Aircraft Accident/Incident Report

Avalon, California 90704
Saturday, May 24, 2008 9:20 PDT

NTSB Narrative Summary Released at Completion of Accident

The helicopter was descending to the planned destination during the on-demand air taxi flight when witnesses reported hearing a loud pop, followed by flames emitting from the back of the engine. The helicopter subsequently collided with the ground. A surviving passenger reported that just after the loud pop, the pilot told passengers that he was going to autorotate. The helicopter entered a descent at an altitude witnesses on the ground estimated at 200 to 400 feet above ground level. During the descent, the pilot had to clear numerous obstacles, including buildings and power lines, to reach an open field located beyond the obstacles but short of the normal landing area. The ground witnesses stated that the helicopter was in an area near the shoreline when they witnessed the flames and heard the loud pop; however, the exact location in reference to the shoreline could not be determined. Since the pilot stated to passengers that he was going to autorotate, it is likely that the helicopter experienced a loss of power after the loud pop. In the event of a loss of engine power, the pilot must enter an autorotation by immediately reducing the collective pitch to maintain main rotor speed to avoid a main rotor stall. The collective pitch must be reduced to the point required to maintain, or regain a safe main rotor speed. This would allow the pilot to maintain sufficient rotor speed while maneuvering to a suitable landing area, and to arrest the descent when needed. If the main rotor blades stall, this will ultimately result in a loss of control and uncontrolled descent. Because of the relatively low altitude at which the loss of power occurred, it is likely that the accident pilot had to trade rotor rpm to maintain the altitude needed to clear the obstacles and reach the open field. This would have resulted in a lack of sufficient rotor rpm to arrest the helicopter’s descent rate as it approached the ground. Further, examination of the main rotor blades at the accident scene did not show evidence of high rotational energy at impact. Postaccident inspection of the turbine engine revealed localized damage to four consecutive power turbine blades. Two of the blades were fractured transversely across the airfoil above the blade root platform and two were fractured higher up their respective airfoils near the blade tips. Generalized damage was observed to the remaining power turbine blades; however, all blades were in place and remained secured to the power turbine wheel. A Safety Board materials engineer's examination of the fractured blades revealed striation features typical of fatigue cracking on the pressure (concave) side of the airfoil. The fatigue crack features emanated from the boundary area between the base material and a casting pin. Further analysis disclosed that the fracture was the result of fatigue cracking that emanated from two platinum casting pins on the pressure side of the blade adjacent to the platform. The fracture face of the blade contained isolated regions of fatigue cracking that were separated by fracture regions and showed oxidation damage consistent with fatigue. Additional testing of the fractured blade(s) indicated that the microstructure in the airfoil portions showed no evidence of operation above a temperature profile expected for this stage of the engine. The fracture features of the remaining turbine blades were consistent with overstress separation. Review of maintenance records indicated that, the engine's cycle counting process, inspection requirements, and compliance with airworthiness directives and service bulletins were all satisfactory. More specifically, due to the power turbine blade failures, the life and maintenance history of the power turbine rotor, including the power turbine blades, were assessed. The information contained in the maintenance records, as well as the information provided by the manufacturer on the history and inspection requirements of the power turbine blades showed that they were operated in accordance with the requirements set forth by the manufacturer.\ Following the accident, Honeywell Aerospace issued Service Bulletins; LT 101-71-00-0252 and LTS101-71-00-0253. The Service Bulletins require the removal and inspection of the turbine assemblies, "To address a service related difficulty with Power Turbine Rotor Blade Part No. 4-141-084-06 cracking at the mid span of the airfoil that can lead to a blade separation and subsequent inability to maintain powered flight resulting in potential injuries and damage to the aircraft." Additionally, two FAA Airworthiness Directives pertaining to this issue are pending.

NTSB Probable Cause Narrative

Loss of engine power during approach for landing due to a fatigue fracture of a power turbine blade.

Event Information

Type of Event Accident
Event Date 5/24/2008
Event Day of the Week Saturday
Time of Event 920
Event Time Zone Pacific Daylight Time
Event City Avalon
Event State CALIFORNIA
Event Country --
Zipcode of the event site 90704
Event Date Year 2008
Event Date Month 5
MidAir Collision Indicator No
On Ground Collision occurred ? No
Event Location Latitude 332618N
Event Location Longitude 1182959W
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 --
Investigator's weather source Weather Observation Facility
Time of the weather observation 928 Pacific Daylight Time
Direction of event from weather observation facility (degrees) 135
Weather Observation Facility ID AVX
Elevation of weather observation facility 1597
Distance of event from weather observation facility (units?) 5
Time Zone of the weather observation PDT
Lighting Conditions Day
Lowest Ceiling Height 1500
Lowest Non-Ceiling Height 700
Sky/Lowest/Cloud Conditions Thin Broken
Sky Condition for Lowest Ceiling Broken
Visibility Runway Visual Range (Feet) --
Visibility Runway Visual Value (Statute Miles) --
Visibility (Statute Miles) 10
Air Temperature at event time (in degrees celsius) 9
Dew Point at event time (in degress fahrenheit) 8
Wind Direction (degrees magnetic) 80
Variable Wind Indicator Wind direction could be determined
Wind Speed (knots) 3
Wind Velocity Indicator --
Wind Gust Indicator Not Gusting
Wind Gust (knots) --
Altimeter Setting at event time (in. Hg) 29.96
Density Altitude (feet) --
Intensity of Precipitation --
METAR weather report --
Event Highest Injury Fatal
On Ground, Fatal Injuries --
On Ground, Minor Injuries --
On Ground, Serious Injuries --
Injury Total Fatal 3
Injury Total Minor --
Injury Total None --
Injury Total Serious 3
Injury Total All 6
Investigating Agency NTSB
NTSB Docket Number (internal use) 25664
NTSB Notification Source FAA Regional Operations Center
NTSB Notification Date May 24 2008 12:00AM
NTSB Notification Time --
Fiche Number and/or location -used to find docket information --
Date of most recent change to record Apr 28 2010 4:08PM
User who most recently changed record lema
Basic weather conditions Visual Meteorological Cond
FAA District Office FAA AAI-100

Aircraft Involved

Aircraft #1

Aircraft Registration Number N67GE
NTSB Number SEA08MA136
Missing Aircraft Indicator --
Federal Aviation Reg. Part Part 135: Air Taxi & Commuter
Type of Flight Plan filed Company VFR
Flight plan Was Activated? Yes
Damage Destroyed
Aircraft Fire Ground
Aircraft Explosion Ground
Aircraft Manufacturer's Full Name AEROSPATIALE
Aircraft Model AS-350-D
Aircraft Series Identifier --
Aircraft Serial Number 1640
Certified Max Gross Weight 4300
Aircraft Category Helicopter
Aircraft Registration Class --
Aircraft is a homebuilt? No
Flight Crew Seats 1
Cabin Crew Seats --
Passenger Seats 6
Total number of seats on the aircraft 7
Number of Engines 1
Fixed gear or retractable gear Fixed
Aircraft, Type of Last Inspection 100 Hour
Date of Last Inspection May 20 2008 12:00AM
Airframe hours since last inspection 7
Airframe Hours 9687
ELT Installed Yes
ELT Activated Yes
ELT Aided Location of Event Site No
ELT Type C91-A
Aircraft Owner Name Island Express Helicopters
Aircraft Owner Street Address 1175 Queens Highway South
Aircraft Owner City Long Beach
Aircraft Owner State CA
Aircraft Owner Country USA
Aircraft Owner Zipcode 90704
Operator is an individual? No
Operator Name Island Express Helicopters
Operator Same as Owner? Yes
Operator Is Doing Business As --
Operator Address Same as Owner? Yes
Operator Street Address 1175 Queens Highway South
Operator City Long Beach
Operator State CA
Operator Country USA
Operator Zip code 90704
Operator Code ISHA
Owner has at least one certificate Yes - certificate holder
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 Non-scheduled
Indicates Domestic or International Flight Domestic
Operator carrying Pax/Cargo/Mail Passenger Only
Type of Flying (Per_Bus / Primary) --
Second Pilot on Board No
Departure Point Same as Event No
Departure Airport Code --
Departure City Long Beach
Departure State CA
Departure Country USA
Departure Time 907
Departure Time Zone PDT
Destination Same as Local Flt crash at destination city
Destination Airport Code --
Destination City Avalon
Destination State CA
Destination Country USA
Specific Phase of Flight Approach - VFR pattern - final approach
Report sent to ICAO? --
Evacuation occurred --
Date of most recent change to record Jun 30 2009 3:12PM
User who most recently changed record stam
Since inspection or accident Time of Accident
Event Location Runway Number and Location --
Runway Length --
Runway Width --
Sight Seeing flight No
Air Medical Flight No
Medical Flight --