# NTSB LAX95FA225: Hughes 369D, N1089N, Highland, CA, June 26, 1995 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Field investigation · Final report - Date: June 26, 1995, 10:20 local (17:20 UTC) - Place: Highland, CA - Coordinates: 34.130363, -117.150016 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=34.1304&lon=-117.1500&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Highest injury: Serious injuries - Injuries: 1 serious, 3 minor - Status: Completed, report March 21, 1996 - Report: Approved by Office Director - NTSB case key (mKey): 28928 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX95FA225 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/28928/pdf - Page: https://openairdocs.org/ntsb/LAX95FA225 ## Probable cause the pilot's failure to verify the security of his passenger's cargo/personal belongings which departed the aircraft striking the tailrotor. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Rotor failure/malfunction, cruise - terrain condition - mountainous/hilly (contributing factor) - rotor system,tail rotor blade - foreign object damage (cause) - security of cargo - not verified, pilot in command (cause) - rotor drive system,tail rotor gearbox(90 deg) - overload - Loss of control - in flight, descent - emergency - aircraft control - not possible - Hard landing, descent - emergency ## Analysis The helicopter pilot was operating in mountainous terrain with three doors removed. He was positioning survey personnel to remark survey sites. During departure from the mountainous terrain the pilot briefly noticed something in his skid mounted mirror. At that point, the pilot and the three passengers heard a loud 'whump' followed by a loss of tail rotor control. The pilot maneuvered the spinning helicopter over some power lines and onto a downward sloping ridgeline. The helicopter landed hard and rolled down the mountain about 100 to 150 feet. The tail rotor blades, along with half of the severed gear box were not recovered. The left rear seat passenger was missing a sweat jacket. An abundance of 12-inch reinforced marker tape was found at the accident site. Metallurgical analysis revealed that a high strain rate crack growth had occured as in a one-time overload on the tail rotor gearbox casting. ## Factual narrative On June 26, 1995, about 1020 hours Pacific daylight time, a Hughes 369D helicopter, N1089N, was substantially damaged during an emergency landing in mountainous terrain near Highland, California. The pilot and two passengers received minor injuries; a third passenger received serious injuries. Visual meteorological conditions prevailed for the 14 CFR Part 135 local survey flight. A company VFR flight plan had been filed. The flight originated at Rialto, California, at 0920 hours on the morning of the accident. The helicopter was being operated with the two left doors and the right rear door removed. The pilot stated that he observed something in his left skid mounted mirror for a fraction of a second just prior to experiencing a loss of tail rotor control. Postaccident investigation revealed that the tail rotor and half of the tail rotor gearbox were missing. Numerous ground and air searches have failed to find the rotor system components and a passenger's missing jacket. During the investigation, an abundance of 12-inch-wide nylon reinforced plastic survey marker tape was found at the accident site. PERSONNEL INFORMATION The 12,000-hour commercial instructor pilot stated that he had briefed the passengers prior to flight regarding operations with doors removed and the security of loose items. The pilot stated that they were in cruise flight heading out of the mountains and had started a gentle descent when two things happened almost simultaneously. First, "I saw something move in the field of vision of my skid-mounted convex mirror". Less than a second later, a strong "whump" was felt and heard by everyone onboard, and the helicopter yawed to the right. WRECKAGE AND IMPACT INFORMATION The loss of the tail rotor control occurred over mountainous terrain. The pilot was able to maneuver around some power lines and control the spinning descent onto a ridgeline with approximately a 10-degree down slope. After impact, the helicopter rolled downhill about 100 to 150 feet. The tailboom with the vertical and horizontal stabilizers still attached was found at the initial point of impact. The tail rotor blades, the gearbox output shaft, and half of the gearbox were missing. Subsequent searches failed to find the missing items, nor a purple sweat jacket belonging to the left rear seat passenger. ADDITIONAL INFORMATION A metallurgical analysis was performed on the remaining gearbox casting. According to the results of the analysis, a high strain rate crack growth had occurred, similar to a one-time overload. ## Aircraft - Registration: [N1089N](https://openairdocs.org/deregistered/N1089N-1996-06-14), registration cancelled 1996-06-14, S/N 510964D (OpenAirDocs) - Reported make and model: HUGHES 369D - Registry model: [Hughes Helicopters HUGHES 369D](https://openairdocs.org/model/hughes-helicopters-hughes-369d) (registry code 4470706) (OpenAirDocs) - Category: Helicopter - Serial number: 510964D - Airframe hours: 6112 - Engines: ALLISON 250-C20B 420 horsepower turbo shaft - Damage: Substantial damage - Flight: Part 135 - Operator: Hsi Helicopters, Inc., doing business as Western Helicopters, Inc. - Registered owner: South Coast Helicopters, Inc. - Airworthiness certificate: Standard, Normal - Last inspection: 100 hour, May 30, 1995, 32 hours before - Departed: L67, CA - Flight plan: Company VFR ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 62; commercial; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 2, valid medical--w/ waivers/lim; seat: left; flight hours: 12,000 total, 5,305 in this make and model, 161 in the last 90 days, 57 in the last 30 days, 1 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Visibility: 3 statute miles - Lowest ceiling: none ## 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 19950626014879A](https://openairdocs.org/incident/19950626014879A), Jun 26, 1995: Hughes 369D, Highland, CA, Substantial damage. Local survey flight. Lost tail rotor control. Spun to impact. Tail rotor seperated when fouled by loose survey tape ## Other investigations on N1089N (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 FTW82DQD04](https://openairdocs.org/ntsb/FTW82DQD04), Nov 24, 1981: Hughes 369D (N1089N), Deming, NM, substantial damage 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.