsberichte/1994/Bericht__94__CX027-0,templateId=raw,property=publicationFile.pdf/Bericht_94_CX027-0.pdf

The conclusion of the German Accident Investigation :

Zum Unfall kam es, weil das Flugzeug infolge einer Überbeanspruchung der Struktur nach einem abrupten Höhensteuerausschlag seine Flugfähigkeit verlor. Zum Entstehen des unzulässigen Lastfalles hatte möglicherweise ein Defekt im Autoflight-System beigetragen. Ausgehend von diesem Defekt konnte sich in Verbindung mit einer Unachtsamkeit des Flugzeugführers eine Fehltrimmsituation am Flugzeug entwickeln, die sich wie beschrieben auswirkte.

In a free translation:

The aircraft lost its flying capablities after an abrupt elevator deflection caused structural limits to be exceeded. A possible cause was a defect in the Autoflight-System. Assuming that this defect took place together with the failure of the flight instructor to observe an abnormal trim situation (trim-runaway), led to the sequence of events.

[happybiker]

I am aware that there have been catastrophic in flight failures previously which were attributed to the rudder trim tab becomes disconnected and the resultant flutter has resulted in the loss of the aircraft. While this may not have occurred in this case it is certainly worth while looking at this AAIB report from 1994 which provides information on such events.

http://www.aaib.gov.uk/cms_resources.cfm?file=/dft_avsafety_pdf_502128.pdf

[Centaurus]

Presumably the investigators will look closely into the instructional technique used by the instructor in that aircraft. Other students who had previously flown with him would have good knowledge of his techniques. An in-flight break up such as described does not occur in normal straight and level flight assuming no thunderstorm penetration. There could be many reasons that the aircraft assumed an unusual attitude although an experienced instructor should have no trouble recovering from one provided he had received proper training. A failed artificial horizon (or covered over to simulate failure) may lead to mishandling by whoever is flying at the time and in IMC it doesn't take long before the aircraft goes into a steep spiral dive. If the instructor is not proficient or current at stopping this from happening, a serious situation may occur. In my experience there is often lack of serious training for failure of the artificial horizon in light training aircraft. The standby flight instrument called the Turn-Coordinator is a vital instrument because if an artificial horizon fails or gives erroneous attitude information, the pilot must be proficient on then using the Turn Coordinator. This should be practiced in a flight simulator first as it can be a very difficult part of flying on instruments.

Some instructors are known to simulate failures of flight instruments while flying and this can be hazardous under certain conditions like night or in cloud. In-flight break up is usually caused by delayed or incorrect recovery from an unusual attitude. What or who initiated the unusual attitude is the big question and without a CVR or FDR this may never be known for certain.

[JLFPilot]

I'm so sorry to hear of your loss and I hope that you can find peace in knowing he was doing what he loved to do.
Has anyone looked at pilot incapcitation issues and perhaps a collision with birds or something else? A very precise review of the maintanence logs of both engines and the airframe may offer some hints as to any possible contibuting factors. An independent review may help ease your mind on such issues. I'm a B-777 Captain and have not flown light aircraft for many years, but I do know that the training environment is much harder on aircraft and engines than just normal everyday use.I review of any past history such as hard landings, engine issues, airframe overspeed incidents and avionics maintenance history may cast a light on potential stresses put on the aircraft itself. Currency of maintenace and inspections should also be looked at. I hope that this helps a little bit. I do agree with most of the other comments made in this formum about waht might have happened. If I can be of further help, let me know.

Jim Ferrai, Severna Park, Maryland USA

[busidriver]

Mr and Mrs Miller,

My condolences on your loss.

Are you in touch with the OVV? There should be a Dutch 'Expert' appointed to the Portuguese investiugation, according to ICAO Annex 13 Chapter 5.

He should be given access to investigative material, and may be able to influence the nature of the investigation.

You might also consider getting in touch directly with Mr Lourenco.

There are independent accident investigators who work freelance, but I think your first strategy should be to understand the official Annex 13 investigation, and exert influence as you see fit to ensre it is conducted properly.

I'll look at the report again later and try to offer some insight.

[Pace]

I am really sorry this is awful news for you and any parents nightmare.

I have over 3000 hrs in Seneca fives in all weather day and night and all over Europe. They are very forgiving well tried and tested aircraft.

I noted the aircraft was a 1998 version. That is one of the earlier Seneca fives which was kitted out with King avionics and a King Autopilot. This later changed to the S tech autopilot unit.

I flew a 1998 aircraft and while I always thought the King unit was a better autopilot than the S tech the aircraft went into a very violent wing over while on autopilot and completely out of the blue. So violent it would have been a major problem at night.

Problems with the autopilot first manifested as a slight lateral wing rock which was there for some time

As this appears to be an IFR practice flight at night rather than manouvres something odd must have happened to have caused this accident?
It maybe worth a consideration?

The gear being down may have been an attempt at a behond VNE recovery or maybe it was never retracted in the first place?

You may have to come to terms with the fact that there may never be a definative answer as to what happened on that awful night. it is also of note that The instructor was low time on this aircraft with 80 odd hours.

[sky_ONE]

Dear Mr.Miller

First I would like to express my condolences for your loss.

I work at A.A.E and after all these months I´ve taken the decission to contact you with the only objetive of avoing more accidents, more deaths.The situation is desperate and perhaps you can achieve something else than me.

Let me give you more information about the aircraft crashed OO-TML.

As you know, this aircraft was leased from BAFA Antwerp.The intermediate for the lease by NLS (Nederlandse Luchtvaartschool). During the flight from Belgium to Èvora (A.A.E) the pilots had an engine failure.A few days before accident an instructor advised to C.F.I that the these aircraft was not able for flying due some malfuntions, why nobody made anything?

It`s no only a rumour, it`s the opinion of most of us, we think that during the flight at cruise level was an extension of the flaps or some problem in the rudder, something like the accident in 1994 with the result of 2 deaths.

One of the greatest responsibles of the maintenance has been dismissed suddenly. Why?

If you can do something for us, for the students, for the future of the school, for avoiding more accidents, more deaths, we all of us will be very thankful.

[rpcrete]

I am unable to read report, can only read french and english. Does anyone know where the nose baggage door and latch mechanism were found? Do we have pictures of any of the nose fiberglass items?

[N15926]

Does anyone hava any pictures of the fiberglass nose cone or pieces therof, the forward baggage door, and the left propeller? If you do please send then to [email protected]
Thank you,

[rpcrete]

Does anyone have any opinion as to why the left engine has no cowlings at all and the right one does?


I believe you may be onto something, maybe, just maybe, the nose baggage door latch mechanism got wrapped up in the left propeller and tore the cowling off. Just like it did in Oklahoma in 85 and in Boston in 87. See senecacrash.com

[Beafis]

2 Days ago an other AAE student died during a solo flight. Aircraft involved was a Socata TB200GT CS-DEH.