Photo: N279AJ Wreckage, right side, from NTSB Accident Docket CEN09LA116.

Eddie Sez:

The NTSB chalks this mishap up to both pilots failing to positively identify a snow-covered runway prior to landing but it involved so much more than that. Both pilots obviously had no problem flying a Category C aircraft on an approach where Category C minimums were not authorized. But after the first approach led to a missed approach, the PIC forcefully talked the SIC into an unplanned circling approach that could not have been flown in a stable manner and probably left them with inadequate time to positively identify the runway. It is doubtful the SIC, who was the pilot flying, ever really saw the runway.

How could this happen? Crew coordination was obviously a factor. The pilot flying (PF) was the Second in Command (SIC) and was junior in experience: 36 years old, 3,520 hours total, 831 hours in type. The pilot not flying (PNF) was the Pilot in Command (PIC) and was senior: 42 years old, 4,800 hours, 1,038 hours in type.

But perhaps even worse than the poor instrument procedures and flawed crew coordination there was a tragic lack of flight discipline.

What follows are quotes from the sources listed below, as well as my comments in blue.


Accident Report


Narrative

[NTSB Aircraft Accident Narrative, CEN09LA116]


Analysis

Figure: KTEX LOC/DME Rwy 9 approach plate, from NTSB Accident Docket CEN09LA116.

[NTSB Aircraft Accident Narrative, CEN09LA116]

  • According to an excerpt from the CVR, the common traffic advisory frequency (CTAF) reported to the pilots that Telluride had "an inch and half of snow or so on the runway. We have not plowed it, we were waiting until tomorrow. We’re scattered at 300, overcast at 1,700 and heavy snow."

  • A review of the Localizer/DME approach chart to runway 9 revealed that the approach is valid for category A and B aircraft; aircraft with reference landing speeds (Vref) lower than 121 knots. The circling and straight-in minimum descent altitudes are both 11,100 feet mean sea level. The weather required for both the circling and straight-in approaches were listed as 2,100 feet ceiling and 2 miles visibility.

Figure: N279AJ flight data recorder, from Group Chairman's Factual Report, NTSB CEN09LA116.

The airspeed during the circle (bottom red line) was clearly around 125 knots, well above the Category B maximum speed for circling at sea level; making a circling approach for this airplane at this airport illegal. Their true airspeed at the approach MDA (11,100') would have been 152 knots; making the decision to circle even more foolhardy.

[NTSB Aircraft Accident Docket, CEN09LA116, PF Statement]

[NTSB Aircraft Accident Docket, CEN09LA116, Cockpit Voice Recorder]

[NTSB Aircraft Accident Narrative, CEN09LA116] An on-scene investigation was conducted by a Federal Aviation Administration (FAA) inspector. The initial examination of the area indicated that the airplane had touched down about 20-feet to the right, and off, the runway. Additionally, the airplane's wings were torn from the fuselage. The tail section had separated just aft of the engines. No pre-impact anomalies with the airframe and engines were detected during the investigation.


Probable Cause

[NTSB Aircraft Accident Docket, CEN09LA116, Probable Cause Statement]

The airplane was destroyed; but it was a cheap airplane and nobody got seriously hurt so the NTSB didn't put a lot of effort into this investigation. They didn't issue a full report and the statement of probable cause was one sentence long. They could have done a lot better:


See Also:

Basic Aerodynamics / Turn Performance

Instrument Procedures / Approach Categories

Instrument Procedures / Circling Approach Area

Instrument Procedures / Circling Approaches

Procedures & Techniques / Crew Resource Management

Procedures & Techniques / Situational Awareness

Procedures & Techniques / Stabilized Approaches


References

NTSB Aircraft Accident Docket, CEN09LA116

NTSB Aircraft Accident Narrative, CEN09LA116