DCA94GA010

NTSB accident investigation · Beech 300/F · Front Royal, VA · October 26, 1993

Accident · FatalClass 1Final report
Date
October 26, 1993, 15:52 local (19:52 UTC)
Place
Front Royal, VA
Injuries
3 fatal
Damage
Destroyed
Phase of flight
Maneuvering
Aircraft
N82Beech 300/F
Weather
Instrument (IMC) · Day
Status
Completed · report March 30, 1995
Report
Board-adopted at Board Meeting
Investigation class
Class 1
NTSB office
Major Investigations Division
Safety recommendations
Yes
Case key
10978

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

On this page

Probable cause

the failure of the pilot-in-command to ensure that the airplane remained in visual meteorological conditions over mountainous terrain, and the failure of the Federal Aviation Administration executives and managers responsible for the FAA flying program to: 1)establish effective and accountable leadership and oversight of flying operations; 2)establish minimum mission and operational performance standards; 3)recognize and address performance-related problems among the organization's pilots; and 4) remove from flight operations duty pilots who were not performing to standards.

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.

In flight encounter with weatherManeuvering
Weather condition - low ceilingFactor
Vfr flight into imc - continuedPilot in commandCause
Inadequate surveillance of operationFaa(organization)Cause
Insufficient standards/requirementsFaa(organization)Cause
Inadequate certification/approvalFaa(organization)Cause
In flight collision with terrain/waterManeuvering
Terrain condition - mountainous/hilly

Analysis

The airplane was flying at 2,000 feet in the vicinity of high terrain when the airplane entered IMC conditions. The airplane struck the high terrain near the LINDEN VOR, while the PIC was awaiting an IFR clearance.

Factual narrative

The airplane, used to inspect airways facilities, had departed nearby Winchester Regional Airport in visual meteorlogical conditions (VMC) on a routine point-to-point flight to Newport News/Williamsburg International Airport. Witnesses described low clouds that were consistent with instrument meteorological conditions (IMC) in the area of the accident, which was about 15 south of the departure field. An IFR flight plan was on file in the ATC system, but the flight plan had not been activated. The flight was being conducted under 14 CFR 91.

At 1549, the PIC reported, "we're over the Linden VOR at 2,000 feet, can you get us a little higher, VFR on top and we'll be on our way." The airplane struck high terrain at 2,000 feet.

Aircraft

Registration
N82
Reported as
Beech 300/F
Category
Airplane
Serial number
FF-17
Airframe hours
3,353
Engine
P&W PT6A-60A, 1,050 horsepower, turbo prop
Damage
Destroyed
Fire
On-Ground
Flight
Public aircraft · Part 91
Operator
Federal Aviation Admin
Registered owner
Federal Aviation Admin
Airworthiness certificate
Standard, Normal
Last inspection
Continuous airworthiness · September 30, 1993 · 73 hours before
Departed
W16 · Winchester, VA
Destination
PHF · Newport News, VA

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
55
Certificates
Airline transport, Flight instructor
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Seat
Left
Toxicology
Performed
Flight hours
6,700 total · 2,000 in this make and model · 108 in the last 90 days · 38 in the last 30 days

Weather

Conditions
Instrument (IMC) · Day
Lowest ceiling
2,000 ft overcast
Observed at
W16, 15 nm away