WPR22FA198

NTSB accident investigation · Beech 77 · Hemet, CA · June 7, 2022

Accident · FatalClass 3 · FieldFinal report
Date
June 7, 2022, 09:30 local (16:30 UTC)
Place
Hemet, CA
Injuries
1 fatal
Damage
Substantial damage
Phase of flight
Landing
Aircraft
N18244Beech 77
Defining event
Landing-landing roll: Collision with terr/obj (non-CFIT)
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
FAA, Textron Aviation, Lycoming Engines
FAA report
20220607010499A
Case key
105212

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

On this page

Probable cause

The student pilot’s failure to maintain clearance from a cinderblock wall while performing a go-around.

Findings · 4

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.

Action: lack of actionPersonnel issues › Action/decision · Student/instructed pilotBeech 77: 2 casesAll aircraft: 792 casesProbable cause
Temp/humidity/pressure: conducive to carburetor icingEnvironmental issues › Conditions/weather/phenomena · Effect on equipmentBeech 77: 2 casesAll aircraft: 435 cases
Object/animal/substance: wall/barricadeEnvironmental issues › Physical environment · Contributed to outcomeBeech 77: 1 caseAll aircraft: 29 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

During the student pilot’s second solo cross-country flight, he flew about 25 miles south to Hemet, California, to perform takeoffs and landings. The student pilot was operating on the downwind leg of the airport traffic pattern, when a witness, also flying in the traffic pattern, heard the student pilot’s distress call stating that the airplane had sustained a loss of engine power. The student pilot’s approach path to runway 23 overshot his intended landing point and he transmitted a radio call indicating that he was going around. The student pilot made a left turn, and the airplane touched down in a dirt field just over a mile southeast of the departure end of runway 23. From the initial touchdown point ground scar in the dirt field, three additional ground scars were observed on a track of 110° and the airplane traveled about 665 ft, before impacting an 8-ft-high cinder block wall near a residential area. The impact and thermal damage were consistent with a high-energy impact as revealed by the engine compartment, cabin and both wings having breached the cinder block wall. Although impact and thermal damage restricted the position confirmation of the ignition switch, throttle, mixture, carburetor heat, and flap positions, postaccident examination of the fuel selector valve revealed that the fuel selector remained in the “On” position. Additionally, postaccident examination of the airframe and engine revealed no evidence of any preimpact mechanical malfunctions or failures that would have precluded normal operation. The propeller revealed “S” bending, chordwise scratches, and leading-edge material gouges that were indicative of engine power during impact. Given the icing probability, the student pilot may have experienced carburetor icing that led to a partial loss of engine power while operating on the downwind leg of the airport traffic pattern. With the student pilot’s limited flight experience, it is likely that he overshot the intended runway during the forced landing, consistent with eyewitness statements that the airplane’s approach was too fast to land on runway 23. While a partial loss of engine power can be experienced when carburetor icing occurs, the student pilot did not specify the degree of engine power loss. The false sense of intermittent engine power and the drag experienced during the airplane’s multiple touchdown points in the soft dirt field suggest that the loss of engine power was partial in nature, however, the investigation could not determine the extent of the loss of engine power.

Factual narrative

On June 07, 2022, about 0930 Pacific daylight time, a Beech 77 Skipper, N18244, was substantially damaged when it was involved in an accident in Hemet, California. The student pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 instructional flight. The student pilot's flight instructor reported that he had authorized the student pilot to conduct his second cross-country solo flight, departing from Redlands Municipal Airport (REI), Redlands, California, and flying about 25 nautical miles south to Hemet-Ryan Airport (HMT), Hemet, California. According to FAA SAIB CE 09-35, the airplane was operating in serious icing conditions when the engine was operated using glide power. The pilot operating handbook (POH) identified the maximum glide airspeed as 63 kts. A witness who was piloting an airplane in the HMT airport traffic pattern reported that he was flying on the upwind leg of the airport traffic pattern when he heard the student pilot transmit a radio call over the Common Traffic Advisory Frequency (CTAF) that stated, “Right downwind for 23, I have no power.” As the witness turned onto the left downwind leg, he saw the accident airplane about midfield over the runway 23 and descending through about 150 ft above ground level (agl). He reported that the accident airplane was flying faster than a normal approach speed. He heard a radio transmission that stated, “going around,” and subsequently, the accident airplane overflew the departure end of runway 23 by about 100 ft agl. The witness lost sight of the airplane and shortly after observed a plume of smoke in the distance. A second witness, who was an employee at HMT, reported that he heard a distress call transmitted over the CTAF declaring an emergency and a loss of power. He reported that the accident airplane had made two touch and go landings and had aborted the third landing to runway 23. According to the witness, during the third approach and landing the airplane did not touch down on the runway and remained about 30 ft agl before aborting the landing. The witness reported that the airplane made a left turn and touched down in a dirt field. Ground markings in the field revealed that the airplane touched down three times. The ground scars showed a veer to the right, just before crossing over a three-lane asphalt highway, colliding with a curb, and impacting a cinder block wall near a residence. The total ground roll distance was about 665 ft. The FAA Forensic Sciences Laboratory conducted the toxicology testing. Carboxyhemoglobin and ethanol were not detected. Lidocaine, ketamine, and the metabolite norketamine were detected. The pilot succumbed to his injuries in the hospital and these drugs were most likely administered during acute medical care. The student pilot’s logbook indicated that while accumulating flight experience with the accident operator the student pilot had flown eight different airplanes, with six of the airplanes beingdifferent makes and models. The student pilot amassed 66.5 hours of flight experience in the accident airplane make and model. The airplane collided with a retaining wall on the east side of a road. The airplane's engine, cabin, left wing root, and right wing breached the 8-ft-high cinder block retaining wall and sustained thermal damage. The engine separated from the airframe at the firewall and consequently did not sustain thermal damage. The aft fuselage and the empennage did not breach the wall and did not sustain thermal damage. Postaccident examination of the wreckage revealed that airplane’s fuel system, electrical system, induction, and exhaust systems sustained impact and thermal damage, which restricted the confirmation of the ignition switch, throttle, mixture, carburetor heat, and flap positions. The examination of the fuel selector valve revealed that the fuel selector remained in the “On” position. Post-accident examination of the engine revealed thumb compression on all cylinders, and drivetrain continuity was confirmed throughout. The left and right magnetos were function tested and current was observed. The fixed pitch, two-bladed propeller remained attached to the engine crankshaft flange. One propeller blade exhibited bending to the non-camber side, with blade tip curling, chordwise scratches and leading-edge gouges. The opposite blade exhibited bending emanating from the outboard 1/3 to the blade tip, as well as chordwise scratches emanating from the leading edge.

Aircraft

Registration
N18244
Reported as
Beech 77
Category
Airplane
Serial number
WA-295
Built
1981
Airframe hours
7,279
Engine
Lycoming O-235-L2C, 115 horsepower, reciprocating
Damage
Substantial damage
Fire
On-Ground
Flight
Instructional · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
Annual · April 7, 2022 · 107 hours before
Departed
REI · Redlands, CA
Destination
Same as departure
Airport
HMT · Hemet-Ryan, runway 23, 4,315 × 100 ft, asphalt
Equipment
ADS-B

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
Student pilot
Age
62
Injuries
Fatal
Certificate
Student
Medical
Class 3, With waivers/limitations
Seat
Front
Toxicology
Performed
Flight hours
124.4 total · 66.5 in this make and model · 8.5 as pilot in command

Weather

Conditions
Visual (VMC) · Day
Wind
210° at 4 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
77 °F, dew point 55 °F
Altimeter
29.88 inHg
Observed at
KHMT, 1 nm away
METAR
KHMT 071635Z AUTO 21004KT 10SM CLR 25/13 A2988 RMK AO2 T02550132

Docket · 9

The files NTSB released with the investigation on April 25, 2024, on NTSB’s docket system: statements, records, photos and specialists’ reports. 627 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 N18244 · 1

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