National Transportation Safety Board
B-Roll
T. Bella Dinh-Zarr, PhD, MPH
Board Member of the National Transportation Safety Board
and
Todd G. Gunther
Investigator In Charge
National Transportation Safety Board
B-Roll
T. Bella Dinh-Zarr, PhD, MPH
Board Member of the National Transportation Safety Board
and
Todd G. Gunther
Investigator In Charge
National Transportation Safety Board
Interior bench seat.
Federal Aviation Administration
Attach point.
Federal Aviation Administration
Lanyards.
Federal Aviation Administration
Carabiner and tether.
Federal Aviation Administration
Helicopter interior.
Federal Aviation Administration
The National Transportation Safety Board traveled to the scene of this accident.
Additional Participating Entities:
Federal Aviation Administration Accident Investigation & Prevention FAA / AVP-100; Washington, District of Columbia
Airbus Helicopters; Grand Prairie, Texas
SAFRAN Helicopter Engines; Grand Prairie, Texas
BEA; Le Bourget, FN
Liberty Helicopters Inc.; Kearny, New Jersey
NYONair; Kearny, New Jersey
Dart Aerospace; San Diego, California
Transportation Safety Board of Canada; Ottawa
Transport Canada; Ottawa
EuroTec Canada Ltd; Millgrove, Ontario
European Aviation Safety Agency; Cologne, Germany
Aviation Accident Final Report - National Transportation Safety Board: https://app.ntsb.gov/pdf
Investigation Docket - National Transportation Safety Board: https://dms.ntsb.gov/pubdms
http://registry.faa.gov/N350LH
Location: New York, NY
Accident Number: ERA18MA099
Date & Time: 03/11/2018, 1908 EDT
Registration: N350LH
Aircraft: AMERICAN EUROCOPTER CORP AS350B2
Aircraft Damage: Substantial
Defining Event: Miscellaneous/other
Injuries: 5 Fatal, 1 Minor
Flight Conducted Under: Part 91: General Aviation - Other Work Use - Sightseeing
Analysis
The Safety Board's full report is available at http://www.ntsb.gov/investigations/AccidentReports/Pages/aviation.aspx. The Aircraft Accident Report number is NTSB/AAR-19/04.
On March 11, 2018, about 1908 eastern daylight time, an Airbus Helicopters AS350 B2, N350LH, lost engine power during cruise flight, and the pilot performed an autorotative descent and ditching on the East River in New York, New York. The pilot sustained minor injuries, the five passengers drowned, and the helicopter was substantially damaged. The FlyNYON-branded flight was operated by Liberty Helicopters Inc. (Liberty), per a contractual agreement with NYONair; both companies considered the flight to be an aerial photography flight operated under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91. (During this accident investigation, the Federal Aviation Administration determined that Liberty operated the flight as a nonstop commercial air tour under 14 CFR Part 91.) Visual flight rules weather conditions prevailed, and no flight plan was filed for the intended 30-minute local flight, which departed from Helo Kearny Heliport, Kearny, New Jersey, about 1850.
Probable Cause and Findings
The National Transportation Safety Board determines the probable cause(s) of this accident to be:
Liberty Helicopters Inc.'s use of a NYONair-provided passenger harness/tether system, which caught on and activated the floor-mounted engine fuel shutoff lever and resulted in the in-flight loss of engine power and the subsequent ditching. Contributing to this accident were (1) Liberty's and NYONair's deficient safety management, which did not adequately mitigate foreseeable risks associated with the harness/tether system interfering with the floor-mounted controls and hindering passenger egress; (2) Liberty allowing NYONair to influence the operational control of Liberty's FlyNYON flights; and (3) the Federal Aviation Administration's inadequate oversight of Title 14 Code of Federal Regulations Part 91 revenue passenger-carrying operations. Contributing to the severity of the accident were (1) the rapid capsizing of the helicopter due to partial inflation of the emergency flotation system and (2) Liberty and NYONair's use of the harness/tether system that hindered passenger egress.
Findings
Aircraft
Flight compartment equipment - Design (Cause)
Fuel selector/shutoff valve - Unintentional use/operation (Cause)
Emergency floatation section - Design (Factor)
Passenger compartment equip - Unnecessary use/operation (Factor)
Organizational issues
Safety - Operator (Factor)
Adherence to safety program - Operator (Factor)
Oversight of operation - Operator (Factor)
Safety - Other institution/organization (Factor)
Availability of safety program - Other institution/organization (Factor)
Oversight of operation - FAA/Regulator (Factor)
Regulatory requirements - FAA/Regulator (Factor)
Adequacy of policy/proc - FAA/Regulator (Factor)
Factual Information
The Safety Board's full report is available at http://www.ntsb.gov/investigations/AccidentReports/Pages/aviation.aspx. The Aircraft Accident Report number is NTSB/AAR-19/04.
On March 11, 2018, about 1908 eastern daylight time, an Airbus Helicopters AS350 B2, N350LH, lost engine power during cruise flight, and the pilot performed an autorotative descent and ditching on the East River in New York, New York. The pilot sustained minor injuries, the five passengers drowned, and the helicopter was substantially damaged. The FlyNYON-branded flight was operated by Liberty Helicopters Inc. (Liberty), per a contractual agreement with NYONair; both companies considered the flight to be an aerial photography flight operated under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91. (During this accident investigation, the Federal Aviation Administration determined that Liberty operated the flight as a nonstop commercial air tour under 14 CFR Part 91.) Visual flight rules weather conditions prevailed, and no flight plan was filed for the intended 30-minute local flight, which departed from Helo Kearny Heliport, Kearny, New Jersey, about 1850.
History of Flight
Prior to flight
Miscellaneous/other (Defining event)
Maneuvering
Fuel starvation
Loss of engine power (total)
Emergency descent
Attempted remediation/recovery
Off-field or emergency landing
Landing
Roll over
After landing
Evacuation
Miscellaneous/other
The pilot of the helicopter, Richard Vance, after emerging from the frigid waters of New York City's East River.
From top left, Brian McDaniel, Trevor Cadigan, Daniel Thompson, Tristan Hill and Carla Vallejos Blanco
Pilot Information
Certificate: Flight Instructor; Commercial
Age: 33, Male
Airplane Rating(s): None
Seat Occupied: Right
Other Aircraft Rating(s): Helicopter
Restraint Used:
Instrument Rating(s): Helicopter
Second Pilot Present: No
Instructor Rating(s): Helicopter; Instrument Helicopter
Toxicology Performed: Yes
Medical Certification: Class 2 Without Waivers/Limitations
Last FAA Medical Exam: 07/27/2017
Occupational Pilot: Yes
Last Flight Review or Equivalent: 02/21/2018
Flight Time: (Estimated) 3100 hours (Total, all aircraft), 1430 hours (Total, this make and model), 3020 hours (Pilot In Command, all aircraft), 57 hours (Last 90 days, all aircraft), 33 hours (Last 30 days, all aircraft), 2 hours (Last 24 hours, all aircraft)
Aircraft and Owner/Operator Information
Aircraft Make: AMERICAN EUROCOPTER CORP
Registration: N350LH
Model/Series: AS350B2
Aircraft Category: Helicopter
Year of Manufacture: 2013
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 7654
Landing Gear Type: Emergency Float; High Skid
Seats: 7
Date/Type of Last Inspection: 03/06/2018, 100 Hour
Certified Max Gross Wt.: 4961 lbs
Time Since Last Inspection: 14 Hours
Engines: 1 Turbo Shaft
Airframe Total Time: 5510.2 Hours at time of accident
Engine Manufacturer: Turbomeca
ELT: C126 installed, not activated
Engine Model/Series: Arriel 1D1
Registered Owner: MERIDIAN CONSULTING CORP INC
Rated Power: 712 hp
Operator: LIBERTY HELICOPTERS INC
Operating Certificate(s) Held: Certificate of Authorization or Waiver (COA); On-demand Air Taxi (135)
Operator Does Business As:
Operator Designator Code: OEMJ
Meteorological Information and Flight Plan
Conditions at Accident Site: Visual Conditions
Condition of Light: Dusk
Observation Facility, Elevation: LGA, 21 ft msl
Distance from Accident Site: 3 Nautical Miles
Observation Time: 1914 EDT
Direction from Accident Site: 88°
Lowest Cloud Condition: Scattered / 250 ft agl
Visibility: 10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 7 knots /
Turbulence Type Forecast/Actual: / None
Wind Direction: 330°
Turbulence Severity Forecast/Actual: / N/A
Altimeter Setting: 30.06 inches Hg
Temperature/Dew Point: 7°C / -6°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: KEARNY, NJ (65NJ)
Type of Flight Plan Filed: Company VFR
Destination: KEARNY, NJ (65NJ)
Type of Clearance: Traffic Advisory; VFR Flight Following
Departure Time: 1850 EDT
Type of Airspace: Air Traffic Control; Class B
Wreckage and Impact Information
Crew Injuries: 1 Minor
Aircraft Damage: Substantial
Passenger Injuries: 5 Fatal
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 5 Fatal, 1 Minor
Latitude, Longitude: 40.775556, -73.940000
