# NTSB LAX91LA189: Piper PA 38-112, N2578L, Fresno, CA, May 1, 1991 - Type: NTSB accident investigation - Classification: Accident · No injuries · Limited investigation · Final report - Date: April 30, 1991, 20:00 local (May 1, 1991, 03:00 UTC) - Place: Fresno, CA - Coordinates: 36.789512, -119.759811 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=36.7895&lon=-119.7598&mi=10 - Phase of flight: [Landing](https://openairdocs.org/ntsb-phases/550) (OpenAirDocs' grouping) - Highest injury: No injuries - Injuries: 1 uninjured - Status: Completed, report December 30, 1992 - Report: Approved by Office Director - NTSB case key (mKey): 27186 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX91LA189 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/27186/pdf - Page: https://openairdocs.org/ntsb/LAX91LA189 ## Probable cause THE PILOT-IN-COMMAND'S FAILURE TO MAINTAIN DIRECTIONAL CONTROL AND INADEQUATE COMPENSATION FOR WIND CONDITIONS DURING THE LANDING TOUCHDOWN. CONTRIBUTING TO THE ACCIDENT WAS THE PILOT-IN-COMMAND'S OVERCONFIDENCE IN HIS ABILITY WHILE ANALYZING THE FORECAST WINDS DURING PREFLIGHT PLANNING, AND THE STRONG WIND CONDITIONS THAT EXISTED DURING HIS LANDING. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - Loss of control - on ground/water, landing - flare/touchdown - weather condition - crosswind (contributing factor) - preflight planning/preparation - misjudged, pilot in command (contributing factor) - overconfidence in personal ability, pilot in command (contributing factor) - directional control - not maintained, pilot in command (cause) - compensation for wind conditions - inadequate, pilot in command (cause) - On ground/water collision with object, landing - roll - object - sign (contributing factor) ## Analysis A PIPER PA 38-112 COLLIDED WITH A SIGN POST AFTER A LOSS OF CONTROL ON RUNWAY 29R. THE PILOT FAILED TO MAINTAIN DIRECTIONAL CONTROL AND THE AIRPLANE YAWED LEFT DURING THE LANDING FLARE AND TOUCHED DOWN WITH THE NOSE 20 DEGREES LEFT OF CENTERLINE. THE AIRPLANE THEN ROLLED OUT ACROSS THE RUNWAY SHOULDER AND STRUCK A SIGN POST WITH THE RIGHT WING. THERE WERE NO MECHANICAL FAILURES OR MALFUNCTIONS WITH THE AIRPLANE BEFORE THE ACCIDENT. THE PILOT STATED, 'I MADE AN ERROR IN JUDGEMENT IN DEPARTING WITH SUCH STRONG FORECASTED WINDS. THE GREATEST ERROR WAS IN JUDGING THAT I WAS CAPABLE OF HANDLING THOSE WINDS.' THE WINDS AT THE TIME OF THE ACCIDENT WERE REPORTED TO BE FROM 322 DEGREES AT 25 KNOTS GUSTING TO 29 KNOTS. ## Aircraft - Registration: [N2578L](https://openairdocs.org/deregistered/N2578L-2016-07-14), registration cancelled 2016-07-14, S/N 38-79A0768, built 1979 (OpenAirDocs) - Reported make and model: PIPER PA 38-112 - Registry model: [Piper PA-38-112](https://openairdocs.org/model/piper-pa-38-112) (registry code 7103812) (OpenAirDocs) - Registry engine: [Lycoming 0-235 series](https://openairdocs.org/engine/lycoming-0-235-series) (registry code 41505, 4 cycle) (OpenAirDocs) - Category: Airplane - Serial number: 79A0768 - Airframe hours: 2920 - Engines: LYCOMING O-235 L2C 112 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Operator: Golden Eagle Enterprises - Registered owner: Golden Eagle Enterprises - Airworthiness certificate: Standard, Utility; Standard, Normal - Last inspection: 100 hour, April 26, 1991, 17 hours before - Departed: BFL, BAKERSFIELD, CA - Flight plan: VFR - Airport: FAT, Fresno Air Terminal, runway 29, 9,222 × 150 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 51; private; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 3, valid medical--w/ waivers/lim; seat: left; flight hours: 370 total, 115 in this make and model, 325 as pilot in command, 21 in the last 90 days, 9 in the last 30 days, 2 in the last 24 hours ## Weather - Conditions: Visual (VMC), Night/dark - Wind: 322° at 25 knots, gusting 29 - Visibility: 7 statute miles - Lowest ceiling: none - Temperature: 66 °F, dew point 21 °F - Altimeter: 29.00 inHg - Observed at: FAT, 1 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 19910430014009A](https://openairdocs.org/incident/19910430014009A), Apr 30, 1991: Piper PA38112, Fresno, CA, Substantial damage. Lost directional control on flare for landing in strong crosswind. Landed in a crab angle. Left runway. Struck sign ## Other investigations on N2578L (1) 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 WPR13LA383](https://openairdocs.org/ntsb/WPR13LA383), Aug 22, 2013: Piper PA-38 (N2578L), Madera, CA, substantial damage. Probable cause: The pilots' inadequate fuel planning, which resulted in the airplane departing with insufficient fuel to complete the planned flight, and their failure to recognize that discrepancy en route, which… 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.