NYC91LA092

NTSB accident investigation · Piper PA-23-160 · Westbrook, ME · March 23, 1991

Accident · No injuriesLimited investigationFinal report
Date
March 23, 1991, 16:08 local (21:08 UTC)
Place
Westbrook, ME
Injuries
4 uninjured
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N4155PPiper PA-23-160
Weather
Instrument (IMC) · Day
Status
Completed · report May 5, 1993
Report
Approved by Office Director
FAA report
19910323007299A
Case key
36893

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

Improper emergency procedures by the pilot. Factors related to the accident were: the pilot's lack of experience and flight time in type of airplane, the pilots decision to take an airplane with a known mechanical defect, a leaky accelerator pump seal on the carburetor, and instrument meteorological conditions.

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 - normal
Preflight planning/preparation - improperPilot in command(cfi)Cause
Operation with known deficiencies in equipment - intentionalPilot in command(cfi)Cause
Fuel system,carburetor - failure,partialFactor
Maintenance,adjustment - improperOther maintenance personnelFactor
1 engineCause
Emergency procedure - improperPilot in command(cfi)Cause
Inadequate training(emergency procedure(s))Pilot in command(cfi)Cause
Lack of total experience in type of aircraftPilot in command(cfi)Cause
Forced landingDescent - emergency
Altitude - not maintainedPilot in command(cfi)
On ground/water encounter with terrain/waterLanding - flare/touchdown
Weather condition - cloudsFactor
Weather condition - snowFactor
Terrain condition - rough/unevenFactor

Analysis

On an IFR flight in IMC conditions the right engine started to shudder and produce black smoke, and then the propeller went into feather without actuation of the propeller control. The pilot was unable to maintain altitude and the pilot made a forced landing in an open field. The right engine oil was diluted by gasoline, due to a leak in the accelerator pump of the carburetor which caused the engine to run rich. Interviews disclosed the pilot had 'denial' on the engine problem, did not secure the engine, and did not declare an emergency with arc. Both engines were high time with high time since overhaul. Hartzell propellers personnel verified diluted oil could cause a propeller to go into uncommanded feather.

Aircraft

Registration
N4155P
Reported as
Piper PA-23-160
Category
Airplane
Serial number
23-1639
Airframe hours
5,297
Engine
Lycoming O-320B, 160 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Operator
Phoenix East Aviation
Registered owner
Phoenix East Aviation
Last inspection
100 hour · October 28, 1990 · 131 hours before
Departed
MLT · Millinocket, ME
Destination
LWM · Lawrence, MA
Flight plan
IFR
Airport
PWM · Portland

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
23
Certificates
Flight instructor, Commercial
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 2, Valid Medical--no waivers/lim.
Seat
Right
Flight hours
975 total · 31 in this make and model · 904 as pilot in command · 139 in the last 90 days · 66 in the last 30 days · 4 in the last 24 hours

Weather

Conditions
Instrument (IMC) · Day
Wind
130° at 14 knots, gusting 23
Lowest ceiling
500 ft
Observed at
PWM, 6 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.