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NTSB Report
February 28, 1987 · British Aerospace BA146-200A · N356PS
Fresno, CA
Overview
Report Status
Probable Cause
Event Type
Accident
Date
February 28, 1987
Injury Outcomes
No injuries (87 uninjured)
Location
Fresno, CA
Aircraft
British Aerospace BA146-200A
Tail Number
N356PS
Operator
Pacific Southwest Airlines
Injuries
None
Aircraft Damage
Substantial
NTSB Number
LAX87FA128
THE FLIGHT WAS UNEVENTFUL DURING TAKEOFF AND CLIMB TO AN ASSIGNED CRUISE ALTITUDE OF FL260. APPROXIMATELY 40 MINUTES AFTER TAKEOFF THE NUMBER 3 ENGINE EXPERIENCED AN UNCONTAINED FAILURE OF THE TURBINE BLADES ON THE NUMBER 4 POWER TURBINE WHEEL. ALTHOUGH DEBRIS FROM THE ENGINE PENETRATED THE PRESSURE VESSEL, THE PILOT MADE AN UNSCHEDULED LANDING AT AN AIRPORT WITHOUT FURTHER INCIDENT. EXAMINATION OF THE ENGINE REVEALED THAT FERROUS CHIPS WERE CONTAMINATING, AND OIL WAS BYPASSING THE ENGINE OIL FILTER FOR AT LEAST 40 DAYS. HOWEVER, NO CORRECTIVE ACTION WAS TAKEN BY COMPANY MAINTENANCE PERSONNEL. THE OIL AND FILTER WERE CHANGED THREE TIMES IN THE THREE MONTHS PREVIOUS TO THE ACCIDENT. THE EXAM REVEALED THAT THE CONTAMINATED OIL CONTRIBUTED TO THE FAILURE OF THE NUMBER FOUR TURBINE BEARING SUBSEQUENTLY LEADING TO OVERHEATING AND DAMAGE TO THE OVERSPEED SENSORS. THE TURBINE OVERSPED AND THE TURBINE BLADES DEPARTED THE TURBINE DISC.
NTSB Probable Cause
FAILURE OF COMPANY MAINTENANCE PERSONNEL TO ADEQUATELY EXAMINE THE ENGINE LUBRICATION SYSTEM WHEN CONTAMINATION WAS DETECTED.
Full Narrative
THE FLIGHT WAS UNEVENTFUL DURING TAKEOFF AND CLIMB TO AN ASSIGNED CRUISE ALTITUDE OF FL260. APPROXIMATELY 40 MINUTES AFTER TAKEOFF THE NUMBER 3 ENGINE EXPERIENCED AN UNCONTAINED FAILURE OF THE TURBINE BLADES ON THE NUMBER 4 POWER TURBINE WHEEL. ALTHOUGH DEBRIS FROM THE ENGINE PENETRATED THE PRESSURE VESSEL, THE PILOT MADE AN UNSCHEDULED LANDING AT AN AIRPORT WITHOUT FURTHER INCIDENT. EXAMINATION OF THE ENGINE REVEALED THAT FERROUS CHIPS WERE CONTAMINATING, AND OIL WAS BYPASSING THE ENGINE OIL FILTER FOR AT LEAST 40 DAYS. HOWEVER, NO CORRECTIVE ACTION WAS TAKEN BY COMPANY MAINTENANCE PERSONNEL. THE OIL AND FILTER WERE CHANGED THREE TIMES IN THE THREE MONTHS PREVIOUS TO THE ACCIDENT. THE EXAM REVEALED THAT THE CONTAMINATED OIL CONTRIBUTED TO THE FAILURE OF THE NUMBER FOUR TURBINE BEARING SUBSEQUENTLY LEADING TO OVERHEATING AND DAMAGE TO THE OVERSPEED SENSORS. THE TURBINE OVERSPED AND THE TURBINE BLADES DEPARTED THE TURBINE DISC.
Flight
Event TypeAccident
Event Time20:00 PST
Nearest AirportFresno Air Terminal (0nm N)
Runway11L
Runway Length9218 ft
Runway Width150 ft
Flight Plan FiledIFR
Aircraft FireNo
Aircraft ExplosionNo
Aircraft
AircraftBritish Aerospace BA146-200A
Tail NumberN356PS
Aircraft CategoryAir
DamageSubstantial
OperatorPacific Southwest Airlines
Operating RulePart 121
Engines4
Engine TypeTurbofan
Engine DetailsLycoming · ALF502R-5 · Turbofan · 6970
Seats109
People & Injuries
Injury SummaryNo injuries (87 uninjured)
Fatal0
Serious0
Minor0
Uninjured87
Total87
Crew 1Age 42 · First Class
Conditions
ConditionsVMC
LightBright Night
Wind10° @ 5 kt
Visibility10 sm
CeilingNone
Temperature / Dew Point52 / 34 C
Altimeter30.00 inHg
Observation Time03:50
Weather SourceWFAC