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ASN Wikibase Occurrence # 237358
Last updated: 10 September 2021
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Date:27-JUL-2016
Time:21:12 UTC
Type:Silhouette image of generic AT72 model; specific model in this crash may look slightly different
ATR 72-600 (72-212A)
Owner/operator:Royal Air Maroc Express
Registration: CN-COH
MSN: 1034
Fatalities:Fatalities: 0 / Occupants: 2
Other fatalities:0
Aircraft damage: Minor
Category:Serious incident
Location:Benslimane Airport (GMMB) -   Morocco
Phase: Taxi
Nature:Ferry/positioning
Departure airport:Benslimane Airport (GMMB)
Destination airport:Casablanca/Mohammed V Airport (GMMN)
Narrative:
On 27 July 2016 at 20:30, the crew boarded the aircraft 30 minutes before the airport closure (GMMB) for a positioning flight to Casablanca/Mohammed V Airport (GMMN).
After starting the engines at 20:54, the crew taxied to the taxiway and received clearance for take-off at 21:00 on runway Runway 32.
During the first take-off attempt, speed indication problems appeared. The take-off phase continued until an uncommanded lift-off. The captan then decided to abort the take-off (RTO). He taxied back to runway Runway 32 for a second take-off.
At 21:08 UTC, the captain carried out a second take-off. This second take-off attempt was deliberately aborted because of a speed indication problem (IAS DISAGREE) characterised by a difference in speed indication between the captain's side and the first officer's side. The aircraft proceeded up runway 32 and then up the ramp. At about 21:12, while taxiing, and just after the left turn to the overrun ramp, the air traffic controller advised the aircraft crew of the presence of a fire on the right engine and immediately alerted the Airport Aircraft Rescue and Firefighting Service (ARFFS). The crew followed the right-engine fire procedure and then evacuated the aircraft.
An ARFF intervention brought the landing gear fire under control.
The aircraft had just come out of the technical check (Check A) carried out in an approved maintenance workshop at Benslimane Airport (GMMB).


Direct Causes
- Obstruction of the Pitot probes which caused an underestimation of the take-off speed ;
- Take-off speed deviation not identified during the first attempt, due to non-application of operational procedures ;
- Excessive braking actions and durations following the two consecutive RTOs aggravated by high-speed "Flight Idle" taxiing.
2. Contributing factors
- Absence of ATR manufacturer's procedures relating to brake cooling following an RTO ;
- Time pressure related to airport closure ;
- CRM failure ;
- Human factors aspects such as stress and the strong captain ascent gradient in relation to the co-pilot's reactions ;
- Risks related to the nature of the Benslimane airport environment which could obstruct the tubes of the pitot probes when they are not protected (Presence of impurities/insects).

Sources:

https://www.aviationcivile.gov.ma/wp-content/uploads/2019/07/Report-CN-COH.pdf

Accident investigation:
cover
  
Investigating agency: 
Status: Investigation completed
Duration:
Download report: Final report


Images:

Photo of CN-COH courtesy AirHistory.net


Valencia (LEVC / VLC)
22 January 2013; (c) Streep

Revision history:

Date/timeContributorUpdates
25-Jun-2020 18:32 harro Added

Corrections or additions? ... Edit this accident description