# NTSB ERA22LA322: Vans RV10, N910BW, Palatka, FL, July 18, 2022 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Class 3 · Limited · Final report - Date: July 18, 2022, 08:04 local (12:04 UTC) - Place: Palatka, FL · 3 NE of airport - Coordinates: 29.658382, -81.689503 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=29.6584&lon=-81.6895&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Defining event: [Initial climb: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341) - Highest injury: Serious injuries - Injuries: 1 serious - Status: Completed - Report: Approved by Office Director - Investigation class: Class 3 - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO - NTSB case key (mKey): 105519 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA22LA322 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/105519/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=105519 - Page: https://openairdocs.org/ntsb/ERA22LA322 ## Probable cause Total loss of engine power due to the improper installation of an electronic ignition system connector plug. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Maintenance: installation](https://openairdocs.org/ntsb-findings/02062035): Personnel issues › Task performance · Maintenance personnel (probable cause); cases with it: [Darrell Bryan Wade RV-10, 1 case](https://openairdocs.org/ntsb-findings/02062035/cases.md?model=05636FN), [All aircraft, 371 cases](https://openairdocs.org/ntsb-findings/02062035/cases.md) - [Ignition system: ignition system wiring](https://openairdocs.org/ntsb-findings/01057497): Aircraft › Aircraft power plant · Incorrect service/maintenance (probable cause); cases with it: [Darrell Bryan Wade RV-10, 1 case](https://openairdocs.org/ntsb-findings/01057497/cases.md?model=05636FN), [All aircraft, 16 cases](https://openairdocs.org/ntsb-findings/01057497/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Initial climb: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341) (defining event); cases with it: [Darrell Bryan Wade RV-10, 1 case](https://openairdocs.org/ntsb-events/341/sequence.md?model=05636FN), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md) - [Emergency descent: Loss of engine power (total)](https://openairdocs.org/ntsb-events/341); cases with it: [Darrell Bryan Wade RV-10, 1 case](https://openairdocs.org/ntsb-events/341/sequence.md?model=05636FN), [All aircraft, 3,820 cases](https://openairdocs.org/ntsb-events/341/sequence.md) - [Emergency descent: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Darrell Bryan Wade RV-10, 1 case](https://openairdocs.org/ntsb-events/470/sequence.md?model=05636FN), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis Shortly after takeoff, the experimental amateur-built airplane’s engine lost total power and the pilot made an off-airport forced landing, resulting in substantial damage to the fuselage, both wings, and the tail section. Postaccident examination of the engine revealed that a cannon plug-type circular connector that connected the engine’s electronic ignition system’s wire harness to the two electronic control units was not properly connected. The manufacturer of the ignition system stated that disengagement of the connector, which carried all electrical signals required to run the ignition system, “…would result in a single point failure of the entire ignition system.” Maintenance records showed that the ignition system had been installed about 21 months before the accident, with no other work to that system detailed between that time and the accident. Based on this information, it is likely that the connector had not been fully secured when the system was installed, and that over time, the partial connection had loosened, ultimately resulting in the loss of engine power. ## Factual narrative On July 18, 2022, at 0804 eastern daylight time, an experimental amateur-built RV-10 airplane, N910BW, was substantially damaged when it was involved in an accident near Palatka, Florida. The pilot was seriously injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot stated that shortly after takeoff, the engine sputtered then lost total power. He was unable to return to the airport and made a forced landing to heavily wooded terrain, resulting in substantial damage to the fuselage, both wings, and the tail section. Postaccident examination of the engine revealed that the cannon plug type circular connector that connected the electronic ignition wiring harness to the firewall was not locked, and the connector was partially engaged. The connector provided the connection between the wiring harness and the two electronic control units located on the cockpit side of the firewall. According to a representative of the manufacturer of the ignition system, if the firewall connector was not secure “…this would result in a single point failure of the entire ignition system.” A review of the airplane’s maintenance records revealed that the electronic ignition system was installed in October 2020. There were no subsequent entries that discussed maintenance of the ignition system since that date. ## Aircraft - Registration: [N910BW](https://openairdocs.org/aircraft/N910BW), registered now, S/N 40929 (OpenAirDocs) - Reported make and model: VANS RV10 - Registry model: [Darrell Bryan Wade RV-10](https://openairdocs.org/model/darrell-bryan-wade-rv-10) (registry code 05636FN) (OpenAirDocs) - Registry engine: [Lycoming IO-540-T4B5](https://openairdocs.org/engine/lycoming-io-540-t4b5) (registry code 41804, reciprocating) (OpenAirDocs) - Category: Airplane, amateur-built - Serial number: 40929 - Airframe hours: 195.6 - Engines: Lycoming IO-540-T4B5D 300 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Special, Experimental (Special) - Last inspection: Annual, November 30, 2021 - Destination: GKT, Gatlinburg, TN - Flight plan: IFR - Airport: 28J, Palatka Muni - Lt Kay Larkin Fld - Equipment: Angle of attack indicator, Auto-pilot, ADS-B, Data recorder, Electronic multifunction display, Stall warning system, Electronic primary flight display, Heads up display, Onboard weather, Satellite tracking device ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 55; injuries: serious; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, with waivers/limitations; last flight review May 5, 2021; seat: left; restraint: lap only; flight hours: 682.6 total, 56.8 in this make and model, 638.5 as pilot in command, 56.8 in the last 90 days, 23.3 in the last 30 days, 0 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: variable at 3 knots - Visibility: 8 statute miles - Temperature: 72 °F, dew point 72 °F - Altimeter: 30.07 inHg - Observed at: 28J, 3 nm away - METAR: SA 18/07/2022 11:35-> METAR K28J 181135Z AUTO VRB03KT 8SM 22/22 A3007 ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20220718012539A](https://openairdocs.org/incident/20220718012539A), Jul 18, 2022: Darrell Bryan Wade RV-10, Palatka, FL, Destroyed. On 07/18/2022 at approximately 08:03 EST an RV10,[privacy data omitted] was departing rwy 09 at 28J (Palatka, FL) under day VMC conditions when the aircraft… ## Docket (5 files) The files NTSB released with the investigation on November 15, 2023, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=105519. 57.2 MB in all. - Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 9 pages, 2.9 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14808732&FileExtension=pdf&FileName=6120%20signed_Redacted-Rel.pdf - NTSB summary of record - FAA inspector's reports (item 2, PDF, 3 pages, 83 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14816861&FileExtension=pdf&FileName=NTSB%20Record%20of%20Summary%20-%20FAA%20Inspector%20Reports-Rel.pdf - Witness statement (item 3, PDF, 2 pages, 82 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14816871&FileExtension=pdf&FileName=Ryan%20Austin%20Statement_%20N910BW%20Crash%2028J%20July%2018%202022_Redacted-Rel.pdf - Photos (item 4, PDF, 3 pages, 3 photos, 846 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14817075&FileExtension=pdf&FileName=Photo%20Array-Rel.pdf - Maintenance records (item 5, PDF, 26 pages, 26 photos, 53.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14816172&FileExtension=pdf&FileName=Aircraft%20Logbooks_Redacted-Rel.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.