Pilot Debrief

PIPER PA28 near Port Jefferson, NY — 2016-02-21

Final reportERA16LA109
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Date
2016-02-21
Location
Port Jefferson, NY, USA
Aircraft
PIPER PA28
Registration
N29099
Category
Airplane
Highest injury
Fatal
Fatalities
1
Phase of flight
Cruise

Probable cause

The flight instructor's inadequate preflight fuel planning, which resulted in a total loss of engine power due to fuel exhaustion.

NTSB narrative

The student pilot and flight instructor were conducting an instructional cross-country flight with two passengers on board. They were returning to their home airport at night; the flight instructor estimated that there was a headwind of 30-40 knots and the airplane's groundspeed was about 81 knots during the cruise portion of the flight. Just before crossing a large ocean inlet, the flight instructor suggested that they divert for fuel on the other side of the inlet. Shortly thereafter, the engine "sputtered." The flight instructor then turned on the electric fuel pump and instructed the student pilot to switch the fuel selector to the left fuel tank and to maintain 2,000 ft msl. Once the fuel selector had been selected to the left fuel tank, the engine stopped sputtering. The flight instructor informed air traffic control that he wanted to divert to a nearby airport. They continued to fly for another 2-3 minutes when the engine sputtered again and lost total power. The instructor then took control of the airplane from the student pilot and advised the tower controller at the diversion airport that he was declaring an emergency. The flight instructor then made a 180° turn and headed for the shoreline. As the airplane descended, he was unable to see the shoreline due to the darkness and decided to ditch the airplane as close as he could to the beach. Upon touching down, the flight instructor opened the cabin door and instructed everyone to exit the airplane. The student pilot handed the instructor a life vest. The two passengers jumped into the water and started swimming for shore. Neither the student pilot nor the passengers were wearing life vests. About 3 minutes after the ditching, the airplane was located by a helicopter. The flight instructor, student, and one passenger were rescued. A search by the police department and the US Coast Guard could not locate the remaining passenger. About 2 months later, the missing passenger's body was discovered on a beach. The autopsy listed the cause of death as drowning. Postaccident examination of the wreckage revealed no evidence of any preimpact failure or malfunction of the engine or airplane that would have precluded normal operation. Examination of the fuel system revealed that the system was essentially devoid of fuel. The flight instructor estimated that 40 gallons of fuel were onboard before departure on the first leg of the flight; the student estimated 36 gallons were onboard. Before they departed from their home airport, the student pilot asked the flight instructor if he wanted to refuel, and the flight instructor advised him that they had plenty of fuel. The student again asked about refueling during the return flight, but the instructor stated the fuel looked good. There was no evidence that the flight instructor had obtained an official weather briefing before the initial or return leg of the flight. On the first leg of the flight, the instructor recognized that the winds aloft increased their groundspeed, allowing them to arrive at their destination sooner, but on the second leg of the flight, those same winds significantly increased their flying time. The instructor should have accounted for the effect of wind on the flight's duration. Review of the POH indicated that, at a 65% power setting, with full fuel tanks (48 gallons usable), endurance would be about 5.3 hours, and at a 65% power setting, with 40 gallons of fuel, endurance would be about 4.4 hours. Examination of aircraft rental and fueling records revealed that the airplane had been operated for 5.1 hours since it was last refueled. Thus it is likely that the flight instructor did not conduct adequate preflight fuel planning; had they done so and had they accounted for the wind, they would have recognized there was insufficient fuel to complete the flight and maintain the required 45 minutes of reserve fuel.

Analysis

Primary failure mode
Fuel management
First missed decision gate
Instructor should have refueled before departure from FIT.

NTSB coding

Evidence available

  • ADS-B / radar
  • Photos
  • 15 docket documents
View NTSB final reportView NTSB docket

Docket documents15

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