NTSB Reports On Four Recent Aviation Accidents

CESSNA T210
Clovis, New Mexico
Injuries: 1 

The private pilot reported that he departed for the local flight in the airplane with 17 gallons of fuel in the right fuel tank and 22 gallons of fuel in the left fuel tank. While he was descending the airplane through 6,500 ft mean sea level and drawing fuel from the right tank, the engine lost total power. The pilot switched to the left fuel tank, turned on the fuel pump, and engaged the engine starter in an attempt to restart the engine to no avail. The pilot subsequently conducted a forced landing, during which the airplane collided with a power line, and the left aileron and fuselage sustained substantial damage.

Examinations of the airframe, fuel system, and engine revealed no evidence of any preimpact mechanical malfunctions or failures that would have precluded normal operation, and the engine was test-run successfully. At recovery, 2 gallons of fuel were found in the left fuel tank (although a small amount had leaked from the damaged fuel drain), and 9 gallons of fuel were found in the right fuel tank. The investigation could not determine the reason for the engine power loss.

The Pilot's Operating Handbook engine restart procedures stated, in part, to select the fuller fuel tank. Given that there was adequate fuel onboard when the engine lost power, if the pilot had properly conducted the engine restart procedures by selecting the fuller fuel tank, it is possible that engine power could have been restored.

Probable cause(s): The total loss of engine power for reasons that could not be determined because examination of the engine revealed no evidence of any preimpact mechanical malfunctions or failures that would have precluded normal operation.

QUICKSILVER SPORT II
Point Mugu, California
Injuries: 1 Fatal, 1 Minor

The two pilots, who were both qualified to fly the experimental light sport airplane, were conducting a local flight with two other similar airplanes from the same flight club. After takeoff, the three airplanes proceeded to the ocean shoreline and then flew slightly offshore along the coast. The flight was conducted at a low altitude, which, once over the ocean, was about 300 ft. Soon after reaching the ocean, both pilots noted a "skip" in the engine. They decided to climb for safety and turn around to return to their departure airport. Despite moving their respective throttles to the full throttle position, neither pilot was able to obtain full power from the engine to effect a climb, and the engine rpm began slowly decreasing. Because the airplane was no longer able to maintain altitude, control of the airplane was transferred to the pilot who held a flight instructor certificate. Due to the rocky coastline and traffic on the road along that coastline, the pilots determined that they would have to ditch in the ocean. After the ditching, both pilots escaped from the airplane, and, when the airplane began to sink, they began to swim to shore, which was about 200 ft away. Neither pilot appeared injured. No personal flotation devices were aboard the airplane or worn by the pilots. One pilot successfully swam to shore, but the other pilot drowned.

The airplane washed ashore the following morning and was heavily damaged by wave action, contact with rocks, and the salt water immersion. Postaccident examination did not reveal evidence of any preaccident mechanical failures but obscuration or destruction of such evidence due to the ditching and subsequent environmental damage could not be ruled out.

The examination revealed several maintenance-related discrepancies. The type of fuel line clamps used and the installation of the fuel pumps were not in accordance with the engine manufacturer's specifications, and this could have affected fuel delivery to the carburetors. After the accident, the throttle cable was found disconnected from the cockpit control, and it could not be determined whether that was a result of a partial slippage during flight, which would have limited or eliminated pilot control of the engine rpm and power.

Although a similar airplane in the flight did not report any carburetor icing, the symptoms described by the surviving pilot were consistent with carburetor icing, and the ambient temperature and dew point values allowed for the possibility of carburetor icing. Despite such equipment being recommended by the engine manufacturer, the lack of carburetor heat provisions on the accident airplane prevented the pilots from being able to prevent carburetor icing, or counter carburetor icing if it did occur.

Finally, although the engine manufacturer specified an overhaul interval of 300 hours, the flight club elected to adhere to a 450-hour overhaul interval advocated by a repair facility that was not approved by the engine manufacturer. At the time of the accident, the engine was about 127 hours beyond the Page 2 of 4 WPR17FA146 manufacturer-recommended 300-hour overhaul interval. Although none of these discrepancies discovered during the investigation was able to be definitively linked to the accident, all were potential factors, and all were maintenance-related.

The low glide ratio of the airplane (about 5:1) limited its range in the event of a loss of engine power, reducing the forced landing site options available to the pilots. The forced landing site options were further reduced by the pilots' decision to operate at 300 ft, a very low altitude. The pilots' over-water route and low cruise altitude were reported to be common for pilots in the flight club. Even though the altitude and route combination increased the likelihood of an ocean ditching in the event of a loss of engine power, neither the pilots nor the airplane were equipped for an ocean ditching. Precautions such as higher over-water cruise altitudes and water-ditching equipment, such as personal flotation devices, may have prevented this event from becoming a fatal accident.

Probable cause(s): A partial loss of engine power for reasons that could not be determined during postaccident examination in combination with the low cruise altitude selected by the pilots, which resulted in an ocean ditching. The lack of personal flotation devices likely contributed to the drowning of one of the pilots.

BEECH 55
San Antonio, Texas
Injuries: 1 Minor

The pilot reported that, the day before the accident flight, he had flown the airplane and wanted to become more comfortable with new instruments that had been installed. So, after the flight, while in a hangar, he and a friend turned the airplane's electrical power on to familiarize the pilot with the autopilot system and specifically with how it would follow heading bug settings. During the familiarization, they "ran the [pitch] trim all the way up."

The pilot added that, before takeoff for the accident flight, he did not check the pitch trim setting because he believed it would be the same as his previous flight, instead of the pitch trim setting after his autopilot ground familiarization. He added that, during takeoff, the nose pitched up severely. He lowered the nose, and the airplane entered a negative G condition. He realized that he "did not latch the seat belt very good" and saw that his seatbelt had disconnected and that he was no longer in his seat and could not regain airplane control. The airplane struck the runway, porpoised, and the nose landing gear collapsed. The airplane skidded and struck a taxiway light.

Postaccident examination of the airplane revealed that the vertical trim tab was in the full-down position, indicating that full nose-up trim was applied.

The airplane sustained substantial damage to both engines and the fuselage.

The pilot reported that there were no preaccident mechanical failures or malfunctions with the airplane that would have precluded normal operation.

The Pilot's Operating Handbook checklist titled, "Before Takeoff," stated:

Seat Belts and Shoulder Harnesses -- CHECK! 15. Trim -- AS REQUIRED FOR TAKE-OFF

Probable cause(s): The pilot's improper takeoff trim setting and failure to properly secure his seatbelt, which resulted in a loss of airplane control. Contributing to the accident was the pilot's failure to follow the Before Takeoff checklist.

PIPER PA28
Fort Myers, Florida
Injuries: 1 Fatal, 1 Serious

The private pilot and passenger were departing on a cross-country flight. Shortly after takeoff, the engine experienced a partial loss of power and the airplane would not climb. The pilot chose to perform a forced landing to a road, during which the airplane impacted a building, then the ground; a postimpact fire ensued.

The airplane was operated by a flying club. On two separate occasions before the accident, two different pilots experienced a loss of engine power in the accident airplane. About 1 month before the accident, a pilot experienced a partial loss of engine power shortly after takeoff; he subsequently landed the airplane on the remaining runway. Following that incident, a maintenance inspection revealed no anomalies. Maintenance personnel flushed both right and left fuel tanks, installed new fuel cap seals, drained the carburetor fuel bowl, cleaned and inspected the fuel filter, and flushed the fuel lines. A subsequent test run of the engine revealed no anomalies. Another pilot reported that, about 2 weeks before the accident, while in cruise flight at 8,000 ft, the engine experienced a total loss of power. The pilot was able to restart the engine at an altitude of 3,000 ft and uneventfully performed a precautionary landing. A subsequent maintenance inspection did not reveal any anomalies. Postaccident examination of the engine did not reveal any preimpact mechanical malfunctions. Continuity of the crankshaft and camshaft were observed during manual rotation of the engine and the interiors of each cylinder revealed no anomalies.

However, postimpact fire damage precluded a thorough examination of the ignition, fuel, and induction systems, and the reason for the partial loss of engine power could not be determined based on the available information.

Probable cause(s): A partial loss of engine power during initial climb for reasons that could not be determined because extensive fire damage precluded thorough examination of the engine and its associated systems.

NOTE: The reports republished here are from the NTSB and are printed verbatim and in their complete form.