C-47 6832 Accident Summary (The coelacanth Dakota)


(Reprinted by kind permission of Clinton Barnard – Aviation & Safety Magazine)

NOTE: This is the same aircraft that was involved in the coelacanth flight in December 1952

Occurrence Date: 26 January 1966

Aircraft Involved: one Douglas C-47A Dakota Mk III NAV (serial 6832)

Aircrew & Aircraft Home Unit: Station Flight, AFS Ysterplaat

Accident Root Cause: human error (groundcrew error)

Aircraft Damage Classification: undamaged

Total Human Involvement: 3

Total On-Board Human Involvement: 2

Total Human Attrition: 1 injured, 2 OK

Identities of Involved: pilot, Lt John Gerald Thompson (01504935R) OK;

co-pilot, 2/Lt Erasmus Johannes Pienaar (05570494R) OK;

other, A/Sgt Edward Alfred Smith (05203179E) injured

Major (Maj) AP Rich was Officer Commanding (OC) Flying at Air Force Station (AFS) Ysterplaat, which fell under the South African Air Force’s (SAAF) Maritime Group. On January 26, 1966, he was also OC night flying for Station Flight during their continuation training and, as such, also authorised all the flying that night. All participating aircrews had signed documents to the effect that they had carried out self briefing. The Maj authorised Lieutenant (Lt) JG Thompson and 2nd Lieutenant (2/Lt) EJ Pienaar, both from Station Flight, to complete two back-to-back periods of circuits and landings commencing at 21H30 in Douglas C-47A Dakota Mk III NAV serial 6832 under visual flight rules conditions. During the first 45-minute period, 2/Lt Pienaar would be the aircraft commander and Lt Thompson the co-pilot, and, after a full-stop landing, they would switch seats and roles for the second 45-minute period. It would appear as though no flight engineer had been assigned for this flight.

While initial take-offs and final landings would occur at Ysterplaat, the actual circuits and landings and crew change-overs were to take place at nearby DF Malan International Airport (later Cape Town International Airport).

Air Sergeant (A/Sgt) EA Smith was a member of 17 Squadron based at AFS Ysterplaat. Over and above his usual duties with this unit, he had also been briefed from time to time regarding the servicing of Station Flight’s Dakota transports and performed duty as part of the Duty Crew for Station Flight.

As such, on the night of January 26, he was tasked by the NCO in charge of the Duty Crew, A/Sgt AN Sergeant, to collect a torch and proceed to DF Malan Airport in order to perform undercarriage and tyre checks on the Dakotas performing training there that night. A/Sgt Sergeant was fully satisfied with A/Sgt Smith’s competency in performing this task, which would require the A/Sgt to marshal the Dakota to a dead stop into wind on the South African Airways (SAA) tarmac, switch off the marshalling torches and approach the aircraft midway between the port engine and port wingtip. He would then have to proceed under the port wing to the port undercarriage and inspect it by torchlight for any apparent damage and wear and tear. He also had to examine the wheel bay for any leaks, before proceeding straight across to the starboard undercarriage and repeating the whole procedure.

During this time, the pilots would be engaged in swapping their seats in anticipation of their second flying period. He then had to backtrack, take up the marshalling torches and marshal the aircraft forwards for half the radius of the tyres in order to repeat the inspection as before, but this time on the section of tyre that had previously been in contact with the ground during his initial examination.

Lt Thompson was born in 1943 and had 859.35 total flying hours achieved on all types thus far in his SAAF service career, 796.35 hours having been accumulated on C-47s alone, of which 622.45 hours were as aircraft commander on the Dak. Instrument flying experience consisted of 7.45 hours on the Link Trainer, 51.40 hours simulated and 72.45 actual hours. He held a green instrument rating and his most recent assessment of flying proficiency achieved an average rating at Ysterplaat on March 31, 1965.

2/Lt Pienaar was born in 1944 and had 477 total flight hours, 379 having been on type with 180.15 hours as flight commander on the Dakota. He presently held a white instrument rating with a total of 20 instrument Link hours, 40 hours simulated and 17 hours actual instrument flying. His most recent flight proficiency assessment was an average achieved at Ysterplaat on May 10, 1965.

Neither pilot had any previous record of accidents due to pilot error.

Dakota 6832 lifted off as scheduled from Ysterplaat and, at the conclusion of the first period at 22H13, 2/Lt Pienaar taxied the aircraft onto the dispersal at DF Malan Airport. The aircraft marshaller was a civilian employed as an airport assistant, Mr PC Esterhuysen, who turned the transport into wind and brought it to a complete stop heading north to south. 2/Lt Pienaar activated the parking brake and completely closed both engine throttles to ground idle. The pilots undid their safety harnesses, unplugged their earphones and microphones and swapped seats in anticipation of the next flight period.

As Lt Thompson got comfortable in his seat, he noticed the marshaller indicating ‘chocks in’. While still busy plugging in their microphones and earphones, both pilots experienced a sudden jerk on the aircraft. Believing that one of the engines might have cut due to a fuel shortage, instinct was to first check the fuel pressure gauges, but these indicated nothing untoward. All other cockpit indications were normal. The Lt then looked out of the port cockpit window towards the port (No. 1) engine and was alarmed and concerned by what he saw….

While Mr Esterhuysen kept watch from in front of the Dakota, A/Sgt Smith moved in beneath the aircraft to perform his inspection. After having completed his inspection on the port undercarriage, the A/Sgt straightened up and stepped back from the wheel, his back being towards the engine propeller and the marshaller. The next instant, the propeller struck the A/Sgt from behind and flung him to the ground directly beneath the propeller. As Mr Esterhuysen watched, the A/Sgt attempted to stand up. The marshaller immediately indicated to the flight crew to cut their engines and then he ran forwards to help pull the injured A/Sgt from under the still rotating propeller.

From the cockpit, Lt Thompson saw someone in a SAAF uniform lying on the ground. He immediately cut both engines and both pilots hastened outside to see what had happened. As they arrived at the scene, they found the marshaller attempting to assist a bloodied A/Sgt Smith. Mr Esterhuysen then used his mobile radio to inform the control tower of the accident and to request the presence of the necessary emergency services. At  22H14 the aircraft docking assistant at DF Malan, Mr NJ le Grange, ran into the office to inform Mr PJB Oppel, the senior airport assistant at DF Malan, of the accident. The men rushed to the accident scene to find an A/Sgt lying on the ground about 6 ft (1.8 m) away from the aircraft propeller. Due to the patient’s extensive injuries, sustained from behind, the men present kept him lying on his back while Mr Oppel applied pressure to help keep the artery in the injured man’s neck closed.

The doctor and ambulance arrived within 12 minutes and the patient was conveyed by ambulance to Carl Bremer Hospital where he was diagnosed with a single laceration on the right side of the skull, an extensive laceration of the right shoulder, a fracture of the right collar bone, with approximately 1.5 inches (5 cm) of the collar bone missing, fracture of the right shoulder bone, pneumohemothorax of the right lung, while the coupling of the right lung was also torn open. After stabilisation, at 15H00 on January 28, the A/Sgt was transferred to Wynberg Military Hospital. In the opinion of Maj CF Scheepers, a medical officer who treated the A/Sgt, there could possibly be some future permanent restriction of movement to the right shoulder, the degree of which would only become evident with the passage of time. He anticipated that the degree of permanent disability would eventually not be very severe.

Maj Rich was informed of the accident at about 22H20, whereupon he ordered the Dakota to be locked, the aircraft’s pyrotechnics to be removed and that the aircraft be guarded. At approximately 09H00 the following morning, the Engineering Officer at Ysterplaat, Captain (Capt) FD Jooste, examined the port propeller of Dakota 6832 prior to the aircraft being moved from the scene of the accident. He performed a blade tracking check and found all three blades within limits. He also pulled the propeller through about five revolutions to establish freedom of movement, following which he declared the engine and propeller fully serviceable for flight. After photos had been taken of the accident scene, on January 27 the aircraft was flown back to Ysterplaat since an SAA aircraft required the use of that particular tarmac for operations. Capt Jooste stated that Dakota 6832 had subsequently flown 4.30 hours since the accident and had given no trouble.

A Board of Inquiry was ordered by the Chief Commandant of Maritime Group to investigate the accident. There were no civil claims and no damage to any property except for the individual involved who was found solely and directly to blame for not keeping clear of the rotating propeller. The fact that it was night time was considered by the Board as a contributory cause.

The Board found all the witness evidence to be credible and recommended that the procedure for the checking of tyres and undercarriages be reviewed by the relevant departments involved in the light of this accident. The Station Commander agreed with the Board’s findings and recommendations, but added that the practice of checking undercarriages and tyres on both Harvards and Dakotas had now ceased, except where a pilot reported a hard landing. In this event, the engines would be switched off for the necessary examinations to be safely performed. The Air Staff Aircraft Accident Board (ASAAB) concurred with the findings of the Board and classed the accident as an avoidable major ground accident and the cause down to human error, specifically groundcrew error, due to inadvertence.

At the time of this occurrence, Dakota 6832 had flown 622.50 hours since its last major servicing and had accumulated 7 240.45 total flying hours since new. It continued to serve with the SAAF until becoming one of only two Dakotas transferred to the SAAF Museum for preservation purposes. By the time of its last service flight with 35 Squadron at DF Malan Airport on March 3, 1995, it had achieved a credible 16 282.2 total airframe flying hours.