NTSB Factual Report

HISTORY OF FLIGHT

On March 24, 2000, about 1248 Pacific standard time, a Robinson R22 Beta, N8328Q, operated by Universal Aviators Academy, Inc., El Monte, California, descended into terrain while on final approach to the (uncontrolled) Rialto Municipal Airport, Rialto, California. The helicopter was destroyed, and the private pilot was fatally injured. Visual meteorological conditions prevailed, and no flight plan was filed for the solo instructional flight. The flight was being performed under 14 CFR Part 91, and it originated from El Monte about noon.

The pilot's certified flight instructor (CFI) reported to the National Transportation Safety Board investigator that his student, who was certificated to pilot airplanes, was learning to fly rotorcraft. The accident occurred during the student's first solo cross-country flight in rotorcraft.

During the morning of March 24, the pilot received a dual flight lesson from his CFI in the accident helicopter. The 1.1-hour-long lesson involved flying a round robin course between El Monte and Rialto. About 1045, upon returning to El Monte, the CFI endorsed his student's logbook for his first solo cross-country flight in the R22. The planned route of flight was to be identical to the route they had just flown. Prior to taking off the helicopter's fuel tanks were completely filled.

En route to Rialto, the pilot passed the Ontario International Airport. Thereafter, according to Federal Aviation Administration (FAA) recorded radar data, the pilot flew in an easterly and northeasterly direction toward Rialto. Approaching Rialto's downwind leg in the traffic pattern, the helicopter's ground speed was about 84 knots, and it was cruising about 1,900 feet msl (about 500 feet above ground level (agl)), as indicated by the helicopter's Mode C (altitude reporting) transponder.

The radar data indicates that about 1247:15, when the helicopter turned onto the base leg for taxiway 24, it had descended to about 1,600 feet msl. (Rialto Airport's elevation is 1,455 feet msl.) At this time its ground speed had decreased to about 72 knots. The helicopter was last recorded on radar at 1247:19. At this time the helicopter was on base leg, its altitude was 1,600 feet msl, and its ground speed had decreased to approximately 41 knots.

Several witnesses observed and heard the helicopter in the vicinity of the Rialto Airport seconds before it crashed. In summary, a paramedic, who was located about 1/3-mile northwest of the crash site, reported that he heard the helicopter and then observed it hovering between 150 and 200 feet agl. The helicopter was "stationary" and was pointed westerly (toward the airport). After between 3 and 10 seconds, the helicopter turned or pivoted left about a point, thus changing its heading between 45 and 90 degrees. Then, while headed in a southwesterly or southerly direction, the helicopter's nose pitched about 45 degrees downward, and it started flying westward in this nose down attitude without any apparent loss of altitude. After proceeding less than five helicopter lengths in this nose down attitude, the helicopter began descending. Its nose down attitude remained the same. The paramedic additionally stated that he lost sight of the helicopter when it descended below a small ridgeline, but a second thereafter he observed a cloud of dirt propagate upward, which indicated to him that the helicopter had crashed. During the entire time in which the paramedic heard the helicopter, no unusual sounds, like popping, banging, or engine missing sounds, were heard.

A 13-year-old boy, who was located an estimated 1/3-mile southwest of the crash site, reported that he observed the helicopter "stopped in the air" for about 5 seconds. It "wobbled," tilted nose down about 45 degrees, and descended. A dirt cloud came up about 1 second later.

A non-English speaking witness, located about 1/10-mile west of the crash site, reported (through an interpreter) that he first observed the helicopter flying level. White smoke was trailing from the helicopter. The helicopter started shaking, nosed over, and descended at a 45-degree angle until he lost sight of it. The witness did not see any fire or recall hearing any noise from the helicopter.

Seconds before the accident, a flight instructor was near the midfield location over the Rialto Airport. The flight instructor reported that he observed the accident helicopter enter downwind for taxiway 24 at 500 feet agl. The helicopter turned onto the base leg and nothing unusual occurred. When the helicopter was on base leg it had descended between 250 and 300 feet agl. The visibility was about 10 miles, and the wind was light and variable. The air was smooth and "it was good autorotation weather."

The accident pilot's CFI subsequently reported to the Safety Board investigator that, based upon his observations of the accident site's location and its proximity to the airport, he opined that his student had crashed while flying over an appropriate flight route. The accident site location was indicative of the helicopter having descended from the traffic pattern to ground level while on either the base or final approach legs to the taxiway that parallels runway 24.

PERSONNEL INFORMATION

A review of the pilot's personal flight record logbook revealed he commenced primary flight training in February 1992, and principally flew Cessna 150 and Piper PA-28-151 airplanes. He obtained a private pilot certificate in March 1994. Thereafter, he continued flying on a monthly basis until August 1996, whereupon he discontinued flying. The pilot's logbook indicates that he resumed flying on March 8, 1999. On that date he completed a flight review in a Cessna.

On June 7, 1999, the pilot began taking flying lessons in the accident helicopter. He continued taking lessons several times per month, and by the accident date he had logged about 27 individual flights in the Robinson R22.

By the date of the accident, the pilot's total aircraft flight time was about 140.5 hours. Of this time, approximately 110.4 hours had been flown in airplanes and about 30.1 hours had been flown in rotorcraft, of which about 29.1 hours had been flown in the Robinson R22. Including the 0.9-hour-long accident flight, the pilot's total solo flight time in R22s was about 5.7 hours.

HELICOPTER INFORMATION

A review of the maintenance logbooks revealed that on January 31, 2000, the helicopter's total airframe and engine times were 2,764.2 hours and 2,006.9 hours, respectively. At this time, the helicopter was overhauled by the Robinson Helicopter Company and was returned to service.

The logbooks indicate that on March 13, 2000, the operator's contract mechanic performed a 100-hour inspection at a total helicopter time of 2,861.7 hours (97.5 hours since overhaul). Thereafter, the helicopter was returned to service.

The next and final entry in the maintenance logs was noted on March 21, 2000. At that time the helicopter's total time was 2,882.0 hours (117.8 hours since overhaul). The helicopter was serviced by the operator's contract mechanic and, in part, a starter vibrator was replaced. Thereafter, the helicopter was operationally checked and returned to service.

The CFI reported that just prior to the fatal flight when he had flown the helicopter, all control systems and warning lights were functioning properly. He stated, "everything was working." The operator reported that when the pilot rented the helicopter from the flight school for the accident flight, there were no outstanding squawks pertinent to the helicopter.

During the postimpact examination of the wreckage, the helicopter's Hobbs hour recording meter was located and was observed displaying the numbers 2,890.1 hours. Based upon this value, the calculated number of hours since the helicopter was overhauled and received its last 100-hour inspection were 125.9 and 28.4 hours, respectively.

METEOROLOGICAL INFORMATION

A witness to the accident, who was located about 1/3-mile northwest of the impact site, reported that at the time the surface wind was virtually calm.

A battalion chief from the Rialto City Fire Department responded to the accident site within a few minutes after receiving the emergency notification call. The chief reported to the Safety Board investigator that upon his arrival he noted that the wind was from the north. He described its speed as being between light and variable and 2 mph, but definitely less than 5 mph.

The Ontario International Airport is located about 13 miles southwest of the accident site. In pertinent part, at 1253, Ontario reported the following meteorological conditions: scattered clouds at 18,000 feet; overcast ceiling at 25,000 feet; visibility 10 miles; wind calm; and temperature/dew point of 70 and 30 degrees Fahrenheit, respectively.

COMMUNICATION

The Federal Aviation Administration (FAA) reported that all communications with the pilot during his flight were routine. The last recorded communications with the pilot occurred as the eastbound helicopter exited Ontario International Airport's airspace.

A search of additional FAA facilities did not reveal evidence that any air-to-ground communications or services had been provided to the pilot of N8328Q while it was in the vicinity of the Rialto Airport.

A flight instructor, who was flying in a helicopter near the Rialto Airport, reported to the Safety Board investigator that he heard what he subsequently ascertained was the accident pilot. The flight instructor stated that the pilot made the following transmission: "Downwind landing Rialto."

WRECKAGE AND IMPACT INFORMATION:

The on scene examination of the accident site and helicopter wreckage revealed evidence of an initial point of impact (IPI) with terrain about 0.67 nm northeast (059 degrees, magnetic) from the Rialto Airport. The main wreckage was found about 100 feet southwest of the IPI at global positioning satellite coordinates of about 34 degrees 7 minutes 55.8 seconds north latitude by 117 degrees 23 minutes 19.0 seconds west longitude.

The IPI was observed in an open level field, elevation about 1,450 feet msl. The field is adjacent to a dry wash. One skid-like mark that was dimensionally and geometrically similar to one of the helicopter's landing gear skids was observed at this location.

Pieces from the broken right skid including its toe, and a belly panel were located 15 to 40 feet southwest to west of the IPI in the dry wash bed. The auxiliary fuel tank cap, anticollision strobe light, pilot's head set earpiece, the right door vent, and a piece of belly sheet metal were located about 10 to 30 feet further southwest.

Most of the helicopter's Plexiglas bubble material was accounted for and was located between the IPI and the main wreckage. The main wreckage was found on its right side, partially resting against bushes, and on a magnetic heading of 141 degrees. Additional components, including the aft portion of the tail cone, the right skid's heel, the top portion of the right doorframe, and a tail rotor blade tip cap, were found about 55 feet southwest to northwest from the main wreckage.

The tail rotor assembly was found attached to the gearbox and remained connected to the outboard portion of the tailcone. This area (bays 5 and 6) was found as a unit, but separated from the main wreckage. There was no evidence of oil spray or fire associated with any of the wreckage. The magnetic bearing from the IPI to the main wreckage, and also from the wreckage to the airport, was about 237 degrees.

MEDICAL AND PATHOLOGICAL INFORMATION

On March 27, 2000, an autopsy was performed by the San Bernardino County Coroner's Office. No evidence was reported during the external examination of the decedent that was consistent with him having been contacted by the main rotor blade.

The FAA's Civil Aeromedical Institute, Toxicology and Accident Research Laboratory, performed toxicology tests on blood and urine specimens from the pilot. No evidence of ethanol, carbon monoxide, cyanide or any screened drugs was found.

TESTS AND RESEARCH

Airframe and Component Part Examination.

The helicopter was recovered from the accident site and was examined at the Robinson Helicopter Company. In summary, the main rotor blades exhibited multiple nicks and gouges throughout their spans. The leading edges were found bent in an aft direction. The blades' trailing edge skin was observed accordioned. The leading edges of both tail rotor blades were also impact damaged.

The continuity of the driveline and the flight control system was confirmed. The main rotor spindles, droop tusks, and the elastomeric teeter stops were examined. The Robinson participant opined that no evidence was observed consistent with any preimpact over-travel of either main rotor blade. The tail rotor blade's pitch change links were found intact and functional. All warning systems and annunciator lights were functionally tested and were found operational.

The Telatemp indicators, used to track changes in operating temperatures of gearboxes and bearings, were all found indicating within the range limits specified by Robinson in its "R22 Maintenance Manual."

The low rotor warning horn system was functionally tested. It was found operational, and no discrepancies were noted.

Fuel System.

The gascolator screen was observed devoid of foreign material. Fuel was found in the carburetor fuel inlet and associated fuel line. Also, beneath the main wreckage a 3/4-foot diameter circular area was found saturated with a substance that smelled like fuel. The moist soil, with a pronounced fuel-like odor, was noted to a depth of at least 1/2 foot.

Engine and Component Part Examination.

The engine's cooling fan exhibited scoring along its circumference, as well as circular score marks on its forward surface. Small pieces of wood material were found inside the cooling ducts above the cylinders. The aluminum vanes, as well as the fan's fiberglass shell, exhibited scoring in a direction parallel to the cooling fan's directing of rotation.

Under the supervision of the Safety Board investigator, the dual tachometer system and the low rotor rpm warning horn and light system were functionally tested. The Robinson Helicopter participant reported that no discrepancies were noted. The rpm governor controller electronic unit was tested while still attached to the helicopter and was found operationally functional. The governor motor assembly was removed from the helicopter and was tested. It was also found functional.

Under the supervision of the Safety Board investigator, the impact-damaged engine was run up in a test cell. The Lycoming engine participant reported that it operated and produced maximum rated power.

ADDITIONAL INFORMATION

The CFI reported that the throttle governor was functioning properly during his previous flight with the accident student.

The helicopter wreckage was released to the operator's assigned insurance adjuster on June 14, 2001.

NTSB Probable Cause

The pilot's in-flight loss of control for undetermined reasons.