3 dead, 2 uninjured in NWT

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godsrcrazy
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Re: 3 dead, 2 uninjured in NWT

Post by godsrcrazy » Fri Mar 01, 2019 7:57 am

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Zaibatsu
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Re: 3 dead, 2 uninjured in NWT

Post by Zaibatsu » Sun Mar 03, 2019 2:50 pm

I knew it.

Hopefully this spurs some action from industry and regulator to address this issue.
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TailwheelPilot
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Re: 3 dead, 2 uninjured in NWT

Post by TailwheelPilot » Sun Mar 03, 2019 9:29 pm

A study on emergency exits from submerged floatplanes was commissioned in 2006, but it ultimately indicated “there were no suitable design changes that could feasibly be applied to the entire Cessna 206 fleet,” the TSB said.
The flap/rear door issue is well known and has always been an issue - IMO Cessna should have foreseen the problem and dealt with it on the drawing board - but the extra cabin volume and the large cargo door are what make the 206 desirable (and why so few P models exist).

The co-pilot door is expensive and small, and not useful for the rear passengers. Redesigned cargo doors or flaps would be great but the cost to certify and modify all 206s would probably see many operators replacing them instead. Punch-out or opening rear windows may also work, but again probably a lot of engineering work would be required. A paper restriction (ie four people; or five with only one middle seat like the 206H, I think) may help, but not in this accident since at least one middle row passenger did not survive (assuming 2-2-1 seating).

I found that the middle row access to the left door is very good - easier to get in and out than it was for me in the pilot seat without moving my seat. That has me wondering why only two people got out. Was initial egress through the window versus the door (quoted at Cabin Radio from the TSB advisory) a factor that made it more difficult for the deceased to egress? What was the physical condition of the 72 year olds and was it an issue?

Something that may have helped is a better design for the door handles/latches - after egress the pilot could not get the doors open due to them being latched from the inside. It always struck me as odd that many Cessnas (at least the single pistons) have external door handles that cannot open the door when latched from the inside (but not locked, since those are only on the exterior). Handles that can open the door from either side when unlocked and separate locks for each door makes far more sense to me. The rear baggage door on other single piston Cessnas only having an exterior latch has also been an issue in previous accidents (as well as being locked for flight).
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pelmet
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Re: 3 dead, 2 uninjured in NWT

Post by pelmet » Wed Jan 15, 2020 4:16 pm

Here is the final report....

http://www.bst-tsb.gc.ca/eng/rapports-r ... 8w0129.pdf

Very inexperienced pilot. I thought the insurance companies required a lot more hours than that. Or is this typical for total experience for the first job.
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porcsord
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Re: 3 dead, 2 uninjured in NWT

Post by porcsord » Wed Jan 15, 2020 5:00 pm

For a first job?

I mean, she had 5 times the total time legally required, and 4 times the float time legally required.
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Victory
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Re: 3 dead, 2 uninjured in NWT

Post by Victory » Wed Jan 15, 2020 5:51 pm

Shocking door design. The rear passengers didn't have a chance.
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pelmet
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Re: 3 dead, 2 uninjured in NWT

Post by pelmet » Wed Jan 15, 2020 6:42 pm

porcsord wrote:
Wed Jan 15, 2020 5:00 pm
For a first job?

I mean, she had 5 times the total time legally required, and 4 times the float time legally required.
7 hours float time when hired. I have read over and over that no-one will hire a new float rated person until many more hours are accumulated(possibly 100) due to insurance reasons and that is just for a rental. Has that changed for some reason. Pilot shortage?
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beaverpuq
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Re: 3 dead, 2 uninjured in NWT

Post by beaverpuq » Wed Jan 15, 2020 7:09 pm

Flown a few different types on floats. There are certain seats on all of them I would not want to be in if I were upside down. The egress training will shock you when you see how easy it is to get confused. Sad stuff again.
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magic wand
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Re: 3 dead, 2 uninjured in NWT

Post by magic wand » Wed Jan 15, 2020 9:19 pm

Victory wrote:
Wed Jan 15, 2020 5:51 pm
Shocking door design. The rear passengers didn't have a chance.
Will the appropriate authorities do anything about this..NO.

Until the egress issue, on floats, is addressed - I think that all C206 should be restricted to land operations.


There is a simple solution yet the regulators refuse to act on the issue.
https://www.cbc.ca/news/canada/north/ca ... -1.5037433


Time for the FAA or TSB or TC or whom-ever to grow a set and cease float operations until the breakaway doors are
installed.
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shimmydampner
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Re: 3 dead, 2 uninjured in NWT

Post by shimmydampner » Wed Jan 15, 2020 9:20 pm

porcsord wrote:
Wed Jan 15, 2020 5:00 pm
For a first job?

I mean, she had 5 times the total time legally required, and 4 times the float time legally required.
32 hours floats at the time of the accident. That's a challenging corner of the country to be flying floats in with so little experience.
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porcsord
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Re: 3 dead, 2 uninjured in NWT

Post by porcsord » Wed Jan 15, 2020 11:27 pm

7 on floats, but almost 800 in the same type, in the same area. Float flying isn't rocket science, and little doctor lake isn't some small high density altitude lake in a mountain bowl.

I'm not saying that mistakes weren't made, just that it's perfectly reasonable to start flying floats at 7 hours, many of us have done it, and done it safely. I've never worked anywhere that had an hour requirement for insurance, it's always required a successful checkout by the chief pilot or a delegate.
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pelmet
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Re: 3 dead, 2 uninjured in NWT

Post by pelmet » Thu Jan 16, 2020 1:40 am

porcsord wrote:
Wed Jan 15, 2020 11:27 pm
7 on floats, but almost 800 in the same type, in the same area. Float flying isn't rocket science, and little doctor lake isn't some small high density altitude lake in a mountain bowl.
I bet the 793 hours on type for wheel ops had little value for the float ops. Based on the number of accidents I read about every summer, it appears to be much higher risk. After all, would these passengers have died if the same thing(bounce with wingtip strike) happened at an airport. Not likely. Float operations is a whole different world. Wouldn't surprise me if the accident rate for a given amount of experience is significantly higher.

Was the pilot insurable? How much experience does a typical Cessna floatplane operator require for a newhire to be sent out alone? I might have to start asking questions to the pilot next time I am a pax on a floatplane. Doesn't happen often but I was on a Caravan last week as the only pax.
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Heliian
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Re: 3 dead, 2 uninjured in NWT

Post by Heliian » Thu Jan 16, 2020 5:37 am

Considering that pilots with 10000hrs of float time have crashed on lakes with fatal consequences, I don't think time on floats in this case is relevant.

The Poor design of the aircraft that prevented egress is the problem and directly caused the deaths of 3 people.
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Victory
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Re: 3 dead, 2 uninjured in NWT

Post by Victory » Thu Jan 16, 2020 6:08 am

pelmet wrote:
Thu Jan 16, 2020 1:40 am
Was the pilot insurable?
I have worked for operators where insurance has said it's up to you to decide who flies your airplanes. We trust you enough to not put incompetent people in there. So it's not always the insurance company making that call.
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shimmydampner
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Re: 3 dead, 2 uninjured in NWT

Post by shimmydampner » Thu Jan 16, 2020 6:55 am

Heliian wrote:
Thu Jan 16, 2020 5:37 am
Considering that pilots with 10000hrs of float time have crashed on lakes with fatal consequences, I don't think time on floats in this case is relevant.

The Poor design of the aircraft that prevented egress is the problem and directly caused the deaths of 3 people.
Certainly the aircraft design is absolutely the reason why the passengers couldn't egress. However, the aircraft did not end up inverted in the water due to any design flaw. That was directly related to pilot inexperience. Sure, 10000 hour float pilots can kill themselves but that's usually a result of decision making. I think it's very rare indeed for an experienced float pilot to botch the correct landing attitude at all, let alone to the degree it becomes fatal. That speaks directly to a lack of skill, which was evidently mentioned in training records, according to the report.
porcsord wrote:
Wed Jan 15, 2020 11:27 pm
7 on floats, but almost 800 in the same type, in the same area. Float flying isn't rocket science, and little doctor lake isn't some small high density altitude lake in a mountain bowl.

I'm not saying that mistakes weren't made, just that it's perfectly reasonable to start flying floats at 7 hours, many of us have done it, and done it safely.
That's all well and good and I'm sure everyone involved is happy for you and the "many of us" who "have done it and done it safely." However, given that float flying is not rocket science and the lake is not the most challenging, why then did this landing in benign conditions go so badly that the aircraft flipped? I'm pretty sure the answer lies squarely in the skill level of a 32 hour float pilot.
Furthermore, trying to equate a small amount of wheel flying experience to floats doesn't hold up in my opinion. The consequences of screwing up a landing attitude or bounce recovery on wheels are rarely more than embarrassment. The penalty for failure on floats is often much more dire. It demands more skill than was evidently on display in this case.
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valleyboy
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Re: 3 dead, 2 uninjured in NWT

Post by valleyboy » Thu Jan 16, 2020 10:02 am

Not much actual met information but from all the information but possibly a tad slow and she got caught. The 206 has a history of a terrible float plane, many because of door setup but also performance. Very sad indeed.
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bigsky
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Re: 3 dead, 2 uninjured in NWT

Post by bigsky » Thu Jan 16, 2020 5:53 pm

Victory wrote:
Thu Jan 16, 2020 6:08 am
pelmet wrote:
Thu Jan 16, 2020 1:40 am
Was the pilot insurable?
I have worked for operators where insurance has said it's up to you to decide who flies your airplanes. We trust you enough to not put incompetent people in there. So it's not always the insurance company making that call.
Pilot aside..the question should be “is the aircraft type” insurable.
One would think that operators of the C206 on floats will be paying through the nose
to obtain insurance.
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Victory
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Re: 3 dead, 2 uninjured in NWT

Post by Victory » Thu Jan 16, 2020 6:14 pm

Oh I agree 100% it's an airplane issue. Float planes flip. I know multiple career float pilots that have flipped them. There is no way anyone should be putting innocent people in a float plane without a reasonable chance of egress available to them via a simple to operate emergency exit. These are the kinds of things people assume they are protected from by regulators and commercial operators. Insurers could be a last ditch protection but that usually takes big lawsuits after the fact to get their attention. It shouldn't have to come to that.
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Re: 3 dead, 2 uninjured in NWT

Post by TailwheelPilot » Thu Jan 16, 2020 6:27 pm

The pilot's progression was quite fairly typical for a new float pilot. Work for the operator for a season/year (in this case flying the 206 not working the dock) and then into a float flying position. Presumably the operator felt the pilot could handle it. How much float time is enough? Why does TC not mandate more time if 7 hours is insufficient? How should one go from the float rating (7 hours) to being employable? Should they rent a float plane (and instructor at most places) for that time? Most (Canadian) pilots are of the opinion that paying for type ratings, hours to get an ATPL, etc are horrible things to do - why should paying for float hours be different?

Training was done in June/July (done by the 5th). Two flights under supervision in mid-July (approximately 1.5-2 weeks after initial training). A training flight another two weeks later on 3 August. The accident was on the eighth leg after that, eleven days later. That seems like a long time with significant delays in training and not much flying once it was finally done. Definitely something I would consider to be undesirable, especially for a new float pilot. Get them trained and then immediately let them cement the training by flying a lot.

Simpson Air has decided to no longer use 206s on floats. That got me wondering if the back door on a P206 get blocked by flaps as well? It seems reasonably large and, if it does not get blocked with flaps down, it would still provide more cabin space, comfortable seating for four passengers, and (slightly) easier loading over a 185 while having better egress options than a U206.

No one has mentioned TC's threat to the FAA/Cessna to issue an AD limiting U206s to 5 people if they do not improve the cargo door exit. That potential AD would not have helped anyways in this case (the float 206 I knew more about was company limited to five people for weight and performance reasons anyways). Perhaps the AD should go further to limit floatplane U206s to four passengers if there is no cargo door improvement, in the front two rows, and mandate a co-pilot door or opening window as a second exit (although the window is likely too small to be properly an exit).
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Re: 3 dead, 2 uninjured in NWT

Post by Redneck_pilot86 » Thu Jan 16, 2020 8:07 pm

Pretty sure the H model is restricted to 4 passengers.
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Re: 3 dead, 2 uninjured in NWT

Post by TailwheelPilot » Thu Jan 16, 2020 8:31 pm

Sorry, I meant four people. The TC AD threat to restrict it to five people would still mean one person in the third row.
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Mick G
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Re: 3 dead, 2 uninjured in NWT

Post by Mick G » Fri Jan 17, 2020 11:49 am

Lets not armchair bash on her too much, remember we all started out at one time, and had to build our hours and experience, just like her. She also did have a decent amount of experience off floats. We can't paint the entire industry with one brushstroke from one pilots error.
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Re: 3 dead, 2 uninjured in NWT

Post by beaverpuq » Fri Jan 17, 2020 2:29 pm

To get lots of experience you have to had been lucky a time or two.
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Re: 3 dead, 2 uninjured in NWT

Post by corethatthermal » Fri Jan 17, 2020 9:22 pm

Wat would it cost for a company to engineer a fix ( Make the forward door fixed and increase the aft door and put a handle on it ) $10-$15000 ? Is TC too anal to fast track approval of a companies aft door mod kit ? Will Cessna be trying to prevent this kind of mod? Maybe get 10 customers deposits with a promised kit price and quoted install cost?

On another note, and this is not a sexist remark , so flamers, please go somewhere else. Some companies will fast track or push a female pilot through for the token rewards of being such an affirmative action company. There were warning signs during training and im sure a lot more signs that are not uncovered. Bush flying requires strength, quick intuitive reflexes, assertiveness, lots of confidence, the ability to make solitary decisions and decisions that may go against the grain. A male is better equipped for bush flying to due an inherent higher level of these traits! A female is better equipped for airline flying IF there are no issues with foolish alpha males trying to screw things up AND the female is able to progress to a level of confidence and assertiveness , combined with experience and ability to overcome the negative stereotyping in the industry.
When a person looks at young men and women drivers, women are safer ! Men tend to learn things like driving in a snowstorm ( testosterone effect )
I would also prefer to ride as a passenger in a big bus with an experienced female driver, as compared to an experienced male driver who likes to take chances with traffic ! ( I remember my school age days when an experienced older owner/driver took waaaay too many chances with us 40 + kids seated behind him! We all survived BUT it was an accident waiting to happen !
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Re: 3 dead, 2 uninjured in NWT

Post by Checklist » Fri Jan 17, 2020 10:34 pm

corethatthermal wrote:
Fri Jan 17, 2020 9:22 pm
Wat would it cost for a company to engineer a fix ( Make the forward door fixed and increase the aft door and put a handle on it ) $10-$15000 ? Is TC too anal to fast track approval of a companies aft door mod kit ? Will Cessna be trying to prevent this kind of mod? Maybe get 10 customers deposits with a promised kit price and quoted install cost?

On another note, and this is not a sexist remark , so flamers, please go somewhere else. Some companies will fast track or push a female pilot through for the token rewards of being such an affirmative action company. There were warning signs during training and im sure a lot more signs that are not uncovered. Bush flying requires strength, quick intuitive reflexes, assertiveness, lots of confidence, the ability to make solitary decisions and decisions that may go against the grain. A male is better equipped for bush flying to due an inherent higher level of these traits! A female is better equipped for airline flying IF there are no issues with foolish alpha males trying to screw things up AND the female is able to progress to a level of confidence and assertiveness , combined with experience and ability to overcome the negative stereotyping in the industry.
When a person looks at young men and women drivers, women are safer ! Men tend to learn things like driving in a snowstorm ( testosterone effect )
I would also prefer to ride as a passenger in a big bus with an experienced female driver, as compared to an experienced male driver who likes to take chances with traffic ! ( I remember my school age days when an experienced older owner/driver took waaaay too many chances with us 40 + kids seated behind him! We all survived BUT it was an accident waiting to happen !
Maybe Jordan Peterson would agree with you but male vs female argument is about as broad you can get.

Men say women aren’t as strong. Have you watched the Olympics? Can you throw 400lbs over your head? Go to your local gym for that matter, plenty of women that could out bench most of us.

Applies to flying (bush or otherwise) too. A lot of women out there that are sharper pilots than most men. The difference is when a women makes a mistake, men immediately to point out their sex as if it has relevance.

It doesn’t.

There’s good pilots and bad pilots. And then most of us in between with just enough luck to have never paid so dearly for one of our many mistakes.

A truly tragic accident. Has me seriously doubting how viable the 206 is for commercial operations.
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