# NTSB ERA17LA324: Cessna 195, N2100C, Newman, GA, August 10, 2017 - Type: NTSB accident investigation - Classification: Accident · No injuries · Limited investigation · Final report - Date: August 10, 2017, 17:00 local (21:00 UTC) - Place: Newman, GA - Coordinates: 33.311668, -84.769721 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=33.3117&lon=-84.7697&mi=10 - Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping) - Defining event: [Takeoff: Loss of control on ground](https://openairdocs.org/ntsb-events/230) - Highest injury: No injuries - Injuries: 2 uninjured - Status: Completed, report July 23, 2019 - Report: Approved by Office Director - NTSB office: Eastern Region Aviation - Parties: FAA/FSO - NTSB case key (mKey): 96009 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA17LA324 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/96009/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=96009 - Page: https://openairdocs.org/ntsb/ERA17LA324 ## Probable cause The improper rigging of the tailwheel assembly, which resulted in a loss of directional control during takeoff. Contributing to accident was the pilot’s decision to operate the airplane despite knowing it required excessive right rudder inputs for it to move straight ahead. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Landing gear system: landing gear steering system](https://openairdocs.org/ntsb-findings/01023250): Aircraft › Aircraft systems · Incorrect service/maintenance (probable cause); cases with it: [Cessna 195, 1 case](https://openairdocs.org/ntsb-findings/01023250/cases.md?model=2073102), [All aircraft, 32 cases](https://openairdocs.org/ntsb-findings/01023250/cases.md) - [Info processing/decision: decision making/judgment](https://openairdocs.org/ntsb-findings/02041520): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Cessna 195, 1 case](https://openairdocs.org/ntsb-findings/02041520/cases.md?model=2073102), [All aircraft, 3,098 cases](https://openairdocs.org/ntsb-findings/02041520/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Takeoff: Loss of control on ground](https://openairdocs.org/ntsb-events/230) (defining event); cases with it: [Cessna 195, 14 cases](https://openairdocs.org/ntsb-events/230/sequence.md?model=2073102), [All aircraft, 4,585 cases](https://openairdocs.org/ntsb-events/230/sequence.md) - [Takeoff: Attempted remediation/recovery](https://openairdocs.org/ntsb-events/060); cases with it: [Cessna 195, 3 cases](https://openairdocs.org/ntsb-events/060/sequence.md?model=2073102), [All aircraft, 1,422 cases](https://openairdocs.org/ntsb-events/060/sequence.md) - [Takeoff: Runway excursion](https://openairdocs.org/ntsb-events/300); cases with it: [Cessna 195, 8 cases](https://openairdocs.org/ntsb-events/300/sequence.md?model=2073102), [All aircraft, 3,643 cases](https://openairdocs.org/ntsb-events/300/sequence.md) - [Takeoff: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Cessna 195, 11 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=2073102), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis According to airline transport pilot, during the takeoff roll, the airplane veered left. The pilot tried to correct the turn without success, and the airplane subsequently departed the left side of the runway, struck a taxiway light, and then came to rest in grass adjacent to the runway. The airplane sustained substantial damage to the fuselage and right wing. The pilot reported that he had owned the airplane for about 1 month, during which time he observed that he had to continuously apply right rudder for the airplane to taxi straight ahead, which he thought was normal for that airplane. Examination of the tailwheel assembly revealed that, when the rudder pedals were centered, the rudder was also centered. However, the tailwheel remained in a left-turn position and required about 75% right rudder input to center the tailwheel, and with full-right rudder deflection, the tailwheel turned very little to the right. A review of the maintenance records revealed that maintenance, including the installation of a new upper mount assembly and a new tailwheel strut, was performed on the tailwheel assembly about 3 years before the accident. Given the pilot's report that he had always needed to apply right rudder for the airplane to taxi straight ahead, it is likely that the tailwheel assembly was improperly rigged following the previous maintenance. ## Factual narrative On August 10, 2017, about 1700 eastern daylight time, a Cessna 195, N2100C, was substantially damaged during takeoff from Newnan Coweta County Airport (CCO), Newnan, Georgia. The airline transport pilot and passenger were not injured. The personal flight was conducted under the provisions of Title 14 Code of Federal Regulations Part 91. Visual meteorological conditions prevailed and no flight plan was filed for the local flight.According to the pilot, he taxied the airplane to the active runway for takeoff. During the takeoff roll, the airplane veered to the left. The pilot attempted to correct the turn but was unsuccessful. The airplane departed the left side of the runway, collided with a taxiway light and came to rest in the grass adjacent to the runway. Examination of the airplane by a Federal Aviation administration (FAA) inspector revealed that the fuselage and the right wing was buckled. An examination of the rudder and tail wheel assembly revealed that when the rudder pedals were centered, the rudder was also centered. However, the tail wheel remained in a left turn position. It required approximately 75% right rudder input to center the tail wheel. With full right rudder deflection, there was very little right turn in the tail wheel. Review of the airplane's maintenance logbooks revealed that maintenance was performed on tailwheel assembly, that included the installation of a new upper mount assembly with channel kit as well as an overhauled tailwheel strut in August 2014. The airplane accumulated 48.5 hours since that overhaul. The last annual inspection was completed on March 23, 2017. During an interview the pilot stated that he purchased the airplane one month prior to the accident. He operated the airplane a total of about 12 hours, which included 15 landings. He received his tailwheel endorsement on July 27, 2017. He further stated that while taxiing, he had to "keep the rudder in" to taxi straight ahead, which he thought was a normal characteristic of the airplane. ## Aircraft - Registration: [N2100C](https://openairdocs.org/aircraft/N2100C), registered now, S/N 16085, built 1953 (OpenAirDocs) - Reported make and model: CESSNA 195 (UNDESIGNAT) - Registry model: [Cessna 195](https://openairdocs.org/model/cessna-195) (registry code 2073102) (OpenAirDocs) - Registry engine: [Jacobs R755A series](https://openairdocs.org/engine/jacobs-r755a-series) (registry code 35006, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 16085 - Year built: 1953 - Airframe hours: 2550 - Engines: JACOBS R755A SERIES 350 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Standard, Normal - Last inspection: Annual, September 30, 2016, 15 hours before - Departed: CCO, Newman, GA - Destination: CCO, Newman, GA - Airport: CCO, Newnan Coweta County, runway 14, 5,500 × 100 ft, asphalt - Equipment: Stall warning system ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 56; injuries: none; airline transport; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 1, with waivers/limitations; seat: left; restraint: 4-point; flight hours: 13,000 total, 12 in this make and model, 9,600 as pilot in command, 12 in the last 90 days ## Weather - Conditions: Visual (VMC), Day - Wind: 150° at 5 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 86 °F, dew point 77 °F - Altimeter: 30.10 inHg - Observed at: cco ## Docket (7 files) The files NTSB released with the investigation on March 5, 2019, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=96009. 8.5 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 313 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470851&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF - Pilot's Logbook Excerpts (item 2, .PDF, 7.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470852&FileExtension=.PDF&FileName=Pilot%27s%20Logbook%20Excerpts-Master.PDF - Passenger Statement (item 3, .PDF, 28 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470853&FileExtension=.PDF&FileName=Passenger%20Statement-Master.PDF - FAA Inspector's Statement (item 4, .PDF, 120 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470854&FileExtension=.PDF&FileName=FAA%20Inspector%27s%20Statement-Master.PDF - Maintenance Records (item 5, .PDF, 517 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470855&FileExtension=.PDF&FileName=Maintenance%20Records-Master.PDF - Photo Array (item 6, .PDF, 3 photos, 217 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470856&FileExtension=.PDF&FileName=Photo%20Array-Master.PDF - Wreckage Diagrams (item 7, .PDF, 309 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40470857&FileExtension=.PDF&FileName=Wreckage%20Diagrams-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.