LAX01LA019

NTSB accident investigation · Beech 300 · Concord, CA · October 19, 2000

Accident · Serious injuriesLimited investigationFinal report
Date
October 19, 2000, 15:38 local (22:38 UTC)
Place
Concord, CA
Injuries
1 serious, 1 minor; on the ground: 1 serious
Damage
Substantial damage
Phase of flight
Takeoff
Aircraft
N398DEBeech 300
Weather
Visual (VMC) · Day
Status
Completed · report November 25, 2003
Report
Approved by Office Director
Parties
Raytheon Aircraft Company, Hartzell Propeller Inc., Federal Aviation Administration
FAA report
20001019038809A
Case key
50502

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 pilot's delayed decision to abort the takeoff and his failure to utilize the propeller's reverse pitch function.

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.

OverrunTakeoff - aborted
Aborted takeoff - delayedPilot in commandCause
Reversers - not usedPilot in commandCause
On ground/water collision with objectTakeoff - aborted
Object - fence
Object - vehicle

Analysis

The twin turboprop airplane overran the runway, impacted two fences, and an occupied automobile after the airline transport pilot attempted to abort a takeoff. The pilot performed a rolling takeoff and was paying close attention to balancing the engine power and keeping runway centerline alignment. As the airplane accelerated, the pilot set the power above 80 percent and began an instrument scan. He then noted the airspeed indicator was reading zero with the needle resting on the peg. After a moment's hesitation, the pilot attempted to abort the takeoff by reducing the power levers to flight idle, and subsequently over the gate to ground fine. He reported to the FAA that he did not place the power controls into the reverse position. Air traffic controllers reported they observed the airplane with its nose wheel off of the ground approximately 3/4 of the way down the 4,602-foot long runway. The aircraft's left and right pitot/static systems were examined and tested after the accident, and no anomalies were noted. The pilot obtained verbal training on rejected/aborted takeoffs for the accident airplane. He obtained his type rating and 14 CFR 135 check-out in the accident airplane approximately 1 month prior to the accident. The pilot had accumulated a total of 10,867.5 hours of flight time, of which 34.7 hours were accumulated in the accident aircraft make and model. The pilot reported his total pilot-in-command flight time in the accident aircraft make and model as 20 hours, all of which were accumulated within the preceding 30 days of the accident. Examination of the airplane, the flight instruments and the pitot/static system found no explanation for the pilot reported lack of airspeed reading. The brakes were found to be fully functional. Review of the performance charts for the airplane disclosed that for the weight and ambient conditions of the takeoff, the airplane required 4,100 feet for an accelerate-stop distance; the runway was 4,602 feet long.

Factual narrative

History of flight

On October 19, 2000, at 1538 Pacific daylight time, a Beech 300 twin-engine airplane, N398DE, overran the runway and struck an automobile during an aborted takeoff at the Buchanan Field, Concord, California. The airplane sustained substantial damage; however, the airline transport pilot sustained minor injuries. The driver, who was the sole occupant of the automobile, received serious injuries. The airplane was registered to King Air Charter, Danville, California, and was operated by AeroSmith Aviation, Inc., Concord, as a positioning flight under 14 CFR Part 91 when the accident occurred. The flight was originating at the time of the accident and was destined for San Jose, California. Visual meteorological conditions prevailed, and a flight plan was not filed.

According to the pilot's written statement, he performed a rolling takeoff on runway 32R and was paying close attention to balancing the engine power and keeping runway centerline alignment. As the airplane accelerated, the pilot set the engine power above 80 percent and began an instrument scan. He then noted the airspeed indicator was reading zero with the needle resting on the peg. The pilot looked back at the power (torque) gauges, and then back to the airspeed indicator. He then attempted to abort the takeoff by reducing the power levers to idle, then to reverse, and by applying the brakes.

The airplane skidded off the end of the runway, through a chain link perimeter fence, and struck an automobile that was traveling on the perimeter road. The airplane continued across the road, coming to rest on second chain link fence that bordered California State Highway 4.

After coming to a stop, the pilot moved the fuel control levers to fuel cutoff, closed the engine firewall fuel shutoff valves, and moved the gang bar down to shutoff all electrical power. He then deplaned through the aft main cabin door.

Federal Aviaiton Administration (FAA) inspectors, who responded to the accident site, interviewed the Concord Air Traffic Control Tower controllers. The air traffic controllers observed the airplane with its nose wheel off of the ground between the intersections of runways 32R and 19R and taxiway E, which is approximately 3/4 of the way down the 4,602-foot-long runway.

Personnel information

The pilot held an airline transport pilot certificate with an airplane multiengine land rating and type ratings in BE-300 and BA-3100 aircraft. He also held a commercial pilot certificate with an airplane single engine land rating. The pilot was issued a first-class medical certificate with no limitations on September 27, 2000.

The pilot underwent "Beechcraft Super King Air 300 Differences Ground & Flight Training" on August 23-26, 1999. Review of the pilot's training records revealed he obtained discussion training on rejected/aborted takeoffs. The pilot obtained the BE-300 type rating on September 17, 2000. According to the Airmen Competency/Proficiency Check Form for FAR 135 operations, dated September 18, 2000, the pilot received a satisfactory grade for Rejected Takeoffs.

The pilot's FAR 135 flight training with AeroSmith Aviation included the following aircraft:

BE-F90 April 27, 1999

BE-200B May 14, 1999

BE-200 November 30, 1999

BE-F90 May 30, 2000

BE-300 September 18, 2000

FAA inspectors reported the pilot had only received discussion training for high speed takeoff aborts in both the 200 and 300 aircraft. The high speed aborts were never practiced or demonstrated during the pilot's training and checkouts.

According to the Pilot/Operator Aircraft Accident Report, the pilot had accumulated a total of 10,867.5 hours of flight time, of which 34.7 hours were accumulated in the accident aircraft make and model. The pilot listed his total pilot-in-command flight time in a 300 as 20 hours, all of which were accumulated within the preceding 30 days of the accident.

Aircraft information

The Beechcraft Super King Air 300 power levers have three possible ranges: 1. the flight range, from full power to idle (flight idle) position; 2. ground fine (ground idle); and 3. reverse. The power levers can move uninhibited from maximum power to idle. The levers must then be lifted over a detent to place the power levers to the ground fine position. The levers must be lifted again over another detent to place the power levers to the reverse position. The power lever columns have two LIFT placards located adjacent to the detent positions. For the model 200, the power levers have only the flight range and reverse, which is achieved by lifting the lever once at the idle stop over a gate.

There were two airspeed indicators installed in the aircraft; one on the pilot instrument panel, and one on the co-pilot instrument panel. The aircraft was also equipped with two entirely independent pitot/static systems. The aircraft's last altimeter and static system inspection was performed on November 17, 1998.

The pilot fueled the aircraft prior to departure, providing 2,400 pounds of fuel at the time of takeoff. The approximate takeoff weight at the time of departure was 11,192 pounds.

Meteorological information

The weather conditions at the time of the accident were winds from 310 degrees at 7 knots; temperature 26 degrees Celsius; dew point 8 degrees Celsius; and altimeter setting of 29.98 inches of mercury.

Wreckage and impact information

Tire skid marks, which led to the aircraft's final resting place, were noted in the runway surface approximately 203 feet prior to the runway end. The tire marks, from start to end, measured 699 feet in length and were noted on the runway, grass, road, and curbs.

The airplane's nose landing gear had separated from the aircraft at its lower strut was found laying near the automobile. The left landing gear collapsed; however, it remained attached to the aircraft. The right main landing gear remained upright and attached to the airplane. Some of the landing gear tires displayed flat spots, some of which had chord showing through. The brake linings were inspected and found to be within operational limits. No leaks were noted in any of the brake lines.

The gust lock pin assembly was found loose in the cockpit. The gust lock pin hole in the control column did exhibit some scoring on its forward edge; however, it was not elongated.

The right pitot tube was found stuck in the chain link fence and was removed by airport personnel and was given to FAA inspectors. The left pitot tube was removed by FAA inspectors, and both pitot tubes were sent to the National Transportation Safety Board Materials Laboratory for further examination.

The propellers were examined by a manufacturer's representative. Prior to disassembly, both propellers were visually at a reverse pitch position; however, the representative indicated "this position is explainable by impact damage and is not necessarily a pre-impact position." One blade from each propeller had been turned about 90 degrees toward low/reverse pitch, and one blade from each propeller was bent aft. According to the representative, the spinners did not display impact damage that could be correlated to a propeller blade angle.

The left and right propeller blades (labeled L 1-4 and R 1-4) were examined. Blade L1 was bent aft 90 degrees and displayed scoring on the blade face and tip damage. Blade L2 was bent aft 20 degrees and displayed scoring on the leading edge and camber side. Blade L3 displayed impact marks on the camber side and the tip was twisted and torn off. Blade L4 was bent aft 45 degrees. All four of the left propeller blades were twisted toward low pitch.

Blade R1 was bent aft 90 degrees and displayed leading and trailing edge damage. Blade R2 was undamaged. Blade R3 was bent aft slightly and displayed leading edge, trailing edge, and tip damage. Blade R4 was bent aft 45 degrees and displayed lead

Aircraft

Registration
N398DE
Reported as
Beech 300 (BE-300)
Category
Airplane
Serial number
FA-109
Airframe hours
3,801.2
Engines
Pratt & Whitney PT6A-60A, 1,050 horsepower, turbo propPratt & Whitney PT6A-60A, 1,050 horsepower, turbo prop
Damage
Substantial damage
Flight
Positioning · Part 91
Operator
AeroSmith Aviation, Inc., doing business as AeroSmith Aviation, Inc.
Registered owner
King Air Charter
Airworthiness certificate
Standard, Normal
Last inspection
Continuous airworthiness · September 22, 2000 · 47.3 hours before
Departed
CCR · Concord, CA
Destination
SJC · San Jose
Airport
CCR · Buchanan Field, runway 32R, 4,601 × 150 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
Pilot
Age
44
Injuries
Minor
Certificates
Flight instructor, Commercial, Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Valid Medical--no waivers/lim.
Last flight review
September 17, 2000
Seat
Left
Flight hours
10,868 total · 35 in this make and model · 5,905 as pilot in command · 212 in the last 90 days · 46 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
310° at 7 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
79 °F, dew point 46 °F
Altimeter
29.97 inHg
Observed at
CCR

Docket · 12

The files NTSB released with the investigation on September 26, 2003, on NTSB’s docket system: statements, records, photos and specialists’ reports. 2.5 MB in all.

FAA reports on this event · 1

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