# NTSB CEN18LA290: Bell 206, N352CT, Todd Mission, TX, July 20, 2018

- Type: NTSB accident investigation
- Classification: Accident · Minor injuries · Limited investigation · Final report
- Date: July 20, 2018, 12:15 local (17:15 UTC)
- Place: Todd Mission, TX
- Coordinates: 30.251943, -95.844718 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=30.2519&lon=-95.8447&mi=10
- Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping)
- Defining event: [Takeoff: Loss of control in flight](https://openairdocs.org/ntsb-events/240)
- Highest injury: Minor injuries
- Injuries: 2 minor, 2 uninjured
- Status: Completed, report September 14, 2020
- Report: Approved by Office Director
- NTSB office: Central Region
- Parties: Rolls-Royce, FAA Houston FSDO, Transportation Safety Board of Canada, Bell Helicopter
- NTSB case key (mKey): 97855
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN18LA290
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/97855/pdf
- NTSB docket: https://data.ntsb.gov/Docket?ProjectID=97855
- Page: https://openairdocs.org/ntsb/CEN18LA290

## Probable cause

The passenger’s inadvertent interference with the tail rotor pedals, which resulted in a loss of helicopter control during takeoff and the subsequent impact with terrain.

## Findings

NTSB's coded findings; those marked are part of the probable cause.

- [Rotorcraft flight control: tail rotor control system](https://openairdocs.org/ntsb-findings/01046720): Aircraft › Aircraft propeller/rotor · Unintentional use/operation (probable cause); cases with it: [Bell 206B, 2 cases](https://openairdocs.org/ntsb-findings/01046720/cases.md?model=1181511), [All aircraft, 13 cases](https://openairdocs.org/ntsb-findings/01046720/cases.md)
- [Action: incorrect action performance](https://openairdocs.org/ntsb-findings/02041015): Personnel issues › Action/decision · Passenger (probable cause); cases with it: [Bell 206B, 11 cases](https://openairdocs.org/ntsb-findings/02041015/cases.md?model=1181511), [All aircraft, 1,386 cases](https://openairdocs.org/ntsb-findings/02041015/cases.md)
- [Performance/control parameters: directional control](https://openairdocs.org/ntsb-findings/01062020): Aircraft › Aircraft oper/perf/capability · Attain/maintain not possible (probable cause); cases with it: [Bell 206B, 8 cases](https://openairdocs.org/ntsb-findings/01062020/cases.md?model=1181511), [All aircraft, 3,958 cases](https://openairdocs.org/ntsb-findings/01062020/cases.md)

## Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event best describes what happened.

- [Takeoff: Miscellaneous/other](https://openairdocs.org/ntsb-events/900); cases with it: [Bell 206B, 10 cases](https://openairdocs.org/ntsb-events/900/sequence.md?model=1181511), [All aircraft, 1,556 cases](https://openairdocs.org/ntsb-events/900/sequence.md)
- [Takeoff: Flight control sys malf/fail](https://openairdocs.org/ntsb-events/333); cases with it: [Bell 206B, 1 case](https://openairdocs.org/ntsb-events/333/sequence.md?model=1181511), [All aircraft, 410 cases](https://openairdocs.org/ntsb-events/333/sequence.md)
- [Takeoff: Loss of control in flight](https://openairdocs.org/ntsb-events/240) (defining event); cases with it: [Bell 206B, 32 cases](https://openairdocs.org/ntsb-events/240/sequence.md?model=1181511), [All aircraft, 5,002 cases](https://openairdocs.org/ntsb-events/240/sequence.md)
- [Takeoff: Attempted remediation/recovery](https://openairdocs.org/ntsb-events/060); cases with it: [Bell 206B, 14 cases](https://openairdocs.org/ntsb-events/060/sequence.md?model=1181511), [All aircraft, 1,422 cases](https://openairdocs.org/ntsb-events/060/sequence.md)
- [Takeoff: Collision during takeoff/land](https://openairdocs.org/ntsb-events/490); cases with it: [Bell 206B, 2 cases](https://openairdocs.org/ntsb-events/490/sequence.md?model=1181511), [All aircraft, 1,309 cases](https://openairdocs.org/ntsb-events/490/sequence.md)

## Analysis

The pilot landed the helicopter on a grass field so that the three passengers could switch seat positions during the local personal flight. As the helicopter took off from the field, it began to rotate to the right. Once airborne, the helicopter spun several revolutions to the right. The pilot reported that she applied full left pedal with no response from the helicopter. The left skid impacted the ground, and the helicopter rolled to the left and came to rest on the left side of the fuselage. The helicopter sustained substantial damage to the main rotor system, the fuselage, the tailboom, and the tail rotor system. A postaccident examination of the airframe and engine revealed no preimpact mechanical malfunctions or failures that would have precluded normal operation. The cyclic, collective, and the two tail rotor pedals were installed on the left side of the helicopter. The passenger in the front left seat was asked if he had his feet on top of the tail rotor pedals; he reported "that or on the floor" and then stated that he was not sure. Postaccident passenger interference testing in a flight training device revealed performance similar to the helicopter's accident sequence. Although the pilot had briefed the passengers about not touching any of the flight controls, it is likely that, during the takeoff, the passenger had his feet either on or up against the tail rotor pedals, which resulted in the helicopter's rotation to the right and the subsequent loss of control.

## Factual narrative

On July 20, 2018, about 1215 central daylight time, a Bell 206B, N325CT, sustained substantial damage when it was involved in an accident near Todd Mission, Texas. The private pilot and one passenger sustained minor injuries and two passengers sustained no injury. The helicopter was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. After flying in the local area and refueling, the pilot landed on a grass field to facilitate the passengers switching their seat positions in the helicopter. During the seat-switching process, the pilot reduced the throttle to the flight idle position. After the passengers switched seats and secured their restraint systems, with one passenger stationed in the front left seat, and two passengers stationed in the cabin, the pilot increased the throttle to 100 percent and lifted the helicopter off from the field. A review of accident sequence video footage shows that the helicopter began to rotate right during the takeoff. The pilot reported that about 10 ft above ground level with about 5 kts of forward airspeed and a heading of about 270°, the helicopter spun four 360° revolutions to the right. The pilot reported she applied full left pedal with no response from the helicopter. During the loss of control sequence, the pilot observed the torque gauge "jump" and she heard a "whining" noise emit from the engine. Prior to the impact with terrain, the pilot reduced the throttle to the flight idle position. The left skid impacted the ground, the helicopter rolled to the left, and came to rest on the left side of the fuselage. The pilot executed an emergency shutdown and the occupants egressed from the helicopter without further incident. The helicopter sustained substantial damage to the main rotor system, the fuselage, the tailboom, and the tail rotor system. A postaccident examination of the airframe and engine revealed no preimpact mechanical malfunctions or failures that would have precluded normal operation. The helicopter had the cyclic, collective, and the two tail rotor pedals installed in the left side of the helicopter. The pilot reported that she briefed all of the passengers about not touching any of the flight controls. The passenger in the front left seat was asked if he had his feet on top of the tail rotor pedals as a footrest. He stated "that or on the floor," and then stated that he was not sure. The passenger further reported that the pilot did give a passenger safety briefing about not touching any of the flight controls. Postaccident testing was conducted in a Bell 206B flight training device. Wind conditions were replicated for the accident site. The National Transportation Safety Board (NTSB) investigator-in-charge (IIC) rested his feet on top of the tail rotor pedals for two flight iterations with no force applied and with medium force applied. When the Bell chief training pilot (CTP) attempted to takeoff for both iterations, the helicopter started to immediately rotate tothe right. The CTP had a hard time maintaining directional control due to the interference of the feet on the tail rotor pedals. The NTSB IIC also placed the tips of his feet on the floorboards up against the tail rotor pedals. When the CTP attempted to takeoff for the third iteration, the helicopter started to immediately rotate to the right. The CTP had a hard time maintaining directional control due to the interference of the feet up against the tail rotor pedals. A review of the Bell 206B rotorcraft flight manual found no guidance regarding the carrying of passengers in the cockpit and the interference of flight controls. The Federal Aviation Administration Helicopter Flying Handbook (FAA-H-8083-21B) discusses operations when carrying passengers in the cockpit and states, "If possible, remove front passenger flight controls and ensure all passenger personal items, such as cameras and mobile phones are secure."

## Aircraft

- Registration: [N352CT](https://openairdocs.org/deregistered/N352CT-2023-02-04), registration cancelled 2023-02-04, S/N 340, built 1969 (OpenAirDocs)
- Reported make and model: Bell 206 (B)
- Registry model: [Bell 206B](https://openairdocs.org/model/bell-206b) (registry code 1181511) (OpenAirDocs)
- Registry engine: [Allison 250 SER 400HP](https://openairdocs.org/engine/allison-250-ser-400hp) (registry code 03013, turbo-shaft) (OpenAirDocs)
- Category: Helicopter
- Serial number: 340
- Year built: 1969
- Airframe hours: 7102.6
- Engines: Rolls-Royce 250-C20 400 horsepower turbo shaft
- Damage: Substantial damage
- Flight: Personal, Part 91
- Airworthiness certificate: Standard, Normal
- Last inspection: Annual, October 23, 2017
- Departed: DWH, Houston, TX
- Destination: Pinehurst, TX
- Equipment: Electronic primary flight display

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 73; injuries: minor; private; medical: class 3, with waivers/limitations; last flight review January 10, 2018; seat: right; restraint: 4-point; flight hours: 3,780 total

## Weather

- Conditions: Visual (VMC), Day
- Wind: 220° at 5 knots
- Visibility: 10 statute miles
- Lowest ceiling: none
- Temperature: 91 °F, dew point 73 °F
- Altimeter: 29.97 inHg
- Observed at: KDWH, 19 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 (OpenAirDocs).

- [Accident 20180720018729A](https://openairdocs.org/incident/20180720018729A), Jul 20, 2018: Bell 206B, Todd Mission, TX, Substantial damage. On July 20, 2018, a Bell model 206B helicopter crashed on takeoff from fairgroundd located in Todd Mission, TX. Four pax on board all sustained minor injures.…

## Docket (9 files)

The files NTSB released with the investigation on June 26, 2020, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=97855. 366 MB in all.

- Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 10 pages, 10.8 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9576006&FileExtension=pdf&FileName=NTSB%20Form%206120_1%20Redacted-Rel.pdf
- Accident photographs (item 2, PDF, 7 pages, 802 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9575162&FileExtension=pdf&FileName=Accident%20Photographs-Rel.pdf
- Accident video footage (courtesy of a witness provided to the FAA) (item 3, MP4, 325 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9572904&FileExtension=mp4&FileName=Accident%20Video%20Footage-Rel.mp4
- Records of conversations (item 4, PDF, 2 pages, 83 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9575943&FileExtension=pdf&FileName=Record%20of%20Conversations-Rel.pdf
- Pilot and passenger heights and weights email (item 5, PDF, 2 pages, 18 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9575678&FileExtension=pdf&FileName=Heights%20and%20Weights%20Email%20Redacted-Rel.pdf
- NTSB reports (item 6, PDF, 4 pages, 132 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9576407&FileExtension=pdf&FileName=NTSB%20Reports-Rel.pdf
- Most recent helicopter log entries (item 7, PDF, 2 pages, 26.5 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9575952&FileExtension=pdf&FileName=Most%20Recent%20Helicopter%20Log%20Entries%20Redacted-Rel.pdf
- Helicopter accessory service reports (item 8, PDF, 4 pages, 3.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9575371&FileExtension=pdf&FileName=Helicopter%20Accessory%20Service%20Reports%20Redacted-Rel.pdf
- NTSB party member form (item 9, PDF, 1 page, 115 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=9576015&FileExtension=pdf&FileName=NTSB%20Party%20Member%20Form%20Redacted-Rel.pdf

From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model.

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