NYC05LA017

NTSB accident investigation · Labhart Kolb Twinstar Mk III · London, KY · November 14, 2004

Accident · FatalLimited investigationFinal report
Date
November 14, 2004, 12:40 local (17:40 UTC)
Place
London, KY
Injuries
1 fatal, 1 serious
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N83NKLabhart Kolb Twinstar Mk III
Weather
Visual (VMC) · Day
Status
Completed · report July 7, 2005
Report
Approved by Office Director
Parties
FAA FSDO-01
Case key
60567

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 pilot's inadequate preflight inspection, which resulted in a total loss of engine power due to fuel contamination. A factor was the lack of an installed fuel strainer.

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) - nonmechanicalApproach
Aircraft preflight - inadequatePilot in commandCause
Fluid,fuel - contamination
Fuel system,strainer - not installedFactor
Forced landingDescent - emergency
In flight collision with terrain/waterEmergency landing
Terrain condition - uphill

Analysis

The airplane was equipped with two semi opaque 5-gallon fuel tanks that simultaneously fed into the engine. The airplane was not equipped with a fuel strainer. Prior to the accident flight, 1 gallon of automobile gasoline was added to each tank, which brought the total amount of fuel on board to approximately 8 gallons. The pilot completed a preflight inspection of the airplane, and departed the airport. After two takeoffs and landings at the airport, the pilot boarded a passenger, and completed another takeoff and landing. While in the traffic pattern for another landing, the engine lost all power. The pilot attempted to glide to the runway, but the airplane impacted up-sloping terrain about 2-3 feet prior to the runway. Examination of the wreckage revealed contamination in the fuel tanks, fuel lines, fuel filter, and carburetor bowls. The engine was subsequently test run with a clean fuel supply, and it ran continuously with no abnormalities noted.

Factual narrative

On November 14, 2004, about 1240 eastern standard time, an amateur built Kolb Twinstar Mark III, N83NK, was substantially damaged during a forced landing at Chestnut Knolls Airport (3KY2), London, Kentucky. The certificated private pilot was fatally injured, and the passenger sustained serious injuries. Visual meteorological conditions prevailed, and no flight plan was filed for the personal flight conducted under 14 CFR Part 91.

According to a Federal Aviation Administration (FAA) inspector, the pilot owned the airplane and kept it in a hangar at 3KY2. The airplane was equipped with two semi opaque 5-gallon fuel tanks that simultaneously fed into the engine. The airplane was not equipped with a fuel strainer. On the day of the accident, 1 gallon of automobile gasoline was added to each tank, which brought the total amount of fuel on board to approximately 8 gallons. The pilot completed a preflight inspection of the airplane. He then started the engine, taxied to runway 26, and departed uneventfully. The pilot completed a touch and go landing, and a full stop landing on runway 26.

The pilot then boarded a passenger, and completed another touch and go landing. While in the traffic pattern for a second landing with the passenger, the engine lost power. The pilot attempted to glide to runway 26, but the airplane impacted up-sloping terrain 2-3 feet prior to the runway threshold. The airplane came to rest upright, in a grassy area to the left of runway centerline. During the impact, the airplane sustained substantial damage to the forward fuselage area.

Assembly of the airplane was completed in 2004. The airplane was equipped with a Rotax 912 ULS, 100-horsepower engine.

The pilot held a private pilot certificate, with a rating for single engine land. On his most recent application for an FAA third class medical certificate, dated July 9, 2003, the pilot reported 625 hours of total flight experience.

Examination of the airplane revealed no rotational damage to the propeller. The FAA inspector observed fuel present in both fuel tanks, fuel lines, the mechanical fuel pump, the electrical fuel pump, and both carburetors. However, sediment was noted in the fuel line prior to the fuel filter. The inspector also observed sediment in the left and right fuel tanks, and retained samples from both fuel tanks and the fuel supply drum. In addition, the engine was retained for further examination.

The fuel samples were tested at a Safety Board office on January 7, 2005. The right fuel tank sample was consistent in color and odor with automobile gasoline. However, the sample contained visible contamination, including insect remains. When the fuel sample was applied to a coupon containing water-finding paste, the paste turned to a reddish-pink color, indicating the presence of water.

The left fuel tank sample was consistent in color and odor with automobile gasoline. However, the sample contained visible contamination. When the fuel sample was applied to a coupon containing water-finding paste, the paste turned to a reddish-pink color, indicating the presence of water.

The fuel supply drum sample was consistent in color and odor to automobile gasoline. When the fuel sample was applied to a coupon containing water-finding paste, the paste remained brown, indicating that no water was present.

On January 13, 2005, the engine was set up for a test run at a facility in Sebring, Florida, under the supervision of an FAA inspector. The engine fuel lines and filter contained water and debris, and the float bowls on the carburetors contained debris, water and corrosion. The engine crankshaft rotated freely, without any binding. The carburetor float bowls were cleaned, and a clean fuel source was supplied to the engine. No other engine work was preformed with the exception of connecting it to a test stand and removing debris from float bowls. The engine started without trouble on the first attempt, and was warmed up at idle power. All engine gauges indicated normal, and the engine was successfully run at different power settings, with no abnormalities noted.

Toxicological testing was conducted on the pilot at the FAA Toxicology Accident Research Laboratory, Oklahoma City, Oklahoma. According to the toxicology report:

"3.522 (ug/ml, ug/g) PHENYTOIN detected in Blood

1.869 (ug/ml, ug/g) PHENYTOIN detected in Urine"

The pilot's wife stated that he had suffered a seizure 2-3 years prior to the accident. Subsequent testing revealed an inflammation caused by an infection, which gradually reduced in size. After the seizure, the pilot remained on Dilantin. He was also using Advair for allergies.

The reported weather at an airport approximately 8 miles east of the accident site, at 1253, was: wind from 050 degrees at 4 knots; visibility 10 miles; sky clear; temperature 55 degrees F; dew point 34 degrees F; altimeter 30.64 inches Hg.

Aircraft

Registration
N83NK
Reported as
Labhart Kolb Twinstar Mk III
Category
Airplane, amateur-built
Serial number
M3X-04-1-00052
Engine
Rotax 912 ULS, 100 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Operator
Norman J. Labhart
Registered owner
Lightning Strike Leasing Llc.
Airworthiness certificate
Special, Experimental (Special)
Departed
3KY2 · London, KY
Airport
3KY2 · Chestnut Knolls Airport, runway 26, 2,150 × 70 ft, grass/turf

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
48
Injuries
Fatal
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 3, Valid Medical--w/ waivers/lim
Seat
Left
Toxicology
Performed
Flight hours
625 total

Weather

Conditions
Visual (VMC) · Day
Wind
50° at 4 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
55 °F, dew point 34 °F
Altimeter
30.63 inHg
Observed at
LOZ, 8 nm away