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Accidents · NTSB LAX04FA113 · Final report

Cessna 414A accident near Laupahoehoe, Hawaii, January 31, 2004

On January 31, 2004 at about 11:40 am local time, a Cessna 414A, registered N5637C, was destroyed in an accident near Laupahoehoe, Hawaii. It was a positioning flight under general aviation rules (Part 91). 3 people were killed. The weather was instrument conditions (cloud, fog or low visibility).

The NTSB's probable cause their words, unchanged

the pilot's disregard for an in-flight weather advisory, his likely encounter with marginal VFR or IMC weather conditions, his decision to continue flight into those conditions, and failure to maintain an adequate terrain clearance altitude resulting in an in-flight collision with trees and mountainous terrain. A contributing factor was the pilot's failure to adhere to the VFR weather minimum procedures in the company's Operations Manual.

Source: NTSB aviation accident database, copy made October 5, 2026. Docket and reports at the NTSB.

What the record shows

Date
January 31, 2004 · about 11:40 am local time
Place
Laupahoehoe, Hawaii · map
Type
Accident
Injuries
3 people were killed.
Weather
instrument conditions (cloud, fog or low visibility)
Aircraft
Cessna 414A · all 414As on the register
Registration
N5637C · no longer on the register · serial 414A0118
Damage
Destroyed
Flight
Positioning flight · general aviation rules (Part 91)

The NTSB's narrative final · quoted from the NTSB record

The airplane collided with trees and mountainous terrain at the 3,600-foot-level of Mauna Kea Volcano during an en route cruise descent toward the destination airport that was 21 miles east of the accident site. The flight departed Honolulu VFR at 0032 to pickup a patient in Hilo, on the Island of Hawaii. The inter island cruising altitude was 9,500 feet and the flight was obtaining VFR flight advisories. At 0113, just before the flight crossed the northwestern coast of Hawaii, the controller provided the pilot with the current Hilo weather, which was reporting a visibility of 1 3/4 miles in heavy rain and mist with ceiling 1,700 feet broken, 2,300 overcast. Recorded radar data showed that the flight crossed the coast of Hawaii at 0122, descending through 7,400 feet tracking southeast bound toward the northern slopes of Mauna Kea and Hilo beyond. The last recorded position of the aircraft was about 26 miles northwest of the accident site at a mode C reported altitude of 6,400 feet. At 0130, the controller informed the pilot that radar contact was lost and also said that at the airplane's altitude, radar coverage would not be available inbound to Hilo. The controller terminated radar services. A witness who lived in the immediate area of the accident site reported that around 0130 he heard a low-flying airplane coming from the north. He walked outside his residence and observed an airplane fly over about 500 feet above ground level (agl) traveling in the direction of the accident site about 3 miles east. The witness said that light rain was falling and he could see a half moon, which he thought provided fair illumination. The area forecast in effect at the time of the flight's departure called for broken to overcast layers from 1,000 to 2,000 feet, with merging layers to 30,000 feet and isolated cumulonimbus clouds with tops to 40,000 feet. It also indicated that the visibility could temporarily go below 3 statute miles. The debris path extended about 500 feet along a magnetic bearing of 100 degrees with debris scattered both on the ground and in tree branches. Investigators found no anomalies with the airplane or engines that would have precluded normal operation. Pilots for the operator typically departed under VFR, even in night conditions or with expectations of encountering adverse weather, to preclude ground holding delays. The pilots would then pickup their instrument flight rules (IFR) clearance en route. The forecast and actual weather conditions at Hilo were below the minimums specified in the company Operations Manual for VFR operations.

The complete narrative as the NTSB published it. The NTSB's docket holds the report as a PDF and any photographs, statements and other documents from the investigation.

The factual record from the NTSB's investigation tables, in plain English

Pilot

  • Certificate: airline transport pilot, commercial pilot
  • Ratings: multi-engine land; single-engine land; instrument: airplane
  • Flight time: 8,230 hours in all; 1,037 in this make and model; 110 in the last 90 days; 30 in the last 30 days; 8,145 as pilot in command
  • Last flight review: December 1, 2003
  • Medical certificate: Class 1 (valid medical--no waivers/lim.)
  • Seat: left
  • Injury: fatal

The aircraft

  • Airframe total time: 11,899 hours
  • Last inspection: approved inspection programme, January 1, 2004; 39 hours since
  • Maximum gross weight: 7,085 lb
  • Seats: 6
  • Landing gear: retractable
  • Engine 1: Teledyne Continental TSIO-520-NB (piston); 0 hours total
  • Engine 2: Teledyne Continental TSIO-520JC-NB (piston); 0 hours total
  • Fire on the ground
  • Operator: Hawaii Air Ambulance

The flight

  • Departed from: HNL Honolulu HI at 10:32 am
  • Destination: ITO Hilo HI
  • Flight plan: VFR

Weather at the time

  • Light: night
  • Wind: from 260° at 8 knots
  • Visibility: 2.5 statute miles
  • Sky: broken clouds at 1,800 ft; scat at 1,300 ft
  • Temperature: 66°F (19°C), dew point 64°F (18°C)
  • Altimeter: 30.03 inHg
  • Observation at 11:31 am from PHTO, 21 miles away

Injuries

FatalSeriousMinorNone
Crew1
Passengers2

Documents from the investigation the NTSB's docket: the evidence folder behind the report

The docket, the folder of records gathered during an investigation (maintenance records, photographs, witness statements, examinations), has not been read from the NTSB for this case yet; the list appears here once it has. Open the docket at the NTSB.

Everything on this page comes from the NTSB's public records. The narrative, probable cause and findings are the NTSB's own words; the coded tables behind the report are written out in plain English, with pilots' ages, home towns and medical details left out. The documents and photographs are the NTSB's docket, shown as the NTSB released them. This site's own text never names anyone involved. A preliminary report can change; the final report usually follows one to two years later, and the page is refreshed when it does.