What happened
On June 12, 2023, at approximately 15:33 UTC, a Neiva EMB-711ST (registration PT-RHJ) departed from Aeródromo Senador Petrônio Portela in Teresina, Brazil, bound for Araguaína, Brazil. Shortly after rotation, the pilot was alerted by a passenger that the cabin door was unlatched. During the initial climb, the pilot also observed the engine overpressure warning light illuminate.
While attempting to manage these issues and requesting a return to the departure airfield, the aircraft experienced fluctuations in altitude and heading. The pilot maintained a speed between 80 and 85 knots, which was below the recommended 97 knots for the best rate of climb. After retracting the landing gear and flaps, the aircraft's rate of climb dropped below 500 ft/min. While executing a left turn to return to the runway, the aircraft lost control and performed an emergency landing in a soccer field located near the runway threshold. The aircraft struck a low-voltage power line before impacting the ground, resulting in substantial damage to the airframe.
The investigation
CENIPA investigators examined the aircraft's mechanical condition, the engine, and the fuel. The analysis of the Teledyne Continental engine revealed no signs of malfunction; the internal components were well-lubricated, and the propeller blades showed evidence of rotation during impact. Fuel samples were found to be in compliance with regulatory specifications. The investigation also reviewed the aircraft's weight and balance, finding the center of gravity was at the extreme rear limit.
Investigators also evaluated the pilot's performance and the cockpit environment. The investigation noted that the pilot was managing multiple simultaneous stressors, including the unlatched door, the overpressure warning, and air traffic control instructions. The aircraft was also carrying five occupants, exceeding the certified capacity of four, including a five-year-old child seated on an adult's lap.
Findings
- The aircraft was operating at its maximum takeoff weight with the center of gravity at the extreme rear limit.
- The pilot maintained an airspeed of 80–85 knots, which was below the required 97 knots for the best rate of climb.
- The illumination of the overpressure warning light likely led the pilot to believe an engine failure was occurring.
- The pilot experienced a high cognitive workload due to the simultaneous occurrence of the door issue, the engine warning, and communication with the tower.
- The aircraft was carrying five people, which exceeded the certified limit of four occupants.