What happened
On November 3, 1991, a Cessna 170A, registration PT-AMA, departed from São José do Rio Preto for a local aerial filming mission. The aircraft was operated by Luar Propaganda Aérea Ltda. The flight, which was intended to film a reservoir approximately 3 nautical miles from the airfield, involved the pilot and two passengers.
During the return leg, the engine began to run irregularly and eventually failed. The pilot attempted an emergency landing in a fenced, vacant lot. During the approach, the aircraft struck an elevation and fence posts, causing the nose to impact the ground in a nose-down attitude. The impact triggered a 2/3 turn to the right, and the engine and propeller were forced into the cabin. The pilot and one passenger sustained severe injuries and passed away several days later, while the second passenger sustained minor injuries.
The investigation
CENIPA's investigation revealed that the aircraft was being used for aerial filming, a mission for which it was not certified; the aircraft was instead approved for aerial advertising (banner towing). The investigation found significant safety irregularities regarding passenger seating, noting that the aircraft was operating without a right-side door or seat, and one passenger had to be secured to the airframe by his thighs, while another sat on the cabin floor without restraints.
Regarding fuel management, the aircraft had been fueled with only 20 liters of gasoline in the left tank. The investigation established that the pilot failed to maintain effective control of remaining fuel levels. While the flight was initially planned for 20 minutes, the mission extended to approximately 50 minutes due to the nature of the filming tasks. The investigation also noted that the pilot's maintenance records for the engine and propeller were not up to date.
Findings
- Fuel exhaustion was the primary cause of the engine failure.
- Inadequate flight planning led to an insufficient fuel load for the actual duration of the mission.
- Operational non-compliance, including using the aircraft for an unauthorized mission type and improper passenger seating configurations.
- Human factors, specifically deficient judgment regarding mission duration and refueling requirements.