Pilot Error Cited In Fatal C-130 Crash

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Image: Savannah Professional Firefighters Association

Image: Savannah Professional Firefighters Association

A report released by the U.S. Air Force points to pilot error as the primary cause of an Air National Guard WC-130 Hercules crash that killed all nine servicemembers onboard. The accident occurred on May 2, 2018, shortly after takeoff from Savannah/Hilton Head International Airport (SAV) in Savannah, Georgia. According to the USAF Accident Investigation Board report, the pilots and crew failed to respond appropriately when one of the aircraft’s four engines lost power on the takeoff roll.

In spite of the power loss, the aircraft was able to make it into the air. Almost immediately after takeoff, the problem was identified and the pilot flying made the decision to return to the airport. The investigation concluded that the aircraft was still flyable, but a series of procedural and aircraft handling failures, compounded by confusion and uncertainty in the cockpit, led the pilot flying to turn toward the inoperative engine at a low airspeed and higher-than-recommended bank angle. This was followed by a hard left rudder input "which resulted in a subsequent skid below three-engine minimum controllable airspeed, a left-wing stall, and the [aircraft’s] departure from controlled flight.”

According to investigators, the aircraft had undergone maintenance after a flight in April reported experiencing RPM issues with the same engine. The investigation found that the maintenance crew did not use a precision tachometer when troubleshooting the engine malfunction, which was a violation of USAF maintenance Technical Orders. The report (PDF) lists several factors that contributed to the crash, including the crew’s failure to adequately prepare for emergencies, failure to reject the takeoff, improperly executed after takeoff and engine shutdown checklists and procedures, and the failure of the maintenance crew to properly diagnose and repair engine.

The aircraft was assigned to the Puerto Rico Air National Guard 156th Airlift Wing. The accident flight’s destination was Davis-Monthan Air Force Base, Arizona, where the aircraft was scheduled to be removed from service.

Comments (2)

Like most accidents this event could/should be used as a case study for basic root cause analysis and Human Factors training. Yes the MX Team did not use the specific tool that the technical orders call for, but the article does not go the next step by stating - Why. They couldn't use it because all but one of the Wing's tools were out of service. Yes the Flt.Crew may not have been prepared for the flight, but there is plenty of blame to go around.

In my opinion the Wing Command (CO, MX Officer, Engine Shop Leadership, etc.) is more at fault for not supplying the maintenance crew with the proper tooling, and for sending them on a mission that they could not complete I/A/W all orders.

Posted by: Gerry Shutrump | November 14, 2018 11:55 AM    Report this comment

Whatever the cause humans need to understand that flying is safe but unforgiving. RIP crew and passengers.

Posted by: bruce postlethwait | November 14, 2018 4:09 PM    Report this comment

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