ASN Wikibase Occurrence # 248379
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| Date: | Thursday 11 February 2021 |
| Time: | |
| Type: |  Eurocopter AS 365N3 Dauphin 2 |
| Owner/operator: | Pilote Le Havre |
| Registration: | F-GYLH |
| MSN: | 6760 |
| Fatalities: | Fatalities: 0 / Occupants: 4 |
| Aircraft damage: | None |
| Category: | Serious incident |
| Location: | off Le Harve -
 France
|
| Phase: | En route |
| Nature: | Offshore |
| Departure airport: | Le Harve |
| Le Harve | |
| Investigating agency: | BEA |
| Confidence Rating: |  Information verified through data from accident investigation authorities |
The BEA say: "The pilot and a winch operator embarked two marine pilots to drop them off on ships at sea.
Shortly after takeoff, passing 700 ft, the autopilot's heading hold mode is engaged but not the altitude hold mode. The helicopter started descending. The crew did not hear the radio altitude alarms emitted at 500 and 300 ft. One of the passengers alerted the crew of the low flying height.
The pilot regained altitude and the crew continued the mission without further event. The minimum height noted by the pilot is 60 ft."
The BEA summarised this as a "short, routine single-pilot flight on a complex aircraft...during a dark night" and concluded the following factors contributed to the near collision with the surface of the water:
The lack of monitoring of flight parameters such as altitude, speed and the autopilot modes engaged, which can be explained in particular by the workload experienced by the helicopter pilot and hoist operator in this very short flight phase.
The non-perception by the helicopter pilot and hoist operator of the audio and visual indications of the radio altimeters warning of approaching the ground which can be explained in particular by the low salience, both audio and visual, of the indications of the radio-altimeters. decision height (DH) crossing altimeters.
Inaccuracies and contradictions in the Operational Manual procedures, for example not making it mandatory to engage ALT mode during cruises in night or IFR flight and not requiring the completion of a checklist in this very short flight phase.
The non-application of the Operational Manual procedure requiring in particular the announcement by the pilot and the verification by the hoist operators of the autopilot upper modes engaged. This non-application of the procedures can be explained in particular by an insufficient adequacy of the written flight procedures in relation to the reality of the operation.
Operational ab initio training of hoist operators that allowed a low tolerance for errors and omissions in a single-pilot situation.
Accident investigation:
 |
|
Sources:
https://bea.aero/les-enquetes/evenements-notifies/detail/incident-grave-de-lairbus-as365-immatricule-f-gylh-survenu-le-11-02-2021-au-large-du-havre-76/
https://www.bea.aero/en/investigation-reports/notified-events/detail/serious-incident-to-the-airbus-as365-registered-f-gylh-on-11-02-2021-off-the-coast-of-le-havre/
http://aerossurance.com/helicopters/offshore-night-mpt-automation/
Location
Media:
During high workload night single pilot #helicopter hoist flight an error in #automation selection was not detected until a passenger warned the aircraft had descended to just 59 ft. https://t.co/cHkKfsXfTi #offshore #humanfactors #aviationsafety #flightsafety pic.twitter.com/1NapYr8K8R
— Aerossurance (@Aerossurance) March 19, 2022
Revision history:
| Date/time | Contributor | Updates |
|---|---|---|
| 01-Mar-2021 15:28 | Aerossurance | Added |
| 01-Mar-2021 15:28 | Aerossurance | Updated [Narrative] |
| 01-Mar-2021 15:45 | Aerossurance | Updated [Narrative] |
| 01-Mar-2021 16:06 | Aerossurance | Updated [Source, Narrative] |
| 19-Mar-2022 16:37 | Aerossurance | Updated [Source] |
| 19-Mar-2022 16:48 | Aerossurance | Updated [Embed code, Narrative] |
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