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A combination of factors, including faulty radio, poor visibility, and inadequate risk controls, was behind 2023’s fatal Sea World helicopter crash, the ATSB has said.
In its final report into the disaster, which killed four people and injured six others when two EC130 helicopters collided mid-air on Main Beach minutes away from Surfers Paradise on 2 January 2023, the transport safety watchdog made 28 findings, including around the operator’s actions in the preceding months.
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According to the ATSB, Sea World Helicopters had started using the two EC130s, VH-XH9 and VH-XKQ, a week before the crash.
“In the months prior to this tragic accident, the operator had made changes to improve its tourism product, including commissioning the use of a second helipad location, known as the park pad, the introduction of the larger EC130 helicopters, and new hangar and office facilities,” ATSB chief commissioner Angus Mitchell said.
“Over time, these changes undermined risk controls used to manage traffic separation and created a conflict point between launching and departing helicopters, which is where the two helicopters collided.
“The operator’s safety management system did not effectively manage the safety risk present in its aviation operation, and when numerous changes were introduced, did not implement processes to consider whether they would affect the overall safety of their flights.”
The inbound helicopter, VH‑XH9, had radioed ahead, but the pilot of VH-XKQ had not registered the call, as he was loading passengers at the time. According to the ATSB, a member of the ground crew then gave VH-XKQ the all-clear to take off.
“However, this advice was no longer accurate by the time the helicopter took off more than 20 seconds later, as the inbound helicopter was continuing its approach to land,” Mitchell said.
“In addition, restrictions on manoeuvring at the park pad and the angles of closure of the two helicopters limited the visibility for the departing pilot to identify the approaching helicopter.”
The pilot of the helicopter that survived the crash, Michael James, told investigators he did not see the other aircraft taking off. The ATSB conducted a visibility study, which found that both pilots would have had a “limited” view of each other in the lead-up to the collision.
“This limited visibility combined with both pilots’ competing priorities and understanding the airspace was clear, led to the midair collision as both helicopters passed through the conflict point created by the introduction of a second helipad nine months earlier,” Mitchell said.
“While the operator did have in place a system of radio calls, hand signals and visibility devices that was intended to alert pilots of the presence of another helicopter, the investigation found that system to have significant flaws.”
The preliminary report compiled by the ATSB had also detailed how James “did not recall” hearing a “taxiing” radio call from the second helicopter outlining that it was due to take off, which the final report said may have been caused by a defective radio on VH-XKQ.
“The ATSB found faults in the radio antenna of the departing helicopter which likely prevented broadcast of the taxi call,” said Mitchell.
“Without the taxiing call being received, the pilot of the inbound helicopter, who was likely focusing on their landing site, had no trigger to reassess the status of the departing helicopter as a collision risk.
“This dependency highlights that aviation operations should have multiple safety defences in place and not be vulnerable to single points of failure such as faulty radios, or a pilot’s ability to detect another helicopter in a visually constrained environment.”
Mitchell had previously said James’ “remarkable” manoeuvre meant a “far worse situation” was averted. James passed away from cancer in June last year.
Four of the surviving passengers onboard – New Zealand couple Edward and Marle Swart and friends Riaan and Elmarie Steenberg – had also released a statement hailing him as a hero.
“To our pilot, who, through all the chaos, landed the helicopter safely, keeping us and other bystanders safe,” they said. “You are our hero. Thank you so very much.”
According to the ATSB, the operator has since taken “a number of safety actions” following the disaster.
“These include introducing a ‘pad boss’, a new ground staff position to provide pilots with traffic advisory information, displaying positional information of other aircraft (using ‘ADS-B in’) on a map display in its helicopters (using iPads with EFBs), new radio call protocols, and fitting its helicopters with strobe lighting and applying high visibility paint on main rotor blades,” the ATSB said.
