ERA20LA163

NTSB accident investigation · Piper PA28 · East Hampton, NY · April 25, 2020

Accident · No injuriesClass 3 · LimitedFinal report
Date
April 25, 2020, 13:40 local (17:40 UTC)
Place
East Hampton, NY · Field off departure end off runway 10
Injuries
3 uninjured
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N33005Piper PA28
Defining event
Approach-VFR pattern downwind: Fuel related
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Eastern Region Aviation
Parties
FAA FSDO
FAA report
20200425006109A
Case key
101210

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 partial loss of engine power after takeoff due to the formation of carburetor ice while on the ground. Contributing to the accident was the pilot’s failure to apply carburetor heat.

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.

Temp/humidity/pressure: conducive to carburetor icingEnvironmental issues › Conditions/weather/phenomena · Effect on equipmentPiper PA-28-151: 4 casesAll aircraft: 435 casesProbable cause
Action: forgotten action/omissionPersonnel issues › Action/decision · PilotPiper PA-28-151: 1 caseAll aircraft: 440 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

During the climb after takeoff and with the throttle in the full throttle position, the pilot noticed a vibration and diminished engine power. At 400 or 500 ft mean seal level (msl), the engine began sputtering. The pilot maneuvered the airplane to return to the airport. When the airplane was at an altitude of 300 to 400 ft msl, the engine continued to sputter then experienced a total loss of power. The airplane descended, and the pilot made a right turn toward a runway. The airplane touched down about 3/4 down the runway, went off the end through a fence, and came to rest in a field. The airplane sustained substantial damage. Postaccident examination found no evidence of any preimpact mechanical failures or malfunctions of the airframe or engine that would preclude normal operation. After the examination, the engine was started and test run normally. Review of the meteorological conditions that existed around the time of the accident and a carburetor icing chart indicated that conditions were conducive to the formation of carburetor icing at glide (idle) and cruise power. Per the pilot’s operating handbook (POH), the pilot had turned off the carburetor heat after the pre-takeoff engine runup. Afterward, during the climb and despite experiencing a partial loss of power and engine roughness, the pilot did not turn on carburetor heat as directed in the POH emergency procedures. Therefore, it is likely that carburetor ice accumulated while the airplane was on the ground, which resulted in a partial loss of power once airborne.

Factual narrative

On April 25, 2020, about 1340 eastern daylight time, a Piper PA-28-151, N33005 was substantially damaged when it was involved in an accident near East Hampton, New York. The pilot and two passengers were not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the pilot, they departed Igor I. Sikorsky Memorial Airport (BDR), Bridgeport, Connecticut about 1045. She landed at East Hampton Airport (HTO) about 1115 and parked the airplane. She subsequently returned to the airplane with the passengers about 1315. The pilot then reviewed the weather and performed a preflight inspection of the airplane with no anomalies noted. The pilot started the engine and taxied to the delta intersection of runway 28, where she performed an engine run-up procedure and configured the airplane for takeoff. The takeoff roll was normal, but after rotation during the climb, the pilot noticed a vibration and diminished engine power, though the throttle was in the full throttle position. At 400 or 500 feet mean seal level (msl), the engine began sputtering. The pilot made a successful right turn back to the airport before the engine lost power completely. The pilot was able to return to the airport and land about 3/4 down an available runway. The airplane went off the end of the runway through a deer fence and came to rest in a field. Examination of the airplane by a Federal Aviation Administration (FAA) inspector revealed substantial damage to both wings and the fuselage. The propeller displayed scratches on the leading edges of both blades with no curling of the blade tips. No visible damage was present in the engine compartment. No oil or fuel leaks were noted. Engine oil on the dipstick showed the correct level and appeared clean. Examination of the throttle, mixture, and carburetor heat controls revealed that they were intact, displayed correct movement, with no evidence of binding. The fuel in the left- and right-wing fuel tanks was sampled, and no debris or water contamination was visible. Examination of the fuel strainer showed no debris or water, and fuel was present in both wing tanks with the fuel quantities at a level just below the tabs. The drive train was rotated by turning the propeller and compression was evident on all four cylinders. After the examination, the fuel selector was turned on, the engine was primed using the electric fuel pump and started. The engine was first idled at 1,200 rpm, and then power was increased to 1,500 rpm. The engine ran normally, and no vibrations or sputtering was noted. After 8 minutes, the engine was shut down. Review of the meteorological conditions that existed around the time of the accident and the carburetor icing chart from FAA Special Airworthiness Information Bulletin CE-09-35 “Carburetor Icing Prevention” indicated a potential for icing at glide (idle) power and cruise power at the temperature and dew point that existed around the time of the accident.Review of the pilot’s NTSB Form 6120.1 Pilot/Operator Aircraft Accident/Incident Report revealed that after the runup, the pilot had turned the “Carb heat off”, and examination of a post-accident photo of the instrument panel also indicated that the carburetor heat control was in the off or nearly off position. The Emergency Procedures section under Engine Roughness in the Cherokee Warrior pilot operating handbook (POH) described engine roughness as usually due to carburetor icing, which is indicated by a drop in rpm and may be accompanied by a slight loss of airspeed or altitude. It went on to advise that if too much ice is allowed to accumulate, restoration of full power may not be possible; therefore, prompt action is required. It further advised, in part, that once the carburetor heat is selected on, the rpm will decrease slightly, and roughness will increase. Pilot should wait for a decrease in engine roughness or an increase in rpm, indicating ice removal. Further review of the POH revealed that the Engine Power Loss During Takeoff and Engine Power Loss in Flight sections also advised to turn on the carburetor heat.

Aircraft

Registration
N33005
Reported as
Piper PA28 (151)
Category
Airplane
Serial number
28-7515288
Built
1975
Airframe hours
8,390.5
Engine
Lycoming O-320-D3G, 160 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Standard, Normal; Standard, Utility
Last inspection
Annual · June 14, 2019 · 38 hours before
Departed
HTO · East Hampton, NY
Destination
BDR · Bridgeport, CT
Airport
HTO · East Hampton, runway 10, 4,255 × 100 ft, asphalt
Equipment
Onboard weather, Handheld GPS, ADS-B, 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
58
Injuries
None
Certificate
Private
Airplane ratings
Single-engine land
Medical
BasicMed, With waivers/limitations
Last flight review
August 30, 2018
Seat
Left
Restraint
3-point
Flight hours
772 total · 743 in this make and model · 11 in the last 90 days · 3 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
160° at 9 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
57 °F, dew point 27 °F
Altimeter
30.08 inHg
Observed at
HTO

Docket · 10

The files NTSB released with the investigation on April 29, 2022, on NTSB’s docket system: statements, records, photos and specialists’ reports. 3.6 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.