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  • B744, Johannesburg South Africa, 2009 (Synopsis: On 11 May 2009, a British Airways Boeing 747-400 departing Johannesburg came close to stalling following a stall protection system activation during night rotation which continued until landing gear retraction despite immediate appropriate crew response. Subsequent investigation found that loss of lift on rotation had resulted from the unanticipated effect of a design modification in respect of thrust reverser unlocked signals with the aircraft in ‘ground’ status. The Investigation found that the potential effects of this on the transition from ‘ground’ to ‘air’ status including the lower stalling angle of attack in ground effect had not been foreseen.)
  • B789, en-route, eastern Belgium, 2017 (Synopsis: On 29 April 2017, a Boeing 787-9 which had just reached cruise altitude after despatch with only one main ECS available began to lose cabin pressure. A precautionary descent and PAN was upgraded to a rapid descent and MAYDAY as cabin altitude rose above 10,000 feet. The Investigation found that aircraft release to service had not been preceded by a thorough enough validation of the likely reliability of the remaining ECS system. The inaudibility of the automated announcement accompanying the cabin oxygen mask drop and ongoing issues with the quality of CVR readout from 787 crash-protected recorders was also highlighted.)
  • CVLP, vicinity San Juan Puerto Rico, 2012 (Synopsis: On 15 March 2012 the right hand engine exhaust of a Convair 440 freighter caught fire soon after take off and the fire was not contained within the exhaust duct or the zone covered by the fire protection system. After shutting this engine down, the subsequent Investigation concluded that the crew had lost control at low airspeed during an attempted turn back due to either an aerodynamic stall or a loss of directional control. It also found that the Operator involved was in serial violation of many regulatory requirements and that FAA oversight of the operation had been wholly ineffective.)
  • DH8C, Darwin NT Australia, 2019 (Synopsis: On 11 November 2019, one of the two PW100 series engines of a Bombardier DHC8-300 failed catastrophically when takeoff power was set prior to brake release. The Investigation found that the power turbine shaft had fractured in two places and all first and second stage power turbine blades had separated from their disks. The shaft failure was found to have been caused by fatigue cracking initiated by corrosion pitting which was assessed as probably the result of prolonged marine low-altitude operations by the aircraft. It was found that this fatigue cracking could increase undetected during service between scheduled inspections.)
  • DH8D, Aalborg Denmark, 2007 (Synopsis: On 9 September 2007 the crew of an SAS Bombardier DHC8-400 approaching Aalborg were unable to lock the right MLG down and prepared accordingly. During the subsequent landing, the unlocked gear leg collapsed and the right engine propeller blades struck the runway. Two detached completely and penetrated the passenger cabin injuring one passenger. The Investigation found that the gear malfunction had been caused by severe corrosion of a critical connection and noted that no scheduled maintenance task included appropriate inspection. A Safety Recommendation to the EASA to review the design, certification and maintenance of the assembly involved was made.)
  • DHC2, manoeuvring, Jerusalem Bay north of Sydney Australia, 2017 (Synopsis: On 31 December 2017, a de Havilland DHC2 floatplane being manoeuvred at low level over Jerusalem Bay shortly after takeoff was observed to enter a steeply banked turn from which it appeared to depart controlled flight and impact the water surface below almost vertically. The Investigation concluded that the aircraft had stalled despite the exemplary proficiency record of the pilot and that in the absence of any other plausible explanation found that the loss of control was likely to have been the effect of an elevated exposure to carbon monoxide found during post mortem toxicology testing.)