# NTSB FTW95LA074: Cessna 150H, N6417S, Monahans, TX, December 27, 1994 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Limited investigation · Final report - Date: December 27, 1994, 08:06 local (14:06 UTC) - Place: Monahans, TX - Coordinates: 31.540233, -102.83905 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=31.5402&lon=-102.8391&mi=10 - Phase of flight: [Initial climb](https://openairdocs.org/ntsb-phases/350) (OpenAirDocs' grouping) - Highest injury: Serious injuries - Injuries: 2 serious - Status: Completed, report June 19, 1995 - Report: Approved by Office Director - NTSB case key (mKey): 19328 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=FTW95LA074 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/19328/pdf - Page: https://openairdocs.org/ntsb/FTW95LA074 ## Probable cause THE PILOT'S FAILURE TO USE THE CARBURETOR HEAT AND FAILURE TO MAINTAIN AIRSPEED. A FACTOR WAS THE ICING CONDITIONS. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of engine power(partial) - nonmechanical, takeoff - initial climb - weather condition - icing conditions (contributing factor) - fuel system,carburetor - ice (cause) - anti-ice/deice system,carburetor/heat - not activated (cause) - Loss of engine power(total) - nonmechanical, maneuvering - turn to landing area (emergency) - Forced landing, emergency landing after takeoff - On ground/water collision with object, descent - uncontrolled - airspeed(vs) - not maintained, pilot in command (cause) - stall - inadvertent, pilot in command - object - fence ## Analysis DURING THE INITIAL CLIMB, 200 FEET ABOVE GROUND LEVEL, THE PILOT EXPERIENCED A ROUGH RUNNING ENGINE FOLLOWED BY A COMPLETE LOSS OF POWER. FOLLOWING THE ONSET OF THE ROUGH RUNNING ENGINE THE PILOT DECREASED POWER INITIALLY AND THEN ADDED FULL POWER TO SUSTAIN LEVEL FLIGHT. DURING THE ATTEMPT TO MAINTAIN LEVEL FLIGHT THE PILOT REALIZED THAT HE WAS LOSING ALTITUDE, SO HE EXECUTED A DESCENDING LEFT TURN IN AN ATTEMPT TO RETURN TO THE RUNWAY. THE PILOT LOWERED THE FLAPS TO 20 DEGREES DURING THE DESCENT. DURING THE DESCENT THE PILOT HEARD THE STALL WARNING HORN. THE AIRCRAFT IMPACTED THE GROUND AND SLID SIDEWAYS INTO A FENCE SURROUNDING A GAS LINE. THE AIRCRAFT WAS CONSUMED BY FIRE. ACCORDING TO THE CARBURETOR ICING PROBABILITY CHART THE AIRCRAFT WAS OPERATING IN SERIOUS ICING CONDITIONS. THE TEMPERATURE WAS 45 DEGREES AND THE DEW POINT WAS 43 DEGREES. ## Factual narrative On December 27, 1994, at 0806 central standard time, a Cessna 150H, N6417S, was destroyed during a forced landing near Monahans, Texas. The airplane, owned and operated by the passenger, had just departed from the airport on what was to have been a local personal flight. There was no flight plan filed and visual meteorological conditions prevailed. The commercial pilot and the pilot rated passenger sustained serious injuries. In a written report submitted by the pilot, he stated that he planned the flight to check the engine recently installed. He further stated that he performed a pre-flight and executed a "normal" takeoff. During the initial climb (200 feet above ground level) and at a point close to the end of the runway the engine began "running rough." Power was reduced so that he could land on the remaining runway. The rated passenger checked the fuel mixture shortly after the engine began to run rough. When the pilot realized that he could not make the runway he "added full power and levelled off at his current altitude." After levelling off the engine began to lose power as the pilot executed a left descending turn and added 20 degrees of flaps in preparation for landing. Both the pilot and passenger reported that at some point they both heard the stall warning horn. The pilot stated that "touchdown was very hard and the ground roll was very short due to the low airspeed." Following touchdown, the aircraft slid sideways into a fence, around a gas pipe line. Following the impact with the fence the aircraft was consumed by fire. The pilot further stated that he thought "he had experienced carburetor icing." No evidence of carburetor heat being applied was found and the pilot did not report that he had used it. An examination of the aircraft records revealed that the engine was installed on December 26, 1994 (date of sign off in log books). A physical inspection of the engine revealed that the rocker arms were installed incorrectly. It was noted that the engine would not rotate because the thrust flange was broken and pushed to the rear. The carburetor assembly melted off of its mounting point. Inspection of the oil pump revealed that it rotated freely. Temperature at the time of the accident was reported to be 45 degrees and the dew point was 43 degrees. A review of the icing probability chart established that the aircraft was operating in an area of serious icing conditions. ## Aircraft - Registration: [N6417S](https://openairdocs.org/deregistered/N6417S-1995-11-21), registration cancelled 1995-11-21, S/N 15067217 (OpenAirDocs) - Reported make and model: CESSNA 150H - Registry model: [Cessna 150H](https://openairdocs.org/model/cessna-150h) (registry code 2071818) (OpenAirDocs) - Category: Airplane - Serial number: 15067217 - Airframe hours: 3414 - Engines: CONTINENTAL O-200A 100 horsepower reciprocating - Damage: Destroyed - Fire: On-Ground - Flight: Personal, Part 91 - Registered owner: Henry R. Cutbirth - Airworthiness certificate: Standard, Normal - Last inspection: Annual, December 26, 1994, 1 hours before ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 40; commercial, flight instructor; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 2, valid medical--no waivers/lim.; seat: right; flight hours: 1,168 total, 156 in this make and model, 964 as pilot in command, 13 in the last 90 days, 4 in the last 30 days, 1 in the last 24 hours ## Weather - Conditions: Visual (VMC), Day - Wind: 120° at 4 knots - Visibility: 10 statute miles - Lowest ceiling: 2,000 ft overcast - Temperature: 45 °F, dew point 43 °F - Altimeter: 30.00 inHg - Observed at: INK ## 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 19941227042339A](https://openairdocs.org/incident/19941227042339A), Dec 27, 1994: Cessna 150H, Monahans, TX, Destroyed. Newly installed engine test flight. Aborted due rough engine then went around. Stalled slid into fence. Carb icing. ## Other investigations on N6417S (2) 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. - [NTSB NYC70DHD28](https://openairdocs.org/ntsb/NYC70DHD28), May 23, 1970: Cessna 150 (N6417S), Medford, NJ, substantial damage - [NTSB DIA68D0106](https://openairdocs.org/ntsb/DIA68D0106), Oct 11, 1967: Cessna 150 (N6417S), Middletown, DE, substantial damage 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.