Pilot Debrief

Piper PA28 near Bridgeport, TX — 2020-07-02

Final reportCEN20LA258
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Date
2020-07-02
Location
Bridgeport, TX, USA
Airport
XBP
Aircraft
Piper PA28
Registration
N6530W
Category
Airplane
Highest injury
None
Fatalities
0
Phase of flight
Initial climb

Probable cause

Maintenance personnel’s inadequate inspection, which resulted in a total loss of engine power due to a restricted air intake-induction system.

NTSB narrative

The pilot reported the engine seemed to lose power shortly after takeoff. His attempts to restore engine power were not successful, and he executed a forced landing. A postaccident engine examination revealed evidence of an insect (mud dauber) nest within the carburetor heat induction system. The pilot purchased the airplane 2 days before the accident. Airplane maintenance records indicated that an annual inspection was completed on the day the airplane was sold to the accident pilot. The records also indicated the airplane had not been flown between the annual inspection in 2017 and the most recent inspection 2 days before the accident. Furthermore, the markings on the oil filter suggested that the oil was not changed during the most recent annual inspection. The airplane was operated 1.16 hours since that most recent inspection. The insect nest in the carburetor heat system likely became dislodged during airplane operation and subsequently restricted air flow to the carburetor resulting in a loss of engine power. The location of the insect nest was not in an area visible to the pilot during a preflight inspection. However, the presence of the nest could have been detected during a thorough and complete annual maintenance inspection. In addition, the failure of the mechanic to change the engine oil and filter during the most recent annual inspection suggested that the inspection was less than thorough and complete. Although there was a slight possibility of carburetor icing at glide and cruise power, it is unlikely to have been the cause of the power loss since the loss of engine power occurred shortly after takeoff.

Analysis

Primary failure mode
Engine power loss
First missed decision gate
Pilot could have checked for carburetor icing before takeoff.

NTSB coding

Evidence available

  • Photos
  • 6 docket documents
View NTSB final reportView NTSB docket

Docket documents6

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