Summary

A commercial flight under visual flight rules (VFR) with a hot air balloon was planned from Mantorp Park to St. Ölstorp with 12 passengers and a pilot. During the morning, the pilot was in contact with SMHI to obtain a weather forecast for the evening. Considering the weather forecast, the pilot decided to go to Mantorp Park to assess the weather on site.

After arriving to Mantorp Park, the pilot released a helium balloon at 18.30 and noted that the wind speed was relatively high with strong gusts, and therefore decided to delay the start. A new balloon was released and the pilot experienced that both the wind speed and gusts had begun to decrease. This strengthened his expectation based on the SMHI forecast, that the wind would continue to decrease during the evening and he decided to fly.

At 20.08 the balloon took off and rose in a north-westerly direction. At 350 feet above the ground, the pilot felt that the wind speed was higher than expected. After about ten minutes of flight time he decided to descend and made two landing attempts before the final landing.

Before the second landing attempt, the pilot felt that the balloon was affected by the wind and was pushed down. The contact with the ground was hard and the basket temporarily tipped forward, which according to a study performed by the United Kingdom's Civil Avia­tion Authority represents the greatest risk of injury to passengers. The study recommends that passengers in a split basket should take a backwards landing position, which was also stated in the Flight Manual. However, there was no information about how the passengers should position themselves before landing in the operator’s Operations Manual. The method used was for the passengers to stand sideways when landing.

On landing, a passenger was seriously injured and the pilot aborted the landing and climbed.

The final landing was also hard and the basket tipped forward and was dragged behind the balloon. The balloon then lifted slightly before the next ground contact just before a road. While the pilot deflated the balloon casing, the balloon was dragged across the road before finally coming to rest in a ditch.

The rescue operation is deemed relevant and reasonable. SHK has therefore had no reason to further analyse the rescue operation.

The technical investigations carried out did not identify any technical faults or deficiencies that could have contributed to the accident.

SHK assesses that the wind was probably within the balloon's limitations, but that the verti­cal mixing in the atmosphere affected the balloon so that it was pushed down towards the ground on landing.

The operator's Operations Manual was not updated according to the new EASA regulations. There were therefore no documented risk assessments that could answer why it differed from the Flight Manual in terms of the position of the passengers upon landing.

Overall, the accident was caused by several factors. Primarily, there was an absence of a functioning Management System that could contribute to the assessments of risks and their reduction during flights. As a result, the passengers were not positioned in a position with the lowest risk of injury in accordance with the study by the UK Civil Aviation Authority and the Flight Manual.

Causes

The accident was caused by the absence of a functioning Management System that could contribute to risk assessments and minimization of the risks during flights. This resulted in the passengers not being positioned in a position with the lowest risk of injury, which in the prevailing weather conditions likely resulted in one of the passengers being seriously injured.

Contributing factors have been that weather information from meteorologists was not obtained closer to the flight.

Safety recommendations

Regarding the circumstances that in this case are attributable to the operator, SHK notes that the Swedish Transport Agency has carried out oversight and that the operator has taken measures. Against this background, SHK refrains from issuing any safety recommendations.