# NTSB CEN12LA118: Piper PA-32-260, N997TB, Elk Rapids, MI, December 31, 2011 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Limited investigation · Final report - Date: December 31, 2011, 12:20 local (17:20 UTC) - Place: Elk Rapids, MI - Coordinates: 44.908889, -85.410003 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=44.9089&lon=-85.4100&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Defining event: [Enroute-cruise: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342) - Highest injury: Minor injuries - Injuries: 1 minor, 4 uninjured - Status: Completed, report May 21, 2012 - Report: Approved by Office Director - NTSB office: Central Region - Parties: FAA Grand Rapids FSDO - NTSB case key (mKey): 82594 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN12LA118 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/82594/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=82594 - Page: https://openairdocs.org/ntsb/CEN12LA118 ## Probable cause The loss of engine power due to the failure of the exhaust valve. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Engine (reciprocating): recip eng cyl section](https://openairdocs.org/ntsb-findings/01058530): Aircraft › Aircraft power plant · Failure (probable cause); cases with it: [Piper PA-32-260, 3 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md?model=7103206), [All aircraft, 373 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md) - [Engine (reciprocating): recip eng cyl section](https://openairdocs.org/ntsb-findings/01058530): Aircraft › Aircraft power plant · Not serviced/maintained; cases with it: [Piper PA-32-260, 3 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md?model=7103206), [All aircraft, 373 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Enroute-cruise: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342) (defining event); cases with it: [Piper PA-32-260, 11 cases](https://openairdocs.org/ntsb-events/342/sequence.md?model=7103206), [All aircraft, 1,858 cases](https://openairdocs.org/ntsb-events/342/sequence.md) - [Emergency descent: Off-field or emergency landing](https://openairdocs.org/ntsb-events/440); cases with it: [Piper PA-32-260, 19 cases](https://openairdocs.org/ntsb-events/440/sequence.md?model=7103206), [All aircraft, 3,365 cases](https://openairdocs.org/ntsb-events/440/sequence.md) - [Landing-landing roll: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Piper PA-32-260, 30 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=7103206), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The pilot reported that the airplane was in cruise flight when the engine started to run rough and vibrate. He adjusted and checked the fuel mixture, throttle, magnetos, boost pump, and carburetor heat, but the vibration continued to get worse. He executed a forced landing to a field, but the airplane impacted a line of trees at the end of the field. Postaccident examination of the engine revealed that the No. 1 cylinder exhaust valve was broken with about 50 percent of the valve face missing. The engine logbooks revealed that the engine was overhauled in 1994 and had accumulated 1,972.3 hours since the last overhaul. The engine manufacturer recommends that the engine be overhauled every 2,000 hours or after 12 years since last overhaul. ## Factual narrative On December 31, 2011, about 1220 eastern standard time, a Piper PA-32-260, N997TB, sustained substantial damage during a forced landing to a field after a loss of engine power near Elk Rapids, Michigan. The commercial pilot and three passengers were not injured and one passenger received minor injuries. The airplane was registered to Bulldog Air LLC and operated by the pilot as a personal flight under the provisions of the 14 Code of Federal Regulations Part 91. Visual meteorological conditions prevailed at the time of the accident, and no flight plan was filed. The local flight departed from the Cherry Capital Airport (TVC), Traverse City, Michigan, at 1150. The pilot reported that the airplane was in cruise flight when the engine started to run rough and vibrate. He adjusted and checked the fuel mixture, throttle, magnetos, boost pump, and carburetor heat, but the vibration continued to get worse. He decided to execute a forced landing to a farmer’s field and touched down with the airplane aligned with the furrows. He reported that the braking was ineffective due to the frozen field, and the airplane impacted a line of trees at the end of the field. A Federal Aviation Administration airworthiness inspector examined the engine. He determined that the number one and number four cylinders had little to no compression when the propeller was rotated by hand. Both cylinders were removed. The number one cylinder exhaust valve was broken with approximately 50 per cent of the valve face missing. The piston and cylinder head were scarred with impact marks. The number four cylinder’s intact valve and seat were scarred, which was consistent with the compression loss. The upper and lower spark plug electrodes of the number four cylinder were forced closed, and there were impact marks on the piston and cylinder head. Examination of the airplane’s engine logbooks revealed that the Lycoming O-540-E4B5 engine was overhauled in 1994 by an airframe and powerplant (A&P) mechanic. There was 1,972.3 hours logged on the engine since the last overhaul. There was no indication in the engine logbook that the number one and number four cylinders were repaired or replaced since the engine was overhauled. The most recent annual inspection was completed in April 2011. The Lycoming Service Instruction No. 1009AT, “Recommended Time Between Overhaul Periods” recommended that the O-540-E4B5 engine be overhauled every 2,000 hours, or after 12 years of service since engine overhaul. ## Aircraft - Registration: [N997TB](https://openairdocs.org/deregistered/N997TB-2012-11-28), registration cancelled 2012-11-28, S/N 32-508, built 1966 (OpenAirDocs) - Reported make and model: PIPER PA-32-260 - Registry model: [Piper PA-32-260](https://openairdocs.org/model/piper-pa-32-260) (registry code 7103206) (OpenAirDocs) - Registry engine: [Lycoming 0-540 series](https://openairdocs.org/engine/lycoming-0-540-series) (registry code 41532, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 32-508 - Airframe hours: 6712 - Engines: LYCOMING O-540-E4B5 250 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Operator: Sam Pfeiffer, Jr. - Registered owner: Bulldog Air LLC - Airworthiness certificate: Standard, Normal - Last inspection: Annual, April 15, 2011 - Departed: TVC, Traverse City, MI - Destination: TVC, Traverse City, MI ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 65; injuries: none; commercial; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane, helicopter; medical: class 2, with waivers/limitations; last flight review December 28, 2011; seat: left; flight hours: 6,045 total, 734 in this make and model, 3 in the last 90 days, 2 in the last 30 days, 1 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: 160° at 6 knots - Visibility: 10 statute miles - Lowest ceiling: 2,600 ft broken - Temperature: 37 °F, dew point 27 °F - Altimeter: 29.92 inHg - Observed at: TVC, 12 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 20111231030349A](https://openairdocs.org/incident/20111231030349A), Dec 31, 2011: Piper PA-32-260, Elk Rapids, MI, Substantial damage. On 12/31/2011 at 1150 local time a CFR part 91 pleasure flight departed ktvc for a local sight seeing flight. Pilot stated during cruise flight the engine… ## Docket (5 files) The files NTSB released with the investigation on April 30, 2012, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=82594. 3.3 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 1.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40365987&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF - Engine Logbook Entries (item 2, .PDF, 1.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40365990&FileExtension=.PDF&FileName=Engine%20Logbook%20Entries-Redacted.PDF - Lycoming Service Instruction (item 3, .PDF, 431 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40366018&FileExtension=.PDF&FileName=Lycoming%20Service%20Instruction-Master.PDF - Photo 1: Airplane Wreckage (item 4, .PDF, 210 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40366004&FileExtension=.PDF&FileName=Photo%201%3A%20Airplane%20Wreckage-Master.PDF - Photo 2: View of Airplane Wreckage (item 5, .PDF, 222 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40366005&FileExtension=.PDF&FileName=Photo%202%3A%20View%20of%20Airplane%20Wreckage-Master.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.