Serious incident Antonov An-12BK UR-KDM,
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ASN Wikibase Occurrence # 319697
 
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Date:Friday 30 March 2018
Time:16:49
Type:Silhouette image of generic AN12 model; specific model in this crash may look slightly different    
Antonov An-12BK
Owner/operator:Cavok Air
Registration: UR-KDM
MSN: 02348107
Year of manufacture:1972
Total airframe hrs:7359 hours
Engine model:Ivchenko AI-20M-6
Fatalities:Fatalities: 0 / Occupants: 7
Aircraft damage: Substantial
Category:Serious incident
Location:Gao Airport (GAQ) -   Mali
Phase: Landing
Nature:Cargo
Departure airport:Bamako Airport (BKO/GABS)
Destination airport:Gao Airport (GAQ/GAGO)
Investigating agency: BEA-E
Confidence Rating: Accident investigation report completed and information captured
Narrative:
The Antonov An-12 transport plane carried fresh food from Châlons-Vatry, France, to Gao in Mali for the French armed forces that were stationed there. Arriving on final approach at the airport, the limited visibility prompted the crew to carry out a go-around and divert to Bamako. In the early afternoon, judging that the conditions were improving, the crew took off again and made it to the final approach on the laterite runway 07R of Gao.
With visibility reduced to 3,000 metres and the runway difficult to spot, the crew requested Gao air traffic control to mark the runway threshold with flashing lights.
The crew only perceived this secondary runway late and made corrections to line up on the runway axis on short final. As a result, the approach was not stabilized. This unstable final approach resulted in a late and poorly controlled flare.
The aircraft touched down on the runway and bounced back three times. One or more of these contacts with the runway produced excessive forces on the nose gear and its fracture.
The aircraft slid over the front of the fuselage for 500 metres before coming to rest. The crew shut down the engines and systems, then evacuated the aircraft on their own.

Causes of the event
The causes of this event are environmental, organizational and human factors.
The following factors contributed to the late detection of the active runway:
- reduced visibility conditions due to haze (less than 3,000 metres);
- the absence of contrast of the laterite runway with the surrounding terrain;
- the lack of effectiveness of portable lighting installed at the runway threshold at the crew's request.
The following factors contributed to an unstable final approach and a late and poorly controlled flare:
- the focus of attention on the landing, leading to a poorly executed landing without a go-around;
- operational pressure to deliver fresh food on time;
- the emulation induced by the performance of another crew from the same company who may have landed earlier in Gao under the same conditions;
- the fatigue accumulated by the sequence of flights and the weather conditions, which are conducive to errors of judgment and delays in decision-making;
- the organisation of the cockpit not promoting synergy within the crew.

Accident investigation:
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Investigating agency: BEA-E
Report number: E-2018-003-I
Status: Investigation completed
Duration: 1 year and 4 months
Download report: Final report

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