# NTSB LAX91LA076: Piper PA-28-181, N3043D, Mokuleia, HI, January 19, 1991

- Type: NTSB accident investigation
- Classification: Accident · Minor injuries · Limited investigation · Final report
- Date: January 18, 1991, 14:15 local (Jan 19, 1991, 00:15 UTC)
- Place: Mokuleia, HI
- Coordinates: 21.570682, -158.120407 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=21.5707&lon=-158.1204&mi=10
- Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping)
- Highest injury: Minor injuries
- Injuries: 2 minor
- Status: Completed, report March 31, 1993
- Report: Approved by Office Director
- NTSB case key (mKey): 27095
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX91LA076
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/27095/pdf
- Page: https://openairdocs.org/ntsb/LAX91LA076

## Probable cause

THE CFI'S FAILURE TO USE CARBURETOR HEAT. A FACTOR WAS THE MANUFACTURER'S INADEQUATE PROCEDURE.

## Sequence of events

In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf).

- Loss of engine power(total) - nonmechanical, climb
  - weather condition - carburetor icing conditions
  - carburetor heat - not used, pilot in command(cfi) (cause)
  - procedure inadequate, manufacturer (contributing factor)
- Forced landing, descent - emergency
- Ditching, descent - emergency
  - terrain condition - water

## Analysis

DURING TOUCH AND GO LANDINGS ON A STUDENT'S FIRST TRAINING FLIGHT, THE ENGINE LOST POWER, AND THE AIRPLANE WAS DITCHED IN THE SURF LINE. THE POWER SETTINGS AND METEOROLOGICAL CONDITIONS WERE CONDUCIVE TO CARBURETOR ICING. THE MANUFACTURER DOES NOT RECOMMEND THE USE OF CARBURETOR HEAT AS A NORMAL PRECAUTION DURING APPROACH AND LANDING, AND THE CFI DID NOT INDICATE THE USE OF CARBURETOR HEAT. NO MECHANICAL MALFUNCTION WAS FOUND.

## Aircraft

- Registration: [N3043D](https://openairdocs.org/deregistered/N3043D-2012-09-05), registration cancelled 2012-09-05, S/N 28-7990174, built 1978 (OpenAirDocs)
- Reported make and model: PIPER PA-28-181
- Registry model: [Piper PA-28-181](https://openairdocs.org/model/piper-pa-28-181) (registry code 7102807) (OpenAirDocs)
- Registry engine: [Lycoming O&VO-360 series](https://openairdocs.org/engine/lycoming-o-vo-360-series) (registry code 41514, reciprocating) (OpenAirDocs)
- Category: Airplane
- Serial number: 287990174
- Airframe hours: 287
- Engines: LYCOMING O-360-A4M 180 horsepower reciprocating
- Damage: Destroyed
- Flight: Instructional, Part 91
- Operator: Cosmo Flying School Inc.
- Registered owner: Asahi Kikaku Co. Ltd.
- Airworthiness certificate: Standard, Utility; Standard, Normal
- Last inspection: 100 hour, December 4, 1991, 61 hours before
- Departed: HNL, HONOLULU, HI

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 29; commercial, flight instructor; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 2, valid medical--w/ waivers/lim; seat: right; flight hours: 1,340 total, 950 in this make and model, 1,250 as pilot in command, 220 in the last 90 days, 80 in the last 30 days, 3 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Day
- Wind: 270° at 5 knots
- Visibility: 10 statute miles
- Lowest ceiling: none
- Temperature: 81 °F, dew point -0 °F
- Altimeter: 30.00 inHg

## 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 19910118000839A](https://openairdocs.org/incident/19910118000839A), Jan 18, 1991: Piper PA28181, Mokuleia, HI, Destroyed. Engine quit in pattern over a lagoon. Ditched and flipped over in water. No defects. Carb icing conditions existed

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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