Individually Owned: 150,657
Corporate Owned: 137,281
Mackay-Dee Hospital Helipad Airport
Aircraft Accident/Incident Report
Ogden, Utah 84405
Friday, November 9, 2001 14:45 MST
NTSB Narrative Summary Released at Completion of Accident
Prior to accepting delivery of the new helicopter, the pilot noticed a 4 percent decay in rotor rpm when the collective control was lowered after landing, activating the aural and visual LOW ROTOR RPM warnings. After a few seconds, engine and rotor speed returned to normal. The engine manufacturer said it should be of no concern as long as it operated normally during flight, but suggested adjusting the linear variable differential transducer after they ferried the helicopter home. On the day of the accident, the pilot intended to make a low pass and land at a hospital helipad. He lowered the collective control and noticed rotor rpm had decreased to 96 percent. The LOW ROTOR RPM warnings activated. He realized he was too low to attempt an autorotation. He reduced collective and pitch attitude further. RPM drooped to 90 percent, and stabilized. Approximately 20 to 30 feet above the helipad, the pilot raised the collective control to flare for landing. RPM rapidly deteriorated. The aircraft impacted the helipad in a tail-down position, rolled over, and came to rest on its left side. The operator found the rotary variable differential transformer rigged at 57.9 degrees of twist grip travel at the Flight Gate position. According to the A119 maintenance manual, the device is supposed to be rigged to achieve 60 degree (+ or - 1 degree). The operator said misrigging of the rotary variable differential transducer would cause incorrect fuel scheduling to the fuel control unit.
NTSB Probable Cause Narrative
improper rigging of the rotary variable differential transformer by the manufacturer, resulting in incorrect fuel scheduling to the fuel control unit.
Event Information
| Type of Event | Accident |
| Event Date | 11/9/2001 |
| Event Day of the Week | Friday |
| Time of Event | 1445 |
| Event Time Zone | Mountain Standard Time |
| Event City | Ogden |
| Event State | UTAH |
| Event Country | -- |
| Zipcode of the event site | 84405 |
| Event Date Year | 2001 |
| Event Date Month | 11 |
| MidAir Collision Indicator | No |
| On Ground Collision occurred ? | No |
| Event Location Latitude | -- |
| Event Location Longitude | -- |
| Event Location Airport | Mackay-Dee Hospital Helipad |
| Event Location Nearest Airport ID | NONE |
| Indicates whether the acc/inc occurred off or on an airport | On Airport |
| Distance from airport in statute miles | -- |
| Degrees magnetic from airport | -- |
| Airport Elevation | -- |
| Weather Briefing Completeness | Not pertinent |
| Investigator's weather source | Weather Observation Facility |
| Time of the weather observation | 1453 Mountain Standard Time |
| Direction of event from weather observation facility (degrees) | -- |
| Weather Observation Facility ID | OGD |
| Elevation of weather observation facility | 4470 |
| Distance of event from weather observation facility (units?) | -- |
| Time Zone of the weather observation | MST |
| Lighting Conditions | Day |
| Lowest Ceiling Height | -- |
| Lowest Non-Ceiling Height | -- |
| Sky/Lowest/Cloud Conditions | Clear |
| Sky Condition for Lowest Ceiling | None |
| Visibility Runway Visual Range (Feet) | -- |
| Visibility Runway Visual Value (Statute Miles) | -- |
| Visibility (Statute Miles) | 10 |
| Air Temperature at event time (in degrees celsius) | 13 |
| Dew Point at event time (in degress fahrenheit) | -1 |
| Wind Direction (degrees magnetic) | -- |
| Variable Wind Indicator | Variable |
| Wind Speed (knots) | 4 |
| Wind Velocity Indicator | -- |
| Wind Gust Indicator | Not Gusting |
| Wind Gust (knots) | -- |
| Altimeter Setting at event time (in. Hg) | 30.32 |
| Density Altitude (feet) | 4780 |
| Intensity of Precipitation | -- |
| METAR weather report | -- |
| Event Highest Injury | Minor |
| On Ground, Fatal Injuries | -- |
| On Ground, Minor Injuries | -- |
| On Ground, Serious Injuries | -- |
| Injury Total Fatal | -- |
| Injury Total Minor | 3 |
| Injury Total None | -- |
| Injury Total Serious | -- |
| Injury Total All | 3 |
| Investigating Agency | NTSB |
| NTSB Docket Number (internal use) | 12289 |
| NTSB Notification Source | F |
| NTSB Notification Date | Nov 9 2001 12:00AM |
| NTSB Notification Time | 1453 |
| Fiche Number and/or location -used to find docket information | DMS |
| Date of most recent change to record | Feb 2 2009 1:23PM |
| User who most recently changed record | johb |
| Basic weather conditions | Visual Meteorological Cond |
| FAA District Office | Salt Lake City, Utah |
Aircraft Involved |
|
|---|---|
Aircraft #1 |
|
| Aircraft Registration Number | N119RX |
| NTSB Number | DEN02LA010 |
| Missing Aircraft Indicator | -- |
| Federal Aviation Reg. Part | Part 91: General Aviation |
| Type of Flight Plan filed | Company VFR |
| Flight plan Was Activated? | Yes |
| Damage | Destroyed |
| Aircraft Fire | None |
| Aircraft Explosion | None |
| Aircraft Manufacturer's Full Name | Agusta |
| Aircraft Model | A119 |
| Aircraft Series Identifier | -- |
| Aircraft Serial Number | 14014 |
| Certified Max Gross Weight | 5997 |
| Aircraft Category | Helicopter |
| 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 | Fixed |
| Aircraft, Type of Last Inspection | AAIP |
| Date of Last Inspection | Mar 2 2001 12:00AM |
| Airframe hours since last inspection | 40 |
| Airframe Hours | 40 |
| ELT Installed | Yes |
| ELT Activated | Yes |
| ELT Aided Location of Event Site | No |
| ELT Type | -- |
| Aircraft Owner Name | Intermountain Health Care |
| Aircraft Owner Street Address | 8th Ave. & C St. |
| Aircraft Owner City | Salt Lake City |
| Aircraft Owner State | UT |
| Aircraft Owner Country | USA |
| Aircraft Owner Zipcode | 84143 |
| Operator is an individual? | No |
| Operator Name | -- |
| Operator Same as Owner? | Yes |
| Operator Is Doing Business As | -- |
| Operator Address Same as Owner? | Yes |
| Operator Street Address | -- |
| Operator City | -- |
| Operator State | -- |
| Operator Country | USA |
| Operator Zip code | -- |
| Operator Code | I7LA |
| Owner has at least one certificate | -- |
| Other Operator of large aircraft? | No |
| Certified for Part 133 or 137 Operation | -- |
| 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 | SLC |
| Departure City | Salt Lake City |
| Departure State | UT |
| Departure Country | USA |
| Departure Time | 1220 |
| Departure Time Zone | MST |
| Destination Same as Local Flt | dest & departure same, accident can occur anywhere |
| Destination Airport Code | -- |
| Destination City | Ogden |
| Destination State | UT |
| Destination Country | USA |
| Specific Phase of Flight | Landing |
| Report sent to ICAO? | No |
| Evacuation occurred | No |
| Date of most recent change to record | Feb 2 2009 1:23PM |
| User who most recently changed record | johb |
| Since inspection or accident | Time of Accident |
| Event Location Runway Number and Location | -- |
| Runway Length | -- |
| Runway Width | -- |
| Sight Seeing flight | No |
| Air Medical Flight | Yes |
| Medical Flight | -- |