TUCSON, AZ, USA
N2847F
Piper PA-28R-201T
At 300 feet agl in the takeoff initial climb the engine ran roughly for a moment, then smoothed out for a short time at a low power output. The pilot stated that the engine power was insufficient for flight, and, he did not feel that he had sufficient altitude or vehicle energy to return to the runway. The pilot therefore elected to land on a dirt road. The right wing contacted trees during the landing rollout. An engine overhaul was completed on April 3, 1997, and it was reinstalled on the airframe on April 17th, 2 hours prior to the accident. The overhaul facility performed work on only the core engine. The operator's maintenance facility reinstalled all accessories, including all fuel system components, on the engine prior to installing it on the airframe. External visual examination of the engine noted blistered, missing, and discolored paint on the No. 2 cylinder, which had no compression. No valve lash was observed at the No. 2 cylinder intake valve, and air leakage was noted from that area. Exhaust gas residue was noted in all intake tubes during their removal from the engine. The No. 2 cylinder bottom spark plug electrode was damaged, with deposits of what appeared to be molten metal particles. The plugs for cylinders 1, 3, and 4 exhibited sooting. All fuel injection nozzles, including the No. 2 cylinder, were unobstructed. Bench flow tests confirmed normal postaccident flows for the distributor, nozzles, and lines. The No. 2 cylinder was removed from the engine. The piston and combustion chamber were burned. The intake valve stem and back face were burned, and the head was distorted into a tulip configuration. The valve length was stretched. No other internal abnormalities were noted with the engine.
On April 18, 1997, at 1306 mountain standard time, a Piper PA-28R-201T, N2847F, collided with trees during a forced landing near the Ryan airport, Tucson, Arizona. The forced landing was precipitated by a loss of engine power during the takeoff initial climb from runway 6R at Ryan airport. The aircraft was operated by Chandler Air Service of Chandler, Arizona, and was rented by the pilot for the personal cross-country flight. Visual meteorological conditions prevailed at the time and no flight plan was filed for the operation. The aircraft sustained substantial damage. The certificated commercial pilot and his one passenger were not injured. The flight was originating as a return to Chandler. In his written statement, the pilot reported that he had initial difficulty starting the engine, but following use of a ground power unit the engine started. All ground taxi and run-up operations appeared to be normal. At 300 feet agl in the takeoff initial climb the engine ran roughly for a moment, then smoothed out for a short time at what the pilot believed was a lower power output. The pilot stated that the engine power was insufficient for flight, and, he did not feel that he had sufficient altitude or vehicle energy to return to the runway. The pilot therefore elected to land on a dirt road. The right wing contacted trees during the landing rollout. An initial review of the maintenance records disclosed that the Lycoming IO-360-C1C6 engine, serial number L-18733-51A, completed an overhaul on April 3, 1997, and was reinstalled on the airframe on April 17, 2 hours prior to the accident. The records established that the overhaul facility performed work on only the core engine. The operator's maintenance facility reinstalled all accessories, including all fuel system components, on the engine prior to installing it on the airframe. Pertinent portions of the maintenance records are attached. Following recovery of the aircraft to a storage facility in Phoenix, the engine was examined by the Safety Board with the assistance of a technical representative from Textron Lycoming engines. External visual examination of the engine noted blistered, missing, and discolored paint on the No. 2 cylinder. Rotation of the crankshaft verified accessory gear and valve train continuity, with compression noted in all but the No. 2 cylinder. Magneto to engine timing was found to be within published Lycoming limits. No valve lash was observed at the No. 2 cylinder intake valve, and air leakage was noted from that area. No dry tappet clearance was noted on this valve. Exhaust gas residue was noted in all intake tubes during their removal from the engine. The No. 2 cylinder bottom spark plug electrode was damaged, with deposits of what appeared to be molten metal particles. The plugs for cylinders 1, 3, and 4 exhibited sooting. All fuel injection nozzles, including the No. 2 cylinder, were unobstructed. The fuel injection line from the distributor to the No. 2 nozzle was observed to be bent at the nozzle end beyond the minimum bend radius specified by Lycoming, and a slight crimp was noted in the bend area. The No. 2 cylinder was removed from the engine. The piston and combustion chamber were burned. The intake valve stem and back face were burned, and the head was distorted into a tulip configuration. The valve length was stretched. The fuel nozzle and associated line from the No. 2 cylinder were taken to a Bendix authorized repair station for a flow test in accordance with the procedures specified in the appropriate Bendix overhaul/repair manual. The components flowed with specified limits. The fuel distributor was subsequently flow tested and functioned within specifications.
The partial blockage of the No. 2 cylinder injection line/nozzle by a transient contaminant, which induced an excessively lean mixture in that cylinder, and the subsequent overheating of the cylinder and intake valve. The engine power loss was due to the open intake valve allowing hot exhaust gasses into the induction system. The contamination was due to inadequate installation/inspection procedures used by the operator's maintenance organization when the fuel system was reinstalled on the engine following the overhaul.
Source: NTSB Aviation Accident Database
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