# NTSB MIA92MA131: CASA 212, N355CA, Mayaguez, PR, June 7, 1992

- Type: NTSB accident investigation
- Classification: Accident · Fatal · Major investigation · Final report
- Date: June 7, 1992, 14:34 local (18:34 UTC)
- Place: Mayaguez, PR
- Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping)
- Highest injury: Fatal
- Injuries: 5 fatal
- Status: Completed, report October 10, 1995
- Report: Approved by Office Director
- NTSB case key (mKey): 33145
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=MIA92MA131
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/33145/pdf
- Page: https://openairdocs.org/ntsb/MIA92MA131

## Probable cause

THE FAILURE OF THE BETA BLOCKING DEVICE FOR UNDETERMINED REASON(S), AND THE SECOND-PILOT'S INADVERTENT ACTIVATION OF THE POWER LEVER, OR LEVERS, AFT OF THE FLIGHT IDLE POSITION AND INTO THE BETA RANGE, RESULTING IN A LOSS OF AIRPLANE CONTROL.

## Sequence of events

In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf).

- Loss of control - in flight, approach
  - throttle/power lever - undetermined (cause)
  - powerplant controls - inadvertent activation, copilot/second pilot (cause)
- In flight collision with terrain/water, descent - uncontrolled

## Analysis

THE AIRPLANE CRASHED ON APCH 3/4 MI SW OF THE ARPT. A WITNESS HEARD SOUND HE ASSOCIATED WITH PROPS GOING INTO REVERSE, THEN OBSERVED AIRPLANE EMERGE FROM CLOUDS IN A NOSE-LOW ATTITUDE. CVR TAPE REVEALED SOUND OF AN ABRUPT CHANGE IN FREQ & AMPLITUDE 10 SECS PRIOR TO IMPACT. EXAM OF THE LEFT ENG BETA INDICATOR LAMP REVEALED HEAVY OXIDE DEPOSIT & STRETCHED COILS INDICATIVE OF THE LAMP BEING ILLUMINATED AT IMPACT; RIGHT ENG BETA LAMP WAS DESTROYED. POWER LEVERS AND (BETA MODE) TRIGGER LOCKS OPERATED NORMALLY; TRIGGER RETURN SPRINGS INTACT. FLIGHT IDLE STOPS SHOWED NO EVIDENCE OF EXCESSIVE WEAR OR DEFORMATION. THE POWER LEVER (BETA) BLOCKING DEVICE LOCKOUT SOLENOID WAS TESTED ELECTRICALLY AND FUNCTIONED NORMALLY. THE RIGGING OF THE BETA LOCKOUT DEVICE COULD NOT BE CHECKED DUE TO IMPACT DAMAGE. THE OPERATOR CONDUCTED A FUNCT TEST OF THE ELECTRICAL OR BACKUP BETA BLOCKING DEVICES ON THE REMAINING 8 CASA 212 AIRPLANES; 3 WERE FOUND TO BE INOPERATIVE. NEITHER THE MFGR NOR OPERATOR HAD AN INSPECTION OR FUNCT TEST REQUIREMENT FOR THE BLOCKING DEVICES.

## Aircraft

- Registration: [N355CA](https://openairdocs.org/deregistered/N355CA-1992-09-22), registration cancelled 1992-09-22, S/N 234 (OpenAirDocs)
- Reported make and model: CASA 212
- Registry model: [Construcciones Aeronauticas 212-200](https://openairdocs.org/model/construcciones-aeronauticas-212-200) (registry code 2410200) (OpenAirDocs)
- Category: Airplane
- Serial number: 234
- Airframe hours: 14135
- Engines: GARRETT TPE331-10R-51 900 horsepower turbo prop
- Damage: Destroyed
- Flight: Part 135
- Operator: Executive Air Charter, Inc., doing business as American Eagle
- Registered owner: Island Int Leasing Inc.
- Airworthiness certificate: Standard, Transport
- Last inspection: Continuous airworthiness, May 29, 1992, 41 hours before
- Departed: TSJU, SAN JUAN, PR
- Flight plan: IFR
- Airport: Eugenuio Maria De Hosto

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 31; airline transport, commercial; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--no waivers/lim.; seat: left; toxicology performed; flight hours: 6,634 total, 2,634 in this make and model, 3,113 as pilot in command, 170 in the last 90 days, 71 in the last 30 days, 2 in the last 24 hours

## Weather

- Conditions: Instrument (IMC), Day
- Wind: 200° at 16 knots
- Visibility: 2 statute miles
- Lowest ceiling: 2,000 ft overcast
- Temperature: -0 °F, dew point -0 °F
- Altimeter: 30.00 inHg
- Observed at: EXK, 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 19920607030049A](https://openairdocs.org/incident/19920607030049A), Jun 7, 1992: Casa C212, Mayaguez, Puerto Rico, Destroyed, 5 fatal. Indicates props went to beta just prior crash encountering windshear on approach. Stalled and dived into ground.

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.

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