What happened
On July 7, 2009, a Cessna 152, registration PR-EJK, was performing a local flight departing from Jundiaary Aerodrome (SBJD) in São Paulo. During the landing phase, the pilot was notified by the control tower to be alert for other aircraft in the traffic pattern and to ensure the runway was clear.
As the aircraft approached the runway, the pilot became indecisive regarding whether to execute a go-around due to the presence of other traffic. Ultimately, the pilot decided to proceed with the landing but did so at a speed significantly higher than normal. The initial touchdown occurred on the nosewheel, causing the aircraft to bounce. A second, more violent impact followed, which resulted in a twisted nose gear strut and a broken wheel.
The investigation
CENIPA's investigation focused on the pilot's decision-making process, the flight school's training standards, and the communication environment at the aerodrome. The investigation established that the pilot was undergoing training for a Commercial Pilot License (CPL) but had not yet officially received her Private Pilot License (PPL) due to administrative delays.
Investigators examined the pilot's experience, noting she was more accustomed to flying conventional gear aircraft (such as the Embraer EMB-721 Paulistinha) and had not been adequately trained for the transition to tricycle gear or for managing high-density radio communications. The investigation also reviewed the flight school's oversight, finding that the student was permitted to fly solo without the required documentation in hand.
Findings
- Inadequate transition training: The pilot lacked sufficient adaptation to tricycle gear aircraft and had not been properly trained for radio communications in heavy traffic.
- Improper landing technique: The pilot applied a nose-down pitch command during the landing flare, leading to the initial nosewheel impact.
- Decision-making errors: The pilot's decision to land at excessive speed, driven by a desire to avoid rules infringements and an overconfidence in the aircraft's durability, was a primary factor.
- Organizational deficiencies: The flight school failed to ensure the pilot was properly trained for high-traffic environments and allowed training to proceed despite missing regulatory documentation.
- Communication breakdown: The pilot experienced selective hearing due to visual overload, failing to process critical instructions from the tower, while the controller was unable to provide runway status updates in time due to high traffic volume.