WPR21LA059

NTSB accident investigation · Cessna TU206 · Twentynine Palms, CA · November 21, 2020

Accident · No injuriesClass 3 · LimitedFinal report
Date
November 21, 2020, 12:50 local (20:50 UTC)
Place
Twentynine Palms, CA
Injuries
6 uninjured
Damage
Substantial damage
Phase of flight
Takeoff
Aircraft
N878AHCessna TU206
Defining event
Takeoff: Loss of engine power (total)
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
FAA
FAA report
20201121021789A
Case key
102327

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 decision to takeoff with a known mechanical engine anomaly, and the failure of the No. 2-cylinder exhaust valve, which resulted in a total loss of engine power during the initial climb and subsequent impact with terrain.

Findings · 2

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.

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 during the first cross-country flight after an annual inspection, he experienced a rough running engine. He noted that when the engine roughness began, the airplane’s airspeed decreased by 23 knots, and the No. 2 cylinder head temperature decreased from 1,350° F to 650° F. He decided to continue flight at the slower airspeed. The engine roughness once again returned, and the pilot elected to land as soon as practical and have a mechanic look at the engine. However, there were no mechanics available, so the pilot decided to refuel and takeoff. The first takeoff attempt was unsuccessful because the pilot felt a slight hesitation in the engine power during the takeoff roll, and he aborted the takeoff. During the second takeoff attempt, at 250 ft agl, the engine lost power. The airplane descended to the ground, impacted a sand berm, and nosed over. It sustained substantial damage to the right wing and wing left strut A postaccident examination of the engine revealed that the No. 2-cylinder exhaust valve failed. The No. 2 cylinder exhaust valve was missing about 45 percent of the valve head and foreign object compression signatures were sustained to the No. 2 piston and cylinder head. The missing exhaust valve head was not present in the No. 2 cylinder. Additionally, the No. 5 cylinder piston and cylinder head sustained foreign object compression signatures. The No. 5 cylinder intake valve exhibited material deformation around the valve seat. The engine total time was 2,180.1 hours when the annual inspection was completed. The engine had acquired 3 hours since the last annual. The engine was overhauled after acquiring 909 hours. At the time of the accident, the engine had amassed 1,274.1 hours since major overhaul. It is likely that the initial engine roughness and partial loss of engine power, followed by the total loss of engine power during takeoff was due to the failure of the exhaust valve.

Factual narrative

On November 21, 2020, about 1250 Pacific standard time, a Cessna TU206G, N878AH, was substantially damaged when it was involved in an accident in Twentynine Palms, California. The pilot and his five passengers were not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot reported that the accident flight was the first flight after the completion of the airplane’s annual inspection. He departed from South Valley Regional Airport (KU42), in Salt Lake City, Utah with the destination of Jacqueline Cochran Regional Airport (KTRM) in Thermal, California. The pilot recalled that about 275 nm into the flight, the engine began running rough, the No. 2-cylinder head temperature decreased from 1,350° F to 650° F, and the airplane’s airspeed decreased about 23 knots. The pilot decided to continue the remaining 200 nautical mile (nm) flight to his destination. However, about 168 nm later, the pilot once again noticed a “slight roughness” then it seemed to be “ok”. The pilot switched the fuel selector from the left tank to the right tank and the engine lost total power. He turned on the auxiliary fuel pump and the engine regained power. The pilot elected to land at the nearest available airport and have a mechanic look over the engine. Twentynine Palms Airport was the nearest available airport, but there were no mechanics available to assist. The pilot refueled the airplane taking on 35 gallons of 100LL and taxied to runway 26 with the intent to fly the remaining 32 nm to his destination airport. He reported that he had completed an engine run-up, entered the runway and initiated the takeoff roll. About halfway into the takeoff roll, he felt a “slight hesitation” in engine power, and he aborted the takeoff. The pilot taxied back to runway 26 and completed another engine run-up during the takeoff roll, the engine power appeared to be normal; however, upon reaching about 250 ft agl, a total loss of engine power occurred, and the airplane descended. The pilot made a slight left turn during the descent to avoid colliding with a home and the airplane touched down on the sand covered desert terrain. The airplane impacted a sand berm and nosed over, sustaining substantial damage to the right wing and wing left strut. Examination of the airplane’s fuel system revealed no anomalies or malfunctions. An external examination of the airplane’s engine and accessory case revealed no anomalies. The top spark plugs were removed from each cylinder and thumb compression could not be obtained on cylinders Nos. 2 and 5. A lighted borescope was used to examine each of the effected cylinders and revealed that the No. 2 cylinder exhaust valve was missing about 45 percent of the valve head. Foreign object compression signatures were sustained to the No. 2 piston and cylinder head. The missing exhaust valve head was not present in the No. 2 cylinder. Additionally, the No. 5 cylinder piston and cylinder head sustained foreignobject compression signatures. The No. 5 cylinder top and bottom spark plugs sustained damage to the three ground electrode points, and the center electrode to the copper core. The No. 5 cylinder exhaust valve and intake valve were present and sustained foreign object compression signatures. According to the airplane’s maintenance logbook, the engine total time was 2,180.1 hours when the annual inspection was completed. The engine had acquired 3 hours since the last annual. The engine was overhauled after acquiring 909 hours. At the time of the accident, the engine had amassed 1,274.1 hours since major overhaul.

Aircraft

Registration
N878AH
Reported as
Cessna TU206 (G)
Category
Airplane
Serial number
U20604570
Built
1978
Airframe hours
4,555
Engine
Continental TSIO-520-M, 310 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Registered owner
T V Specialists Inc
Airworthiness certificate
Standard, Normal
Last inspection
Annual · November 1, 2020 · 3 hours before
Destination
TRM · Thermal, CA
Airport
TNP · 29 Palms Airport, runway 26, 5,531 × 75 ft, asphalt
Equipment
ADS-B, Auto-pilot, Handheld GPS

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
64
Injuries
None
Certificate
Private
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
BasicMed, With waivers/limitations
Last flight review
May 25, 2020
Seat
Left
Restraint
3-point
Flight hours
1,550 total · 1,500 in this make and model · 1,550 as pilot in command · 8 in the last 90 days

Weather

Conditions
Visual (VMC) · Day
Wind
Calm
Visibility
10 statute miles
Lowest ceiling
None
Temperature
84 °F, dew point 27 °F
Altimeter
30.06 inHg
Observed at
KPSP, 33 nm away
METAR
METAR KPSP 211953Z 00000KT 10SM CLR 29/M03 A3006 RMK AO2 SLP177 T02941028=

Docket · 5

The files NTSB released with the investigation on August 25, 2022, on NTSB’s docket system: statements, records, photos and specialists’ reports. 12.3 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.

Other investigations on N878AH · 1

Matched to the same aircraft by N-number and date.