# NTSB ERA09LA203: Wayne O Robinson S6S Rans, N312RW, Cartersville, GA, March 19, 2009 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Limited investigation · Final report - Date: March 19, 2009, 11:08 local (15:08 UTC) - Place: Cartersville, GA - Coordinates: 34.123054, -84.848609 - Nearby events: https://openairdocs.org/map.md?lat=34.1231&lon=-84.8486&mi=10 - Phase of flight: [Emergency descent](https://openairdocs.org/ntsb-phases/600) (OpenAirDocs' grouping) - Defining event: [Emergency descent: Aerodynamic stall/spin](https://openairdocs.org/ntsb-events/241) - Highest injury: Serious injuries - Injuries: 2 serious - Status: Completed, report June 17, 2010 - Report: Approved by Office Director - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO - NTSB case key (mKey): 73513 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA09LA203 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/73513/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=73513 - Page: https://openairdocs.org/ntsb/ERA09LA203 ## Probable cause The pilot's failure to maintain airspeed following a partial loss of engine power during initial climb, which resulted in an aerodynamic stall. Contributing to the accident was chafed wires in the ignition system. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Action: incorrect action performance](https://openairdocs.org/ntsb-findings/02041015): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Robinson Wayne O S6S RANS, 1 case](https://openairdocs.org/ntsb-findings/02041015/cases.md?model=05625IH), [All aircraft, 1,386 cases](https://openairdocs.org/ntsb-findings/02041015/cases.md) - [Performance/control parameters: airspeed](https://openairdocs.org/ntsb-findings/01062010): Aircraft › Aircraft oper/perf/capability · Not attained/maintained (probable cause); cases with it: [Robinson Wayne O S6S RANS, 1 case](https://openairdocs.org/ntsb-findings/01062010/cases.md?model=05625IH), [All aircraft, 1,681 cases](https://openairdocs.org/ntsb-findings/01062010/cases.md) - [Electrical power system: electrical pwr sys wiring](https://openairdocs.org/ntsb-findings/01022497): Aircraft › Aircraft systems · Damaged/degraded (probable cause); cases with it: [Robinson Wayne O S6S RANS, 1 case](https://openairdocs.org/ntsb-findings/01022497/cases.md?model=05625IH), [All aircraft, 44 cases](https://openairdocs.org/ntsb-findings/01022497/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Initial climb: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342); cases with it: [Robinson Wayne O S6S RANS, 1 case](https://openairdocs.org/ntsb-events/342/sequence.md?model=05625IH), [All aircraft, 1,858 cases](https://openairdocs.org/ntsb-events/342/sequence.md) - [Emergency descent: Aerodynamic stall/spin](https://openairdocs.org/ntsb-events/241) (defining event); cases with it: [Robinson Wayne O S6S RANS, 1 case](https://openairdocs.org/ntsb-events/241/sequence.md?model=05625IH), [All aircraft, 1,529 cases](https://openairdocs.org/ntsb-events/241/sequence.md) ## Analysis The pilot was departing in an experimental, amateur-built airplane, equipped with a non-certificated 65-horsepower engine. Shortly after takeoff, the airplane lost partial engine power, banked 90 degrees left, nosed down and collided with the ground while attempting to return to the runway. Examination of the engine ignition system found that it was equipped with two coil packs. Chafing was observed on two wires from the aft coil pack. If the chafed wire running to the ignition made contact with the adjacent ground wire, or the engine block, the aft cylinder would have stopped producing power, and the remaining cylinder would have had difficulty continuing normal operation. ## Factual narrative On March 19, 2009, at 1108 eastern daylight time, an experimental, amateur-built S6S Rans, N312RW, received substantial damage when it collided with the ground following a loss of engine power after takeoff from the Cartersville Airport (VPC), Cartersville, Georgia. The certificated private pilot and passenger received serious injuries. Visual meteorological conditions prevailed and no flight plan was filed for the local flight. The airplane was registered to a private individual and operated by the private pilot under the provision of 14 Code of Federal Regulations Part 91. Witnesses stated that shortly after takeoff, the engine lost power and the pilot attempted to return to the runway. While turning at a steep bank angle, approximately 90 degrees left bank, the airplane nosed down and collided with the ground. Witnesses called local authorities and proceeded to the accident site to lend assistance. Examination of the airplane found that it had impacted the ground in about a 30-degree nose down attitude. The engine was displaced back into the firewall and the firewall was displaced into the cockpit. Both wings sustained leading edge impact damage, and both main landing gear were observed bowed outward. The cargo area, empennage, rudder, and horizontal stabilizers were undamaged. Flight control continuity was established throughout the airplane. Examination of the airframe and flight controls revealed no anomalies. Examination of the engine revealed it was equipped with two coil packs, one for each cylinder. Both coil packs were removed and the wiring harness to the ignitions switch was also removed. Chafing was observed on two wires in the rear coil packs wiring. One wire, light brown in color, was connected to the coil pack and to a ground nut on the alternator. It was observed chafed near a plastic wire connector, traversing along the rear of the engine. A second wire was observed chafed at the same location, but was black and yellow in color and was connected at the ignition switch and the aft coil pack. The two-seat, high-wing, fixed tricycle gear airplane, serial number 11041619S, was issued a Federal Aviation Administration experimental airworthiness certificate on January 25, 2008. It was powered by a non-certificated Rotax 582 DCDI, 65-horsepower engine. According to the aircraft flight logbook, the last conditional inspection was performed on August 7, 2008. At that time, the airplane had accumulated 40 hours of operation. At the time of the accident, the airplane had accumulated 103 hours of operation. ## Aircraft - Registration: [N312RW](https://openairdocs.org/deregistered/N312RW-2014-10-29), registration cancelled 2014-10-29, S/N 11041619S, built 2007 (OpenAirDocs) - Reported make and model: Wayne O Robinson S6S Rans - Registry model: [Robinson Wayne O S6S RANS](https://openairdocs.org/model/robinson-wayne-o-s6s-rans) (registry code 05625IH) (OpenAirDocs) - Registry engine: [Rotax 582DCDI](https://openairdocs.org/engine/rotax-582dcdi) (registry code 55562, 2 cycle) (OpenAirDocs) - Category: Airplane, amateur-built - Serial number: 11041619S - Airframe hours: 103 - Engines: Rotax 582 DCDI 65 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Special, Experimental (Special) - Last inspection: Condition, August 7, 2008, 63 hours before - Departed: VPC, Cartersville, GA - Destination: VPC, Cartersville, GA - Airport: VPC, Cartersville Airport, runway 19, 5,760 × 100 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 49; injuries: serious; private; airplane ratings: single-engine land; medical: class 3, without waivers/limitations; seat: left; flight hours: 1,500 total ## Weather - Conditions: Visual (VMC), Day - Wind: variable at 3 knots - Visibility: 10 statute miles - Lowest ceiling: 6,000 ft broken - Temperature: 66 °F, dew point 48 °F - Altimeter: 30.17 inHg - Observed at: VPC, 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 20090319003999A](https://openairdocs.org/incident/20090319003999A), Mar 19, 2009: Robins S6SRANS, Cartersville, GA, Substantial damage. (-23) Aircraft took off to the south. Shortly after take off, the engine lost power and the pilot attempted to return to the airport for landing. Aircraft… ## Docket (9 files) The files NTSB released with the investigation on April 19, 2010, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=73513. 1.5 MB in all. - Other Pertinent Forms and Reports; Logbook (item 1, .PDF, 125 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324294&FileExtension=.PDF&FileName=Other%20Pertinent%20Forms%20and%20Reports;%20Logbook-Redacted.PDF - Witness Statement (item 2, .PDF, 346 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324295&FileExtension=.PDF&FileName=Witness%20Statement-Redacted.PDF - FAA Digital Photo 1, Wreckage Site. (item 3, .PDF, 81 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324296&FileExtension=.PDF&FileName=FAA%20Digital%20Photo%201,%20Wreckage%20Site.-Master.PDF - FAA Digital Photo 2, Propeller Damage. (item 4, .PDF, 73 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324297&FileExtension=.PDF&FileName=FAA%20Digital%20Photo%202,%20Propeller%20Damage.-Master.PDF - FAA Digital Photo 3, Cockpit area. (item 5, .PDF, 253 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324298&FileExtension=.PDF&FileName=FAA%20Digital%20Photo%203,%20Cockpit%20area.-Master.PDF - NTSB Digital Photo 4, Propeller blade damage. (item 6, .PDF, 269 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324299&FileExtension=.PDF&FileName=NTSB%20Digital%20Photo%204,%20Propeller%20blade%20damage.-Master.PDF - NTSB Digital Photo 5, P-Lead and ground wire chafing. (item 7, .PDF, 200 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324300&FileExtension=.PDF&FileName=NTSB%20Digital%20Photo%205,%20P-Lead%20and%20ground%20wire%20chafing.-Master.PDF - NTSB Digital Photo 6, Chafed Wiring. (item 8, .PDF, 130 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40324301&FileExtension=.PDF&FileName=NTSB%20Digital%20Photo%206,%20Chafed%20Wiring.-Master.PDF - Witness Statement, Record of Telephone Conversation (item 9, .PDF, 49 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40328642&FileExtension=.PDF&FileName=Witness%20Statement,%20Record%20of%20Telephone%20Conversation-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.