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Atlas / NTSB / SEA91FA143

NTSB CAROL · Event

Event SEA91FA143

1991-06-27 INDEX, Washington, United States Serious 1 aircraft Status: Completed

Aircraft involved

Probable cause & findings

THE CONTROL INTERFERENCE BY THE MECHANIC WHEN HE INADVERTENTLY RAISED THE COLLECTIVE PITCH AND THE COPILOT'S FAILURE TO ATTEND THE FLIGHT CONTROLS. FACTORS RELATING TO THE ACCIDENT WERE THE MOTION SICKNESS OF THE MECHANIC, INADEQUATE COLLECTIVE PITCH CONTROL LOCKING MECHANISM UTILIZED BY THE COMPANY, AND ADMINISTRATIVE TASKS THAT DIVERTED THE CO-PILOT'S ATTENTION FROM ATTENDING THE FLIGHT CONTROLS.

Factual narrative

THE ACFT WAS ON AN EXTERNAL LOAD LOGGING OPN AND THE PIC HAD LANDED AT A FIELD SITE TO REFUEL. THE PIC EXITED, WITH THE ACFT RUNNING AT FULL RPM WHILE IT WAS BEING REFUELED, AND THE COPILOT REMAINED IN THE RIGHT SEAT COMPLETING LOAD REPORTS. THE ACFT CONTROLS WERE UNATTENDED. THE CREW CHIEF WAS SEATED IN THE AFT FACING HOIST OPR STATION, WHICH HAD THE COLLECTIVE PITCH STICK INSTALLED BESIDE THE SEAT. HE HAD BECOME AIR SICK DURING THE FLT, AND REMAINED SEATED AFTER THE PIC EXITED. WHEN HE ATTEMPTED TO EXIT, WHICH REQUIRED THAT HE STAND, TURN AROUND AND STEP UP OUT OF THE SEAT WELL, THE ACFT TOOK OFF TO A HOVER AND ROTATED TO THE LEFT. THE TAIL ROTOR STRUCK A ROTOR BLADE BOX ON TOP OF A SUPPORT TRAILER PARKED BY THE REFUELING SITE, FRACTURING THE AFT TAIL BOOM, PYLON AND TAIL ROTOR FROM THE ACFT. THE ACFT PITCHED NOSE DOWN, ROLLED OVER AND IMPACTED THE GROUND. Source: NTSB Aviation Accident Database (Pre-2008 Archive) Retrieved: 2026-02-12

Verbatim from NTSB's published report. Source file NTSB_1991_SEA91FA143.txt. Findings + structured fields enriched from FAA avall.mdb. Full investigation docket on data.ntsb.gov ↗.

Related research

What the literature says.

Academic papers and agency reports matching this event's aircraft type or causal vocabulary (stall). Sourced from NASA NTRS, NTSB Safety Studies, FAA CAMI, AOPA Air Safety Institute, Embry-Riddle Scholarly Commons, arXiv, and the Semantic Scholar academic graph.

Browse the full corpus — academia portal ↗