ERA21LA059

NTSB accident investigation · Piper PA38 · Pembroke Pines, FL · December 2, 2020

Accident · No injuriesClass 3 · LimitedFinal report
Date
December 2, 2020, 07:51 local (12:51 UTC)
Place
Pembroke Pines, FL
Injuries
2 uninjured
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N2420FPiper PA38
Defining event
Approach-VFR pattern crosswind: Fuel contamination
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Eastern Region Aviation
Parties
FAA
FAA report
20201202020079A
Case key
102359

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

On this page

Probable cause

A total loss of engine power due to fuel contamination.

Findings · 1

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.

Fluids: fuelAircraft › Fluids/misc hardware · Fluid conditionPiper PA-38-112: 8 casesAll aircraft: 1,695 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 purpose of the instructional flight was to fly the traffic pattern with the student pilot. Prior to the flight, the flight instructor and student pilot performed a preflight inspection with no anomalies noted. After performing several takeoffs and landings in the traffic pattern, the flight instructor switched from the left fuel tank to the right tank. They performed a go-around procedure and, on the upwind leg of the traffic pattern, noticed a strong smell of something “being burnt.” During the turn to the crosswind leg of the traffic pattern, the flight instructor noticed a “lack of engine power.” He assumed control of the airplane from the student pilot, verified that the fuel mixture control was in the full-rich position, and moved the throttle lever with no response from the engine. He then declared an emergency, turned back toward the airport, and unsuccessfully attempted to restart the engine multiple times during the descent. The airplane struck an airport perimeter fence, nosed over, and came to rest inverted, resulting in substantial damage to the fuselage, wings and empennage. The fuel tanks were breached, the gascolator was impact separated, and fuel was noted at the accident site. The source of the burning odor could not be determined. Examination of the airplane revealed no anomalies with the fuel tanks, fuel caps, or seals. Examination of the engine revealed water contamination in the fuel system at the gascolator, electric fuel pump, engine-driven fuel pump, and carburetor. It is likely that since the fuel cap seals and tanks did not exhibit any anomalies, the water contamination came from another source, which ultimately resulted in a total loss of engine power.

Factual narrative

On December 2, 2020, about 0751 eastern standard time, a Piper PA-38, N2420F, was substantially damaged when it was involved in an accident near North Perry Airport (HWO), Pembroke Pines, Florida. The flight instructor and student pilot were not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 instructional flight. According to the flight instructor, the purpose of the flight was to fly in the airport traffic pattern with the student pilot. Prior to the flight, they performed a preflight inspection and sampled fuel from the fuel tanks with no anomalies noted. After performing several takeoffs and landings in the traffic pattern, the flight instructor’s “fuel timer” went off on a downwind leg of the traffic pattern to switch tanks from the left tank to the right tank. They performed a go around procedure and on the upwind leg of the traffic pattern they noticed a strong smell of something “being burnt.” The flight instructor conducted a scan of the instruments, and noted the carbon monoxide detector was black, which indicated high levels of carbon monoxide were present. At that point, they were 400 ft mean sea level, and the student pilot began to turn to the crosswind leg of the traffic pattern. During the turn, the flight instructor noticed a “lack of engine power.” He assumed control of the airplane from the student pilot and verified that the fuel mixture control was in the full-rich position and moved the throttle lever with no response from the engine. He then declared an emergency, turned back toward the airport, and unsuccessfully attempted to restart the engine multiple times during the descent. The airplane struck an airport perimeter fence, nosed over, and came to rest inverted resulting in substantial damage to the fuselage and empennage. The flight instructor and student pilot egressed the airplane. According to the maintenance records, an annual inspection was completed on August 18, 2020, at a total time of 4,930.07 hours. On November 30, 2020, a new engine-driven fuel pump was installed on the engine at a total time of 4,940.3 hours. An examination of the wreckage by a Federal Aviation Administration inspector revealed that fuel leaked out of the airplane as it was inverted, the fuel tanks were breached, and the gascolator was impact separated. The left and right wet wing tanks were found to be clean. Inspection plates from both wing tanks were removed and the seals found in good condition with no evidence of leakage or seepage into tanks. Inspection of both fuel caps found the seals in good condition with proper sealing and no play once the caps were secured. The fuel selector switch inside the cockpit was found to be operating normally. Continuity of the throttle and mixture controls was confirmed. Compression was confirmed on all cylinders. The magnetos were examined and there were no anomalies with the timing. The air filter and induction system were examined with no anomalies noted. Thegascolator was found damaged on impact with no fuel found inside, but dried brown/orange corrosion staining at the bottom of the gascolator bowl was observed. The electric fuel pump was found to be operational, and removal of the lower drain cap revealed brown/orange water contamination and corrosion. A brown/orange dust and contaminated water were found in the carburetor fuel bowl and in the bottom of the engine driven fuel pump. Examination of the electrical system in the engine compartment and behind the cockpit panel did not reveal any signs of overheating or burning.

Aircraft

Registration
N2420F
Reported as
Piper PA38 (112)
Category
Airplane
Serial number
38-79A0433
Built
1979
Airframe hours
4,940.43
Engine
Lycoming O-235-L2C, 125 horsepower, reciprocating
Damage
Substantial damage
Flight
Instructional · Part 91
Operator
Everglades Aviation Academy LLC
Registered owner
Everglades Aviation Academy LLC
Airworthiness certificate
Standard, Utility; Standard, Normal
Last inspection
Annual · August 18, 2020 · 10 hours before
Destination
Same as departure
Airport
HWO · North Perry, runway 1R, 3,260 × 100 ft, asphalt
Equipment
Stall warning system, ADS-B

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 · 2

As NTSB recorded them. NTSB leaves out names.

Role
Flight instructor
Age
20
Injuries
None
Certificates
Flight instructor, Commercial
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
September 27, 2020
Seat
Right
Restraint
3-point
Flight hours
303 total · 27 in this make and model · 210 as pilot in command · 47 in the last 90 days · 25 in the last 30 days · 2.4 in the last 24 hours
Role
Student pilot
Age
22
Injuries
None
Certificate
Student
Seat
Left
Restraint
3-point
Flight hours
17 total · 7 in this make and model · 9 in the last 90 days · 5 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Wind
340° at 7 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
55 °F, dew point 46 °F
Altimeter
30.22 inHg
Observed at
HWO

Docket · 5

The files NTSB released with the investigation on September 28, 2022, on NTSB’s docket system: statements, records, photos and specialists’ reports. 9.3 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.