# NTSB ERA23LA297: Cessna 150L, N16071, Elberton, GA, July 12, 2023

- Type: NTSB accident investigation
- Classification: Accident · Minor injuries · Class 3 · Limited · Final report
- Date: July 12, 2023, 13:35 local (17:35 UTC)
- Place: Elberton, GA · Country, red dirt road.
- Coordinates: 34.093626, -82.80066 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=34.0936&lon=-82.8007&mi=10
- Phase of flight: [Takeoff](https://openairdocs.org/ntsb-phases/300) (OpenAirDocs' grouping)
- Defining event: [Takeoff: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342)
- Highest injury: Minor injuries
- Injuries: 1 minor
- Status: Completed
- Report: Approved by Office Director
- Investigation class: Class 3
- NTSB office: Eastern Region Aviation
- Parties: FAA/FSDO
- NTSB case key (mKey): 192616
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA23LA297
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/192616/pdf
- NTSB docket: https://data.ntsb.gov/Docket?ProjectID=192616
- Page: https://openairdocs.org/ntsb/ERA23LA297

## Probable cause

The pilot’s decision to take off with a known engine issue, which resulted in a partial loss of power on the initial climb due to the No. 1 cylinder’s exhaust valve becoming stuck. Contributing to the outcome, was the pilot’s delay in aborting the takeoff.

## Findings

NTSB's coded findings; those marked are part of the probable cause.

- [Info processing/decision: decision making/judgment](https://openairdocs.org/ntsb-findings/02041520): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Cessna 150L, 15 cases](https://openairdocs.org/ntsb-findings/02041520/cases.md?model=2071826), [All aircraft, 3,098 cases](https://openairdocs.org/ntsb-findings/02041520/cases.md)
- [Engine (reciprocating): recip eng cyl section](https://openairdocs.org/ntsb-findings/01058530): Aircraft › Aircraft power plant · Malfunction (probable cause); cases with it: [Cessna 150L, 6 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md?model=2071826), [All aircraft, 373 cases](https://openairdocs.org/ntsb-findings/01058530/cases.md)
- [Action: delayed action](https://openairdocs.org/ntsb-findings/02041025): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Cessna 150L, 9 cases](https://openairdocs.org/ntsb-findings/02041025/cases.md?model=2071826), [All aircraft, 894 cases](https://openairdocs.org/ntsb-findings/02041025/cases.md)

## Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event best describes what happened.

- [Takeoff: Loss of engine power (partial)](https://openairdocs.org/ntsb-events/342) (defining event); cases with it: [Cessna 150L, 11 cases](https://openairdocs.org/ntsb-events/342/sequence.md?model=2071826), [All aircraft, 1,858 cases](https://openairdocs.org/ntsb-events/342/sequence.md)
- [Initial climb: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Cessna 150L, 37 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=2071826), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md)

## Analysis

The pilot reported that while taxiing before the flight, the engine had “skipped,” but normal power was regained during the run-up, so he decided to take off. The pilot reported that during the initial climb, the engine sustained a partial loss of power. He reported that, after the partial loss of power, he became fixated on the throttle and mixture and keeping the wings level. Subsequently, he realized he had traveled too far down the runway to abort the takeoff. He reduced the pitch attitude, navigated towards an open grassy area between trees, and lowered flaps to 40°. During the touchdown, the left wing abruptly dropped and impacted the ground and the airplane nosed over during the roll out. The fuselage, wings, and empennage sustained substantial damage. Multiple witnesses described that during the taxi and takeoff, the engine was running rough and skipping, and that the airplane struggled to gain altitude. Airport surveillance video captured most of the takeoff and initial climb. The video was consistent with the witness reports that the airplane struggled to climb throughout the entirety of the takeoff and initial climb, before disappearing out of view. Postaccident examination of the engine revealed that the No. 1 cylinder exhaust valve was stuck. There were no other anomalies observed with the airplane or engine. The pilot reported that in the few days preceding the accident, he had experienced multiple partial losses of engine power. He changed the spark plugs the day before the accident and the accident flight was the first flight after that maintenance. It is likely that the repeated engine skipping and partial losses of power the pilot experienced were evidence of a sticking valve, which ultimately became stuck during the accident flight. Had the pilot decided to allow a mechanic to examine the repeated engine issues more thoroughly, the stuck/sticking valve may have been properly diagnosed. Further contributing to the outcome was the pilot’s continuation of the takeoff roll and initial climb despite the opportunity to abort the takeoff and land on the remaining runway surface.

## Factual narrative

On July 12, 2023, about 1335 eastern daylight time, a Cessna 150L airplane, N16071, was substantially damaged when it was involved in an accident at the Elbert County Airport (EBA), Elberton, Georgia. The pilot sustained minor injuries. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot reported that during the engine start the engine “skipped” a few times. He then taxied to runway 11 at EBA and performed a run-up, which he described as “normal.” The pilot applied full power for takeoff, and when the airplane became airborne the engine exhibited “a couple of quick power surges” and then a steady partial loss of power. He recalled seeing an engine speed of 2,100 rpm and that he became “fixated” on the throttle, mixture, and keeping the wings level. During the initial climb, he realized he had traveled too far down the runway to abort the takeoff. Subsequently, he reduced pitch, navigated towards an open grassy area between trees, and lowered flaps to 40°. During the touchdown, the left wing abruptly dropped and impacted the ground, and the airplane nosed over during the roll out. The fuselage, wings, and empennage sustained substantial damage. Three witnesses at the airport heard and observed portions of the pilot’s taxi, run-up, and takeoff. The witnesses reported that during the pilot’s taxi the engine was skipping and running rough and continued to run rough during the takeoff. They described that during the initial climb, while the airplane was over the runway, the airplane could not gain altitude and eventually descended out of view towards trees and terrain. Airport surveillance video captured most of the takeoff and initial climb (the video did not capture sound). The airplane’s first rotation attempt occurred about 2,300 ft from the beginning of runway 31 (total length 5,004 ft). About 300 ft further down the runway, the airplane becomame airborne, but remained near ground effect and did not climb while flying over most of the remaining runway surface. After the airplane flew over the remaining runway surface, it again attempted to climb, and the airplane gained altitude for a few seconds, but descended in a left turn towards terrain and trees before it exited the camera’s view. The pilot reported that on July 8th, 2024, he had experienced a partial loss of power for about 4-5 seconds during flight, with the engine returning to normal power, and no further anomalies were observed. On July 11th, 2024, he completed a two-and-a-half-hour flight and refueled the airplane, with the engine performing normally. After refueling, the engine began to run rough and, as a result, the pilot changed the spark plugs and the engine operation returned to normal. The accident flight was the first flight after he changed the spark plugs. Postaccident examination of the airplane found that about 15 gallons of fuel remained on board. The engine examination revealed no anomalies with the fuel system, sparkplugs, or carburetor. The engine’s crankshaft could be rotated by hand. Crankshaft and camshaft continuity was confirmed, and all piston valves operated normally, with exception to the No. 1 cylinder exhaust valve. The valve was stuck and did not move despite the remainder of the valves operating normally. The airplane’s maintenance records documented that the most recent 100-hour inspection of the engine was completed August 2, 2022. The engine had accumulated 16.5 hours since this inspection. The engine was last overhauled on December 17, 1990, and it had accumulated 1,591 hours since this overhaul.

## Aircraft

- Registration: [N16071](https://openairdocs.org/deregistered/N16071-2023-12-06), registration cancelled 2023-12-06, S/N 15073455 (OpenAirDocs)
- Reported make and model: CESSNA 150L (NO SERIES)
- Registry model: [Cessna 150L](https://openairdocs.org/model/cessna-150l) (registry code 2071826) (OpenAirDocs)
- Registry engine: [Continental 0-200 series](https://openairdocs.org/engine/continental-0-200-series) (registry code 17020, reciprocating) (OpenAirDocs)
- Category: Airplane
- Serial number: 15073455
- Year built: 1972
- Airframe hours: 6792
- Engines: Continental Motors O-200 100 horsepower reciprocating
- Damage: Substantial damage
- Flight: Personal, Part 91
- Airworthiness certificate: Standard, Utility
- Last inspection: 100 hour, August 2, 2022, 16 hours before
- Departed: EBA, Elberton, GA
- Destination: LQK, Liberty, SC
- Airport: EBA, Elbert County Airport-Patz Field, runway 11-29, 5,004 × 75 ft, asphalt
- Equipment: None

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 60; injuries: minor; private; airplane ratings: single-engine land; medical: class 3, with waivers/limitations; last flight review December 16, 2022; seat: left; restraint: 3-point; flight hours: 5,632 total, 5,051 in this make and model, 5,632 as pilot in command, 14 in the last 90 days, 14 in the last 30 days, 0 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Day
- Wind: 180° at 5 knots
- Visibility: 10 statute miles
- Lowest ceiling: 5,000 ft broken
- Temperature: 84 °F, dew point 68 °F
- Altimeter: 30.06 inHg
- Observed at: EBA, 0.4 nm away
- METAR: METAR KEBA 121735Z AUTO 18005KT 10SM BKN050 BKN065 29/20 A3006 RMK AO2 T02940198=

## 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 20230712013959A](https://openairdocs.org/incident/20230712013959A), Jul 12, 2023: Cessna 150L, Elberton, GA, Destroyed. Pilot stated he had a loss of power on 7/8/2023 and ran rough after refueling on 7/11/2023. The pilot removed, cleaned, and replaced the spark plugs. On…

## Docket (7 files)

The files NTSB released with the investigation on September 18, 2024, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=192616. 363 MB in all.

- Pilot/operator aircraft accident report, NTSB form 6120.1 (item 1, PDF, 9 pages, 7.4 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17130733&FileExtension=pdf&FileName=NTSB%20Form%206120.1_Redacted2-Rel.pdf
- FAA inspector statements (item 2, PDF, 2 pages, 118 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17131177&FileExtension=pdf&FileName=FAA%20Inspector%20Statements%20-%20Redacted-Rel.pdf
- Witness statements (item 3, PDF, 3 pages, 757 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17131167&FileExtension=pdf&FileName=All%20Witness%20Statements_Redacted2-Rel.pdf
- Accident video (item 4, MP4, 347 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17130977&FileExtension=mp4&FileName=Accident%20Video-Rel.mp4
- Investigation photographs (item 5, PDF, 8 pages, 7 photos, 2.2 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17130390&FileExtension=pdf&FileName=Investigation%20Photographs-Rel.pdf
- Excerpts of maintenance records (item 6, PDF, 3 pages, 4.9 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17130892&FileExtension=pdf&FileName=Excerpts%20of%20Maintenance%20Records%20-%20Redacted-Rel.pdf
- Release of aircraft wreckage, NTSB form 6120.15 (item 7, PDF, 1 page, 544 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=17131064&FileExtension=pdf&FileName=NTSB%20Wreckage%20Release_SIGNED%20-%20Redacted-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.

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