LAX00FA134

NTSB accident investigation · Robinson R22 Beta · Rialto, CA · March 24, 2000

Accident · FatalField investigationFinal report
Date
March 24, 2000, 12:48 local (20:48 UTC)
Place
Rialto, CA
Injuries
1 fatal
Damage
Destroyed
Phase of flight
Approach
Aircraft
N8328QRobinson R22 Beta
Weather
Visual (VMC) · Day
Status
Completed · report November 25, 2003
Report
Approved by Office Director
Parties
Lycoming Engines, Robinson Helicopter Company, FAA FSDO
FAA report
20000324009649A
Case key
48928

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

The pilot's in-flight loss of control for undetermined reasons.

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.

Loss of control - in flightApproach - vfr pattern - final approach
Reason for occurrence undetermined
In flight collision with terrain/waterDescent - uncontrolled
Terrain condition - ground

Analysis

For undetermined reasons, the pilot began hovering between 150 and 250 feet agl while on final approach to the airport. He then lost control of the helicopter and descended in a nose low attitude until impacting the ground. Earlier during the morning the pilot had flown with his flight instructor (CFI) on a round robin cross-country flight to the same airport. According to the CFI, the pilot had demonstrated that he was competent to make the same flight solo, so the CFI endorsed his logbook authorizing the flight. Subsequently, the pilot departed on his first solo cross-country flight in the helicopter. Recorded radar data indicates that the pilot proceeded to the destination airport, entered its traffic pattern about 500 feet agl, and turned onto the base leg while descending to about 200 feet agl. Two witnesses observed the pilot on the final approach leg. One witness reported that the helicopter appeared to hover for 3 to 10 seconds, while the other witness estimated it was stopped in the air for 5 seconds. Both witnesses reported seeing the helicopter's pitch attitude decrease, then the helicopter descended while in a 45-degree nose low attitude. The on-scene accident site examination revealed the helicopter impacted hard onto the level ground while heading toward the airport. The helicopter's landing gear structure fragmented, and the main rotor blades bent aftward. The helicopter came to rest 100 feet from the initial point of impact. No evidence was found of any in-flight contact between the main rotor blades and the fuselage. No evidence was found of any preimpact mechanical malfunction with the flight control, driveline, and throttle governor systems. The engine was test run and full rated power was obtained. The pilot was certificated to fly airplanes and had about 110 hours of fixed wing flying experience. His total dual and solo experience flying the Robinson R22 was 29 and 5.7 hours, respectively.

Factual narrative

History of flight

On March 24, 2000, about 1248 Pacific standard time, a Robinson R22 Beta, N8328Q, operated by Universal Aviators Academy, Inc., El Monte, California, descended into terrain while on final approach to the (uncontrolled) Rialto Municipal Airport, Rialto, California. The helicopter was destroyed, and the private pilot was fatally injured. Visual meteorological conditions prevailed, and no flight plan was filed for the solo instructional flight. The flight was being performed under 14 CFR Part 91, and it originated from El Monte about noon.

The pilot's certified flight instructor (CFI) reported to the National Transportation Safety Board investigator that his student, who was certificated to pilot airplanes, was learning to fly rotorcraft. The accident occurred during the student's first solo cross-country flight in rotorcraft.

During the morning of March 24, the pilot received a dual flight lesson from his CFI in the accident helicopter. The 1.1-hour-long lesson involved flying a round robin course between El Monte and Rialto. About 1045, upon returning to El Monte, the CFI endorsed his student's logbook for his first solo cross-country flight in the R22. The planned route of flight was to be identical to the route they had just flown. Prior to taking off the helicopter's fuel tanks were completely filled.

En route to Rialto, the pilot passed the Ontario International Airport. Thereafter, according to Federal Aviation Administration (FAA) recorded radar data, the pilot flew in an easterly and northeasterly direction toward Rialto. Approaching Rialto's downwind leg in the traffic pattern, the helicopter's ground speed was about 84 knots, and it was cruising about 1,900 feet msl (about 500 feet above ground level (agl)), as indicated by the helicopter's Mode C (altitude reporting) transponder.

The radar data indicates that about 1247:15, when the helicopter turned onto the base leg for taxiway 24, it had descended to about 1,600 feet msl. (Rialto Airport's elevation is 1,455 feet msl.) At this time its ground speed had decreased to about 72 knots. The helicopter was last recorded on radar at 1247:19. At this time the helicopter was on base leg, its altitude was 1,600 feet msl, and its ground speed had decreased to approximately 41 knots.

Several witnesses observed and heard the helicopter in the vicinity of the Rialto Airport seconds before it crashed. In summary, a paramedic, who was located about 1/3-mile northwest of the crash site, reported that he heard the helicopter and then observed it hovering between 150 and 200 feet agl. The helicopter was "stationary" and was pointed westerly (toward the airport). After between 3 and 10 seconds, the helicopter turned or pivoted left about a point, thus changing its heading between 45 and 90 degrees. Then, while headed in a southwesterly or southerly direction, the helicopter's nose pitched about 45 degrees downward, and it started flying westward in this nose down attitude without any apparent loss of altitude. After proceeding less than five helicopter lengths in this nose down attitude, the helicopter began descending. Its nose down attitude remained the same. The paramedic additionally stated that he lost sight of the helicopter when it descended below a small ridgeline, but a second thereafter he observed a cloud of dirt propagate upward, which indicated to him that the helicopter had crashed. During the entire time in which the paramedic heard the helicopter, no unusual sounds, like popping, banging, or engine missing sounds, were heard.

A 13-year-old boy, who was located an estimated 1/3-mile southwest of the crash site, reported that he observed the helicopter "stopped in the air" for about 5 seconds. It "wobbled," tilted nose down about 45 degrees, and descended. A dirt cloud came up about 1 second later.

A non-English speaking witness, located about 1/10-mile west of the crash site, reported (through an interpreter) that he first observed the helicopter flying level. White smoke was trailing from the helicopter. The helicopter started shaking, nosed over, and descended at a 45-degree angle until he lost sight of it. The witness did not see any fire or recall hearing any noise from the helicopter.

Seconds before the accident, a flight instructor was near the midfield location over the Rialto Airport. The flight instructor reported that he observed the accident helicopter enter downwind for taxiway 24 at 500 feet agl. The helicopter turned onto the base leg and nothing unusual occurred. When the helicopter was on base leg it had descended between 250 and 300 feet agl. The visibility was about 10 miles, and the wind was light and variable. The air was smooth and "it was good autorotation weather."

The accident pilot's CFI subsequently reported to the Safety Board investigator that, based upon his observations of the accident site's location and its proximity to the airport, he opined that his student had crashed while flying over an appropriate flight route. The accident site location was indicative of the helicopter having descended from the traffic pattern to ground level while on either the base or final approach legs to the taxiway that parallels runway 24.

Personnel information

A review of the pilot's personal flight record logbook revealed he commenced primary flight training in February 1992, and principally flew Cessna 150 and Piper PA-28-151 airplanes. He obtained a private pilot certificate in March 1994. Thereafter, he continued flying on a monthly basis until August 1996, whereupon he discontinued flying. The pilot's logbook indicates that he resumed flying on March 8, 1999. On that date he completed a flight review in a Cessna.

On June 7, 1999, the pilot began taking flying lessons in the accident helicopter. He continued taking lessons several times per month, and by the accident date he had logged about 27 individual flights in the Robinson R22.

By the date of the accident, the pilot's total aircraft flight time was about 140.5 hours. Of this time, approximately 110.4 hours had been flown in airplanes and about 30.1 hours had been flown in rotorcraft, of which about 29.1 hours had been flown in the Robinson R22. Including the 0.9-hour-long accident flight, the pilot's total solo flight time in R22s was about 5.7 hours.

Aircraft information

A review of the maintenance logbooks revealed that on January 31, 2000, the helicopter's total airframe and engine times were 2,764.2 hours and 2,006.9 hours, respectively. At this time, the helicopter was overhauled by the Robinson Helicopter Company and was returned to service.

The logbooks indicate that on March 13, 2000, the operator's contract mechanic performed a 100-hour inspection at a total helicopter time of 2,861.7 hours (97.5 hours since overhaul). Thereafter, the helicopter was returned to service.

The next and final entry in the maintenance logs was noted on March 21, 2000. At that time the helicopter's total time was 2,882.0 hours (117.8 hours since overhaul). The helicopter was serviced by the operator's contract mechanic and, in part, a starter vibrator was replaced. Thereafter, the helicopter was operationally checked and returned to service.

The CFI reported that just prior to the fatal flight when he had flown the helicopter, all control systems and warning lights were functioning properly. He stated, "everything was working." The operator reported that when the pilot rented the helicopter from the flight school for the accident flight, there were no outstanding squawks pertinent to the helicopter.

During the postimpact examination of the wreckage, the helicopter's Hobbs hour recording meter was located and was observed displaying the numbers 2,890.1 hours. Based upon this value, the calculated number of hours since the helicopter was overhauled and received its last 100-hour inspection were 12

Aircraft

Registration
N8328Q
Reported as
Robinson R22 Beta
Category
Helicopter
Serial number
2565
Airframe hours
2,890
Engine
Lycoming O-320-B2C, 160 horsepower, reciprocating
Damage
Destroyed
Flight
Instructional · Part 91
Operator
Universal Air Academy
Registered owner
Universal Aviators Academy, Inc.
Airworthiness certificate
Standard, Normal
Last inspection
100 hour · March 13, 2000 · 28 hours before
Departed
EMT · El Monte, CA
Destination
L67 · Rialto, CA
Airport
L67 · Rialto Municipal, runway 24, 4,500 × 100 ft, asphalt

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
Student pilot
Age
50
Injuries
Fatal
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 3, Without waivers/limitations
Last flight review
March 8, 1999
Seat
Right
Toxicology
Performed
Flight hours
141 total · 29 in this make and model · 76 as pilot in command · 13 in the last 90 days · 7 in the last 30 days · 2 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
Calm
Visibility
10 statute miles
Lowest ceiling
25,000 ft overcast
Temperature
70 °F, dew point 30 °F
Altimeter
29.94 inHg
Observed at
ONT, 13 nm away

Docket · 32

The files NTSB released with the investigation on September 17, 2003, on NTSB’s docket system: statements, records, photos and specialists’ reports. 22.2 MB in all.

Supplement AItem 1 · .PDF · 306 KBSupplement BItem 2 · .PDF · 433 KBSupplement KItem 3 · .PDF · 471 KBWitness StatementsItem 4 · .PDF · 170 KBFAA Personnel ReportItem 5 · .PDF · 103 KBAccident Site MapsItem 6 · .PDF · 2.0 MBWreckage DiagramItem 7 · .PDF · 90 KBReports from Parties to the Investigation: LycomingItem 8 · .PDF · 900 KBReports from Parties to the Investigation: RobinsonItem 9 · .PDF · 1.1 MBStatement of Party Representatives to NTSB InvestigationItem 10 · .PDF · 537 KBRelease of Aircraft Wreckage, NTSB Form 6120.15Item 11 · .PDF · 89 KBPilot's LogbookItem 12 · .PDF · 2.0 MBToxicological ReportItem 13 · .PDF · 106 KBWeather: Radar Data and PlotsItem 14 · .PDF · 1.7 MBFuel ReceiptItem 15 · .PDF · 177 KBRental RecordsItem 16 · .PDF · 80 KBAirplane and Enigine Logbook ExcerptsItem 17 · .PDF · 516 KBPhoto 1: Southwest View of the Main Wreckage from the Initial Point of ImpactItem 18 · .PDF · 700 KBPhoto 2: Main WreckageItem 19 · .PDF · 858 KBPhoto 3: Main Wreckage (aft view)Item 20 · .PDF · 974 KBPhoto 4: Main Wreckage (front view)Item 21 · .PDF · 950 KBPhoto 5: Tail and GearboxItem 22 · .PDF · 982 KBPhoto 6: Right DoorItem 23 · .PDF · 747 KBPhoto 7: Left DoorItem 24 · .PDF · 832 KBPhoto 8: Landing Gear Skids (partially reassembled)Item 25 · .PDF · 628 KBPhoto 9: Plexiglass FragmentsItem 26 · .PDF · 770 KBPhoto 10: CockpitItem 27 · .PDF · 1.0 MBPhoto 11: EngineItem 28 · .PDF · 850 KBPhoto 12: Tail Rotor BladesItem 29 · .PDF · 819 KBPhoto 13: Main Rotor BladesItem 30 · .PDF · 691 KBPhoto 1. View from normal downwind at 500 agl for taxiway 24. Western Operations, Inc. photo.Item 31 · .PDF · 259 KBPhoto 2. View showing final for taxiway 24. Western Operations, Inc. photo.Item 32 · .PDF · 308 KB

FAA reports on this event · 1

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

Other investigations on N8328Q · 1

Matched to the same aircraft by N-number and date.