ERA11FA210

NTSB accident investigation · Piper PA-20 · Elgin, SC · March 25, 2011

Accident · FatalField investigationFinal report
Date
March 25, 2011, 13:52 local (17:52 UTC)
Place
Elgin, SC
Injuries
1 fatal
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N7746KPiper PA-20
Defining event
Enroute-cruise: Fuel exhaustion
Weather
Visual (VMC) · Day
Status
Completed · report March 8, 2012
Report
Approved by Office Director
NTSB office
Eastern Region Aviation
Parties
Piper Aircraft, FAA/FSDO
FAA report
20110325004709A
Case key
78680

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

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Probable cause

A total loss of engine power due to fuel exhaustion resulting from the pilot’s inadequate preflight planning. Contributing to the accident was that the pilot did not maintain an adequate airspeed, which resulted in an aerodynamic stall.

Findings · 6

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Object/animal/substance: tree(s)Environmental issues › Physical environment · Contributed to outcomePiper PA-20: 2 casesAll aircraft: 933 cases
AircraftAircraft › Aircraft power plant · FailurePiper PA-20: 2 casesAll aircraft: 151 casesProbable cause
Performance/control parameters: airspeedAircraft › Aircraft oper/perf/capability · Not attained/maintainedPiper PA-20: 1 caseAll aircraft: 1,681 casesProbable cause
Planning/preparation: fuel planningPersonnel issues › Task performance · PilotPiper PA-20: 1 caseAll aircraft: 719 casesProbable cause
Fluids: fuelAircraft › Fluids/misc hardware · Fluid levelPiper PA-20: 1 caseAll aircraft: 1,695 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Analysis

The pilot was on a cross-country flight and no flight plan was filed. While en route, a witness observed an airplane flying at a slow airspeed between 200 and 300 feet above the ground behind his place of business. The engine was revving up and down as if it was running out of fuel. The witness observed the nose pitch up to an attitude between 35 and 40 degrees, and then the nose pitched straight down. The airplane went below the tree line, then there was an explosion and a postcrash fire. Examination of the crash site revealed no anomalies with the airframe, engine assembly, or accessories. The fuel selector was found positioned to the right main fuel tank. The right main fuel tank had ruptured and was absent of fuel. The airplane has two 18-gallon fuel tanks with a total capacity of 36 gallons. The cruise airspeed for the airplane is 126 mph. The straight-line distance from the departure airport to the crash site is 607 miles. According to the engine-operating manual, the engine will burn 7.2 gallons of fuel per hour at 75-percent power and 6.3 gallons of fuel per hour at 65-percent power. In a no wind condition at 75-percent power, it would take 4 hours and 50 minutes to fly from the departure airport to the accident site; at 65-percent power it would take 5 hours and 33 minutes to fly to the accident site. Based on a straight line, no wind, and non-maneuvering flight profile, available fuel range would be about 523 nautical miles. These calculations do not account for fuel consumed during the start, taxi, and take off sequence. Thus, the pilot exceeded the fuel endurance, and the engine lost power. Also, the high-pitch attitude of the airplane observed by the witness could have resulted in the stall.

Factual narrative

HISTORY OF FLIGHT On March 25, 2011 about 1352 eastern daylight time, a Piper PA-20, N7746K, registered to a private individual, experienced a loss of engine power in the vicinity of Elgin, South Carolina, and collided with trees during a forced landing. The airplane was operating as 14 Code of Federal Regulation Part 91 personal flight. The airplane sustained substantial damage and a post crash fire ensued. The certificated commercial pilot was killed. Visual meteorological conditions prevailed and no flight plan was filed. The flight originated from Bloecher Farm Airport (92NY) Strykersville, New York, at an undetermined time with a final destination of Lakeland, Florida. A witness stated he heard the airplanes engine "struggling." The airplane crashed and within 5 to 7 seconds, it exploded. Another witness stated he was standing outside his shop with a customer and heard a small plane flying overhead. The airplane was flying at a slow airspeed between 200 to 300 feet north of Interstate 20 traveling in the direction of Columbia, South Carolina. The engine was surging up and down or sputtering like it was "running out of fuel." The airplane passed behind the shop and he observed the nose pitch up to an attitude between 35 to 40 degrees. The nose then pitched straight down. At first he thought the pilot would pull up, but when the airplane went below the tree line, he knew it was going to crash PERSONNEL INFORMATION The certificated commercial pilot, age 71, held a commercial pilot certificate with ratings for airplane single-engine land and instrument airplane, issued on July 13, 2009.The pilot was issued a flight instructor certificate with a rating for airplane single-engine on August 15, 2009, and an airframe and power plant mechanic certificate on July 13, 2008. The pilot’s last flight review was conducted on July 9, 2010. In addition, the pilot held a second-class medical certificate with the restriction "must wear corrective lenses," issued on August 2, 2010. The pilot indicated on his application for the second-class medical that he had 7,100 total flight hours. AIRCRAFT INFORMATION The Piper PA-20 Pacer is a four place high wing airplane with a tail wheel landing gear, serial number 20-569, manufactured in 1950. A Lycoming O-290-D2, 135 horsepower, horizontally-opposed four-cylinder engine powered the airplane. The last annual inspection was conducted on December 8, 2010. The tachometer at the crash site was destroyed. The total airframe hours at the time of the annual inspection were 1,743 hours. It was not determined when the airplane was last refueled. METEOROLOGICAL INFORMATION The Woodland Field Airport (CDN), Camden, South Carolina, 1315 surface weather observation was: wind 230 degrees at 7 knots, visibility 10 miles, clear clouds, temperature 18 degrees Celsius, dew point temperature 4 degrees Celsius, altimeter 29.97 inches HG. AIRPORT INFORMATION Over the Hill Airport (12SC), Elgin, South Carolina, is a private use airportlocated on Old White Road and is located 5 miles southeast of Elgin, South Carolina. The airport elevation is 250 feet . The turf runway 09/27 is 2,400 feet long and 100 feet wide. According to the witness at the shop, the airport is located adjacent to Interstate I-20, south of Jeffers Road which is about 1/2 to 3/4 mile from the accident site. WRECKAGE AND IMPACT INFORMATION The wreckage was located adjacent to Larry Jeffers Road in Elgin, South Carolina. Examination of the crash site revealed the airplane collided with trees in a nose-down, right wing low attitude. The airplane cart-wheeled through the trees and the outboard left wing collided with several trees. The airplane continued forward about 60 feet and came to rest upright. A post crash fire ensued. The propeller assembly separated from the propeller crankshaft flange and was located behind the main wreckage. One propeller blade was bent aft 6 inches outboard of the propeller hub. Chord wise scarring was present on the cambered and non-cambered side of the propeller blade. The remaining propeller blade was bent aft and chord wise scarring was present on the cambered and non-cambered side of the propeller blade. The crankshaft was bent to the right. The spinner was crushed and exhibited evidence of rotation. "V" cuts were present on the trees along the crash debris line. The right wing collided with the ground and was pushed aft and the left wing was inverted and accelerated forward. The engine assembly was separated from the firewall and displaced to the right. The upper and lower engine cowlings were destroyed. The gascolator was not located. The cabin windshield was destroyed. Both cabin doors separated from the airplane and were fire damaged. The steel tube fuselage was damaged. All airplane fabric was destroyed. The fuselage frame top section was bent upward at a 45-degree angle. The forward section with the instrument panel exhibited aft crushing. The flight instruments and engine tachometer were destroyed. The left and right forward seats and seatbelts were destroyed. The aft passenger seat area contained an cylindrical tank in lieu of a bench seat assembly, which was partially destroyed by fire. The control wheels and rudder pedals were damaged and burned. Control continuity was confirmed from the rudder and elevator forward to the cockpit. The engine controls were destroyed. The fuel selector was located on the right main fuel tank .The main landing gear was fire damaged, collapsed, and separated from the airframe. The right wing was partially connected to the wing root. The right wing was pushed aft and the fabric had been consumed by fire. The flap and aileron remained attached at all hinge points. Control continuity for the flap and the aileron was traced to the forward cabin area. The flap was in the retracted position. The forward wing strut and leading edge of the wing exhibited impact damage consistent with a tree impact. The main spar and the forward lift strut werebent upward about a 20-degree angle. The right main fuel tank was ruptured and no fuel was present. The fuel cap was located behind the wing and was in the closed position with part of the filler neck attached. The vertical fin was fire damaged and the rudder was attached at all hinge points. The left and right horizontal stabilizers remained attached to the empennage and both elevators remained attached to both stabilizers. The stabilizer trim indicated 13 threads equating to an approximate nose-down condition. The steerable tail wheel was in place and exhibited heat damage. The left wing was inverted, partially connected to the wing root and was accelerated forward. The left flap and aileron hinge points were melted. Control continuity for the flap and the aileron was traced to the forward cabin area. The left flap was in the retracted position. The forward and aft wing strut exhibited signatures consistent of a tree strike. The leading edge of the wing was destroyed by fire. The left main fuel tank separated from the wing and was ruptured. Some residual fuel was present in the fuel tank. The fuel cap was located and was in the closed position. Examination of the engine assembly revealed the left and right engine exhaust tubes were damaged. The muffler remained attached to the engine assembly and the heat shroud was fire damaged. The induction tubes were damaged. The oil pressure screen housing remained attached to the accessory section and was fire damaged. The oil filter screen was removed and was free of contaminants. The starter remained attached to the engine and was fire damaged. The left and right magnetos remained attached to their respective mounts and were fire damaged. The vent plugs were fire damaged. The magnetos were removed and disassembled. The internal components were fire damaged and could not be checked for spark at the ignition towers. The engine baffling was consumed by fire. All engine cylinders remained attached to the engine and the push rods were intact. The No. 1 and No. 3 valve covers were pushed inward with holes and were fire damaged. The No. 2 and No. 4 valve covers were fire damaged and all valve covers were removed. The upper were removed and exhibited thermal discoloration. The were dark gray in color. The ignition harness was consumed by fire. The oil cooler was fire damaged. The carburetor was partially attached to its mount. The carburetor was disassembled and there was no fuel in the carburetor bowl. Dark gray soot was present only in the area of the fuel inlet. The right carburetor float separated along the solder joint and the float was thermally discolored. The float was forwarded to the NTSB Laboratory for analysis. The pieces were color-tinted consistent with thermal oxidation at elevated temperatures. Examination of the solder joints, joining the floats to the frame of the clamshell seams, joining the two halves of each float, revealed evidence of solder reflow, solder joint dewetting, and oxidationof dewetted solder base metal. The crankshaft propeller flange was rotated by hand with a breaker bar. Suction and compression were obtained on all cylinders. Valve train continuity was observed through all cylinder rocker arms. The accessory drive gears were observed rotating. Crankshaft and valve train continuity was verified. MEDICAL AND PATHOLOGICAL INFORMATION The Office of the Chief Medical Examiner, Newberry Pathology Associates, P.A. Newberry, South Carolina, conducted an autopsy on the pilot on March 26, 2011. The cause of death was multiple blunt force injuries due to an airplane crash. The Bioaeronautical Research Science Laboratory, Federal Aviation Administration, Oklahoma City, Oklahoma performed a postmortem toxicology of specimens from the pilot. No carbon monoxide or cyanide was detected in the blood. No ethanol was detected in the urine. The specimens were negative for basic, acidic, and neutral drugs. Naproxen which is used to treat pain or inflammation caused by arthritis, ankylosing spondylitis, tendinitis and gout was present in the urine. ADDITIONAL INFORMATION: Review of the Pilot Operating Handbook states the stall speed with the flaps retracted, with 0 and 10 degrees angle of bank, is 52 mph. The distance between 92NY and 12SC is 527.7 nautical miles on a straight line heading of 192.5 degrees magnetic. It is not known if the pilot made any en-route stops and there are no known communications along the way with air traffic control. The cruise airspeed is 126 mph or 109 knots. According to the Lycoming Operating Manual for the O-290-D Series engine, the engine will burn 7.5 gallons of fuel per hour at 75 percent power. In a no wind condition, at 109 knots or 126 mph, it would take 4 hours and 50 minutes to fly to Elgin, South Carolina. At 65 percent power the airplane would burn 6.5 gallons per hours and it would take 5 hours and 33 minutes to reach Elgin South Carolina. The airplane is equipped with two 18 gallon fuel tanks for a total of 36 gallons of fuel. The Piper Owners Handbook does not distinguish what amount of fuel may be unusable. Additionally, the Owners Handbook includes fuel consumption planning data for cruise flight but does not include fuel consumption planning data for start, taxi, preflight checks and takeoffs.

Aircraft

Registration
N7746K
Reported as
Piper PA-20
Category
Airplane
Serial number
20-569
Airframe hours
1,743
Engine
Lycoming O-290 D, 130 horsepower, reciprocating
Damage
Substantial damage
Fire
On-Ground
Flight
Personal · Part 91
Operator
Buergel Wolfgang
Registered owner
Buergel Wolfgang
Airworthiness certificate
Standard, Normal
Last inspection
Annual · December 8, 2010
Departed
92NY · Bloecher Farm, NY
Destination
LAL · Lakeland, FL

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
71
Injuries
Fatal
Certificate
Commercial
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 2, With waivers/limitations
Last flight review
July 9, 2010
Seat
Left
Toxicology
Performed
Flight hours
7,100 total

Weather

Conditions
Visual (VMC) · Day
Wind
230° at 7 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
64 °F, dew point 39 °F
Altimeter
29.96 inHg
Observed at
CDN, 15 nm away

Docket · 29

The files NTSB released with the investigation on January 4, 2012, on NTSB’s docket system: statements, records, photos and specialists’ reports. 33.1 MB in all.

Witness StatementsItem 1 · .PDF · 1.0 MBKershaw County Sheriff County Incident ReportItem 2 · .PDF · 134 KB911 Emergency Operator LogItem 3 · .PDF · 149 KBBlaney Fire ReportItem 4 · .PDF · 236 KBExtract Pilot LogbookItem 5 · .PDF · 732 KBExtract Maintenance RecordsItem 6 · .PDF · 755 KBExtract PA-20 Flight ManualItem 7 · .PDF · 225 KBExtract Owners HandbookItem 8 · .PDF · 174 KB92NY Bloecher Airport InfoItem 9 · .PDF · 99 KB12SC Over The Hill Airport InformationItem 10 · .PDF · 104 KBFlight Planning InformationItem 11 · .PDF · 35 KBExtract Lycoming Operator Manual O 290 D2 SeriesItem 12 · .PDF · 36 KBMaterials Laboratory Factual Report 11-115 (5 embedded images)Item 13 · .PDF · 1.6 MBStatement of Party Representatives to NTSB InvestigationItem 14 · .PDF · 55 KBNTSB Wreckage ReleaseItem 15 · .PDF · 1.0 MBToxicology ReportItem 16 · .PDF · 36 KBPhoto 1 View of impact with trees. Photo NTSBItem 17 · .PDF · 1.3 MBPhoto 2 View of separated propeller assembly and trees with V cuts. Photo NTSBItem 18 · .PDF · 1.7 MBPhoto 3 Front view of airplane at rest. Photo PiperItem 19 · .PDF · 773 KBPhoto 4 Right side view of airplane at rest. Photo PiperItem 20 · .PDF · 605 KBPhoto 5 Left rear side view. Photo NTSBItem 21 · .PDF · 1.6 MBPhoto 6 Left side view of airplane at rest. Photo PiperItem 22 · .PDF · 556 KBPhoto 7 View of left side of engine assembly. Photo NTSBItem 23 · .PDF · 1.3 MBPhoto 8 View of right side of engine. Photo NTSBItem 24 · .PDF · 1.7 MBPhoto 9 View of back side of accessory case. Photo NTSBItem 25 · .PDF · 3.8 MBPhoto 10 View of removed upper 1, 3, 2, and 4 sparkplugs. Photo NTSBItem 26 · .PDF · 3.6 MBPhoto 11 View of disassembled carburetor with float assembly. Photo NTSBItem 27 · .PDF · 3.8 MBPhoto 12 View of left magneto after disassembly. Photo NTSBItem 28 · .PDF · 2.7 MBPhoto 13 View of right magneto after disassembly. Photo NTSBItem 29 · .PDF · 3.1 MB

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.