# NTSB CEN14LA134: Cessna 172K, N4VN, Milan, IL, January 26, 2014 - Type: NTSB accident investigation - Classification: Accident · No injuries · Limited investigation · Final report - Date: January 26, 2014, 17:17 local (23:17 UTC) - Place: Milan, IL - Coordinates: 41.440032, -90.559196 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=41.4400&lon=-90.5592&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Defining event: [Approach-VFR pattern final: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341) - Highest injury: No injuries - Injuries: 2 uninjured - Status: Completed, report September 24, 2014 - Report: Approved by Office Director - NTSB office: Central Region - Parties: Federal Aviation Administration; DuPage FSDO - SAIBs cited in the narratives: [SAIB CE-09-35](https://openairdocs.org/saib/CE-09-35) (OpenAirDocs) - NTSB case key (mKey): 88792 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN14LA134 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/88792/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=88792 - Page: https://openairdocs.org/ntsb/CEN14LA134 ## Probable cause The pilot’s delayed use of carburetor heat while operating the airplane in atmospheric conditions conducive to carburetor icing, which resulted in a total loss of engine power due to carburetor icing during a short final approach. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Action: delayed action](https://openairdocs.org/ntsb-findings/02041025): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Cessna 172K, 5 cases](https://openairdocs.org/ntsb-findings/02041025/cases.md?model=2072430), [All aircraft, 894 cases](https://openairdocs.org/ntsb-findings/02041025/cases.md) - [Engine fuel and control: fuel control/carburetor](https://openairdocs.org/ntsb-findings/01057322): Aircraft › Aircraft power plant · Incorrect use/operation (probable cause); cases with it: [Cessna 172K, 1 case](https://openairdocs.org/ntsb-findings/01057322/cases.md?model=2072430), [All aircraft, 195 cases](https://openairdocs.org/ntsb-findings/01057322/cases.md) - [Temp/humidity/pressure: conducive to carburetor icing](https://openairdocs.org/ntsb-findings/03031030): Environmental issues › Conditions/weather/phenomena · Effect on equipment (probable cause); cases with it: [Cessna 172K, 2 cases](https://openairdocs.org/ntsb-findings/03031030/cases.md?model=2072430), [All aircraft, 435 cases](https://openairdocs.org/ntsb-findings/03031030/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Approach: Other weather encounter](https://openairdocs.org/ntsb-events/400); cases with it: [Cessna 172K, 3 cases](https://openairdocs.org/ntsb-events/400/sequence.md?model=2072430), [All aircraft, 1,127 cases](https://openairdocs.org/ntsb-events/400/sequence.md) - [Approach-VFR pattern final: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341) (defining event); cases with it: [Cessna 172K, 11 cases](https://openairdocs.org/ntsb-events/341/sequence.md?model=2072430), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md) - [Emergency descent: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341); cases with it: [Cessna 172K, 11 cases](https://openairdocs.org/ntsb-events/341/sequence.md?model=2072430), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md) - [Landing: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Cessna 172K, 33 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=2072430), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The pilot reported that the airplane experienced a total loss of engine power when he applied carburetor heat during a 1-mile final approach to the destination airport. The pilot then performed a forced landing to a field. Although the pilot stated that the engine rpm decreased when he actuated the carburetor heat during the preflight run-up, postaccident examinations revealed no mechanical anomalies with the carburetor or its heat system that would have precluded normal operation. Atmospheric conditions at the time of the accident were conducive to the accumulation of carburetor icing at glide and cruise power. It is likely that the pilot's delayed use of carburetor heat resulted in a total loss of engine power due to carburetor icing. ## Factual narrative On January 26, 2014, at 1717 central standard time, a Cessna 172K, N4VN, experienced a total loss of engine power when the pilot applied carburetor heat during a visual approach to Quad City International Airport (MLI), Moline, Illinois. The pilot performed a forced landing to a field near Milan, Illinois. The airplane sustained substantial damage to the right wing. The commercial pilot and passenger were uninjured. Visual meteorological conditions prevailed at the time of the accident. The 14 CFR Part 91 personal flight was not operating on a flight plan. The flight originated from Davenport Municipal Airport, Davenport, Iowa, at 1615 and was destined to MLI. The pilot stated that he applied carburetor heat after the MLI air traffic control tower issued a landing clearance for runway 31 after receiving a special visual flight rules clearance to the airport. When he applied carburetor heat about one mile from the runway, the engine quit. He performed a forced landing to a field and touched down at 10-15 mph. The Federal Aviation Administration (FAA) Dupage Flight Standard District Office, West Chicago, Illinois, did not send an FAA maintenance inspector to examine the airplane on-scene following the accident. The National Transportation Safety Board Investigator-In-Charge (IIC) then requested that the airplane owner provide the carburetor and maintenance logbook copies for examination, which were provided by the owner. The airplane owner stated the mechanic who had performed that last annual inspection also installed the carburetor and then removed it for the post-accident examination. The airplane owner stated that during the post-accident removal of the carburetor, there were no mechanical anomalies with the carburetor heat system. The pilot stated that there was an engine rpm decrease when he checked the operation of carburetor heat during an engine run-up prior to departing on the accident flight. The MLI Automated Surface Observing System (ASOS) recorded the following observation: At 1715; special (unscheduled) report; wind – 340 degrees at 11 knots, gust - 21 knots; visibility – 1 statute mile; runway 9 runway visual range – 6,000 feet; weather phenomena - light frozen precipitation; sky condition - broken at 2,700 feet mean sea level, broken at 4,000 feet, overcast at 4,900 feet; temperature - -1 degree Celsius; dew point - -5 degrees Celsius; altimeter – 29.55 inches of mercury. The pilot stated that the airplane did not enter any of the snow showers that were approaching MLI during the accident flight. He said that the snow showers arrived at MLI about 30 minutes after the accident. Special Airworthiness Bulletin, CE-09-35, Carburetor Icing Prevention, includes a graph that shows the probability of carburetor icing for various temperature and relative humidity conditions. At a temperature and dew point as recorded by the MLI ASOS, there was a probability of icing in glide and cruise power. The received carburetor was a Marvel ScheblerMA-4-5, part number 10-3676, serial number MS820601, carburetor. Logbook copies included an Authorized Release Certificate, FAA Form 8130-3, which stated the carburetor was overhauled by Marvel-Schebler Aircraft Carburetors, LLC. The date of FAA Form 8130-3 was July 25, 2013. Copies of logbook entry dated June 25, 2013, at a tachometer time of 4,571 hours, stated that an annual inspection was performed. An entry dated October 21, 2013, at a tachometer time of 4,626 hours, stated that the carburetor was [removed and replaced] with an overhauled carburetor, referencing Form 8130-2. The airplane owner said that the tachometer time at the time of the accident was 4,669 hours. Post-accident disassembly examination of the airplane under the supervision of the IIC and an FAA inspector from Dupage Flight Standard District Office revealed that the fuel screen did not contain contaminant, the idle screw was extended about 2 ½ turns, and the throttle valve and float had clearances from the carburetor body that were within service manual specifications. All of the carburetor retaining hardware was in place and secure. ## Aircraft - Registration: [N4VN](https://openairdocs.org/deregistered/N4VN-2014-12-22), registration cancelled 2014-12-22, S/N 17258242, built 1969 (OpenAirDocs) - Reported make and model: CESSNA 172K - Registry model: [Cessna 172K](https://openairdocs.org/model/cessna-172k) (registry code 2072430) (OpenAirDocs) - Registry engine: [Lycoming 0-320 series](https://openairdocs.org/engine/lycoming-0-320-series) (registry code 41508, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 17258242 - Airframe hours: 4571 - Engines: Lycoming O-360-A1A L-14253-36A 180 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Operator: Pilot - Registered owner: Aaxiom Consulting LLC - Airworthiness certificate: Standard, Normal - Last inspection: Annual, June 25, 2013, 98 hours before - Departed: DVN, Davenport, IA - Destination: MLI, Milan, IL - Airport: MLI, Quad City International Airpor, runway 31, 7,301 × 150 ft, asphalt - Equipment: Stall warning system ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 65; injuries: none; commercial; airplane ratings: multi-engine land; instrument ratings: airplane; medical: class 2, with waivers/limitations; last flight review October 23, 2013; seat: left; restraint: lap only; flight hours: 16,180 total, 663 in this make and model, 16,180 as pilot in command ## Weather - Conditions: Visual (VMC), Day - Wind: 340° at 13 knots, gusting 21 - Visibility: 8 statute miles - Lowest ceiling: 4,600 ft overcast - Temperature: 30 °F, dew point 23 °F - Altimeter: 29.51 inHg - Observed at: MLI, 2 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 20140126000979A](https://openairdocs.org/incident/20140126000979A), Jan 26, 2014: Cessna 172K, Milan, IL, Substantial damage. Aircraft departed davenport, IA (dvn) enroute to Washington airport, Washington, Iowa (kawg). Due to deteriorating weather conditions the pilot in command… ## Docket (5 files) The files NTSB released with the investigation on May 21, 2014, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=88792. 2.3 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 1.8 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40412552&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF - Record of Conversation Pilot (item 2, .PDF, 53 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40412553&FileExtension=.PDF&FileName=Record%20of%20Conversation%20Pilot-Master.PDF - Weather Information (item 3, .PDF, 85 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40412554&FileExtension=.PDF&FileName=Weather%20Information-Master.PDF - Carburetor Probability Icing Chart (item 4, .PDF, 260 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40412555&FileExtension=.PDF&FileName=Carburetor%20Probability%20Icing%20Chart-Master.PDF - SAIB CE-09-05 (item 5, .PDF, 111 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40412556&FileExtension=.PDF&FileName=SAIB%20CE-09-05-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.