Wednesday, December 26, 2018

System / Component Malfunction / Failure (Non-Power): Glasair FT, N4EJ, accident occurred May 16, 2018 at Rocky Mountain Metropolitan Airport (KBJC), Broomfield, Colorado

The National Transportation Safety Board did not travel to the scene of this accident.

Federal Aviation Administration / Flight Standards District Office; Denver, Colorado


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


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


Aviation Accident Data Summary - National Transportation Safety Board: https://app.ntsb.gov/pdf 
 
http://registry.faa.gov/N4EJ


Location: Broomfield, CO
Accident Number: CEN18LA180
Date & Time: 05/16/2018, 1520 MDT
Registration: N4EJ
Aircraft: Roger G White Glasair
Aircraft Damage: Substantial
Defining Event: Sys/Comp malf/fail (non-power)
Injuries: 1 Minor
Flight Conducted Under: Part 91: General Aviation - Personal 

Analysis 

The airline transport pilot reported that, during the landing roll, the experimental, amateur-built airplane started drifting to the left and he applied right rudder to correct. He subsequently attempted to apply right brake pressure to further correct for the drift as the airplane was traveling about 50 knots. At that time, the right brake pedal "went to the floor," and there was "zero" right brake available. The airplane departed the left side of the runway, crossed the grass, and came to rest on the parallel taxiway.

A postrecovery examination revealed that the plastic right brake line was broken near the upper end of the landing gear strut. The airplane was equipped with a free-castering nosewheel and did not have any nosewheel steering capability. Directional control during ground operations was maintained with differential braking. As a result, maintaining directional control after the brake failure was not possible. 

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be:
The failure of the right brake line, which resulted in a loss of directional control and runway excursion.

Findings

Aircraft
Landing gear brakes system - Failure (Cause)
Directional control - Attain/maintain not possible (Cause)

Factual Information

On May 16, 2018, about 1520 mountain daylight time, an experimental, amateur-built Roger G White Glasair airplane, N4EJ, was substantially damaged during a runway excursion after landing on runway 12L (9,000 ft by 100 ft, asphalt) at the Rocky Mountain Metropolitan Airport (BJC), Broomfield, Colorado. The pilot sustained minor injuries. The airplane was registered to a private individual and operated by the pilot as a Title 14 Code of Federal Regulations Part 91 personal flight. Day visual meteorological conditions prevailed. The flight was not operated on a flight plan. The flight originated from the Vance Brand Airport (LMO), Longmont, Colorado about 1500 and was destined for BJC.

The pilot reported that he was relocating the airplane from LMO to BJC for modification of the fuel injection system after a recent sale. He noted that his preflight inspection and run-up did not reveal any anomalies. He specifically checked the brakes and detected no problems. The takeoff, cruise, and landing approach were conducted without incident. However, during the landing rollout, the airplane started drifting to the left and he applied right rudder to correct. He subsequently attempted to apply right brake pressure to further correct for the drift as the airplane was traveling about 50 knots. At that time, the right brake pedal "went to the floor;" there was "zero" right brake available. The airplane departed the left side of the runway, crossed the grass, and came to rest on the parallel taxiway.

A postrecovery examination conducted by a Federal Aviation Administration inspector revealed that the right brake line was broken near the upper end of the landing gear strut. The brake line consisted of a flexible plastic line at that location. The brake master cylinder was intact. No anomalies were observed related to the brake master cylinder or the caliper assemblies.

The airplane was equipped with a free castering nose wheel and did not have any nose wheel steering capability. Directional control during ground operations was maintained with differential braking. 

History of Flight

Landing-landing roll
Sys/Comp malf/fail (non-power) (Defining event)
Loss of control on ground

Runway excursion

Pilot Information

Certificate: Airline Transport; Flight Instructor
Age: 81, Male
Airplane Rating(s): Multi-engine Land; Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): Glider
Restraint Used: 3-point
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s): Airplane Multi-engine; Airplane Single-engine; Glider; Instrument Airplane
Toxicology Performed: No
Medical Certification: Class 2 With Waivers/Limitations
Last FAA Medical Exam: 01/16/2017
Occupational Pilot: Yes
Last Flight Review or Equivalent: 11/18/2016
Flight Time: 14800 hours (Total, all aircraft), 250 hours (Total, this make and model)

Aircraft and Owner/Operator Information

Aircraft Make: Roger G White
Registration: N4EJ
Model/Series: Glasair FT
Aircraft Category: Airplane
Year of Manufacture: 1990
Amateur Built: Yes
Airworthiness Certificate: Experimental
Serial Number: 265
Landing Gear Type: Tricycle
Seats: 2
Date/Type of Last Inspection: 11/08/2017, Condition
Certified Max Gross Wt.:
Time Since Last Inspection: 0 Hours
Engines: 1 Reciprocating
Airframe Total Time: 1589.3 Hours at time of accident
Engine Manufacturer: Lycoming
ELT: Installed, not activated
Engine Model/Series: O-360-A3A
Registered Owner: Gene W Gay
Rated Power: 180 hp
Operator: On file
Operating Certificate(s) Held: None

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: BJC, 5673 ft msl
Distance from Accident Site: 0 Nautical Miles
Observation Time: 1545 MDT
Direction from Accident Site: 90°
Lowest Cloud Condition: Scattered / 8000 ft agl
Visibility:  50 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 7 knots /
Turbulence Type Forecast/Actual: /
Wind Direction: 120°
Turbulence Severity Forecast/Actual: /
Altimeter Setting: 30.01 inches Hg
Temperature/Dew Point: 27°C / -4°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Longmont, CO (LMO)
Type of Flight Plan Filed: None
Destination: Broomfield, CO (BJC)
Type of Clearance: VFR
Departure Time: 1500 MDT
Type of Airspace: Class D

Airport Information

Airport: Rocky Mountain Muni (BJC)
Runway Surface Type: Asphalt
Airport Elevation: 5673 ft
Runway Surface Condition: Dry
Runway Used: 12L
IFR Approach: None
Runway Length/Width: 9000 ft / 100 ft
VFR Approach/Landing: Full Stop; Traffic Pattern

Wreckage and Impact Information

Crew Injuries: 1 Minor
Aircraft Damage: Substantial
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Minor
Latitude, Longitude: 39.908889, -105.117222 (est)

Van's RV-6, registered to and operated by the pilot under the provisions of Title 14 Code of Federal Regulations Part 91 as a personal flight, N833DW: Accident occurred May 11, 2018 at Hutchinson County Airport (KBGD), Borger, Texas

The National Transportation Safety Board did not travel to the scene of this accident.

Additional Participating Entity:

Federal Aviation Administration / Flight Standards District Office; Lubbock, Texas

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


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


Aviation Accident Data Summary - National Transportation Safety Board: https://app.ntsb.gov/pdf 
 
http://registry.faa.gov/N833DW


Location: Borger, TX
Accident Number: CEN18LA172
Date & Time: 05/11/2018, 0827 CDT
Registration: N833DW
Aircraft: WITTMAN D R/WITTMAN D M RV 6
Aircraft Damage: Destroyed
Defining Event: Loss of control on ground
Injuries: 1 Serious
Flight Conducted Under:  Part 91: General Aviation - Personal 

Analysis 

The private pilot stated that, during approach to the airport, the weather observation system reported variable winds of 4 to 6 knots, which was less than forecast. While on short final approach for landing to runway 21, the pilot experienced "strong updrafts from unusual landforms," and when the airplane landed about halfway down the runway, he experienced "strong gusts causing swerving." The airplane was departing the side of the runway when the pilot chose to abort the landing by applying full engine power. The airplane was unable to outclimb the rising terrain off the side of the runway and subsequently impacted the ground and a fence.

Postaccident examination of the airplane revealed no anomalies that would have precluded normal operation. A review of recorded weather information showed winds consistently from 220° at 23 to 32 knots, which would have resulted in a crosswind component of between 2 and 6 knots. The strong updrafts the pilot experienced would have been consistent with mechanical turbulence, which could have been confirmed by wind indications from the airport windsock(s).

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be:
The pilot's failure to maintain airplane control during landing and during the subsequent aborted landing attempt in crosswind conditions.

Findings

Aircraft
Directional control - Not attained/maintained (Cause)
Performance/control parameters - Not attained/maintained (Cause)

Personnel issues

Aircraft control - Pilot (Cause)

Factual Information

On May 11, 2018, at 0827 central daylight time (CDT), an experimental amateur-built Whittman RV6 airplane, N833DW, impacted terrain during an aborted landing on runway 21 at Hutchinson County Airport (BGD), Borger, Texas. The airplane was destroyed by impact forces. The private pilot sustained serious injuries. The airplane was registered to and operated by the pilot under the provisions of Title 14 Code of Federal Regulations Part 91 as a personal flight. Visual meteorological conditions prevailed and no flight plan was filed for the cross country flight. The flight departed from H A Clark Memorial Field Airport, Williams, Arizona, at 0830 mountain standard time (MST) and was destined to BGD.

The pilot stated the BGD automated surface observing system (ASOS) was reporting a variable wind of 4-6 knots, which was less than forecast. During a visual approach to runway 21 (3,897 feet by 100 feet, dry asphalt), the pilot stated that he flew an upwind pattern entry and on short final, experienced "strong updrafts from unusual landforms". The pilot landed the tailwheel equipped airplane on runway 21, near the intersection of runway 17/35 (about 1,650 feet down runway 21), and "experienced strong wind gusts causing swerving". The pilot said that as "conditions deteriorated," he decided to abort the landing and applied full engine power while the airplane was departing the runway at about a 20° angle toward the right. The airplane began to climb over rising terrain off the side of the runway. The landing gear dragged through heavy brush/weeds, which reduced the airplane's acceleration. The pilot attempted to fly the airplane under approaching powerlines due to a lack of airspeed needed for a climb. The airplane then impacted the ground and a chain link fence.

Airport Facility Directory information for BGD showed the installation of three windsocks at the airport. The windsocks were located between the approach end of runways 17 and 35 and between runways 3 and 35.

BGD ASOS recorded the following wind information:

At 0551 CDT: wind - 220° at 17 knots, gust - 28 knots

At 0651 CDT: wind - 220° at 21 knots, gust - 32 knots

At 0751 CDT: wind - 220° at 17 knots, gust – 26 knots

At 0851 CDT: wind - 220° at 14 knots, gust – 23 knots

The calculated crosswind component on runway 21 with a wind from 220° at 14 knots was 2 knots and winds from 220° at 32 knots was 6 knots.

The airplane did not have and was not required to have a published maximum demonstrated crosswind velocity capability due to its classification as an experimental airplane A flight instructor, who provided flight instruction in RV-6 airplanes, stated that a comfortable crosswind velocity for a pilot with average skill would be about 15 knots, and a skilled pilot could land the airplane with a 20-25 knot crosswind. He said the RV6 was capable of landing in 20-25 knot crosswinds.

According to a Federal Aviation Administrator (FAA) inspector from the Lubbock Flight Standards District Office, there were no witnesses to the accident. The UNICOM operator at the time did not realize the airplane was landing because he did not hear the pilot make radio calls on UNICOM. The operator first learned of the accident through 911, which was looking for the airplane.

Post-accident examination of the airplane by the FAA inspector revealed no mechanical anomalies that would have precluded normal airplane operation. The inspector stated that the wing flaps were in the fully extended position of 40 °.

The Airplane Flying Handbook (FAA-H-8083-3B), Chapter 8, Approaches and Landings, stated in part:

"…a review of accident statistics indicates that over 45 percent of all general aviation accidents occur during the approach and landing phases of a flight. A closer look shows that the cause of over 90 percent of those cases was pilot related and loss of control was also a major contributing factor in 33 percent of the cases."

Chapter 8, Approaches and Landings stated that stabilized descent angle is controlled throughout the approach so that the airplane lands in the center of the first third of the runway and if a landing cannot be made on the first third of the runway, or the airplane drifts sideways, execute a go-around. 

History of Flight

Landing-flare/touchdown
Landing area overshoot

Landing-landing roll
Loss of control on ground (Defining event)

Landing-aborted after touchdown
Attempted remediation/recovery

Initial climb
Loss of control in flight

Uncontrolled descent

Collision with terr/obj (non-CFIT)

Pilot Information

Certificate: Private
Age: 63, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used: 3-point
Instrument Rating(s): None
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed: No
Medical Certification: BasicMed
Last FAA Medical Exam:
Occupational Pilot: No
Last Flight Review or Equivalent: 03/22/2018
Flight Time:  277 hours (Total, all aircraft), 180 hours (Total, this make and model), 14 hours (Last 90 days, all aircraft)

Aircraft and Owner/Operator Information

Aircraft Make: WITTMAN D R/WITTMAN D M
Registration: N833DW
Model/Series: RV 6
Aircraft Category: Airplane
Year of Manufacture: 2003
Amateur Built: Yes
Airworthiness Certificate: Experimental
Serial Number: 23207
Landing Gear Type: Tricycle
Seats: 2
Date/Type of Last Inspection: 11/01/2017, Condition
Certified Max Gross Wt.: 1800 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 405.7 Hours at time of accident
Engine Manufacturer: LYCOMING
ELT: Installed, not activated
Engine Model/Series: O-360-A1A
Registered Owner: Pilot
Rated Power: 180 hp
Operator: Pilot
Operating Certificate(s) Held: None

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: BGD, 3055 ft msl
Distance from Accident Site: 1 Nautical Miles
Observation Time: 0851 CDT
Direction from Accident Site: 270°
Lowest Cloud Condition: Clear
Visibility:  10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 14 knots / 23 knots
Turbulence Type Forecast/Actual: / None
Wind Direction: 220°
Turbulence Severity Forecast/Actual: / N/A
Altimeter Setting: 29.75 inches Hg
Temperature/Dew Point: 24°C / 10°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Williams, AZ (CMR)
Type of Flight Plan Filed: None
Destination: Borger, TX (BGD)
Type of Clearance: None
Departure Time: 0830 MST
Type of Airspace: Class E

Airport Information

Airport: Hutchinson County Airport (BGD)
Runway Surface Type: Asphalt
Airport Elevation: 3055 ft
Runway Surface Condition:
Runway Used: 21
IFR Approach: None
Runway Length/Width: 3897 ft / 100 ft
VFR Approach/Landing: Go Around; Traffic Pattern 

Wreckage and Impact Information

Crew Injuries: 1 Serious
Aircraft Damage: Destroyed
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Serious
Latitude, Longitude:  35.700833, -101.393611 (est)

Aerodynamic Stall / Spin: Cessna 172N Skyhawk, N738XT, accident occurred May 11, 2018 at Markley Farm Airport (OH24), Orrville, Wayne County, Ohio


The National Transportation Safety Board did not travel to the scene of this accident.


Additional Participating Entity:

Federal Aviation Administration / Flight Standards District Office; Cleveland, Ohio

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


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


Aviation Accident Data Summary - National Transportation Safety Board: https://app.ntsb.gov/pdf 

 
http://registry.faa.gov/N738XT


Location: ORRVILLE, OH
Accident Number: CEN18LA171
Date & Time: 05/11/2018, 0940 EDT
Registration: N738XT
Aircraft: CESSNA 172N
Aircraft Damage: Substantial
Defining Event: Aerodynamic stall/spin
Injuries: 1 Serious, 1 Minor
Flight Conducted Under: Part 91: General Aviation - Personal

Analysis

During initial climb after a soft field takeoff, the private pilot noted that the airspeed was low, which he thought was due to a pitot system error. He pulled back on the yoke and the airplane's stall warning horn immediately sounded. The airplane was descending, and the pilot maneuvered to avoid obstructions. He pulled the yoke all the way back to fully stall the airplane before the airplane impacted the ground and nosed over. The pilot reported that there were no mechanical failures or malfunctions with the airplane that would have precluded normal operation. Based on the available information, it is likely that the pilot failed to attain adequate airspeed control during the takeoff and initial climb, which resulted in an exceedance of the airplane's critical angle of attack and a subsequent aerodynamic stall.

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be:
The pilot's failure to attain adequate airspeed during the soft field takeoff, which resulted in an exceedance of the airplane's critical angle of attack and an aerodynamic stall.

Findings

Aircraft
Airspeed - Not attained/maintained (Cause)
Angle of attack - Capability exceeded (Cause)

Personnel issues
Aircraft control - Pilot (Cause)

Factual Information 

On May 11, 2018, about 0940 eastern daylight time, Cessna 172N airplane, N738XT, was substantially damaged when it impacted the ground and nosed over during takeoff from runway 10 at the Markley Farm Airport (OH24), Orrville, Ohio. The private pilot received serious injuries and the passenger received minor injuries. The airplane sustained damage to the fuselage, wings and vertical tail. The aircraft was registered to and operated by the pilot under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Visual meteorological conditions prevailed for the flight, which was not operated on a flight plan. The flight was originating at the time of the accident and the Greenbrier Valley Airport (LWB), near Lewisburg, West Virginia, was the intended destination.

The pilot reported that he was taking off on runway 10 from his private grass airstrip. He reported that he noted the wind was calm and that the temperature was "warmer", and he referenced the pilot's operating handbook for a soft field takeoff using 10 degrees of flaps. He stated that after takeoff the airplane was in ground-effect and was gaining speed. He noted that he checked, and the airspeed was between 50 and 60 knots. When he looked back toward the runway, he was left of the runway and corrected back to the right. He re-checked the airspeed and it was now reading between zero and the bottom of the white arc (41 knots). He stated that he thought that the airspeed reading was due to a pitot system error and pulled back on the yoke to see if he could climb out; however, the stall warning horn sounded immediately. He diverted to the left to avoid obstructions and was losing altitude rapidly. He pulled the yoke back all the way to fully stall the airplane and it struck the ground and nosed over. He noted in his report that, to the best of his knowledge, there were no mechanical failures or malfunctions with the airplane, engine, or systems that would have precluded normal operation. 

History of Flight

Initial climb
Loss of control in flight
Aerodynamic stall/spin (Defining event)
Collision with terr/obj (non-CFIT)

Pilot Information

Certificate: Private
Age: 64, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): None
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed: No
Medical Certification: Class 3 With Waivers/Limitations
Last FAA Medical Exam: 11/10/2015
Occupational Pilot:No 
Last Flight Review or Equivalent:
Flight Time:  353 hours (Total, all aircraft), 353 hours (Total, this make and model), 320 hours (Pilot In Command, all aircraft), 50.6 hours (Last 90 days, all aircraft), 24.8 hours (Last 30 days, all aircraft), 0 hours (Last 24 hours, all aircraft)

Aircraft and Owner/Operator Information

Aircraft Make: CESSNA
Registration: N738XT
Model/Series: 172N N
Aircraft Category: Airplane
Year of Manufacture: 1978
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 17270324
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection: 02/11/2018, Annual
Certified Max Gross Wt.: 2299 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 1924 Hours as of last inspection
Engine Manufacturer: LYCOMING
ELT: Installed, not activated
Engine Model/Series: O-320-H2AD
Registered Owner: On file
Rated Power: 160 hp
Operator: On file
Operating Certificate(s) Held:None  

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: BJJ, 1136 ft msl
Distance from Accident Site: 5 Nautical Miles
Observation Time: 1256 UTC
Direction from Accident Site: 270°
Lowest Cloud Condition: Few / 6500 ft agl
Visibility: 10 Miles
Lowest Ceiling: Overcast / 9500 ft agl
Visibility (RVR):
Wind Speed/Gusts: 8 knots /
Turbulence Type Forecast/Actual:
Wind Direction: 30°
Turbulence Severity Forecast/Actual:
Altimeter Setting: 30.12 inches Hg
Temperature/Dew Point: 9°C / 1°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: ORRVILLE, OH (OH24)
Type of Flight Plan Filed: None
Destination: Lewisburg, WV (LWB)
Type of Clearance: None
Departure Time: 0940 EDT
Type of Airspace: Class G

Airport Information

Airport: MARKLEY FARM (OH24)
Runway Surface Type: Grass/turf
Airport Elevation: 1110 ft
Runway Surface Condition:
Runway Used: 10
IFR Approach: None
Runway Length/Width: 1633 ft / 200 ft
VFR Approach/Landing: None

Wreckage and Impact Information

Crew Injuries: 1 Serious
Aircraft Damage: Substantial
Passenger Injuries: 1 Minor
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Serious, 1 Minor

Latitude, Longitude:  40.875556, -81.766389



Location: ORRVILLE, OH
Accident Number: CEN18LA171
Date & Time: 05/11/2018, 0940 EDT
Registration: N738XT
Aircraft: CESSNA 172N
Aircraft Damage: Substantial
Defining Event: Aerodynamic stall/spin
Injuries: 1 Serious, 1 Minor
Flight Conducted Under: Part 91: General Aviation - Personal

On May 11, 2018, about 0940 eastern daylight time, Cessna 172N airplane, N738XT, was substantially damaged when it impacted the ground and nosed over during takeoff from runway 10 at the Markley Farm Airport (OH24), Orrville, Ohio. The private pilot received serious injuries and the passenger received minor injuries. The airplane sustained damage to the fuselage, wings and vertical tail. The aircraft was registered to and operated by the pilot under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Visual meteorological conditions prevailed for the flight, which was not operated on a flight plan. The flight was originating at the time of the accident and the Greenbrier Valley Airport (LWB), near Lewisburg, West Virginia, was the intended destination.

The pilot reported that he was taking off on runway 10 from his private grass airstrip. He reported that he noted the wind was calm and that the temperature was "warmer", and he referenced the pilot's operating handbook for a soft field takeoff using 10 degrees of flaps. He stated that after takeoff the airplane was in ground-effect and was gaining speed. He noted that he checked, and the airspeed was between 50 and 60 knots. When he looked back toward the runway, he was left of the runway and corrected back to the right. He re-checked the airspeed and it was now reading between zero and the bottom of the white arc (41 knots). He stated that he thought that the airspeed reading was due to a pitot system error and pulled back on the yoke to see if he could climb out; however, the stall warning horn sounded immediately. He diverted to the left to avoid obstructions and was losing altitude rapidly. He pulled the yoke back all the way to fully stall the airplane and it struck the ground and nosed over. He noted in his report that, to the best of his knowledge, there were no mechanical failures or malfunctions with the airplane, engine, or systems that would have precluded normal operation.



Pilot Information

Certificate: Private
Age: 64, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used:
Instrument Rating(s): None
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed: No
Medical Certification: Class 3 With Waivers/Limitations
Last FAA Medical Exam: 11/10/2015
Occupational Pilot: No
Last Flight Review or Equivalent:
Flight Time:   353 hours (Total, all aircraft), 353 hours (Total, this make and model), 320 hours (Pilot In Command, all aircraft), 50.6 hours (Last 90 days, all aircraft), 24.8 hours (Last 30 days, all aircraft), 0 hours (Last 24 hours, all aircraft)



Aircraft and Owner/Operator Information

Aircraft Make: CESSNA
Registration: N738XT
Model/Series: 172N N
Aircraft Category: Airplane
Year of Manufacture: 1978
Amateur Built: No
Airworthiness Certificate: Normal
Serial Number: 17270324
Landing Gear Type: Tricycle
Seats: 4
Date/Type of Last Inspection 02/11/2018, Annual
Certified Max Gross Wt.: 2299 lbs
Time Since Last Inspection:
Engines: 1 Reciprocating
Airframe Total Time: 1924 Hours as of last inspection
Engine Manufacturer: LYCOMING
ELT: Installed, not activated
Engine Model/Series: O-320-H2AD
Registered Owner: On file
Rated Power: 160 hp
Operator: On file
Operating Certificate(s) Held: None



Meteorological Information and Flight Plan


Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: BJJ, 1136 ft msl
Distance from Accident Site: 5 Nautical Miles
Observation Time: 1256 UTC
Direction from Accident Site: 270°
Lowest Cloud Condition: Few / 6500 ft agl
Visibility:  10 Miles
Lowest Ceiling: Overcast / 9500 ft agl
Visibility (RVR):
Wind Speed/Gusts: 8 knots /
Turbulence Type Forecast/Actual: /
Wind Direction: 30°
Turbulence Severity Forecast/Actual: /
Altimeter Setting: 30.12 inches Hg
Temperature/Dew Point: 9°C / 1°C
Precipitation and Obscuration:  No Obscuration; No Precipitation
Departure Point: ORRVILLE, OH (OH24)
Type of Flight Plan Filed: None
Destination: Lewisburg, WV (LWB)
Type of Clearance: None
Departure Time: 0940 EDT
Type of Airspace: Class G



Airport Information

Airport: MARKLEY FARM (OH24)
Runway Surface Type: Grass/turf
Airport Elevation: 1110 ft
Runway Surface Condition:
Runway Used: 10
IFR Approach: None
Runway Length/Width: 1633 ft / 200 ft
VFR Approach/Landing: None



Wreckage and Impact Information

Crew Injuries: 1 Serious
Aircraft Damage: Substantial
Passenger Injuries: 1 Minor
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 Serious, 1 Minor
Latitude, Longitude:  40.875556, -81.766389

Loss of Engine Power (Total): Beech A36 Bonanza, N36LP, accident occurred May 04, 2018 in Shullsburg, Lafayette County, Wisconsin

The National Transportation Safety Board did not travel to the scene of this accident.

Additional Participating Entities:

Federal Aviation Administration / Flight Standards District Office; Milwaukee, Wisconsin 
Continental Motors Inc; Mobile, Alabama

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


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


Aviation Accident Data Summary - National Transportation Safety Board: https://app.ntsb.gov/pdf
 
http://registry.faa.gov/N36LP


Location: Shullsburg, WI
Accident Number: CEN18LA159
Date & Time: 05/04/2018, 1930 CDT
Registration: N36LP
Aircraft: BEECH A36
Aircraft Damage: Substantial
Defining Event: Loss of engine power (total)
Injuries: 1 None
Flight Conducted Under: Part 91: General Aviation - Personal 

Analysis 

The commercial pilot reported that he heard an unusual noise from the engine during cruise flight and shortly afterward, the engine experienced a total loss of power. The pilot performed a forced landing to an open field.

Visual examination of the engine revealed a hole in the crankcase. A teardown examination revealed fretting on the crankcase mating surfaces, shifting of the No. 2 main bearing within the journal support, thermal damage consistent with a loss of oil lubrication, and separation of the crankshaft. The observed fretting damage was consistent with relative movement of the crankcase halves during operation due to a lack of through-bolt torque. The main journal bearing damage, the separation of the crankshaft, and the crankcase damage were secondary and a result of the loss of lubrication.

An engine overhaul was completed in about 11 years 5 months before the accident; about 849 flight hours had accumulated since the overhaul. Two cylinders were replaced 6 years before the accident, and one cylinder was replaced during the most recent annual inspection about 9 months before the accident. It is likely that improper torque of the through-bolt nuts was applied during one of the cylinder replacement events, though it could not be determined which event.

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be: 
A catastrophic engine failure due to improper torque on the engine through-bolt nuts, which resulted in relative movement between the crankcase halves, damage to a main journal bearing, and a loss of oil lubrication.

Findings

Aircraft
Recip engine power section - Failure (Cause)
Recip engine power section - Incorrect service/maintenance (Cause)

Personnel issues
Scheduled/routine maintenance - Maintenance personnel (Cause)

Factual Information

On May 4, 2018, about 1930 central daylight time, a Beech A36 airplane, N36LP, was substantially damaged during a forced landing following a loss of engine power near Shullsburg, Wisconsin. The pilot was not injured. The airplane was registered to and operated by a private individual as a Title 14 Code of Federal Regulations Part 91 personal flight. Visual meteorological conditions prevailed, and the flight was operating on an instrument flight rules flight plan. The flight originated from the Okmulgee Regional Airport (OKM), Okmulgee, Oklahoma, about 1537. The intended destination was Bucky's Airport (WN09), Plainfield, Wisconsin.

The pilot reported that the airplane was in cruise flight at 7,000 ft mean sea level when he heard an unusual noise from the engine. Shortly afterward, the engine lost power and he executed a forced landing to an open field. He recalled thinking that oil may have escaped from the engine because he observed smoke. The airplane sustained substantial damage to the lower fuselage/nose landing gear wheel well structure.

A postaccident engine examination revealed a hole in the crankcase above the no. 1 cylinder. A teardown examination revealed wear on the mating crankcase surfaces consistent with fretting of the case halves. The no. 2 main journal bearing was shifted within the bearing support, the lock tab was elongated, and the bearing was extruded. Bearing fragments were recovered from the oil sump. The crankshaft was separated between the no. 2 main bearing journal and the no. 2 connecting rod journal. The crankshaft was discolored adjacent to the separation consistent with thermal damage due to a lack of oil lubrication. The remaining portions of the crankshaft displayed normal operating and lubrication signatures. The no. 2 connecting rod bearing exhibited damage consistent with lubrication distress. The oil pump housing and impellers exhibited scoring consistent with hard particle passage.

Airplane maintenance records indicated that an engine overhaul was completed in November 2006. The no. 2 and no. 4 cylinders were replaced in June 2012. The most recent annual inspection was completed in August 2017. The no. 5 cylinder was replaced during the annual inspection. At the accident site, the airplane recording hour (Hobbs) meter and tachometer indicated 4,698.4 hours and 7.951.79 hours, respectively. At the time of the accident, the engine had accumulated 848.9 hours since overhaul and 9.8 hours since the annual inspection. The time between overhaul (TBO) interval recommended by the engine manufacturer was 1,700 hours or 12 years, whichever came first.

In October 2016, the NTSB issued a safety alert regarding improper torque of engine fasteners during maintenance activities. 

History of Flight

Enroute-cruise
Loss of engine power (total) (Defining event)

Emergency descent
Off-field or emergency landing

Pilot Information

Certificate: Flight Instructor; Commercial
Age: 49, Male
Airplane Rating(s): Multi-engine Land; Single-engine Land
Seat Occupied: Left
Other Aircraft Rating(s): None
Restraint Used: 3-point
Instrument Rating(s): Airplane
Second Pilot Present: No
Instructor Rating(s): Airplane Multi-engine; Airplane Single-engine; Instrument Airplane
Toxicology Performed: No
Medical Certification: Class 1 Without Waivers/Limitations
Last FAA Medical Exam: 02/21/2018
Occupational Pilot: Yes
Last Flight Review or Equivalent: 02/02/2018
Flight Time:  994 hours (Total, all aircraft), 281 hours (Total, this make and model), 942 hours (Pilot In Command, all aircraft), 299 hours (Last 90 days, all aircraft), 111 hours (Last 30 days, all aircraft), 8 hours (Last 24 hours, all aircraft) 

Aircraft and Owner/Operator Information

Aircraft Make: BEECH
Registration: N36LP
Model/Series: A36 UNDESIGNATED
Aircraft Category: Airplane
Year of Manufacture: 1976
Amateur Built: No
Airworthiness Certificate: Utility
Serial Number: E-894
Landing Gear Type: Retractable - Tricycle
Seats: 6
Date/Type of Last Inspection: 08/19/2017, Annual
Certified Max Gross Wt.: 3651 lbs
Time Since Last Inspection: 10 Hours
Engines: 1 Reciprocating
Airframe Total Time: 7951.8 Hours at time of accident
Engine Manufacturer: Continental
ELT: C91  installed, activated, aided in locating accident
Engine Model/Series: IO-520-BB
Registered Owner: On file
Rated Power: 285 hp
Operator: On file
Operating Certificate(s) Held: None 

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: PVB
Distance from Accident Site: 12 Nautical Miles
Observation Time: 1855 CDT
Direction from Accident Site: 307°
Lowest Cloud Condition: Clear
Visibility:  10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 9 knots /
Turbulence Type Forecast/Actual: /
Wind Direction: 290°
Turbulence Severity Forecast/Actual: /
Altimeter Setting: 29.98 inches Hg
Temperature/Dew Point: 22°C / 8°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Okmulgee, OK (OKM)
Type of Flight Plan Filed: IFR
Destination: Plainfield, WI (WN09)
Type of Clearance: IFR
Departure Time: 1530 CDT
Type of Airspace: Class E; Class G 

Wreckage and Impact Information

Crew Injuries: 1 None
Aircraft Damage: Substantial
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 None
Latitude, Longitude: 42.573056, -90.232222 (est)

Grumman G-164 Ag-Cat, registered to and operated by Aero Ag Services Inc as a Title 14 Code of Federal Regulations Part 137 aerial application flight, N6637: Accident occurred April 27, 2018 in Garwood, Colorado County, Texas

The National Transportation Safety Board did not travel to the scene of this accident. 

Additional Participating Entity: 

Federal Aviation Administration / Flight Standards District Office; Houston, Texas

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


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


Aviation Accident Data Summary - National Transportation Safety Board: https://app.ntsb.gov/pdf  

http://registry.faa.gov/N6637


Location: Garwood, TX
Accident Number: CEN18LA152
Date & Time: 04/27/2018, 1800 CDT
Registration: N6637
Aircraft: GRUMMAN G 164A
Aircraft Damage: Substantial
Defining Event: Loss of engine power (partial)
Injuries: 1 None
Flight Conducted Under: Part 137: Agricultural 

Analysis 

The commercial pilot was departing on an agricultural application flight when the engine experienced a partial loss of power shortly after takeoff. The pilot released part of the load of fertilizer and attempted to land in a nearby field. The airplane contacted a levee during the landing, which separated the landing gear. The airplane became airborne again, then settled back onto the ground and subsequently nosed over. The reported weather conditions were conducive to serious carburetor icing at glide power; however, the airplane was operating at a high power setting for takeoff. Therefore, it is unlikely that carburetor icing was present. A postaccident examination of the engine did not reveal any mechanical malfunctions or anomalies and the reason for the partial loss of power could not be determined.

Probable Cause and Findings

The National Transportation Safety Board determines the probable cause(s) of this accident to be:
A partial loss of engine power for reasons that could not be determined because postaccident examination of the engine did not reveal any anomalies that would have precluded normal operation.

Findings

Not determined
Not determined - Unknown/Not determined (Cause)


Factual Information

On April 27, 2018, at 1800 central daylight time, a Grumman G-164A airplane, nosed over during an off airport forced landing in Garwood, Texas. The pilot was not injured. The airplane was substantially damaged. The airplane was registered to and operated by Aero Ag Services Inc., as a Title 14 Code of Federal Regulations Part 137 aerial application flight. Day visual meteorological conditions prevailed. The flight was not operated on flight plan. The local flight was originating from a private airstrip in Garwood, Texas, when the accident occurred.

The pilot reported that he was taking off with a full load of fertilizer on the 28TH flight of the day when the accident occurred. He stated the ground run and lift off were normal. After lifting off, he began a turn and reduced the engine power to 32 inches of manifold pressure. He then felt a "slight shudder" and an additional reduction in engine power with no sputtering or backfiring. Although the manifold pressure still indicated 32 inches of manifold pressure and the propeller was at full rpm, the pilot decided to return to the airstrip. As he turned, the pilot perceived that the engine was not producing power, so he leveled the wings, lowered the nose, and dumped some of the fertilizer load. The airplane contacted a levee during the forced landing which separated the landing gear and the airplane becoming airborne. The airplane touched down a second time and nosed over.

A postaccident examination of the engine was conducted on September 12, 2018, at Air Salvage of Dallas, Lancaster, Texas. One propeller blade was bent rearward about 70° and the other was slightly bent rearward. The carburetor was broken off the engine. Both magnetos produced spark when rotated by hand. Engine continuity was established, and compression was achieved on all cylinders except for the No. 5 cylinder that sustained impact damage. The spark plugs were removed. All the plugs were slightly dark in color with normal wear signatures. The blower impeller was visually examined and appeared normal. The impeller appeared to have excessive backlash, about 0.750 inches, but there was no end play and no signs of contact between the impeller and the case. No metal was detected in the oil sump or inlet screen. The air box and air filter were clear of debris. The carburetor heat door was wired in the open/off position. The examination of the engine did not reveal any anomalies that would have precluded normal operation.

The temperature and dewpoint recorded at the Wharton Regional Airport (ARM), Wharton, Texas, located 23 miles southeast of the accident site, at 1815 were 77°F and 48°F respectively. According to the Federal Aviation Administration SAIB CE-09-35 Carburetor Icing Probability Chart those conditions were favorable for serious carburetor icing at glide power.

History of Flight

Initial climb
Loss of engine power (partial) (Defining event)

Landing
Collision with terr/obj (non-CFIT)

Landing-flare/touchdown
Landing gear collapse

Nose over/nose down

Pilot Information

Certificate: Commercial
Age: 29, Male
Airplane Rating(s): Single-engine Land
Seat Occupied: Center
Other Aircraft Rating(s): None
Restraint Used: 4-point
Instrument Rating(s): None
Second Pilot Present: No
Instructor Rating(s): None
Toxicology Performed: No
Medical Certification: Class 2 Without Waivers/Limitations
Last FAA Medical Exam: 12/28/2017
Occupational Pilot: Yes
Last Flight Review or Equivalent: 01/05/2017
Flight Time:  2140 hours (Total, all aircraft), 1125 hours (Total, this make and model), 2115 hours (Pilot In Command, all aircraft), 240 hours (Last 90 days, all aircraft), 40 hours (Last 30 days, all aircraft), 6 hours (Last 24 hours, all aircraft)

Aircraft and Owner/Operator Information

Aircraft Make: GRUMMAN
Registration: N6637
Model/Series: G 164A
Aircraft Category: Airplane
Year of Manufacture: 1970
Amateur Built: No
Airworthiness Certificate: Restricted
Serial Number: 766
Landing Gear Type: Tailwheel
Seats: 1
Date/Type of Last Inspection: 02/28/2018, Annual
Certified Max Gross Wt.: 6000 lbs
Time Since Last Inspection: 20 Hours
Engines: 1 Reciprocating
Airframe Total Time: 17000 Hours
Engine Manufacturer: Pratt & Whitney
ELT: Not installed
Engine Model/Series: R-1340-AN1
Registered Owner: AERO AG SERVICES INC
Rated Power: 600 hp
Operator: AERO AG SERVICES INC
Operating Certificate(s) Held: Agricultural Aircraft (137) 

Meteorological Information and Flight Plan

Conditions at Accident Site: Visual Conditions
Condition of Light: Day
Observation Facility, Elevation: KARM, 100 ft msl
Distance from Accident Site: 23 Nautical Miles
Observation Time: 1815 CDT
Direction from Accident Site: 118°
Lowest Cloud Condition: Clear
Visibility: 10 Miles
Lowest Ceiling: None
Visibility (RVR):
Wind Speed/Gusts: 7 knots /
Turbulence Type Forecast/Actual: /
Wind Direction: 10°
Turbulence Severity Forecast/Actual: /
Altimeter Setting: 30.01 inches Hg
Temperature/Dew Point: 25°C / 9°C
Precipitation and Obscuration: No Obscuration; No Precipitation
Departure Point: Garwood, TX (PVT)
Type of Flight Plan Filed: None
Destination: Garwood, TX (PVT)
Type of Clearance: None
Departure Time:  CDT
Type of Airspace: Class G

Airport Information

Airport: Private (PVT)
Runway Surface Type: Dirt
Airport Elevation: 178 ft
Runway Surface Condition: Rough
Runway Used: N/A
IFR Approach: None
Runway Length/Width:  
VFR Approach/Landing: Forced Landing 

Wreckage and Impact Information

Crew Injuries: 1 None
Aircraft Damage: Substantial
Passenger Injuries: N/A
Aircraft Fire: None
Ground Injuries: N/A
Aircraft Explosion: None
Total Injuries: 1 None
Latitude, Longitude: 29.444722, -96.399167