# NTSB CEN22LA063: Mcdonnell Douglas Helicopter 369E, N911PH, St. Louis, MO, December 2, 2021 - Type: NTSB accident investigation - Classification: Accident · No injuries · Class 4 · Limited · Final report - Date: December 2, 2021, 12:58 local (18:58 UTC) - Place: St. Louis, MO - Coordinates: 38.66211, -90.65205 - Nearby events: https://openairdocs.org/map.md?lat=38.6621&lon=-90.6521&mi=10 - Phase of flight: [Landing](https://openairdocs.org/ntsb-phases/550) (OpenAirDocs' grouping) - Defining event: [Landing-flare/touchdown: Hard landing](https://openairdocs.org/ntsb-events/092) - Highest injury: No injuries - Injuries: 2 uninjured - Status: Completed - Report: Approved by Office Director - Investigation class: Class 4 - Basic report with no Prelim publish - NTSB office: Central Region - Parties: Federal Aviation Administration - NTSB case key (mKey): 104364 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN22LA063 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/104364/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=104364 - Page: https://openairdocs.org/ntsb/CEN22LA063 ## Probable cause The pilot’s failure to apply power during the recovery procedure for the practice autorotation, which resulted in a hard landing. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Use of equip/info: aircraft control](https://openairdocs.org/ntsb-findings/02063040): Personnel issues › Task performance · Pilot; cases with it: [Mcdonnell Douglas Helicopter 369E, 6 cases](https://openairdocs.org/ntsb-findings/02063040/cases.md?model=3027369), [All aircraft, 9,295 cases](https://openairdocs.org/ntsb-findings/02063040/cases.md) - [Action: lack of action](https://openairdocs.org/ntsb-findings/02041030): Personnel issues › Action/decision · Pilot; cases with it: [Mcdonnell Douglas Helicopter 369E, 1 case](https://openairdocs.org/ntsb-findings/02041030/cases.md?model=3027369), [All aircraft, 792 cases](https://openairdocs.org/ntsb-findings/02041030/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Landing-flare/touchdown: Hard landing](https://openairdocs.org/ntsb-events/092) (defining event); cases with it: [Mcdonnell Douglas Helicopter 369E, 8 cases](https://openairdocs.org/ntsb-events/092/sequence.md?model=3027369), [All aircraft, 2,102 cases](https://openairdocs.org/ntsb-events/092/sequence.md) ## Analysis The pilot reported that he intended to perform a straight-in autorotation that would terminate with a power on recovery procedure over the runway. The autorotation was performed without incident; however, the pilot did not advance the engine power in time for the recovery. The helicopter impacted the runway hard and came to rest upright on the skids. During the impact sequence, the main rotor blades contacted and severed the tail boom, which resulted in substantial damage. The pilot reported there were no preimpact mechanical malfunctions or failures with the airframe and engine that would have precluded normal operations. ## Aircraft - Registration: [N911PH](https://openairdocs.org/aircraft/N911PH), registered now, S/N 0217E, built 1987 (OpenAirDocs) - Reported make and model: MCDONNELL DOUGLAS HELICOPTER 369E - Registry model: [Mcdonnell Douglas Helicopter 369E](https://openairdocs.org/model/mcdonnell-douglas-helicopter-369e) (registry code 3027369) (OpenAirDocs) - Registry engine: [Amateur-built UNKNOWN ENG](https://openairdocs.org/engine/amateur-built-unknown-eng) (registry code 99999) (OpenAirDocs) - Category: Helicopter - Serial number: 0217E - Year built: 1987 - Airframe hours: 16203 - Engines: Rolls Royce 250 420 hp turbo shaft - Damage: Substantial damage - Flight: Business, Part 91 - Operator: St Louis County Police Department - Registered owner: St Louis County Police Department - Airworthiness certificate: Standard, Normal - Last inspection: 100 hour, December 1, 2021, 3 hours before - Airport: SUS, Spirit of St Louis Airport, runway 26L, 7,485 × 150 ft, concrete - Equipment: ADS-B ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 44; injuries: none; flight instructor, commercial; medical: class 2, without waivers/limitations; last flight review December 24, 2020; seat: left; restraint: 4-point; flight hours: 1,330 total, 1,257 in this make and model, 1,262 as pilot in command, 49 in the last 90 days, 24 in the last 30 days, 4 in the last 24 hours - Pilot; age 34; injuries: none; private; medical: class 2, without waivers/limitations; last flight review October 8, 2021; seat: right; restraint: 4-point; flight hours: 55 total, 0 in this make and model, 16 as pilot in command, 1 in the last 90 days, 0 in the last 30 days, 0 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: 250° at 6 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 70 °F, dew point 37 °F - Altimeter: 29.94 inHg - Observed at: KSUS - METAR: KSUS 021854Z 25006KT 10SM CLR 21/03 A2994 RMK AO2 SLP135 T02110028 ## 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 20211202019209A](https://openairdocs.org/incident/20211202019209A), Dec 2, 2021: Mcdonnell Douglas Helicopter 369E, Chesterfield, MO, Substantial damage. The pilot was returning to the airport after patrol and was practicing an auto-rotation on runway 26L. At the bottom of the auto-rotation, the pilot started… ## Docket (2 files) The files NTSB released with the investigation on January 18, 2022, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=104364. 8.7 MB in all. - Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 9 pages, 7.6 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=12993992&FileExtension=pdf&FileName=6120%20printed_Redacted-Rel.pdf - On scene photos - courtesy of airport operations (item 2, PDF, 2 pages, 1.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=12994537&FileExtension=pdf&FileName=on%20scene%20photos-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. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.