LAX02FA144

NTSB accident investigation · Cessna 177B · Fullerton, CA · April 26, 2002

Accident · Minor injuriesField investigationFinal report
Date
April 26, 2002, 05:53 local (12:53 UTC)
Place
Fullerton, CA
Injuries
2 minor, 1 uninjured
Damage
Destroyed
Phase of flight
Enroute
Aircraft
N177DPCessna 177B
Weather
Visual (VMC) · Dawn
Status
Completed · report September 29, 2004
Report
Approved by Office Director
Parties
Lycoming Engines, Cessna Aircraft Company, Federal Aviation Administration
FAA report
20020426007609A
Case key
54592

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

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Probable cause

The total loss of engine power during cruise flight resulting from oil exhaustion. The oil exhaustion resulted from deterioration and total failure of the oil filter converter plate gasket, which had not been replaced due to maintenance personnel's failure to comply with an airworthiness directive.

Sequence of events

NTSB’s coding before 2008: each occurrence and phase of flight, and the causes and factors under it. The codes are defined in NTSB’s coding manual.

Loss of engine power(total) - mech failure/malfCruise - normal
Fluid,oil - loss,totalCause
Maintenance,compliance with ad - not performedOther maintenance personnelCause
Lubricating system,oil gasket - deteriorated
Lubricating system,oil gasket - failure,totalCause
Forced landingDescent - emergency
In flight collision with objectLanding - flare/touchdown
Object - poleFactor
Nose overLanding - flare/touchdown
Terrain condition - none suitableFactor

Analysis

During cruise flight, the airplane's engine seized and the pilot made a forced landing. During the landing flare over a baseball field, the airplane collided with poles and came to rest partially inverted. The airplane had been operated about 188 hours since last receiving an annual inspection on April 5, 2001, approximately 1 calendar year prior to the accident. Upon completion of the 2001 inspection, repair station personnel, who maintained the airplane for the pilot-owner, reported in the airplane's maintenance logbook that (emergency) airworthiness directive (AD) number 2000-18-53 was not applicable. This was an error. The repair station failed to note that the AD was pertinent to the oil filter converter plate gasket it had installed in the airplane's engine, and it should have so indicated by making an appropriate maintenance logbook entry. Compliance with the AD required, in part, that the gasket be replaced on a recurring 50-hour basis. The FAA indicated that gasket replacement was warranted because "...protruding or swelling of the gasket allows oil to leak from between the plate and the accessory housing. This condition, if not corrected, could result in complete loss of engine oil and subsequent seizing of the engine...." During the Safety Board investigator's examination of the airplane, only 8 ounces of oil were found in the 8-quart capacity oil sump, and the bottom of the airplane was oil soaked. The oil leak originated from a breach in the oil converter plate gasket. A 3/4-inch-long section of the gasket material was observed protruding from between the plate and the accessory housing. The engine's seizure was attributed to the loss of engine oil emanating from the extruded converter plate gasket, resulting in lubricating deprivation to the internal reciprocating components.

Factual narrative

History of flight

On April 26, 2002, about 0553 Pacific daylight time, a Cessna 177B, N177DP, experienced a total loss of engine power during cruise flight. The pilot made a forced landing in a high school baseball field in Fullerton, California. During the landing flare, the airplane collided with an obstacle, nosed over, and was destroyed. The private pilot and one passenger sustained minor injuries. The second passenger was not injured. The pilot owned and operated the airplane. The accident occurred while the pilot was commuting to work between Corona and Hawthorne, California. The personal flight was performed under the provisions of 14 CFR Part 91. Visual meteorological conditions prevailed during the dawn flight that originated from Corona approximately 0540.

The pilot indicated to the National Transportation Safety Board investigator that he had flown his airplane to work hundreds of times, and he was familiar with the route of flight. Nothing unusual was noted during the preflight inspection on the morning of the accident flight. No fresh oil residue was noted on the ground at the airplane's tie down location.

The pilot additionally reported that his taxi out, initial climb, and the first few minutes of the cruise flight were normal. However, about 8 minutes after departure, while cruising about 1,800 feet mean sea level (msl), he noted a variation in the engine's speed. Specifically, the engine's crankshaft rotation speed (in revolutions per minute (rpm)) increased from its previously set speed of 2,450 rpm to between 2,700 and 2,800 rpm. The pilot reduced engine power and prepared for a precautionary or forced landing.

According to the pilot, approximately 1 minute later the engine's oil pressure was observed at zero pounds per square inch. Seconds thereafter, a "tapping sound" was detected coming from the engine. The noise increased in intensity, and a vibration was noted. About 45 seconds later the vibration had become severe, the engine made a "terrible" noise, and the propeller abruptly stopped rotating. The airplane was not within gliding distance to any airport when all engine power was lost.

While descending during the forced landing, the pilot saw vehicles and personnel in close proximity to the first two possible emergency landing areas that he observed. The pilot indicated to the Safety Board investigator that he responded by maneuvering the airplane toward a third but smaller location, an unoccupied baseball field. During the landing flare, the airplane collided with a fence and came to rest inverted.

Personnel information

A review of the instrument rated private pilot's personal flight record logs indicated that during the 12-month period preceding the accident, he had flown over 150 times from Corona to his work location near the city of Hawthorne. The pilot reported that his total flying experience was about 3,500 hours. His total experience flying the accident airplane was about 3,050 hours.

During the 90-day period that preceded the accident, the pilot had logged about 45.5 hours in the airplane. The pilot's last flight review was satisfactorily accomplished in the accident airplane on June 30, 2000.

Aircraft information

An overhauled 180-horsepower engine, a Lycoming O-360-A1F6D, serial number L-20605-36A, was installed in the accident airplane on December 1, 1997. At installation, the airplane's total time, and its tachometer time, was 2,479.7 hours.

The Cessna Aircraft Company's "Pilot's Operating Handbook" for the airplane indicated that the engine's total oil capacity is 9 quarts, and the oil sump's capacity is 8 quarts. The minimum oil quantity for engine operation is 6 quarts.

Communication

The pilot was not communicating with any Federal Aviation Administration (FAA) air traffic control facility during the time period encompassing the accident sequence.

Wreckage and impact information

The accident site is located at the following approximate global positioning satellite coordinates: 33 degrees 52.737 minutes north latitude by 117 degrees 53.658 minutes west longitude. The estimated accident site elevation is 230 feet msl.

The nearest airport to the accident site is located in Fullerton. The distance and magnetic bearing from the accident site to the Fullerton Municipal Airport is about 4.3 nautical miles and 251 degrees.

The Safety Board investigator's on-scene examination of the accident site and wreckage revealed that a chain link fence was located in the baseball field. Vertically oriented metal poles, which had supported the fence, were found in the field bent over in a westward direction. No ground scar was evident on the east side of the fence. At the initial point of impact (IPI), one of the poles was observed covered with an oil residue. To the west of the poles, a ground scar having the approximate lateral dimensions of the airplane's tires was observed in the grass-covered field. The tire track-like ground scar marked a swath between the poles and the airplane wreckage. The magnetic bearing and estimated distance between the IPI and the airplane was 255 degrees and 78 feet.

The airplane was found with its longitudinal axis oriented in an easterly direction (100-degree magnetic bearing) and on its right side, partially inverted. The wings and their respective carry through structure had separated from the fuselage (see photographs). All airframe components were found with the main wreckage along with all flight control surfaces, which had remained attached to their respective hinges.

Two pole-like curved depressions were noted in the leading edges of both wings. The depressions were oriented perpendicular to the airplane's wing span (lateral axis). The depressions' curvatures matched the circumference of the aforementioned bent poles.

No evidence of leading edge gouges or chordwise scratches were noted on the propeller blades, which had remained attached to the crankshaft mounting flange. One blade appeared straight, and the other blade appeared bent in an aft direction.

Several cracks were noted in the upper (top) portion of the engine case. Oil was observed dripping from the bottom of the engine, and oil was covering the bottom of the airframe from the firewall to the aft portion of the empennage. Evidence of an oil spray residue was noted on the fuselage. The oil residue was observed oriented in a forward-to-aft direction consistent with the direction of airflow.

The engine's recording tachometer was observed registering 3,294.3 hours. There was no evidence of fire.

Tests and research

Oil Leak Documentation.

Under the Safety Board investigator's supervision, the airplane was reoriented to an upright attitude, and the residual oil was drained from the engine's oil sump. About 8 ounces of oil were recovered. Thereafter, an examination was performed of the engine and its accessories to locate the source of the oil leak.

The engine's crankcase was observed cracked in numerous locations. The crankshaft could only be rotated through approximately 45 degrees of arc. Oil was principally noted on the exterior surface of the right, rear side of the engine. Oil residue was found on the accessory section, in the vicinity of the oil filter assembly. No evidence was observed of broken or disconnected hoses.

The oil filter was found safety wired in place, and it was secured by its threads to the accessory housing. The gasket located between the oil filter converter plate and the accessory housing was found partially extruding from around the seat of the oil filter converter plate, and in one location a 3/4-inch-long section of gasket material was completely dislodged from the back of the plate. Given the magnitude of this oil gasket position breach, the Lycoming engine participant opined that, during flight, oil exhaustion could occur within minutes.

Following

Aircraft

Registration
N177DP
Reported as
Cessna 177B
Category
Airplane
Serial number
17702364
Airframe hours
3,204
Engine
Lycoming O-360-A1F6D, 180 horsepower, reciprocating
Damage
Destroyed
Flight
Personal · Part 91
Operator
Dale R. Ploung
Registered owner
Dale R. & Sandra K. Ploung
Airworthiness certificate
Standard, Utility; Standard, Normal
Last inspection
Annual · April 5, 2001 · 188 hours before
Departed
AJO · Corona, CA
Destination
HHR · Hawthorne, CA

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
53
Injuries
Minor
Certificate
Private
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 3, Valid Medical--w/ waivers/lim
Last flight review
June 30, 2000
Seat
Left
Flight hours
3,500 total · 3,050 in this make and model · 3,500 as pilot in command · 46 in the last 90 days · 17 in the last 30 days · 1 in the last 24 hours

Weather

Conditions
Visual (VMC) · Dawn
Wind
Calm
Visibility
10 statute miles
Lowest ceiling
6,000 ft overcast
Temperature
57 °F, dew point 52 °F
Altimeter
29.89 inHg
Observed at
FUL, 4 nm away

Docket · 39

The files NTSB released with the investigation on August 11, 2004, on NTSB’s docket system: statements, records, photos and specialists’ reports. 10.3 MB in all.

Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1Item 1 · .PDF · 695 KBReport from Federal Aviation AdministrationItem 2 · .PDF · 99 KBReport from LycomingItem 3 · .PDF · 1 photo · 78 KBAttachment to Lycoming Report - Reference Figure 1Item 4 · .PDF · 176 KBAttachment to Lycoming Report - Reference Figure 2Item 5 · .PDF · 1 photo · 69 KBAttachment to Lycoming Report - Reference CrankcaseItem 6 · .PDF · 1 photo · 133 KBAttachment to Lycoming Report - Reference Figure 3Item 7 · .PDF · 2 photos · 195 KBAttachment to Lycoming Report - Reference Figure 4Item 8 · .PDF · 2 photos · 173 KBAttachment to Lycoming Report - Reference Service Instruction 1453Item 9 · .PDF · 154 KBAttachment to Lycoming Report - Reference 7581378Item 10 · .PDF · 1 photo · 139 KBAttachment to Lycoming Report - Reference Figure 5Item 11 · .PDF · 254 KBAttachment to Lycoming Report - Reference Figure 6Item 12 · .PDF · 389 KBAttachment to Lycoming Report - Reference AD2000-18-53Item 13 · .PDF · 41 KBAttachment to Lycoming Report - Reference MSB 543AItem 14 · .PDF · 266 KBAttachment to Lycoming Report - Reference Annual InspectionItem 15 · .PDF · 254 KBAttachment to Lycoming Report - Reference Supplement 1 to MSB 543AItem 16 · .PDF · 113 KBAttachment to Lycoming Report - Reference Figure 7Item 17 · .PDF · 29 KBAttachment to Lycoming Report - Reference AD 2002-12-07Item 18 · .PDF · 66 KBAttachment to Lycoming Report - Reference Photo Log (Photos on file with Lycoming; not included in NTSB report)Item 19 · .PDF · 33 KBReport from CessnaItem 20 · .PDF · 770 KBExtract from Aircraft's Airframe LogbookItem 21 · .PDF · 822 KBExtract from Aircraft's Engine LogbookItem 22 · .PDF · 1.2 MBExtract from Pilot's LogbookItem 23 · .PDF · 337 KBExtract from Repair Station (Annual Inspection/Maintenance Records)Item 24 · .PDF · 1.1 MBStatement of Party Representatives to NTSB InvestigationItem 25 · .PDF · 305 KBRelease of Aircraft Wreckage, NTSB Form 6120.15Item 26 · .PDF · 84 KBPhoto 1. East View Showing Aircraft's Approach PathItem 27 · .PDF · 117 KBPhoto 2. West View Aircraft in FieldItem 28 · .PDF · 152 KBPhoto 3. Aircraft Front ViewItem 29 · .PDF · 149 KBPhoto 4. Aircraft Bottom ViewItem 30 · .PDF · 164 KBPhoto 5. Cabin and CockpitItem 31 · .PDF · 226 KBPhoto 6. Airframe and Engine Right SideItem 32 · .PDF · 220 KBPhoto 7. Engine Right SideItem 33 · .PDF · 217 KBPhoto 8. Oil FilterItem 34 · .PDF · 191 KBPhoto 9. Oil Filter AdapterItem 35 · .PDF · 210 KBPhoto 10. GasketItem 36 · .PDF · 211 KBPhoto 11. Extruded Gasket, Close-upItem 37 · .PDF · 109 KBPhoto 12. Converter PlateItem 38 · .PDF · 217 KBPhoto 13. GasketItem 39 · .PDF · 181 KB

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.