# NTSB GAA19CA185: Rockwell S 2R, N4250X, Hermiston, OR, March 28, 2019 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Data collection · Final report - Date: March 28, 2019, 14:53 local (21:53 UTC) - Place: Hermiston, OR - Coordinates: 45.819999, -119.28083 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=45.8200&lon=-119.2808&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Defining event: [Approach-VFR pattern final: Miscellaneous/other](https://openairdocs.org/ntsb-events/900) - Highest injury: Minor injuries - Injuries: 1 minor - Status: Completed, report November 6, 2019 - Report: Approved by Office Director - NTSB office: General Aviation Accidents - Parties: FAA - NTSB case key (mKey): 99194 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=GAA19CA185 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/99194/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=99194 - Page: https://openairdocs.org/ntsb/GAA19CA185 ## Probable cause The pilot's distraction due to a spray handle opening and his improper pitch trim setting during final approach, which resulted in an excessive pitchdown when he took his hand off the controls to close the handle. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Performance/control parameters: pitch control](https://openairdocs.org/ntsb-findings/01062022): Aircraft › Aircraft oper/perf/capability · Not attained/maintained (probable cause); cases with it: [Rockwell International S-2R, 1 case](https://openairdocs.org/ntsb-findings/01062022/cases.md?model=7630202), [All aircraft, 526 cases](https://openairdocs.org/ntsb-findings/01062022/cases.md) - [Flight control system: elevator tab control system](https://openairdocs.org/ntsb-findings/01022731): Aircraft › Aircraft systems · Incorrect use/operation (probable cause); cases with it: [Rockwell International S-2R, 1 case](https://openairdocs.org/ntsb-findings/01022731/cases.md?model=7630202), [All aircraft, 37 cases](https://openairdocs.org/ntsb-findings/01022731/cases.md) - [Use of equip/info: use of equip/system](https://openairdocs.org/ntsb-findings/02063015): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Rockwell International S-2R, 2 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md?model=7630202), [All aircraft, 1,391 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md) - [Attention/monitoring: attention](https://openairdocs.org/ntsb-findings/02021510): Personnel issues › Psychological · Pilot (probable cause); cases with it: [Rockwell International S-2R, 2 cases](https://openairdocs.org/ntsb-findings/02021510/cases.md?model=7630202), [All aircraft, 226 cases](https://openairdocs.org/ntsb-findings/02021510/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Approach-VFR pattern final: Miscellaneous/other](https://openairdocs.org/ntsb-events/900) (defining event); cases with it: [Rockwell International S-2R, 2 cases](https://openairdocs.org/ntsb-events/900/sequence.md?model=7630202), [All aircraft, 1,556 cases](https://openairdocs.org/ntsb-events/900/sequence.md) - [Approach-VFR pattern final: Attempted remediation/recovery](https://openairdocs.org/ntsb-events/060); cases with it: [Rockwell International S-2R, 1 case](https://openairdocs.org/ntsb-events/060/sequence.md?model=7630202), [All aircraft, 1,422 cases](https://openairdocs.org/ntsb-events/060/sequence.md) - [Approach-VFR pattern final: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Rockwell International S-2R, 20 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=7630202), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) - [Approach-VFR pattern final: Part(s) separation from AC](https://openairdocs.org/ntsb-events/338); cases with it: [Rockwell International S-2R, 1 case](https://openairdocs.org/ntsb-events/338/sequence.md?model=7630202), [All aircraft, 563 cases](https://openairdocs.org/ntsb-events/338/sequence.md) ## Analysis The pilot reported that, after completing an agricultural application flight, he returned to the airport. He added that, on final, he added flaps and became distracted by a spray handle that became open due to vibration. He took his hand off the control stick to close the spray handle, but because the airplane was improperly trimmed, the airplane pitched down severely. He pitched the nose up to about level, but the main landing gear struck the ground. The airplane bounced and impacted an irrigation system, the right main landing gear separated, and the airplane spun around before coming to rest. The airplane sustained substantial damage to both wings, the fuselage, and the empennage. The pilot reported that there were no preaccident mechanical failures or malfunctions with the airplane that would have precluded normal operation. ## Factual narrative The pilot reported that, after completing an agricultural spraying flight, he returned to the airport. He added that, on final, he added flaps and became distracted by a spray handle that became open due to vibration. He took his hand off the control stick to close the spray handle, but because the airplane was improperly trimmed, the airplane pitched down severely. He pitched the nose up to about level, but the main landing gear struck the ground. The airplane bounced onto an irrigation system, the right main landing gear separated, and the airplane spun around before coming to rest. The airplane sustained substantial damage to both wings, fuselage, and empennage. The pilot reported that there were no preaccident mechanical failures or malfunctions with the airplane that would have precluded normal operation. ## Aircraft - Registration: [N4250X](https://openairdocs.org/aircraft/N4250X), registered now, S/N 2030R, built 1974 (OpenAirDocs) - Reported make and model: Rockwell S 2R (No Series) - Registry model: [Rockwell International S-2R](https://openairdocs.org/model/rockwell-international-s-2r) (registry code 7630202) (OpenAirDocs) - Registry engine: [Pratt & Whitney R1340 series](https://openairdocs.org/engine/pratt-whitney-r1340-series) (registry code 52016, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 2030R - Year built: 1974 - Airframe hours: 19154.9 - Engines: GE Aviation M601E-11 751 horsepower turbo prop - Damage: Substantial damage - Flight: Aerial application, Part 137 - Operator: AG Specialties INC. - Registered owner: Pesicka, Theodore J. - Airworthiness certificate: Special, Restricted (Special) - Last inspection: Annual, March 15, 2019 - Departed: HRI, Hermiston, OR - Destination: HRI, Hermiston, OR - Flight plan: Unknown - Airport: HRI, Hermiston Muni, runway 05, 4,501 × 75 ft, asphalt - Equipment: None ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 60; injuries: minor; commercial; airplane ratings: single-engine land; medical: class 2, with waivers/limitations; last flight review June 29, 2018; seat: single; restraint: 4-point; flight hours: 12,744 total, 11,749 in this make and model, 12,633 as pilot in command, 17 in the last 90 days, 17 in the last 30 days, 5 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: calm - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 59 °F, dew point 36 °F - Altimeter: 30.11 inHg - Observed at: KHRI, 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 20190328002089A](https://openairdocs.org/incident/20190328002089A), Mar 28, 2019: Rockwell International S-2R, Hermiston, OR, Substantial damage. On Thursday, March 28, 2019, a Rockwell International S-2R, registered as N4250X, was involved in an accident approx. ¾ of a mile west of runway 4 at Hermiston… ## Other investigations on N4250X (1) 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. - [NTSB SEA03LA152](https://openairdocs.org/ntsb/SEA03LA152), Jul 21, 2003: Rockwell S-2R (N4250X), Hermiston, OR, substantial damage. Probable cause: The pilot's inadequate in-flight decision by failing to refuel, resulting in fuel exhaustion and the loss of power. Rocky terrain was a factor. ## Docket (3 files) The files NTSB released with the investigation on April 24, 2019, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=99194. 4.1 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 3.6 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472160&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF - Record of Conversation - Pilot (item 2, .PDF, 67 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472161&FileExtension=.PDF&FileName=Record%20of%20Conversation%20-%20Pilot-Master.PDF - Accident Photo (item 3, .PDF, 1 photo, 414 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472162&FileExtension=.PDF&FileName=Accident%20Photo-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.