Pilot Debrief

Cessna 152 near St. Augustine, FL — 2018-09-08

Final reportERA18LA259
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Date
2018-09-08
Location
St. Augustine, FL, USA
Aircraft
Cessna 152
Registration
N6469P
Category
Airplane
Highest injury
None
Fatalities
0
Phase of flight
Climb

Probable cause

The partial loss of engine power due to a fractured exhaust valve, which resulted in a forced landing on unsuitable terrain and a subsequent rollover.

NTSB narrative

The private pilot was conducting a personal, cross-country flight. He reported that, when the airplane was about 12 miles from the departure airport, the engine started running roughly, and the airplane was "violently shaking." He decided to conduct a forced landing in a field, during which the nose landing gear dug into the soft ground, and the airplane flipped over. Postaccident examination of the engine revealed that the No. 4 cylinder exhaust valve was fractured, and although the head of the exhaust valve was not recovered, the fracture features on the exhaust valve stem were consistent with fatigue. A review of maintenance records revealed that the exhaust valves were installed during an overhaul of the engine about 28 years before the accident. The engine manufacturer recommended that the engine be overhauled every 12 years or 2,400 hours, whichever comes first.

Analysis

Primary failure mode
Mechanical failure
First missed decision gate
Pilot could have opted for an earlier landing instead of continuing flight after engine issues.

NTSB coding

Evidence available

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

Docket documents6

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