NYC06FA015

NTSB accident investigation · Cessna 411 · East Hampton, NY · October 23, 2005

Accident · FatalField investigationFinal report
Date
October 23, 2005, 13:45 local (17:45 UTC)
Place
East Hampton, NY
Injuries
1 fatal
Damage
Destroyed
Phase of flight
Enroute
Aircraft
N7345UCessna 411
Weather
Visual (VMC) · Day
Status
Completed · report January 31, 2008
Report
Approved by Office Director
Parties
Cessna Aircraft Company, FAA/FSDO, Teledyne Continental Motors
FAA report
20051023032849A
Case key
62704

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 failure to maintain airspeed, while maneuvering with the left engine inoperative. Contributing to the accident were the failure of the left engine, and the pilot's lack of multiengine certification.

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
1 engine - failureFactor
Loss of control - in flightManeuvering
Airspeed - not maintainedPilot in commandCause
Lack of certificationPilot in commandFactor
In flight collision with terrain/waterDescent - uncontrolled
Terrain condition - ground

Analysis

The pilot purchased the multiengine airplane about 18 months prior to the accident, and was conducting his first flight in the airplane, as he flew it from Georgia to Massachusetts. While en route, the airplane experienced a failure of the left engine. The airplane began maneuvering near an airport, as its groundspeed decreased from 173 miles per hour (mph) to 90 mph, 13 mph below the minimum single engine control speed. A witness reported that the airplane appeared to be attempting to land, when it banked to the left, and descended to the ground. The airplane impacted on a road, about 3 miles east-southeast of the airport. A 3-inch, by 2.5-inch hole was observed on the top of the left engine crankcase, and streaks of oil were present on the left gear door, left flap, and the left side of the fuselage. The number two connecting rod was fractured and heat distressed. The number 2 piston assembly was seized in the cylinder barrel. The airplane had been operated about 30 hours, during the 6 years prior to the accident, and it had not been flown since its most recent annual inspection, which was performed about 16 months prior to the accident. In addition, both engines were being operated beyond the manufacturer's recommended time between overhaul limits. The pilot did not possess a multiengine airplane rating. He attended an airplane type specific training course about 20 months prior to the accident. At that time, he reported 452 hours of total flight experience, with 0 hours of multiengine flight experience.

Factual narrative

History of flight

On October 23, 2005, about 1345 eastern daylight time, a Cessna 411, N7345U, was destroyed when it impacted the ground while maneuvering, after a loss of engine power near East Hampton, New York. The certificated private pilot was fatally injured. Visual meteorological conditions prevailed and no flight plan had been filed for the flight that departed the Jackson County Airport (19A), Jefferson, Georgia, about 0944, destined for Nantucket, Massachusetts. The personal flight was conducted under 14 CFR Part 91.

The pilot's father reported that the pilot had purchased the airplane about 18 months prior to the accident. The accident flight was the pilot's first flight in the airplane, and he intended to fly to Nantucket, Massachusetts.

A witness near the accident site reported that he observed the airplane and thought that the pilot may have been attempting to land at the East Hampton Airport (HTO), East Hampton, New York. The airplane's engine noise "did not sound right," and he observed a trail of white smoke emanating from the left engine. The airplane banked to the left, and descended to the ground. Another witness reported that the airplane's wings were "vertical," when he observed the airplane strike a tree, before it struck the ground.

Another witness, who was an airline pilot, stated the airplane circled over his house at what sounded like a high power setting. It then disappeared and then reappeared, turning from the base leg to final approach for runway 28, at HTO. When the airplane rolled out of the turn, he heard a loud "prop over boost sound...consistent with the sound of [the] throttle and propeller levers being advanced very rapidly." The airplane disappeared below the tree line, and he heard the sounds of police sirens about 6 to 7 minutes later.

The accident occurred during the hours of daylight approximately 40 degrees, 57.58 minutes north latitude, and 72 degrees, 10.30 minutes west longitude.

Personnel information

The pilot held a private pilot certificate with an airplane single engine land rating. A check of the Federal Aviation Administration (FAA) airman certificate database revealed that the pilot did not possess a multiengine airplane rating.

The pilot's logbook was not recovered. The pilot attended and completed a Cessna 411 initial training course during February 2004. The course consisted of approximately 10 hours of simulator flight training, and 20 hours of class room instruction. At the time of the training, the pilot reported 452 hours of total flight experience, with 0 hours in multiengine airplanes.

The pilot's most recent application for an FAA second class medical certificate, was issued on January 6, 2004.

Aircraft information

According to a bill of sale, the pilot purchased the airplane on April 18, 2004. The previous owner reported that he believed the airplane had remained parked at the Jackson County Airport, since it was purchased, until the day of the accident. He also estimated that the airplane had been operated for about 30 hours, during the 6 years prior to the accident.

According to the airplane's logbooks, it's most recent annual inspection was performed on June 7, 2004. At the time of the accident, the airplane had been operated for 2.5 hours since the inspection, and had approximately 2,808 total hours, which included 53 total hours since August 1994. In addition, the airplane had accumulated approximately 8 hours of flight time between an annual inspection that was performed on April 25, 2003, and the time of the accident.

The airplane was equipped with two Teledyne Continental Motors GTSIO-520C engines. According to the engine logbooks, both engines underwent a major overhaul on March 5, 1975, about 920 hours prior to the accident. The left engine was disassembled and repaired on May 21, 1996, after a propeller strike.

The engines were each equipped with a Hartzell HC-A3VF-2D propeller assembly. Both the left and right propellers were overhauled on April 25, 2003.

Teledyne Continental Motors service information letter SIL98-A, stated that the recommended time between overhaul (TBO) for the GTSIO-520C engine, was 1200 hours of operation or at least every 12 years.

Meteorological information

A weather observation taken at HTO, at 1358, reported: winds from 310 degrees at 10 knots; visibility 10 statue miles; ceiling 1,500 feet overcast; temperature 10 degrees Celsius (C), dew point 5 degrees C; altimeter 29.73 inches of mercury.

Wreckage and impact information

The airplane impacted on a road, about 3 miles east-southeast of the East Hampton Airport. The airplane came to rest inverted, on a heading about 300 degrees. All major portions of the airplane were accounted for at the accident site. The airplane was moved to the East Hampton Village Public Works facility for further examination.

The roof of the fuselage was crushed downward into the cabin. Postcrash fire damage was noted in the vicinity of each respective engine nacelle, and the portions of the left and right wings outboard of their respective nacelles were separated. Sooting was observed on the fuselage and empennage. In addition, the fuselage structure aft of the cabin was compromised, and remained attached via control cables. The top 3 feet of the rudder and vertical stabilizer assembly was crushed downward. Flight control continuity was confirmed from the rudder and elevator to the cockpit. Aileron control continuity was confirmed from the cockpit, through the left and right bellcranks, to their respective outboard wing areas. The landing gear was found in the extended position, and examination of the flap actuator sprocket control corresponded with a 30-degree flap extension setting.

Both engines were separated from their mounts and remained attached via cables and hoses. A 3-inch, by 2.5-inch hole was observed on the top on the left engine crankcase. The hole was above the number 1 cylinder, and exposed a crankshaft counterweight. In addition, streaks of oil were observed on the left gear door, left flap, and the left side of the fuselage. Both propellers remained attached at their respective crankshaft flanges. Both propellers were impact damaged, and one of the three propeller blades had separated from each engine. Both propellers were retained for further examination. Both engines were removed and examined at Teledyne Mattituck Services Inc., Mattituck, New York.

Disassembly of the left engine revealed that the number 2 connecting rod was fractured at the "yoke." Portions of the number 2 connecting rod cap were located in the oil sump. The number 2 piston assembly was seized in the cylinder barrel. The number 2 and 3 connecting rods were black and discolored, consistent with thermal distress. The number 2 and 3 connecting rod journals were also heat distressed. The number 2 connecting rod main bearing was smeared, and portions of the bearing were located in the oil sump. The number 3 connecting rod bearing was spun, but remained intact. The number 1, 4, 5, and 6 connecting rod assemblies exhibited normal operational signatures. All spark plug electrodes were intact and covered with black soot. Both magnetos were separated; however, they produced a spark from all towers when placed on a test bench.

The right engine was rotated by hand. Valve movement was observed at all cylinders, and crankshaft continuity was observed through the accessory section. Thumb compression was attained on all cylinders except the number 5 cylinder, which was impact damaged. The right magneto was impact damaged near the mounting flange. The left magneto remained secured to the engine. Both magnetos produced a spark from all towers when rotated on a test bench. The top spark plugs were removed. Their electrodes were intact, except for the number 1 and 5 spark plugs, which were impact damaged.

The airplane's f

Aircraft

Registration
N7345U
Reported as
Cessna 411
Category
Airplane
Serial number
4110045
Airframe hours
2,808
Engines
Teledyne Continental GTSIO-520C, 340 horsepower, reciprocatingTeledyne Continental GTSIO-520C, 340 horsepower, reciprocating
Damage
Destroyed
Fire
On-Ground
Flight
Personal · Part 91
Registered owner
William F. Holdgate
Airworthiness certificate
Standard, Normal
Last inspection
Annual · June 1, 2004 · 3 hours before
Departed
19A · Jefferson, GA
Destination
ACK · Nantucket, MA
Airport
HTO · East Hampton, runway 28, 4,255 × 100 ft, asphalt

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
50
Injuries
Fatal
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 2, With waivers/limitations
Seat
Left
Flight hours
452 total

Weather

Conditions
Visual (VMC) · Day
Wind
310° at 10 knots
Visibility
10 statute miles
Lowest ceiling
1,500 ft overcast
Temperature
50 °F, dew point 41 °F
Altimeter
29.72 inHg
Observed at
HTO, 3 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.