N3029YThrush Aircraft S2R-T34 · 2013

On September 23, 2008, about 1355 eastern daylight time, a Piper PA-32-300, N3029Y, was substantially damaged when it impacted trees and terrain during an attempt to return to Dekalb-Peachtree Airport (PDK), Atlanta, Georgia shortly after takeoff. The certificated commercial pilot, the sole occupant, was fatally injured. The personal flight was operated under the provisions of Title 14 Code of Federal Regulations Part 91. Visual meteorological conditions prevailed for the flight, and no flight plan was filed.

According to relatives of the pilot, the pilot resided in Michigan, and he flew his Beechcraft Bonanza to PDK the day prior to the accident, in order to complete the sale of the Bonanza. The pilot planned to take the accident airplane in partial trade for the Bonanza, and fly it back to Michigan.

According to the pilot who delivered the accident airplane to PDK, it was kept in a hangar at Craig Municipal Airport (CRG), Jacksonville, Florida. The delivery pilot stated that the flight was uneventful, and that he arrived at PDK about 0845, about 5 to 10 minutes after the Bonanza. Shortly after arrival, the delivery pilot permitted the accident pilot to conduct a pre-buy examination of the accident airplane. The delivery pilot assisted the pilot with removal of the upper engine cowl, and the pilot removed several other access panels from the airplane. The delivery pilot stated that the examination took about a half hour, and then the cowling and access panels were re-installed. He also stated that the pilot told him that he was satisfied with the condition of the airplane, and that he planned to depart in it the following day.

The delivery pilot said that he departed CRG with full fuel, and that after arrival at PDK, he requested a fuel top-off from the fixed-base operator (FBO). FBO records indicated that 34 gallons were added to the accident airplane, and that the fuel transaction was closed out at 1552 the day prior the accident.

According to Federal Aviation Administration (FAA) information from the PDK air traffic control tower, on the day of the accident, the pilot contacted ground control about 1344, and stated that he was planning to depart "northbound" for Coldwater, Michigan. He also requested flight-following services. The ground controller cleared the pilot to taxi to runway 2L, provided him with a frequency to contact Atlanta departure control for flight following once airborne, and instructed the pilot to advise ground control after he completed his pre-flight run-up. At 1349:31, the pilot advised ground control that he was ready for takeoff. The controller again instructed him to taxi to runway 2L, and to monitor the tower frequency. At 1351:13 the local controller approved N3029Y for a "left turnout," and cleared the airplane for takeoff from runway 2L. The pilot acknowledged the takeoff clearance. At 1352:19, the local controller instructed the pilot to contact Atlanta departure control; the pilot did not respond to this communication, and there was no record of any contact between the airplane and Atlanta departure control. At 1354:17, the pilot transmitted "atlanta tower, atlanta tower" on the PDK local control frequency. The PDK local controller responded immediately with "this is Peachtree tower," and at 1354:52 the pilot transmitted "peachtree tower, I have an emergency, three two nine yankee, uh, I'm uh, (unintelligible) I need to land again." Twice, at 1355:03 and 1355:15, the local controller queried the pilot regarding his request and the nature of the emergency, but no other transmissions were received from the airplane. About 1355, the airplane struck trees and terrain in a residential neighborhood approximately 2 miles north-northwest of PDK. There was no fire.

The pilot held a commercial pilot certificate with airplane single engine land, single engine sea, and instrument ratings, and a private pilot certificate with an airplane multiengine land rating. FAA records indicated that the pilot’s most recent FAA second-class medical certificate was issued in June 2007, and that he reported 4,900 total hours of flight experience at that time. The pilot's logbook listed 5,031 total hours of flight experience as of September 20, 2008. The flight to PDK was not included in the logbook. The logbook entries also stated that the pilot had 4,020 hours in single-engine airplanes, and 1,107 hours in multi-engine airplanes, which summed to a total of 5,127 hours. The reason(s) for the discrepancy between the listed total and the sum of the single- and multi-engine times could not be determined. The logbook indicated that the pilot had accrued approximately 37, 61 and 91 hours respectively, all in single-engine airplanes, in the 30, 60 and 90 days prior to the accident. The pilot's previous experience in the accident airplane make and model was not determined.

The airplane was manufactured in 1979. It was a six place, low wing airplane of all-metal construction, with fixed, tricycle-configuration landing gear. According to the Pilots Operating Handbook (POH), the airplane was equipped with two fuel tanks that held a total of 94 gallons of usable fuel. Each POH-designated "tank" was actually comprised of two separate but interconnected tanks in each wing. The fuel selector valve had three positions: "OFF, LEFT, and RIGHT." The airplane was equipped with conventional flight controls that included a stabilator. Secondary flight controls included manually actuated flaps and pitch trim. The cockpit entrance door was on the right side of the airplane, and a double-door on the aft left side of the fuselage allowed for passenger and baggage loading.

The airplane was equipped with a Lycoming IO-540 piston engine, and a Hartzell three-blade, constant-speed propeller. The engine was overhauled by Lycoming in December 2005, placed in service in March 2006, and had accumulated approximately 350 hours in service as of the date of the accident. The most recent annual inspection was accomplished in April 2008. At the time of the annual inspection, the airplane tachometer registered a total time in service of 5,511.71 hours. At the time of the accident, the airplane tachometer registered 5759.78 hours.

The 1302 special weather observation at PDK included winds from 100 degrees, variable between 060 and 130 degrees, at 7 knots, clear skies, 10 miles visibility, temperature 26 degrees C, dew point 12 degrees C, and an altimeter setting of 30.28 inches of mercury.

The accident site was located in a residential neighborhood, approximately 1 3/4 miles north of the threshold of PDK runway 16. According to witnesses in the vicinity of the accident site, none of them saw the airplane prior to its first tree strike, and most only heard, rather than saw, the accident. Some witnesses reported hearing the engine, while others reported that they did not hear the engine.

Witness marks indicated that the airplane first struck two trees at the northern boundary of a residential property, approximately 30 feet above the tree bases. Approximately 42 feet beyond the first trees, the airplane struck another tree approximately 12 feet above its base. About 34 feet beyond that, the airplane impacted trees and a 5-foot high earthen berm. Airplane debris and displaced earth from the berm splayed out approximately 60 feet beyond the berm, to where the main wreckage was located. The main wreckage consisted of the engine, cockpit/cabin, aft fuselage and empennage. The debris path was oriented along a heading of approximately 160 degrees magnetic.

The cockpit/cabin came to rest inverted, pointing back along the debris path. The aft fuselage and empennage were relatively intact, and remained attached to the cockpit/cabin, but the aft fuselage was bent and came to rest pointing up, with the vertical stabilizer pointing in the direction of travel. The cockpit door, and fragments of the wings, cowl and landing gear, were distributed along the debris path. All fuel tanks were severely compromised.

One propeller blade was found separated from the propeller hub, near the berm. The blade was bent approximately 90 degrees forward near the mid-span point, and exhibited chordwise scratching, and trailing edge S-bending. The other two blades remained attached to the hub, which was located just short of the main wreckage. One blade was jammed in approximately the feathered position, bent aft approximately 20 degrees at the root, and exhibited chordwise scratching. The outboard 4-inch portion of the blade was bent forward. The other blade rotated freely in the hub, was bent aft approximately 75 degrees near the mid-span point, and was missing the outboard 4 inches. The blade exhibited leading edge gouges, chordwise scratching, and trailing edge S-bending.

The engine was found inverted, and partially attached to the firewall by cables and the engine mount. The engine mount was severely distorted, and most fittings were fractured. The firewall was heavily crumpled, and its central area was covered a white powdery layer consistent with corrosion. The firewall was penetrated at the approximate center of the powdered area. The airplane battery was fractured and crushed against the aft side of the firewall, and was visible from the forward side of the firewall through the penetration.

The engine case was intact, with no cracks or penetrations. The engine oil sump was fractured and penetrated at its forward end. The exhaust system was crushed up and aft. The rocker arm cover and a portion of the No. two cylinder were separated from the engine, and were found early in the debris path. Most of the engine accessories were found separated from the engine. The two oil coolers remained attached to the engine. The left oil cooler was crushed and compromised, and the right one was intact. The three hoses associated with the oil-cooling system appeared intact, and all six ends retained their fittings. Five of the six oil hose fittings were intact, and one was fractured; its threads exhibited significant distortion. The oil dipstick was found separated from the engine, and its housing was fragmented.

The cockpit and cabin exhibited significant structural disruption and crushing. The configuration and security of the cockpit and cabin door latches prior to impact could not be determined. The windshield was highly fragmented, and many of the instruments and avionics were separated from the instrument panel. An hour meter registered 4782.0 hours, and the engine tachometer registered hours. The vertical speed indicator registered a descent rate of 400 feet per minute (fpm). The fuel boost switch was found in the "OFF" position, but the subpanel that it was mounted in was found separated from the airplane. The ignition switch was found in the "BOTH" position, with the key broken off in the switch. The flap handle was bent, and not locked in any detent. The left flap actuator arm was found in a position that corresponded to flaps retracted. The stabilator trim tab actuator extension equated to a trim position of neutral to slightly airplane nose up.

The emergency locator transmitter (ELT) and its attached battery pack were intact. The cockpit-panel-mounted ELT switch was found in the "ON" position. No ELT signal was reported on the day of the accident, but about 22 hours after the accident, the signal was detected and reported. The battery pack carried a "Replace" date of December 2007.

An autopsy was conducted by the Medical Examiner of DeKalb County, Georgia. The autopsy report listed the cause of death as blunt-force trauma, and the report noted the "absence of identifiable natural disease processes or congenital anomalies." Toxicological testing was conducted by the FAA Civil Aero Medical Institute; no carbon monoxide, cyanide, ethanol, or screened drugs were detected.

Airport Surveillance Camera Imagery

Recorded image data from the surveillance camera system at the FBO was provided to the investigation. The data, which included date and time stamp information, covered the period from 0844 on September 22, 2008 through 1345 on September 23, 2008. The day before the accident, the accident pilot was observed near or in the airplane for approximately 70 minutes. The day of the accident, the pilot was observed near or in the airplane for approximately 14 minutes, before he entered the airplane for departure. The following details were obtained from the surveillance camera image data.

The accident airplane arrived and parked on the east ramp of the FBO at 0845 on September 22, 2008. At 0848, a fuel truck arrived at the airplane and began fueling it. About 1 minute later, the delivery pilot and another individual, presumed to be the accident pilot, walked around, and appeared to visually examine, the airplane. About 0851, the two pilots removed the upper engine cowl, and at 0855 the fuel truck departed. About 0900, both pilots entered the airplane, and they exited 12 minutes later. The two pilots re-installed the upper cowling about 0919. The delivery pilot went over to the accident pilot's Bonanza, but the accident pilot remained near the accident airplane, and appeared to continue to examine it until about 1000. Image resolution precluded the identification of most of the accident pilot's specific activity. About 1012, both pilots walked away from the airplane. About 1024, three individuals and a tug pushed the airplane to a new parking spot on the east ramp. The airplane remained undisturbed in that location until the accident pilot arrived about 1258 the following day, which was the day of the accident.

About 1258 on September 23, 2009, the accident pilot and another individual pushing a baggage cart arrived at a point just behind the left wing of the airplane. Two minutes later, the other individual left the airplane, pushing the now-empty baggage cart. Three minutes after that, the pilot walked around the front of the airplane, opened the right-side door, and entered the cockpit. Two minutes later, the pilot exited the cockpit, and walked around the back of the airplane to the location just aft of the left wing. In the next 2 minutes, the pilot repeated that process two more times. Starting about 1308, he entered the cockpit, exited after 10 seconds, and then remained near the nose for about 20 seconds. A parked truck partially obscured the view of the airplane, and the pilot's specific location and activities could not be discerned. The pilot then re-entered the cockpit, exited after 10 seconds, and then again remained near the nose for another 90 seconds. About 1311 he appeared to remove the wheel chocks, and about 1312 entered the cockpit for the final time. The cockpit door was closed about 1327, the engine was started about 1336, and the airplane vacated its parking spot on the FBO ramp about 1343.

Airplane Doors

The airplane was equipped with four primary doors. The baggage compartment door was installed on the right side of the fuselage, between the cockpit and the firewall. The metal door was relatively undamaged, but was separated from the fuselage. The hinge remained attached to the door. The doorframe and skin that the hinge attached to was fracture-separated from the fuselage, but remained attached to the hinge. The door handle and latch were in their respective locked positions, and appeared undamaged.

The forward cabin entry door was installed on the right side of the fuselage, adjacent to the right front seat. The metal door was relatively undamaged, but was separated from the fuselage. The two hinges remained attached to the door. The doorframe and skin that the hinges attached to was fracture-separated from the fuselage, but remained attached to the hinges. The upper- and mid-door handles and latches were all in their respective locked positions, and appeared undamaged.

The aft cabin entry consisted of two (one forward, one aft) mating doors installed on the left side of the fuselage, aft of the left wing. The forward door was composite, while the aft door was metal. Both the upper and lower hinges for the forward door remained attached to the fuselage, but only fragments of the forward door were attached to the hinges. The aft door was moderately damaged, and remained attached to the fuselage. The door latch pin located at the lower forward corner of the door was in the extended (latched) position and bent; the pin actuating mechanism was in the latched position, and was undamaged.

Upper Engine Cowl

The upper engine cowl was constructed primarily of fiberglass, and was designed for rapid removal and re-installation as a single-piece assembly. The upper cowl extended from just aft of the propeller to the firewall, and the longitudinal parting lines that separated it from the lower cowl were located on the fuselage sides, approximately 10 inches below the top surface of the upper cowl.

Two quick-release studs secured the upper cowl to the firewall, and two quick-release latches on each side of the fuselage secured the upper cowl to the lower cowl. Each latch consisted of an upper clip bolted the upper cowl, a lower arm that hinged at the bottom of the clip, and a quarter-turn stud at the bottom of the lower arm. Each stud mated to a receptacle in the lower cowl. Removal of the upper cowl required disengagement of the two studs from their receptacles in the firewall, and disengagement of the four quarter-turn studs from their receptacles in the lower cowl.

The two holes in the aft upper cowl, which were for the studs that attached the cowl to the firewall, exhibited tearouts in the aft direction. The studs and firewall receptacles were not identified in the wreckage. Both right-side latches were complete and remained attached to the upper cowl, but both lower arms were permanently deformed in the aft and up directions. The upper cowl segment, where the forward left clip attached, was fracture-separated from the cowl. Neither this cowl segment, nor the forward left latch, was identified in the wreckage. The aft left clip remained attached to the upper cowl, but the lower arm was fracture-separated from it, and was not identified in the wreckage.

Oil Coating on Airplane Exterior Surfaces

Portions of the stabilator, the vertical tail, the windshield, and some upper surfaces of the engine cowl and aft fuselage exhibited a coating of oil. The oil stream marks were primarily aligned forward to aft, and dirt and vegetation fragments were trapped in the oil. Portions of the upper surfaces of the left-side engine cylinders also exhibited the oil coating. The landing gear fairings, wings and the majority of the fuselage did not exhibit any similar oil coating. The only oil on any lower surfaces of the airplane was on the stabilator. At least one ruptured 1-quart oil container was found outside the airplane at the accident site.

Eight major fragments of the upper engine cowl were recovered at the accident site. A two-dimensional layout of the fragments indicated that they comprised approximately 90 percent of the upper cowl, and that the oil coating was discontinuous across some fracture lines. In particular, the left forward fragment was free of oil, while adjacent fragments were nearly completely coated with oil.

Detailed Engine Examination

The engine was examined in detail at a secure facility. The crankshaft was slightly bent at the front end of the engine, but the front crank oil seal was intact. Only a few fragments of the propeller governor were recovered. The fuel servo was impact-separated, its inlet screen was free of debris, and approximately 1/2 ounce of clean fuel was recovered from the unit. The throttle arm was fractured-separated from the servo, the servo fuel-side and air-side diaphragms were intact, and no internal abnormalities were noted with the servo. The fuel flow divider diaphragm was intact, the spring was in place, and clean fuel remained in the unit. No abnormalities were noted with the flow divider.

The engine-driven fuel pump was impact-separated from the engine, but remained attached to the fuel servo by its flexible fuel line. Clean fuel was recovered from the unit, the diaphragm was intact, and no abnormalities were noted. Fuel was recovered from the line between the electric boost pump and the engine-driven pump. Five of the six fuel injector nozzles were recovered; the No. 2 injector was not found. The No. 4 injector was fractured into two pieces. All recovered nozzles were free of obstructions.

All spark plugs were recovered; all electrodes showed normal wear, and were gray in appearance. The ignition harnesses were severely impact-damaged. Both magnetos were impact-separated, and both sparked at all towers when hand rotated. The starter was impact-separated and damaged. The alternator was impact-separated and severely damaged. The vacuum pump was impact-separated, and its drive remained attached to the engine. The pump was able to be hand rotated, but it presented noticeable resistance. The oil filter was impact-separated. The filter element was wet with oil, and appeared clean, with no particulates observed.

The crankshaft engine was rotated by hand, and thumb compressions were obtained on cylinder Nos. one, five and six. All cylinders were removed from the engine. No damage other than impact damage was noted on any of the cylinders, pistons, or connecting rods. All connecting rods were free to rotate on their bearing journals, and oil was found throughout the engine. According to the Lycoming investigator, the first indications of oil starvation in the IO-540 engine will appear at the connecting rods and crankshaft journals for the No. five and six pistons. The crankshaft bearings and journals for the Nos. five and six connecting rods appeared normal, were coated with oil, and no indications of oil starvation were present.

Recovered Flight Data

Two Garmin handheld global positioning system (GPS) GPSMAP 396 units, and one Insight GEM 602 engine monitor, were found at the accident site. These three units were sent to the National Transportation Safety Board (NTSB) recorders laboratory, in order to extract any recorded data. Recorders laboratory personnel determined that the recovered engine monitor was not capable of retaining data after power removal, and therefore no engine data was available for the investigation.

Each of the two GPS units was capable of storing a detailed track log for up to 50 flights, including latitude, longitude, date, time, and groundspeed information. Details regarding the GPS units and their data were documented in a separate report issued by the NTSB recorders laboratory.

Examination of the Garmin GPS units, serial numbers (s/n) 28208662 and 28201728, revealed that both units were impact-damaged. No data was recovered from s/n 28201728, but s/n 28208622 was repaired, and accident flight data was successfully recovered. Evaluations of the GPS-recorded altitudes when the airplane was on the ground in locations with known terrain elevations revealed that the GPS altitude data was approximately 15 feet lower than the corresponding terrain data.

The first GPS data point for the accident flight was recorded when the airplane was on the ramp at PDK. This occurred at 1338:07, and the GPS altitude was recorded as 961 feet. The data indicated that the airplane began the takeoff roll about 1352:31, and became airborne about 30 seconds later. At 1354:05, the airplane began a turn to the left, when climbing through a GPS altitude of 1,500 feet, or approximately 500 feet above ground level (agl). At this time, the GPS-recorded groundspeed was approximately 106 mph.

At 1354:31, the maximum recorded GPS altitude of 1,726 feet (approximately 720 feet agl) was achieved, the groundspeed had increased to 113 mph, and the airplane was on a northerly track. About 10 seconds later, the airplane began a 180 degree turn to the left, and began to descend. About 14 seconds after the turn was initiated, the airplane was westbound, and the descent rate increased significantly. Over the next 16 seconds, the airplane completed another 90 degrees of the turn to a southerly track, and descended into the terrain. For this segment of the turn, the descent rate was approximately 2,600 fpm, the groundspeed had increased to 137 mph, and geometric calculations that presumed a zero-wind condition indicated that the airspeed averaged approximately 142 mph. The diameter of the 180 degree turn was approximately 3,200 feet, which required a bank angle of approximately 30 to 40 degrees in a coordinated turn. The last recorded GPS data point was at 1355:10, with a GPS altitude of 988 feet, and a location that coincided with the first tree strike.