Friday, February 24, 2017

Bellanca 17-30A Super Viking, N6629V: Fatal accident occurred November 30, 2014 near Jesse Viertel Memorial Airport (KVER), Boonville, Missouri

Aviation Accident Final Report - National Transportation Safety Board: https://app.ntsb.gov/pdf 

NTSB Identification: CEN15FA060
14 CFR Part 91: General Aviation
Accident occurred Sunday, November 30, 2014 in Boonville, MO
Probable Cause Approval Date: 03/08/2017
Aircraft: BELLANCA 17-30A, registration: N6629V
Injuries: 1 Fatal, 3 Serious.

NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

The commercial pilot was on a cross-country flight when the airplane encountered deteriorating weather conditions. A surviving passenger reported that the pilot decided to divert to a nearby airport. The airplane experienced a loss of engine power in the airport traffic pattern shortly after the pilot extended the landing gear during the base-to-final turn. The pilot was able to restore engine power briefly by advancing the throttle, but the engine quickly experienced a total loss of power. The passenger stated that the airplane entered an aerodynamic stall about 250 ft above the ground. The airplane subsequently impacted terrain in a near-level attitude. The pilot likely failed to maintain adequate airspeed following the loss of engine power, which resulted in the airplane exceeding its critical angle of attack and a subsequent aerodynamic stall at a low altitude.

A postaccident examination did not reveal any mechanical malfunctions that would have precluded normal engine operation; however, the right main fuel tank was void of any usable fuel, and the left main fuel tank contained about 1.5 gallons of usable fuel. Additionally, no fuel was recovered from the supply line connected to the fuel manifold valve, and only trace amounts of fuel were recovered from the engine-driven fuel pump outflow line. A first responder reported that the main fuel selector was positioned to draw fuel from the auxiliary fuel tanks. Although placarded for use during level flight only, both auxiliary fuel tanks contained sufficient fuel to maintain coverage over their respective outlet ports during maneuvering flight, and would have provided fuel to the engine. As such, it is likely that the main fuel selector was positioned to draw fuel from the right main fuel tank when the airplane initially experienced a loss of engine power due to fuel starvation. The pilot then likely switched to the right auxiliary fuel tank while attempting to restore engine power; however, there was likely insufficient time and altitude to re-establish fuel flow to the engine.

Although the airplane had experienced an alternator malfunction during the previous flight, a possible charging system failure would not have affected engine operation during the accident flight. 

The National Transportation Safety Board determines the probable cause(s) of this accident as follows:
The pilot's failure to maintain adequate airspeed during a forced landing following a total loss of engine power due to fuel starvation, which resulted in the airplane exceeding its critical angle of attack, and an aerodynamic stall at a low altitude. Contributing to the accident was the pilot’s improper fuel management.

Charles K. Sojka is seen here in front of a Piper Cherokee in an old photo of the Woodward Airport. He was a Woodward native and a 1969 graduate of Woodward High School. He was a life-long pilot, flight instructor and Director of Maintenance for the Aviation Department at Kansas State University, Salina. Sojka was killed on November 30th, 2014 in a Bellanca 17-30A Super Viking plane crash in Boonville, Missouri.



The National Transportation Safety Board traveled to the scene of this accident. 

Additional Participating Entities: 
Federal Aviation Administration / Flight Standards District Office; Kansas City, Missouri
Continental Motors, Inc.; Mobile, Alabama

Aviation Accident Factual Report - National Transportation Safety Board:  https://app.ntsb.gov/pdf

Docket And Docket Items - National Transportation Safety Board: https://dms.ntsb.gov/pubdms

https://registry.faa.gov/N6629V

NTSB Identification: CEN15FA060 
14 CFR Part 91: General Aviation
Accident occurred Sunday, November 30, 2014 in Boonville, MO
Aircraft: BELLANCA 17-30A, registration: N6629V
Injuries: 1 Fatal, 3 Serious.

NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

HISTORY OF FLIGHT

On November 30, 2014, about 0857 central standard time (CST), a Bellanca model 17-30A single-engine airplane, N6629V, was substantially damaged when it collided with terrain during landing approach to runway 36 at Jesse Viertel Memorial Airport (VER), Boonville, Missouri. The commercial pilot was fatally injured and his three passengers were seriously injured. The airplane was registered to and operated by the pilot under the provisions of 14 Code of Federal Regulations Part 91 without a flight plan. Day marginal visual meteorological conditions prevailed for the cross-country flight that departed Spirit of St. Louis Airport (SUS), Chesterfield, Missouri, about 0740, and was originally destined for Charles B. Wheeler Downtown Airport (MKC), Kansas City, Missouri.

The day preceding the accident, the pilot had flown from MKC to SUS. After landing, about 1207, the pilot told a fixed-base operator (FBO) line technician that he had a depleted battery because of an unspecified charging system malfunction. The pilot, who also was an aviation mechanic, removed the battery from the airplane to have it charged. About 1800, the pilot returned to the FBO with the recharged battery. After reinstalling the battery, the pilot started and ran the engine for about 5 to 7 minutes. Following the engine run, the pilot removed the cowling and began adjusting a subcomponent of the alternator control unit (ACU). After adjusting the ACU, the pilot performed another engine test run that lasted about 10 minutes. Following the second engine test run, the pilot told the FBO line technician that the airplane's ammeter was still showing a slight discharge while the engine was running, and that he was uncomfortable departing at night with a charging system issue. The pilot asked if he and his passengers could stay the night in the pilot's lounge so they could depart early the following morning. The pilot also asked for the airplane to be towed to the self-serve fuel pumps because he did not want to deplete the battery further with another engine start.

The pilot prepaid for 20 gallons of fuel at the self-serve fuel pump. According to the line technician, the pilot nearly topped-off the right inboard fuel tank with 13 gallons before switching over to the left inboard tank. Upon a visual inspection of the left inboard tank, the pilot told the line technician that it contained less fuel than he had expected. The pilot proceeded to add the remaining 7 gallons of the prepaid 20 gallons to the left inboard fuel tank. The line technician noted that after fueling the left inboard fuel tank, the fluid level was about 2 inches from the top of the tank. The pilot did not purchase any additional fuel and told the line technician that both outboard "auxiliary" fuel tanks were nearly full. The line technician then towed the airplane back to the ramp for the evening. The line technician reported that the airplane departed FBO ramp the following morning.

According to air traffic control (ATC) data, the first radar return for the accident flight was shortly after the airplane departed from runway 26L at 0740:50 (hhmm:ss). The airplane initially transmitted a visual flight rules (VFR) beacon code (1200) during accident flight. The plotted radar track revealed the airplane flew west-northwest from SUS toward the planned destination. At 0751:03, the airplane stopped transmitting a 1200 beacon code and continued as a primary-only radar target. The location of the final 1200 code was about 21.5 miles west-northwest of SUS at 2,400 ft mean sea level (msl). The lack of a reinforced beacon return was consistent with the pilot turning the airplane transponder off. The primary-only radar track continued west-northwest at an unknown altitude. (The airplane's transponder transmits altitude data to the radar facility; a primary-only radar return does not include altitude data) At 0832:04, the airplane was still traveling west-northwest and was about 5 miles south of Jesse Viertel Memorial Airport (VER). At 0836:21, the airplane descended below available radar coverage about 11 miles west-southwest of VER. There was no radar coverage with the airplane for about 19 minutes. At 0855:30, the radar facility began tracking a VFR reinforced beacon return (1200) about 2.3 miles north of VER descending through 1,500 feet msl. The time and location of the radar returns are consistent with the accident flight maneuvering to land at VER. The airplane entered a left downwind for runway 36 at 1,200 feet msl. At 0856:49, the last recorded radar return was about 0.9 mile southwest of the runway 36 threshold at 1,100 feet msl (about 400 feet above the ground).

According to one of the surviving passengers, while enroute at an altitude of 2,000 to 3,000 ft msl, the airplane encountered a line of "dense clouds" near Sedalia, Missouri. The pilot attempted to navigate beneath the clouds, at an altitude of about 1,500 ft msl, before deciding to make a course reversal and divert to a nearby airport. The pilot told the passenger, who was seated in the forward-right seat, to be on the lookout for towers and obstructions because of their low proximity to the ground. The passenger reported that after flying east for a few minutes the pilot identified VER on his Apple iPad Mini. The flight approached the airport traffic pattern from the west and made a left base-to-final turn toward runway 36. The passenger reported that the landing gear extended normally. However, when the pilot reduced engine power, in attempt to reduce airspeed, the engine experienced a loss of power. The pilot was able to restore engine power briefly by advancing the throttle, but the engine quickly lost total power. The passenger reported that the pilot then began making rapid changes to the engine throttle and mixture control without any noticeable effect to engine operation. The passenger stated that as the pilot prepared for a forced landing the airplane encountered an aerodynamic stall about 250 ft above the ground. The passenger did not recall the airplane impacting the ground.

PERSONNEL INFORMATION

According to Federal Aviation Administration (FAA) records, the 63-year-old pilot held a commercial pilot certificate with single engine land, single engine sea, multiengine land, and instrument airplane ratings. He also held a flight instructor certificate with single engine, multiengine, and instrument airplane ratings. The pilot's last aviation medical examination was on April 11, 2014, when he was issued a third-class medical certificate with a limitation for corrective lenses. A search of FAA records showed no previous accidents, incidents, or enforcement proceedings. The pilot completed a flight review, as required by FAA regulation 61.56, on November 12, 2014, in a single-engine Cessna model 180 airplane.

The pilot's flight history was reconstructed using his pilot logbook and a computer spreadsheet. The last flight entry in the pilot logbook was dated January 8, 2012. The computer spreadsheet was last updated on November 16, 2014, at which time he had accumulated 3,036 hours total flight time, of which 2,955 hours were listed as pilot-in-command. He had accumulated 2,428 hours in single engine airplanes and 608 hours in multi-engine airplanes. Additionally, he had logged 43 hours in actual instrument meteorological conditions, 175 hours in simulated instrument meteorological conditions, and 233 hours at night.

According to available logbook documentation, the pilot had flown 19 hours during the previous 6 months, 10 hours during prior 90 days, and 3 hours in the month before the accident flight. According to a flight-monitoring website, FlightAware.com, the pilot had flown 1.3 hours during the 24-hour period preceding the accident flight.

AIRCRAFT INFORMATION

The accident airplane was a 1970 Bellanca model 17-30A, Super Viking, serial number 30312. The Super Viking is a single-engine, low wing monoplane with an all-wood wing construction and a fabric covered steel-tube fuselage. A 300-horsepower Continental Motors model IO-520-K reciprocating engine, serial number 209048-70K, powered the airplane through a constant speed, three blade, Hartzell model HC-C3YF-1RF propeller. The airplane had a retractable tricycle landing gear, was capable of seating the pilot and three passengers, and had a maximum gross weight of 3,325 pounds. The FAA issued the accident airplane a standard airworthiness certificate on October 23, 1970. The pilot purchased the airplane on July 5, 2014.

The airplane's recording tachometer meter indicated 621.4 hours at the accident site. The airframe and engine had accumulated a total service time of 2,858.7 hours. The engine had accumulated 1,429.7 hours since the last major overhaul completed on December 10, 1976. The engine had accumulated 206.1 hours since a top overhaul that was completed on December 8, 2007. The last annual inspection of the airplane was completed on November 1, 2014, at 2,853.5 total airframe hours. The airplane had accumulated 5.2 hours since the last annual inspection. A postaccident review of the maintenance records found no history of unresolved airworthiness issues.

METEOROLOGICAL INFORMATION

The National Weather Service (NWS) Surface Analysis Chart for 0900 CST depicted a strong cold front immediately east of the accident site. The front stretched across Missouri between the departure airport and the planned destination. The cold front was associated with a defined wind shift and low stratiform clouds behind the front. There were several weather stations located near the accident site that had surface visibility restrictions in fog and mist. Weather radar imagery did not depict any significant weather echoes in the area of the accident site; however, the weather radar did detect a fine line of very light intensity echoes associated with the cold front. Satellite imagery depicted a band of low stratiform clouds extending over the accident site westward through the Kansas City area. The cloud band was located along and behind the cold front. The NWS 12-hour Surface Prognostic Chart depicted a cold front along the planned route of flight, a strong pressure gradient behind the front supporting strong north-northwest winds, and an extensive portion of Missouri that had marginal visual flight rules (MVFR) weather conditions.

At 0855 CST, an automated surface weather observation station located at Jesse Viertel Memorial Airport (VER), Boonville, Missouri, reported: wind 310 degrees at 13 knots, gusting 16 knots; broken cloud ceilings at 2,600 ft above ground level (agl) and 3,400 ft agl, overcast ceiling at 4,100 ft agl; 10 mile surface visibility; temperature 11 degrees Celsius; dew point 7 degrees Celsius; and an altimeter setting of 29.82 inches of mercury.

At 0853 CST, the weather conditions at Sedalia Memorial Airport (DMO), located near where a passenger reported the accident flight had encountered a line of "dense clouds", included a broken ceiling at 1,700 ft agl, another broken ceiling at 2,400 ft agl, and an overcast ceiling at 3,000 feet agl.

At 0854 CST, a surface observation made at the planned destination (MKC), included instrument flight rules (IFR) weather conditions, including an 800 ft agl cloud ceiling and 4 miles surface visibility with mist.

A review of weather briefing requests made to Automated Flight Service Stations (AFSS) and Direct User Access Terminal Service (DUATS) vendors established that the pilot did not receive a formal weather briefing before departure.

AIRPORT INFORMATION

The Jesse Viertel Memorial Airport (VER), located about 3 miles southeast of Boonville, Missouri, was served by a single runway: 18/36 (4,000 ft by 75 ft, asphalt). The airport elevation was 715 ft msl.

WRECKAGE AND IMPACT INFORMATION

A postaccident examination revealed that the airplane impacted a harvested soybean field on a 305-degree magnetic heading. The initial point-of-impact consisted of three parallel depressions in the field that were consistent with the spacing of the airplane's three landing gear. The main wreckage was located about 24 ft from the initial point-of-impact in an upright position. The accident site was located along the extended runway centerline about 0.4 miles south of the runway 36 threshold. Flight control continuity was confirmed from the cockpit controls to the individual flight control surfaces. The wing flaps were about 1/2 of their full deflection. The landing gear selector switch was in the DOWN position; however, all three landing gear assemblies had collapsed during the impact sequence. The main fuel selector was in the OFF position; however, a first responder had moved the fuel selector from the AUX position to OFF during rescue efforts. Additionally, the first responder turned the engine magneto/ignition key to OFF and disconnected the battery terminals after hearing the sound of an electric motor located under the floorboards. (The sound of an electric motor was later identified to be the electrohydraulic motor for the landing gear extension/retraction system.) The auxiliary fuel tank selector was in the RIGHT position. The electrical master switch was in the ON position. The digital transponder was in the ON/Altitude Encoding position. The electric fuel pump switch was in the OFF position. There were no anomalies identified during functional tests of the electric fuel pump and the aerodynamic stall warning system. The postaccident airframe examination revealed no evidence of a mechanical malfunction or failure that would have precluded normal operation.

The airplane was equipped with two inboard main fuel tanks and two outboard auxiliary fuel tanks. The reported capacity of each main fuel tank was 19 gallons, of which 15.5 gallons were usable per tank. The reported capacity of each outboard auxiliary fuel tank was 17 gallons; however, according to a cockpit placard, the auxiliary tanks were for use during level flight only. A visual examination of the four fuel tanks revealed no damage or evidence of a fuel leak. The left main tank contained about 5 gallons of fuel. The right main tank contained 3-1/2 pints of fuel. The left auxiliary tank was near its 17-gallon capacity. The right auxiliary tank contained about 11 gallons of fuel. There was no fuel recovered from the supply line connected to the inlet port of the engine-driven fuel pump; however, the gascolator drain had fractured during impact and there was evidence of a small fuel spill underneath the gascolator assembly at the accident site. There was a trace amount of fuel recovered from the engine-driven fuel pump outflow line. There was no fuel recovered from the fuel supply line connected to the fuel manifold valve.

The engine remained partially attached to the firewall by its engine mounts and control cables. Mechanical continuity was confirmed from the engine components to their respective cockpit engine controls. Internal engine and valve train continuity was confirmed as the engine crankshaft was rotated. Compression and suction were noted on all cylinders in conjunction with crankshaft rotation. The upper spark plugs were removed and exhibited features consistent with normal engine operation. Both magnetos provided spark on all leads when rotated. There were no obstructions between the air filter housing and the fuel control unit. The three blade propeller and crankshaft flange had separated from the engine. The propeller blades exhibited minor burnishing of the blade face and back. One blade appeared straight. Another blade exhibited a shallow S-shape bend along its span. The remaining blade was bent aft about midspan. The postaccident examination revealed no evidence of a mechanical malfunction or failure that would have precluded normal engine operation.

MEDICAL AND PATHOLOGICAL INFORMATION

On December 1, 2014, at the request of the Cooper County Coroner, the Boone/Callaway County Medical Examiner's Office located in Columbia, Missouri, performed an autopsy on the pilot. The cause of death was attributed to multiple blunt-force injuries sustained during the accident. The FAA's Civil Aerospace Medical Institute located in Oklahoma City, Oklahoma, performed toxicology tests on samples obtained during the autopsy. The toxicological test results were negative for carbon monoxide, ethanol, and all drugs and medications.

TESTS AND RESEARCH

Four personal electronic devices were recovered at the accident site and sent to the National Transportation Safety Board (NTSB) Vehicle Recorders Laboratory in Washington D.C. for potential non-volatile memory (NVM) data recovery.

An examination of the pilot's Apple iPad Mini revealed it had the ForeFlight application installed. The application's map page displayed route information for a flight from SUS to MKC. The specifics of the flight included a calculated distance of 186 nautical miles between SUS and MKC, a calculated course of 281 degrees magnetic, an estimated time enroute of 1 hour 10 minutes (calculated using 160 knots true airspeed without the effect of winds aloft), and an calculated fuel consumption of 17.4 gallons. There was no track history for the accident flight; the option to record a track history was not selected for the accident flight. The most recent track history was for a flight completed on August 24, 2014. Further examination of the device established that the text messages, photos, and internet browser history did not contain any information pertinent information to the investigation. According to a passenger, the pilot had used the iPad Mini to navigate during the accident flight.

An examination of a passenger's Samsung Galaxy S III smartphone revealed that there were four photos taken during the accident flight between 0826:47 and 0831:51. During the five-minute period of recovered photos, the observed cloud cover near the airplane increased from clear skies to low-level, overcast stratocumulus clouds. Further examination of the device established that the text messages did not contain any information pertinent information to the investigation.

The remaining two devices, a Motorola Droid Smartphone and an Apple iPod Touch, did not contain any data pertinent to the accident investigation.

ADDITIONAL DATA/INFORMATION

According to available air traffic control data, the accident flight was at least 1 hour 17 minutes in duration. According to the airplane's owner manual, the expected fuel consumption rate at 2,500 ft msl and 77-percent power was 16.1 gallons per hour. At 77-percent engine power, the accident airplane would have used at least 20.7 gallons of fuel; however, engine operation above 77-percent power and/or insufficient leaning would have consumed additional fuel.



 






NTSB Identification: CEN15FA060 
14 CFR Part 91: General Aviation
Accident occurred Sunday, November 30, 2014 in Boonville, MO
Aircraft: BELLANCA 17-30A, registration: N6629V
Injuries: 1 Fatal,3 Serious.

This is preliminary information, subject to change, and may contain errors. Any errors in this report will be corrected when the final report has been completed. NTSB investigators either traveled in support of this investigation or conducted a significant amount of investigative work without any travel, and used data obtained from various sources to prepare this aircraft accident report.

On November 30, 2014, about 0900 central standard time, a Bellanca model 17-30A airplane, N6629V, was substantially damaged when it collided with terrain during landing approach to runway 36 at Jesse Viertel Memorial Airport (VER), Boonville, Missouri. The commercial pilot was fatally injured and his 3 passengers were seriously injured. The airplane was registered to and operated by the pilot under the provisions of 14 Code of Federal Regulations Part 91 without a flight plan. Day visual meteorological conditions prevailed for the cross-country flight that departed Spirit of St. Louis Airport (SUS), Chesterfield, Missouri, about 0738, and was originally destined for Charles B. Wheeler Downtown Airport (MKC), Kansas City, Missouri.

The day before the accident, the pilot had flown from MKC to SUS. After landing, about 1207, the pilot told a fixed-base operator (FBO) line technician that he had a depleted battery because of an unspecified charging system malfunction. The pilot, who also was an aviation mechanic, removed the battery from the airplane to have it charged. About 1800, the pilot returned to the FBO with the recharged battery. After reinstalling the battery, the pilot started and ran the engine for about 5 to 7 minutes. Following the engine run, the pilot removed the cowling and began adjusting a subcomponent of the alternator control unit (ACU). After adjusting the ACU, the pilot performed another engine test run that lasted about 10 minutes. Following the second engine test run, the pilot told the FBO line technician that the airplane's ammeter was still showing a slight discharge while the engine was running, and that he was uncomfortable departing at night with a charging system issue. The pilot asked if he and his passengers could stay the night in the pilot's lounge so they could depart early the following morning. The pilot also asked for the airplane to be towed to the self-serve fuel pumps because he didn't want to further deplete the battery with another engine start.

The pilot prepaid for 20 gallons of fuel at the self-serve fuel pump. According to the line technician, the pilot nearly topped-off the right inboard fuel tank with 13 gallons before switching over to the left inboard tank. Upon a visual inspection of the left inboard tank, the pilot told the line technician that it contained less fuel than he had expected. The pilot proceeded to add the remaining 7 gallons of the prepaid 20 gallons to the left inboard fuel tank. The line technician noted that after fueling the left inboard fuel tank, the fluid level was about 2 inches from the top of the tank. The pilot did not purchase any additional fuel and told the line technician that both outboard "auxiliary" fuel tanks were nearly full. The line technician then towed the airplane back to the ramp for the evening. The line technician reported that the airplane departed FBO ramp the following morning.

According to one of the surviving passengers, while enroute at an altitude of 2,000 to 3,000 feet mean sea level, the flight encountered a line of "dense clouds" near Sedalia, Missouri. The pilot attempted to navigate beneath the clouds, at an altitude of about 1,500 feet msl, before deciding to make a course reversal and locate a nearby airport to divert to. The pilot told the passenger, who was seated in the forward-right seat, to be on the lookout for towers and obstructions because of their low proximity to the ground. The passenger reported that after flying east for a few minutes the pilot identified VER on his tablet computer. The flight approached the airport traffic pattern from the west and made a left base-to-final turn toward runway 36. The passenger reported that the pilot extended the landing gear without any difficulties. However, when the pilot reduced engine power, in attempt to reduce airspeed, the engine experienced a loss of power. The pilot was able to briefly restore engine power by advancing the throttle, but the engine quickly lost total power. The passenger reported that the pilot then began making rapid changes to the engine throttle and mixture control without any noticeable effect to engine operation. The passenger stated that the airplane eventually "stalled completely", about 250 feet above the ground, as the pilot prepared for a forced landing; however, the passenger did not recall the airplane impacting terrain.

A postaccident examination revealed that the airplane impacted a harvested soybean field on a 305 degree magnetic heading. The initial point of impact consisted of three parallel depressions in the field that were consistent with the spacing of the accident airplane landing gear. The main wreckage was located about 24 feet from the initial point of impact in an upright position. The accident site was situated along the extended runway 36 centerline, about 0.4 miles south of the runway approach threshold. Flight control continuity was confirmed from the cockpit controls to the individual flight control surfaces. The electric master switch was found in the "on" position. The wing flaps were observed to be positioned about 1/2 of their full deflection. The landing gear selector switch was in the "down" position; however, all three landing gear assemblies had collapsed during the accident. The main fuel selector was found in the "off" position; however, a first responder had moved the fuel selector from the "auxiliary" position to the "off" position during rescue efforts. The first responder also turned the engine magneto/ignition key to "off" and disconnected the battery terminals after hearing the sound of an electric motor located under the floorboards. (The sound of an electric motor was later identified to be the electrohydraulic motor for the landing gear extension/retraction system.) The auxiliary fuel tank selector was found positioned to the "right" auxiliary wing tank. (The auxiliary fuel tank selector had two positions, "right auxiliary" or "left auxiliary.") The electric fuel pump switch was found in the "off" position. There were no anomalies identified during functional tests of the electric fuel pump and the aerodynamic stall warning system.

The airplane was equipped with two inboard "main" fuel tanks and two outboard "auxiliary" fuel tanks. The reported capacity of each inboard fuel tank was 19 gallons, of which 15.5 gallons were useable per tank. The left inboard tank contained about 5 gallons of fuel. The right inboard tank contained 3-1/2 pints of fuel. The inboard fuel tanks appeared to be undamaged and there was no evidence of a fuel leak from either tank. The reported capacity of each outboard "auxiliary" fuel tank was 17 gallons; however, those tanks were placarded for level flight only. The outboard fuel tanks also appeared to be undamaged and there was no evidence of a fuel leak from either tank. A visual inspection of the left outboard tank confirmed that it was filled near its capacity. The right outboard tank contained about 11 gallons of fuel. No fuel was recovered from the fuel supply line connected to the engine-driven fuel pump inlet port; however, the fuel gascolator drain had fractured during the accident and there was evidence of a small fuel spill underneath the gascolator assembly at the accident site. Only trace amounts of fuel were recovered from the engine-driven fuel pump outflow fuel line. No fuel was recovered from the fuel supply line connected to the flow-divider assembly.

The engine remained partially attached to the firewall by its engine mounts and control cables. Internal engine and valve train continuity was confirmed as the engine crankshaft was rotated. Compression and suction were noted on all cylinders in conjunction with crankshaft rotation. The upper spark plugs were removed and exhibited features consistent with normal engine operation. Both magnetos provided spark on all leads when rotated. There were no obstructions between the air filter housing and the fuel control unit. Mechanical continuity was confirmed from the engine components to their respective cockpit engine controls. The postaccident examination revealed no evidence of mechanical malfunctions or failures that would have precluded normal engine operation.

According to Federal Aviation Administration (FAA) air traffic control data, the accident flight departed SUS around 0738. According to local law enforcement, the initial 911-emergency call was received at 0901. As such, the accident flight, from takeoff to the accident, was at least 1 hour 22 minutes in duration. According to the airplane's owner manual, the expected fuel consumption rate at 2,500 feet msl and 77-percent power was 16.1 gallons per hour. At 77-percent engine power, the accident flight would have consumed at least 22 gallons of fuel; however, engine operation above 77-percent power and/or insufficient leaning would have consumed additional fuel.

At 0855, the VER automated surface observing system reported: wind 310 degrees at 13 knots, gusting 16 knots; broken cloud ceilings at 2,600 feet above ground level (agl) and 3,400 feet agl, overcast ceiling at 4,100 feet agl; 10 mile surface visibility; temperature 11 degrees Celsius; dew point 7 degrees Celsius; and an altimeter setting of 29.82 inches of mercury.

1 comment:

Fred Rohlfing said...

The final accident recently reported this-----A The pilot did not hold a medical certificate. An autopsy of the pilot revealed coronary artery disease and significant brain pathology. It is unlikely that the pilot's coronary artery disease contributed to the accident as it would not have impaired the pilot's judgment, vision, or decision-making. The pilot had scarring from a previous brain injury and severe damage to his left optic nerve to the extent that he was nearly blind in that eye. Given that the pilot failed to maintain proper altitude while operating in visual conditions and struck a potentially visible hazard, it is likely that his vision deficiency contributed to the accident.

Toxicology test results indicated that the pilot had used multiple psychoactive drugs before the accident, including cocaine, methamphetamine, clonazepam, and diphenhydramine. In addition to their psychoactive effects, these drugs are potent vasoconstrictors and can cause small arteries to spasm, cutting off blood flow to portions of vital organs. Although the neuropathologist who examined the pilot's brain believed the degree of cerebral hypoxic/ischemic damage he identified would take several hours to develop, the pilot was deceased by the time first responders arrived about 10 minutes after the witnessed crash. Therefore, this hypoxic/ischemic damage had to have begun before the accident and was likely caused by the pilot's misuse of cocaine and methamphetamine. This evolving brain ischemia may have played a role in the circumstances of the accident, but without specific information regarding the pilot's symptoms, its exact role cannot be determined. Although the pilot's stage of intoxication with methamphetamine or cocaine at the time of the accident is unknown, it is very likely that he was impaired by the combined effects of these drugs.