Colgan Air 3407- The real cause of crash

A Bombardier Q400 was preparing for its regular passenger flight. The flight was destined for Buffalo Niagara International Airport, Buffalo, New York.

Onboard the flight were 45 passengers and 4 crew members.
Among the passengers were Two Canadian, one Chinese, one Israeli, and 41 American. All four crew members were American.

The crew turned on the pitot static deicing equipment before take off.

Then ATC cleared the aircraft for take-off for its 53 minutes flight to Buffalo, New York.

The crew turned on the propeller and airframe deice equipment during the climb. The cruise portion of the flight was routine and uneventful. The captain instructed the first officer to get discretion to twelve thousand feet.

Less than 1 minute later, a controller from Cleveland Center cleared the flight to descend 11,000 feet.

The first officer made initial contact with Buffalo approach control and informed that the flight was descending to 11,000 feet. Then the approach controller provided the altimeter setting and told the crew to plan an ILS approach to runway 23.

The captain began the approach briefing. During that time, ATC cleared the flight crew to descend and maintain 6,000 feet.

The airplane descended through 10,000 feet. From that point on, the flight crew was required to observe the sterile cockpit rule.

The sterile cockpit rule is a procedural requirement that during critical phases of flight, only activities required for the safe operation of the aircraft may be carried out by the flight crew, and all non-essential activities in the cockpit are forbidden.

The approach controller cleared the flight crew to descend and maintain 5,000 and 4,000 feet, respectively.

Then the captain and the first officer began talking about unnecessary things unrelated to their flying duties. Here's some of their conversation:

The approach controller cleared the flight crew to descend and maintain 2,300 feet, which was acknowledged by the first officer.

Afterward, while the captain and the first officer performed their duties, they were still having an unnecessary conversation not related to flying duties.

Thereon, the approach controller cleared the flight crew to turn left onto a heading of 260° and maintain 2,300 feet until established on the localizer for the ILS runway 23.

The captain began to slow the airplane less than 3 miles from the outer marker to establish the appropriate airspeed before landing.

The propeller condition levers moved forward to their maximum RPM position. The pitch trim in the airplane-nose-up direction was applied by AP.

The control columns moved aft and the engine power levers were advanced. The airplane pitched up; rolled to the left, reaching a roll angle of 45° left wing down, and rolled to the right. As the airplane rolled to the right through wings level, the stick pusher activated.

The airspeed decreased to about 100 knots. The roll angle reached 105° right wing down and the plane began to roll back to the left.

The airplane’s pitch and roll angles reached about 25° airplane nose down and 100° right wing down and it entered a steep descent.

The plane crashed into a house killing all 49 occupants onboard. The impact killed a person inside the house as well.

Investigation report:
The investigation was done by NTSB United States. According to them, the icing on the aircraft was most likely a key contributing factor, with weather reports indicating icy conditions with light snow at the time of the crash.

They added that the probable cause of the crash was the captain's inappropriate response to the activation of the stick shaker, which led to an aerodynamic stall from which the airplane did not recover. Contributing to the accident were (1) the flight crew's failure to monitor airspeed in relation to the rising position of the low-speed cue, (2) the flight crew's failure to adhere to sterile cockpit procedures, (3) the captain's failure to effectively manage the flight, and (4) Colgan Air's inadequate procedures for airspeed selection and management during approaches in icing conditions.

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