75 killed, 6 survivors after plane carrying Brazilian soccer team crashes

[Kip Powick]

https://www.thestar.com/

 

http://www.cnn.com/2016/11/29/americas/colombia-plane-accident/index.html

 

(some photos/maps/weather etc in CNN link)

 

MEDELLIN, COLOMBIA—A chartered plane with a Brazilian first division soccer team crashed near Medellin while on its way to the finals of a regional tournament, killing 75 people, Colombian officials said. Six people survived.

The British Aerospace 146 short-haul plane, operated by a charter airline named LaMia, declared an emergency and lost radar contact just before 10 p.m. Monday because of an electrical failure, aviation authorities said.

The aircraft, which had departed from Santa Cruz, Bolivia, was transporting the Chapecoense soccer team from southern Brazil for the first leg Wednesday of a two-game Copa Sudamericana final against Atletico Nacional of Medellin.

“What was supposed to be a celebration has turned into a tragedy,” Medellin Mayor Federico Gutierrez said from the search and rescue command centre.

The club said in a brief statement on its Facebook page that “may God accompany our athletes, officials, journalists and other guests travelling with our delegation.”

South America’s soccer federation extended its condolences to the entire Chapecoense community and said its president, Alejandro Dominguez, was on his way to Medellin. All soccer activities were suspended until further notice, the organization said in a statement.

Dozens of rescuers working through the night were initially heartened after pulling three passengers alive from the wreckage. But as the hours passed, and heavy rainfall and low visibility grounded helicopters and complicated efforts to reach the mountainside crash site, the mood soured to the point that authorities had to freeze until dusk what was by then a body recovery operation.

Images broadcast on local television showed three passengers arriving to a local hospital in ambulances on stretchers and covered in blankets connected to an IV. Among the survivors was a Chapecoense defender named Alan Ruschel, who doctors said suffered spinal injuries. Two goalkeepers, Danilo and Jackson Follmann, as well as a member of the team’s delegation and a Bolivian flight attendant, also survived.

The plane was carrying 72 passengers and nine crew members, aviation authorities said in a statement. Local radio said the same aircraft transported Argentina’s national squad for a match earlier this month in Brazil, and previously had transported Venezuela’s national team.

British Aerospace, which is now known as BAE Systems, says that the first 146-model plane took off in 1981 and that just under 400 — including the successor Avro RJ — were built in total in the U.K. through 2003. It says around 220 of are still in service in a variety of roles, including aerial firefighting and overnight freight services.

Alfredo Bocanegra, the head of Colombia’s aviation authority, said initial reports suggest the aircraft was suffering electrical problems although investigators were also looking into an account from one of the survivors that the plane had run out of fuel about five minutes from its expected landing at Jose Maria Cordova airport outside Medellin.

A video published on the team’s Facebook page showed the team readying for the flight earlier Monday in Sao Paulo’s Guarulhos international airport. It wasn’t immediately clear if the team switched planes in Bolivia or just made a stopover with the same plane.

The team, from the small city of Chapeco, was in the middle of a fairy tale season. It joined Brazil’s first division in 2014 for the first time since the 1970s and made it last week to the Copa Sudamericana finals — the equivalent of the UEFA Europa League tournament — after defeating two of Argentina’s fiercest squads, San Lorenzo and Independiente, as well as Colombia’s Junior.

“This morning I said goodbye to them and they told me they were going after the dream, turning that dream into reality,” Chapecoense board member told TV Globo. “The dream was over early this morning.”

The team is so modest that its 22,000-seat arena was ruled by tournament organizers too small to host the final match, which was instead moved to a stadium 480 kilometres to the north in the city of Curitiba.

“This is unbelievable, I am walking on the grass of the stadium and I feel like I am floating,” Andrei Copetti, a team spokesman, told The Associated Press. “No one understands how a story that was so amazing could suffer such a devastating reversal. For many people here reality has still not struck.”

 

[Canoehead]

Hard pictures to look at.

A couple of reports indicating "the pilot" (one of them I guess) was also the owner of the airline.  However reports are also calling him a "hero" for dumping fuel before the crash (BA146 doesn't have that capability).  So the reports coming out are going to be hard to believe.  Hopefully the Colombian authorities can put out a good, factual report in the end?!

[Kasey]

http://www.bbc.com/news/world-latin-america-38160713

 

Ran out of fuel!! Theory.......

[Kip Powick]

Looks like  the lack of fuel is being assessed as the most probable cause of the crash......

 

https://www.thestar.com/news/world/2016/11/30/leaked-recording-from-colombia-plane-crash-reveals-pilots-mayday-call.html

[Guest]

Colombia's CAA confirms that crashed Avro operated without mandatory fuel reserves

• 01 December, 2016
• BY: Rainer Uphoff
• Madrid

Colombia’s Civil Aviation Authority has officially confirmed that the Bolivian BAe Avro RJ85 operated by Lamia crashed near Medellin with empty fuel tanks..

During a press conference held on 30 November, Aerocivil’s Secretary of Aviation Safety Freddy Bonilla assures that "the aircraft did not operate with the mandatory fuel reserves mandated by international regulations”.

He said that Lamia’s flight plan had established as the alternative airport Bogota, which is slightly less distant from de Santa Cruz (Bolivia) than Medellin, indicating, however, that “the aircraft had not loaded sufficient fuel for an eventual diversion back to the alternative airport, nor for the internationally established 35min fuel reserve”.

Bonilla also confirmed that the actual distance between Santa Cruz and Medellin on the route followed by the Lamia flight was 1,588nm. “We will investigate why Lamia authorised a flight, which [taking into account the mandatory reserves] was beyond the range of the aircraft [1,600 NM]”.

He also confirmed the authenticity of the ATC recording that had been filtered to FlightGlobal and some other media, but said that he could "not confirm if the recording was complete, resembling the exact timing of the sequence of events.”

“We are working with specialists from Bolivia, Brazil, the UK and the US to reach the final conclusions as soon as possible”, he concluded.

Previously, Bolivia’s Civil Aviation Authority DGAC had declared almost immediately after the accident that Lamia had its AOC in order, the aircraft maintenance record correct and both pilots' licenses up-to-date.

Incidentally, DGAC's director of aircraft registries, Gustavo Vargas Villegas, is the son of Lamia’s owner, Gustavo Vargas Gamboa. In addition to establishing any aircraft's operational specifications as part of the registry process, one of the attributions of Vargas Villegas’ role at the DGAC is the safe custody of all documents and informations related to any Bolivian registered aircraft involved in an incident or accident

[DEFCON]

Pretty much everybody died as the result of what appears to be a criminal act, but the paper trail looks good? The oversight of carriers down there doesn't sound a whole lot different than what we have here, which gives the criminal entrepreneur plenty of opportunity to flourish.

 

[Don Hudson]

Regarding the "paper trail" in this accident, it does not look good at all. The flight plan for this flight can be found at https://social.shorthand.com/diarioeldeber/3yfgFr9Jbe/una-tragedia-que-se-pudo-evitar and google translate can provide some insight into the dispatch process and the strong disagreements that the person overseeing the flight planning process, (Celia Castedo Monasterio, funcionaria de Aasana Viru Viru airport), and person doing the dispatching of the LaMia flight had had.

Essentially, the disagreement was that the flight plan time enroute was equal to the total fuel on board - ie., there was no reserve whatsoever. The disagreement was "normalized" by the captain and the dispatcher went along with the captain, agreeing with the fuel load. From the link above, here is the record of that conversation, between Celia Castedo who was overseeing the flight plan process and the Dispatcher.

I'm not precisely informed of Bolivian oversight processes or general culture, but contrary to some claims made here comparing Canadian oversight and "criminal entrepreneurs" in South America, clearly there were strong oversight processes at work there - they just got dismissed by the Dispatcher and the Captain of the flight.

Flight Plan:

Comments from Celia Castedo Monasterio

From the linked site, using Babylon Translation:

Quote

 

Before the aircraft leave, the document that delivered the dispatcher of the company LaMia, Álex Quispe (one of the seven crew members of the aircraft that died), had at least five observations made by Celia Castedo Monastery, Viru Viru Aasana officer, who was on duty at the offices where you review all of the flight plans. The Responsible indicated that the autonomy of flight was not adequate, which lacked a second alternate plan, that the report was poorly filled and that it was necessary to make changes.

The main observation made by the staff member of Aasana had to do with the time of flight scheduled between Santa Cruz and the airport of Medellin, which was equal to the fuel autonomy that had the aircraft. In accordance with the documents, the estimated time in route was of 4 hours and 22 minutes. The same time that was recorded for the autonomy of flight of the nave, aspect that should never be equal.

A commander of aviation, with 31 years of experience, said that this is an error that you should not commit never a pilot, as this information is equivalent to saying that the aircraft will fly with just the right amount of fuel to reach the programd destination, not a minute more, not a minute less.

"When you a flight plan, you must contemplate the combustible load that scope to get from our point of takeoff until the point of destination. In addition, provision should be made for the time it would take to reach an alternate airport in case of emergency or refuelling, joined 45 minutes of autonomy in the air before any eventuality," said experienced pilot, which described what happened as a chain of errors that began from the moment in which the ship was stopped in the track of Viru Viru and made a flight plan impossible to approve.

The document of Celia Castedo describes the conversation she had with the dispatcher of LaMia with regard to this topic and asserts in its drafting that Quispe told him that the flight captain, Miguel Quiroga (died in the accident), had given him this information and that the time they reach. Even the operator of Aasana placed in its report a textual response of Quispe to its observations on this point and said: "No Madam Celia, such autonomy i have passed, we reaches well... Just like that I present it, we do so in less time, don't worry. It is just like that, quiet, that is fine, just [forget about it]".

 

 

[DEFCON]

I was attempting to be facetious; I don't know, but the facts reproduced here would seem to indicate the Country involved, like Canada, is employing some form of SMS to manage its aviation industry?

The flight plan was filed with and accepted by a government agency. It would appear the operator was comfortable and confident he could 'get away' with this kind of filing. Therefore, and it's only a guess based on opinion, it would probably be safe to bet this criminal offence was not the first and only demonstration of unscrupulous behaviours being fostered by a giant lack of oversight.

 

[Don Hudson]

I don't know anything about Bolivia's flight safety culture or requirements. I don't know whether such things are routine as implied, or anomalies as they are in Canada.

As with Canada, the available, current literature would suggest that Bolivia's aviation operation is on an above-average par with many countries including Canada, as indicated in the ICAO Flight Safety Report, (2015):

Quote

Each ICAO Member State should establish and implement an effective safety oversight system that reflects the shared responsibility of States and the broader aviation community, to address all areas of aviation activities. The Universal Safety Oversight Audit Programme (USOAP) measures the effective implementation of protocols that cover the entire spectrum of a State’s civil aviation oversight activities.

. . . .

Each audit protocol is a comprehensive checklist covering  all areas of a State’s safety oversight system subject to  the USOAP audit process. Using the audit protocol as a guideline, ICAO is then able to determine a State’s capability for safety oversight.

USOAP State Performance:
Both Canada and Bolivia are among those states listed as having Effective Implementation above the global average of 62%.

 

And, the Bolivian aviation authorities have suspended LaMia's OC, https://www.thestar.com/news/world/2016/12/01/bolivia-indefinitely-suspends-airline-involved-in-deadly-crash-in-colombia.html

Quote

The Bolivian Civil Aviation Authority announced Thursday it was indefinitely suspending all flights operated by LaMia. British aviation authorities said the flight data and cockpit voice recorders recovered from the accident site were being brought to Britain for study.

It took Bolivian authorities just over two days to suspend indefinitely, the carrier's OC. I think it is reasonable to say that that kind of a standard for one's country's aviation industry is pretty robust and firm and clearly has high flight safety standards in mind.

[mo32a]

8 hours ago, DEFCON said:

I was attempting to be facetious; I don't know, but the facts reproduced here would seem to indicate the Country involved, like Canada, is employing some form of SMS to manage its aviation industry?

The flight plan was filed with and accepted by a government agency. It would appear the operator was comfortable and confident he could 'get away' with this kind of filing. Therefore, and it's only a guess based on opinion, it would probably be safe to bet this criminal offence was not the first and only demonstration of unscrupulous behaviours being fostered by a giant lack of oversight.

 

The flight plan being accepted by a government agency would only mean it was within the parameters required by the agency. They would have no way of knowing your fuel onboard. If you file a flight plan from YYZ to YUL ATC would assume you had enough fuel to do that flight, they wouldn't know if you had empty tanks or just topped up, that is what your dispatch center is for. 

[Don Hudson]

HI mo32a;

Now the task is to determine why the captain, who would have known his aircraft well, decided prior to flight, to bypass a logical enroute alternate.

This is of course more than using the reclearance technique, (when fuel is tight, planning a closer destination and "re-clearing" closer to that destination when circumstances warrant, - ie., weather improvement, opening of longer runways, etc.). This was a flight-planning decision which involved potential fuel-starvation; why?

[Gumbi]

Unless I'm mistaken, this operation was not the equivalent of our 705, so as I see it, not as regulated as the ops most of us her are used to.

I stand to be corrected.

[Zan Vetter]

No amount of additional regulation or oversight can overcome a captain, in the moment, who has chosen to disregard the legal and moral obligations of his role. The captain is supposed to be the oversight, full stop. It's the entire point of the position. Maybe they should put a flight attendant in the cockpit to oversee the fuel loading? Sheesh

[Gumbi]

6 hours ago, Zan Vetter said:

No amount of additional regulation or oversight can overcome a captain, in the moment, who has chosen to disregard the legal and moral obligations of his role. The captain is supposed to be the oversight, full stop. It's the entire point of the position. Maybe they should put a flight attendant in the cockpit to oversee the fuel loading? Sheesh

No need to resort to "sheeshing"... I don't need a lecture on captaincy either, thank you!

I completely agree with what you say.  My comment about regulation in the kind of ops they were doing was simply aimed at the fact that I don't think they benefit from the same ops specs that we do in the 705, re; Reclearance, no ALTN fuel flight planning, Landing below MIN DIV, etc...

No wonder some people hesitate to post here nowadays...

[Don Hudson]

Gumbi - I agree with you re 605 vs. 705 ops specs, and I doubt very much whether the S.A. carrier involved was operating under our equivalent 705.

Yes, posting sometimes is reminiscent of an average day in parliament, isn't it?

[Kip Powick]

1 hour ago, Don Hudson said:

Gumbi - I agree with you re 605 vs. 705 ops specs, and I doubt very much whether the S.A. carrier involved was operating under our equivalent 705.

Yes, posting sometimes is reminiscent of an average day in parliament, isn't it?

Uhh........ahh............Not really.......unless you are dragging in as much as a Fed MP is bringing in each day $$

[blues deville]

12 hours ago, Don Hudson said:

Now the task is to determine why the captain, who would have known his aircraft well, decided prior to flight, to bypass a logical enroute alternate.

Apparently the Captain, who was also the owner of the airline, was behind schedule with this charter. The soccer team needed to be in that first city for a rest before playing and then traveling to another city/game.

Perhaps the next SMS and CRM event for classroom discussion?

[Don Hudson]

Bolivia minister: country could face US aviation downgrade

LA PAZ, Bolivia - The U.S. could downgrade the country's aviation safety rating because of irregularities that may have contributed to this week's crash of a chartered plane carrying a Brazilian soccer team, Bolivia's Defense Minister said Saturday.
http://www.phillyvoice.com/bolivia-minister-country-could-face-us-aviation-do/

[Don Hudson]

http://www.foxnews.com/world/2016/12/05/bolivia-crashed-jet-company-left-trail-unpaid-debts.html

BOGOTA, Colombia - The airline involved in last week's crash in the Andes left a trail of unpaid bills that forced Bolivia's air force to seize two planes and briefly jail one of the company's owners, Bolivian Defense Minister Reymi Ferreira said Monday.

The revelation added to a string of human errors and unsettling details about the Bolivian-based LaMia charter company's checkered past that experts say should have served as warnings to aviation authorities.

A LaMia jet carrying 77 people, including a Brazilian soccer team heading to a South American championship final, slammed into a Colombian mountainside just minutes after the pilot reported running out of fuel. Investigators are centering their probe on why the short-range jet was allowed to attempt a direct flight with barely enough fuel on board to cover the distance between Santa Cruz, Bolivia, and Medellin, Colombia.

Ferreira said that in 2014, LaMia brought its three airplanes - all of them short-haul jets made by British Aerospace - to Bolivia's air force for repair. He didn't say what maintenance work was performed but accused the airline of paying for only half the work and abandoning two of the planes.

After months of the company refusing to pay hangar fees, the government took legal action and seized the planes, Ferreira said. He added that one of LaMia's owners, pilot Miguel Quiroga, who died in the crash, was detained for a few days five months ago in the case.

Ferreira said aviation officials who signed off on LaMia's irregular flight plan would be prosecuted.

The airline, which was only licensed to fly earlier this year, has also been suspended and Bolivian officials are looking into whether the son of another owner, former air force Gen. Gustavo Vargas, favored the airline as head of the office responsible for licensing aircraft.

"This was a mistake by two or three people who are causing enormous damage to Bolivia's aviation industry, but it's not the country that's to blame," Ferreira said, alluding to the possibility that the U.S. Federal Aviation Administration could downgrade Bolivia's aviation safety ranking.

Minutes before the crash, Quiroga requested permission to land, telling air traffic controllers that he was having fuel problems without making a formal distress call, according to air traffic tower recordings. Minutes later, as the jetliner circled in a holding pattern awaiting another aircraft with its own mechanical problems to land, his voice became more desperate as he reported the fuel had run out and the aircraft was experiencing a "complete electrical failure."

Passengers on the flight were oblivious to the tense exchange and had no time to prepare for the crash, according to one of six survivors who on Monday described the final moments of the doomed flight.

"Nobody knew there was a problem," Erwin Tumiri, a technician on the flight, told Blu radio of Colombia. "We felt the plane descending but all along we thought it was preparing to land. Everything happened very quickly and from one moment to the next the plane began to shake, the lights went out and the emergency lights turned on."

Tumiri, who is recovering in a hospital in his hometown of Cochabamba, Bolivia, said the cockpit never alerted him that the plane was running low on fuel and that the pilot had requested an emergency landing.

"I think the pilot should've at least communicated to me the situation," Tumiri said, adding that he only learned about the fuel shortage from another survivor, flight attendant Ximena Sanchez.

Investigators in Colombia said Monday that they hope to have their preliminary accident report ready in 10 days.
 

[Kip Powick]

Don,

You may recall the American Airline that was approaching Cali Colombia from the North and then turned east and then during  the "I'm lost" procedure hit the moutainside. I did not read the official version, but had hears bits and bytes as to  the cause of the accident

 

I did, however,  watch it on You Tube last nite. If the official version of what transpired in the cockpit is the same as the You Tube version, were you not surprised by the complete  lack of  cross-check when they started that fatal turn to the east?? 

Based on the two pilots extensive flying experience I couldn't believe they made that turn............  which should have been quickly questioned by the FO (PF).

Talk about the complete loss of situation awarenes by both pilots......so sad.

[Don Hudson]

Hi Kip;

Yes, I do recall the accident - December 20, 1995; the Colombian Aeronautica Civil Report is assembled by Peter Ladkin at http://sunnyday.mit.edu/accidents/calirep.html .

I do recall being surprised at the turn towards the "R" beacon while descending in mountainous territory - the terrain was almost 9000ft - one wonders if there were some misplaced confidence that they were "high enough" even though they were familiar with the route? Also, it was before the days of Enhanced GPWS, (developed late 1990's), and likely would not occur today, given that crews would not dismiss the warnings as false and were properly trained to respond to EGPWS warnings.

Also, I believe it mentions in the Report that the aircraft could possibly have missed the hill if the speedbrakes had auto-retracted with TOGA thrust, which had been applied in the avoidance manoeuvre.

The key is, of course, awareness of what's below the airplane - the MSA, no matter whether on vectors or not.

I recall, a long time ago now, a number of times being vectored "below the MSA" but at a "safe radar vectoring altitude" which made no sense as the controller was the only one in possession of that information. Eventually, charts were published that provided that same info to crews.

[Critter]

I don't have a link, but on the BBC news app they've reported the first officer as being pretty green having only been licensed in 2014. Is it a classic case of an overbearing captain making a bad call and a new FO unwilling (or unable) to point out the error?

[st27]

Not a good combination....

http://abcnews.go.com/International/colombia-plane-crash-pilots-flight-airline/story?id=43914879

http://www.dailymail.co.uk/news/article-3989820/Pictured-beautiful-pilot-killed-Colombia-plane-crash-flight-haunting-footage-shows-interview-footballers-crew-doomed-jet-took-off.html

[blues deville]

On 2016-12-06 at 0:47 PM, Kip Powick said:

Don,

You may recall the American Airline that was approaching Cali Colombia from the North and then turned east and then during  the "I'm lost" procedure hit the moutainside. I did not read the official version, but had hears bits and bytes as to  the cause of the accident

 

I did, however,  watch it on You Tube last nite. If the official version of what transpired in the cockpit is the same as the You Tube version, were you not surprised by the complete  lack of  cross-check when they started that fatal turn to the east?? 

Based on the two pilots extensive flying experience I couldn't believe they made that turn............  which should have been quickly questioned by the FO (PF).

Talk about the complete loss of situation awarenes by both pilots......so sad.

Complete loss of situational awareness. Spent a lot of time at AA's sim training center just south of DFW. During some casual chats with their pilots I was told the CVR  revealed that Cali crew spent more time discussing schedule bidding and pilot seniority issues rather than the approach into the mountainous area. 

[J.O.]

I've heard that story too but I take it with a big grain of salt given it wasn't mentioned in the report.

I used the Cali accident as a case study in human factors training and prevention of automation traps. Many of the CRM dirty words were involved. Distraction, time pressure, target fixation, confirmation bias, lack of planning and preparation, failure to confirm an FMS entry, changing the plan at a critical time were all involved. The biggest single factor that (for me) could have prevented the accident was how the FMS presented multiple examples of the same navaid identifier. When the crew entered the "R" beacon into the FMS, a list of several examples appeared. They chose the top one on the list, probably assuming they'd be arranged according to distance. In those days, they weren't. They were arranged according to most recently added to the database. While the crew were clearly not at their best, when you add in the fact that newer variants of the B757 in the AA fleet were equipped with automatic speed brake retraction with TOGA thrust, you start to see how the potential for prevention was there for the taking, had someone decided to take it.