ANC98LA059

NTSB accident investigation · Cessna 207 · Bethel, AK · May 29, 1998

Accident · No injuriesLimited investigationFinal report
Date
May 29, 1998, 15:57 local (23:57 UTC)
Place
Bethel, AK
Injuries
1 uninjured
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N9956MCessna 207
Weather
Visual (VMC) · Day
Status
Completed · report February 15, 2001
Report
Approved by Office Director
NTSB office
Alaska Regional Office
FAA report
19980529014859A
Case key
3147

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

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Probable cause

The throttle arm disconnecting from the throttle linkage to the engine as a result of inadequate inspection by company maintenance personnel. Factors associated with this accident were the company maintenance personnel not following the repetitive Service Bulletin inspection, and the inadequate design of the throttle arm by the manufacturer.

Sequence of events

NTSB’s coding before 2008: each occurrence and phase of flight, and the causes and factors under it. The codes are defined in NTSB’s coding manual.

Loss of engine powerClimb - to cruise
Throttle/power lever,linkage - disconnectedCause
Maintenance,inspection - inadequateCompany maintenance personnelCause
Maintenance,service bulletin/letter - not followedCompany maintenance personnelFactor
Maintenance,design change - requiredManufacturerFactor
Acft/equip,inadequate designManufacturerFactor
Forced landingDescent - emergency
Nose overEmergency descent/landing

Analysis

During climb to cruise while passing 2,000 feet msl, the engine lost total power. The airplane nosed onto its back during the subsequent forced landing in marshy tundra. Postaccident inspection revealed wear between the throttle arm and the connecting hardware bushing. The throttle control lever had disconnected from the throttle arm. Service Bulletin SEB95-15R1, 'Throttle Lever Inspection,' that required a visual inspection for wear between the arm and bushing each 50 hours or 12 months, had been complied with 56 hours, 163 hours, and 268 hours prior to the accident by company mechanics. The newly overhauled engine was installed 334 hours prior to the accident.

Factual narrative

On May 29, 1998, at 1557 Alaska daylight time, a Cessna 207 airplane, N9956M, sustained substantial damage during a forced landing 10 miles south of Bethel, Alaska. The solo airline transport pilot was uninjured. The flight was operated by Arctic Transportation Services, Inc., of Anchorage, Alaska, as an on-demand cargo flight from Bethel to Tununak, Alaska. Visual meteorological conditions prevailed at the time of the accident, and a company VFR flight plan was filed.

The pilot reported to the NTSB Investigator-In-Charge during a telephone interview on May 30, 1998, that during the initial climb to cruise, passing 2,000 feet msl, the engine power dropped to idle. He indicated that manipulating the engine controls did not result in power above idle. During the subsequent forced landing in marshy tundra, the airplane nosed over onto its back.

Postaccident investigation revealed that the throttle control lever, manufactured by Teledyne Continental Motors, and assigned Cessna part number 632555-31, became disconnected from the engine throttle. Metallurgical investigation conducted at the NTSB metallurgical laboratory on July 9, revealed wear between the attaching hardware bushing and the throttle arm.

Cessna Aircraft Corporation, Inc., issued Service Bulletin SEB95-15 on June 30, 1995, requiring a repetitive inspection every 50 hours or 12 months, on the Throttle Lever Control part number 632555-31. This procedure is a visual inspection for wear, loose bushings, or worn attachment holes. If wear is found, the throttle arm is to be replaced with part number 632555-65. Aircraft with part number 632555-65 do not require repetitive inspection.

The Teledyne Continental Motors IO-520F engine, serial number 286404-R, was overhauled 334 hours prior to the accident, and installed by company mechanics on November 21, 1997. Service Bulletin SB95-15R1 ("Throttle Lever Inspection") was complied with on January 28, 1998, at 11,342 airframe hours; on March 23, 1998, at 11,447 airframe hours; and on May 7, 1998, at 11,554 airframe hours. This last inspection was 56 hours prior to the accident. All of these inspections were performed by company mechanics.

Aircraft

Registration
N9956M
Reported as
Cessna 207
Category
Airplane
Serial number
20700763
Airframe hours
11,610
Engine
Continental IO-520-F, 300 horsepower, reciprocating
Damage
Substantial damage
Flight
Part 135
Registered owner
Arctic Transportation Service
Airworthiness certificate
Standard, Normal
Last inspection
AAIP · May 8, 1998 · 56 hours before
Departed
BET
Destination
AK45 · Tununak, AK
Flight plan
Company VFR

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
24
Certificate
Airline transport
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Seat
Left
Flight hours
4,050 total · 1,770 in this make and model · 3,875 as pilot in command · 220 in the last 90 days · 85 in the last 30 days · 5 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
90° at 13 knots
Visibility
40 statute miles
Lowest ceiling
6,500 ft broken
Temperature
59 °F, dew point 45 °F
Altimeter
29.00 inHg
Observed at
BET, 10 nm away

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.