# NTSB CEN15LA418: Cessna 421B, N813CA, Platteville, WI, September 21, 2015

- Type: NTSB accident investigation
- Classification: Accident · Minor injuries · Limited investigation · Final report
- Date: September 21, 2015, 10:40 local (15:40 UTC)
- Place: Platteville, WI
- Coordinates: 42.689445, -90.444442 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=42.6894&lon=-90.4444&mi=10
- Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping)
- Defining event: [Takeoff-rejected takeoff: Runway excursion](https://openairdocs.org/ntsb-events/300)
- Highest injury: Minor injuries
- Injuries: 2 minor
- Status: Completed, report November 6, 2019
- Report: Approved by Office Director
- NTSB office: Central Region
- Parties: FAA, Textron Aviation, Continental Motors
- NTSB case key (mKey): 92032
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN15LA418
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/92032/pdf
- NTSB docket: https://data.ntsb.gov/Docket?ProjectID=92032
- Page: https://openairdocs.org/ntsb/CEN15LA418

## Probable cause

The partial loss of right engine power for undetermined reasons with insufficient runway remaining for the aborted takeoff.

## Findings

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

- [Not determined](https://openairdocs.org/ntsb-findings/05000000): Not determined › Not determined · Unknown/Not determined (probable cause); cases with it: [Cessna 421B, 4 cases](https://openairdocs.org/ntsb-findings/05000000/cases.md?model=2076014), [All aircraft, 2,247 cases](https://openairdocs.org/ntsb-findings/05000000/cases.md)
- [Airport facilities/design: runway/landing area length](https://openairdocs.org/ntsb-findings/03017037): Environmental issues › Operating environment · Decision related to condition (probable cause); cases with it: [Cessna 421B, 1 case](https://openairdocs.org/ntsb-findings/03017037/cases.md?model=2076014), [All aircraft, 34 cases](https://openairdocs.org/ntsb-findings/03017037/cases.md)
- [Airport facilities/design: runway/landing area length](https://openairdocs.org/ntsb-findings/03017037): Environmental issues › Operating environment · Contributed to outcome (probable cause); cases with it: [Cessna 421B, 1 case](https://openairdocs.org/ntsb-findings/03017037/cases.md?model=2076014), [All aircraft, 34 cases](https://openairdocs.org/ntsb-findings/03017037/cases.md)
- [Engine indicating system: manifold pressure (MP)](https://openairdocs.org/ntsb-findings/01057713): Aircraft › Aircraft power plant · Related operating info; cases with it: [Cessna 421B, 1 case](https://openairdocs.org/ntsb-findings/01057713/cases.md?model=2076014), [All aircraft, 1 case](https://openairdocs.org/ntsb-findings/01057713/cases.md)

## Sequence of events

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

- [Takeoff: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342); cases with it: [Cessna 421B, 3 cases](https://openairdocs.org/ntsb-events/342/sequence.md?model=2076014), [All aircraft, 1,858 cases](https://openairdocs.org/ntsb-events/342/sequence.md)
- [Takeoff-rejected takeoff: Runway excursion](https://openairdocs.org/ntsb-events/300) (defining event); cases with it: [Cessna 421B, 6 cases](https://openairdocs.org/ntsb-events/300/sequence.md?model=2076014), [All aircraft, 3,643 cases](https://openairdocs.org/ntsb-events/300/sequence.md)

## Analysis

The commercial pilot reported that he completed the pretakeoff checklist, which included a run-up of each engine; no anomalies were noted. During the takeoff roll, the pilot noticed a decrease in manifold pressure in the right engine and felt a power reduction. He attempted to abort the takeoff with about 1,000 ft of runway pavement remaining. However, the airplane was traveling at 85 knots at the time of his decision, and the airplane would have needed about 2,400 ft of runway to stop. The airplane departed the runway surface, continued through a grassy area, and came to a stop in an adjacent field, which resulted in substantial damage to the nose and wing. During the postaccident examination of the right engine, the engine was successfully test run, and no anomalies were found during the run that would have precluded normal operation or production of rated horsepower. The circumstances of the accident are consistent with the pilot choosing to abort the takeoff with inadequate runway distance remaining after a reported loss of engine power. The exact magneto timing was not determined, and although it could have affected the engine performance, the reason for the loss of engine power could not be determined based on the available evidence.

## Factual narrative

On September 21, 2015, about 1040 central daylight time, a Cessna 421B airplane, N813CA, sustained substantial damage after a loss of engine power and runway excursion at Platteville Municipal Airport (PBV), Platteville, Wisconsin. The commercial-rated pilot and passenger were not injured. The airplane was registered to Blue Hansa LLC and operated by a private individual under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Visual meteorological conditions prevailed at the time of the accident and an instrument flight rules flight plan was filed. The flight was originating at the time of the accident. The pilot reported he completed a preflight inspection of the airplane per the checklist and checked the weather. He taxied to the end of runway 15 and completed the pre-takeoff checklist, which included an engine run-up for each engine. There were no anomalies noted during the pre-flight or pre-takeoff checklists. He taxied onto the runway and advanced both throttles full forward. At 85 knots, just before the runway 7/25 crossing, he started rotation and noticed the right engine manifold pressure decrease and felt a power reduction. He aborted the takeoff; he pulled back both throttles and applied the brakes "hard." The airplane continued on the runway for about 1,000 ft then off of the runway into the grass and a soybean field where it came to rest. The responding Federal Aviation Administration (FAA) inspector documented the witness marks left from the accident airplane on the runway and grass surfaces. There were airplane tire skid marks on the last 1,000 ft of runway pavement and tire marks in the grass for 290 ft off the end of the runway where the terrain slopes downward. The tire marks were not present for about 90 ft consistent with the airplane becoming airborne until the airplane impacted the ground again and the gear collapsed. The witness marks in the grass continued for another 90 ft where the airplane came to rest in a soybean field. Runway 15/33 at PVB is 3,999 ft in length. The intersection of runway 7/25 is about 3,000 ft from the beginning of runway 15; the remaining runway distance from the intersection to the departure end of runway 15 is about 1,000 ft. According to Cessna 421B operating manual, the distance needed during an accelerated stop with a decision speed of 85 knots is about 2,400 ft. The right engine was sent to Continental Motors, Inc (CMI) in Mobile, Alabama for examination and an engine test run, which were completed on January 4 and 5, 2015. The right engine was received intact with no signs of significant impact damage. The cylinders were borescoped; the cylinders, piston faces, and valve heads displayed normal operating and combustion signatures. The magneto-to-engine timing was checked, the exact timing was not determined because it was about 5º past the specified timing scale visible from the engine timing plug. The right engine was mounted on a test stand for functionaltesting. The engine started normally, on the first attempt with no signs of hesitation in RPM. The propeller was out of track because the propeller flange was bent. Shims were placed between the propeller flange and hub to bring the propeller back in track. The engine was restarted, and the engine RPM was advanced in steps for warm-up in preparation for full power operation; the engine run time was limited due to the damage to the propeller flange. Throughout the test phase, the engine accelerated normally without any hesitation or interruption in power and demonstrated the ability to produce rated horsepower.

## Aircraft

- Registration: [N813CA](https://openairdocs.org/deregistered/N813CA-2018-03-23), registration cancelled 2018-03-23, S/N 421B0894 (OpenAirDocs)
- Reported make and model: CESSNA 421B (B)
- Registry model: [Cessna 421B](https://openairdocs.org/model/cessna-421b) (registry code 2076014) (OpenAirDocs)
- Category: Airplane
- Serial number: 421B0894
- Airframe hours: 3844.7
- Engines: Continental GTSIO-520 H1B 375 horsepower reciprocating; Continental GTSIO-520 H2B 375 horsepower reciprocating
- Damage: Substantial damage
- Flight: Business, Part 91
- Airworthiness certificate: Standard, Normal
- Last inspection: Annual, August 1, 2015
- Departed: PVB, Platteville, WI
- Destination: DAY, DAYTON, OH
- Flight plan: IFR
- Airport: PVB, Platteville Muni, runway 15, 3,999 × 75 ft, asphalt
- Equipment: Stall warning system, Satellite tracking device, Onboard weather, Auto-pilot, ADS-B

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 66; injuries: none; private, commercial; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 2, with waivers/limitations; last flight review September 27, 2013; seat: left; flight hours: 1,478 total, 194 in this make and model, 1,478 as pilot in command, 27 in the last 90 days, 4 in the last 30 days

## Weather

- Conditions: Visual (VMC), Day
- Wind: 170° at 8 knots
- Visibility: 10 statute miles
- Lowest ceiling: none
- Temperature: 64 °F, dew point 52 °F
- Altimeter: 30.12 inHg
- Observed at: KPVB

## 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 20150921017819A](https://openairdocs.org/incident/20150921017819A), Sep 21, 2015: Cessna 421B, Platteville, WI, Substantial damage. PIC had a normal preflight and run-up. PIC back-taxied for takeoff on rwy 15. Pilot experienced normal acceleration until approximately 82 KIAS. At that point,…

## Docket (5 files)

The files NTSB released with the investigation on April 30, 2019, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=92032. 3.3 MB in all.

- Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 2.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472298&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF
- Notes from Right Engine Test Run for N813CA (item 2, .PDF, 150 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472299&FileExtension=.PDF&FileName=Notes%20from%20Right%20Engine%20Test%20Run%20for%20N813CA-Master.PDF
- Release of Aircraft Wreckage, NTSB Form 6120.15 (item 3, .PDF, 205 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472300&FileExtension=.PDF&FileName=Release%20of%20Aircraft%20Wreckage,%20NTSB%20Form%206120.15-Master.PDF
- Party Form (Textron) (item 4, .PDF, 225 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472301&FileExtension=.PDF&FileName=Party%20Form%20(Textron)-Master.PDF
- Party Form (Continental Motors) (item 5, .PDF, 669 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40472302&FileExtension=.PDF&FileName=Party%20Form%20(Continental%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.

---
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.