Aircraft Accident/Incident Report

Lake Hughes, California 93532
Wednesday, February 26, 1992 8:17 PST

NTSB Narrative Summary Released at Completion of Accident

THE AIRPLANE WAS ON A U.S. NAVY MISSION AND FLOWN BY A NAVY AVIATOR; ANOTHER NAVY AVIATOR OCCUPIED THE RIGHT FRONT SEAT. WHILE OVER MOUNTAINOUS TERRAIN THE ENGINE SUSTAINED A CATASPHROPHIC CRANKSHAFT FAILURE. THE PILOT ELECTED TO PROCEED TOWARDS HIGHER TERRAIN BYPASSING LOWER AND MORE SUITIBLE EMERGENCY LANDING AREAS. INTERNAL COMMUNICATIONS BETWEEN THE RIGHT SEAT OCCUPANT, A MORE EXPERIENCED PILOT, AND THE PIC INDICATED THEY PLANNED TO STALL THE AIRPLANE PRIOR TO LANDING ON AN UPWARD SLOPING MOUNTAIN RIDGE. THE PILOT MISJUDGED THE ALTITUDE AND STALLED THE AIRPLANE. BOTH PILOTS WERE KILLED. THE INVESTIGATION REVEALED THAT THE CRANKSHAFT FAILED DUE TO INADEQUATE TORQUE OF THE THROUGH BOLTS CAUSING FRETTING AND GALLING ON THE CRANKCASE HALVES. THE ENGINE HAD ACCURED 618 HOURS SINCE MAJOR OVERHAUL AND HAD EXPERIENCED 7 VACCUM PUMP FAILURES DUE TO MISALIGNMENT OF THE CRANKSHAFT DRIVE GEAR. THE THROUGH BOLTS WERE REMOVED BY THE OPERATOR TO REPAIR THE NO. 3 ROSAN STUD 322 HOURS BEFORE THE CRANKSHAFT FAILED.

NTSB Probable Cause Narrative

POOR MAINTENANCE REPAIR AND ANNUAL INSPECTION BY THE COMPANY'S MAINTENANCE PERSONNEL AND THE PILOT-IN-COMMAND'S MISJUDGING ALTITUDE. CONTRIBUTING TO THIS ACCIDENT WAS THE PILOT-IN-COMMAND INTENTIONAL STALL, IMPROPER EMERGENCY PROCEDURE, SELECTION OF UNSUITABLE TERRAIN FOR THE FORCED LANDING AND THE MOUNTAINOUS TERRAIN.

Event Information

Type of Event Accident
Event Date 2/26/1992
Event Day of the Week Wednesday
Time of Event 817
Event Time Zone Pacific Standard Time
Event City LAKE HUGHES
Event State CALIFORNIA
Event Country --
Zipcode of the event site 93532
Event Date Year 1992
Event Date Month 2
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 0
Degrees magnetic from airport 0
Airport Elevation --
Weather Briefing Completeness Not pertinent
Investigator's weather source Witness
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) 50
Air Temperature at event time (in degrees celsius) --
Dew Point at event time (in degress fahrenheit) --
Wind Direction (degrees magnetic) 0
Variable Wind Indicator Unknown
Wind Speed (knots) 0
Wind Velocity Indicator Unknown
Wind Gust Indicator Unknown
Wind Gust (knots) 0
Altimeter Setting at event time (in. Hg) --
Density Altitude (feet) --
Intensity of Precipitation Unknown
METAR weather report --
Event Highest Injury Fatal
On Ground, Fatal Injuries 0
On Ground, Minor Injuries 0
On Ground, Serious Injuries 0
Injury Total Fatal 2
Injury Total Minor --
Injury Total None --
Injury Total Serious --
Injury Total All 2
Investigating Agency NTSB
NTSB Docket Number (internal use) 389
NTSB Notification Source --
NTSB Notification Date --
NTSB Notification Time 0
Fiche Number and/or location -used to find docket information 46551
Date of most recent change to record Dec 11 2000 2:45PM
User who most recently changed record dbo
Basic weather conditions Visual Meteorological Cond
FAA District Office --

Aircraft Involved

Aircraft #1

Aircraft Registration Number N9YT
NTSB Number LAX92GA128
Missing Aircraft Indicator N
Federal Aviation Reg. Part Part 91: General Aviation
Type of Flight Plan filed IFR
Flight plan Was Activated? --
Damage Destroyed
Aircraft Fire None
Aircraft Explosion None
Aircraft Manufacturer's Full Name CESSNA
Aircraft Model T210N
Aircraft Series Identifier T210N
Aircraft Serial Number 21063474
Certified Max Gross Weight 4000
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 6
Number of Engines 1
Fixed gear or retractable gear Retractable
Aircraft, Type of Last Inspection Annual
Date of Last Inspection Feb 4 1992 12:00AM
Airframe hours since last inspection 22
Airframe Hours 3344
ELT Installed Yes
ELT Activated Yes
ELT Aided Location of Event Site Yes
ELT Type --
Aircraft Owner Name CHANNEL ISLAND AVIATION, INC
Aircraft Owner Street Address 305 DURLEY AVENUE, BLDG 233
Aircraft Owner City CAMARILLO
Aircraft Owner State CA
Aircraft Owner Country
Aircraft Owner Zipcode 93010
Operator is an individual? --
Operator Name CHANNEL ISLAND AVIATION, INC
Operator Same as Owner? Yes
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address 305 DURLEY AVENUE, BLDG 233
Operator City CAMARILLO
Operator State CA
Operator Country
Operator Zip code 93010
Operator Code DDEA
Owner has at least one certificate Yes - certificate holder
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) Public Use
Second Pilot on Board Yes
Departure Point Same as Event No
Departure Airport Code NTD
Departure City PT MUGU
Departure State CA
Departure Country
Departure Time 747
Departure Time Zone PST
Destination Same as Local Flt --
Destination Airport Code NID
Destination City CHINA LAKE
Destination State CA
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 --