ERA18LA023

NTSB accident investigation · Great Lakes 2T1A · Montague, MA · November 2, 2017

Accident · No injuriesLimited investigationFinal report
Date
November 2, 2017, 14:00 local (18:00 UTC)
Place
Montague, MA
Injuries
1 uninjured
Damage
Substantial damage
Phase of flight
Takeoff
Aircraft
N3512LGreat Lakes 2T1A
Defining event
Takeoff: Loss of control on ground
Weather
Visual (VMC) · Day
Status
Completed · report July 23, 2019
Report
Approved by Office Director
NTSB office
Eastern Region Aviation
Parties
FAA/FSDO
FAA report
20171102018139A
Case key
96320

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 failure to maintain directional control during the attempted takeoff, which resulted in a runway excursion.

Findings · 2

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.

Performance/control parameters: directional controlAircraft › Aircraft oper/perf/capability · Not attained/maintainedGreat Lakes 2T-1A-2: 4 casesAll aircraft: 3,958 casesProbable cause
Use of equip/info: aircraft controlPersonnel issues › Task performance · PilotGreat Lakes 2T-1A-2: 5 casesAll aircraft: 9,295 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 private pilot was initiating takeoff for the positioning flight with no winds and with the airplane's tail off the runway when the airplane suddenly veered left, which he could not correct. The airplane exited the left side of the runway and then slid down a sharp incline into a ditch and nosed over. Postaccident examination of the runway revealed skid marks made by the right main landing gear (MLG) tire that continued off the runway, and by the tailwheel tire, which began 50 ft past the beginning of the right MLG tire marks and also continued off the runway. The left MLG tire only made light tire marks, which indicates that the airplane was light on the left MLG tire during the takeoff. No flat spots were noted on either MLG tire, and examination of both brakes and the flight controls revealed no evidence of a preimpact mechanical malfunctions or failures that would have precluded normal operation. During an operational test, the left brake operated normally. The right brake could not be operationally tested due to damage to its components Given the evidence, it is likely that the pilot lost directional control during the attempted takeoff.

Factual narrative

On November 2, 2017, about 1400 eastern daylight time, a privately owned and operated Great Lakes Aircraft Company 2T-1A-2, N3512L, experienced a runway excursion during takeoff and nosed over at Turners Falls Airport (0B5), Montague, Massachusetts. The private pilot was not injured and the airplane, which was being operated under the provisions of 14 Code of Federal Regulations Part 91, as a personal flight, was substantially damaged. Visual meteorological conditions prevailed at the time and no flight plan was filed. The flight was originating at the time of the accident and was destined for the Orange Municipal Airport (ORE), Orange, Massachusetts.The pilot stated that he flew to 0B5 the day before the accident and assisted the mechanic with removing panels and bleeding the airplane's brakes as part of an annual inspection. He also reported that the left brake pads were replaced. He returned home that evening, then arrived at 0B5 the afternoon of the accident. After arrival he performed a preflight inspection, which included a visual inspection of the brakes, and rudder cables. He started the engine and began taxiing to the approach end of runway 16, reporting no discrepancies with the brakes while taxiing or during the run-up. He taxied onto the runway and with no wind, began the takeoff roll reporting all was normal for the first 200 ft. With the empennage off the runway, the airplane suddenly veered to the left, which he could not correct. The airplane went off the left side of the runway, down a sharp incline, then nosed over. He immediately released the restraint and exited the airplane. According to a Federal Aviation Administration inspector who examined the runway and airplane the same day, the airplane departed the left side of the runway about 425 from the approach end, and came to rest inverted in grass off the east side of the runway. Inspection of the runway revealed dark marks made by the right tire on runway centerline beginning about 350 feet from the approach edge of the runway. The marks were continuous off the east edge of the runway onto grass. Marks from the left tire were too light to capture in a photograph, while "squiggly" marks associated with the tailwheel tire began about 50 feet past the beginning of the right tire marks and continued off the east edge of the runway onto grass. The inspector reported no flat spots of either main landing gear tire. Visual inspection of the brakes while the airplane was inverted revealed both wheels rotated with no resistance. Both brakes were attached and appeared to be serviceable. The brake lines were also intact with no evidence of fluid loss. The airplane was then uprighted, which further damaged the right main landing gear, fractured the right brake line and right outer wheel half, and sheared a bolt of the brake caliper causing it to separate. Fluid was noted leaking from the right brake line when it fractured, leaving about a one-foot round stain on the pavement. Operationaltesting of the left brake revealed no evidence of failure or malfunction. The right brake could not be tested because of damage caused by recovery. Flight control continuity was confirmed for roll, pitch, and yaw with no evidence of binding or malfunction reported.

Aircraft

Registration
N3512L
Reported as
Great Lakes 2T1A (2)
Category
Airplane
Serial number
0794
Built
1978
Airframe hours
1,520
Engine
Lycoming AEIO-360-B1G6, 180 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Standard, Aerobatic
Last inspection
Annual · November 1, 2017
Departed
0B5 · Montague, MA
Destination
ORE · Orange, MA
Airport
0B5 · Turners Falls Airport, runway 16, 3,200 × 75 ft, asphalt
Equipment
Handheld GPS

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
78
Injuries
None
Certificate
Private
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
BasicMed, Without waivers/limitations
Last flight review
March 5, 2016
Seat
Rear
Restraint
3-point
Flight hours
4,220 total · 1,575 in this make and model · 4,070 as pilot in command · 30 in the last 90 days · 20 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
170° at 5 knots
Visibility
10 statute miles
Lowest ceiling
12,000 ft broken
Temperature
63 °F, dew point 57 °F
Altimeter
30.20 inHg
Observed at
ORE, 11 nm away

Docket · 8

The files NTSB released with the investigation on March 6, 2019, on NTSB’s docket system: statements, records, photos and specialists’ reports. 3.4 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.