Mastery Flight Training, Inc. 

Beech Weekly Accident Update archives

March 2008 Reports

Official information from FAA and NTSB sources (unless otherwise noted).  Editorial comments (contained in parentheses), year-to-date summary and closing comments are those of the author.  All information is preliminary and subject to change.  Comments on preliminary topics are meant solely to enhance flying safety.  Please use these reports to help you more accurately evaluate the potential risks when you make your own decisions about how and when to fly.  Please accept my sincere personal condolences if anyone you know was in a mishap. I welcome your comments, suggestions and criticisms.  Fly safe, and have fun!

©2008 Mastery Flight Training, Inc.  All Rights Reserved

NEW REPORTS THIS WEEK

2/20 1852Z (1952 local time):  The pilot of a Be55 was killed, and a passenger suffered “serious” injuries, when the Baron impacted terrain following failure of an engine during a flight between Bourg Ceyzeriat, France and Toussus-Le-Noble, France.  The crash occurred during an apparent attempt to divert and land at Auxerre Airfield (LFAQ) France.  The Baron was “destroyed”; visual meteorological conditions prevailed.  F-BPJF (TC-1143) was a 1968 B55, but ownership details were not reported.

(“Loss of control—single engine visual approach”; “Fatal”; “Aircraft destroyed”—this mishap is eerily similar to another recent Baron crash [coincidentally, also in France], where the pilot apparently successfully dealt with an engine failure in cruise flight only to crash during an attempted single-engine landing.  For more on control and decision-making after shutting down an engine in a twin, see my article “Identify, Verify, Feather—Now What?” in the March 2007 issue of Twin and Turbine magazine.  The fact the passenger survived in this case points to a relatively low-speed impact and possibly a fire, as opposed to a loss of control at higher altitude that would have almost certainly killed all aboard by impact forces.  Do any European readers have more details you are willing to share to further pilot education and decision-making?)

2/28 1721 (1121 local):  While on a training flight, a Be76 taxiied into a runway light at Tulsa, Oklahoma’s Richard Lloyd Jones/Riverside Airport.  The instructor and student were not hurt; aircraft damage is “unknown”.  Weather: “clear and 10” with a 12-knot wind.  N3812C (ME-390) is a 1981 Duchess registered since 2003 to a Wilmington, Delaware-based corporation,

(“Taxiied into obstruction”—Most likely this was a prop strike.  Both Lycoming and Teledyne Continental now recommend an engine tear-down and inspection following any sudden stoppage of a propeller or a propeller strike, defined as any impact that changes the rotational speed of the propeller or that requires the propeller be removed from the airplane to be repaired.  The latter means even prop damage that occurs when the propeller is not spinning requires an engine tear-down, if the propeller is damaged enough it needs to be removed for repairs.  There is growing evidence that a large number of in-flight crankshaft and other internal engine structural failures are predated by a propeller strike, hence the manufacturers' recommendation.  Insurance companies are becoming enlightened about the wisdom of an engine tear-down and inspection following a prop strike or sudden stoppage to prevent more serious claims in the future, although word is that some claims adjusters still need to be educated on the need for this inspection, and some owners report having to be insistent to obtain insurance coverage of the tear-down, repair of items showing damage as a direct result of the stoppage, and engine reassembly.

A flight instructor’s primary purpose is to teach safe flying practices.  At times safety and mishap avoidance must pre-empt even the instructional mission of the CFI/MEI.  When the airplane is in motion on the ground all attention should be outside the aircraft to avoid runway incursions and collisions with obstacles.  Delay tasks not immediately necessary until the aircraft is brought to a stop in the run-up area or at the end of the runway.  Program navigation systems before taxi or when at a complete stop afterward.  Do not attempt to conduct systems checks, brief the departure or any other phase of the upcoming flight, or run checklists while taxiing.  After landing and clear of the runway, bring the aircraft to a complete stop to run After Landing checks and the reconfigure the aircraft [this will help prevent an inadvertent gear retraction in retractable gear airplanes, also].  Then taxi to parking with all eyes focused outside.  Instructors—reinforce these taxi habits by making them your own, and insisting your students focus on position awareness and obstacle avoidance in motion on the ground.)

2/29 0230Z (2030 local 2/28/2008):  During a night landing at Okmulgee, Oklahoma, a Be76 struck a deer.  The two aboard the Duchess were not hurt; damage is “minor” and weather conditions were “not reported”.  N92ER (ME-425) is a 1982 Duchess registered since 2003 to the same Wilmington, Delaware corporation as the aircraft in the taxi incident above.

(“Impact with animal while landing”; “Night”—animals often remain near runways on cool nights after sunny days, to stay warm as the pavement radiates heat it absorbed in the daytime.  Some pilots like to make one or two careful, low passes over a runway before touching down at night to drive animals away.)

3/1 1830Z (1230 local):  A Be50 landed gear up at Savanna, Illinois.  Two aboard the Twin Bonanza weren’t hurt; airplane damage is “minor”.  Weather: 6000 overcast, visibility 10 miles with a seven-knot surface wind. N3250Q (58-1334) is a 1958 U-8D recently (July 2007) registered to an individual in Galena, Illinois.

(“Gear up landing”; “Recent registration”—‘minor’ damage is relative.  It almost certainly means the T-Bone’s two engines will need to be torn down and likely overhauled; given the cost of doing so on the relatively rare engines and the typical hull value of a Twin Bonanza any insurance will likely “total” the aircraft, and it may not be financially feasible for the owner to repair the aircraft.)

3/3 0030Z (1630 local 3/2/2008):  “On takeoff,” a Be36 “lost engine power and crashed into a field” at Mammoth Lakes, California.  The two aboard have “minor” injuries; aircraft damage is “substantial”.  Weather conditions were “not reported”.  N234MT (EA-656) is a 2000 B36TC registered since new to a Los Angeles, California-based corporation.

(“Engine failure on takeoff”; “Substantial damage”)

3/3 0040Z (1640 local 3/2/2008):  A Be24 landed gear up at Hayward, California.  The solo pilot reports no injury; damage is “minor” and weather was “not reported.”  N60097 (MC-619) is a 1978 C24R registered since 1998 to a co-ownership in San Lorenzo, California.

(“Gear up landing: known mechanical system failure”—This event was reported as a “gear collapse” in the FAA preliminary report.  However, a national television network aired video [which I’ve not personally seen] that shows the airplane landing with the gear up.  This indicates the aircraft had a mechanical failure, or else the news videographers would not have known to be in position to record the landing.  The Sierra has a hydraulic landing gear system.  If for any reason the gear will not extend normally, procedure is to use a dedicated, castellated tool to move a valve under a small cover between the pilot’s feet.  This relieves pressure and allows the gear to free-fall into the down-and-locked position.  Failure of this method to extend the gear results from one of four possibilities:

[1] the pilot did not know the procedure, as a result of an incomplete pilot checkout in type;

[2] the castellated tool was not available to the pilot when needed, as a result of poor preflight inspection, which requires checking the tool may be reached from the pilot’s seat;

[3] the pilot mad a poor decision to continue with the planned flight if the tool was not found and put in its proper place during preflight; or

[4] there was mechanical binding of the landing gear system such that it did not extend using the alternate gear extension procedure.

Readers, do you know more details that will serve the purpose of pilot education?)

3/5 0115Z (1515 local 3/4/2008):  A Be35 landed gear up at Mountain View, California.  Two aboard were not hurt; damage is “minor” and weather conditions were “not reported”.  N317CH (D-9543) is a 1973 V35B registered since 1997 to an individual in Zephyr Cove, Nevada.

(“Gear up landing”)

NEW NTSB PRELIMINARY or FACTUAL REPORTS:  All previously reported in the Weekly Accident Update, and subject to change per NTSB findings.

** 2/20 fatal Baron loss of control at Auxerre Airfield (LFAQ) France, after an engine failure, cited above.**

CORRECTION

Two previously reported Bonanza mishaps—one involving a propeller overspeed, the other a forced landing for unknown reasons—now prove to be the same event.  Here are the two items as they originally appeared in the Weekly Accident Update.  First:

A reader reports:  On or about 2/26/2008 a Be35 made a forced landing in a field near Atlanta, Georgia.  No one was hurt but airplane damage was "substantial" as the Bonanza ran into a ditch during the off-airport landing.  According to the pilot, the propeller went into overspeed during a test flight immediately following an annual inspection that included replacing two cylinders.  Prop control varied with throttle movement and exceeded redline when the throttle was near fully open.  The engine continued to run smoothly.  Weather conditions were VMC.  The airplane's registration and serial number are not available, but the aircraft is a 1979 V35B.

("Propeller overspeed"; "Substantial damage")

The above item was followed by significant discussion of propeller overspeed, as well as the need to conduct a thorough test flight within gliding range of the airport before venturing off on a flight, especially after engine repair or cylinder replacement.  Here’s the second item: 

2/26/2143Z (1643 local):  The pilot of a Be36 “reported a mechanical problem [and] force-landed in a field,” six miles from the airport at Athens, Georgia.  The flight had departed the Atlanta area en route to Charlotte, North Carolina, but turned back toward Athens, presumably after reporting the problem.  The Bonanza “nosed over on rollout,” suffering “unknown” damage.  The solo pilot reports no injury.   Weather was 3900 broken, 5000 overcast, with visibility of 10 miles.  N623CQ (E-1382) is/was a 1978 A36 registered since 2001 to a corporation in Atlanta, Georgia.

(“Forced landing/unknown”—I’d suspect an engine problem but we have no further information right now.  Readers?)

All discussion of the mishap remains valid.  You may review the lessons of this by accessing the  February 2008 archives and scroll down to the 2/28/2008 report.  Updating the record, remove one aircraft from the report total, one entry for VMC, one entry for Be35, “Forced Landing/unknown”, and change “Propeller overspeed” from Be35 to Be36.  All changes are accomplished in the SUMMARY section below. 

A photo in a local news report suggests that shoulder harnesses were worn given there is no reported injury.  We’ve seen many times in the Weekly Accident Update where seemingly minor nose-overs or off-airport landings like this have resulted in serious injury or death from head trauma suffered during deceleration.

UPDATE

Regarding the 3/5/2008 V35B landing gear-related mishap at Moffett Field, Mountain View, California:  Photos circulating on the internet confirm the Bonanza arrived with the nosewheel and right main gear fully extended, with the left main (including gear doors) completely retracted. Change “Gear up landing” to “Gear up landing—known mechanical system failure”, and “Weather unknown” to “VMC”.

Local news video of the landing shows the pilot was able to retract the gear fully before touchdown, likely his/her best choice given the earlier gear configuration.  It looks like the touchdown was done quite well.  The only debrief critique I might offer is the pilot did not turn off electrical power before touchdown, as indicated by the flashing rotating beacon in the video.  “Battery, Alternator and Magneto/Start Switches—OFF” is included in the V35B LANDING GEAR RETRACTED—WITH POWER checklist in the Pilot’s Operating Handbook. 

Such a failure mode almost certainly must have resulted from a mis-adjusted gear uplock, a bent or broken extension pushrod or a rod end associated with the left main gear.  Often when this happens the gear is “noisy” or makes a “boom” or “crack” in transit; sounds may or may not accompany a popped landing gear circuit breaker.  Most of us were taught if the gear does not go down as expected that we should “cycle the gear”—reverse the gear selector, reset the breaker if needed, retract the landing gear and then try to extend it again.  Trouble is, the motion of retracting the gear may overstress the offending gear component, jamming the gear up or partially up, or causing total failure in transit during the second extension attempt.  I know of at least one reader of this report who has had this very thing happen.  Better chances of success come instead from initially leaving the gear in whatever position it was in when motion stopped, then completing the Landing Gear Manual Extension procedure (being careful to check the gear breaker is still pulled).  This puts far less force on the gear system than does electric extension, and if a rod is bent or near breaking it’s less likely to completely fail as extension is continued than if the pilot tries to retract and then re-extend the landing gear.

Many Beech maintenance experts recommend removal and inspection of pushrods, and pre-emptive replacement of rod ends, at 2000 hours time in service (TIS) to prevent this fairly common failure.  Generally there are no warning signs before failure; this is one area where skimping on maintenance is a false economy.

NEW REPORTS THIS WEEK

There are no newly-posted piston Beechcraft preliminary reports this week.  This is only the third week this has occurred in the nearly nine years I’ve been posting the Weekly Accident Update.  (Even in the time immediately following September 11, 2001, when all airplanes in the U.S. were grounded, there were new reports of Beech piston mishaps in the U.S. and elsewhere).  Good job, Beech pilots!

NEW NTSB PRELIMINARY or FACTUAL REPORTS:  All previously reported in the Weekly Accident Update, and subject to change per NTSB findings.

** 3/2 “serious injuries” B36TC engine failure at Mammoth, CA.   “According to the pilot, three or four minutes after takeoff the engine started to lose power, but did not completely stop running. He therefore switched fuel tanks, checked the magnetos, activated the fuel boost pump, and switched to alternate inductions air. When none of these actions seemed to help, the pilot turned back toward the airport, but soon realized that he was not going to be able to get back. He therefore elected to execute a forced landing on snow-covered terrain. He ultimately touched down with the landing gear extended in about three feet of snow. The impact with the snow resulted in crushing damage to the belly of the aircraft.”  Change “Engine failure on takeoff” to “Engine failure in flight” and add “serious” injuries.

A reader submits unconfirmed information from a local source:  “A group of airplanes flew to KMMH together (not [in a] formation)…. They were getting ready to leave and were taxiing out. The discussion among the pilots on Unicom was about which way to return home. Apparently the original plan was to go over Mammoth Pass (over the Sierra Nevada) and then down the central valley. But the pilot of the yet-to-crash aircraft said that his engine had been running poorly and [he] didn't want to go that way, but preferred to go down the Owens Valley which he considered safer. It was unclear…whether or not the ‘running poorly’ included the trip up or only after start-up, but my impression is that it was the former.  The aircraft departed KMMH on runway 9 to the east and got over Crowley Lake (about 5 miles) when it had engine problems. The aircraft turned around and headed back toward runway 27, but didn't make it. The pilot put the landing gear down and landed in the snow short of the airport.”  The reader adds: “I don't vouch for its accuracy, except to give the [local] source.”

There’s no confirmation this report is true, but whether or not it is it raises the issue of flight with a known problem.  Pressures are great to “get home” when abnormal situations occur.  Logistics, maintenance and costs are all easier to handle when the airplane is at its home base.  The temptation can easily drive a “go” decision, even when the pilot consciously makes an accommodation for the known problem (in this account, rerouting over lower, “safer” terrain).   Engine abnormalities are grounds for immediate investigation, even if the location and logistics make investigation inconvenient or costly.  Certainly the “serious” injuries suffered by the passenger, “minor” injuries to the pilot and “substantial” aircraft damage are and will be more costly and inconvenient than having left the airplane in Mammoth that Sunday afternoon to be looked at later.

If you find yourself rationalizing a course of action (lower terrain because of engine abnormalities, scud running because of ice in low clouds, violating personal fatigue minimums tonight to avoid forecast adverse weather tomorrow, etc.), pause to consider whether the “accommodation” would have itself made sense from the standpoint of risk management had the reason driving the accommodation did not exist.  In other words, don’t accept high risk you would not otherwise consider, just because it’s an alternative to an even more hazardous flight.   

UPDATE

Regarding the 2/26/2008 propeller overspeed reported (and oft-commented upon) in the Weekly Accident Update:

The purpose of the WAU and the FLYING LESSONS that result is to highlight possibilities, so pilots may consider scenarios, options and outcomes before they might encounter similar situations in flight.  The lessons discussed from the propeller overspeed report are all useful and valid.  We’re uniquely fortunate that a pilot who was on board the A36 that led to this discussion called me and now provides a first-person account of the event…and it was truly unusual, with yet more great FLYING LESSONS.  Here’s his report:

The caller is a long-time owner of the Bonanza, with about 1700 hours total flying time.  He was in the right seat; a 400-hour pilot (who was just becoming a partner in the airplane) was in the left seat acting as PIC.  They had just picked up the A36 following a propeller overhaul.

Before starting home, the pair seemingly did everything right.  First, they started the engine, ran it up, checked propeller operation, then shut down and had the shop look for leaks.  All was fine.  Next, the pilots conducted a high-speed taxi test, checking higher power operation, and again the airplane passed all checks and a post-test leak check.  Then, they made a short test flight, circling over the airport, followed by landing and another leak check—the propeller was seemingly perfect.  (Sounds a lot like the FLYING LESSONS suggestions prompted when this incident was first reported--tt).

Satisfied, the pair took off toward their home.  But in cruise flight the propeller “suddenly surged” to between 2800 and 3000 rpm.  The pilot brought the propeller control back right away and the prop speed fell below redline.  Oil pressure was normal.  Cautiously re-advancing the propeller control, all seemed normal for a while.  The caller later self-critiqued that the only thing they should have done differently was to immediately divert for landing at this point.

But before long the prop went into overspeed again.  The caller remembers advising the PIC to immediately declare an emergency (they were operating IFR), and they told ATC they were headed for nearby Athens, Georgia.  Reducing power didn’t fix things this time; the propeller was “running away” and exceeded redline any time the throttle was “cracked” open anything above full idle. 

Sharing duties, the two pilots continued toward Athens while working with ATC—controllers reported the airport was six miles away as the airplane passed through 3500 feet.  With the propeller running near redline even with the throttle completely closed, however, glide performance was significantly worse than reported in the Pilot’s Operating Handbook (where glide performance is predicated on the propeller being in the low-drag, lowest rpm position).  Opening the throttle just slightly put the prop into overspeed and made things worse.  The pilots knew they could not make it to the airport. 

Between them and Athens was “nothing but trees”…except for a small pasture.  The pilot adroitly touched down on the only available landing spot.   The ground was soft and the nosewheel collapsed (initial reports that the airplane had “run into a ditch” are incorrect).  No one was hurt but the airplane suffered “substantial” damage and the owner’s insurance company has already “totaled” the airplane.

Propeller overspeeds are almost always a symptom of an oil delivery problem—low oil pressure drives the pitch mechanism into high rpm and, without normal internal resistance, beyond its redline.  In this event, however, the caller reports oil pressure was normal throughout the entire time, right up to landing.   Initial investigation shows there was oil in the propeller dome, and the caller suggests there may have been a mechanical problem with the propeller that developed during overhaul. 

Even when the pilot does everything right, there’s always the chance of mechanical failure.  When that occurs survival depends on:

• Polished stick-and-rudder skills, to fly under control all the way through landing with whatever capability remains.

• Systems knowledge, to troubleshoot failures and restore function, if possible.

• Division of attention between handling the failure and flying the airplane, to fully manage the emergency.

• Use of resources, in the cockpit and out, for information and workload reduction.

• Judgment, including careful observation of actual performance that at times may not be nearly as good as the POH suggests, and decisive action when the original goal proves out of reach.

• Willingness to divert and land at the first sign of a vital systems problem—an even more difficult decision when an indication appears but then goes away.

• Sound safety practices observed on every flight, including use of seat belts and shoulder harnesses and securing baggage to prevent injury in the unlikely event of an off-airport landing, because you likely won’t have time to reconfigure the cabin or buckle shoulder harnesses if an emergency occurs.

Thanks, caller, for your account, and what you’ve taught us.  I hope you’re flying again soon, and will become an avid reader of FLYING LESSONS.

NEW REPORTS THIS WEEK

3/14 1700Z (1000 local):  A Be23 “crashed during [a] landing attempt in strong, gusty winds,” at Marble Canyon, Arizona.  Four aboard avoided injury despite “substantial” aircraft damage.  Weather was “VFR”, with winds from 310˚ at 12 gusting to 22 knots.  N9374S (M-1672) is a 1975 C23 registered since 1997 to a corporation in Phoenix, Arizona.

(“Loss of control on landing—strong, gusty winds”; “Substantial damage”; “Wind >15 knots”—The Marble Canyon airport hosts a single Runway 3/21, 3700ft long x 35ft wide.  The strong, gusty wind was almost directly across the narrow runway.  With four aboard this class of airplane, it’s a valid assumption this was a pleasure trip.  But business or pleasure, no airplane is capable of flying in all weather conditions; faced with challenges we must assess the combination of the wind, the runway, the airplane’s capability and our own piloting prowess—and when conditions are too challenging, it’s up to us to be wise enough to choose against making the attempt.)

3/15 2324Z (1624 local):  A Be33 “landed long and rolled off the end of Runway 33,” at Aspen-Pitkin County Airport, Aspen, Colorado.  There were “no injuries reported to the five” persons on board.  The extent of damage is “unknown” and weather data were not reported.  N233LH (CE-550) is/was a 1974 F33A, “registration pending” to an individual in Kansas City, Kansas.

(“Landed long”; “Recent registration”—Airspeed control is a common issue with pilots, especially when new to an aircraft.  Most tend to land far faster than optimum.  At high density altitudes, even proper speed control results in higher true airspeeds because of the thinner air…and consequently, greater distance covered in the landing flare and a longer rollout.  If the pilot is not precise with airspeed control, but instead lands even a little faster than “book”, then flare and landing distances will be even greater.  A possible complicating factor is the number of people on board—the report does not indicate whether any were children or if the airplane was within c.g. limits.  Even if it was within center of gravity limits, however, the c.g. would have been far aft with such a passenger (and likely, baggage) load.  One technique for countering the resulting instability is to carry additional speed on final for greater airflow over control surfaces, and therefore greater control effectiveness.  That works if the pilot plans carefully to land in the touchdown zone, but if combined with landing long it can be disastrous.)

3/16 1923Z (1523 local):  A Be76 was “unable to extend [its] landing gear” and landed gear up, at Lexington, Kentucky’s Blue Grass Airport.  The solo pilot reports no injury; damage is “unknown”.  Weather: 4000 overcast, visibility 10 with surface winds at four knots.  N17AT (ME-51) is a 1978 Duchess recently (September 2007) registered to an individual in Frankfort, Kentucky.

(“Gear up landing—known mechanical system failure” [assumed given the FAA’s preliminary report]; “Recent registration”)

3/16 2010Z (1510 local):  A Be36’s landing gear collapsed on rollout at McPherson, Kansas.  The three aboard were not injured; damage is “unknown” and weather was “VFR”.  N6690Y (E-1627) is a 1979 A36 registered since 2004 to a corporation based in McPherson.

(“Gear collapse on landing”)

3/16 2150Z (1650 local):  A Be24 landed gear up at Charles Baker Airport, Millington, Tennessee, resulting in “minor” damage and no injury to the two aboard the Sierra.  Weather was “VFR”.  N757AP (MC-122) is a 1972 A24R registered since 1992 to an individual in Memphis, Tennessee.

(“Gear up landing”—that’s a mechanical gear failure, a gear collapse and a gear up landing in under two and a half hours)

NEW NTSB PRELIMINARY or FACTUAL REPORTS:  All previously reported in the Weekly Accident Update, and subject to change per NTSB findings.

** There are no newly posted piston Beech NTSB reports this week**

NEW REPORTS THIS WEEK

1/16 (time not reported):  Two occupants of a Be58 avoided injury, and aircraft damage appears to meet the definition of “minor”, during a landing mishap at Hereford, Texas.  According to the NTSB the pilot “was on a visual approach to Runway 3 with winds reported to be [from] 360 degrees at 25 knots gusting to 32 knots. The pilot stated that the approach seemed normal using 15 degrees of flaps and a little more power due to the winds. When the pilot began his flare a ‘tremendous gust of wind caught under the left wing’ causing the right wing to drag the pavement. This produced a slight nose down attitude and a right turn. The airplane departed the runway and the pilot was able to regain control. The airplane right wing, right engine prop and landing gear main struts were damaged.”  N42SM (TJ-109) is a 1977 58P registered since 1995 to a Mt. Pleasant, Texas corporation.

(“Loss of control on landing—strong/gusty winds”; “Wind”—this is the latest of several recent landings-gone-bad in strong or gusty surface winds.  As winds gust they also tend to shift in direction toward the area of lower air pressure.  In this northern hemisphere this means a shift to the wind’s own left; for my southern hemisphere readers this indicates a shift to the right.  The stronger the wind gust, typically, the bigger the change in wind direction during the gust—the shift can be as much as 30 degrees.  In the case of this particular mishap that means the strong wind about 30° off runway heading would in the gusts not only increase by seven knots, but also come from a greater crosswind angle.  Using an online crosswind calculator, the crosswind component varied from 22 knots [winds 360@25] to as much as 32 knots [330@32].  Failing to anticipate and correct for the increase in left crosswind, the pilot let the airplane’s right wing strike the pavement.  Luckily the pilot was able to recover without injury or greater damage.  When evaluating crosswind components for takeoff or landing, include the variation in wind direction as well as speed in wind gusts.  Remember you have the option of delaying your flight or landing on a runway better suited to conditions.)

3/21 2020Z (1620 local):  Two aboard a Be76 died during an instructional flight at Rome, Georgia.  The Duchess burned and was “destroyed”.  The airplane “crashed on departure.”  Weather was “clear and 10” with winds from 170˚ at seven knots.  N184AA (ME-400) was a Model 76 Duchess, year not reported, registered since 1996 to a corporation in Atlanta, Georgia.

(“Loss of control—single engine visual approach” [either actual or simulated, based on news reports]; “Fatal”; “Aircraft destroyed”; “Dual instruction”—an online news report quotes the Rome airport manager as saying: "I saw them nose down and try to come back to the runway and it came straight down into the trees."  Another report contains pictures of the wreckage.  It appears the Duchess impacted flat, with little forward motion at touchdown; the horizontal T-tail may be slightly twisted relative to the longitudinal axis of the airplane, suggesting spin-like rotation on impact.  This would be consistent with loss of control following an actual or simulated engine failure.  Yet another account  confirms it was an instructional flight.  Internet chat room discussions provide unverified discussion that the airplane departed Rome’s Runway 19 [consistent with reported surface winds] and crashed attempting a return to land on Runway 25.  If true this is indicative of a possible engine failure, whether actual or simulated, and a too-rapid attempt to return to the airport.  We’re taught that when faced with an engine failure in a multiengine airplane we should land at the nearest available runway.  The very minimal single-engine performance of most light twins, however, permits only a very slight climb straight ahead at blue line airspeed.  Any turn at all degrades performance and will usually turn a blue-line climb into a slight rate of descent.  Temptation then will be to resist the descent with up elevator, slowing the airplane further and degrading performance even more.   Without strict discipline to maintain airspeed throughout all maneuvers, attempting to turn back to the airport too soon can quickly degenerate into a descent into the ground, or a reduction in airspeed that leads to a stall or a V_MC  loss of control.  In most cases, engine failure on takeoff should be met with a climb straight ahead until reaching pattern altitude, where the airplane may be leveled and accelerate to a speed where it can maintain altitude in a half-standard-rate turn back to the departure airport.  In many cases it may be prudent to continue straight ahead to a more suitable airport for single-engine recovery.  For much more on decision-making after dealing with an engine failure, see my article “Identify, Verify, Feather—Now What?”, published in the March 2007 issue of Twin and Turbine magazine.    

NEW NTSB PRELIMINARY or FACTUAL REPORTS:  All previously reported in the Weekly Accident Update, and subject to change per NTSB findings.

**1/16 58P loss of control landing in gusty winds at Hereford, Texas, cited above.**

**2/10 Beech 23 loss of control on landing in a gusty crosswind at Pineland, Florida.  Add “Substantial damage” (one wing separated from the aircraft).**

**2/20 A36 off-airport landing near Pahokee, Florida.  “According to the pilot, the flight originally departed from North Palm Beach County Airport (F45), West Palm Beach, Florida. He performed a preflight inspection prior to departure from F45, and noticed no anomalies. Shortly after takeoff, the airplane's engine began to ‘surge.’ The pilot reported the engine ‘surging’ to air traffic control (ATC), and the controller informed him that he was 7 miles from PHK. The pilot was able to maintain altitude, and landed uneventfully at PHK.

”After landing, the pilot examined the engine, and checked the fuel system for leaks or contamination. He observed no anomalies and decided to depart again, after performing a run-up inspection. After departure from PHK, the pilot attempted to retract the landing gear, but the gear would not retract. He attempted to recycle the landing gear, but was again unsuccessful in retracting it, and decided to return to F45…. When the airplane was about 9 miles from PHK and an altitude of about 2,000 feet, the engine started to lose power, and the pilot prepared for a forced landing. He observed a paved road, but decided to land in a sugar cane field parallel to the road. During the landing, the landing gear ‘dug in’ and the airplane rotated onto its nose.”  Change “Crash/unknown” to “Engine failure in flight”; add “Substantial damage” and change “Weather unknown” to “VMC”.  There’s no indication why the landing gear would not retract for the pilot**.

**2/21 double-fatality A36 crash on approach into Cumberland, Maryland.”  Other arriving pilots were quoted at the time of the crash as suspecting airframe ice accumulation during the short duration the Bonanza was in the clouds on the approach, but ice is not specifically mentioned in the NTSB preliminary report**

SUMMARY: Reported Hawker Beechcraft piston mishaps, year-to-date 2008:

Total reported:  42 reports 

Operation in VMC: 28 reports  

Operation in IMC:    1 report  

Weather “unknown” or “not reported”:  13 reports

Operation at night:  8 reports 

Surface wind > 15 knots:  4 reports           

Fatal accidents: 6 reports  

“Serious” injury accidents (not involving fatalities): 1 report 

“Substantial” damage: 11 reports  

Aircraft “destroyed”:   5 reports   

Recent registration (within previous 12 months):  7 reports  

(Note: FAA preliminary reports no longer identify the purpose of the flight involved in mishap.  Consequently the number and percentage of Beech mishaps that occur during dual instruction will become less and less accurate over time.  Since the late 1990s the percentage of Beech mishaps that take place during dual flight instruction has remained very consistently about 10%). 

By Aircraft Type:

Be36 Bonanza  7 reports  

Be76 Duchess  7 reports  

Be58 Baron  6 reports   

Be33 Debonair/Bonanza  5 reports  

Be35 Bonanza  4 reports  

Be23 Musketeer/Sundowner  2 reports 

Be24 Sierra   2 reports 

Be50 Twin Bonanza  2 reports 

Be55 Baron  2 reports  

Be45 (T-34) Mentor  1 report   

Be60 Duke  1 report 

Be65 Queen Air  1 report 

Be77 Skipper  1 report  

Be95 Travel Air   1 report  

PRELIMINARY DETERMINATION OF CAUSE (all subject to update per NTSB findings):

LANDING GEAR-RELATED MISHAPS (20 reports) 

Gear up landing

7 reports (Be24; two Be33s; Be35; Be50; Be58; Be76)

Gear collapse (landing)

5 reports (Be36; Be50; Be58; Be60; Be95)

Gear up landing—known mechanical system failure

3 reports (Be35; Be45; Be76)

Failure of nose gear to extend due to mechanical failure

2 reports (Be65, Be76)

Gear collapse on landing—known mechanical system failure

1 report (Be55)

Gear collapse—pilot activation of gear on ground

1 report (Be33)

Gear collapse on landing: electrical failure/incomplete manual extension

1 report (Be45)

...for more on Landing Gear-Related Mishaps see these data and this commentary. 

IMPACT ON LANDING  (9 reports) 

Loss of directional control on landing

2 reports (Be23; Be77)

Loss of control on landing—strong, gusty winds

2 reports (Be23; Be58)

Hard landing

1 report (Be35)

Wing strike on landing

1 report (Be58)

Hard landing—strong, gusty wind

1 report (Be36)

Impact with animal while landing

1 report (Be76)

Landed long

1 report (Be33)

ENGINE FAILURE   (5 reports) 

Engine failure in flight

3 reports (Be35; two Be36s)

Partial power loss: fuel line leak

1 report (Be36)

Propeller overspeed

1 report (Be36)

MISCELLANEOUS CAUSES  (3 reports) 

Pilot incapacitation—heart attack

1 report (Be58)

Bird strike on landing

1 report (Be33)

Taxied into obstruction

1 report (Be76)

LOSS OF CONTROL IN FLIGHT   (3 reports) 

Loss of control—single engine visual approach

3 reports (Be55; Be58; Be76)

CAUSE UNKNOWN  (1 report)  

Approach/Unknown

1 report (Be36)

IMPACT WITH OBJECT DURING TAKEOFF   (1 report) 

Loss of directional control during takeoff

1 report (Be76)

IN-FLIGHT CONTROL VIBRATION/ FLUTTER/ AIRFRAME SEPARATION  (1 report)  

In-flight break-up—probable pilot incapacitation

1 report (Be35)

Recognize an N-number?  Want to check on friends or family that may have been involved in a cited mishap?  Click here to find the registered owner.   

Please accept my sincere personal condolences if you or anyone you know was involved in a mishap.  I welcome your comments, suggestions and criticisms.  Fly safe, and have fun!

Thomas P. Turner, M.S. Aviation Safety, Master CFI

2008 FAA Central Region CFI of the Year

Mastery Flight Training, Inc.

mastery.flight.training@cox.net

There's much more aviation safety information at www.thomaspturner.net.

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