# NTSB ERA23LA035: Beech V35A, N7893R, Shellman Bluff, GA, October 22, 2022 - Type: NTSB accident investigation - Classification: Accident · No injuries · Class 3 · Limited · Final report - Date: October 22, 2022, 18:17 local (22:17 UTC) - Place: Shellman Bluff, GA · Submerged in Marsh - Coordinates: 32.25, -81.416667 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=32.2500&lon=-81.4167&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Defining event: [Approach: Fuel exhaustion](https://openairdocs.org/ntsb-events/192) - 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): 106180 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA23LA035 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/106180/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=106180 - Page: https://openairdocs.org/ntsb/ERA23LA035 ## Probable cause The pilot’s inadequate preflight fuel planning, which resulted in a total loss of engine power due to fuel exhaustion. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Fluids: fuel](https://openairdocs.org/ntsb-findings/01071010): Aircraft › Fluids/misc hardware · Fluid level (probable cause); cases with it: [Beech V35A, 1 case](https://openairdocs.org/ntsb-findings/01071010/cases.md?model=1151544), [All aircraft, 1,696 cases](https://openairdocs.org/ntsb-findings/01071010/cases.md) - [Planning/preparation: fuel planning](https://openairdocs.org/ntsb-findings/02061030): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Beech V35A, 2 cases](https://openairdocs.org/ntsb-findings/02061030/cases.md?model=1151544), [All aircraft, 720 cases](https://openairdocs.org/ntsb-findings/02061030/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Approach: Fuel exhaustion](https://openairdocs.org/ntsb-events/192) (defining event); cases with it: [Beech V35A, 1 case](https://openairdocs.org/ntsb-events/192/sequence.md?model=1151544), [All aircraft, 805 cases](https://openairdocs.org/ntsb-events/192/sequence.md) - [Emergency descent: Ditching](https://openairdocs.org/ntsb-events/441); cases with it: [Beech V35A, 1 case](https://openairdocs.org/ntsb-events/441/sequence.md?model=1151544), [All aircraft, 187 cases](https://openairdocs.org/ntsb-events/441/sequence.md) ## Analysis The pilot departed for a local flight to practice instrument approaches, and after completing two approaches to a nearby airport, was returning to the departure airport. While maneuvering to enter the airport traffic pattern the engine suddenly lost power completely. The pilot attempted to troubleshoot the loss of engine power by switching fuel tanks and adjusting the engine controls, but was not successful. He subsequently ditched the airplane into a river and the airframe was substantially damaged during the landing. Postaccident examination of the airplane revealed that the intact fuel tanks each contained a quantity of fuel less than their unusable capacity. Additionally, downstream components of the fuel system contained only trace amounts of fuel. Examination of the engine and airframe revealed no evidence of any mechanical malfunction or failure that would have precluded normal operation. Data recovered from an engine data monitor revealed that, about 1 hour into the flight, the exhaust gas temperature (EGT) of all the engine’s cylinders suddenly increased before then rapidly decreasing, consistent with the sudden loss of engine power described by the pilot. The sudden increase of EGT that preceded the rapid decrease is consistent with a leaning of the engine’s fuel mixture (consistent with what would occur following an interruption or exhaustion of the available fuel supply). Given the lack of fuel found during the postaccident examinations of the airplane, and based on the engine monitor data, it is likely that the pilot misjudged the amount of fuel onboard the airplane before departing on the accident flight, which resulted in fuel exhaustion and a total loss of engine power. ## Factual narrative On October 22, 2022, about 1817 eastern daylight time, a Beech V35A airplane, N7893R, was substantially damaged when it was involved in an accident near Sunbury, Georgia. The pilot was not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the pilot, before the flight, he had about 35 gallons of fuel in the left wing’s fuel tank, and an estimated 15 to 20 gallons of fuel in the right wing’s fuel tank. Subsequently, the pilot departed Eagle Neck Airpark (1GA0), Shellman Bluff, Georgia, about 1720 and flew to Brunswick Golden Isles Airport (BQK), Brunswick, Georgia, to practice instrument approaches. After completing two approaches at BQK, he flew back to 1GA0. After arriving at 1GA0 and entering the traffic pattern, he extended the left downwind leg about 10 miles north of the airport before turning on to a left base leg. The engine then suddenly lost power. The pilot immediately switched fuel tanks with no result. At this point, the airplane’s airspeed was about 120 mph, and it was at 1,500 ft above mean sea level. Having switched tanks and still with no engine power, he moved the throttle, propeller, and mixture controls full forward without result. He then “called mayday” over the radio and had a choice between a forced landing to the Medway River and a marsh. He chose to perform a forced landing to the river, close to the marsh. He kept the landing gear retracted, and when the airplane touched down on the water, it came to a stop very quickly. After the landing, the pilot stepped out onto the wing and called 911. The airplane was in about six feet of water, and as it settled, the pilot stood on the top of the fuselage with water up to his knees and awaited rescue. About 1 hour later, he was rescued by the United States Coast Guard. The airplane was recovered from the water two days after the accident and Federal Aviation Administration (FAA) inspectors observed the airplane’s recovery. The right lower wing root displayed crush and compression damage, and the right outboard wing panel was twisted. The left ruddervator was missing a portion of its outboard section; its balance weight had separated from the control surface and was not recovered. The nose landing gear doors, lower engine cowling, and lower fuselage displayed crush and compression damage, and was missing an access panel on the lower fuselage below the passenger cabin. The inspectors did not note the presence of fuel or oil leaking from the airplane. About 1 gallon of fuel was recovered from each of the airplane’s left- and right-wing fuel tanks. The airplane was subsequently transported to an aircraft recovery facility and examined in detail. The fuel selector was found selected to the left fuel tank, the throttle control was fully open, the mixture control was set to fully rich, and the propeller control was in the high rpm position. The propeller displayed visible aft bending. The fuel tanks remained intact. A traceamount of fuel was recovered from the fuel strainer, and the fuel distribution valve was absent of fuel. The fuel distribution valve screen and fuel injectors were absent of debris or other obstructions. The magnetos were water-damaged and could not be tested. An engine data monitoring device was recovered from the airplane and its data were downloaded by the NTSB Vehicle Recorders Laboratory. The recovered data included a dataset that correlated to the accident flight, though the unit’s internal clock had not been set accurately; therefore, a correlation of the data to actual time could not be made. The data included cylinder head (CHT) and exhaust gas temperatures (EGT) for each of the engine’s six cylinders, with data for each parameter captured every six seconds. The dataset correlated to the accident flight was 1 hour and 7 minutes long. Rises in CHT and EGT consistent with the application of takeoff power began about 8 minutes into the recording session. About 1 hour and 4 minutes after the beginning of the recording, a sudden increase in EGT of about 100°F for all the engine’s cylinders was observed that persisted over a duration of about 30 seconds. The sudden EGT increase was followed by a rapid decrease in EGT and gradual decrease in CHT that continued for the remaining 3 minutes of the recording, consistent with a loss of engine power. According to the airplane’s FAA-Approved Airplane Flight Manual, “Maximum usable fuel of each 39 or 40 gal. main tank is 37 gallons.” The fuel selector in the accident airplane had placards for each fuel tank that indicated a capacity of 37 gallons. ## Aircraft - Registration: [N7893R](https://openairdocs.org/deregistered/N7893R-2024-10-07), registration cancelled 2024-10-07, S/N D-8945, built 1969 (OpenAirDocs) - Reported make and model: BEECH V35A - Registry model: [Beech V35A](https://openairdocs.org/model/beech-v35a) (registry code 1151544) (OpenAirDocs) - Registry engine: [Continental IO-520 series](https://openairdocs.org/engine/continental-io-520-series) (registry code 17032, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: D-8945 - Year built: 1969 - Airframe hours: 5924.6 - Engines: Continental IO-520-BA6B 285 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Standard, Utility - Last inspection: Annual, October 2, 2021, 82.2 hours before - Departed: 1GA0, Shellman Bluff, GA - Destination: 1GA0, Shellman Bluff, GA - Equipment: Electronic primary flight display, Auto-pilot, ADS-B, Stall warning system ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 71; injuries: none; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, without waivers/limitations; seat: left; flight hours: 2,166 total, 1,163 in this make and model, 1,802 as pilot in command, 13 in the last 90 days, 1 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: 40° at 6 knots - Visibility: 10 statute miles - Temperature: 32 °F, dew point 32 °F - Altimeter: 30.10 inHg - Observed at: SAV, 8 nm away - METAR: SA 22/10/2022 21:53-> METAR KSAV 222153Z 04006KT 10SM CLR 22/03 A3010 RMK AO2 SLP192 T02220033= ## 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 20221022023439A](https://openairdocs.org/incident/20221022023439A), Oct 22, 2022: Beech V35A, Midway, GA, Destroyed. On October 22nd 2022, at approximately 1830 eastern time, [privacy data omitted], a 1969 bonanza BE35 (single engine), s/n D-8945, was forced to make an… ## Docket (8 files) The files NTSB released with the investigation on December 5, 2024, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=106180. 15.3 MB in all. - Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 11 pages, 4.8 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17972837&FileExtension=pdf&FileName=NTSB%20Form6120_redacted-Rel.pdf - FAA inspector's statement (item 2, PDF, 1 page, 45 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17972370&FileExtension=pdf&FileName=FAA%20Inspector%20Statement_Redacted-Rel.pdf - Memorandum for record - wreckage examination (item 3, PDF, 1 page, 121 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17973293&FileExtension=pdf&FileName=Memorandum%20For%20Record%20-%20Wreckage%20Examination-Rel.pdf - Engine data monitor - specialist's factual report (item 4, PDF, 6 pages, 3 photos, 1.3 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15694188&FileExtension=pdf&FileName=Engine%20Data%20Monitor%20-%20Specialist%27s%20Factual%20Report-Rel.pdf - Engine data monitor - specialist's factual report - ATTACHMENT1 (item 5, CSV, 43 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15693463&FileExtension=csv&FileName=Engine%20Data%20Monitor%20-%20Specialist%27s%20Factual%20Report%20-%20Attachment1-Rel.csv - Investigation photographs (item 6, PDF, 5 pages, 4 photos, 3.1 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17973759&FileExtension=pdf&FileName=Investigative%20Photographs-Rel.pdf - Airplane flight manual (excerpt) (item 7, PDF, 2 pages, 2.4 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17975127&FileExtension=pdf&FileName=AFM%20Extract-Rel.pdf - Release of aircraft wreckage, NTSB form 6120.15 and evidence control documentation (item 8, PDF, 2 pages, 3.5 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17972946&FileExtension=pdf&FileName=Wreckage%20Release%20and%20Evidence%20Control%20Documentation_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.