# NTSB LAX93GA053: Cessna 404, N5429J, Tucson, AZ, November 27, 1992

- Type: NTSB accident investigation
- Classification: Accident · No injuries · Final report
- Date: November 26, 1992, 19:15 local (Nov 27, 1992, 02:15 UTC)
- Place: Tucson, AZ
- Coordinates: 32.18011, -110.870559 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=32.1801&lon=-110.8706&mi=10
- Phase of flight: [Enroute](https://openairdocs.org/ntsb-phases/400) (OpenAirDocs' grouping)
- Highest injury: No injuries
- Injuries: 1 uninjured
- Status: Completed, report August 26, 1993
- Report: Approved by Office Director
- NTSB case key (mKey): 27835
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=LAX93GA053
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/27835/pdf
- Page: https://openairdocs.org/ntsb/LAX93GA053

## Probable cause

THE PILOT'S INFLIGHT DECISION TO DEVIATE FROM THE AIRPLANE'S ENGINE MANUAL AND THE PILOT'S OPERATING HANDBOOK BY MAINTAINING THE FUEL MIXTURE AT FULL RICH THROUGHOUT THE MISSION AND RAPIDLY DESCENDING THE AIRPLANE WHICH RESULTED IN BOTH ENGINE'S LOSING TOTAL POWER.  FACTORS IN THIS ACCIDENT WERE 1) THE PILOT NOT FOLLOWING THE EMERGENCY PROCEDURE FOR BOTH ENGINES FAILING AS OUTLINED IN THE PILOT'S OPERATING HANDBOOK, AND 2) THE PILOT NOT PERFORMING A FLARE DURING THE LANDING SEQUENCE WHICH RESULTED IN THE AIRPLANE COLLIDING WITH THE TERRAIN.

## Sequence of events

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

- Loss of engine power(total) - nonmechanical, descent - normal
  - 2 engines
  - in-flight planning/decision - poor, pilot in command (cause)
  - procedures/directives - not followed, pilot in command (cause)
- Forced landing, descent - emergency
- In flight collision with terrain/water, descent - emergency
  - emergency procedure - not followed, pilot in command (contributing factor)
  - flare - not performed, pilot in command (contributing factor)
  - terrain condition - ground

## Analysis

DURING A 2 HOUR AND 40 MINUTE TRAINING MISSION, THE PILOT MAINTAINED A LOW POWER SETTING WITH THE FUEL MIX AT FULL RICH. AFTER THE MISSION, THE PILOT CLIMBED THE AIRPLANE TO 9,000 FEET AGL TO CLEAR OBSTACLES BETWEEN HIS LOCATION AND HIS DESTINATION. DURING THE DESCENT, THE PILOT SAID HE REDUCED POWER MORE RAPIDLY THAN USUAL AND DESCENDED FASTER THAN NORMAL AT ABOUT 180 KIAS. ABOUT 800 TO 1,000 FEET AGL, IN THE TRAFFIC PATTERN, THE PILOT APPLIED POWER. BOTH ENGINES LOST TOTAL POWER. HE SET UP AN 85 KIAS GLIDE; COMPETED EMERGENCY PROCEDURES; AND RETRACTED THE LANDING GEAR. THE ENGINES DID NOT RE START. HE DID NOT FEATHER THE PROPELLERS.  HE EXTENDED THE LANDING GEAR PRIOR TO TOUCHDOWN. THE PILOT SAID HE DID NOT FLARE THE AIRPLANE DURING LANDING WHICH RESULTED IN THE AIRPLANE COLLIDING WITH THE GROUND. THE ENGINE MANUAL AND THE POH RECOMMEND ADJUSTING THE FUEL MIXTURE FOR CRUISE. AN ENGINE MANUAL NOTE STATES LONG DESCENTS AT LOW POWER SHOULD BE AVOIDED BECAUSE THE ENGINES MAY COOL EXCESSIVELY AND MAY NOT ACCELERATE SATISFACTORILY WHEN POWER IS RE APPLIED. THE POH RECOMMENDS FEATHERING PROPELLERS AND GLIDING AT 120 KIAS FOR DUAL ENGINE FAILURE. SOOT WAS NOTED ON ALL SPARK PLUGS DURING ENGINE EXAM. BOTH ENGINES STARTED AND RAN NORMALLY FROM IDLE TO FULL ACCELERATION DURING THE EXAM.

## Aircraft

- Registration: N5429J (not matched to a registry record)
- Reported make and model: CESSNA 404
- Category: Airplane
- Serial number: 4040107
- Airframe hours: 4011
- Engines: CONTINENTAL GSTIO-520-M2B 375 horsepower reciprocating
- Damage: Destroyed
- Flight: Public aircraft, Part 91
- Operator: U. S. Customs Service, doing business as Tucson Air Branch
- Registered owner: United States Customs Service
- Airworthiness certificate: Standard, Normal
- Last inspection: Continuous airworthiness, October 26, 1992, 38 hours before
- Departed: DMA
- Destination: DMA
- Flight plan: Company VFR
- Airport: DMA, Davis Monthan Afb, runway 12, 13,645 × 200 ft, concrete

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 33; airline transport, commercial; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 1, valid medical--no waivers/lim.; seat: left; flight hours: 4,981 total, 685 in this make and model, 4,154 as pilot in command, 49 in the last 90 days, 22 in the last 30 days, 3 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Night/dark
- Wind: 40° at 6 knots
- Visibility: 30 statute miles
- Lowest ceiling: none
- Temperature: 54 °F, dew point 12 °F
- Altimeter: 30.00 inHg
- Observed at: TUS, 4 nm away

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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