# NTSB GAA16CA348: Beech B200, N87SA, Carolina, PR, January 11, 2016 - Type: NTSB accident investigation - Classification: Accident · No injuries · Data collection · Final report - Date: January 10, 2016, 22:00 local (Jan 11, 2016, 02:00 UTC) - Place: Carolina, PR - Coordinates: 18.26361, -66.001388 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=18.2636&lon=-66.0014&mi=10 - Phase of flight: [Standing](https://openairdocs.org/ntsb-phases/150) (OpenAirDocs' grouping) - Defining event: [Standing-engine(s) shutdown: Ground collision](https://openairdocs.org/ntsb-events/200) - Highest injury: No injuries - Injuries: 5 uninjured - Status: Completed, report December 5, 2016 - Report: Approved by Office Director - NTSB office: General Aviation Accidents - Parties: FAA - NTSB case key (mKey): 93507 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=GAA16CA348 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/93507/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=93507 - Page: https://openairdocs.org/ntsb/GAA16CA348 ## Probable cause The pilot's failure to actuate the parking brake prior to leaving his seat, resulting in substantial damage. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Landing gear system: brake](https://openairdocs.org/ntsb-findings/01023242): Aircraft › Aircraft systems · Not used/operated (probable cause); cases with it: [Beech B200, 1 case](https://openairdocs.org/ntsb-findings/01023242/cases.md?model=1152922), [All aircraft, 297 cases](https://openairdocs.org/ntsb-findings/01023242/cases.md) - [Action: lack of action](https://openairdocs.org/ntsb-findings/02041030): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Beech B200, 1 case](https://openairdocs.org/ntsb-findings/02041030/cases.md?model=1152922), [All aircraft, 792 cases](https://openairdocs.org/ntsb-findings/02041030/cases.md) - [Object/animal/substance: airport structure](https://openairdocs.org/ntsb-findings/03022042): Environmental issues › Physical environment · Contributed to outcome; cases with it: [Beech B200, 1 case](https://openairdocs.org/ntsb-findings/03022042/cases.md?model=1152922), [All aircraft, 50 cases](https://openairdocs.org/ntsb-findings/03022042/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Standing-engine(s) shutdown: Ground collision](https://openairdocs.org/ntsb-events/200) (defining event); cases with it: [Beech B200, 2 cases](https://openairdocs.org/ntsb-events/200/sequence.md?model=1152922), [All aircraft, 618 cases](https://openairdocs.org/ntsb-events/200/sequence.md) ## Analysis The pilot reported that he parked the airplane and shut down the requisite systems, then proceeded to the back of the airplane to allow the passengers to disembark and set the wheel chocks. He reported that as he began to open the cabin door, he realized that the airplane was rolling backwards. The airplane rolled into the wall of the airport terminal and the left and right elevators sustained substantial damage. The pilot reported that there were no mechanical failures or anomalies with the airplane or any of its systems that would have prevented normal operation. According to the manufacturer's pilot operating handbook and the operator, the accident airplane was equipped with a parking brake. The operator reported that their maintenance department inspected the parking brake system after the accident, and in accordance with the Beech B200 service manual and found no failures or anomalies. ## Factual narrative The pilot reported that he parked the airplane and shut down the requisite systems, then proceeded to the back of the airplane to allow the passengers to disembark and set the wheel chocks. He reported that as he began to open the cabin door, he realized that the airplane was rolling backwards. The airplane rolled into the wall of the airport terminal and the left and right elevators sustained substantial damage. The pilot reported that there were no mechanical failures or anomalies with the airplane or any of its systems that would have prevented normal operation. According to the manufacturer's pilot operating handbook and the operator, the accident airplane was equipped with a parking brake. The operator reported that their maintenance department inspected the parking brake system after the accident, and in accordance with the Beech B200 service manual and found no failures or anomalies. ## Aircraft - Registration: [N87SA](https://openairdocs.org/aircraft/N87SA), registered now, S/N BB-1089, built 1982 (OpenAirDocs) - Reported make and model: BEECH B200 (UNDESIGNAT) - Registry model: [Beech B200](https://openairdocs.org/model/beech-b200) (registry code 1152922) (OpenAirDocs) - Registry engine: [Pratt & Whitney PT6A series](https://openairdocs.org/engine/pratt-whitney-pt6a-series) (registry code 52032, turbo-prop) (OpenAirDocs) - Category: Airplane - Serial number: BB-1089 - Year built: 1982 - Airframe hours: 12545.6 - Engines: Pratt and Whitney PT6A-42 850 horsepower turbo prop; Pratt and Whitney PT6A-42 850 horsepower turbo prop - Damage: Substantial damage - Flight: Part 135 - Operator: Island Airlines, LLC, doing business as Island Airways - Registered owner: Liberty Air LLC - Airworthiness certificate: Standard, Normal - Last inspection: December 17, 2015 - Departed: TISX, St. Croix - Destination: TJSJ, Carolina, PR - Flight plan: Company VFR - Airport: TJSJ, San Juan Luis Munoz Internatio, runway 10, 8,610 × 150 ft, asphalt - Equipment: Stall warning system, Auto-pilot, Electronic multifunction display, Electronic primary flight display ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 45; injuries: none; airline transport; airplane ratings: single-engine sea, multi-engine sea; instrument ratings: airplane; medical: class 1, without waivers/limitations; last flight review October 15, 2015; seat: left; restraint: none; flight hours: 9,597 total, 2,000 in this make and model, 9,597 as pilot in command, 20 in the last 90 days, 10 in the last 30 days, 1 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: calm - Visibility: 10 statute miles - Temperature: 79 °F, dew point 72 °F - Altimeter: 30.03 inHg - Observed at: TJSJ, 1 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 20160110007519A](https://openairdocs.org/incident/20160110007519A), Jan 10, 2016: Beech B200, Carolina, PR, Substantial damage. After landing at sju the aircraft taxied to the ramp. The aircraft parked in a downslope area. After the engines were shutdown, the aircraft started to move… ## Docket (4 files) The files NTSB released with the investigation on October 13, 2016, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=93507. 2.5 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 1.9 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40445292&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF - Pilot's Statement (item 2, .PDF, 101 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40445293&FileExtension=.PDF&FileName=Pilot%27s%20Statement-Master.PDF - Island Airlines B200 Checklist (item 3, .PDF, 233 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40445294&FileExtension=.PDF&FileName=Island%20Airlines%20B200%20Checklist-Master.PDF - Photos (Courtesy of FAA) (item 4, .PDF, 3 photos, 256 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40445295&FileExtension=.PDF&FileName=Photos%20(Courtesy%20of%20FAA)-Master.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.