Pilot error not a factor, faulty maintenance cited in Kapar plane crash report

PUTRAJAYA - The preliminary report on the fatal plane crash in Kapar, Selangor revealed that the disintegration of the container failed to prevent intrusion of outside objects, resulting in fatal injuries to the occupants.

According to the Aircraft Accident Preliminary Report by the Ministry of Transport (MOT) Air Accident Investigation Bureau (AAIB), the aircraft container was shattered into pieces due to the high-energy impact.

Container refers to the space occupied by the aircrew, encompassing both the cockpit and cabin spaces. It was designed to be robust, to withstand deformation as a reduction in this occupiable space and is likely to cause injury or death.

"Two victims were fatally injured in this accident, the pilot in the front seat and the passenger in the rear seat. Evidence indicates that the pilot was psychologically and physically well prior to the flight.

"There is no evidence to indicate that the victims were in any form of financial, social, family and emotional distress. There were no survivors in this catastrophic accident,” the report stated.

On Feb 13, a Blackshape Gabriél BK 160TR (bearing the registration mark of I-POOC), with the call sign ADV429 and operated by Aviation Safety Technology Pte Ltd, Singapore, departed the Sultan Abdul Aziz Shah Airport, Subang, Selangor to the West of Kapar area for a leisure or recreational flight.

At about 1.36pm, the aircraft crashed into a small-holding oil palm plantation located at the village of Kampung Tok Muda near Kapar, Selangor.

The aircraft was found destroyed, and the two occupants of the aircraft were fatally injured.

The 58-page report also found that irregular maintenance activities and exceeding weight limitation were among the findings recorded in the damage assessment, which was performed with the assistance provided by the Accredited Representative (Accrep) from the National Agency for the Safety of Flight, Italy (ANSV) and his team of three Technical Advisers (TA) from Blackshape S.p.A., Italy.

The team was dispatched from Italy to Kuala Lumpur, Malaysia to provide technical assistance to the investigation of the accident.

"There is evidence indicating that irregular maintenance activities had been performed on the BK 160TR.

"These irregular maintenance activities include installation of uncertified or non-conforming aircraft parts, as well as installation of aircraft parts and aircraft servicing by unauthorised maintenance organisation or persons who were not properly qualified to carry out the maintenance activities,” the report said.

It said the investigation report on the maintenance practices of the aircraft would be updated as further evidence are being made available.

On the exceeding weight limitation findings, the report said there is evidence that the aircraft had exceeded the maximum take-off weight of the aircraft, which is 850 kilogram (kg) during the accident flight.

It also noted that presuming that there was no luggage taken onboard and no significant change to the weight of either the pilot or passenger since the time that their weights were recorded, the aircraft’s actual total weight had exceeded the maximum take-off weight limitation by approximately 8.4 per cent for the accident flight.

"The BK 160TR is a relatively weight-sensitive aircraft, and based on evidence, there is a high probability that there were other flights flown by the late pilot previously that had also exceeded the limitation of the aircraft operating weight,” it said.

The report said the aircraft was also not equipped with any flight data recorders but was equipped with two Garmin G3X GDU 460 primary flight displays, one each at the front and rear cabins of the aircraft.

"There have been past successful attempts by air accident investigation laboratories abroad in extracting parametric data recorded on similar accident-damaged devices.

"One of the Garmin G3X primary flight displays of I-POOC aircraft was recovered in heavily damaged condition from the aircraft wreckage, and the damaged unit is being dispatched to the National Transportation Safety Board, US, who has offered to assist in recovering data from the unit,” it said.

The preliminary report can be downloaded https://www.mot.gov.my/en/AAIB/report/a03-24.

Meanwhile, the MOT in a statement said the final report on the accident shall be completed and made publicly available within 12 months of the accident in accordance with the Convention on International Civil Aviation (ICAO Annex 13).

It said the AAIB investigation is ongoing to determine the causes and contributing factors that have led to the fatal accident. - BERNAMA