ANC24LA011

NTSB accident investigation · Cessna 172P · Kahului, HI · December 23, 2023

Accident · No injuriesClass 3 · LimitedFinal report
Date
December 23, 2023, 10:00 local (20:00 UTC)
Place
Kahului, HI
Injuries
3 uninjured
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N53725Cessna 172P
Defining event
Approach-VFR pattern base: Fuel related
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Alaska Regional Office
Parties
FAA Honolulu FSDO
FAA report
20231223022269A
Case key
193608

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

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Probable cause

A partial loss of engine power due to the formation of carburetor ice, which resulted in the inability to maintain altitude in the traffic pattern. Contributing to the outcome was the pilot’s delayed use of carburetor heat in conditions conducive to the formation of carburetor ice.

Findings · 3

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Ice/rain protection system: intake anti-ice, deiceAircraft › Aircraft systems · Not used/operatedCessna 172P: 2 casesAll aircraft: 108 casesProbable cause
Action: delayed actionPersonnel issues › Action/decision · PilotCessna 172P: 9 casesAll aircraft: 894 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Analysis

The pilot reported that, after five touch-and-go landings, while on the base leg of the traffic pattern, the engine lost partial power. The pilot applied carburetor heat, switched the fuel tanks, and pumped the throttle, but engine power remained at idle. The pilot was unable to reach the runway and performed a forced landing short of the runway. Upon touchdown, the airplane nosed over and came to rest inverted, which resulted in substantial damage to the fuselage and empennage. The atmospheric conditions at the time of the accident were conducive to serious icing at glide power. Although the pilot reported that he used carburetor heat after experiencing the loss of engine power, it is likely that the ice had already accumulated to the degree that the carburetor heat was insufficient to melt the ice and restore full engine power. Based on the available information, it is likely that the partial loss of engine power was a result of the formation of carburetor ice. A postaccident examination of the engine revealed no preimpact mechanical malfunctions or failures that would have precluded normal operation.

Factual narrative

On December 23, 2023, about 1000 Hawaii-Aleutian standard time, a Cessna 172P, N53725, was substantially damaged when it was involved in an accident near Kahului Airport (PHOG), Kahului, Hawaii. The pilot and two passengers were not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot reported that, after five touch-and-go landings, while on the base leg of the traffic pattern, the engine lost partial power. The pilot applied carburetor heat, switched the fuel tanks, and pumped the throttle, but engine power remained at idle. Unable to reach the runway, the pilot performed a forced landing short of the runway. Upon touchdown, the airplane nosed over and came to rest inverted, which resulted in substantial damage to the fuselage and empennage. About 20 gallons of automotive fuel remained in the fuel tanks at the accident site. A postaccident engine examination revealed the presence of fuel in the strainer and carburetor bowl. The fuel was drained from the strainer and carburetor bowl, and a trace amount of water was found. Continuity was established on all linkages to the carburetor and airbox; all linkages functioned normally, and the butterfly valves were found to operate normally. The spark plugs were removed and the plug electrodes appeared normal. The magnetos produced spark on all ignition leads. The airplane was started normally and accelerated smoothly from idle to 1,700 rpm with no anomalies noted. A review of the local meteorological data and the Carburetor Icing Probability Chart located in the Federal Aviation Administration’s (FAA) Special Airworthiness Information Bulletin CE-09-35, Carburetor Icing Prevention, dated June 30, 2009, revealed that the weather conditions at the time of the accident were conducive to serious icing at glide power. FAA Special Airworthiness Information Bulletin (CE-09-35) – Carburetor Icing Prevention, stated that: “…pilots should be aware that carburetor icing doesn't just occur in freezing conditions, it can occur at temperatures well above freezing temperatures when there is visible moisture or high humidity. Icing can occur in the carburetor at temperatures above freezing because vaporization of fuel, combined with the expansion of air as it flows through the carburetor, (Venturi Effect) causes sudden cooling, sometimes by a significant amount within a fraction of a second. Carburetor ice can be detected by a drop in rpm in fixed pitch propeller airplanes and a drop in manifold pressure in constant speed propeller airplanes. In both types, usually there will be a roughness in engine operation.” According to Transport Canada TP 10737 (Use of Automotive Gasoline [Mogas] in Aviation), Mogas is generally higher in volatility than Avgas and will thus absorb more heat from the mixing air when vaporizing, resulting in ice accumulation at higher ambient temperatures. It goes on to say that “the likelihood of carb icing while flying on Mogas ishigher,” and advises that, “[a]lthough the severity of the carb icing and the methods to deal with it are similar for both Avgas and Mogas, its ONSET is likely to occur at HIGHER AMBIENT TEMPERATURES and at LOWER HUMIDITY with Mogas. In other words, conditions under which a pilot may feel there is only a slight risk for carb icing on Avgas may in fact be ideal for the formation of ice while using more volatile Mogas. This will result in the need to select ‘carb heat on’ in less severe icing conditions and for a longer duration while using Mogas.”

Aircraft

Registration
N53725
Reported as
Cessna 172P
Category
Airplane
Serial number
17274808
Built
1981
Airframe hours
6,858
Engine
Lycoming O320-D2J, 160 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
Annual · January 23, 2023 · 134.8 hours before
Departed
PHOG · Kahului, HI
Destination
Same as departure
Airport
PHOG · Kahului Airport
Equipment
Stall warning system, ADS-B, Auto-pilot

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
64
Injuries
None
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 3, Unknown
Last flight review
December 14, 2023
Seat
Left
Restraint
4-point
Flight hours
20,000 total · 2,200 in this make and model · 120 in the last 90 days · 30 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
50° at 19 knots, gusting 25
Visibility
9 statute miles
Temperature
77 °F, dew point 66 °F
Altimeter
30.13 inHg
Observed at
HOG, 1 nm away
METAR
PHOG 231954Z 05019G25KT 10SM FEW020 25/19 A3013 RMK AO2 PK WND 05027/1938 SLP207 T02500194

Docket · 5

The files NTSB released with the investigation on April 2, 2025, on NTSB’s docket system: statements, records, photos and specialists’ reports. 18.4 MB in all.

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.