# NTSB FTW96LA358: Piper PA-28-235, N8565W, Tulsa, OK, August 24, 1996 - Type: NTSB accident investigation - Classification: Accident · Serious injuries · Limited investigation · Final report - Date: August 24, 1996, 12:30 local (17:30 UTC) - Place: Tulsa, OK - Coordinates: 36.139602, -95.789665 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=36.1396&lon=-95.7897&mi=10 - Phase of flight: [Landing](https://openairdocs.org/ntsb-phases/550) (OpenAirDocs' grouping) - Highest injury: Serious injuries - Injuries: 1 serious - Status: Completed, report December 23, 1996 - Report: Approved by Office Director - NTSB case key (mKey): 19955 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=FTW96LA358 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/19955/pdf - Page: https://openairdocs.org/ntsb/FTW96LA358 ## Probable cause low fluid level in the hydraulic reservoir, due to inadequate maintenance/inspection, which resulted in an inoperative brake system. Factors relating to the accident were: the down sloping runway, and trees at the departure end of the runway. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Overrun, landing - roll - maintenance,inspection - inadequate, other maintenance personnel (cause) - fluid,hydraulic - low level (cause) - landing gear,normal brake system - inoperative (cause) - On ground/water collision with object, landing - roll - airport facilities,runway/landing area condition - downhill (contributing factor) - object - tree(s) (contributing factor) ## Analysis According to the pilot, he executed a normal approach with two notches of flaps. He added that as 'he pulled the brake handle after touching down, the handle came all the way back and [he] realized the brakes had failed.' The pilot added that he pumped the brake handle a few more times in an attempt to stop, but without success. The pilot further stated that he elected not to abort the landing, because he was too far down the runway and too close to the 25 foot trees, obstructing the departure end of the runway. The airplane subsequently overran the 300 foot grass overrun area and impacted a tree stump and bushes. No tire skid marks were found on the freshly sealed 2,580 foot asphalt runway. Postaccident examination of the airplane confirmed that the brake fluid reservoir was empty. A review of the aircraft maintenance records revealed that maintenance was performed on the brake system during the last annual inspection, which was completed 12 flight hours prior to the accident. The runway sloped downhill in the direction of landing. ## Factual narrative On August 24, 1996, at 1230 central daylight time, a Piper PA-28-235, N8565W, was substantially damaged during a runway overrun while landing near Tulsa, Oklahoma. The airplane, owned and operated by a private owner, was being operated as a personal flight under Title 14 CFR Part 91. The private pilot, sole occupant of the airplane, was seriously injured. Visual meteorological conditions prevailed for the cross country flight for which a VFR flight plan was filed. The airplane departed from Kirk Field in Paragould, Arkansas, at approximately 1030. According to witnesses who were waiting for the airplane's arrival at the Harvey Young Airport, the airplane "made a normal approach and touchdown on runway 35." According to the pilot, he executed a normal approach with two notches of flaps. He added that as "he pulled the brake handle after touching down, the handle came all the way back and [he] realized the brakes had failed." The pilot added that he pumped the brake handle a few more times to stop without success. The pilot further stated that he elected not to abort the landing because he was too far down the runway and too close to the 25 foot trees obstructing the departure end of the runway. The airplane subsequently overran the 300 foot grass overrun area at the departure end of the runway and impacted a tree stump and bushes. No tire skid marks were found on the freshly sealed 2,580 foot asphalt runway. Photos submitted by the pilot's sister of the landing sequence of the airplane indicated that the pilot did not land long (as was initially reported by local law enforcement personnel). Post-accident examination of the airplane confirmed that the brake fluid reservoir was empty. A review of the aircraft maintenance records revealed that maintenance was performed on the brake system of the 1963 model airplane during the last annual inspection completed 12 flight hours prior to the accident. Pertinent maintenance records and invoices are enclosed. Both wings, the left side of the fuselage, and the nose section of the airframe sustained structural damage. A pilot who operates a similar single engine airplane from the airport stated that "the fact that runway 35 slopes slightly downhill probably contributed to the airplane's poor deceleration during the landing roll." ## Aircraft - Registration: [N8565W](https://openairdocs.org/deregistered/N8565W-2012-11-14), registration cancelled 2012-11-14, S/N 28-10077, built 1963 (OpenAirDocs) - Reported make and model: Piper PA-28-235 - Registry model: [Piper PA-28-235](https://openairdocs.org/model/piper-pa-28-235) (registry code 7102810) (OpenAirDocs) - Registry engine: [Lycoming 0-540 series](https://openairdocs.org/engine/lycoming-0-540-series) (registry code 41532, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 28-10077 - Airframe hours: 2313 - Engines: Lycoming O-540 235 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Registered owner: Alvin D. And Linda Wells - Airworthiness certificate: Standard, Normal - Last inspection: 100 hour, April 23, 1996, 12 hours before - Departed: PGR, PARAGOULD, AR - Destination: 1H6 - Flight plan: VFR - Airport: IH6, Harvey Young, runway 35, 2,580 × 20 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 59; private; airplane ratings: single-engine land; medical: class 3, valid medical--w/ waivers/lim; seat: left; flight hours: 483 total, 9 in this make and model ## Weather - Conditions: Visual (VMC), Day - Wind: 360° at 4 knots - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 88 °F, dew point 72 °F - Altimeter: 30.00 inHg - Observed at: TUL, 4 nm away ## 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 19960824024069A](https://openairdocs.org/incident/19960824024069A), Aug 24, 1996: Piper PA28235, Tulsa, OK, Substantial damage. Brakes failed on landing roll. Ran off end runway and impacted a tree stump. Brake reservoir empty. Recent check. (-23) on 08/24/96 at 1210 CDT, a Piper… 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.