What happened
On July 22, 2018, a PA-34-220T aircraft, registration PR-DMC, crashed while on approach to the União da Vitória Aerodrome (SSUV) in Paraná, Brazil. The flight, operated by Siderquimica Indústria e Comércio de Produtos Químicos S/A, departed from Guarapuava (SBGU) carrying a pilot and two passengers.
During the flight, the aircraft entered a region characterized by heavy fog and restricted visibility. Approximately 17 nautical miles from the destination, the aircraft struck the tops of eucalyptus trees in the municipality of Paula Freitas before impacting the ground. The impact destroyed the aircraft and resulted in three fatalities (the pilot and two passengers).
The investigation
CENIPA investigators examined the wreckage, meteorological data, and flight planning. Analysis of radar tracks showed that shortly before the loss of signal, the aircraft deviated from its intended course. Investigators discovered several unofficial, non-standard instrument approach procedures inside the cockpit, including a descent profile for the destination aerodrome that would have required flying below minimum safety requirements.
Meteorological reports, including satellite imagery and GAMET forecasts, confirmed that the region was experiencing significant fog, with cloud ceilings estimated between 200 and 2,000 feet. While the pilot had contacted the destination aerodrome prior to takeoff and was informed of the intense fog, the investigation found that the flight proceeded despite the lack of Visual Flight Rules (VFR) conditions.
Findings
- Adverse meteorological conditions: The presence of heavy fog and low ceilings made it impossible to maintain the visual references required for VFR operations.
- Impaired perception: The degraded weather compromised the pilot's ability to perceive the surrounding environment, leading to a loss of situational awareness.
- Use of unofficial procedures: The pilot was utilizing non-standard, unofficial instrument approach procedures at an aerodrome restricted to VFR operations.
- Inadequate decision-making: A failure to properly assess the operational risks and the meteorological context led to the decision to continue the flight into unfavorable conditions.
- Flight planning deficiencies: There was an inadequate assessment of the weather conditions along the route and at the destination.