What happened
On November 8, 2013, a Cessna 402 (registration HK-4353) was performing a general aviation taxi flight from Quibdó to Pizarro, Chocó, carrying two crew members and eight passengers. During the landing phase on runway 15, the aircraft encountered a strong tailwind component and crosswind at approximately 200 feet above the ground. Despite the destabilized conditions, the crew proceeded with the landing.
The aircraft made contact with the runway surface, which was covered in puddles due to recent rainfall. This resulted in a hydroplaning event, causing the pilot to lose directional control. The aircraft veered to the right, exiting the paved surface and traveling into the right-side safety area. The excursion caused the landing gear to fracture, the engines to stop abruptly, and significant damage to the lower fuselage and nose. All ten occupants evacuated the aircraft uninjured.
The investigation
The GRIAA investigation examined the flight history, crew experience, and environmental conditions. The investigation noted that the crew had been informed of poor weather in Pizarro prior to departure and had waited for visibility to improve. While the crew followed standard communication procedures for an uncontrolled aerodrome, the investigation focused on the decision-to-continue despite an unstable approach.
Investigators also reviewed the aircraft's maintenance records, finding that the Cessna 402 was up to date on its inspections. The investigation also highlighted a previous serious incident involving the same aircraft and pilot at the same aerodrome earlier that year, involving a similar runway excursion caused by an unstable approach.
Findings
- The primary cause was a loss of directional control resulting from an unstabilized approach.
- The crew made a poor decision to continue the landing approach despite experiencing significant wind changes and high speeds that met the criteria for a missed approach.
- The aircraft landed directly into a puddle, triggering a hydroplaning effect.
- Contributing factors included inadequate runway drainage and deficiencies in the aerodrome's safety area.
Safety action
- The operator was recommended to implement stricter controls within its Management System to ensure compliance with regulations for uncontrolled aerodromes.
- The operator was advised to conduct risk analyses for all operational runways and provide refresher training for pilots focusing on decision-making, stabilized approaches, and landing techniques on wet runways.
- The aeronautical authority was recommended to perform a risk analysis of the Pizarro aerodrome to improve operational conditions and drainage.