Accident Details
Probable Cause and Findings
The pilot's failure to maintain main rotor speed after setting the engine fuel control to idle, which resulted in a loss of helicopter control and impact with water.
Aircraft Information
Registered Owner (Historical)
Analysis
HISTORY OF FLIGHTOn September 28, 2018, at 1057 Alaska daylight time, an Airbus Helicopters AS350-B3e helicopter, N907PL, was destroyed when it was involved in an accident in Glacier Bay National Park, about 60 miles northwest of Gustavus, Alaska. The safety pilot was fatally injured, one passenger sustained serious injuries, and the pilot and another passenger remain missing and are presumed fatal. The helicopter was operated as a Title 14 Code of Federal Regulations Part 91 personal flight.
The purpose of the trip was to deliver the newly-purchased helicopter to Anchorage from the Airbus Helicopters factory in Texas. The left seat safety pilot was onboard for insurance coverage purposes and was acting as a safety pilot. The right seat pilot-in-command, who owned the helicopter, planned to drop off the safety pilot in Wasilla, Alaska, then proceed to Anchorage with the passengers. The trip began on September 25, 2018, and included more than 30 stops for sightseeing, fuel, and rest.
In a postaccident interview, the surviving passenger, who was seated in the left rear seat, stated that the accident flight departed Juneau International Airport (JNU), Juneau, Alaska, and proceeded north toward Yakutat Airport (YAK), Yakutat, Alaska, at low altitude parallel to the shoreline. The passengers' headphones were muted, but at one point, the pilot unmuted the passengers' headphones and asked if the passengers wanted to land on a beach to stretch their legs. About 1 minute later, the safety pilot pointed his hand to the right toward a long stretch of beach. The passenger recalled that the pilot initiated a controlled right turn and the helicopter began to descend; the safety pilot did not have his hands on the flight controls. He stated that the pilot pulled up on the collective and rolled the throttle off. He never heard anything abnormal with the engine noise or noticed any anomalies with the helicopter. The pilot left the collective up and the helicopter entered a free fall from about 500 ft agl, then about 30 ft agl the pilot increased the throttle again. Before impact, he heard the pilot yell "NO" and continue to manipulate the flight controls. He felt the helicopter impact the water and noticed water splash in the cabin before he lost consciousness. He later awoke in the water and swam to shore, where he awaited rescue. He was unable to locate the other occupants.
A review of the onboard cockpit image recorder, an Appareo Vision 1000, revealed that the helicopter was refueled at JNU before departing on the accident flight. The helicopter departed JNU and proceeded west over the mountains about 3,000 to 4,000 ft mean sea level (msl), then northwest along the coastline about 500 to 700 ft msl. Figure 1 depicts the helicopter's flight path from JNU to the accident site.
Figure 1 – The helicopter flight track in orange from JNU to the accident site. PERSONNEL INFORMATIONThe pilot began his helicopter flight training in a Robinson R44 helicopter and had accumulated 59 hours of helicopter flight experience. On forms provided to Airbus before conducting AS350-B3e model transition training, the pilot reported no experience in the accident helicopter make and model. On June 4, 2018, the pilot completed transition training for the AS350-B3e with an Airbus Helicopters flight instructor at the Airbus factory in Grand Prairie, Texas; this training included 3 hours of flight time and 1 hour of simulator time.
From June 18 to August 29, 2018, the pilot completed at least 10 flights (more than 18.3 hours) in an AS350-B2 model operated by the safety pilot's company in Alaska. in Alaska. Of the 18.3 hours, 11.4 were conducted with the accident safety pilot and 6.9 were conducted with a company flight instructor.
On August 5, 2018, the pilot completed a 1.5-hour flight at the Airbus factory with the same Airbus Helicopters flight instructor in an AS350-B3e. The pilot had accumulated 4.5 flight hours in the B3e before departing Texas with the accident helicopter.
The safety pilot was the owner, director of operations, and chief pilot for two different commercial helicopter operators in Alaska that operated several AS350-B2 model helicopters.
The surviving passenger was not a pilot, but he did attend helicopter ground school classes with the accident pilot and had knowledge of helicopter procedures and helicopter flight theory. The passenger stated that, when taking delivery of the accident helicopter in Texas, the safety pilot did not seem recently familiar with the B3e model and the options that were installed on the accident helicopter. The safety pilot asked a lot of questions about the B3e, and the pilot appeared more familiar with the helicopter systems than the safety pilot. AIRCRAFT INFORMATIONThe Airbus Helicopters was equipped with a three-bladed main rotor system and a two-bladed tail rotor system. The flight controls are were hydraulically assisted by a dual hydraulic system. The helicopter was equipped with both pilot and safety pilot controls and a Genesys Aerosystems HeliSAS autopilot and stability augmentation system.
The collective-mounted engine control twist grip throttle contains two positions: IDLE and FLIGHT. In the normal procedures section of the AS350 B3e rotorcraft flight manual (RFM), the twist grip throttle is moved from the IDLE position to the FLIGHT position during the run-up checks. The twist grip throttle remains in the FLIGHT position until the postlanding engine and rotor shutdown procedures are performed. When the twist grip throttle is outside of its FLIGHT position, a "TWT GRIP" warning light illuminates on the cockpit caution and warning panel (CWP).
According to Airbus Helicopters, the airframe and engine had accumulated a total time of 13.7 hours at the time of delivery. An estimated 25-30 hours was accumulated from delivery until the accident. METEOROLOGICAL INFORMATIONThe National Weather Service (NWS) Alaska Aviation Weather Unit issued flying weather graphics, which forecast marginal visual flight rules and no low-level turbulence for the accident area.
The FAA Aviation Weather Cameras for YAK and Cape Spencer, Alaska, revealed a broken to overcast cloud layer and clear visibility around the time of the accident flight.
The Appareo Vision 1000 onboard the helicopter showed brief periods of light rain on the helicopter's windscreen. The rain stopped about 7 minutes before the accident. AIRPORT INFORMATIONThe Airbus Helicopters was equipped with a three-bladed main rotor system and a two-bladed tail rotor system. The flight controls are were hydraulically assisted by a dual hydraulic system. The helicopter was equipped with both pilot and safety pilot controls and a Genesys Aerosystems HeliSAS autopilot and stability augmentation system.
The collective-mounted engine control twist grip throttle contains two positions: IDLE and FLIGHT. In the normal procedures section of the AS350 B3e rotorcraft flight manual (RFM), the twist grip throttle is moved from the IDLE position to the FLIGHT position during the run-up checks. The twist grip throttle remains in the FLIGHT position until the postlanding engine and rotor shutdown procedures are performed. When the twist grip throttle is outside of its FLIGHT position, a "TWT GRIP" warning light illuminates on the cockpit caution and warning panel (CWP).
According to Airbus Helicopters, the airframe and engine had accumulated a total time of 13.7 hours at the time of delivery. An estimated 25-30 hours was accumulated from delivery until the accident. WRECKAGE AND IMPACT INFORMATIONThe main fuselage was found on a beach on its left side and partially embedded in the sand as shown in Figure 3. The structure forward of the aft cabin bulkhead had separated from the main fuselage. The left and right aft bench seats remained attached to the aft cabin bulkhead. The two longitudinal floor beams for the cabin floor structure were fractured several inches forward of the aft cabin bulkhead. The rear structure of the main fuselage was crushed inward throughout its circumference. The engine firewall remained attached to the main fuselage; its base was deformed in the aft direction and its upper portion was partially fractured. The engine deck was deformed downward. The engine air inlet barrier filter remained installed within its frame, but the cowling surrounding the frame had separated. Sand was found within the barrier filter.
Figure 3 – Helicopter main wreckage partially embedded in the sand at low tide.
The cockpit floor, with the front seats attached, was recovered. The cockpit and cabin roof structure, about 5.5 ft in length measured from the upper windshield attachment, was also recovered. The Vision 1000 remained attached to the roof structure.
The three main rotor blades were found separated from the rotor hub and were broken into large pieces.
The tail boom, tail rotor assembly, and most of the instrument panel were not found.
The fuel tank remained installed within the center fuselage and was removed at the accident site by the investigation team in support of the wreckage recovery. About 25 gallons of fuel was removed from the fuel tank at the site; additional fuel was removed after recovery of the fuel tank. Evidence of saltwater was observed in the fuel removed from the fuel tank.
All engine electrical, oil, fuel, and pneumatic connections were installed and intact. These connections were separated to facilitate removal of the engine from the airframe. One of the first stage compressor blades exhibited curling deformation in the direction opposite of normal rotation at its tip end.
The pilot cyclic control was fractured from its lower attachment but remained with the wreckage via electrical wiring through its post. The grip remained attached to the pilot cyclic control. The safety pilot cyclic control and grip remained installed but exhibited deformation in multiple locations. Fractures were observed on multiple control t...
Data Source
Data provided by the National Transportation Safety Board (NTSB). For more information on this event, visit the NTSB Records Search website. NTSB# CEN18FA391