Crash of a Cessna 402B in Anchorage

Date & Time: Dec 9, 1987 at 1558 LT
Type of aircraft:
Operator:
Registration:
N969JW
Survivors:
Yes
Schedule:
Valdez - Anchorage
MSN:
402B-0328
YOM:
1972
Flight number:
8F304
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
11495
Captain / Total hours on type:
1225.00
Aircraft flight hours:
5301
Circumstances:
During arrival in heavy traffic, Reeve flight 726 (Boeing 727) and Wilburs flight 304 (Cessna 402B, N969JW) received radar advisories for visual approaches to runways 06L and 06R, respectively. Subsequently, both flights were cleared to land. At 1555:04, the local tower controller transmitted that the wind at the approach end of runway 06R was from 340° at 9 knots and the midfield wind was 330° at 7 knots. At approximately 1557, flight 726 landed on runway 06L. Approximately 69 seconds later, as flight 304 was crossing the threshold (thr) of runway 06R at about 100 feet agl, the aircraft encountered wake turbulences (w/t) and rolled sharply to the right, byd 90°. The pilot corrected with aileron and power, but the aircraft lost altitude and hit the ground before recovery. The wind during the 1601 weather observation was 020° at 5 kts. Runway centerlines were 700 feet apart, threshold of runway 06L was 4,600 feet byd the threshold of runway 06R. The approach control did not advise either flight of the other's position, nor did the tower controller give a w/t advisory to flight 304. Calculations showed vortices could have drifted from runway 06L to runway 06R in as little as 28 seconds. FAA handbook addressed w/t advisory for parallel runway options with less than 2,500 feet separation, but did not address offset thresholds. All five occupants were injured.
Probable cause:
Occurrence #1: vortex turbulence encountered
Phase of operation: approach - vfr pattern - final approach
Findings
1. (f) light condition - dusk
2. (f) atc clearance - improper - atc personnel (dep/apch)
3. (f) unsafe/hazardous condition warning - not issued - atc personnel (lcl/gnd/clnc)
4. Condition(s)/step(s) insufficiently defined - faa (other/organization)
5. (c) in-flight planning/decision - improper - pilot in command
----------
Occurrence #2: in flight collision with terrain/water
Phase of operation: approach - vfr pattern - final approach
Final Report:

Crash of a Cessna 402B in Arthur's Town: 1 killed

Date & Time: Dec 5, 1987 at 1635 LT
Type of aircraft:
Registration:
N422TA
Survivors:
No
Schedule:
Nassau - Arthur's Town
MSN:
402B-0357
YOM:
1973
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Circumstances:
Crashed under unknown circumstances while approaching Arthur's Town Airport. The pilot, sole on board, was killed.

Crash of a Cessna 402B in Bugelenga

Date & Time: Oct 20, 1987 at 0830 LT
Type of aircraft:
Operator:
Registration:
5H-TZZ
Flight Phase:
Survivors:
Yes
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
6200
Circumstances:
En route, one of the engine failed. The pilot reduced his altitude and completed an emergency landing in a pasture. There were no casualties.
Probable cause:
Engine failure for unknown reasons.

Crash of a Cessna 402A off Malekolon: 1 killed

Date & Time: Oct 16, 1987
Type of aircraft:
Operator:
Registration:
P2-GKG
Survivors:
No
MSN:
402A-0070
YOM:
1969
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Circumstances:
On approach to Malekolon Airstrip, the twin engine aircraft crashed in unknown circumstances in the sea and sank. Both occupants were killed.

Crash of a Cessna 402 on Mt Cuilato: 9 killed

Date & Time: Sep 26, 1987
Type of aircraft:
Operator:
Registration:
FAC-5530
Flight Phase:
Flight Type:
Survivors:
No
Site:
Schedule:
Carimagua - Saravena
Country:
Crew on board:
1
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
9
Circumstances:
While cruising at an altitude of 9,000 feet, the twin engine aircraft struck the slope of Mt Cuilato located southwest of Saravena. As the aircraft failed to arrive at destination, SAR operations were initiated but eventually suspended on 15 October 1987 as no trace of the aircraft nor the nine occupants was found. The wreckage was localized in an isolated area on 30 March 2000.

Crash of a Cessna 402C in Chicago: 1 killed

Date & Time: Jul 20, 1987 at 2219 LT
Type of aircraft:
Operator:
Registration:
N3742C
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Chicago - Kansas City
MSN:
402C-0600
YOM:
1974
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
3200
Aircraft flight hours:
2597
Circumstances:
On initial climb the pilot reported 'just lost one', followed by a loss of control and descent into a residential area. Subsequent investigation revealed a loose connection between the left engine throttle serrated washer and the serrated shaft. The engine had been removed and reinstalled a few flight hours prior to the occurrence. The pilot, sole on board, was killed.
Probable cause:
The NTSB determines the probable cause(s) of this accident to be:
Failure of maintenance personnel to perform proper installation of the left throttle linkage.
Findings:
Occurrence #1: airframe/component/system failure/malfunction
Phase of operation: takeoff - initial climb
Findings
1. (c) induction air control, linkage - loose
2. (c) maintenance, installation - improper - other maintenance personnel
----------
Occurrence #2: loss of control - in flight
Phase of operation: takeoff
Findings
3. (c) propeller feathering - not performed - pilot in command
4. (c) airspeed (vmc) - disregarded - pilot in command
5. (f) light condition - dark night
----------
Occurrence #3: in flight collision with terrain/water
Phase of operation: descent - uncontrolled
Findings
6. Object - wire, static
7. Object - building (nonresidential)
Final Report:

Crash of a Cessna 402C in Bundaberg: 4 killed

Date & Time: Jun 21, 1987 at 0318 LT
Type of aircraft:
Operator:
Registration:
VH-WBQ
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
Bundaberg - Brisbane
MSN:
402C-0627
YOM:
1982
Country:
Region:
Crew on board:
1
Crew fatalities:
Pax on board:
4
Pax fatalities:
Other fatalities:
Total fatalities:
4
Circumstances:
The flight had been arranged to transport a critically injured patient to hospital in Brisbane. The pilot evidently experienced some difficulty in starting one of the engines. However, witnesses reported that the engines sounded normal as the aircraft commenced moving from the parking area. At 0310 hours the pilot contacted Brisbane Flight Service Unit and reported that the aircraft was taxying. He advised that he was in a hurry, and indicated that he would provide details of the flight after takeoff. Two minutes later he advised that takeoff was being commenced from Runway 14. No further transmissions were received from the aircraft. The aircraft was seen to become airborne and shortly afterwards enter a fog bank. Other witnesses subsequently reported hearing the sounds of an impact. The flight had been arranged to transport a critically injured patient to hospital in Brisbane. The pilot evidently experienced some difficulty in starting one of the engines. However, witnesses reported that the engines sounded normal as the aircraft commenced moving from the parking area. At 0310 hours the pilot contacted Brisbane Flight Service Unit and reported that the aircraft was taxying. He advised that he was in a hurry, and indicated that he would provide details of the flight after takeoff. Two minutes later he advised that takeoff was being commenced from Runway 14. No further transmissions were received from the aircraft. The aircraft was seen to become airborne and shortly afterwards enter a fog bank. Other witnesses subsequently reported hearing the sounds of an impact. The flight had been arranged to transport a critically injured patient to hospital in Brisbane. The pilot evidently experienced some difficulty in starting one of the engines. However, witnesses reported that the engines sounded normal as the aircraft commenced moving from the parking area. At 0310 hours the pilot contacted Brisbane Flight Service Unit and reported that the aircraft was taxying. He advised that he was in a hurry, and indicated that he would provide details of the flight after takeoff. Two minutes later he advised that takeoff was being commenced from Runway 14. No further transmissions were received from the aircraft. The aircraft was seen to become airborne and shortly afterwards enter a fog bank. Other witnesses subsequently reported hearing the sounds of an impact. The investigation revealed that the aircraft had collided with a tree 800 metres beyond the aerodrome boundary, while tracking about 10 degrees to the right of the extended centreline of the runway. It had then continued on the same heading until striking the ground 177 metres beyond the initial impact point. The wreckage was almost totally consumed by fire.
Probable cause:
The extensive fire damage hampered the investigation of the accident. The surviving passenger believed that the aircraft was on fire before the collision with the tree. No other evidence of an in-flight fire could be obtained, and it was considered possible that the survivor's recall of the accident sequence had been affected by the impact and the fire. Such discrepancies in recall are not uncommon among accident survivors. The elevator trim control jack was found to be in the full nose-down position, but it was not possible to establish whether the trim was in this position prior to impact. Such a pre-impact position could indicate either a runaway electric trim situation or that, in his hurry to depart, the pilot had not correctly set the trim for takeoff. The aircraft was known to have had an intermittent fault in the engine fire warning system. The fault apparently caused the fire warning light to illuminate, and the fire bell to sound, usually just after the aircraft became airborne. The pilot was aware of this fault. It was considered possible that, if the fault occurred on this occasion as the aircraft entered the fog shortly after liftoff, the pilot's attention may have been focussed temporarily on the task of cancelling the warnings. During this time he would not have been monitoring the primary flight attitude indicator, and would have had no external visual references. It was also possible that, if for some reason the pilot was not monitoring his flight instruments as the aircraft entered the fog, he suffered a form of spatial disorientation known as the somatogravic illusion. This illusion has been identified as a major factor in many similar accidents following night takeoffs. As an aircraft accelerates, the combination of the forces of acceleration and gravity induce a sensation that the aircraft is pitching nose-up. The typical reaction of the pilot is to counter this apparent pitch by gently applying forward elevator control, which can result in the aircraft descending into the ground. In this particular case, the pilot would probably have been more susceptible to disorientating effects, because he was suffering from a bronchial or influenzal infection. Although all of the above were possible explanations for the accident, there was insufficient evidence available to form a firm conclusion. The precise cause of the accident remains undetermined.
It is considered that some of the following factors may have been relevant to the development of the accident
1. The pilot was making a hurried DEPARTURE. It is possible that he did not correctly set the elevator trim and/or the engines may not have reached normal operating temperatures before the takeoff was commenced.
2. Shortly after liftoff the aircraft entered a fog bank, which would have deprived the pilot of external visual references.
3. The aircraft had a defective engine fire warning system. Had the system activated it may have distracted the pilot at a critical stage of flight.
4. The aircraft might have suffered an electric elevator trim malfunction, or an internal fire, leading to loss of control of the aircraft.
5. The pilot may have experienced the somatogravic illusion and inadvertently flown the aircraft into the ground. The chances of such an illusion occurring would have been increased because the pilot was evidently suffering from an infection.
Final Report:

Crash of a Cessna 402C off Palm Beach: 1 killed

Date & Time: May 27, 1987
Type of aircraft:
Operator:
Registration:
N2652B
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Palm Beach - Marsh Harbour
MSN:
402C-0345
YOM:
1980
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
16740
Captain / Total hours on type:
165.00
Aircraft flight hours:
9151
Circumstances:
On 5/27/87 at about 0915 edt, the pilot departed Palm Beach-Intl Airport (PBI) on a flight to Marsh Harbour, Great Abaco Island, Bahamas. When the aircraft did not arrive at the destination, a search was initiated. The aircraft was not found and was presumed to have been destroyed. The pilot was presumed to have been fatally injured. Radar data revealed that the aircraft had departed toward Marsh Harbour, but the last contact with the flight was approximately 12 miles east of PBI. An aircraft was seen flying eastbound over the destination airport at about the time of the estimated arrival time. Also, another pilot thought she heard a radio transmission from the missing aircraft when the pilot reported in the vicinity of Grand Bahama Island.
Probable cause:
Occurrence #1: missing aircraft
Phase of operation: unknown
Findings
1. (c) reason for occurrence undetermined
Final Report:

Crash of a Cessna 402A in Kahului

Date & Time: Apr 29, 1987 at 0854 LT
Type of aircraft:
Registration:
N4588Q
Flight Type:
Survivors:
Yes
Schedule:
Kahului - Lanai
MSN:
402A-0088
YOM:
1969
Location:
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
6650
Circumstances:
Shortly after takeoff, the pilot requested an 'immediate downwind' to return to the airport and was cleared to land. When asked if equipment was needed, he replied, 'negative, sir, a little matter of fuel.' A witness said the aircraft appeared very low on final approach with both props turning. The aircraft crash landed short of the runway, went thru a perimeter fence and came to rest on an incline about 10 feet short of the runway. The pilot received a head injury and couldn't remember many details of the occurrence. In an early interview, he induced there was a partial power loss and the aircraft yawed, but he couldn't remember which engine 'cut out first.' Later, he was unable to recall losing power. Six gallons of fuel was found in the left main tank, about 1.5 gallon was in the right main tank. The left fuel selector was found in the 'main' position, but due to damage and rescue activities, the position of the right fuel selector was not determined. Both auxiliary pump switches were in the 'off' position. The left propeller control was in the feather position, but neither propeller had feathered. Each main tank held one gallon of unusable fuel. A test of the pilot's blood showed 0,45‰ alcohol.
Probable cause:
Occurrence #1: loss of engine power (partial) - nonmechanical
Phase of operation: approach
Findings
1. (c) preflight planning/preparation - inadequate - pilot in command
2. (f) refueling - not performed - pilot in command
3. (f) fluid, fuel - low level
4. Precautionary landing - initiated
5. (c) fluid, fuel - starvation
6. (c) fuel supply - inadequate - pilot in command
7. (f) impairment (alcohol) - pilot in command
----------
Occurrence #2: forced landing
Phase of operation: descent - emergency
Findings
8. (c) planning/decision - improper - pilot in command
----------
Occurrence #3: in flight collision with terrain/water
Phase of operation: landing
Findings
9. (f) terrain condition - rough/uneven
----------
Occurrence #4: on ground/water collision with object
Phase of operation: landing
Findings
10. (f) object - fence
Final Report:

Crash of a Cessna 402C in Hyannis

Date & Time: Apr 12, 1987 at 1115 LT
Type of aircraft:
Operator:
Registration:
N87PB
Survivors:
Yes
Schedule:
Hyannis - Nantucket
MSN:
402C-0639
YOM:
1982
Crew on board:
1
Crew fatalities:
Pax on board:
8
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
2629
Captain / Total hours on type:
550.00
Aircraft flight hours:
6032
Circumstances:
Shortly after the initial power reduction during takeoff, the pilot noted a partial loss of power in the right engine. He said he 'went to full power on both engines' and noted an 'extremely high' fuel flow indication to the right engine. He said, 'thinking that the engine was flooding, I placed the boost pump switch from high to off to possibly eliminate the problem with no result. I then placed the pump back to high and tried to decrease the fuel flow by leaning the mixture. This also did not seem to eliminate the problem.' While troubleshooting the problem, he turned to a downwind and stayed in the traffic pattern, but could not maint altitude. Subsequently, a wheels-up landing was made in an area of small trees approximately 1/2 mile before reaching runway 24. An examination of the right engine revealed the spark plugs were wet with fuel and black with soot. Also, its #5 fuel nozzle had been cross-threaded and was knocked out of its hole during impact. During an initial test, the right fuel pressure sensing switch did not sense operating pressure (over 6 psi); this would have resulted in a high boost/fuel flow condition. Later, the switch was tested ok. All nine occupants escaped uninjured.
Probable cause:
Occurrence #1: loss of engine power (partial) - mech failure/malf
Phase of operation: takeoff - initial climb
Findings
1. (f) fuel system - pressure excessive
2. (f) powerplant controls - improper use of - pilot in command
----------
Occurrence #2: forced landing
Phase of operation: descent - emergency
Findings
3. (c) emergency procedure - improper - pilot in command
----------
Occurrence #3: in flight collision with terrain/water
Phase of operation: landing - flare/touchdown
Findings
4. (f) terrain condition - high vegetation
Final Report: