# NTSB ERA12LA295: Raytheon A36, N821SM, Yorktown, NY, April 20, 2012 - Type: NTSB accident investigation - Classification: Accident · Minor injuries · Limited investigation · Final report - Date: April 20, 2012, 16:26 local (20:26 UTC) - Place: Yorktown, NY - Coordinates: 41.207778, -73.801391 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=41.2078&lon=-73.8014&mi=10 - Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping) - Defining event: [Enroute-cruise: Fuel starvation](https://openairdocs.org/ntsb-events/191) - Highest injury: Minor injuries - Injuries: 2 minor - Status: Completed, report May 9, 2013 - Report: Approved by Office Director - NTSB office: Eastern Region Aviation - Parties: FAA FSDO, Continental Engines - NTSB case key (mKey): 83448 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA12LA295 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/83448/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=83448 - Page: https://openairdocs.org/ntsb/ERA12LA295 ## Probable cause The pilot's improper placement of the fuel selector, which resulted in fuel starvation and a total loss of engine power. Contributing to the accident was the pilot's failure to perform the published emergency procedure by the checklist. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Fuel system: fuel selector/shutoff valve](https://openairdocs.org/ntsb-findings/01022823): Aircraft › Aircraft systems · Incorrect use/operation (probable cause); cases with it: [Raytheon A36, 1 case](https://openairdocs.org/ntsb-findings/01022823/cases.md?model=7150001), [All aircraft, 176 cases](https://openairdocs.org/ntsb-findings/01022823/cases.md) - [Use of equip/info: use of equip/system](https://openairdocs.org/ntsb-findings/02063015): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Raytheon A36, 3 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md?model=7150001), [All aircraft, 1,391 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md) - [Use of equip/info: use of checklist](https://openairdocs.org/ntsb-findings/02063030): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Raytheon A36, 2 cases](https://openairdocs.org/ntsb-findings/02063030/cases.md?model=7150001), [All aircraft, 336 cases](https://openairdocs.org/ntsb-findings/02063030/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Enroute-cruise: Fuel starvation](https://openairdocs.org/ntsb-events/191) (defining event); cases with it: [Raytheon A36, 4 cases](https://openairdocs.org/ntsb-events/191/sequence.md?model=7150001), [All aircraft, 733 cases](https://openairdocs.org/ntsb-events/191/sequence.md) - [Enroute-cruise: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342); cases with it: [Raytheon A36, 1 case](https://openairdocs.org/ntsb-events/342/sequence.md?model=7150001), [All aircraft, 1,858 cases](https://openairdocs.org/ntsb-events/342/sequence.md) - [Emergency descent: Off-field or emergency landing](https://openairdocs.org/ntsb-events/440); cases with it: [Raytheon A36, 12 cases](https://openairdocs.org/ntsb-events/440/sequence.md?model=7150001), [All aircraft, 3,365 cases](https://openairdocs.org/ntsb-events/440/sequence.md) - [Landing-flare/touchdown: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Raytheon A36, 17 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=7150001), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The airplane was in cruise flight at 7,000 feet when the engine lost power. The pilot requested vectors to the nearest airport but determined the airplane would not reach the requested landing site. He selected a forced landing site on a corporate complex and completed the forced landing, which resulted in substantial damage to the airplane. During the descent, he stated that he performed remedial actions in accordance with the checklist and switched the fuel selector from the right tank position to the left tank. Later, the pilot stated that he did not consult a checklist, but performed emergency action items "from memory." He added that the engine would surge during the descent but would not produce sufficient power to maintain altitude. A witness stated that he saw the airplane at low altitude near the campus and described the engine sound as surging between idle and "extremely high rpm." He said that the engine sounded as though it was "starving for fuel." Examination of the airplane revealed no preimpact mechanical anomalies. The fuel selector was found in a position between the left tank and right tank detents. A detailed examination revealed continuity of the fuel system, unobstructed fuel lines and filters, and an operational fuel selector. The engine was removed from the airplane and placed in a test cell, where it started immediately, accelerated smoothly, and ran continuously without interruption. The engine run revealed no anomalies that would have prevented normal operation and the production of rated power. A warning in the airplane manufacturer's Pilot's Operating Handbook stated: "POSITION [Fuel] SELECTOR IN DETENTS ONLY – NO FUEL FLOW TO ENGINE BETWEEN DETENTS" It is likely that the pilot moved the fuel selector during cruise flight but did not ensure that it was seated correctly in the detent. Shortly thereafter, the engine lost power. Because the pilot did not perform the requisite emergency procedures, he did not recognize that the fuel selector was not seated properly. ## Factual narrative On April 20, 2012, at 1626 eastern daylight time, a Hawker-Beechcraft Corporation A36, N821SM, was substantially damaged during a forced landing following a loss of engine power during cruise flight in Yorktown, New York. The certificated private pilot and passenger sustained minor injuries. The flight departed Teterboro Airport (TEB), Teterboro, New Jersey about 1600, and was destined for Norwood Memorial Airport (OWD), Norwood, Massachusetts. Visual meteorological conditions prevailed, and an instrument flight rules flight plan was filed for the personal flight, which was conducted under the provisions of Title 14 Code of Federal Regulations Part 91. In a written statement, the pilot stated that the airplane was in cruise flight at 7,000 feet when the engine lost power. He requested vectors to the nearest airport, but determined the airplane would not reach the requested landing site. He selected a forced landing site on the IBM corporate campus in Yorktown, and completed the forced landing, which resulted in substantial damage to the airplane. During the descent, he stated that he performed remedial actions in accordance with the checklist, and switched the fuel selector from the right tank position to the left tank. He added that the engine would surge during the descent but would not produce sufficient power to maintain altitude. In an interview with a Federal Aviation Administration (FAA) inspector, the pilot stated that he did not consult a checklist during the descent, but performed the emergency action items "by memory." In a telephone interview, a witness stated that he saw the airplane at low altitude near the IBM corporate campus and it appeared to be "in distress." He described the engine sound as surging between idle and "extremely high rpm." He said that the engine sounded as though it was "starving for fuel." According to FAA records, the airplane was manufactured in 1996. The most recent annual inspection was completed July 1, 2011, at 1,460.4 total aircraft hours. At the time of the accident, the airplane had accrued 1,503 total aircraft hours. The pilot held a private pilot certificate with ratings for airplane single engine land and instrument airplane. He reported 383.5 total hours of flight experience, of which 165.5 hours were in the accident airplane make and model. His most recent FAA third-class medical certificate was issued November 9, 2011. Examination of the airplane at the scene by FAA inspectors revealed no pre-impact mechanical anomalies. The fuel selector was found in a position between the left tank and right tank detents . A detailed examination by the inspectors at a recovery facility revealed continuity of the fuel system, unobstructed fuel lines and filters, and an operational fuel selector. The engine was removed from the airplane, and placed in a test cell on May 2, 2012. Prior to the test run, a borescope examination of the engine's cylinders revealed "normal" deposits and wear, and no anomalies. Theengine started immediately, accelerated smoothly, and ran continuously without interruption. The engine run revealed no anomalies that would have prevented normal operation and the production of rated power. A warning in the airplane manufacturer's Pilot's Operating Handbook stated: "POSITION [Fuel] SELECTOR IN DETENTS ONLY – NO FUEL FLOW TO ENGINE BETWEEN DETENTS" ## Aircraft - Registration: [N821SM](https://openairdocs.org/deregistered/N821SM-2013-08-29), registration cancelled 2013-08-29, S/N E-3031, built 1996 (OpenAirDocs) - Reported make and model: RAYTHEON AIRCRAFT COMPANY A36 - Registry model: [Raytheon A36](https://openairdocs.org/model/raytheon-a36) (registry code 7150001) (OpenAirDocs) - Registry engine: [Continental IO-550 series](https://openairdocs.org/engine/continental-io-550-series) (registry code 17042, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: E-3031 - Airframe hours: 1503 - Engines: CONT MOTOR IO-550 SERIES 300 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Operator: Ehrenzeller Mark - Registered owner: Ehrenzeller Mark - Last inspection: Annual, July 1, 2011, 43 hours before - Departed: TEB, Teterboro, NJ - Destination: OWD, Norwood, MA - Flight plan: IFR ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 38; injuries: minor; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, without waivers/limitations; seat: left; flight hours: 383 total, 165 in this make and model ## Weather - Conditions: Visual (VMC), Day - Wind: 160° at 9 knots - Visibility: 10 statute miles - Lowest ceiling: 4,000 ft broken - Temperature: 66 °F, dew point 46 °F - Altimeter: 29.95 inHg - Observed at: HPN, 9 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 20120420015079A](https://openairdocs.org/incident/20120420015079A), Apr 20, 2012: Raytheon Aircraft Company A36, Yorktown, NY, Substantial damage. In cruise flight pilot experienced loss of power to aircraft. Pilot performed emergency procedures and elected to divert to closest airport. While en-rpute… ## Docket (10 files) The files NTSB released with the investigation on March 22, 2013, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=83448. 17.7 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (Memo for Record) (item 1, .PDF, 50 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385606&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1%20(Memo%20for%20Record)-Master.PDF - Pilot Statement (item 2, .PDF, 153 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385607&FileExtension=.PDF&FileName=Pilot%20Statement-Redacted.PDF - FAA Pilot Interview Notes (item 3, .PDF, 161 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385608&FileExtension=.PDF&FileName=FAA%20Pilot%20Interview%20Notes-Redacted.PDF - Engine Run Field Report (Continental Engines) (item 4, .PDF, 388 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385618&FileExtension=.PDF&FileName=Engine%20Run%20Field%20Report%20(Continental%20Engines)-Redacted.PDF - Video of Post Accident Engine Run (item 5, .PDF, 15 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40367247&FileExtension=.PDF&FileName=Video%20of%20Post%20Accident%20Engine%20Run-Master.PDF - Release of Aircraft Wreckage, NTSB Form 6120.15 (item 6, .PDF, 74 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385623&FileExtension=.PDF&FileName=Release%20of%20Aircraft%20Wreckage,%20NTSB%20Form%206120.15-Redacted.PDF - Photo 1: View of Wreckage Facing Direction of Travel (FAA) (item 7, .PDF, 9.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385613&FileExtension=.PDF&FileName=Photo%201%3A%20View%20of%20Wreckage%20Facing%20Direction%20of%20Travel%20(FAA)-Master.PDF - Photo 2: View of Main Wreckage as Found (FAA) (item 8, .PDF, 7.4 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385614&FileExtension=.PDF&FileName=Photo%202%3A%20View%20of%20Main%20Wreckage%20as%20Found%20(FAA)-Master.PDF - Photo 3: View of Fuel Selector as Found (FAA) (item 9, .PDF, 115 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385626&FileExtension=.PDF&FileName=Photo%203%3A%20View%20of%20Fuel%20Selector%20as%20Found%20(FAA)-Master.PDF - Photo 4: Fore and Aft View of Fuel Selector as Found (FAA) (item 10, .PDF, 107 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40385628&FileExtension=.PDF&FileName=Photo%204%3A%20Fore%20and%20Aft%20View%20of%20Fuel%20Selector%20as%20Found%20(FAA)-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.