WPR13CA071

NTSB accident investigation · Hughes 369 · Pasadena, CA · December 7, 2012

Accident · No injuriesData collectionFinal report
Date
December 7, 2012, 09:30 local (17:30 UTC)
Place
Pasadena, CA
Injuries
1 uninjured
Damage
Substantial damage
Phase of flight
Standing
Aircraft
N818CEHughes 369
Defining event
Standing-engine(s) operating: Cabin safety event
Weather
Visual (VMC) · Day
Status
Completed · report April 10, 2013
Report
Approved by Office Director
NTSB office
Western Pacific Region
Parties
Federal Aviation Administration
FAA report
20121207028009A
Case key
85842

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

An unsecured headset, which struck the leading edge of a tail rotor blade. Contributing to the accident was the pilot's inadequate safety briefing.

Findings · 2

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Misc hardwareAircraft › Fluids/misc hardware · Incorrect use/operationAll aircraft: 41 casesProbable cause
Communication (personnel): issuing instructionsPersonnel issues › Task performance · PilotAll aircraft: 26 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Cabin safety eventStanding-engine(s) operatingAll aircraft: 151 casesDefining event

Analysis

Prior to the flight, the doors were removed in order to make it easier for the passengers to board and exit the helicopter. During the safety briefing, the pilot took a headset from a pouch in the rear of the helicopter, demonstrated how to wear the headsets, and then replaced it. The pilot did not tell the passengers that the headsets needed to be replaced in the pouch after landing and before exiting the helicopter. Additionally, the pilot did not make the passengers aware of the danger associated with loose headsets in the back of the helicopter in a doors-off configuration. After the two passengers were transported to a work site location, the right rear passenger exited the helicopter and placed the headset on the hook located behind the front seats. After departing the site, about 3 to 5 minutes later while en route at an elevation of about 1,000 feet above ground level, the pilot felt something strike the helicopter. After landing and upon inspecting the helicopter, the pilot discovered that the right rear headset was missing and that the leading edge of the tail rotor had been damaged. Upon further inspection of the helicopter, the operator reported that the tail rotor drive shaft was found to be slightly egg shaped at its aft end.

Factual narrative

Prior to the flight the doors were removed in order to make it easier for the passengers to board and exit the helicopter. During the safety briefing, the pilot took a headset from a pouch in the rear of the aircraft, demonstrated how to wear the headsets, and then replaced it. The pilot did not tell the passengers that the headsets needed to be replaced in the pouch after landing and before exiting the helicopter. Additionally, the pilot did not make the passengers aware of the danger associated with loose headsets in the back of the aircraft in a doors-off configuration. After transporting the two passengers to a work site location, the right rear passenger exited the helicopter and placed the headset on the hook located behind the front seats. After departing the site and about 3 to 5 minutes later while en route at an elevation of about 1,000 feet above ground level, the pilot felt something strike the helicopter. After landing and upon inspecting the aircraft, the pilot discovered that the right rear headset was missing and that the leading edge of the tail rotor had been damaged. Upon further inspection of the helicopter, the operator reported that the tail rotor drive shaft was found to be slightly egg shaped at its aft end.

Aircraft

Registration
N818CE
Reported as
Hughes 369 (D)
Category
Helicopter
Serial number
610983D
Airframe hours
11,784
Engine
Allison 250 C20R/2, 450 horsepower, turbo shaft
Damage
Substantial damage
Flight
Other work use · Part 91
Operator
Southern California Edison Co.
Registered owner
Southern California Edison Co.
Airworthiness certificate
Standard, Normal
Last inspection
AAIP · May 16, 2012 · 92 hours before
Departed
27CN · Valencia, CA
Destination
27CN · Valencia, CA

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
47
Injuries
None
Certificate
Commercial
Instrument ratings
Helicopter
Medical
Class 2, With waivers/limitations
Last flight review
June 7, 2012
Seat
Left
Flight hours
11,796 total · 500 in this make and model · 8,159 as pilot in command · 94 in the last 90 days · 14 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
80° at 15 knots, gusting 15
Visibility
10 statute miles
Temperature
52 °F, dew point 43 °F
Altimeter
30.09 inHg

Docket · 1

The files NTSB released with the investigation on January 16, 2013, on NTSB’s docket system: statements, records, photos and specialists’ reports. 3.1 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.