Pilot Debrief

PIPER PA-28-161 near Chandler, AZ — 2010-05-26

Final reportWPR10FA264
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Date
2010-05-26
Location
Chandler, AZ, USA
Airport
CHD
Aircraft
PIPER PA-28-161
Registration
N4122T
Category
Airplane
Highest injury
Serious
Fatalities
0
Phase of flight
Initial climb

Probable cause

Failure of the maintenance personnel to ensure adequate torque of a fuel line fitting, which resulted in an in-flight fire.

NTSB narrative

The certificated flight instructor (CFI) and private pilot were performing touch-and-go practice takeoff and landings. When the airplane was turning to the crosswind leg of the traffic pattern they began to see smoke in the cockpit, which was likely coming through the defroster vents. With the airplane about 1,600 feet mean sea level, the CFI assumed authority of the controls and declared an emergency to the tower air traffic controller. Within several seconds the smoke became thick in the cabin, and the CFI banked the airplane right with the intent of landing on the closet runway. The smoke in the cockpit became so thick that the CFI lost visual reference outside. He flared the airplane and it touched down hard. After the airplane came to a stop, the CFI and the private pilot exited. A review of the airplane maintenance logbooks revealed that the last annual inspection was completed 2 days prior to the accident. According to the records, the airplane had accrued approximately 4 additional flight hours since that inspection. An examination of the firewall revealed that its left side had a white coloration which turned to a black soot color on the right side, consistent with the fire originating on the left side of the engine. The fuel line leading from the engine driven fuel pump to the carburetor was found disconnected at the fuel pump. There was no visible impact damage to the “B” nut on the line or to the fitting on the fuel pump, indicating the line was not connected at the time of impact. Based on this evidence, it is likely that the “B” nut on the line was not properly tightened, which allowed it to back off due to normal engine vibration, resulting in the line disconnecting during the flight. Pressurized fuel from the fuel pump then sprayed onto the left side of the exhaust system and ignited. The engine manufacturer recommended that the fuel line “B” nut torque should be 35 in-lbs.

Analysis

Primary failure mode
Mechanical failure
First missed decision gate
Private pilot could have ensured fuel selector was accessible before takeoff.

NTSB coding

Evidence available

  • 13 docket documents
View NTSB final reportView NTSB docket

Docket documents13

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