Incident Overview

Date: Wednesday 8 October 2008
Aircraft Type: de Havilland Canada DHC-6 Twin Otter 300
Owner/operator: Yeti Airlines
Registration Number: 9N-AFE
Location: Lukla-Tenzing-Hillary Airport (LUA) – ÿ Nepal
Phase of Flight: Landing
Status: Destroyed, written off
Casualties: Fatalities: 18 / Occupants: 19
Component Affected: Aircraft Flight ControlsAircraft Flight Controls
Investigating Agency: NepalNepal
Category: Accident
On October 26, 2023, an aircraft crashed during a domestic flight from Kathmandu Airport to Lukla Airport. The aircraft, a 1600-foot bitumen runway with an upslope of 11.75 degrees, experienced poor visibility due to the Twin Otter’s arrival. It collided with rocks near the runway, resulting in a crash and fire. The captain was the sole survivor. The incident was attributed to a misjudgment by the flight crew regarding cloud cover during final approach, stemming from insufficient weather information and a failure to properly assess the rapidly ascending fog. Regulatory oversight and company safety management practices were also implicated, with AFIS personnel struggling to declare airport closure due to high workload and the presence of multiple preceding aircraft in similar challenging weather conditions.On October 26, 2023, an aircraft crashed during a domestic flight from Kathmandu Airport to Lukla Airport. The aircraft, a 1600-foot bitumen runway with an upslope of 11.75 degrees, experienced poor visibility due to the Twin Otter’s arrival. It collided with rocks near the runway, resulting in a crash and fire. The captain was the sole survivor. The incident was attributed to a misjudgment by the flight crew regarding cloud cover during final approach, stemming from insufficient weather information and a failure to properly assess the rapidly ascending fog. Regulatory oversight and company safety management practices were also implicated, with AFIS personnel struggling to declare airport closure due to high workload and the presence of multiple preceding aircraft in similar challenging weather conditions.

Description

The aircraft took off from Kathmandu Airport at 06:51 on a domestic flight to Lukla (LUA). Lukla Airport has a single runway, 06/24 which is situated at an elevation of 9380 feet. The 1600 feet long bitumen runway has an upslope of 11,75ø. Runway 06 can only be used for landing. Visibility was reported as poor as the Twin Otter came in to land. It contacted rocks near the runway, crashed and caught fire. The captain was the only survivor. Cause: The probable primary cause was flight crew’s misjudgment, based on the weather information from all the preceding aircraft and Lukla Information, to enter into cloud patch on final wherein the aircraft encountered the rapidly uplifting fog on short final resulting in control flight into terrain. a) Failure on the part of regulatory body and company safety management to check the wrong practices being followed by pilots especially in STOL airfields like Lukla on a timely basis. b) AFIS personnel on duty not being able to declare airport closure due to high workload, stress and landing of preceding three aircraft in similar marginal weather condition. c) Operator’s priority of economical aspect over safety such as their unequal treatments between pilots landing in adverse weather and diverters, creating a ‘Must Land’ situation.

Primary Cause

Flight crew’s misjudgment regarding cloud cover during final approach, stemming from insufficient weather information and a failure to properly assess the rapidly ascending fog.Flight crew’s misjudgment regarding cloud cover during final approach, stemming from insufficient weather information and a failure to properly assess the rapidly ascending fog.

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