CT114173 / CT114064 Tutor - Epilogue - Flight Safety Investigation Report

Report / December 10, 2004 / Project number: CT114173- CT114064 - A Category

Location: Mossbank, Saskatchewan
Date: 2004-12-10
Status: Investigation Complete

The Flight Safety Investigation Report (FSIR) is available from DFS.

Epilogue

The Snowbird solos (#8 Opposing Solo and #9 Lead Solo) were conducting training over the abandoned Mossbank aerodrome, about 30 nautical miles south of 15 Wing Moose Jaw. At the time of the accident, the solos were performing a "co-loop", which consists of the two aircraft performing opposing direction loops. As the two aircraft neared the top of the loop, it became evident that there was potential for a collision. Accordingly, one aircraft maintained a predicted flight path (as briefed prior to the mission) so that the other pilot could manoeuvre his aircraft to make the miss. When it was evident that a collision was still imminent, one pilot initiated an evasive manoeuvre to the inside of the loop, his briefed safe exit direction. Immediately following this action, a collision occurred at the top of the loop at about 3500 feet above ground level with the two aircraft having a closing speed between 360 and 400 knots. Both aircraft were destroyed during the collision.

The collision caused a fireball, which engulfed both aircraft. The pilot of #8 was killed instantly in the collision. The pilot of #9 was expelled from his aircraft without initiating ejection. He pulled the "D" ring for his parachute and manually released the lap belt of his ejection seat. Shortly thereafter his parachute blossomed. About 5 seconds later he landed in an open field, having sustained minor injuries. He was assisted by local citizens and taken by civilian Emergency Medical Services (EMS) to the Moose Jaw Union Hospital.

The investigation found no mechanical problems with either aircraft, and focused on the human factors involved. Possible physiological, orientation and perception cause factors were examined. As well, an analysis of Snowbird training was conducted. It was assessed that Snowbird #8's training to conduct the co-loop manoeuvre was deficient, in that he did not have either the dual training or experience to develop the appropriate sight-picture for a 30 foot miss at the top of the maneuver.

The preventive measures for this accident include recommendations regarding squadron manning levels and training, including adjustment to the requirement for dual training. Changes regarding how the co-loop maneuver is flown were proposed. As well, a risk assessment of all the solo specialty maneuvers was recommended.