# NTSB ERA16LA051: Piper PA28, N3971R, Lawrenceville, GA, November 24, 2015 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Limited investigation · Final report - Date: November 24, 2015, 16:00 local (21:00 UTC) - Place: Lawrenceville, GA - Coordinates: 33.978054, -83.962501 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=33.9781&lon=-83.9625&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Defining event: [Initial climb: Fuel starvation](https://openairdocs.org/ntsb-events/191) - Highest injury: Serious injuries - Injuries: 1 serious, 1 minor - Status: Completed, report March 14, 2016 - Report: Approved by Office Director - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO - NTSB case key (mKey): 92367 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA16LA051 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/92367/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=92367 - Page: https://openairdocs.org/ntsb/ERA16LA051 ## Probable cause The flight instructor's inadequate fuel management, which resulted in a total loss of engine power during initial climb due to fuel starvation and a subsequent forced landing. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Fluids: fuel](https://openairdocs.org/ntsb-findings/01071010): Aircraft › Fluids/misc hardware · Fluid management (probable cause); cases with it: [Piper PA-28-180, 32 cases](https://openairdocs.org/ntsb-findings/01071010/cases.md?model=7102808), [All aircraft, 1,695 cases](https://openairdocs.org/ntsb-findings/01071010/cases.md) - [Use of equip/info: use of equip/system](https://openairdocs.org/ntsb-findings/02063015): Personnel issues › Task performance · Instructor/check pilot (probable cause); cases with it: [Piper PA-28-180, 16 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md?model=7102808), [All aircraft, 1,391 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md) - [Object/animal/substance: tree(s)](https://openairdocs.org/ntsb-findings/03022020): Environmental issues › Physical environment · Contributed to outcome; cases with it: [Piper PA-28-180, 14 cases](https://openairdocs.org/ntsb-findings/03022020/cases.md?model=7102808), [All aircraft, 933 cases](https://openairdocs.org/ntsb-findings/03022020/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Initial climb: Fuel starvation](https://openairdocs.org/ntsb-events/191) (defining event); cases with it: [Piper PA-28-180, 17 cases](https://openairdocs.org/ntsb-events/191/sequence.md?model=7102808), [All aircraft, 733 cases](https://openairdocs.org/ntsb-events/191/sequence.md) - [Initial climb: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341); cases with it: [Piper PA-28-180, 37 cases](https://openairdocs.org/ntsb-events/341/sequence.md?model=7102808), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md) - [Emergency descent: Off-field or emergency landing](https://openairdocs.org/ntsb-events/440); cases with it: [Piper PA-28-180, 40 cases](https://openairdocs.org/ntsb-events/440/sequence.md?model=7102808), [All aircraft, 3,365 cases](https://openairdocs.org/ntsb-events/440/sequence.md) - [Landing: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Piper PA-28-180, 96 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=7102808), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The flight instructor and student pilot departed their home airport with about 34 gallons of fuel on board the airplane for the planned approximate 60-mile, round-trip, cross-country instructional flight. The student pilot reported that, after landing at the destination airport, they completed two more full-stop landings before returning to, and then landing uneventfully at, the departure airport. The flight instructor wanted the student pilot to complete one more landing before concluding the lesson. The student stated that, during the subsequent takeoff, everything seemed normal until he turned the airplane onto the crosswind leg of the airport traffic pattern, at which time the engine lost all power. The flight instructor then took control of the airplane. The flight instructor reported that he chose not to attempt to turn back and glide to the airport because the airplane was about 500 ft above ground level. He subsequently performed a forced landing straight ahead into trees. Both fuel tanks were compromised during the impact, and the fuel quantity at impact could not be determined. Subsequently, an engine test run was performed with no anomalies noted. Both pilots reported that they did not switch the fuel tanks following the total loss of engine power. The student pilot further stated that the airplane "ran out of gas." Review of performance information for the make and model airplane revealed that, based on the reported fuel onboard the airplane at the beginning of the day, it should have had between 5 and 10 gallons of fuel remaining at the time of the accident. Although the amount of fuel in each fuel tank could not be determined, the loss of engine power likely resulted from a lack of available fuel in the selected tank. Because the flight instructor was the pilot-in-command and told the student to conduct another landing, he should have been more cognizant of the fuel level in the tanks. ## Factual narrative On November 24, 2015, about 1600 eastern standard time, a Piper PA-28-180, N3971R, operated by a private individual, was substantially damaged during a forced landing into trees, following a total loss of engine power during initial climb from Gwinnett County Airport (LZU), Lawrenceville, Georgia. The flight instructor was seriously injured and the student pilot incurred minor injuries. The instructional flight was conducted under the provisions of 14 Code of Federal Regulations Part 91. Visual meteorological conditions prevailed and no flight plan was filed for the planned local flight. According to the flight instructor's written statement, shortly after turning onto the crosswind leg in the airport traffic pattern for runway 7, the engine lost all power. The flight instructor then took control of the airplane and elected not to attempt to glide back to the airport as the airplane was about 500 feet above ground level. He subsequently performed a forced landing straight ahead into trees. According to the student pilot's written statement, earlier during the day of the accident, they departed LZU with approximately 34 gallons of fuel on a round-trip cross-country flight. After landing at the destination airport, which was about 60 miles from LZU, they completed two more full-stop landings before returning to LZU. After landing uneventfully at LZU, the flight instructor wanted the student pilot to perform one more good landing before concluding the lesson. Everything seemed normal until the student pilot turned the airplane onto the crosswind leg of the airport traffic pattern, at which time the engine lost all power without any sputtering or roughness. He further stated, "It sounded like we had turned off the engine after a lesson: just a smooth shutdown as if the mixture was dropped to full lean after parking…" The student pilot added that the flight instructor tried to restart the engine and it "nearly caught, but then shut off again." Examination of the wreckage by a Federal Aviation Administration (FAA) inspector revealed damage to both wings and the fuselage. Both fuel tanks were compromised during the impact and the inspector was unable to determine fuel quantity. The inspector subsequently performed a successful test-run of the engine at a recovery facility. The four-seat, low-wing, fixed tricycle-gear airplane, serial number 28-7105076, was manufactured in 1971 and was powered by a Lycoming O-360, 180-horsepower engine, equipped with a two-blade Sensenich propeller. It had a total fuel capacity of 50 gallons, which was stored in the main fuel tanks located in each respective wing and were individually selectable through a cockpit fuel selector. Review of the airplane's logbooks revealed that its most recent annual inspection was completed on November 13, 2015. At that time, the airplane had accumulated 6,783 total hours of operation. The engine had accumulated 579 hours since major overhaul. During interviews with the inspector, bothpilots stated that they did not switch fuel tanks following the total loss of engine power. The student pilot further stated that they "ran out of gas." Review of performance information for the make and model airplane revealed that the engine consumed about 10 gallons of fuel per hour at 75 percent power. Based on the student pilot's estimation of 34 gallons onboard at the beginning of the day, the airplane should have had 5 to 10 gallons of fuel remaining at the accident site; however, all of the remaining fuel may have been in one fuel tank. Although the flight instructor provided a written statement to the FAA, he failed to submit a completed NTSB Pilot/Operator Accident Report form after several verbal and written requests. ## Aircraft - Registration: [N3971R](https://openairdocs.org/deregistered/N3971R-2016-02-03), registration cancelled 2016-02-03, S/N 28-7105076, built 1971 (OpenAirDocs) - Reported make and model: PIPER PA28 (180) - Registry model: [Piper PA-28-180](https://openairdocs.org/model/piper-pa-28-180) (registry code 7102808) (OpenAirDocs) - Registry engine: [Lycoming O&VO-360 series](https://openairdocs.org/engine/lycoming-o-vo-360-series) (registry code 41514, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 28-7105076 - Year built: 1971 - Airframe hours: 6783 - Engines: LYCOMING O-360 180 horsepower reciprocating - Damage: Substantial damage - Flight: Instructional, Part 91 - Operator: Resnick Quinn A - Registered owner: Resnick Quinn A - Airworthiness certificate: Standard, Normal - Last inspection: Annual, November 13, 2015 - Departed: LZU, Lawrenceville, GA - Destination: LZU, Lawrenceville, GA - Airport: LZU, Gwinnet County Airport, runway 7, 6,000 × 100 ft, asphalt - Equipment: Stall warning system ## Flight crew As NTSB recorded them. NTSB leaves out names. - Flight instructor; age 24; injuries: serious; commercial, flight instructor; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, with waivers/limitations; seat: right; restraint: 3-point; flight hours: 900 total, 999,999 in this make and model - Student pilot; age 17; injuries: minor; student; medical: class 3, without waivers/limitations; seat: left; restraint: 3-point; flight hours: 30 total, 999,999 in this make and model ## Weather - Conditions: Visual (VMC), Day - Wind: calm - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 57 °F, dew point 25 °F - Altimeter: 30.35 inHg - Observed at: LZU, 2 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 20151124022949A](https://openairdocs.org/incident/20151124022949A), Nov 24, 2015: Piper PA-28-180, Lawerenceville, GA, Destroyed. On November 24, 2015 at Gwinnett county airport-Briscoe field (klzu) in lawrenceville, georiga, a student pilot performed a pre-flight on a Piper aircraft… ## Docket (6 files) The files NTSB released with the investigation on February 4, 2016, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=92367. 693 KB in all. - Pilot Statements (item 1, .PDF, 79 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436383&FileExtension=.PDF&FileName=Pilot%20Statements-Master.PDF - FAA Inspector Statement (item 2, .PDF, 58 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436384&FileExtension=.PDF&FileName=FAA%20Inspector%20Statement-Master.PDF - Interview Summary (item 3, .PDF, 51 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436385&FileExtension=.PDF&FileName=Interview%20Summary-Master.PDF - Excerpts From Maintenance Records (item 4, .PDF, 279 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436388&FileExtension=.PDF&FileName=Excerpts%20From%20Maintenance%20Records-Master.PDF - Excerpt From Piper Cherokee Owner's Handbook (item 5, .PDF, 57 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436387&FileExtension=.PDF&FileName=Excerpt%20From%20Piper%20Cherokee%20Owner%27s%20Handbook-Master.PDF - Photo (item 6, .PDF, 170 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40436389&FileExtension=.PDF&FileName=Photo-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.