Aviation Accident Summaries

Aviation Accident Summary DEN07FA158

Erie, CO, USA

Aircraft #1

N616EV

Evektor-Aerotechnik a.s. SportStar

Analysis

The accident flight was the student pilot's first instructional flight towards a Light Sport Pilot certificate. He was receiving instruction from a commercial pilot with a flight instructor certificate (CFI). According to multiple witnesses, the airplane entered a spin while turning from the upwind leg to the crosswind leg following a touch-and-go landing. The airplane impacted terrain in a left wing down, nose low attitude. Postaccident examination of the airplane and its systems revealed no mechanical anomalies. The investigation disclosed that the airplane was over the certified gross weight at the time of departure for the accident flight. A review of the Aircraft Operating Instructions provided by the manufacturer, revealed insufficient data to accurately calculate the effects of density altitude on the performance of the airplane for takeoff and landing. The manual also lacked sufficient data to calculate the fuel burn of the airplane for any altitude higher than an international standard altitude of 2,000 feet. This additional information is not specified as a requirement by the current ASTM consensus standards. Density altitude at the time of the accident was calculated to be 7,800 feet. As no mechanical reason was discovered for the loss of control, it is likely the CFI allowed the airspeed to decay until an inadvertent stall occurred, and he was unable to recover prior to impact.

Factual Information

HISTORY OF FLIGHT On September 15, 2007, at 1343 mountain daylight time, an Evektor-Aerotechnik a.s. SportStar special light sport airplane (S-LSA), N616EV, owned and operated by SkyRaider Aviation, Inc., was substantially damaged when it impacted terrain at the Erie Municipal Airport (EIK), Erie, Colorado. Visual meteorological conditions prevailed at the time of the accident. The instructional flight was being conducted under the provisions of Title 14 Code of Federal Regulations Part 91 without a flight plan. The student pilot and commercial certificated flight instructor were fatally injured. The local flight departed at 1237. According to Global Positioning System (GPS) data recovered from the accident airplane, the airplane departed EIK at 1237:32 and proceeded as far north as Loveland, Colorado (37 miles north of EIK). The airplane climbed to a GPS altitude of 8,000 feet mean sea level (msl) and performed multiple course reversals. Towards the end of the flight the airplane proceeded south towards EIK. The altitude, airspeed, and flight path of the last two minutes of the flight are consistent with a touch and go landing on runway 15 at EIK. The last line of GPS data was recorded at 1342:53 at a ground speed of 3 miles per hour and an altitude of 5,220 feet msl. The Erie Police Department took witness statements from 9 individuals. The National Transportation Safety Board (Safety Board) Investigator in Charge (IIC) received 2 written statements and interviewed 3 witnesses. These witnesses were located to the east and west of the impact location along highway 7, and north of the impact location at EIK. According to these witnesses, the airplane was performing a touch-and-go landing on runway 15 (4,700 feet by 60 feet, concrete). The owner of SkyRaider Aviation observed the airplane touch down and initiate a takeoff roll and climb. He stated the airplane "looked normal" and he looked away. Several witnesses observed the airplane reverse course 180 degrees from a southerly heading to a northerly heading. The airplane nose pitched up and then dropped. The airplane spun to the ground, impacting in a slight nose low, right wing low attitude. PERSONNEL INFORMATION Certified Flight Instructor The flight instructor, age 41, held a commercial pilot certificate with an airplane single-engine land, airplane multiengine land, and instrument rating, last issued on January 3, 2006. He held a flight instructor certificate with airplane single-engine, multiengine, and instrument airplane privileges. He was issued a second class airman medical certificate on January 31, 2006. The certificate contained no limitations. A copy of the flight instructor's flight log was provided by the family. A review of the logbook indicated that he had logged no less than 418.3 hours total time; 330.9 hours in single-engine airplanes, 56.7 hours dual given, and 2.2 hours in the make and model of the accident airplane. The flight instructor's first flight in an Evektor SportStar was logged as a "dual given" flight on July 1, 2007; total flight time of 1.1 hours. He received an "LSA" checkout in the Evektor SportStar on July 23, 2007; total flight time of 1.1 hours. The flight included power off stalls, power on stalls, steep turns, and touch and goes. The flight instructor's logbook contained an endorsement with regard to him receiving "necessary instruction on spin entry and recovery" and he was found proficient on the "associated teaching methods." The endorsement was not dated. Student Pilot The student pilot, age 58, held a valid Wyoming drivers license with the restriction of "lenses." According to the SkyRaider Aviation - Member Information Sheet, filled out by the student pilot the day of the accident, he had not logged any flight experience in the previous 12 months. The student pilot was pursuing training for a Sport Pilot Certificate and was not required to apply for or hold a medical certificate; the only requirement was to hold a valid driver's license. This was the student's first training flight and he did not hold or maintain a formal pilot flight logbook. AIRCRAFT INFORMATION The accident airplane, an Evektor-Aerotechnik SportStar S-LSA (serial number 20060709), was manufactured in 2006 in the Czech Republic. It was registered with the Federal Aviation Administration on a special airworthiness certificate for light sport operations on December 19, 2006. The airplane was powered by a ROTAX 912ULS engine rated for 100 horsepower at 5,500 rpm. The engine was equipped with a 3-blade, Woodcomp Klassic 170/3/R propeller. The airplane was registered to and operated by SkyRaider Aviation, Inc., of Erie, Colorado, and was maintained in accordance with the Evektor Periodical inspection checklist. SkyRaider Aviation was the sole owner of the airplane. A review of the maintenance records indicated that an "annual inspection" had been completed on September 7, 2007, by VectorAir Aircraft Inspection and Repair of Erie, Colorado, "in accordance with FAR 43 appendix D and Evektor Periodical inspection checklist," at an airframe total time of 587.1 hours. The airplane had flown approximately 20.2 hours since the last inspection and had accumulated a total airframe time of 607.3 hours. Prior to the annual inspection, a 100 hour inspection was performed on July 20, 2007, at an airframe total time of 486.3 hours. The last 50 hour inspection was performed on March 9, 2007, at an airframe total time of 150.9 hours. According to the Aircraft Maintenance and Inspection Procedures Manual for the SportStar, "the manufacturer recommends maintenance checks and periodic inspections after every 50 hours (plus or minus 3 flight hours) and after every 100 hours (plus or minus 5 hours or annual inspection.)" According to a pilot who flew the accident airplane the day of the accident, he "inadvertently activated the elevator trim with [his] thumb." He stated that the airplane went into "an immediate violent abrupt climb attitude." He stated that the attitude was corrected and the flight continued without further incident. METEOROLOGICAL INFORMATION The closest official weather observation station was Rocky Mountain Metropolitan Airport (BJC), Denver, Colorado, located 7 nautical miles (nm) southwest of the accident site. The elevation of the weather observation station was 5,673 feet msl. The routine aviation weather report (METAR) for BJC, issued at 1345 reported winds, 120 degrees at 10 knots; visibility, 40 miles; sky condition, scattered 6,000 feet, towering cumulonimbus, broken 20,000 feet; temperature 30 degrees Celsius (C); dewpoint, 4 degrees C; altimeter, 30.14 inches. Density altitude at the time of the accident was calculated to be 7,800 feet. AIRPORT INFORMATION EIK, is a public, uncontrolled airport (Class G) located 3 miles south of Erie, Colorado, at 40 degrees, 0 minutes, 36 seconds north latitude and 105 degrees, 2 minutes, 52.7 seconds west longitude, at a surveyed elevation of 5,130 feet. Class E airspace begins at 700 feet agl and continues to an altitude of 10,000 feet msl at which point Class B airspace begins. The floor of the Class B airspace drops to 8,000 feet just south of EIK. The airport had one open runway, runway 15/33 (4,700 feet by 60 feet, concrete). FLIGHT RECORDERS A Garmin 296 GPS receiver was mounted on the instrument panel of the accident airplane. The GPS was removed from the airplane by the Safety Board IIC and sent to the Safety Board vehicle recorders division in Washington D.C. for data extraction. Recorded tracklog data was recovered corresponding to four flights on the date of the accident. The duration of the first flight was 39 minutes; the second flight, 24 minutes; the third flight, 25 minutes. The accident flight duration was recorded at 1 hour and 5 minutes. WRECKAGE AND IMPACT INFORMATION The accident site was located in sparsely vegetated, up sloping terrain. The accident site was at an elevation of 5,160 feet msl and the airplane impacted on a magnetic heading of 350 degrees. The main wreckage came to rest upright, approximately 300 yards southwest of the departure end of runway 15. The wreckage was confined to the impact area and consisted of the left and right wings, the empennage, fuselage, and engine/propeller assembly. No ground scaring or debris preceded the main wreckage. Both main landing gear assemblies and the nosewheel were crushed up and aft. The left wing, to include the left aileron and flap, remained attached to the fuselage at the wing root. The wing exhibited a diagonal wrinkle at midspan and leading edge crushing. Due to impact damage, aileron continuity could not be confirmed. The left wing flap was observed in the retracted position. Fuel was observed in the left wing tank. The right wing, to include the right aileron and flap, remained attached to the fuselage at the wing root. The wing was buckled at midspan and exhibited diagonal leading edge crushing along the entire span of the wing. Due to impact damage, aileron continuity could not be confirmed. The wing flap was observed in the retracted position. The right fuel tank was compromised and no fuel was observed inside. The ground directly beneath the wing was wet with fluid consistent in smell with fuel. The fuselage, to include the cabin, instrument panel, and engine assembly exhibited aft accordion crushing from the firewall aft to the wing roots. The upper skin, just aft of the baggage compartment, was torn along the circumference of the upper fuselage. The engine cowling was crushed up and aft and had separated partially from the engine. All three propeller blades separated from the engine at the propeller hub. The throttle control was full forward in a position consistent with full power. All engine instruments displayed a zero indication. The airplane's cabin instruments displayed the following indications: Airspeed - zero Altimeter - 5,280 feet Kollsman Window - 30.10 Turn and Bank Indicator - right bank at 90 degrees Attitude Indicator - inverted Vertical Speed Indicator - 500 foot per minute descent rate The empennage, to include the horizontal stabilizer, vertical stabilizer, rudder, and elevator, was unremarkable. The elevator control tube was continuous from the baggage compartment aft to the control surface. Elevator movement was free and correct. Rudder cables were continuous from the baggage compartment aft to the control surface. Due to impact damage, movement of the rudder could not be confirmed. MEDICAL AND PATHOLOGICAL INFORMATION Autopsies were performed on the flight instructor and student pilot by the Office of the Medical Examiner - Weld County, Colorado, on September 15, 2007, as authorized by the Weld County coroner. The autopsies revealed the cause of death on both occupants as "multiple trauma." During the autopsy, specimens were collected for toxicological testing to be performed by the FAA's Civil Aerospace Medical Institute, Oklahoma City, Oklahoma (CAMI Reference number 200100221001 and 200700221002; flight instructor and student respectively). The flight instructor's results were negative for carbon monoxide, cyanide, ethanol, and drugs. The student's results for carbon monoxide, cyanide, and ethanol were negative. Metoprolol, 0.508 ug/mL of Tramadol (trade name Ultram), 0.056 ug/ml diphenhydramine (trade name Benadryl), and ranitidine were detected in the blood. Metoprolol, diphenhydramine, tramadol, and ranitidine were present in the urine. TESTS AND RESEARCH The wreckage was retained and relocated to a hangar in Greeley, Colorado, for further examination. Representatives from the Safety Board and ROTAX Flying and Safety Club (powerplant representative) examined the airframe and engine on August 21, 2007. Examination of the engine revealed no preimpact anomalies that would have precluded the engine from operating normally. Aileron and rudder control continuity were confirmed. The elevator trim was measured to be 1 degree and 2 degrees down (left and right side respectively). The elevator trim motor was removed and measured at 0.44 inches (0.64 inches full travel). This position is consistent with a slight nose down trim. Approximately 2 gallons of fuel was recovered from the left tank after the airplane was transported. ADDITIONAL INFORMATION SkyRaider Aviation According to their website, SkyRaider Aviation is a "commercial" flying club that focuses on Sport Pilots and Light Sport Aircraft. The club started operations in November of 2006. Airplanes available for rental and training include the Gobosh G700 and the Evektor SportStar. The president of the club stated that the flight instructors are "freelance instructors." The club agreed to hold a safety meeting with their members, conducted by one of their flight instructors, in March of 2008 to discuss weight and balance calculations for their entire fleet. Weight and Balance According to the most recent weight and balance record for the accident airplane, dated September 20, 2006, the empty weight was 736.875 pounds. The combined weight of the flight instructor and passenger, as determined during postmortem examination, was 435 pounds. There was approximately 5 pounds of baggage in the airplane. According to a fuel receipt, the accident airplane was fueled with 10 gallons prior to the accident flight. The individual who fueled the airplane could not recall how much fuel was in the airplane prior to the fueling. The maximum fuel capacity of both fuel tanks is 31.7 gallons. This equated to a total weight of no less than 1,236 pounds and does not include the fuel that was already present at the time the airplane was last serviced with fuel. According to the manufacturer, the maximum takeoff weight is 1,213 pounds. The "Permitted payload range" table in Section 6.3 of the SportStar Aircraft Operating Instructions illustrated the maximum weight of crew based upon fuel volume and baggage weight. Baggage weights offered were zero pounds, 26 pounds, and 55 pounds. The fuel volumes listed were 31.7 gallons, 26.4 gallons, 19.8 gallons, 13.2 gallons, and 6.6 gallons. The crew weights permissible based upon no baggage and correlating fuel volume were as follows: 437 pounds/6.6 gallons of fuel; 397 pounds/13.2 gallons of fuel; 357 pounds/19.8 gallons of fuel; 317 pounds/26.4 gallons; 286 pounds/31.7 gallons. American Society for Testing and Materials (ASTM) consensus standards designation F 2245-07 Section 9 - Pilot Operating Handbook, 9.5.1 states an "installed equipment list" is to be available in the Weight and Balance portion of the "pilot operating handbook." This information was not located in the weight and balance section or in any other section within the manual. A separate weight and balance record listed equipment installed in the "configuration" portion of the weight and balance record. This information was not located in the flight manual. According to the fuel consumption, range, and endurance chart in Section 5.3.3 of the Aircraft Operating Instructions, at an international standard altitude of 2,000 feet, the engine will consume 6.6 gallons per hour at maximum continuous horsepower (MCP). The fuel consumption decreased based upon a percentage of MCP with 3.7 gallons per hour being the lowest consumption rate at 65 percent of MCP. No other altitudes of operation were provided in the manual. According to the owner of the airplane, the airplane averaged 3.5 gallons per hour over a 200 to 300 hour span of operation. According to CFR 91.151 "Fuel requirements for flight in VFR Conditions… (a) No person may begin a flight in an airplane under VFR conditions unless (considering wind and forecast weather conditions) there is enough fuel to fly to the first point of intended landing and, assuming normal cruising speed - (1) During the day, to fly after that for at least 30 minutes." CFR 91.103 "Preflight Actions… Each pilot in command shall, before beginning a flight, become familiar with all available information concerning that flight. This information must include -… (b) For any flight, runway lengths at airports of intended use, and the following takeoff and landing distance information: (1) For civil aircraft for which an approved Airplane or

Probable Cause and Findings

The flight instructor's failure to maintain sufficient airspeed during takeoff-initial climb to avoid a stall/spin. Contributing to the accident was the flight instructor's inadequate preflight planning, his failure to calculate the airplane's weight and balance, the high density altitude, inadequate information for preflight planning provided by the manufacturer, and the insufficient standards for Pilot Operating Handbook information required by the ASTM consensus standards.

 

Source: NTSB Aviation Accident Database

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