What happened
On July 1, 2017, an ICP Savannah ultralight, registration 01-ACM, was conducting a local introductory flight for a passenger near Lyon-Bron, France. Shortly after takeoff, while climbing at approximately 1,250 ft, the aircraft experienced a violent pitch-up movement followed by a sudden, sharp dive. The pilot, unable to recover control, deployed the aircraft's emergency parachute. The aircraft struck the ground at a low energy state, impacting a steep embankment which caused the airframe to flip onto its back. Despite the significant damage to the airframe, the pilot and passenger were uninjured and able to exit the wreckage before emergency services arrived.
The investigation
Investigators examined the wreckage and found no mechanical failures in the flight controls. However, they noted that the aircraft's flaperons were set to the first takeoff notch, a configuration that resulted in a flight speed of approximately 130 km/h, which was roughly 20 km/h above the manufacturer's recommended maximum speed for that setting. The investigation also revealed that the aircraft's weight was slightly above the French regulatory limit for ultralights, though still within the manufacturer's maximum takeoff weight.
Analysis of a GoPro camera on board confirmed the sequence of events, including the sudden change in attitude and the subsequent parachute deployment. The investigation also looked into the operational practices of the operator, Planet’Pilote, noting that the choice of aircraft was driven largely by aesthetics and that the pilot had limited experience with this specific model.
Findings
- The loss of control was likely influenced by the aircraft operating at a speed exceeding the recommended limits for the selected flaperon configuration.
- The pilot's limited experience with the ICP Savannah may have prevented the identification of early warning signs of the aerodynamic instability.
- The passenger, who was seated on the right side, may have inadvertently hindered control recovery by gripping the control stick during the sudden movement.
- The operator had not implemented a formal safety management process to address the transition from fixed-wing operations to ultralight operations, leading to a lack of pilot familiarity with the specific aircraft's handling characteristics.
- The pilot did not follow specific emergency procedures, such as shutting off the engine and fuel supply, prior to impact.
Safety action
- The BEA recommended that the DGAC mandate the installation of emergency parachutes on all ultralights used for commercial passenger flights, where technically feasible.
- The BEA recommended that authorities ensure operators of commercial ultralight flights verify that pilots are fully aware of specific emergency procedures, particularly regarding parachute deployment and engine shutdown.