Incident
On the morning of 18 February 2022, the pilot of a Raytheon B200, registered VH-MVP and operated by Eastern Air Link, conducted an air transport flight from Port Macquarie, New South Wales to Lord Howe Island. At about 0800 local time, the pilot commenced a distance measuring equipment (DME) arrival procedure. Although the flight was conducted under instrument flight rules (IFR), the pilot established visual meteorological conditions early in the approach and transitioned to a visual approach. The pilot then descended the aircraft visually below cloud over water to an altitude below 1,000 ft, positioning for a straight-in approach to runway 10.
During the approach, the aircraft entered an area of reduced visibility due to rain. The aircraft touched down to the left of the runway.
Investigation Findings
The Australian Transport Safety Bureau (ATSB) investigation determined that at the time of the final approach and landing, the aerodrome was experiencing a heavy rain shower with limited visibility, conditions marginal for visual flight. While the pilot commenced a visual approach with required visual cues, it was highly unlikely that visual contact with the runway was retained throughout the approach. Contrary to missed approach requirements, the pilot did not commence a go-around after losing visual cues but continued toward the runway, resulting in increasing displacement from the runway centreline.
Late in the approach, with the aircraft close to the runway but significantly displaced, visual contact was reacquired. Considerable manoeuvring with significant heading changes was required to realign with the runway, resulting in an unstable approach. Despite not meeting the operator's stabilised approach criteria, the pilot elected to continue and land, assessing that a missed approach from short final held excess risk due to high terrain near the runway. The realignment was unsuccessful, and the aircraft touched down off and to the left of the runway, on the runway strip.
The investigation also identified several other flights by Eastern Air Link that followed a similar approach profile to runway 10 in marginal weather conditions. This practice significantly reduced obstacle clearance assurance for both approach and potential missed approach, increasing risk. The ATSB brought this safety issue to the operator's attention. Additionally, the practice of joining for a short straight-in approach from well within the 3 NM requirement while below normal circuit height presented an increased collision risk to other aircraft operating in the circuit or conducting instrument approaches.
Operator Action
Eastern Air Link amended its operations manual to ensure compliance with straight-in approach operational procedures as required by regulations and the aeronautical information publication. The ATSB acknowledged this proactive action but did not consider it sufficient to address the practice of conducting visual approaches in marginal weather. Consequently, the ATSB issued a recommendation that Eastern Air Link take further action to address this safety issue.
Safety Message
Adherence to operational procedures ensures consistency of pilot action and aircraft operation during approach and landing. Careful monitoring of aircraft and approach parameters is essential for safe conduct of approaches. Operators should encourage the use of the most appropriate and safe approach available. In marginal conditions, an instrument approach that provides obstacle clearance assurance minimises risks from unforeseen deterioration. Such approach types provide a protected flight path for missed approaches and are significantly safer than visual approaches in marginal weather.