Crash of a Cessna 550 Citation II in Billings: 8 killed

Date & Time: Dec 18, 1992 at 1645 LT
Type of aircraft:
Operator:
Registration:
N6887Y
Flight Type:
Survivors:
No
Schedule:
Watertown - Billings
MSN:
550-0293
YOM:
1981
Crew on board:
2
Crew fatalities:
Pax on board:
6
Pax fatalities:
Other fatalities:
Total fatalities:
8
Captain / Total flying hours:
6200
Captain / Total hours on type:
4415.00
Aircraft flight hours:
5275
Circumstances:
During descent into Billings, the Citation was sequenced behind a Boeing 757, and both airplanes were eventually cleared for visual approaches. About 1-1/2 mile from the runway the Citation was observed to roll rapidly to the inverted position and descended almost vertically into the ground. According to ATC transcripts and the airplane's cockpit voice recorder, the crew of the Citation had maintained visual awareness of the position of the B757 throughout the approach. At the time of the upset, the vertical separation between airplanes was 600 - 1,000 feet, and the horizontal separation was decreasing below 2.6 miles. One of the Citation captain's last comments was 'almost ran over a seven fifty seven.' Winds were 5 knots. All eight occupants were killed.
Probable cause:
The pilot-in-command's failure to follow established vortex avoidance procedures, as published in the airman's information manual, to provide his own wake turbulence separation.
Final Report:

Crash of a Dassault Falcon 10 in McCall

Date & Time: Dec 18, 1992 at 1500 LT
Type of aircraft:
Registration:
N50TE
Flight Phase:
Flight Type:
Survivors:
Yes
Schedule:
McCall - San Diego
MSN:
86
YOM:
1975
Location:
Crew on board:
2
Crew fatalities:
Pax on board:
2
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3006
Captain / Total hours on type:
420.00
Aircraft flight hours:
4657
Circumstances:
During the takeoff roll on a contaminated runway, the copilot noted a lack of acceleration. Just beyond midfield, the copilot called for an abort, however, the pilot elected to continue. The airplane did not reach Vr and the pilot attempted to rotate the airplane at the end of the runway. The airplane collided with and travelled through a five foot high snowbank and came to rest in a field approximately 500 feet from the end of the runway. During the post crash investigation, evidence indicated that the parking brake had been in the intermediate position or 23% of maximum braking. The parking brake warning light was found to operate correctly if the panel lights were set in the bright light position. In the dim position, the warning light was inoperative. During the on site investigation, the panel lights were found in the dim position. Both passengers were slightly injured while both pilots were seriously injured.
Probable cause:
The failure of the flight crew to follow the checklist and release the parking brake before takeoff. The inoperative parking brake warning light and the failure of the pilot to abort the takeoff were factors.
Final Report:

Crash of a Volpar Turboliner 18 in Cleveland: 1 killed

Date & Time: Dec 15, 1992 at 0912 LT
Type of aircraft:
Registration:
N706M
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Cleveland - Syracuse
MSN:
12360
YOM:
1970
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
4768
Captain / Total hours on type:
91.00
Aircraft flight hours:
16115
Circumstances:
After rotation, during the initial climb, the nose of the airplane pitched up to approximately 60° above the horizon. The airplane continued to climb until about 250 feet above the ground, then rolled right, pitched down and descended. The airplane impacted the ground, approximately 45° nose down, 650 feet to the right of the runway. Post accident investigation of the wreckage revealed the elevator jammed in the full up deflection. The upper end of the elevator control rod was found not connected to the elevator, but was found laying aft, wedged between the tail cone and the elevator faring, holding the elevator in the full up position. The control rod connecting bolt was found laying in the bottom of the tail cone undamaged. The washer, nut and cotter pin related to the control rod connecting bolt were not found. The elevator had been removed, recovered and then installed by company maintenance personnel 166 flight hours prior to the accident. The pilot, sole on board, was killed.
Probable cause:
The improper installation of the elevator by company maintenance personnel and the lack of proper inspections by a company certified mechanic/inspector and the faa certified mechanic with inspector authorization. A factor in this accident was an insufficiently defined maintenance procedures that allowed multiple maintenance tasks to be combined into a single line entry.
Final Report:

Crash of a Piper PA-31P Pressurized Navajo off Oceanside: 2 killed

Date & Time: Dec 14, 1992 at 1445 LT
Type of aircraft:
Registration:
N55UF
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Carlsbad – Santa Ana
MSN:
31-7400182
YOM:
1974
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
1790
Circumstances:
The pilot and his passenger, his son, departed from a controlled airport at 1436 hours. He climbed the airplane to about 5,200 feet mean sea level. Recorded communications between the pilot and the control tower did not reveal anything out of the ordinary. Radar data showed the pilot in a progressive climb to about 5,200 feet. After maintaining that altitude for over two minutes, the airplane descended at an excessive rate until it collided with the ocean about one mile offshore. The engines and propellers were recovered and examined. The engine examination did not reveal any pre existing discrepancies. The propellers had deep leading edge gouges, 'S' twists, and one broken blade. No pre existing deficiencies were found during the examination of the airplane's logbooks and maintenance records. Investigation did not reveal any reason for the airplane's rapid descent and its in flight collision with the ocean. Both occupants were killed.
Probable cause:
The airplane colliding with the ocean due to unknown reason(s).
Final Report:

Crash of a Cessna 402B in Cedar Rapids

Date & Time: Dec 13, 1992 at 1801 LT
Type of aircraft:
Operator:
Registration:
N17CH
Survivors:
Yes
Schedule:
Kansas City - Cedar Rapids
MSN:
402B-0519
YOM:
1973
Crew on board:
1
Crew fatalities:
Pax on board:
6
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
3700
Captain / Total hours on type:
1200.00
Aircraft flight hours:
5929
Circumstances:
During the second ILS approach the airplane descended below the glidepath and impacted the terrain 2,500 feet short of the intended landing runway. The pilot indicated that a failure in the approach lighting system contributed to the accident. A post accident functional check of the approach lighting system failed to reveal any anomalies.
Probable cause:
The pilot-in-command's failure to maintain a proper glidepath.
Final Report:

Crash of a Cessna 421C Golden Eagle III in Wilsonville: 2 killed

Date & Time: Dec 12, 1992 at 1605 LT
Registration:
N98489
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
Portland - Aurora
MSN:
421C-0067
YOM:
1968
Crew on board:
1
Crew fatalities:
Pax on board:
1
Pax fatalities:
Other fatalities:
Total fatalities:
2
Captain / Total flying hours:
4138
Captain / Total hours on type:
727.00
Aircraft flight hours:
2474
Circumstances:
Witnesses reported seeing the airplane flying in a normal cruise attitude when it rolled inverted and the nose dropped near vertical to the terrain. The airplane descended in a near vertical dive. The nose of the airplane started to come up horizontal to the terrain when it struck a 75-ft tree. During the post crash investigation, no evidence of a mechanical failure or malfunction was found. Both occupants were killed.
Probable cause:
The pilot-in-command's failure to maintain control of the aircraft.
Final Report:

Crash of a Volpar Turboliner 18 in Baltimore: 1 killed

Date & Time: Dec 10, 1992 at 1535 LT
Type of aircraft:
Operator:
Registration:
N7770B
Flight Type:
Survivors:
No
Schedule:
Dayton - Baltimore
MSN:
AF-320
YOM:
1951
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
1
Captain / Total flying hours:
2658
Captain / Total hours on type:
657.00
Aircraft flight hours:
26436
Circumstances:
The pilot supervised the loading of the airplane. According to info from a person that helped load the plane, the bill of loading, and actual weights and measurements of the cargo after the accident, the plane was loaded to a gross weight of 11,979 lbs with the cg 2.7 inches behind the aft limit. At the destination, the flight was vectored for an ILS runway 10 approach. About 3 miles from the runway, the pilot was told to make a missed approach due to inadequate separation from traffic. The pilot acknowledged, but soon thereafter, radar contact with the plane was lost. Witnesses saw the plane descend from a low cloud layer before it crashed. One witness said its wings were moving from side to side and the plane was falling faster than it was moving forward. There was evidence the plane had impacted in a flat attitude with little forward movement. Four cargo straps were found loose with no sign of tensile overload; 3 others and a restraining board were found loose as if they had not been used. No preimpact mechanical problem was found. The wind was from 090° at 21 gusting 32 kts. The pilot, sole on board, was killed.
Probable cause:
Failure of the pilot to properly secure the cargo, which allowed a shift in the center of gravity during a missed approach maneuver and resulted in subsequent loss of aircraft control and flying speed. A factor related to the accident was failure of the pilot to assure the airplane was loaded within its proper weight and balance limitations.
Final Report:

Crash of a Lockheed C-141B-LM Starlifter near Harlem: 7 killed

Date & Time: Nov 30, 1992 at 2120 LT
Type of aircraft:
Operator:
Registration:
65-0255
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
McChord - McChord
MSN:
300-6106
YOM:
1965
Location:
Crew on board:
7
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
7
Aircraft flight hours:
37744
Circumstances:
The aircraft departed McChord AFB on an air refuelling mission over Montana. While cruising at an altitude of 25,000 feet by night, the aircraft collided under unknown circumstances with a second USAF Lockheed C-141B-LM Starlifter registered 66-0142, carrying six crew members and taking part to the same mission. Both aircraft entered an uncontrolled descent, disintegrated in the air and crashed about 14 km north of Harlem. All 13 occupants in both aircraft were killed.

Crash of a Lockheed C-141B-LM Starlifter near Harlem: 6 killed

Date & Time: Nov 30, 1992 at 2120 LT
Type of aircraft:
Operator:
Registration:
66-0142
Flight Phase:
Flight Type:
Survivors:
No
Schedule:
McChord - McChord
MSN:
300-6168
YOM:
1966
Location:
Crew on board:
6
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
6
Aircraft flight hours:
31857
Circumstances:
The aircraft departed McChord AFB on an air refuelling mission over Montana. While cruising at an altitude of 25,000 feet by night, the aircraft collided under unknown circumstances with a second USAF Lockheed C-141B-LM Starlifter registered 65-0255, carrying seven crew members and taking part to the same mission. Both aircraft entered an uncontrolled descent, disintegrated in the air and crashed about 14 km north of Harlem. All 13 occupants in both aircraft were killed.

Crash of a Cessna 404 Titan at Davis Monthan AFB

Date & Time: Nov 26, 1992 at 1915 LT
Type of aircraft:
Operator:
Registration:
N5429J
Flight Type:
Survivors:
Yes
Schedule:
Davis Monthan - Davis Monthan
MSN:
404-0107
YOM:
1977
Crew on board:
1
Crew fatalities:
Pax on board:
0
Pax fatalities:
Other fatalities:
Total fatalities:
0
Captain / Total flying hours:
4981
Captain / Total hours on type:
685.00
Aircraft flight hours:
4011
Circumstances:
During a 2 hour and 40 minute training mission, the pilot maintained a low power setting with the fuel mix at full rich. After the mission, the pilot climbed the airplane to 9,000 feet agl to clear obstacles between his location and his destination. During the descent, the pilot said he reduced power more rapidly than usual and descended faster than normal at about 180 kias. About 800 to 1,000 feet agl, in the traffic pattern, the pilot applied power. Both engines lost total power. He set up an 85 kias glide; competed emergency procedures; and retracted the landing gear. The engines did not restart. He did not feather the propellers. He extended the landing gear prior to touchdown. The pilot said he did not flare the airplane during landing which resulted in the airplane colliding with the ground. The engine manual and the poh recommend adjusting the fuel mixture for cruise. An engine manual note states long descents at low power should be avoided because the engines may cool excessively and may not accelerate satisfactorily when power is reapplied. The poh recommends feathering propellers and gliding at 120 kias for dual engine failure. Soot was noted on all spark plugs during engine exam. Both engines started and ran normally from idle to full acceleration during the exam.
Probable cause:
The pilot's inflight decision to deviate from the airplane's engine manual and the pilot's operating handbook by maintaining the fuel mixture at full rich throughout the mission and rapidly descending the airplane which resulted in both engine's losing total power. Factors in this accident were:
1) the pilot not following the emergency procedure for both engines failing as outlined in the pilot's operating handbook, and
2) the pilot not performing a flare during the landing sequence which resulted in the airplane colliding with the terrain.
Final Report: