Report on air accident northeast of the Svartisen glacier in Gildeskål municipality, Nordland county, Norway on 28 August 2018 with Fly Synthesis Storch 22 CLJ amphibian, LN-YSZ

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Description

Two persons used a microlight aircraft registered LN-YSZ to search for reindeer in the mountain areas of the Gildeskål municipality south of Bodø in Norway. The aircraft was reported missing and was later found to have crashed approx. 3 km south of the Ramnfjell mountain in hilly terrain. The two on board perished. There was a fire and the aircraft was destroyed. The Accident Investigation Board Norway finds it likely that the commander was surprised by down drafts when he climbed over a low ridge at low altitude, and lost control of the aircraft.

The investigation has identified several factors related to the national microlight aircraft community that enabled the commander to operate as he did by flying below permissible altitude and with overweight. The Accident Investigation Board Norway (AIBN) therefore believes there is a need for better follow-up of the microlight aircraft segment in Norway.

The Norwegian Air Sports Association (NLF) has an approved safety management system for microlight aircraft operations. The Civil Aviation Authority (CAA-N) conducts oversight by regular audits to ensure that NLF follows up internal routines in accordance with the approved safety management system, as well as following up deviations from previous audits.

Through the investigation of this accident, deficiencies have been revealed both in the NLF's internal follow-up of micro light clubs and in the CAA-N's follow-up of its audits of NLF. The investigation also shows that passengers are not aware of the risk level of flying by microlight aircraft and possible limitations in passenger insurance coverage.

The AIBN issues three safety recommendations in these areas.

Safety recommendation

Safety Recommendation SL No. 2020/07T

On 28 August 2018 a microlight aircraft type Fly Synthesis Storch 22 CLJ Amphibium, registered LN-YSZ, crashed northeast of the Svartisen glacier in Norway. The investigation identified several factors related to the microlight aviation system that allowed the commander to operate with reduced safety margins. The follow-up of planned measures following the Civil Aviation Authority's audits of the Microlight Aviation Section in the Norwegian Air Sports Association (NLF) has not been sufficient. Thus, in several cases, deviations have not been satisfactorily corrected.

The Accident Investigation Board Norway recommends that the CAA Norway carry out a closer and better follow-up of the Norwegian Air Sports Association (NLF) and the Microlight Aviation Section. This is to ensure that their safety system functions as intended, and that planned measures following audits are followed up and complied with.

Safety Recommendation SL No. 2020/08T

On 28 August 2018 a microlight aircraft type Fly Synthesis Storch 22 CLJ Amphibium, registered LN-YSZ, crashed northeast of the Svartisen glacier in Norway. The investigation identified several factors related to the microlight aviation system that allowed the commander to operate with reduced safety margins. Planned measures following the Civil Aviation Authority's audits of the Microlight Aviation Section in the Norwegian Air Sports Association (NLF) were not satisfactorily implemented. Further, NLF had not performed internal audits of the microlight flying clubs in 2018. Thus, in several cases, deviations continued without being satisfactorily corrected.

The Accident Investigation Board Norway recommends that the Norwegian Air Sports Association (NLF) and the Microlight Aviation Section improve their follow-up of the microlight clubs in order to strengthen the safety culture. This includes follow-up on nonconformities discovered during audits, as well as ensuring through internal audits that the clubs and members comply with the association's regulations and recommendations set out in the Microlight Aviation Manual.

Safety Recommendation SL No. 2020/09T

On 28 August 2018 a microlight aircraft type Fly Synthesis Storch 22 CLJ Amphibium, registered LN-YSZ, crashed northeast of the Svartisen glacier in Norway. The investigation shows that passengers have not been adequately aware of the risk they are exposed to, including that the aircraft is not certified by an aviation authority and the limitations in insurance coverage. According to the hierarchy of safety levels for various groups in aviation, the lowest protection is given to passengers and pilots in the sports aviation segment. It is important that passengers are thoroughly informed about the risks they are exposed to in this segment of aviation, and that there may also be limitations in insurance coverage.

The Accident Investigation Board Norway recommends the Norwegian Air Sports Association (NLF) and the Microflight Aviation Section to prepare and introduce a strengthened regime that ensures that passengers are made aware of the risk they are exposed to and the insurance conditions that apply to the flight in question.

Location
Gildeskål, Nordland county, Norway
Occurrence date
28.08.2018
Aircraft
Microlight aircraft
Operator
Salten Mikroflyklubb
Registration
LN-YSZ
Meteorological conditions
VMC
County
Nordland
Type of occurrence
Accident
Type of operation
Private (club)
Category of operation
Microlight aircraft
Aircraft category
Single-engine, Seaplane (incl. amphibian), Piston engine
FIR/AOR
ENBD (Bodø ATCC)
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