Individually Owned: 150,657
Corporate Owned: 137,281
Aircraft Accident/Incident Report
Nacogdoches, Texas 75936
Sunday, October 16, 1994 20:51 CDT
NTSB Narrative Summary Released at Completion of Accident
DURING FLIGHT AT FL370, THE AIRPLANE ENTERED A CLOUD LAYER AND ENCOUNTERED TURBULENCE. A DESCENT WAS MADE TO FL330. AS POWER WAS BEING APPLIED FOR LEVEL OFF AT FL330, THE N1 INDICATION DID NOT RESPOND. AT FL310 THE #1 ENGINE FLAMED OUT. WEATHER INCLUDED ICE CRYSTALS, THUNDERSTORM OUTFLOW, AND TURBULENCE. DURING AN ATTEMPTED CROSS BLEED AIR START, THE #2 ENGINE FLAMED OUT. WITH THE AIR DRIVEN GENERATOR (ADG) DEPLOYED, THE CREW WAS SUCCESSFUL WITH AN APU ASSISTED START. BOTH ENGINES WERE STABILIZED BY 5000 FEET, AND THE FLIGHT LANDED SAFELY. INTERVIEWS AND INFORMATION FROM THE CVR REVEALED THAT THE CREW DID NOT CALL FOR THE EMERGENCY CHECKLIST AND THAT THEY LACKED KNOWLEDGE OF THE AIRPLANE SYSTEMS. AS THE CREW RECOGNIZED THE INITIAL POWER LOSS, THE CAPTAIN ASKED THE FIRST OFFICER IF HE HAD TURNED ON ENGINE ANTI-ICE. HE REPLIED THAT HE HAD NOT. THE CREW HAD NOT ATTENDED A FORMAL TRAINING COURSE FOR THE CL 600. THE CAPTAIN AND COPILOT RECEIVED TYPE RATINGS FROM A DESIGNATED PILOT EXAMINER (DPE) IN MAY AND MARCH 1994, RESPECTIVELY. TESTS OF THE FUEL CONTROL UNITS REVEALED DISCREPANCIES IN THE START AND ACCELERATION SCHEDULES; HOWEVER, NO DISCREPANCIES WERE FOUND THAT WOULD HAVE CONTRIBUTED TO THE FLAMEOUTS.
NTSB Probable Cause Narrative
THE FLIGHT CREW'S IMPROPER USE OF THE ANTI-ICE SYSTEM, WHICH RESULTED IN ENGINE ICE, SUBSEQUENT ICE INGESTION, AND ENGINE FLAMEOUT. FACTORS RELATED TO THE ACCIDENT WERE: FAILURE OF THE FLIGHT CREW TO FOLLOW THE CHECKLIST PROCEDURES AFTER FLIGHT INTO ADVERSE WEATHER CONDITIONS, AND THE AIRCREW'S LACK OF FAMILIARITY WITH THE AIRCRAFT REGARDING FLIGHT IN ICING C0NDITIONS.
Event Information
| Type of Event | Incident |
| Event Date | 10/16/1994 |
| Event Day of the Week | Sunday |
| Time of Event | 2051 |
| Event Time Zone | Central Daylight Time |
| Event City | NACOGDOCHES |
| Event State | TEXAS |
| Event Country | -- |
| Zipcode of the event site | 75936 |
| Event Date Year | 1994 |
| Event Date Month | 10 |
| 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 | Full |
| Investigator's weather source | Weather Observation Facility |
| Time of the weather observation | 2050 Central Standard Time |
| Direction of event from weather observation facility (degrees) | 360 |
| Weather Observation Facility ID | LFT |
| Elevation of weather observation facility | 355 |
| Distance of event from weather observation facility (units?) | 42 |
| Time Zone of the weather observation | CST |
| Lighting Conditions | Night/Dark |
| Lowest Ceiling Height | 300 |
| Lowest Non-Ceiling Height | 0 |
| Sky/Lowest/Cloud Conditions | Unknown |
| Sky Condition for Lowest Ceiling | Overcast |
| Visibility Runway Visual Range (Feet) | 0 |
| Visibility Runway Visual Value (Statute Miles) | 0 |
| Visibility (Statute Miles) | 1 |
| Air Temperature at event time (in degrees celsius) | 22 |
| Dew Point at event time (in degress fahrenheit) | 22 |
| Wind Direction (degrees magnetic) | 90 |
| Variable Wind Indicator | Unknown |
| Wind Speed (knots) | 10 |
| Wind Velocity Indicator | Unknown |
| Wind Gust Indicator | Unknown |
| Wind Gust (knots) | 16 |
| Altimeter Setting at event time (in. Hg) | 29 |
| Density Altitude (feet) | -- |
| Intensity of Precipitation | Heavy |
| 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 | 4 |
| Injury Total Serious | -- |
| Injury Total All | -- |
| Investigating Agency | NTSB |
| NTSB Docket Number (internal use) | 5045 |
| NTSB Notification Source | -- |
| NTSB Notification Date | Oct 17 1994 12:00AM |
| NTSB Notification Time | 730 |
| Fiche Number and/or location -used to find docket information | IMAGE |
| Date of most recent change to record | Dec 6 2000 12:26PM |
| User who most recently changed record | dbo |
| Basic weather conditions | Instrument Meteorological Cond |
| FAA District Office | -- |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | N600RE |
| NTSB Number | FTW95IA022 |
| 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 | CANADAIR |
| Aircraft Model | CL 600 |
| Aircraft Series Identifier | CL 600 |
| Aircraft Serial Number | 1079 |
| Certified Max Gross Weight | 41400 |
| 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 | 15 |
| Number of Engines | 2 |
| Fixed gear or retractable gear | Retractable |
| Aircraft, Type of Last Inspection | AAIP |
| Date of Last Inspection | Jul 29 1994 12:00AM |
| Airframe hours since last inspection | 120 |
| Airframe Hours | 3524 |
| ELT Installed | Unknown |
| ELT Activated | Unknown |
| ELT Aided Location of Event Site | Unknown |
| ELT Type | -- |
| Aircraft Owner Name | INVESTMENTS INC. OF N. C |
| Aircraft Owner Street Address | 300 WEST MARGAU ST. SUITE 1500 |
| Aircraft Owner City | DURHAM |
| Aircraft Owner State | NC |
| Aircraft Owner Country | |
| Aircraft Owner Zipcode | 27702 |
| Operator is an individual? | -- |
| Operator Name | AFFILIATED HEALTH SERVICES INC |
| Operator Same as Owner? | No |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | No |
| Operator Street Address | 2230 S. MACARTHUR DRIVE |
| Operator City | ALEXANDRIA |
| Operator State | LA |
| Operator Country | |
| Operator Zip code | 71301 |
| 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 | TUS |
| Departure City | TUCSON |
| Departure State | AZ |
| Departure Country | |
| Departure Time | 1900 |
| Departure Time Zone | CDT |
| Destination Same as Local Flt | -- |
| Destination Airport Code | SHV |
| Destination City | SHREVEPORT |
| Destination State | LA |
| Destination Country | |
| Specific Phase of Flight | Descent |
| 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 | -- |