NYC94LA174

NTSB accident investigation · Piper PA-24-250 · North Anson, ME · September 10, 1994

Accident · Minor injuriesLimited investigationFinal report
Date
September 10, 1994, 13:00 local (17:00 UTC)
Place
North Anson, ME
Injuries
2 minor
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N55GVPiper PA-24-250
Weather
Visual (VMC) · Day
Status
Completed · report January 26, 1995
Report
Approved by Office Director
FAA report
19940910026179A
Case key
38829

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 inadequately installed cylinder mounting stud nuts, by the engine overhaul facility, which resulted in the separation of the number two cylinder and the subsequent forced landing.

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
Engine assembly,cylinder - separation
Maintenance,overhaul,major - inadequateOther maintenance personnelCause
Forced landingDescent - emergency
On ground/water collision with objectLanding
Object - tree(s)

Analysis

The pilot and passenger were on the second leg of a cross country flight. Thirty minutes into the flight a vibration began, followed by oil seeping from the engine cowling. A few seconds later the engine failed and oil covered the airplane windshield. The pilot performed a forced landing to an open field with no forward visibility due to the oil. The pilot was unable to stop the airplane before it struck trees at the end of the field. Examination revealed that the number two cylinder had separated from the engine. Seven of the eight cylinder studs had sheared. The stud not sheared was intact and undamaged. An upper stud was rusted partially across, with the remainder of the stud sheared cleanly. The engine had been overhauled 362 tach hours before the failure by a local engine overhaul facility.

Factual narrative

On September 10, 1994, at 1300 eastern daylight time, a Piper PA-24-250, N55GV, owned by O&A Aircraft Modifications, Inc., and piloted by Joseph S. Grabin, was substantially damaged during a forced landing to an open field near North Anson, Maine. The pilot and passenger were not injured. Visual meteorological conditions prevailed, and no flight plan had been filed for the flight operating under 14 CFR Part 91.

This was the second leg of a cross country flight that originated in Factoryville, Pennsylvania, the same day. Mr. Grabin and his passenger departed the Oxford County Regional Airport, Oxford, Maine, at approximately 1230 for the last leg to Greenville, Maine.

In the NTSB Form 6120.1/2, the pilot stated:

"...thirty minutes into the flight a vibration began in the engine. A few seconds later I noticed a small bit of oil seeping up at the rear of the cowling. I turned direct to Central Maine Airport. Thirty seconds or so later, more oil came out and covered half of the window. A few seconds later the engine let go followed by more oil in the slip stream, which completely covered the windshield...looking out the side window I turned sharp and slipped into the field with no forward visibility. Touched down was good, but I was unable to stop before the end, and went into the trees."

In the Federal Aviation Administration (FAA) Inspector's report, he stated that an inspection of the engine revealed that the number two cylinder had separated from the engine case. The top of the cylinder did not show any evidence of damage, except where it had punctured the left hand engine cowl. He further stated:

"...All damage appeared to be the result of the cylinder separating from the case. Seven of the eight cylinder mounting studs were sheared off, while the eighth stud (lower forward position) was intact...the absence of paint on this stud's threads would indicate that the nut had been originally installed when the engine was painted during overhaul...the #2 cylinder lower side of the mounting flange and the corresponding case surface showed evidence of fretting...the initial evidence indicated an undertorque situation which could have propagated into the loss of the lower forward stud mount nut. This may have resulted in the failure of the upper forward mount stud over a period of time as suggested by the rusting found on this stud...With the failure of this stud and lack of holding power from the lower forward stud, the stress on the remaining studs conceivably would cause their failure..."

The engine was installed on November 2, 1990. It had been overhauled by a company no longer in business, the Windham Aircraft Engines, Inc., of Willimantic, Connecticut. The engine had accumulated approximately 362 hours since installation.

Aircraft

Registration
N55GV
Reported as
Piper PA-24-250
Category
Airplane
Serial number
24-401
Airframe hours
3,218
Engine
Lycoming O-540-A1A5, 250 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Registered owner
O & N Aircraft Modifications
Airworthiness certificate
Standard, Normal
Last inspection
Annual · May 1, 1994 · 51 hours before
Departed
81B · Oxford, ME
Destination
3B1 · Greenville, ME

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
42
Certificate
Commercial
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 2, Valid Medical--w/ waivers/lim
Seat
Left
Flight hours
2,808 total · 3 in this make and model · 1,470 as pilot in command · 19 in the last 90 days · 5 in the last 30 days · 3 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
260° at 7 knots
Visibility
10 statute miles
Lowest ceiling
4,600 ft broken
Temperature
59 °F, dew point 43 °F
Altimeter
29.00 inHg
Observed at
WVL, 21 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.