FTW92FA025

NTSB accident investigation · Beech B19 · Forth Worth, TX · November 20, 1991

Accident · No injuriesField investigationFinal report
Date
November 20, 1991, 12:18 local (18:18 UTC)
Place
Forth Worth, TX
Injuries
4 uninjured
Phase of flight
Enroute
Aircraft
N9343SBeech B19N94258Convair 600
Weather
Visual (VMC) · Day
Status
Completed · report September 11, 1992
Report
Approved by Office Director
Case key
18342

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

Inadequate visual lookout by the pilots-in-command of both aircraft, which resulted in their failure to see-and-avoid the other aircraft. A factor related to the accident was: failure of the developmental controller or the supervisor to provide adequate control tower service.

Inadequate visual lookout by the pilots-in-command of both aircraft, which resulted in their failure to see-and-avoid the other aircraft. A factor related to the accident was: failure of the developmental controller or the supervisor to provide adequate control tower service.

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.

Midair collisionCruise
Control tower service - inadequateAtc personnel(lcl/gnd/clnc)Factor
Visual lookout - inadequatePilot in commandCause
Visual lookout - inadequatePilot of other aircraftCause
Forced landingDescent - emergency
In flight collision with terrain/waterLanding
Terrain condition - rough/unevenFactor
Midair collisionApproach - vfr pattern - base leg/base to final
Control tower service - inadequateAtc personnel(lcl/gnd/clnc)Factor
Visual lookout - inadequatePilot in command(cfi)Cause
Visual lookout - inadequatePilot of other aircraftCause
Precautionary landing

Analysis

Convair 600, N94258, was on a flt with a coml plt in the l seat & a CFI in the rgt seat. They entered VFR tfc for ILS apchs to rwy 34. The coml plt was using a hood; the CFI was providing simulated ATC vctrs for an apch. A developmental ctlr (d/c) was ctlg tfc at the arpt under supvn of an instructor. The d/c had adzd the plts to maint VFR & that sepn svcs would not be provided. As the convair was in a closed/rgt pattern, the plt of Beech B19, N9343S, ctcd the twr for approval to transit the area fm se to NE. The B19 plt was clrd thru the area at or blo 2400' MSL. Subsequently, the 2 acft converged & collided at an alt of abt 2000' MSL. Impact occurred as the B19 was on a hdg of 060 deg & the convair was in a rgt turn to intercept the ILS final apch course. The B19 plt saw the convair just bfr impact & tried to avoid a collision; the convair plts did not see the B19. After impact, the convair was lndd with a dmgd hrzntl stblzr. The B19 plt was forced to lndg on rough trrn. The ATC ctlrs had not notified either crew of the other acft's psn.

Convair 600, N94258, was on a flt with a coml plt in the l seat & a CFI in the rgt seat. They entered VFR tfc for ILS apchs to rwy 34. The coml plt was using a hood; the CFI was providing simulated ATC vctrs for an apch. A developmental ctlr (d/c) was ctlg tfc at the ftw alliance arpt under supvn of an instructor. D/c adzd the plts to maint VFR & that sepn svcs would not be provided. As the convair was in a closed/rgt pattern, the plt of Beech B19, N9343S, ctcd the twr for approval to transit the area fm se to NE. The B19 plt was clrd thru the area at or blo 2400' MSL. Subsequently, the 2 acft converged & collided at an alt of abt 2000' MSL. Impact occurred as the B19 was on a hdg of 060 deg & the convair was in a rgt turn to intercept the ILS final apch course. The B19 plt saw the convair just bfr impact & tried to avoid a collision; the convair plts did not see the B19. After impact, the convair was lndd with a dmgd hrzntl stblzr. The B19 plt was forced to lndg on rough trrn. The ATC ctlrs had not notified either crew of the otr acft's psn.

Aircraft · 2

Registration
N9343S
Reported as
Beech B19
Category
Airplane
Serial number
MB-777
Engine
Lycoming O-320-E3D, 150 horsepower, reciprocating
Damage
Substantial damage
Flight
Business · Part 91
Registered owner
Michael Cohen
Airworthiness certificate
Standard, Normal
Last inspection
100 hour · October 9, 1991 · 55 hours before
Departed
FTW · Ft Worth, TX
Destination
ADS · Dallas, TX
Airport
AFW · Ft Worth Alliance

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.

Registration
N94258
Reported as
Convair 600
Category
Airplane
Serial number
119
Airframe hours
61,707
Engine
Rolls-Royce RDA-10, 3,060 horsepower, turbo prop
Damage
Substantial damage
Flight
Instructional · Part 91
Registered owner
Aircraft Leasing Inc.
Airworthiness certificate
Standard, Transport
Last inspection
Continuous airworthiness · November 11, 1991 · 1 hours before
Departed
AWF · Fort Worth, TX
Airport
AFW · Ft Worth Alliance, runway 34, 9,600 × 150 ft, concrete

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 · 2

As NTSB recorded them. NTSB leaves out names.

Role
Pilot, aircraft N9343S
Age
21
Certificates
Commercial, Flight instructor
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Seat
Left
Flight hours
690 total · 200 in this make and model · 580 as pilot in command · 180 in the last 90 days · 42 in the last 30 days · 3 in the last 24 hours
Role
Pilot, aircraft N94258
Age
36
Certificates
Flight instructor, Airline transport
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Seat
Right
Flight hours
7,200 total · 5,100 in this make and model · 4,700 as pilot in command · 88 in the last 90 days · 48 in the last 30 days · 2 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
360° at 20 knots
Visibility
20 statute miles
Lowest ceiling
None
Temperature
57 °F
Altimeter
30.00 inHg
Observed at
AFW, 2 nm away

FAA reports on this event · 2

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