MA60, en route, west of Bima Indonesia, 2011

MA60, en route, west of Bima Indonesia, 2011

Summary

On 12 December 2011, the crew of a Xian MA60 delayed their response to an engine fire warning until the existence of a fire had been confirmed by visual inspection and then failed to follow the memory engine shutdown drill properly so that fire continued for considerably longer than it should have. The Investigation found that an improperly tightened fuel line coupling which had been getting slowly but progressively worse during earlier flights had caused the fire. It was also concluded that the pilots' delay in responding to the fire had prolonged risk exposure and jeopardised the safety of the flight.

Description

On 12 December 2011, a Xian MA60 (PZ-MZG) being operated by Merpati Nusantara Airlines on a scheduled domestic passenger flight from Bima to Denpasar as MZ623 was climbing through 6000 feet in day Visual Meteorological Conditions (VMC) when a left engine fire warning occurred. Actual fire was confirmed and the engine was eventually shutdown and an air turnback to Bima accomplished without further event. Damage to the left engine from the effects of fire was externally visible.

The left engine cowling after flight showing cowling damage (Reproduced from the Official Report)

Investigation

An Investigation was carried out by the Indonesian National Transportation Safety Committee (NTSC) - the Komite Nasional Keselamatan Transportasi (KNKT). Data from both the FDR and CVR were successfully downloaded and used to support the Investigation.

The 39 year-old Captain was found to have 4813 hours total flying experience including 1531 on type. Total flying experience for the First Officer was "not available" but he had 1088 hours flying experience on type. It was noted that pilot type conversion training had occurred in Xi'an (Captain) and Jakarta (First Officer) and in both cases had been conducted by instructors from the Aircraft Manufacturer aided by translators.

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