1947 — June 13, Pennsylvania-Central Air Flight 410 too-low crash ~Lookout Rock, WV–50

Compiled by Wayne Blanchard 10-13-2023 for upload to: https://www.usdeadlyevents.com/

—  50  Aviation Safety Network. Accident Description, Pennsylvania-Central Airlines Flight 410

—  50  Baugher, Joseph F.  1942 USAAF Serial Numbers (42-30032 to 42-39757). 8-26-2011 rev.

—  50  CAB. AIR. Pennsylvania-Central Airlines Corp., Lookout Rock, WV – June 13, 1947.

Narrative Information

Baugher: “Douglas C-54 Skymaster….32937 (c/n 3112) to civil registry as N88842 (Capital Airlines).  Crashed near Lookout Rock, WV Jun 13, 1947 with Pennsylvania Central Airlines on flight  from Pittsburgh to Washington DC.  Struck a ridge in the Blue Ridge Mountains at 1425 foot elevation.  All 50 onboard killed.” (Baugher, Joseph F.  1942 USAAF Serial Numbers (42-30032 to 42-39757). 8-26-2011 rev.)

Civil Aeronautics Board, Accident Investigation Report:

“The Accident

“Pennsylvania-Central Airlines Flight 410, NC 88842, crashed near a point known as Lookout Rock, West Virginia, approximately 8 miles Southeast of Charles Town, West Virginia, at approximately 1816 EST, 1 June 13, 1947, while enroute from Pittsburgh, Pennsylvania, to Washington, D C All 50 occupants of the aircraft were killed at impact and the Douglas DC-4 was demolished as a result of the crash and subsequent fire.

“History of the Flight

“Flight 410 departed Chicago, Illinois, at 1352, June 13, 1947, on an instrument flight plan with its destination Norfolk, Virginia, and with stops scheduled at Cleveland, Ohio, Pittsburgh and Washington. While enroute to Cleveland at 7,000 feet, the flight reported that a delay would be necessary because it was attempting to circumnavigate a thunderstorm in the vicinity of Gosen, Indiana. Approximately 15 minutes later a message was again received from the flight indicating that it was not able to circumnavigate the storm and requesting clearance to proceed under it according to contact flight rules. Thes request was approved by Chicago Airway Traffic Control on the condition that Flight 410 was able to proceed according to contact flight rules (CFR) at an altitude of 2,000 feet. Having received this amended clearance, Flight 410 continued underneath the thunderstorm and arrived at Cleaveland at 1604, the flight having consumed 47 minutes originally estimated by the crew. The flight from Cleveland to Pittsburgh was routine.

“The flight departed Pittsburgh at 1724 and at 1753, 29 minutes later, reported over the Flintstone Intersection, 88 miles southeast of Pittsburgh, at 7,000 feet. At 1754 the flight received a message from Washington Airway Traffic Control clearing it to the Herndon Fan Marker to maintain 7,000 feet until further advised. The flight was also instructed that there would be an indefinite delay at Herndon but that approach clearance could be expected no later than 1930, which was approximately one hour and 10 minutes later than its estimated time of arrival. Immediately after receiving this message the flight was given the 1730 hourly weather sequence report for Washington. After acknowledging receipt of the Washington weather report, Flight 410 instructed the company station at Washington to request from Airway Traffic Control a clearance to approach Washington in accordance with contact flight rules on the right side of the west leg of the Arcola radio range. This request was approved by Airway Traffic Control and at 1803 the flight received a message clearing it to the Washington tower to cross the Arcola radio range station at or below 2,500 feet and in accordance with contact flight rules. The flight was advised that if this were not possible it was to hold at 2,500 feet and so to inform Airway Traffic Control.

“Prior to establishing its descent the flight was instructed to report when leaving each 1,000-foot level. In accordance with these instructions Flight 410 reported leaving the 7,000-foot level at 1805 and two minutes later another report was received from the flight indicating it was leaving 6,000 feet. The flight reported its position as ‘south of Martinsburg’ at 1808 and immediately thereafter reported that it was leaving 5,000 feet at that time. At 1810 another report was received from the flight, ‘leaving 4,000 feet.’ Three minutes thereafter the flight again reported its progress and indicated it was leaving 3,000 feet. Approximately 6 minutes later the company station at Washington initiated several calls to the flight but, although these transmissions were continued for several hours, no contact was established.

“Investigation

“Subsequent investigation disclosed that the aircraft had struck a ridge in the Blue Ridge Mountains approximately two miles east of the Shenandoah River…at an elevation of approximately 1,425 feet. The aircraft had struck the broken rock formation with severe impact force in an attitude which was laterally level and in an angle of descent of 2½  degrees. The terrain at the scene of the accident slopes upward toward the east at an angle of approximately twenty degrees, the elevation of the crest of the ridge being approximately 225 feet higher than the scene of the accident….

“Inspection of the wreckage indicates that both the flaps and the under carriage were retracted at the time of impact. All control surfaces were accounted for at the scene of the accident, and no failure or malfunctioning of the control systems was disclosed. The damage sustained by the engine and propellers indicated that all four engines were developing considerable power at impact. The settings of the aircraft altimeters were within one-hundredth of an inch of an inch of the altimeter setting of Washington National Airport which at the time was 29.95 inches of mercury.…

“Discussion

“Inherent difficulties exist in determining the probable cause of accidents of this character. In a collision with terrain in full flight normally all occupants of the aircraft are killed upon impact, the aircraft itself is usually demolished and fire ensues. But the examination made by the Board, though it may leave ‘probable’ cause to some surmise, has brought forth matters of considerable moment.

“This accident, as many others, had a final concluding cause but the chain of causation which enabled the final unfortunate event to occur reaches far back. The first of these that can be noted inheres in certain aspects of the existing system of airway traffic control. 

“It will be noted that Airway Red 61 was approved for use by the Civil Aeronautics Administration without any publication of a minimum altitude for flight under instrument conditions. Indeed, the whole subject of what are minimum altitudes and who prescribes them was in considerable confusion at the time of the accident. This is evidenced by the fact that a number of witnesses from the Airway Traffic Control Section of the Civil Aeronautics Administration were unable to state who, if anyone, prescribes such minimum altitudes and what effect follows upon their establishment.

“The basic minimum altitude for all flying under instrument conditions over all terrain on or off any civil airway is established at 1,000 feet above terrain by Civil Air Regulation 60 23. This requirement will, of course, provide no uniform flight level over any particular route since the height of the terrain will vary. In the Airman’s Guide minimum altitudes for most routes are published, but these minimum altitudes are merely advisory and flight below those altitudes as long as it is 1,000 feet above terrain violates no regulation.

“Meanwhile the companies, for operational purposes, establish their own minimum altitudes. The procedure for doing this, thou it does not seem wholly uniform, is to set forth these minimums in the company’s operating manuals and not in the operating certificates. Minimums governing landings and take-offs, however, are included in the company’s operating certificates. The consequences of this differentiation seem, at least, two (a) operating certificates are ‘approved’ by the Civil Aeronautics Administration, operations manuals, though they may be scrutinized by the Civil Aeronautics Administration, are not ‘approved,’ and (b) departure from the operating certificate is a violation of the Civil Air Regulations involving legal consequences, departure from the operations manual of itself is not a ‘violation,’ whatever disciplinary action the company may take against its personnel for such departures….

“This series of events involves matters for criticism of three parties. In the first place, the pilot in asking for this clearance was asking for something in violation of company rules. The use of the Arcola range had not been authorized by the company, nor had the pilot been qualified to fly it. However, it must be recognized that in view of the pilot’s exceptionally long experience over this area such lack of qualification is only a technicality. In the second place, the company dispatcher, whose business it is to supervise matters of this character, was totally unconversant with the fact that the Arcola range had not been approved for use by the company and that the pilot had not been qualified to fly it. As a matter of practice, air traffic control clearances are delivered by the company communication station to the pilot and the company dispatcher simultaneously. In this instance the dispatcher raised no question as to the propriety of the captain’s request for the clearance nor to the appropriateness of the provisions of the clearance provided by Airway Traffic Control.

“In the third place, the clearance was faulty for many reasons. Under existing instructions Airway Traffic Control is not authorized to give a pilot a clearance below minimums unless requested by the pilot and the pilot must then be advised that the clearance is below the minimum. The minimum that Airway Traffic Control must use is the minimum established by the company. But if no such minimum has been established or is readily available, the controller shall use the minimum published in the Airman’s Guide. If neither of these minimums is available the rule is unclear as to what should be done but in any event CAR 60 establishes the lowest possible minimum.

“An examination of the clearance shows that no request for a clearance beneath minimums was ever made by the pilot. All he asked for was a contact clearance. Again, the pilot was never advised that the clearance was below minimums. The clearance was below any standard of a minimum for this airway….

“The clearance, in short, authorized the pilot who was then on instruments to descend below 3,000 feet to 2,500 feet or below in order to make contact and go into Washington contact. The clearance, moreover, in essence invited such a maneuver….The clearance thus was faulty and should never have been offered by the controller nor accepted y the pilot.

“But the clearance though clearly a contributing cause was not the eventual cause of the accident. It is the pilot’s ultimate responsibility so to operate his aircraft, whatever clearance he receives, to avoid collision with terrain The pilot of this aircraft was familiar with the general characteristics of the terrain between Martinsburg and Washington. Nevertheless he was flying at an elevation of 1,425 feet over terrain that at points rose to greater heights….

“The fact remains that the pilot exercised poor judgment in attempting to conduct the flight between Martinsburg and Arcola at an altitude less than 3,000 feet. He was clearly prompted by the desire to come into contact and thus avoid the delay that would be occasioned by having to hold either over Herndon or Arcola. It is patent that he did not establish contact at 3,000 feet, for even though he may have had occasional vertical reference to the ground, he could hardly have had any forward visibility. The testimony of the witnesses indicates clearly that  the aircraft subsequently passed intermittently through low clouds at an altitude below the crest of the ridge and that, immediately before impact, it entered a dense cloud covering the top of the ridge….

“Findings

….

“8. The existing company enroute minimum altitude between Martinsburg and Herndon is 3,000 feet for both instrument and contact flight.

“9. No enroute minimum altitude between Martinsburg and Arcola had been published in the Airman’s Guide before the route was put into operation.

“10. The company had not authorized operations on the Martinsburg-Arcola route, nor published any minimum altitudes governing it.

“11. The pilot requested a clearance on the Arcola range contrary to established company operating procedures.

“12. The company dispatcher made no effort to determine whether the clearance that was requested and the clearance that was given was in accordance with company procedures.

“13. The clearance given was not in accordance with instructions then governing Airway Traffic Control….

“16. After entering a cloud which covered the top of the ridge, the aircraft crashed at an elevation of approximately 1,425 feet near a point known as Lookout Rock, West Virginia, and was demolished by impact and subsequent fire.

“17. The aircraft struck the ground in an attitude which was laterally level and in a slight descent.

“18. No malfunctioning of the primary aircraft structure, the control system, or the power plants occurred prior to impact….

“Probable Cause

“The Board finds that the probable cause of this accident was the action of the pilot in descending below the minimum en route altitude under conditions of weather which prevented adequate visual reference to the ground. A contributing cause was the faulty clearance given by Airway Traffic Control, tacitly approved by the company dispatcher, and accepted by Flight 410. 

Corrective actions:

“The Administrator of Civil Aeronautics called a conference of all airlines and of his regional personnel in order to establish enroute cruising altitudes and initial approach altitudes which are completely uniform for all air carriers throughout the United States.

“The Administrator of Civil Aeronautics has issued appropriate instructions to Civil Aeronautics Administration personnel prohibiting the issuance of Airway Traffic Control clearances below established minimums.”  (CAB. AIR. Pennsylvania-Central Airlines Corp., Lookout Rock, WV – June 13, 1947.)

Sources

Aviation Safety Network, Flight Safety Foundation, Database, 1947. Pennsylvania-Central Airlines Flight 410 crash into Lookout Rock Ridge, 13 June 1947. Accessed 10-13-2023 at: https://aviation-safety.net/database/record.php?id=19470613-0

Baugher, Joseph F. 1942 USAAF Serial Numbers (42-30032 to 42-39757). Aug 26, 2011 revision. Accessed 12-14-2011 at:  http://www.joebaugher.com/usaf_serials/1942_2.html

Civil Aeronautics Board. Accident Investigation Report. Pennsylvania-Central Airlines Corp., Lookout Rock, West Virginia – June 13, 1947. Washington, DC: CAB, November 19, 1947. Accessed 10-13-2023 at:   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjJ9pXQ8POBAxXxFlkFHfYGDZkQFnoECCsQAQ&url=https%3A%2F%2Frosap.ntl.bts.gov%2Fview%2Fdot%2F33306%2Fdot_33306_DS1.pdf&usg=AOvVaw0bhdIe5_ACA3_-Rv9yFaUW&opi=89978449