# NTSB GAA17CA108: Larson Roger H RV-7, N5897R, Casa Grande, AZ, January 1, 2017 - Type: NTSB accident investigation - Classification: Accident · No injuries · Data collection · Final report - Date: December 31, 2016, 17:00 local (Jan 1, 2017, 00:00 UTC) - Place: Casa Grande, AZ - Coordinates: 32.95639, -111.763885 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=32.9564&lon=-111.7639&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Defining event: [Approach: Aerodynamic stall/spin](https://openairdocs.org/ntsb-events/241) - Highest injury: No injuries - Injuries: 1 uninjured - Status: Completed, report April 4, 2017 - Report: Approved by Office Director - NTSB office: General Aviation Accidents - Parties: FAA - NTSB case key (mKey): 94580 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=GAA17CA108 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/94580/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=94580 - Page: https://openairdocs.org/ntsb/GAA17CA108 ## Probable cause The pilot’s inadvertent application of the autopilot during short final, which resulted in an aerodynamic stall and hard landing. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Performance/control parameters: angle of attack](https://openairdocs.org/ntsb-findings/01062042): Aircraft › Aircraft oper/perf/capability · Capability exceeded (probable cause); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-findings/01062042/cases.md?model=05634J6), [All aircraft, 990 cases](https://openairdocs.org/ntsb-findings/01062042/cases.md) - [Auto flight system: autopilot system](https://openairdocs.org/ntsb-findings/01022210): Aircraft › Aircraft systems · Unintentional use/operation (probable cause); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-findings/01022210/cases.md?model=05634J6), [All aircraft, 28 cases](https://openairdocs.org/ntsb-findings/01022210/cases.md) - [Use of equip/info: use of equip/system](https://openairdocs.org/ntsb-findings/02063015): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-findings/02063015/cases.md?model=05634J6), [All aircraft, 1,391 cases](https://openairdocs.org/ntsb-findings/02063015/cases.md) - [Use of equip/info: aircraft control](https://openairdocs.org/ntsb-findings/02063040): Personnel issues › Task performance · Pilot (probable cause); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-findings/02063040/cases.md?model=05634J6), [All aircraft, 9,295 cases](https://openairdocs.org/ntsb-findings/02063040/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Approach: Miscellaneous/other](https://openairdocs.org/ntsb-events/900); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-events/900/sequence.md?model=05634J6), [All aircraft, 1,556 cases](https://openairdocs.org/ntsb-events/900/sequence.md) - [Approach: Attempted remediation/recovery](https://openairdocs.org/ntsb-events/060); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-events/060/sequence.md?model=05634J6), [All aircraft, 1,422 cases](https://openairdocs.org/ntsb-events/060/sequence.md) - [Approach: Aerodynamic stall/spin](https://openairdocs.org/ntsb-events/241) (defining event); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-events/241/sequence.md?model=05634J6), [All aircraft, 1,529 cases](https://openairdocs.org/ntsb-events/241/sequence.md) - [Landing: Hard landing](https://openairdocs.org/ntsb-events/092); cases with it: [Larson Roger H RV-7A, 1 case](https://openairdocs.org/ntsb-events/092/sequence.md?model=05634J6), [All aircraft, 2,102 cases](https://openairdocs.org/ntsb-events/092/sequence.md) ## Analysis The pilot reported that, during his second flight, following the installation of a new autopilot, he noticed on short final that the mixture was set too lean. He added that, "with a gloved hand," he pushed the mixture in to a richer setting and accidently turned on the autopilot, which was located directly above the mixture control. The autopilot was set to navigation mode, heading mode, and altitude mode from a previous flight. The pilot reported that he was "fighting the auto pilot" and that the airplane aerodynamically stalled, which resulted in a hard landing. The airplane sustained substantial damage to the firewall. The pilot reported that there were no preaccident mechanical failures or malfunctions with the airframe or engine that would have precluded normal operation. ## Factual narrative The pilot reported that during his second flight, following the installation of a new autopilot, he noticed on short final that the mixture was set too lean. He further reported that "with a gloved hand" he pushed the mixture in to a richer setting; and accidently turned on the autopilot, which was located directly above the mixture control. The autopilot was set to navigation mode, heading mode, and altitude mode from a previous flight. The pilot reported that he was "fighting the auto pilot" and the airplane aerodynamically stalled, resulting in a hard landing. The airplane sustained substantial damage to the firewall. The pilot reported there were no pre-accident mechanical failures or malfunctions with the airframe or engine that would have precluded normal operation. ## Aircraft - Registration: [N5897R](https://openairdocs.org/aircraft/N5897R), registered now, S/N 73692 (OpenAirDocs) - Reported make and model: LARSON ROGER H RV-7 (A) - Registry model: [Larson Roger H RV-7A](https://openairdocs.org/model/larson-roger-h-rv-7a) (registry code 05634J6) (OpenAirDocs) - Category: Airplane, amateur-built - Serial number: 73692 - Year built: 2015 - Airframe hours: 53 - Engines: Lycoming O-360-A1A 180 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Special, Experimental (Special) - Last inspection: Unknown, June 26, 2016 - Departed: DXX, MADISON, MN - Destination: CGZ, Casa Grande, AZ - Airport: CGZ, Casa Grande Muni, runway 05, 5,200 × 100 ft, asphalt - Equipment: Electronic multifunction display, Auto-pilot, Angle of attack indicator, Stall warning system, Handheld GPS, Electronic primary flight display ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 76; injuries: none; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, with waivers/limitations; last flight review August 1, 2015; seat: left; restraint: 3-point; flight hours: 1,031.3 total, 54.2 in this make and model, 1,031.3 as pilot in command, 13.3 in the last 90 days, 8.5 in the last 30 days ## Weather - Conditions: Visual (VMC), Day - Wind: calm - Visibility: 10 statute miles - Lowest ceiling: 6,000 ft broken - Temperature: 59 °F, dew point 48 °F - Altimeter: 29.88 inHg - Observed at: KCGZ ## 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 20161231024849A](https://openairdocs.org/incident/20161231024849A), Dec 31, 2016: Vans Aircraft RV7A, Casa Grande, AZ, Substantial damage. On December 31, 2016, a Vans RV7A, N5897R, was damaged during landing and departed the side of runway 05 at Casa Grande AZ. The nose gear collapsed and the… ## Docket (2 files) The files NTSB released with the investigation on March 6, 2017, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=94580. 1.4 MB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1 (item 1, .PDF, 1.0 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40449719&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1-Master.PDF - Accident Photo (Courtesy of FAA) (item 2, .PDF, 1 photo, 326 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40449720&FileExtension=.PDF&FileName=Accident%20Photo%20(Courtesy%20of%20FAA)-Master.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.