# NTSB CEN09CA342: Beech S35, N8636Q, Decatur, TX, June 5, 2009 - Type: NTSB accident investigation - Classification: Accident · No injuries · Data collection · Final report - Date: June 5, 2009, 09:50 local (14:50 UTC) - Place: Decatur, TX - Coordinates: 33.134445, -97.606941 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=33.1344&lon=-97.6069&mi=10 - Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping) - Defining event: [Takeoff-rejected takeoff: Flight instrument malf/fail](https://openairdocs.org/ntsb-events/334) - Highest injury: No injuries - Injuries: 2 uninjured - Status: Completed, report September 10, 2009 - Report: Approved by Office Director - NTSB office: Central Region - Parties: FAA - NTSB case key (mKey): 73979 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN09CA342 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/73979/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=73979 - Page: https://openairdocs.org/ntsb/CEN09CA342 ## Probable cause Both pilots' inadequate preflight inspection and failure to identify the presence of dirt and insect larvae in the pitot tube, and the owner-pilot's attempt to turn off the runway and onto the taxiway at an excessive speed during the aborted takeoff. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Inspection: preflight inspection](https://openairdocs.org/ntsb-findings/02061510): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/02061510/cases.md?model=1151532), [All aircraft, 551 cases](https://openairdocs.org/ntsb-findings/02061510/cases.md) - [Inspection: preflight inspection](https://openairdocs.org/ntsb-findings/02061510): Personnel issues › Task performance · Passenger (probable cause); cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/02061510/cases.md?model=1151532), [All aircraft, 551 cases](https://openairdocs.org/ntsb-findings/02061510/cases.md) - [Navigation system: airspeed/mach indicating](https://openairdocs.org/ntsb-findings/01023414): Aircraft › Aircraft systems · Malfunction; cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/01023414/cases.md?model=1151532), [All aircraft, 6 cases](https://openairdocs.org/ntsb-findings/01023414/cases.md) - [Navigation system: pitot/static system](https://openairdocs.org/ntsb-findings/01023411): Aircraft › Aircraft systems · Inadequate inspection; cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/01023411/cases.md?model=1151532), [All aircraft, 7 cases](https://openairdocs.org/ntsb-findings/01023411/cases.md) - [Object/animal/substance: debris/dirt/foreign object](https://openairdocs.org/ntsb-findings/03022055): Environmental issues › Physical environment · Effect on equipment; cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/03022055/cases.md?model=1151532), [All aircraft, 101 cases](https://openairdocs.org/ntsb-findings/03022055/cases.md) - [Performance/control parameters: surface speed/braking](https://openairdocs.org/ntsb-findings/01062045): Aircraft › Aircraft oper/perf/capability · Incorrect use/operation (probable cause); cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-findings/01062045/cases.md?model=1151532), [All aircraft, 238 cases](https://openairdocs.org/ntsb-findings/01062045/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Prior to flight: Preflight or dispatch event](https://openairdocs.org/ntsb-events/030); cases with it: [Beech S35, 2 cases](https://openairdocs.org/ntsb-events/030/sequence.md?model=1151532), [All aircraft, 355 cases](https://openairdocs.org/ntsb-events/030/sequence.md) - [Takeoff-rejected takeoff: Flight instrument malf/fail](https://openairdocs.org/ntsb-events/334) (defining event); cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-events/334/sequence.md?model=1151532), [All aircraft, 56 cases](https://openairdocs.org/ntsb-events/334/sequence.md) - [Takeoff-rejected takeoff: Loss of control on ground](https://openairdocs.org/ntsb-events/230); cases with it: [Beech S35, 1 case](https://openairdocs.org/ntsb-events/230/sequence.md?model=1151532), [All aircraft, 4,585 cases](https://openairdocs.org/ntsb-events/230/sequence.md) ## Analysis An annual inspection had just been completed on the airplane and it was flown to the owner's location by a pilot mechanic. The owner pilot entered the airplane with the engines running and took control of the airplane from the pilot mechanic. The owner pilot then performed a takeoff on a wet, grass runway. The pilot stated that the airspeed indicator stopped increasing at about 60 knots indicated airspeed, so he aborted the takeoff; during which, the airplane slid on the runway approximately 1,200 feet before the pilot attempted a right turn onto a taxi-way. During the turn the left main landing gear collapsed and the airplane slid into trees located near the taxiway, damaging the left aileron. Examination of the airplane revealed dirt and insect larvae in the pitot tube. The pilot mechanic stated that he performed a preflight, but did not inspect the pitot tube. ## Factual narrative An annual inspection had just been completed on the airplane and it was flown to the owner's location by a pilot-mechanic. The owner-pilot entered the airplane with the engines running and took control of the airplane from the pilot-mechanic. The owner-pilot then performed a takeoff on a wet, grass runway. The owner-pilot stated the airspeed stopped increasing at about 60 knots indicated airspeed, so he aborted the takeoff. During the abort, the airplane slid on the runway approximately 1,200 feet before the owner-pilot attempted a right turn onto a taxiway. During the turn, the left main landing gear collapsed and the airplane slid into trees located near the taxiway, damaging the left aileron. Examination of the airplane revealed dirt and insect larvae in the pitot tube. The pilot-mechanic stated he performed a preflight inspection, but he did not inspect the pitot tube. ## Aircraft - Registration: [N8636Q](https://openairdocs.org/aircraft/N8636Q), registered now, S/N D-7658, built 1964 (OpenAirDocs) - Reported make and model: BEECH S35 - Registry model: [Beech S35](https://openairdocs.org/model/beech-s35) (registry code 1151532) (OpenAirDocs) - Registry engine: [Continental IO-520 series](https://openairdocs.org/engine/continental-io-520-series) (registry code 17032, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: D-7658 - Airframe hours: 6187 - Engines: CONT MOTOR IO 520 SERIES 285 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Operator: Jackson Steven D - Registered owner: Jackson Steven D - Airworthiness certificate: Standard, Normal - Last inspection: Annual, June 1, 2009 - Departed: XA99, Decatur, TX - Destination: XA99, Decatur, TX - Airport: XA99, Flat Bush Airport, runway 35, 2,300 × 100 ft, grass/turf ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 47; injuries: fatal; private; airplane ratings: single-engine land; medical: class 3, with waivers/limitations; last flight review June 6, 2008; seat: left; flight hours: 542 total, 340 in this make and model, 441 as pilot in command, 15 in the last 90 days, 1 in the last 30 days, 1 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: 100° at 4 knots - Visibility: 10 statute miles - Temperature: 73 °F, dew point 52 °F - Altimeter: 30.05 inHg - Observed at: lud, 7 nm away ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20090605008659A](https://openairdocs.org/incident/20090605008659A), Jun 5, 2009: Beech S35, Decatur, TX, Substantial damage. (-23) Aborted takeoff, airspeed lower than minimum. Wet grass airstrip, could not stop prior to the end of the runway, impacted trees and collapsed left gear. ## Other investigations on N8636Q (1) From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. - [NTSB MKC69D0214](https://openairdocs.org/ntsb/MKC69D0214), Aug 18, 1968: Beech S35 (N8636Q), Bethany, MO, substantial damage ## Docket (4 files) The files NTSB released with the investigation on July 22, 2009, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=73979. 413 KB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 328 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40315703&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF - Witness Statement - Pilot (item 2, .PDF, 27 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40315996&FileExtension=.PDF&FileName=Witness%20Statement%20-%20Pilot-Redacted.PDF - Witness Statement - Passenger (item 3, .PDF, 27 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40315997&FileExtension=.PDF&FileName=Witness%20Statement%20-%20Passenger-Redacted.PDF - Witness Statement (item 4, .PDF, 30 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40315998&FileExtension=.PDF&FileName=Witness%20Statement-Redacted.PDF From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.