# NTSB ERA22LA428: Zenith CH 750, N2992W, Cincinnati, OH, September 22, 2022 - Type: NTSB accident investigation - Classification: Accident · No injuries · Class 3 · Limited · Final report - Date: September 22, 2022, 07:00, time zone not recorded - Place: Cincinnati, OH - Coordinates: 39.103333, -84.418611 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=39.1033&lon=-84.4186&mi=10 - Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping) - Defining event: [Takeoff: Flight control sys malf/fail](https://openairdocs.org/ntsb-events/333) - Highest injury: No injuries - Injuries: 1 uninjured - Status: Completed - Report: Approved by Office Director - Investigation class: Class 3 - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO - NTSB case key (mKey): 105988 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA22LA428 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/105988/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=105988 - Page: https://openairdocs.org/ntsb/ERA22LA428 ## Probable cause The airplane builder’s installation of incorrect hardware in the control yoke assembly, which resulted in a loss of control during takeoff. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Misc hardware: fasteners](https://openairdocs.org/ntsb-findings/01071430): Aircraft › Fluids/misc hardware · Not installed/available (probable cause); cases with it: [Drumheller Kenneth G ZENITH CH 750, 1 case](https://openairdocs.org/ntsb-findings/01071430/cases.md?model=05631J9), [All aircraft, 58 cases](https://openairdocs.org/ntsb-findings/01071430/cases.md) - [Info processing/decision: decision making/judgment](https://openairdocs.org/ntsb-findings/02041520): Personnel issues › Action/decision · Owner/builder (probable cause); cases with it: [Drumheller Kenneth G ZENITH CH 750, 1 case](https://openairdocs.org/ntsb-findings/02041520/cases.md?model=05631J9), [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: Flight control sys malf/fail](https://openairdocs.org/ntsb-events/333) (defining event); cases with it: [Drumheller Kenneth G ZENITH CH 750, 1 case](https://openairdocs.org/ntsb-events/333/sequence.md?model=05631J9), [All aircraft, 410 cases](https://openairdocs.org/ntsb-events/333/sequence.md) - [Initial climb: Abnormal runway contact](https://openairdocs.org/ntsb-events/090); cases with it: [Drumheller Kenneth G ZENITH CH 750, 1 case](https://openairdocs.org/ntsb-events/090/sequence.md?model=05631J9), [All aircraft, 1,506 cases](https://openairdocs.org/ntsb-events/090/sequence.md) ## Analysis The pilot stated that, during the takeoff roll in the experimental amateur-built airplane, he noticed that “something felt wrong” with his flight controls. The airplane briefly climbed before landing hard on the nosewheel, resulting in substantial damage to the engine firewall. During a postaccident examination of the airplane, a bolt that attached the control yoke to the flight controls was missing. The missing bolt and a nut were subsequently located within the fuselage of the airplane. The “hardware store” -type nut was not the castle type nut with cotter pin -type that was called for in the airplane’s engineering drawings. Review of the airplane’s maintenance records revealed that it had undergone 3 annual condition inspections since being constructed and that no documented maintenance to, or replacement of the flight control hardware had occurred. Based on this information, it is likely the builder of the airplane used improper hardware to assemble the flight controls, which resulted in the separation of the control yoke from the flight controls and the subsequent loss of control during takeoff. ## Factual narrative On September 22, 2022, about 0700 eastern daylight time, an experimental amateur-built Zenith CH 750, N2992W, was substantially damaged when it was involved in an accident at near Cincinnati, Ohio. The private pilot was not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the pilot, during the takeoff roll he noticed that “something felt wrong.” He reduced power and the airplane started to “bounce” on the runway. The airplane briefly climbed before landing hard on the nosewheel. An examination of the airplane by a Federal Aviation Administration inspector revealed that the engine firewall was buckled. Further examination of the airplane revealed that a control yoke nut and bolt were missing. Both pieces of hardware were subsequently located inside the fuselage. An examination of the hardware revealed that it did not look like any of the other hardware that was attached to the control system, and review of the engineering drawings for the airplane revealed that the separated nut and bolt were not the correct type called for (bolt secured with castle nut and cotter pin). The pilot further described the findings by stating that, “There was a hardware store nut used on the wrong type bolt. Nut came off and bolt fell out [of] elevator control.” A review of the airplane’s maintenance records revealed that it had undergone three annual condition inspections since it had been completed. The records did not note that any work had been performed on the control yoke or replacement of any flight control hardware. ## Aircraft - Registration: [N2992W](https://openairdocs.org/aircraft/N2992W), registered now, S/N 75-8178, built 2015 (OpenAirDocs) - Reported make and model: ZENITH CH 750 - Registry model: [Drumheller Kenneth G ZENITH CH 750](https://openairdocs.org/model/drumheller-kenneth-g-zenith-ch-750) (registry code 05631J9) (OpenAirDocs) - Registry engine: [Rotax 912ULS series](https://openairdocs.org/engine/rotax-912uls-series) (registry code 55572, 4 cycle) (OpenAirDocs) - Category: Airplane, amateur-built - Serial number: 75-8178 - Year built: 2015 - Airframe hours: 43 - Engines: Rotax 912ULS 100 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Special, Experimental (Special) - Last inspection: Condition, August 11, 2022, 43 hours before - Departed: LUK, Cincinnati, OH - Destination: GPH, Excelsior Springs, MO - Airport: LUK, Cincinnati, runway 3R, 6,000 × 100 ft, asphalt - Equipment: Electronic multifunction display, Electronic primary flight display, Handheld GPS, Onboard weather, Satellite tracking device, Stall warning system, ADS-B, Auto-pilot ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 57; injuries: none; private; airplane ratings: single-engine land; medical: class 3; last flight review August 10, 2021; seat: left; restraint: 3-point; flight hours: 1,379 total, 9 in this make and model, 58 in the last 90 days, 29 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: 330° at 13 knots, gusting 23 - Visibility: 10 statute miles - Temperature: 72 °F, dew point 46 °F - Altimeter: 30.05 inHg - Observed at: LUK - METAR: KLUK 221853Z 33013G23KT 10SM SCT055 22/08 A3005 RMK AO2 SLP171 T02170083 ## 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 20220922015519A](https://openairdocs.org/incident/20220922015519A), Sep 22, 2022: Drumheller Kenneth G ZENITH CH 750, Cincinnati, OH, Substantial damage. Cincinnati, OH (luk):[privacy data omitted], exp zenith 750, luk-bmg, VFR, nose landing gear collapsed during takeoff on rwy 03R resulting in damage to the… ## Docket (5 files) The files NTSB released with the investigation on January 31, 2024, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=105988. 67.6 MB in all. - Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 11 pages, 2.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14929312&FileExtension=pdf&FileName=6120%20LA428_Redacted-Rel.pdf - Maintenance records excerpts (item 2, PDF, 6 pages, 63.6 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14941996&FileExtension=pdf&FileName=MX%20Log%20excerpts%20LA428_Redacted-Rel_Redacted-Rel.pdf - FAA inspector's statement (item 3, PDF, 1 page, 128 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14929322&FileExtension=pdf&FileName=FAA%20statement%20LA428-Rel.pdf - Drawings (engineering sketches) (item 4, PDF, 1 page, 522 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14929292&FileExtension=pdf&FileName=CH750%20drawing%2075-CA-2%20marked-Rel.pdf - Investigative photos (item 5, PDF, 3 pages, 1.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=14931045&FileExtension=pdf&FileName=Investigative%20Photos%20LA428-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.