# NTSB DEN01FA162: Cessna 337B, N337PM, St. George, UT, September 24, 2001 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: September 24, 2001, 16:15 local (22:15 UTC) - Place: St. George, UT - Coordinates: 37.180629, -113.599525 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=37.1806&lon=-113.5995&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed, report July 25, 2002 - Report: Approved by Office Director - Parties: FAA Flight Standards District Office - NTSB case key (mKey): 53507 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=DEN01FA162 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/53507/pdf - Page: https://openairdocs.org/ntsb/DEN01FA162 ## Probable cause total loss of engine power on both engines due to fuel starvation and the pilot's inability to access the available fuel supply. Contributing factors were the pilot's inadequate supervision of the refueling operation, and his intentional operation of the airplane with known deficiencies in equipment (no fuel selector valve handles or placards installed). ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of engine power(total) - nonmechanical, approach - vfr pattern - downwind - 2 engines - fuel supply - not possible, pilot in command (cause) - fluid,fuel - starvation (cause) - refueling - performed, dual student - supervision - inadequate, pilot in command (contributing factor) - operation with known deficiencies in equipment - intentional, pilot in command (contributing factor) - In flight collision with object, descent - emergency - object - wire,transmission ## Analysis The airplane had recently been repainted and was being ferried to another airport for complete refurbishing. The interior, including avionics and most of the instruments, had been removed. Prior to departure, the ATP-rated pilot drained both inboard wing tanks and drained no fuel. He requested that 15 gallons of fuel be added to each side. The fuel was put in the inboard (auxiliary) fuel tanks, which have a fuel capacity of 15 gallons each. No fuel was added to the outboard (main) fuel tanks, which have a fuel capacity of 40 gallons each. Departure and the 20 minute en route flight were without reported incident. Witnesses said the pilot had to abandon his initial landing approach to runway 34 due to conflicting traffic. The pilot then turned downwind for runway 6, but the airplane descended below airport elevation (the airport is situated on top of a mesa). Various witness accounts indicated one or both engines lost power. The airplane struck powerlines and impacted a downtown street. Fuel selector valve handles were not found in the wreckage. Upon opening both wings, the left and right fuel selector valves were found slightly misaligned from being centered on the left and right main tanks, respectively. The fuel tanks were then drained. Each auxiliary (inboard) tank contained 15 gallons of fuel. Approximately 3 ounces of fuel were drained from the left main (outboard) tank. No fuel drained from the right main tank. ## Factual narrative HISTORY OF FLIGHT On September 24, 2001, approximately 1615 mountain daylight time, a Cessna 337B, N337PM, operated by Aero West Jet Center, was destroyed when it collided with a powerline and impacted a highway in the town of St. George, Utah. The airline transport certificated pilot, the sole occupant aboard, was fatally injured. Visual meteorological conditions prevailed, and no flight plan had been filed for the ferry flight being conducted under Title 14 CFR Part 91. The flight originated in Mesquite, Nevada, approximately 1555. The owner brought the airplane to St. George in April 2000 to have it completely restored. The pilot flew the airplane to Mesquite on February 8, 2001, where it was repainted. The interior --- including avionics and most of the instruments --- had been removed, and refurbishing was scheduled for a later date. On the day of the accident, a flight student of the pilot, who was a flight instructor, flew him to Mesquite in a Cessna 172. The pilot was to ferry N337PM back to St. George. The student watched the pilot sump both inboard wing tanks. When no fuel came out of the right inboard tank, the pilot taxied the airplane over to the fuel pumps, and told the student to "put 15 gallons [of fuel] in each side." In an interview conducted on September 26, the student was asked to identify which tanks he fueled. Using another Cessna 337 parked on the ramp at St. George, he pointed to the left and right inboard tanks. When the refueling was finished, the pilot started both engines, taxied to the runway, and took off. The student followed in the Cessna 172, but never acquired visual contact with N337PM. There were at least 29 witnesses to the accident, 20 of whom gave written statements for the police report. Seven oral statements were received. Two additional written statements were submitted directly to investigators. When witness #1 (a pilot and FAA-designated aviation safety counselor) first saw the airplane, the pilot was "executing a missed approach [to] runway 34 approximately 50 feet above the ground." A Cessna 172 took off from runway 16 which "caused a conflict requiring the missed approach." He said the accident airplane turned west, dropped below field elevation, reappeared, then turned south. It "appeared to be struggling for altitude in a high angle of attack, approaching a stall and then recovering to normal flight." The airplane then turned east, crossed the departure end of runway 16, "dropped again below field elevation and turned north, close in on downwind, continuing the cycle of near stall and recovery." The witness listened for the sound of engines and noted "a full power sound of one engine," but it was "lacking the familiar rear engine propeller sound which is normal for a Skymaster." Witness #2, an instructor aboard a departing Cessna 150 saw the airplane turn final for runway 34, then make a 360 degree turn to avoid another airplane that took off on runway 16. He watched the accident airplane turn downwind below airport elevation and realized the pilot was in trouble. The airplane then turned left base "far below airport elevation...attempted to climb...stalled and nosed into the ground." Numerous witnesses saw the airplane strike powerlines. Witness #4 said "the engines were sputtering, then quit." Witness #13 heard an engine "cut out." Witness #14 said "it didn't sound like an engine was running." Witness #16 said the airplane "seemed to be stalling out engine power loss" (sic). Another witness, who had just turned south on Bluff Street, saw the airplane hit the powerlines and crash in front of his car. He said the front propeller "was barely turning." PERSONNEL INFORMATION The pilot was a retired FAA aviation safety inspector. He held Convair 240/340/440 and DeHaviland DHC-4 type ratings at the airline transport pilot level, and Boeing 707/720, Douglas DC-3, and North American B-25 type ratings at the commercial pilot level. His most recent logbook contained entries from April 15, 1994, to August 14, 2001. The only Cessna 337 entries in the logbook were made on February 8, 2001, when he ferried N337PM from St. George to Mesquite (0.8 hours), a local test flight on March 6, 2001 (1.0 hours), and a ferry flight from Broomfield, Colorado, to St. George (3.2 hours) on April 25. His wife stated, however, that he had flown the O-2 (the military's version of the Cessna 337) extensively when he served in the U.S. Air Force and Air Force Reserves. AIRCRAFT INFORMATION N337PM (s/n 337-0565), formerly N5465S and C-FFIK, was manufactured by the Cessna Aircraft Company in November 1966. During its last annual inspection on April 24, 1999, two Continental IO-360 factory remanufactured engines were installed --- a -C5B (s/n 060692-R) in the front, and a -D5B (s/n 063044-R) in the rear. The engines were remanufactured on March 27 and April 1, 1999, respectively. Two McCauley 2-blade, all metal, full feathering, constant speed propellers (m/n D2AF34C) were also installed --- a -61 (s/n 781640) in the front, and a -59 (s/n 725730) in the rear. At the time of these installations, the Hobbs meter read 283.4 hours, and the estimated total time on the airframe was 1,760.8 hours. According to the logbook entry, "Total time estimate only, no logs present before Jan. 16, 1987. Time transferred from logs of C-FFIK now changed to N337PM, 1,760.8 hrs." The Hobbs meter was recovered from the wreckage. The faceplate was missing but using a ruler for alignment, a reading of 428.85 was noted. METEOROLOGICAL INFORMATION The following pertinent METAR (Aviation Routine Weather Report) was recorded at the St. George Municipal Airport on the day of the accident at 1615: Wind, 230 degrees at 3 knots; visibility, 10 statute miles; sky condition, clear; temperature, 37 degrees C. (98 degrees F.); dew point, 1 degree C. (34 degrees F.); altimeter setting, 30.00 inches of mercury. AERODROME INFORMATION St. George Municipal Airport (SGU) is located one mile west of the city of St. George. It is situated on top of a mesa at an elevation of 2,941 feet msl. It has one runway: 16-34, 6,606 ft. x 100 ft., asphalt. WRECKAGE AND IMPACT INFORMATION The on-scene investigation commenced on September 25 and terminated on September 27, 2001. According to a spokesman for the St. George Water and Power Company, the airplane struck and severed two lines that crossed South Bluff Street: one was a phase line carrying 7,620 volts, and the other was a neutral line. Both lines were described as being 1 odd ACST (aluminum conduit steel reinforced). Each line consisted of 7 woven strands of wire about 7/16-inch in diameter. The lines spanned the street and were supported by 40-foot poles approximately 400 feet apart. The airplane struck the lines where the droop was about 38 feet above the pavement. Witnesses said that when the phase line dropped to the ground, there was considerable electrical arcing, breaking off large chunks of concrete from the sidewalk. The airplane came to rest on the west shoulder across from 55 S. Bluff Street (Utah Highway 18) at its intersection with Tabernacle Street, on a magnetic heading of 330 degrees. The fuselage was in the gutter. The left wing tip was bent up and was resting against an embankment hill. The left wing was also bent up about 3 feet from the tip and rested on the pavement. The extended landing gear were torn off. The flaps were retracted as measured by the flap actuator. Part of the front engine cowling was knocked off, exposing the engine that was partially separated from the firewall. The propeller assembly was fractured at the crankshaft. The rear engine and propeller were undamaged. The cabin floor was crushed upward and the roof was collapsed. The mixture controls were in the FULL RICH position, the propeller controls were in the LOW PITCH/HIGH RPM position, the front and rear engine throttles were in the midrange and slightly aft of midrange positions, ## Aircraft - Registration: [N337PM](https://openairdocs.org/deregistered/N337PM-2013-08-20), registration cancelled 2013-08-20, S/N 3370565, built 1967 (OpenAirDocs) - Reported make and model: Cessna 337B - Registry model: [Cessna 337B](https://openairdocs.org/model/cessna-337b) (registry code 2075706) (OpenAirDocs) - Registry engine: [Continental IO-360 series](https://openairdocs.org/engine/continental-io-360-series) (registry code 17025, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 337-0565 - Airframe hours: 1761 - Engines: Continental IO-360-C/D 210 horsepower reciprocating - Damage: Destroyed - Flight: Ferry, Part 91 - Operator: Aero West Jet Center - Registered owner: Richard B. Lowe - Airworthiness certificate: Special, Special flight (Special) - Last inspection: Annual, April 24, 1999, 145 hours before - Departed: 67L, Mesquite, NV - Destination: SGU, St. George, UT - Airport: SGU, St. George Municipal, runway 16, 6,606 × 100 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 67; injuries: fatal; commercial, airline transport, flight instructor; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 2, valid medical--w/ waivers/lim; last flight review September 18, 2000; seat: left; toxicology performed; flight hours: 14,701 total, 5 in this make and model, 14,685 as pilot in command, 33 in the last 90 days ## Weather - Conditions: Visual (VMC), Day - Wind: 230° at 3 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 99 °F, dew point 34 °F - Altimeter: 30.00 inHg - Observed at: SGU ## 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 20010924027089A](https://openairdocs.org/incident/20010924027089A), Sep 24, 2001: Cessna 337B, Saint George, UT, No damage. (-23) The aircraft interior had been removed for refurbishment while the aircraft was being painted. Part of the interior pieces removed were the fuel selector… 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.