What happened
On September 4, 1999, an AB-115 Aero Boero, registration PP-GEN, operated by Aeroclube de Resende, was conducting a flight training mission near Resende, Rio de Janeiro. The crew, consisting of a flight instructor and a student pilot, was performing a local flight under visual flight rules (VFR) as part of a private pilot training program.
Approximately 30 minutes into the flight, the student requested that the instructor demonstrate a low-level pass over the terrain. The instructor accepted the request and descended to an altitude of approximately 10 meters while flying near the Paraíba do Sul River. During the maneuver, the aircraft struck high-voltage power lines. The impact caused the wires to become entangled in the stabilizer, elevator, and rudder, leading to a total loss of control. The aircraft traveled roughly 1,000 meters before impacting irregular terrain. The collision resulted in severe injuries to the student pilot and minor injuries to the instructor. The aircraft sustained extensive damage to the landing gear, wings, engine, and airframe, rendering it a total loss.
The investigation
CENIPA's investigation focused on the decision-making process and the operational environment. Investigators examined the aircraft's maintenance records, which were found to be up to date and adequate. The engine was inspected by a certified mechanic and no mechanical abnormalities were found.
Regarding the environment, investigators noted that visibility in the area was partially restricted due to smoke from regional agricultural burning, which may have hindered the crew's ability to detect the wires. The investigation also scrutinized the flight school's oversight, finding that the club lacked formal, standardized instruction rules, leaving instructors to rely on personal methodology. Furthermore, the instructor's psychological state was considered, noting that he was experiencing professional insecurity due to unemployment, which may have influenced his desire to provide a successful demonstration to the student.
Findings
- Deficient Judgment: The instructor performed a high-risk maneuver that violated established air regulations (IMA 100-12), which prohibits flying below 1,000 feet in uninhabited areas.
- Flight Indiscipline: The instructor knowingly accepted an inappropriate suggestion from a student that contravened safety standards.
- Inadequate Supervision: The flight school lacked sufficient mechanisms to supervise instruction or standardize safety protocols.
- Environmental Factors: Smoke from local fires likely contributed to the failure to identify the power lines.
- Psychological Factors: The instructor's need for professional validation may have influenced the decision to perform the unauthorized maneuver.