Aircraft Accident/Incident Report

Rochester, Indiana 46975
Wednesday, March 16, 1994 8:27 EST

NTSB Narrative Summary Released at Completion of Accident

THE PILOTS REPORTED THEY WERE IN CRUISE FLIGHT AT 16,000 FEET, WHEN THEY HEARD A LOUD NOISE, FOLLOWED BY 'MASTER WARNING' AND 'CABIN ALTITUDE' LIGHTS, AND A LOSS OF CABIN PRESSURIZATION. THEY STATED WHEN THEY LOOKED BACK TO THE REAR CABIN THEY SAW THE RIGHT REAR CABIN WINDOW HAD FAILED. THE PILOTS DIVERTED AND LANDED WITHOUT FURTHER INCIDENT. POSTINCIDENT INVESTIGATION REVEALED THE FAILED WIND0W WAS INSTALLED IN OCTOBER, 1985. THE AIRPLANE HAD FLOWN APPROXIMATELY 2100 HOURS AND BEEN REPAINTED TWICE SINCE THAT DATE. THE AIRPLANE HAD FLOWN 4.8 HOURS SINCE THE MOST RECENT REPAINTING. THE MANUFACTURER'S MANUALS AND SERVICE INSTRUCTIONS CAUTIONED THAT EXPOSURE TO PAINT, PAINT STRIPPER, SOLVENTS AND FUMES COULD RESULT IN CRACKED WINDOWS. THEY RECOMMENDED THE USE OF PRESSURE SENSITIVE MASKS, AND STATED, '...THE MASK MUST EXTEND BEYOND THE WINDOW CUTOUTS...[TO] PREVENT THE CHEMICAL COMPOUNDS FROM ATTACKING THE WINDOW EDGES.' EXAMINATION OF THE AIRPLANE'S WINDOWS REVEALED EVIDENCE OF STRIPPER AND PAINT OVERSPRAY.

NTSB Probable Cause Narrative

the airplane painter/refinishers' failure to follow appropriate procedures/directives pertinent to the masking, stripping, painting and cleaning of the airplane cabin windows, which resulted in the in-flight failure of the right aft cabin window. A related factor is inadequate maintenance inspection by company maintenance personnel.

Event Information

Type of Event Incident
Event Date 3/16/1994
Event Day of the Week Wednesday
Time of Event 827
Event Time Zone Eastern Standard Time
Event City ROCHESTER
Event State INDIANA
Event Country --
Zipcode of the event site 46975
Event Date Year 1994
Event Date Month 3
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude
Event Location Longitude
Event Location Airport
Event Location Nearest Airport ID
Indicates whether the acc/inc occurred off or on an airport Off Airport/Airstrip
Distance from airport in statute miles --
Degrees magnetic from airport --
Airport Elevation --
Weather Briefing Completeness Unknown
Investigator's weather source Pilot
Time of the weather observation 0
Direction of event from weather observation facility (degrees) 0
Weather Observation Facility ID
Elevation of weather observation facility 0
Distance of event from weather observation facility (units?) 0
Time Zone of the weather observation
Lighting Conditions Day
Lowest Ceiling Height 0
Lowest Non-Ceiling Height 0
Sky/Lowest/Cloud Conditions Clear
Sky Condition for Lowest Ceiling None
Visibility Runway Visual Range (Feet) 0
Visibility Runway Visual Value (Statute Miles) 0
Visibility (Statute Miles) 20
Air Temperature at event time (in degrees celsius) -19
Dew Point at event time (in degress fahrenheit) --
Wind Direction (degrees magnetic) 310
Variable Wind Indicator Unknown
Wind Speed (knots) 57
Wind Velocity Indicator Unknown
Wind Gust Indicator Not Gusting
Wind Gust (knots) 0
Altimeter Setting at event time (in. Hg) 29
Density Altitude (feet) --
Intensity of Precipitation Unknown
METAR weather report --
Event Highest Injury None
On Ground, Fatal Injuries 0
On Ground, Minor Injuries 0
On Ground, Serious Injuries 0
Injury Total Fatal --
Injury Total Minor --
Injury Total None 5
Injury Total Serious --
Injury Total All --
Investigating Agency NTSB
NTSB Docket Number (internal use) 5031
NTSB Notification Source --
NTSB Notification Date Mar 16 1994 12:00AM
NTSB Notification Time 930
Fiche Number and/or location -used to find docket information IMAGE
Date of most recent change to record Dec 6 2000 10:48AM
User who most recently changed record dbo
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number N210SU
NTSB Number CHI94IA111
Missing Aircraft Indicator N
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed IFR
Flight plan Was Activated? --
Damage Minor
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name BEECH
Aircraft Model BE200
Aircraft Series Identifier BE200
Aircraft Serial Number BB420
Certified Max Gross Weight 12500
Aircraft Category Airplane
Aircraft Registration Class U.S. Registered/U.S. Soil
Aircraft is a homebuilt? No
Flight Crew Seats --
Cabin Crew Seats --
Passenger Seats --
Total number of seats on the aircraft 9
Number of Engines 2
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection AAIP
Date of Last Inspection Mar 12 1994 12:00AM
Airframe hours since last inspection 3
Airframe Hours 4379
ELT Installed Yes
ELT Activated No
ELT Aided Location of Event Site Unknown
ELT Type --
Aircraft Owner Name OHIO STATE UNIVERSITY
Aircraft Owner Street Address 2090 W. LASE ROAD
Aircraft Owner City COLUMBUS
Aircraft Owner State OH
Aircraft Owner Country
Aircraft Owner Zipcode 43238
Operator is an individual? --
Operator Name B. F. GOODRICH
Operator Same as Owner? No
Operator Is Doing Business As --
Operator Address Same as Owner? No
Operator Street Address 2001 POLARIS PKWY.
Operator City COLUMBUS
Operator State OH
Operator Country
Operator Zip code 43240
Operator Code
Owner has at least one certificate None
Other Operator of large aircraft? No
Certified for Part 133 or 137 Operation Unknown
Operator Certificate Number --
Indicates whether an air carrier operation was scheduled or not --
Indicates Domestic or International Flight --
Operator carrying Pax/Cargo/Mail --
Type of Flying (Per_Bus / Primary) Business
Second Pilot on Board Yes
Departure Point Same as Event No
Departure Airport Code OSU
Departure City COLUMBUS
Departure State OH
Departure Country
Departure Time 730
Departure Time Zone EST
Destination Same as Local Flt --
Destination Airport Code SPW
Destination City SPENCER
Destination State IA
Destination Country
Specific Phase of Flight Cruise
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jan 2 2001 10:30AM
User who most recently changed record dbo
Since inspection or accident --
Event Location Runway Number and Location 0
Runway Length --
Runway Width --
Sight Seeing flight No
Air Medical Flight No
Medical Flight --