WPR12LA070

NTSB accident investigation · Ryan Navion · Concord, CA · December 27, 2011

Accident · Serious injuriesLimited investigationFinal report
Date
December 27, 2011, 15:30 local (23:30 UTC)
Place
Concord, CA
Injuries
2 serious
Damage
Substantial damage
Phase of flight
Takeoff
Aircraft
N4398KRyan Navion
Defining event
Takeoff: Fuel contamination
Weather
Visual (VMC) · Day
Status
Completed · report March 13, 2013
Report
Approved by Office Director
NTSB office
Western Pacific Region
Parties
Continental Motors, Inc, Federal Aviation Administration
FAA report
20111227029999A
Case key
82575

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 of the airplane and the subsequent total loss of engine power as a result of debris and water contamination in the fuel system.

Findings · 3

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Fluids: fuelAircraft › Fluids/misc hardware · Fluid conditionRyan NAVION: 2 casesAll aircraft: 1,695 casesProbable cause
Inspection: preflight inspectionPersonnel issues › Task performance · PilotRyan NAVION: 3 casesAll aircraft: 551 casesProbable cause
Fuel systemAircraft › Aircraft systems · Not serviced/maintainedRyan NAVION: 1 caseAll aircraft: 181 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Analysis

The pilot reported that shortly after takeoff, the engine lost power, and during the subsequent attempt to return to the airport, the airplane collided with the terrain. A postaccident examination of the engine fuel system revealed that the fuel in the accumulator sump and the carburetor inlet screen line were contaminated with debris and water. It is likely that the loss of engine power was due to this contamination as no further evidence of a mechanical malfunction or failure that would have precluded normal operation was found.

Factual narrative

HISTORY OF FLIGHT On December 27, 2011, about 1530 Pacific standard time (PST), a Ryan Navion, N4398K, experienced a loss of engine power shortly after takeoff from Buchanan Field Airport, Concord, California. The airplane subsequently landed hard on airport property and was substantially damaged. The owner/pilot was operating the airplane under the provisions of 14 Code of Federal Regulations (CFR) Part 91. The private pilot and passenger were seriously injured. Visual meteorological conditions prevailed, and no flight plan had been filed. Witnesses reported that during takeoff from runway 32R, the airplane was about 250-300 feet above the runway when the engine sounded like it had lost power. The airplane was observed making a banking left turn as it descended toward the parallel runway 14R. The pilot reported that during takeoff as the airplane approached the departure end of runway 32R, the engine quit without warning. He knew that at his current altitude a safe return to the runway was unlikely. He made a left turn away from the busy highway in front of him, and then realized he was headed towards a hangar and made another left turn with added left rudder to avoid the hangar. The pilot lost control of the airplane as it descended to the ground. The airplane hit the ground in a flat, wings level attitude, and slid approximately 100 feet before coming to rest in the dirt area near the approach end of runway 14R. TESTS AND RESEARCH Investigators examined the wreckage at National Aviation Logistics, Madera, California, on January 11, 2012. The airframe and engine were examined with no mechanical anomalies identified that would have precluded normal operation. A detailed examination report with accompanying pictures is contained in the public docket for this accident. The fuel system for the Ryan Navion consists of two aluminum alloy fuel tanks, holding approximately 20 gallons each. An accumulator tank, mounted between the two tanks in the center of the fuselage and interconnected with each, has a capacity of approximately 3/4 gallon. Fuel from both main tanks is gravity fed into the accumulator. From the accumulator, fuel is supplied to the carburetor by an engine driven pump. An emergency electric fuel pump is provided supplying 12 pounds (lbs) fuel pressure for use on takeoff and landing, and in the event of an engine driven fuel pump failure. Examination of the fuel system revealed that the fuel removed from the wing tanks was blue in color, with no sediment or contamination noted. The fuel sample obtained from the fuel line to the carburetor inlet screen was light blue and contained debris. The fuel sample from the accumulator sump was brown in color and had debris; it tested positive for water.

Aircraft

Registration
N4398K
Reported as
Ryan Navion
Category
Airplane
Serial number
NAV-4-1398
Airframe hours
4,717
Engine
Cont Motor E225 SERIES, 225 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
Annual · January 20, 2011 · 54 hours before
Departed
CCR · Concord, CA
Destination
CCR · Concord, CA
Airport
CCR · Concord/ Buchanan Field, runway 32R, 4,602 × 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
67
Injuries
Serious
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 3, With waivers/limitations
Last flight review
August 23, 2010
Seat
Left
Flight hours
1,718 total · 1,518 in this make and model · 1,698 as pilot in command · 11 in the last 90 days · 8 in the last 30 days

Weather

Conditions
Visual (VMC) · Day
Visibility
10 statute miles
Lowest ceiling
None
Temperature
59 °F, dew point 36 °F
Observed at
CCR

Docket · 6

The files NTSB released with the investigation on January 25, 2013, on NTSB’s docket system: statements, records, photos and specialists’ reports. 16.4 MB in all.

FAA reports on this event · 1

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