SEA95LA088

NTSB accident investigation · Piper PA-28-236 · Tacoma, WA · April 21, 1995

Accident · No injuriesLimited investigationFinal report
Date
April 21, 1995, 13:25 local (20:25 UTC)
Place
Tacoma, WA
Injuries
2 uninjured
Damage
Substantial damage
Phase of flight
Initial climb
Aircraft
N2101XPiper PA-28-236
Weather
Visual (VMC) · Day
Status
Completed · report January 29, 1996
Report
Approved by Office Director
FAA report
19950421044649A
Case key
42142

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

Fuel starvation due to an unlocked mixture control that had not been properly rigged. A factor was the ditch in the emergency landing area.

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) - nonmechanicalTakeoff - initial climb
Mixture control - unlockedCause
Maintenance,adjustment - improperCompany maintenance personnelCause
Fluid,fuel - starvationCause
Forced landingEmergency landing after takeoff
On ground/water encounter with terrain/waterEmergency landing after takeoff
Terrain condition - ditchFactor

Analysis

Both pilots stated that at about 200 ft AGL after takeoff they experienced a loss of power. The instructor assumed command of the aircraft, manipulated the throttle to confirm the power loss, then made a forced landing. After the accident the engine was run satisfactorily in a test cell at the factory. An FAA inspector noted that the mixture control lever was aft of its locking mechanism, while the mixture control on the fuel injection system servo body was full rich. The mixture control cable had been replaced by the operator. According to the pilot operating handbook for the aircraft, the purpose of the locking mechanism is to prevent activation of the mixture control instead of the propeller pitch control.

Factual narrative

On April 21, 1995, approximately 1325 Pacific daylight time, a Piper PA-28-236, N2101X, sustained substantial damage when it collided with terrain during a forced landing after a loss of power after takeoff at Tacoma Narrows Airport, Tacoma, Washington. The flight instructor and his private-rated instrument student were uninjured. Visual meteorological conditions prevailed for the flight, for which an instrument flight plan had been filed. There was no fire and the ELT actuated but did not assist in locating the accident site.

The two crewmembers stated that power was lost about 200 feet above the runway just after takeoff. The flight instructor assumed control of the aircraft after a sudden loss of power. He stated that he moved the throttle forward and aft to confirm the loss of power, and set up for an emergency landing slightly west of the runway. The aircraft rolled into a ditch during the emergency landing, where the landing gear separated and the aircraft was substantially damaged. The instrument student noted that the ignition was turned off and the fuel tanks were "closed" after the aircraft stopped moving. The instructor noted that the master switch was also turned off.

The engine was removed and shipped to the manufacturer for testing under the oversight of FAA inspectors. After some difficulties attributed to the test cell, the engine was started and run to full power for fifteen minutes, cooled, restarted and run to full power for an additional ten minutes. In the opinion of those conducting the tests, the engine ran successfully on the TCM test cell and was capable of operating at rated power.

An FAA inspector who inspected the aircraft after the accident noted that the cockpit mixture control lever was rigged so that it was aft of its locking mechanism when the mixture control arm on the fuel injection servo body was against its maximum enrichment stop. The Pilot Operating Handbook for the aircraft states that the purpose of the lock is "to prevent activation of the mixture control instead of the [propeller] pitch control." The FAA inspector noted that the mixture control cable had been replaced by the operator.

Aircraft

Registration
N2101X
Reported as
Piper PA-28-236
Category
Airplane
Serial number
28-7921009
Airframe hours
3,800
Engine
Continental TSIO-360FB, 200 horsepower, reciprocating
Damage
Substantial damage
Flight
Instructional · Part 91
Operator
Pavco
Registered owner
Elihn B. Skinner
Airworthiness certificate
Standard, Normal
Last inspection
Annual · April 8, 1995 · 5 hours before
Flight plan
IFR
Airport
TIW · Tacoma Narrows Airport, runway 17, 5,002 × 150 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
44
Certificates
Flight instructor, Airline transport
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 2, Valid Medical--w/ waivers/lim
Seat
Right
Flight hours
3,750 total · 200 in this make and model · 3,650 as pilot in command

Weather

Conditions
Visual (VMC) · Day
Visibility
20 statute miles
Lowest ceiling
None
Temperature
64 °F

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.