WPR23LA149

NTSB accident investigation · Stevens Kelly C RV-7 · Morgan, UT · April 9, 2023

Accident · No injuriesClass 3 · LimitedFinal report
Date
April 8, 2023, 19:37 local (Apr 9, 2023, 01:37 UTC)
Place
Morgan, UT
Injuries
1 uninjured
Damage
Substantial damage
Phase of flight
Enroute
Aircraft
N17NKStevens Kelly C RV-7
Defining event
Enroute-cruise: Part(s) separation from AC
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Western Pacific Region
Parties
FAA
FAA report
20230408003959A
Case key
107032

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 pilot/builder improperly torqued the propeller attachment bolts while reinstalling the propeller, which resulted in the fatigue failure of the bolts and the separation of the propeller assembly.

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.

Maintenance: installationPersonnel issues › Task performance · Owner/builderStevens Kelly C RV-7: 1 caseAll aircraft: 371 casesProbable cause
Propeller system: propeller assemblyAircraft › Aircraft propeller/rotor · Incorrect service/maintenanceStevens Kelly C RV-7: 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

The pilot reported he noticed an odor of burning oil shortly after takeoff. About a minute later, the airplane began to shake, oil covered the windscreen, and the propeller separated from the crankshaft. The pilot performed a forced landing in a snowy field, and during the landing roll the airplane nosed over and came to rest inverted. The propeller assembly was found in a field about two miles away. The most recent condition inspection was completed by the pilot one week before the accident flight, and the airplane had accrued three flight hours since the inspection. Although brass flakes were observed in the engine oil during the condition inspection, engine data recovered from the airplane’s multi-function display was consistent with normal engine operation. Five of the six propeller bolts were recovered and examined after the accident. The examination revealed fatigue cracks in multiple areas on each bolt that progressed until each bolt failed in overstress. Additionally, two of the recovered bolts displayed more extensive fatigue features than the other three bolts that were examined. The pilot documented that he had removed, inspected, and reinstalled the propeller during the condition inspection. Given this information, it is likely that the pilot/builder had not torqued all the propeller attachment bolts to the correct value, resulting in the progressive fatigue failure of the bolts.

Factual narrative

On April 8, 2023, at about 1937 mountain daylight time, an experimental amateur-built Van’s RV-7, N17NK, was substantially damaged when it was involved in an accident near Morgan, Utah. The pilot was not injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to the pilot/builder, the airplane departed for a local flight about 1916. About 10 minutes into the flight, the pilot noticed the odor of burning oil when the cabin heater was turned on, so he turned back to the departure airport. About one minute later, the pilot noted “some light but not normal vibration in the airframe.” Seconds later, the airplane shuddered, oil covered the windscreen, and the engine lost all power. The pilot estimated the nearest airport was beyond the glide range of the airplane, so he chose to land in an open field. During the landing roll, the airplane’s main wheels sunk into deep snow, and the airplane nosed over. As a result, the airplane sustained substantial damage to the fuselage and empennage. Photos of the airplane at the accident site revealed the propeller assembly had separated from the engine. The propeller assembly was later recovered from a field about two miles from the accident site. Data retrieved from two panel mounted flight displays revealed the cylinder head temperature, exhaust gas temperature, oil temperature, oil pressure, fuel pressure, and rpm were consistent with normal engine operation until 19:28:15. Between 19:28:15 and 19:28:18, engine rpm increased from about 2,300 rpm to 2,841 rpm before decreasing to 0 rpm 2 seconds later, as seen in Figure 1. Figure 1: A portion of recorded engine data. A National Transportation Safety Board materials laboratory examination showed that five of the six propeller attachment bolts remained connected with safety cable within the bolt holes in the hub. The sixth bolt was missing. The fracture surfaces of all five remaining bolts exhibited features consistent with progressive cracking, crack arrest marks, ratchet marks, and multiple thumbnail shaped cracks. Two bolts displayed multiple fatigue crack initiation sites. Further examination with a scanning electron microscope did not reveal any corrosion pits or voids, and although there were some dissimilar materials observed, they were inconsistent with inclusions during the manufacturing process. Overall, the fracture surfaces were consistent with fatigue that had initiated in multiple sites on each bolt and propagated across the bolt cross sections until the remaining material succumbed to overstress fracture. Two of the five examined bolts displayed more extensive fatigue than observed on the other bolts. Review of the airplane’s maintenance records revealed it had flown three hours since its most recent condition inspection. During the condition inspection, which was performed by the pilot/builder, brass flakes were found in the oil sump and filter. After correspondence with a maintenanceconsultant, the pilot intended to fly the airplane an additional 10 hours to monitor the engine’s performance. The pilot stated that during the condition inspection, he removed the propeller to clean sludge from the end of the crankshaft. He stated that he did not see any defects when he visually inspected the propeller and attachment bolts. He re-installed the propeller, torqued the attachment bolts with a torque wrench, and used a ratcheting safety cable tool to install .32-inch safety cable in the bolts. The pilot stated he referenced the MT Propellers technical data included with the purchase of the propeller. He could not recall the torque value he used during the installation of the propeller. According to MT Propellers Operation and Installation Manual E-124, torque values for propeller attachment bolts are 63-66 ft/lbs.

Aircraft

Registration
N17NK
Reported as
Stevens Kelly C RV-7
Category
Airplane, amateur-built
Serial number
73089
Built
2021
Airframe hours
133.95
Engine
Titan IOX-370-A4D3T8, 187 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Special, Experimental (Special)
Last inspection
Condition · April 1, 2023 · 3 hours before
Departed
BTF · Bountiful, UT
Equipment
ADS-B, Angle of attack indicator, Auto-pilot

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
62
Injuries
None
Certificate
Airline transport
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
December 8, 2023
Seat
Left
Restraint
4-point
Flight hours
20,000 total · 145 in this make and model · 15 in the last 90 days · 10 in the last 30 days · 0 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
350° at 5 knots
Visibility
10 statute miles
Temperature
57 °F, dew point 37 °F
Altimeter
30.08 inHg
Observed at
KSLC, 19 nm away
METAR
KSLC 090154Z 35005KT 10SM FEW100 SCT250 14/03 A3008 RMK AO2 SLP167 T01440033 $

Docket · 7

The files NTSB released with the investigation on February 26, 2025, on NTSB’s docket system: statements, records, photos and specialists’ reports. 14.2 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.