# NTSB CEN15LA106: Diamond Aircraft Ind DA 20 C1, N979DC, Shipshewana, IN, January 19, 2015

- Type: NTSB accident investigation
- Classification: Accident · No injuries · Limited investigation · Final report
- Date: January 19, 2015, 17:00 local (22:00 UTC)
- Place: Shipshewana, IN
- Coordinates: 41.705833, -85.613052 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=41.7058&lon=-85.6131&mi=10
- Phase of flight: [Maneuvering](https://openairdocs.org/ntsb-phases/450) (OpenAirDocs' grouping)
- Defining event: [Maneuvering-low-alt flying: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341)
- Highest injury: No injuries
- Injuries: 1 uninjured
- Status: Completed, report March 17, 2015
- Report: Approved by Office Director
- NTSB office: Central Region
- Parties: FAA, Continental Motors Inc
- NTSB case key (mKey): 90617
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN15LA106
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/90617/pdf
- NTSB docket: https://data.ntsb.gov/Docket?ProjectID=90617
- Page: https://openairdocs.org/ntsb/CEN15LA106

## Probable cause

The total loss of engine power due to impact ice obstructing the primary air induction system, which resulted from the student pilot’s failure to operate the alternate air control. Contributing to the accident was the student pilot’s lack of knowledge about using the alternate air control during an engine power loss.

## Findings

NTSB's coded findings; those marked are part of the probable cause.

- [Power plant: air intake](https://openairdocs.org/ntsb-findings/01057160): Aircraft › Aircraft power plant · Incorrect use/operation (probable cause); cases with it: [Diamond Aircraft Ind DA20-C1, 1 case](https://openairdocs.org/ntsb-findings/01057160/cases.md?model=2990001), [All aircraft, 50 cases](https://openairdocs.org/ntsb-findings/01057160/cases.md)
- [Environmental issues](https://openairdocs.org/ntsb-findings/03030000): Environmental issues › Conditions/weather/phenomena · Effect on equipment (probable cause); cases with it: [Diamond Aircraft Ind DA20-C1, 1 case](https://openairdocs.org/ntsb-findings/03030000/cases.md?model=2990001), [All aircraft, 57 cases](https://openairdocs.org/ntsb-findings/03030000/cases.md)
- [Knowledge: knowledge of equipment](https://openairdocs.org/ntsb-findings/02032015): Personnel issues › Experience/knowledge · Student/instructed pilot (probable cause); cases with it: [Diamond Aircraft Ind DA20-C1, 1 case](https://openairdocs.org/ntsb-findings/02032015/cases.md?model=2990001), [All aircraft, 69 cases](https://openairdocs.org/ntsb-findings/02032015/cases.md)
- [Training: training with equipment](https://openairdocs.org/ntsb-findings/02031530): Personnel issues › Experience/knowledge · Student/instructed pilot; cases with it: [Diamond Aircraft Ind DA20-C1, 1 case](https://openairdocs.org/ntsb-findings/02031530/cases.md?model=2990001), [All aircraft, 32 cases](https://openairdocs.org/ntsb-findings/02031530/cases.md)
- [Action: lack of action](https://openairdocs.org/ntsb-findings/02041030): Personnel issues › Action/decision · Student/instructed pilot (probable cause); cases with it: [Diamond Aircraft Ind DA20-C1, 6 cases](https://openairdocs.org/ntsb-findings/02041030/cases.md?model=2990001), [All aircraft, 792 cases](https://openairdocs.org/ntsb-findings/02041030/cases.md)
- [Use of equip/info: use of equip/system](https://openairdocs.org/ntsb-findings/02063015): Personnel issues › Task performance · Student/instructed pilot (probable cause); cases with it: [Diamond Aircraft Ind DA20-C1, 4 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md?model=2990001), [All aircraft, 1,391 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md)

## Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event best describes what happened.

- [Maneuvering-low-alt flying: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341) (defining event); cases with it: [Diamond Aircraft Ind DA20-C1, 12 cases](https://openairdocs.org/ntsb-events/341/sequence.md?model=2990001), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md)
- [Maneuvering-low-alt flying: Other weather encounter](https://openairdocs.org/ntsb-events/400); cases with it: [Diamond Aircraft Ind DA20-C1, 3 cases](https://openairdocs.org/ntsb-events/400/sequence.md?model=2990001), [All aircraft, 1,127 cases](https://openairdocs.org/ntsb-events/400/sequence.md)

## Analysis

The student pilot reported that he was practicing solo ground reference maneuvers about 1,600 ft above ground level when the engine began operating erratically. He further stated that the airplane might have entered an aerodynamic stall. He advanced the throttle to full forward, but the engine did not respond and subsequently experienced a total loss of power. He attempted to restart the engine by completing the emergency procedures that he remembered. The engine "turned over" but did not restart. He then prepared for a forced landing to a nearby field. During the base-to-final turn, he lost control of the airplane, and it descended to the ground. The airplane impacted the field and continued into a propane tank and then a house where it came to rest. A postaccident examination of the airplane revealed that most of the induction air filter was obstructed by ice; no other anomalies were noted. The engine was test run with and without the ice in the air filter, and the engine produced full power under both conditions. The alternate air lever, which selects a second induction air intake in case the primary air intake (air filter) becomes restricted, was found in the "off" position. The aircraft flight manual states that, in the event of an in-flight engine failure, the alternate air control should be opened (or "on"). A Federal Aviation Administration advisory circular warns pilots of induction system icing known as "impact ice," which can build up on components like the air filter when moisture-laden air is near freezing. Based on the near-freezing outside air temperature and clouds in the area in which the flight was operating and the lack of any apparent engine malfunctions, it is likely that the primary air induction system became obstructed with impact ice during the flight. When asked about the airplane's alternate air lever, the student pilot indicated that he was unfamiliar with the lever and did not know its intended use. If the student pilot had opened the alternate air control during the initial power loss, it is likely that engine power would have been restored.

## Factual narrative

On January 19, 2015, about 1700 eastern standard time, a Diamond Aircraft Inc. DA 20 C1 airplane, N979DC, made a forced landing into a field near Shipshewana, Indiana. The solo student pilot was not injured and the airplane sustained substantial damage. The airplane was registered to and operated by New Horizons Aviation Inc. under the provisions of 14 Code of Federal Regulations Part 91 as a solo instructional flight. Visual meteorological conditions prevailed and no flight plan was filed. The local flight departed from the Goshen Municipal Airport (GSH), Goshen, Indiana about 1645. According to the student pilot, he was about 1,600 feet above ground level practicing ground reference maneuvers. He reported that the engine operation became erratic and the airplane might have entered an aerodynamic stall. He advanced the throttle to full forward, but the engine did not respond and experienced a total loss of power. He attempted to restart the engine by completing the emergency procedures that he remembered. The engine "turned over" but did not restart. He then prepared for a forced landing into a nearby field. During the base to final turn, he lost control of the airplane and descended to the ground. The airplane impacted the field and continued into a propane tank and then a house where it came to rest. The student pilot reported having accumulated 12 total flight hours, all of which were logged in the preceding 30 days, and in the same make and model airplane. The airplane was a two seat, low wing, tricycle landing gear, training airplane which was manufactured in 2005. It was powered by a 125-horsepower Continental Motors Inc. IO-240 engine, which drove a Sensenich two-bladed, fixed pitched, wooden propeller. On January 22, 2015, the airplane was examined after the accident by a Federal Aviation Administration (FAA) Inspector and a representative from Continental Motors Inc. The examination revealed that the majority of the induction air filter was covered with ice. The alternate air lever in the airplane was OFF. The engine cylinders each displayed normal operating signatures. The spark plugs displayed normal wear signatures when compared to a Champion Aviation Service Manual No. AV6-R. Internal crankshaft continuity was established by rotating the propeller. Additionally, all four cylinders displayed thumb suction and compression. The top spark plugs and ignition leads were reinstalled for an engine operational test run. The air filter remained impacted with ice during the first engine run; the engine was capable of running with the throttle full forward and produced about 2,200 RPM which is normal for a fixed pitch propeller. The alternate air lever was moved to ON and the engine was still capable of producing about 2,200 RPM. The engine was then shut down and the ice removed from the air filter. The engine was subjected to a second test run; the engine produced 2,200 RPM with the throttle advanced to full forward. The ignition switch wasactuated to test both magnetos and the decreases in RPM were normal and the engine indications displayed normal operating parameters. Other than the ice in the air induction filter there were no anomalies noted that would have precluded normal operation. The airplane sustained substantial damage to the fuselage and empennage. During the postaccident investigation, the pilot was asked about the airplane's alternate air lever. He reported that he was unfamiliar with the lever and did not know its intended use. He also stated that he flew through some low clouds during the flight, but they did not obstruct his view of the ground and he was able to maintain visual flight rules (VFR) the entire time. At 1653 the weather observation station at GSH, which was located 13 miles southwest, reported the following conditions: wind from 200 degrees at 3 knots, visibility 10 miles, few clouds at 12,000 feet, temperature 36° Fahrenheit (F), dew point 30° F, altimeter setting 29.94 inches of mercury. Using the average temperature lapse rate, 3.5° F per 1,000 feet, the temperature at 1,600 feet would have been about 30° F. The Diamond Aircraft Airplane Flight Manual (AFM) stated in Chapter 7.9.2 Engine Controls: The alternate air control selects a second induction air intake in case of restriction of the primary air intake (air filter). AFM Chapter 3.3.1 (c) Engine Failure during Flight – ENGINE RUNNING ROUGHLY – the pilot should perform the following checklist: 1. Mixture – FULL RICH 2. Alternate Air – OPEN 3. Fuel Shut-off – OPEN 4. Fuel Pump – ON 5. Ignition Switch – cycle L – BOTH – R – BOTH 6. Throttle – at present position 7. No Improvement – reduce throttle to minimum required power, land as soon as possible. FAA Advisory Circular 20-113. The Advisory Circular states that one form of induction system icing is impact ice and states in part: "Impact ice is formed by moisture-laden air at temperatures below freezing, striking and freezing on elements of the induction system which are at temperatures of 32° F or below. Under these conditions, ice may build up on such components as the air scoops, heat or alternate air valves, intake screens, and protrusions in the carburetor. Pilots should be particularly alert for such icing when flying in snow, sleet, rain, or clouds, especially when they see ice forming on the windshield or leading edge of the wings. The ambient temperature at which impact ice can be expected to build most rapidly is about 25° F, when the super cooled moisture in the air is still in a semi liquid state. This type of icing affects an engine with fuel injection, as well as carbureted engines. It is usually preferable to use carburetor heat or alternate air as an ice prevention means..."

## Aircraft

- Registration: [N979DC](https://openairdocs.org/deregistered/N979DC-2018-02-15), registration cancelled 2018-02-15, S/N C0314, built 2005 (OpenAirDocs)
- Reported make and model: DIAMOND AIRCRAFT IND INC DA 20 C1
- Registry model: [Diamond Aircraft Ind DA20-C1](https://openairdocs.org/model/diamond-aircraft-ind-da20-c1) (registry code 2990001) (OpenAirDocs)
- Registry engine: [Continental IO-240 series](https://openairdocs.org/engine/continental-io-240-series) (registry code 17063, reciprocating) (OpenAirDocs)
- Category: Airplane
- Serial number: C0314
- Year built: 2005
- Airframe hours: 3195
- Engines: Continental Motors Inc IO-240 125 horsepower reciprocating
- Damage: Substantial damage
- Flight: Instructional, Part 91
- Operator: New Horizons Aviation Inc
- Registered owner: New Horizons Aviation Inc
- Airworthiness certificate: Standard, Utility
- Departed: GSH, GOSHEN, IN
- Destination: GSH, GOSHEN, IN
- Airport: GSH, Goshen Muni

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Student pilot; age 18; injuries: none; student; medical: class 2, without waivers/limitations; seat: left; restraint: 4-point; flight hours: 12 total, 12 in this make and model, 2 as pilot in command, 12 in the last 90 days, 12 in the last 30 days, 2 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Day
- Wind: 200° at 3 knots
- Visibility: 10 statute miles
- Temperature: 36 °F, dew point 30 °F
- Altimeter: 29.94 inHg
- Observed at: KGSH, 13 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 20150119000499A](https://openairdocs.org/incident/20150119000499A), Jan 19, 2015: Diamond Aircraft Ind Inc DA20-C1, Shipshewanna, IN, Substantial damage. Pilot stated that he had departed from goshen airport (gsh) for pattern work and then he flew to elkhart airport (ekm) to do more pattern work. He then went…

## Docket (12 files)

The files NTSB released with the investigation on February 19, 2015, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=90617. 30.4 MB in all.

- Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 619 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422761&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Redacted.PDF
- Engine Run Report CMI (item 2, .PDF, 1.7 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422762&FileExtension=.PDF&FileName=Engine%20Run%20Report%20CMI-Redacted.PDF
- Record of Conversation - Student Pilot (item 3, .PDF, 54 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422763&FileExtension=.PDF&FileName=Record%20of%20Conversation%20-%20Student%20Pilot-Master.PDF
- Airplane Flight Manual Excerpts (item 4, .PDF, 59 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422764&FileExtension=.PDF&FileName=Airplane%20Flight%20Manual%20Excerpts-Master.PDF
- FAA Advisory Circular 20-113 (item 5, .PDF, 546 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422765&FileExtension=.PDF&FileName=FAA%20Advisory%20Circular%2020-113-Master.PDF
- Statement of Party Representatives to NTSB Investigation (item 6, .PDF, 57 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422766&FileExtension=.PDF&FileName=Statement%20of%20Party%20Representatives%20to%20NTSB%20Investigation-Redacted.PDF
- Photo 1 - Main Wreckage (Photo Courtesy of FAA) (item 7, .PDF, 2.5 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422767&FileExtension=.PDF&FileName=Photo%201%20-%20Main%20Wreckage%20(Photo%20Courtesy%20of%20FAA)-Master.PDF
- Photo 2 - Ice in Air Filter (Photo Courtesy of FAA) (item 8, .PDF, 1.7 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422768&FileExtension=.PDF&FileName=Photo%202%20-%20Ice%20in%20Air%20Filter%20(Photo%20Courtesy%20of%20FAA)-Master.PDF
- Photo 3 – Ice in Air Filter During Examination (Photo Courtesy of Continental Motors) (item 9, .PDF, 5.7 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422769&FileExtension=.PDF&FileName=Photo%203%20%E2%80%93%20Ice%20in%20Air%20Filter%20During%20Examination%20(Photo%20Courtesy%20of%20Continental%20Motors)-Master.PDF
- Photo 4 – Ice from Air Filter Side View (Photo Courtesy of Continental Motors) (item 10, .PDF, 5.5 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422770&FileExtension=.PDF&FileName=Photo%204%20%E2%80%93%20Ice%20from%20Air%20Filter%20Side%20View%20(Photo%20Courtesy%20of%20Continental%20Motors)-Master.PDF
- Photo 5 – Ice from Air Filter Top View (Photo Courtesy of Continental Motors) (item 11, .PDF, 6.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422771&FileExtension=.PDF&FileName=Photo%205%20%E2%80%93%20Ice%20from%20Air%20Filter%20Top%20View%20(Photo%20Courtesy%20of%20Continental%20Motors)-Master.PDF
- Photo 6 – Alternate Air Control (Photo Courtesy of Continental Motors) (item 12, .PDF, 5.7 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40422772&FileExtension=.PDF&FileName=Photo%206%20%E2%80%93%20Alternate%20Air%20Control%20(Photo%20Courtesy%20of%20Continental%20Motors)-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.

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