Beech 1900C accident at Quincy, Illinois, 19 Nov 1996

Accident narrative

On November 19, 1996, about 1701 central standard time, United Express flight 5925, a Beechcraft 1900C, and a Beechcraft King Air A90 collided at the intersection of two runways at Quincy Municipal Airport in Quincy, Illinois. The Beech 1900C was completing its landing roll on runway 13, and the King Air was in its takeoff roll on runway 4. Both aircraft were destroyed by the impact and postcrash fire. The two flight crewmembers and 10 passengers aboard the Beech 1900C, and the two occupants aboard the King Air, were killed.

### The flight

Flight 5925 was a scheduled passenger flight operated by Great Lakes Aviation, Ltd., doing business as United Express. The flight departed O'Hare at 1500, running 2 hours and 45 minutes late due to an earlier mechanical problem. After a stop in Burlington, Iowa, the flight departed for Quincy at 1637. The 30-year-old captain had about 4,000 hours of flight time, with 700 hours as pilot-in-command of the Beech 1900. The 24-year-old first officer had about 1,950 hours of flight time, including 800 hours as second-in-command of the Beech 1900.

The King Air A90 was operating a private flight. The 63-year-old pilot was a retired airline captain and flight instructor with 25,647.8 hours of flight time, including 22 hours in the accident airplane. The 34-year-old pilot-rated passenger was also a flight instructor, with 1,462.2 flight hours.

### The sequence of events

The collision occurred in visual meteorological conditions about 15 minutes after sunset. At 1652:07, the captain of flight 5925 announced on the Quincy common traffic advisory frequency that the airplane was about 30 miles north, planned to land on runway 13, and asked any traffic in the area to advise.

At 1655:19, a female voice from the King Air announced it was taxiing out for takeoff on runway 4. Shortly after, the pilot of a Piper Cherokee announced he was taxiing to runway 4 behind the King Air. The flight 5925 captain noted to the first officer that both airplanes were using runway 4, and they agreed to continue planning for runway 13 unless it did not look good.

At 1656:56, flight 5925 announced it was 10 miles north and entering a left base for runway 13. At 1659:03, the King Air announced it was holding short of runway 4 and would be taking the runway for departure. The Cherokee pilot later stated that the King Air pulled into position on runway 4 and held there for about one minute.

At 1659:29, flight 5925 announced it was on a five-mile final for runway 13. At 1700:16, the captain reported on short final and asked over the radio, "the aircraft gonna hold in position on runway four or you guys gonna take off?"

The King Air did not respond. Instead, at 1700:28, the Cherokee pilot transmitted that he was holding for departure on runway 4. His transmission was interrupted on the Beech 1900C's cockpit voice recorder by a ground proximity warning system alert, and ended with the words "on the uh, King Air." Believing this response came from the aircraft first in line for takeoff, the flight 5925 captain replied, "OK, we'll get through your intersection in just a second sir, we appreciate that."

The King Air began its takeoff roll about 13 seconds before flight 5925 touched down at 1700:59. No takeoff announcement from the King Air was heard by witnesses or recorded on the cockpit voice recorder. At 1701, during flight 5925's landing rollout, the two airplanes collided at the intersection.

### What the investigation found

Both airplanes came to rest with their wings interlocked along the east edge of runway 13. The impact forces were at a survivable level, and autopsies indicated that the occupants of both airplanes did not sustain blunt force trauma injuries that would have impeded their mobility. The cause of death for all occupants was determined to be inhalation of smoke, soot, and products of combustion from the postcrash fire.

The Board concluded that the speed and intensity of the fire precluded survivability for the King Air occupants, whose bodies were found behind the cockpit seats. However, witnesses who reached the Beech 1900C immediately after the collision heard sounds of life from within the cabin, and the captain spoke to them from the cockpit window, asking them to get the door open.

The Beech 1900C occupants did not escape because the air stair door and the left overwing exit hatch were not opened. The first officer's body was found between the air stair door and the forward right overwing exit, and the exterior door handle was found in the unlocked position, suggesting he had attempted to open it. Two pilots outside the airplane also attempted to open the air stair door but were unsuccessful. The Board reevaluated the factual evidence and concluded that the air stair door and the left overwing exit hatch were not opened for undetermined reasons.

The investigation found that the lack of adequate aircraft rescue and firefighting services contributed to the severity of the accident. Quincy Municipal Airport had a rescue truck, but it was not staffed at the time because regulations only required staffing for air carrier aircraft with more than 30 passenger seats. The Beech 1900C had 19 passenger seats. The Quincy Fire Department arrived 14 minutes after the collision. The Board concluded that if the on-airport truck had been staffed, it could have reached the scene in no more than one minute, and lives might have been saved.

The Board continues to believe that the Beech 1900C flightcrew made appropriate efforts to coordinate the approach and landing. However, they mistook the Cherokee pilot's transmission as a response from the King Air, mistakenly believing the King Air would hold. The Board noted that the Cherokee pilot's transmission was unnecessary and inappropriate.

The Board concluded that the occupants of the King Air did not hear the transmissions from flight 5925, likely because they did not properly configure their radio receiver or were preoccupied, distracted, or inattentive. A visibility study indicated that while the King Air's cockpit side posts would have partially or momentarily obstructed the view of the landing Beech 1900C, the King Air occupants could have seen the airplane if they had moved their heads and bodies while scanning. The Board concluded they were inattentive to or distracted from their duty to see and avoid other traffic.

### Probable cause

The National Transportation Safety Board determined that the probable cause of this accident was the failure of the pilots in the King Air A90 to effectively monitor the common traffic advisory frequency or to properly scan for traffic, resulting in their commencing a takeoff roll when the Beech 1900C (United Express flight 5925) was landing on an intersecting runway.

Contributing to the cause of the accident was the Cherokee pilot's interrupted radio transmission, which led to the Beech 1900C pilots' misunderstanding of the transmission as an indication from the King Air that it would not take off until after flight 5925 had cleared the runway.

Contributing to the severity of the accident and the loss of life were the lack of adequate aircraft rescue and firefighting services, and the failure of the air stair door on the Beech 1900C to be opened.