Associated links (A23O0028)
Loss of control led to 2023 fatal plane crash
Today, the Transportation Safety Board of Canada (TSB) released its investigation report (A23O0028) into a fatal collision with terrain of a Cessna 208B Caravan aircraft operated by Wilderness North Air.
On February 28, 2023, the aircraft departed Nakina Airport, Ontario, for a visual flight rules (VFR) flight to Fort Hope Airport, Ontario, with two pilots on board. The designated pilot-in-command, initially scheduled to conduct the daytime VFR flight unaccompanied, changed plans after the morning briefing revealed gusty winds and an off-duty pilot, who had more experience, offered to join him, albeit with no assigned flight duties.
The aircraft did not arrive at its destination and was subsequently reported missing to the Joint Rescue Coordination Centre, which initiated an airborne search that continued until March 4, 2023, when the aircraft wreckage was found destroyed and both pilots were fatally injured. There was no emergency locator transmitter on board because it had been removed for recertification.
Based on the high-speed, medium-angle impact, the investigation determined that a loss of control had occurred. However, there was insufficient information available to determine its cause. Both pilots held the appropriate licenses and ratings for VFR flight and there was no indication that either pilot’s performance was affected by fatigue or medical factors. Records for the aircraft did not indicate any outstanding defects at the time of the occurrence. The investigation identified several risk factors that could have contributed to the occurrence including operating under VFR in areas of poor weather, management oversight, group dynamics, flight crew training, cargo restraint, and operating without an emergency locator transmitter.
Following the occurrence, the operator took steps to mitigate risks through additional training and technology. It added “unusual attitude recovery” to the aircraft training syllabus and began upgrading its 208B aircraft with synthetic vision to aid pilot situational awareness, and automatic dependent surveillance-broadcast to enhance data collection and flight following capability. Two of its three aircraft currently have these capabilities, and the third will receive the upgrades as soon as practical.
See the investigation page for more information.
The TSB is an independent agency that investigates air, marine, pipeline, and rail transportation occurrences. Its sole aim is the advancement of transportation safety. It is not the function of the Board to assign fault or determine civil or criminal liability.
For more information, contact:
Transportation Safety Board of Canada
Media Relations
Telephone: 819-360-4376
Email: media@tsb.gc.ca