WPR19LA019

NTSB accident investigation · Bell 47G · Wichita Falls, TX · November 2, 2018

Accident · Serious injuriesClass 3 · LimitedFinal report
Date
November 2, 2018, 11:30 local (16:30 UTC)
Place
Wichita Falls, TX
Injuries
1 serious, 1 minor
Damage
Destroyed
Phase of flight
Emergency descent
Aircraft
N1159WBell 47G
Defining event
Autorotation: Loss of engine power (total)
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
Federal Aviation Administration
FAA report
20181102023229A
Case key
98599

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

A total loss of engine power for reasons that could not be determined based on the available information.

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.

Not determinedNot determined › Not determined · Unknown/Not determinedBell 47G-3B-1: 3 casesAll aircraft: 2,247 casesProbable cause
Engine (reciprocating)Aircraft › Aircraft power plant · Not specifiedBell 47G-3B-1: 1 caseAll aircraft: 497 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.

Analysis

The pilot reported that the purpose of the flight was to practice emergency procedures with a certified flight instructor (CFI). After completing four uneventful autorotations, they climbed the helicopter to an altitude of about 1,500 mean sea level and turned onto the final approach leg of the traffic pattern to conduct a ‘hydraulics off’ approach. Once established on final approach, the CFI reached down to turn off the hydraulic switch, and the engine lost complete power. The pilot immediately gave the flight controls to the CFI, and he prepared for an autorotation in a nearby field. During the descent, the helicopter impacted powerlines before it landed hard. The main rotor blade severed the tailboom, and the helicopter spun before it came to rest on its side. The CFI confirmed that when he reached down to turn off the hydraulic switch, the engine lost complete power. He mentioned that the hydraulic switch is on the lower console, and he was unaware of any nearby switches that would have turned off the engine. During a postaccident examination no anomalies were noted with the engine that would have precluded normal operations. The instrument panel was removed; the electrical wires were examined, and no abnormalities were noted. At the accident site, the ignition switch was found in the BOTH position. The ignition switch positions (RIGHT, LEFT, and BOTH) were tested and functioned normally. However, when the key was in the LEFT or RIGHT position, movement of the key would temporarily ground the switch. It was noted that a long keychain attached to the key extended over the hydraulics switch when the key was in the ignition. It is possible that the CFI moved the keychain away from the hydraulic switch and, in doing so, could have caused the ignition switch to temporarily ground. Subsequently, the engine would lose complete power with no warning. However, this scenario would require the ignition switch to be either in the LEFT or RIGHT position because moving the ignition key while in the BOTH position did not cause the switch to temporarily ground. Since there is no evidence of the switch being in a position other than BOTH, the investigation was unable to determine the reason for the total loss of engine power.

Factual narrative

On November 2, 2018, about 1130 central daylight time, a Bell 47G-3B-1, N1159W, was destroyed when it was involved in an accident in Wichita Falls, Texas. The pilot sustained minor injuries and the certified flight instructor sustained serious injuries. The helicopter was operated as a Title 14 Code of Federal Regulations (CFR) Part 91 personal flight. The pilot reported that the purpose of the flight was to practice emergency procedures with a certified flight instructor (CFI). After completing four uneventful autorotations, they climbed the helicopter to an altitude of about 1,500 mean sea level and turned onto the final approach leg of the traffic pattern to conduct a ‘hydraulics off’ approach. Once established on final approach, the CFI reached down to turn off the hydraulic switch and the engine lost complete power. The pilot immediately gave the flight controls to the CFI, and he prepared for an autorotation in a nearby field. During the descent, the helicopter impacted powerlines before it landed hard. The main rotor blade severed the tailboom, and the helicopter spun before it came to rest on its side. The CFI confirmed that when he reached down to turn off the hydraulic switch the engine lost complete power. There were no abnormal noises, nor were there any indications of an impending engine failure. The CFI mentioned that the hydraulic switch is on the lower console, and he was unaware of any nearby switches that would have turned off the engine. During a postaccident examination by a mechanic and a Federal Aviation Administration inspector, no anomalies were noted with the engine that would have precluded normal operations. The spark plugs were removed and consistent with normal operations. The engine rotated smoothly; the valves moved freely and evenly, thumb compression was established, and spark was obtained from the magnetos. The engine controls remained attached to the carburetor, the mixture was locked to the full rich position and the carburetor heat was in the OFF position. The carburetor was disassembled, and no anomalies were noted with the internal components. The fuel strainer was removed from the engine and the screen/bowl were clear of debris. The oil filter was also removed from the engine and was clear of debris. At the accident site, the ignition switch was found in the BOTH position. The instrument panel was removed, the electrical wires were examined, and no abnormalities were noted. The ignition switch positions (RIGHT, LEFT, and BOTH) were tested and functioned normally. However, when the key was in the LEFT or RIGHT position, a movement of the key would temporarily ground the switch. It was noted that a long keychain attached to the key extended over the hydraulics switch when the key was in the ignition.

Aircraft

Registration
N1159W
Reported as
Bell 47G (3B1)
Category
Helicopter
Serial number
2941
Built
1964
Airframe hours
6,895
Engine
Lycoming TV0-435 SERIE, 270 horsepower, reciprocating
Damage
Destroyed
Flight
Instructional · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
Annual · May 1, 2018 · 27 hours before
Departed
F14 · Wichita Falls, TX
Destination
F14 · Wichita Falls, TX
Airport
F14 · Wichita Valley Airport, runway 31, 3,320 × 40 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 · 2

As NTSB recorded them. NTSB leaves out names.

Role
Flight instructor
Age
83
Injuries
Serious
Certificates
Commercial, Flight instructor
Airplane ratings
Single-engine land
Instrument ratings
Airplane, Helicopter
Medical
BasicMed, With waivers/limitations
Seat
Right
Restraint
Lap only
Role
Pilot
Age
60
Injuries
Serious
Certificates
Flight engineer, Commercial, Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, With waivers/limitations
Last flight review
May 19, 2018
Seat
Left
Restraint
Lap only
Flight hours
14,961 total · 69 in this make and model · 3,000 as pilot in command · 57 in the last 90 days · 2 in the last 30 days · 0 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
270° at 11 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
57 °F, dew point 41 °F
Altimeter
30.05 inHg
Observed at
SPS, 7 nm away

Docket · 5

The files NTSB released with the investigation on October 18, 2021, on NTSB’s docket system: statements, records, photos and specialists’ reports. 5.6 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.

Other investigations on N1159W · 2

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