Individually Owned: 150,657
Corporate Owned: 137,281
Aircraft Accident/Incident Report
Key West, Florida 33040
Saturday, March 9, 1991 19:50 EST
NTSB Narrative Summary Released at Completion of Accident
WITNESSES RPTD THEY HEARD PROPELLER OVERSPEED FOLLOWED BY ENGINE PWR BEING REDUCED TO IDLE AS IF PILOT PULLED THROTTLE CLOSED. ACFT THEN BANKED TO LEFT AND ENTERED SPIN TO THE LEFT CRASHING INTO A PARKING LOT. POST CRASH EXAMINATION OF THE ENGINE, ACFT STRUCTURE, AND FLIGHT CONTROLS REVEALED NO EVIDENCE OF PRECRASH FAILURE OR MALFUNCTION. EXAMINATION OF THE PROPELLER REVEALED THE NUMBER TWO BLADE PITCH CHANGE ACTUATING PIN HAD FAILED DUE TO FATIGUE. THE PIN HAD BEEN INSTALLED AT OVERHAUL, 600 FLT HOURS BEFORE THE ACCIDENT, BY FOLLOWING MCCAULEY SERVICE BULLETIN 99 WHICH IS NOT APPLICABLE TO THIS MODEL PROPELLER. THE PIN WAS INSTALLED BY USING A SHORT THREADED PIN, A THIN SPACER, AND A BLIND HOLE IN THE FERRULE. THIS COMBINATION ALLOWED THE PIN TO BOTTOM OUT IN THE HOLE THUS NOT TORQUING PROPERLY AND THUS CRACKING DUE TO APPLIED LOADS.
NTSB Probable Cause Narrative
THE PILOT-IN-COMMAND'S FAILURE TO MAINTAIN AIRSPEED, WHILE RETURNING FOR AN EMERGENCY LANDING FOLLOWING PROPELLER FAILURE, RESULTING IN THE AIRCRAFT STALLING AND ENTERING A SPIN.
Event Information
| Type of Event | Accident |
| Event Date | 3/9/1991 |
| Event Day of the Week | Saturday |
| Time of Event | 1950 |
| Event Time Zone | Eastern Standard Time |
| Event City | KEY WEST |
| Event State | FLORIDA |
| Event Country | -- |
| Zipcode of the event site | 33040 |
| Event Date Year | 1991 |
| 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 | 1 |
| Degrees magnetic from airport | 350 |
| Airport Elevation | -- |
| Weather Briefing Completeness | Full |
| Investigator's weather source | Weather Observation Facility |
| Time of the weather observation | 1951 Eastern Standard Time |
| Direction of event from weather observation facility (degrees) | 180 |
| Weather Observation Facility ID | EYW |
| Elevation of weather observation facility | 4 |
| Distance of event from weather observation facility (units?) | 1 |
| Time Zone of the weather observation | EST |
| Lighting Conditions | Night/Dark |
| Lowest Ceiling Height | 0 |
| Lowest Non-Ceiling Height | 1000 |
| Sky/Lowest/Cloud Conditions | Scattered |
| Sky Condition for Lowest Ceiling | None |
| Visibility Runway Visual Range (Feet) | 0 |
| Visibility Runway Visual Value (Statute Miles) | 0 |
| Visibility (Statute Miles) | 10 |
| Air Temperature at event time (in degrees celsius) | 23 |
| Dew Point at event time (in degress fahrenheit) | 20 |
| Wind Direction (degrees magnetic) | 350 |
| Variable Wind Indicator | Unknown |
| Wind Speed (knots) | 22 |
| Wind Velocity Indicator | Unknown |
| Wind Gust Indicator | Unknown |
| Wind Gust (knots) | 27 |
| Altimeter Setting at event time (in. Hg) | 29 |
| Density Altitude (feet) | 1000 |
| 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 | 3 |
| Injury Total Minor | -- |
| Injury Total None | -- |
| Injury Total Serious | -- |
| Injury Total All | 3 |
| Investigating Agency | NTSB |
| NTSB Docket Number (internal use) | 272 |
| NTSB Notification Source | -- |
| NTSB Notification Date | -- |
| NTSB Notification Time | 0 |
| Fiche Number and/or location -used to find docket information | 43367 |
| Date of most recent change to record | Dec 12 2000 9:33AM |
| User who most recently changed record | dbo |
| Basic weather conditions | Visual Meteorological Cond |
| FAA District Office | -- |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | N4828J |
| NTSB Number | MIA91FA095 |
| 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 | BEECH |
| Aircraft Model | 35-C33A |
| Aircraft Series Identifier | 35-C33A |
| Aircraft Serial Number | CE-115 |
| Certified Max Gross Weight | 3300 |
| 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 | 4 |
| Number of Engines | 1 |
| Fixed gear or retractable gear | Retractable |
| Aircraft, Type of Last Inspection | Annual |
| Date of Last Inspection | Aug 1 1990 12:00AM |
| Airframe hours since last inspection | 103 |
| Airframe Hours | 4050 |
| ELT Installed | Yes |
| ELT Activated | No |
| ELT Aided Location of Event Site | No |
| ELT Type | -- |
| Aircraft Owner Name | JAMES W. HARDIN |
| Aircraft Owner Street Address | 235 BELMONTE ROAD |
| Aircraft Owner City | WEST PALM BEACH |
| Aircraft Owner State | FL |
| Aircraft Owner Country | |
| Aircraft Owner Zipcode | 33405 |
| Operator is an individual? | -- |
| Operator Name | JAMES W. HARDIN |
| Operator Same as Owner? | Yes |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | Yes |
| Operator Street Address | 235 BELMONTE ROAD |
| Operator City | WEST PALM BEACH |
| Operator State | FL |
| Operator Country | |
| Operator Zip code | 33405 |
| 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) | Personal |
| Second Pilot on Board | No |
| Departure Point Same as Event | Yes |
| Departure Airport Code | |
| Departure City | |
| Departure State | |
| Departure Country | |
| Departure Time | 1948 |
| Departure Time Zone | EST |
| Destination Same as Local Flt | -- |
| Destination Airport Code | PBI |
| Destination City | WEST PALM BEACH |
| Destination State | FL |
| Destination Country | |
| Specific Phase of Flight | Descent |
| Report sent to ICAO? | -- |
| Evacuation occurred | -- |
| Date of most recent change to record | Jan 2 2001 10:35AM |
| 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 | -- |