ERA17LA205

NTSB accident investigation · Cessna P206 · West Creek, NJ · June 13, 2017

Accident · Minor injuriesLimited investigationFinal report
Date
June 12, 2017, 22:55 local (Jun 13, 2017, 02:55 UTC)
Place
West Creek, NJ
Injuries
1 minor
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N206TFCessna P206
Defining event
Approach-VFR pattern downwind: Fuel related
Weather
Visual (VMC) · Not reported
Status
Completed · report November 6, 2019
Report
Approved by Office Director
NTSB office
Eastern Region Aviation
Parties
FAA/FSDO
FAA report
20170612007189A
Case key
95359

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

The pilot's improper fuel management, which resulted in fuel starvation and the subsequent total loss of engine power.

Findings · 3

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.

Use of equip/info: use of equip/systemPersonnel issues › Task performance · PilotCessna P206A: 1 caseAll aircraft: 1,391 casesProbable cause
Fluids: fuelAircraft › Fluids/misc hardware · Fluid managementCessna P206A: 1 caseAll aircraft: 1,695 casesProbable cause
Object/animal/substance: tree(s)Environmental issues › Physical environment · Contributed to outcomeCessna P206A: 1 caseAll aircraft: 933 cases

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 commercial pilot was on the second leg of a postmaintenance flight. The first flight leg, which was about 1-hour long, was uneventful, and the pilot reported that the fuel selector was positioned to the right tank during this flight leg. He landed the airplane but did not purchase fuel before departing for the return leg. The pilot reported that, during the return leg, the fuel selector was positioned to the left tank. While on final approach to the airport, the pilot added power to go around. He turned onto the crosswind and then downwind legs of the airport traffic pattern, and while on the downwind leg, the engine lost all power. The pilot switched the fuel selector to the right tank, but engine power was not restored. Realizing that the airplane would be unable to reach the runway, the pilot conducted a forced landing in trees, and the airplane came to rest inverted. During postaccident examination, more than the unusable amount of fuel was drained from the left fuel tank, which was breached in two locations; only about 6 ounces of fuel were drained from the unbreached right fuel tank. No fuel was found in the engine-driven fuel pump or the flow divider, which is indicative of fuel starvation. Examination of the fuel supply system revealed no evidence of preimpact mechanical failures or malfunctions that would have precluded normal operation. The engine was started and operated briefly using the fuel that had been drained from the airplane with no discrepancies noted. Although the pilot stated that he conducted the entire second flight leg with the fuel selector positioned to the left tank and then switched to the right tank after the engine lost power, the fuel selector was found positioned to the left tank, which had more than the unusable amount of fuel. Therefore, it is likely that the pilot was approaching the airport with the fuel selector positioned to the right tank, which ran out of fuel, and that he then switched to the left tank too late to restore engine power. Given this and the lack of fuel in the engine-driven fuel pump and flow divider, it is likely that the pilot mismanaged the fuel, which resulted in the loss of all engine power.

Factual narrative

On June 12, 2017, about 2255 eastern daylight time, a Cessna P206A, N206TF, was substantially damaged during a forced landing while on approach to Eagles Nest Airport (31E), West Creek, New Jersey. The commercial pilot sustained minor injuries. The airplane was being operated under the provisions of 14 Code of Federal Regulations Part 91 as a post-maintenance flight. Visual meteorological conditions prevailed at the time and a visual flight rules flight plan was filed but not activated for the flight that originated about 1 hour earlier from Danbury Municipal Airport (DXR), Danbury, Connecticut.Two days earlier, 4 repaired cylinders were installed on the airplane's engine that required break-in. In preparation of the flight to break-in the cylinders, the pilot personally spoke with the mechanic and was given the procedures, which included operation of the engine at full rich, and to monitor the cylinder head temperature (CHT). He was also informed to check the fuselage belly for fresh oil. The pilot reported he personally filled both fuel tanks, bringing the total usable capacity in each tank to 31.5 gallons. He then flew the airplane on an uneventful 1 hour flight from 31E to DXR. The entire flight was performed with the fuel selector on the right tank, the mixture control in the full rich position, and the engine operating at 24 inches manifold pressure and 2,400 rpm. No engine discrepancies were noted during the flight, and no fuel was purchased while at DXR. Prior to departing DXR for the return flight to 31E, the pilot stated that he performed a "quick preflight inspection", and although the airplane was equipped with a dipstick to check the fuel quantity, he did not use it during his preflight inspection. The airplane departed with the fuel selector on the left tank position, the mixture control in the full rich position, and climbed at full power to 7,500 ft mean sea level (msl). The pilot maintained 24 inches manifold pressure and 2,400 rpm (same engine settings as the first leg), and flew to 31E while periodically scanning the engine gauges. While on final approach to runway 14, he realized the "sight picture" was not correct, and performed a go-around. He climbed to between 1,000 and 1,200 ft msl, then turned onto the crosswind and downwind legs of the airport traffic pattern. While on the downwind leg of the airport traffic pattern between 1,200 and 1,500 ft msl, before midfield, with the auxiliary fuel pump on, the engine sputtered and quit, and the propeller stopped. The pilot attempted to restart the engine which consisted of moving the fuel selector to the right tank position, verifying the mixture control was full rich, and advancing the throttle, but the engine did not restart. He turned onto the base leg of the airport traffic pattern, and flew towards the runway while maintaining best glide speed of 80 knots; however, the airplane impacted trees then the ground about 1/4 nautical mile before the runway, and came to restinverted. The fuel selector was not moved before exiting the airplane. Postaccident examination of the airplane by a Federal Aviation Administration (FAA) inspector revealed the fuel selector was positioned to the left fuel tank. About 2.5 gallons of fuel were drained from it which was breached in 2 locations, while about 6 ounces of fuel were drained from the un-breached right fuel tank. The ground beneath the left wing smelled of fuel, while the ground beneath the right fuel tank did not smell of fuel, and no fuel blight to vegetation was noted beneath the right fuel tank. No fuel stains were noted aft of either fuel cap. One propeller blade was slightly bent. Examination of the airplane by the same FAA inspector following recovery revealed fuel was present at the inlet and outlet of the auxiliary fuel pump, but no fuel was present at the inlet or outlet of the engine-driven fuel pump, or at the flow divider/manifold valve. With battery power applied, and a fuel supply provided, the auxiliary fuel pump provided fuel to the inlet and outlet of the engine-driven fuel pump. This was repeated with the fuel selector positioned to the left and right tank positions. There were no reported issues with the aircraft's fuel system. The propeller was rotated by hand and with a spark plug removed from each cylinder, suction and compression was noted in each cylinder. Also during hand rotation, the magnetos produced spark at all spark plugs. A temporary fuel supply was plumbed into the aircraft's fuel system, and the engine was started and operated for about 12 seconds. Safety concerns prevented a prolonged run or operation at a high power setting. No discrepancies were noted during the engine run.

Aircraft

Registration
N206TF
Reported as
Cessna P206 (A)
Category
Airplane
Serial number
P206-0289
Built
1966
Airframe hours
11,950.8
Engine
Continental IO-520-A, 285 horsepower, reciprocating
Damage
Substantial damage
Flight
Other work use · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
100 hour · March 8, 2017 · 34 hours before
Departed
DXR · Danbury, CT
Destination
31E · West Creek, NJ
Flight plan
VFR
Airport
31E · Eagles Nest Airport
Equipment
Stall warning system

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
36
Injuries
Minor
Certificate
Commercial
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
April 9, 2017
Seat
Left
Restraint
Lap only
Flight hours
1,050 total · 20 in this make and model · 930 as pilot in command · 89 in the last 90 days · 61 in the last 30 days · 8 in the last 24 hours

Weather

Conditions
Visual (VMC) · Not reported
Wind
240° at 4 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
75 °F, dew point 64 °F
Altimeter
29.98 inHg
Observed at
MJX, 16 nm away

Docket · 5

The files NTSB released with the investigation on July 24, 2019, on NTSB’s docket system: statements, records, photos and specialists’ reports. 5.5 MB in all.

FAA reports on this event · 1

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