# NTSB CHI95LA137: Cessna P210N, N4614K, Dodge City, KS, April 26, 1995 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Limited investigation · Final report - Date: April 26, 1995, 12:34 local (17:34 UTC) - Place: Dodge City, KS - Coordinates: 37.749141, -100.009437 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=37.7491&lon=-100.0094&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Highest injury: Serious injuries - Injuries: 3 serious, 3 uninjured - Status: Completed, report October 13, 1995 - Report: Approved by Office Director - NTSB case key (mKey): 9878 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CHI95LA137 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/9878/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=9878 - Page: https://openairdocs.org/ntsb/CHI95LA137 ## Probable cause fatigue and subsequent catastrophic failure of the connecting rod originating from the decarburized area on the shank of the rod. Factors were the low cloud weather condition and the ditch. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of engine power(total) - mech failure/malf, cruise - normal - engine assembly,connecting rod - fatigue - material defect, manufacturer (cause) - Forced landing, descent - emergency - In flight collision with terrain/water, landing - flare/touchdown - terrain condition - ditch (contributing factor) - weather condition - low ceiling (contributing factor) ## Analysis THE PILOT REPORTED THAT HE WAS CRUISING AT 16,000 FEET MEAN SEA LEVEL WHEN HE HEARD A LOUD EXPLOSION IN THE ENGINE COMPARTMENT AND THE ENGINE LOST POWER. HE DESCENDED THROUGH INSTRUMENT METEOROLOGICAL CONDITIONS AND WHEN HE BROKE OUT OF THE CLOUDS, THE AIRPORT WAS NOT IN SIGHT AND HE MADE A FORCED LANDING IN A FIELD. A FEDERAL AVIATION ADMINISTRATION (FAA) INSPECTOR WHO EXAMINED THE WRECKAGE REPORTED THAT THE PLANE WAS IN A WET WHEAT FIELD AND APPROXIMATELY 1000 FEET OF GROUND SCARS LED THROUGH A DITCH TO THE WRECKAGE. HE REPORTED NO EVIDENCE OF PREIMPACT AIRFRAME MALFUNCTION. DISASSEMBLY OF THE ENGINE REVEALED THE NUMBER ONE CONNECTING ROD FAILED DUE TO FATIGUE ORIGINATING FROM A DECARBURIZED LAYER ON THE SHANK OF THE ROD. ## Factual narrative On April 26, 1995, about 1234 central daylight time, a Cessna P210N, N4614K, piloted by an airline transport rated pilot, sustained minor damage during a forced landing near Dodge City, Kansas. The pilot and two passengers reported no injuries. Three passengers sustained serious injuries. Instrument meteorological conditions prevailed for the 14 CFR Part 91 flight. The flight originated in Sioux Falls, South Dakota, about 1000 with a planned destination of Amarillo, Texas. An IFR flight plan was filed. The pilot reported that he was cruising at 16,000 feet mean sea level with the power set at 63 percent. He heard a loud explosion in the engine compartment and the engine lost power. He reported an "engine failure" to the air route traffic control center. The controller vectored the airplane toward Dodge City, Kansas. The pilot reported that he descended through instrument meteorological conditions and when he broke out of the clouds, the airport was not in sight and he elected to land in a field. A Federal Aviation Administration (FAA) Inspector who examined the wreckage reported that the plane was in a wet wheat field and approximately 1000 feet of ground scars led downwind through a ditch to the wreckage. He reported no evidence of preimpact airframe malfunction. The engine was examined at the Teledyne Continental Motors Laboratory in Mobile, Alabama, on June 13, 1995. The number one and three cylinders, and the number one connecting rod were previously removed. The number one piston remained in the number one cylinder. The right magneto was broken off at the flange and there was a hole in the top of crankcase over the number one cylinder extending toward the crankcase centerline. Disassembly of the engine revealed the main bearings exhibited wiping and the number two through six connecting rod bearings were destroyed. The pistons on the right side of the engine had a thin layer of light white colored deposits and the left side pistons had dark colored deposits with a trace of white. The magnetos, fuel pump, throttle control, and manifold valve operated normally when bench tested. The number one connecting rod was fractured at the junction of the piston pin end and beam section. At the crankshaft end, the cap was spread at the parting surface and the bolts were fractured. A fragment of one bolt remained in the rod. The number one connecting rod was examined by a materials engineer at the NTSB Laboratory, Washington, D.C. In his factual report, the materials engineer stated the fracture at the piston end of the rod featured "characteristic of a fatigue crack emanated from multiple origins" The surface of the connecting rod shank contained a decarburized layer, .01 inch deep and 0.6 inches wide, that extended partially into the fracture zone. ## Aircraft - Registration: [N4614K](https://openairdocs.org/deregistered/N4614K-2023-01-31), registration cancelled 2023-01-31, S/N P21000237, built 1979 (OpenAirDocs) - Reported make and model: CESSNA P210N - Registry model: [Cessna P210N](https://openairdocs.org/model/cessna-p210n) (registry code 2073454) (OpenAirDocs) - Registry engine: [Continental TSIO-520 series](https://openairdocs.org/engine/continental-tsio-520-series) (registry code 17040, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: P21000237 - Engines: CONTINENTAL TSIO-520-P 310 horsepower reciprocating - Damage: Minor damage - Flight: Personal, Part 91 - Registered owner: Vosburg Equipment - Airworthiness certificate: Standard, Normal - Last inspection: Annual, December 1, 1994 - Departed: FSD, SIOUX FALLS, SD - Destination: AMA, AMARILLO, TX - Flight plan: IFR ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 54; airline transport; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, valid medical--w/ waivers/lim; seat: left; flight hours: 11,000 total, 1,000 in this make and model, 9,000 as pilot in command, 60 in the last 90 days, 20 in the last 30 days ## Weather - Conditions: Instrument (IMC), Day - Wind: 350° at 22 knots, gusting 32 - Visibility: 4 statute miles - Lowest ceiling: 1,200 ft overcast - Temperature: 39 °F, dew point 37 °F - Altimeter: 29.00 inHg - Observed at: DDC, 1 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 19950426014539A](https://openairdocs.org/incident/19950426014539A), Apr 26, 1995: Cessna P210N, Dodge City, KS, Minor damage. Loud engine explosion at FL160 and power loss. Landed wet wheat field. Broken connecting rod destroyed engine. ## Other investigations on N4614K (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 CEN21LA460](https://openairdocs.org/ntsb/CEN21LA460), Sep 28, 2021: Cessna P210N (N4614K), El Paso, TX, substantial damage. Probable cause: A faulty landing gear pressure switch prematurely deactivated the landing gear motor during extension, which resulted in the landing gear collapsing during rollout. ## Docket (3 files) The files NTSB released with the investigation on October 1, 1995, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=9878. 715 KB in all. - Supplement S (item 1, .PDF, 41 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40028483&FileExtension=.PDF&FileName=Supplement%20S-Master.PDF - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1/2 (item 2, .PDF, 316 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40439499&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1%2F2-Redacted.PDF - Metallurgist's Factual Report (item 3, .PDF, 358 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40439500&FileExtension=.PDF&FileName=Metallurgist%27s%20Factual%20Report-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.