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NYC06MA005 · Augusta 109E

7 Oct 2005 · Smethport, PA, United States

Augusta 109E · Accident: loss of control in flight on approach

From UPMC Kane Heliport (PA91) to Bradford Regional Airport (BFD)

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Event

NTSB case
NYC06MA005
Event typeAccident: someone killed or seriously injured, or the aircraft substantially damaged (NTSB definition). Incident: an occurrence that affected or could have affected safety, short of that. Glossary
Accident
InvestigationHow far the investigation had got when the record was published: preliminary, ongoing, final or completed. Unknown where the source does not say. Glossary
Completed
API-reported fatalities
1 · all aircraft and ground
Ground fatalities
Unknown
OperationWhat kind of flying it was, grouped by the rules it flew under: airline (US Part 121), air taxi and commuter (Part 135), general aviation (Part 91 and similar), military or government. Glossary
General aviation
WeatherVisual meteorological conditions (VMC): good enough to fly by looking outside. Instrument conditions (IMC): cloud or low visibility, flying by instruments. Glossary
Instrument Meteorological Cond

Augusta 109E

Aircraft type
Augusta 109
Category
Helicopter
RegistrationThe aircraft's tail number, such as N12345 or G-ABCD. Registrations are reissued, so the same one years apart can be a different aircraft. Glossary
N7YL
Operator
Unknown
Onboard fatalities
Unknown
Route
From UPMC Kane Heliport (PA91), Kane, PATo Bradford Regional Airport (BFD), Bradford, PA
Aircraft age
Not recorded
Flight rulesThe regulations the flight operated under: in the US, Part 91 (general aviation), Part 121 (airlines), Part 135 (air taxi and commuter) and others; for flights abroad, the NTSB's coarser commercial or non-commercial code. Glossary
Part 91: General Aviation
Phase of flightThe stage of the flight when things started to go wrong: standing, taxi, takeoff, initial climb, en route, maneuvering, approach or landing. Glossary
Approach · IFR initial approach
First occurrenceThe single coded event the NTSB judges best describes what happened (records from 2008 on). Older records name the first occurrence in the sequence instead. Glossary
Loss of control in flight
Also codedOther events the NTSB coded in the sequence, such as a wire strike after a loss of power. Flight Findings uses them for its kinds of event. Glossary
Tree(s)
DamageDestroyed: beyond practical repair. Substantial: damage that affects the structure, performance or handling and normally needs major repair. Minor: less than that. Glossary
Destroyed

Cause areas

  • Atc personnel(artcc) › Communications/information/atc, improper
  • Pilot in command › Aircraft control, not maintained
  • Pilot in command › Spatial disorientation

Approximate · Coordinates from the NTSB case API, which marks them as estimated or does not say; no uncertainty radius is established.

NTSB narrative

The single-pilot helicopter was flying under instrument flight rules in night instrument meteorological conditions. The controller instructed the pilot to fly heading 340 degrees to intercept the localizer course for an instrument landing system approach. At that time, the helicopter was about 1.5 miles from the localizer centerline, headed 095 degrees, about 150 knots groundspeed. Consequently, the helicopter flew through and ended up well east of the 322-degree localizer course. During the resulting 135-degree turn to rejoin the final approach course, the pilot was issued an approach clearance, but told to "maintain 4,000." The helicopter's track approached the runway centerline, and then turned sharply away from, and to the right of the inbound course. The track showed an approximate heading of 100 degrees, when the radar target disappeared. During the 1 minute and 10 seconds following the pilot's acknowledgement of the 4,000-foot altitude assignment, the helicopter descended only 300 feet, slowed to approximately 65 knots groundspeed, and turned 140 degrees right of course. At the point where the helicopter re-intercepted the localizer, the autopilot was capable of capturing the localizer, but incapable of capturing the glideslope. If altitude hold remained engaged at that point of the flight, and the pilot reduced collective to initiate a descent, the autopilot would adjust pitch in an effort to maintain the selected altitude. Similar scenarios in helicopters and flight simulators have resulted in unusual attitudes and zero airspeed descents to the ground. The pilot had accrued 9,616 total hours of flight experience. He had 100 total hours of instrument flight experience; of which 10 hours was simulated instrument flight experience. Examination of the wreckage revealed no mechanical anomalies. Examination of voice communication tapes revealed that the controller used non-standard approach clearance procedures, did not comply with requirements for weather dissemination, and did not comply with the appropriate intercept angle of 45 degrees for helicopters as prescribed in Federal Aviation Administration orders.

Probable cause

The pilot's failure to maintain aircraft control. Factors in the accident were, night instrument meteorological conditions, pilot workload, and improper air traffic control procedures by the approach controller.

Verbatim NTSB analysis and probable cause from the NTSB dataset

Sources

NTSB record NYC06MA005
Event ID
20051023X01707
Case number
NYC06MA005
Dataset
historical-pre2008
Source SHA-256
89e2df6d848e7ab3b42e7d7c7a03ff403303057a26ca04c95b3ea67201c3ce74
Source notes (4)
  • Unreviewed is an editorial label, not an investigation status. API-sourced is not report-checked or human-reviewed. Explicit event totals are used without summing aircraft injury tables; onboard allocation is withheld. Unknown values remain unknown. The operation category is mapped from the NTSB-reported FAR part and has not been reviewed.
  • Filled from the NTSB case API where the bulk record had no value: local date, investigation status, coordinates. Values present in the bulk record are kept.
  • The date is the local date; the NTSB stores the UTC date 2005-10-08.
  • API snapshot SHA-256: 556460f9923b00eafa38c6db928fde559263e2de8fa5ab85470de00a6fa47455; retrieved 2026-09-20T17:50:18.142Z.