NTSB Factual Report

HISTORY OF FLIGHT

On April 26, 2002, about 0553 Pacific daylight time, a Cessna 177B, N177DP, experienced a total loss of engine power during cruise flight. The pilot made a forced landing in a high school baseball field in Fullerton, California. During the landing flare, the airplane collided with an obstacle, nosed over, and was destroyed. The private pilot and one passenger sustained minor injuries. The second passenger was not injured. The pilot owned and operated the airplane. The accident occurred while the pilot was commuting to work between Corona and Hawthorne, California. The personal flight was performed under the provisions of 14 CFR Part 91. Visual meteorological conditions prevailed during the dawn flight that originated from Corona approximately 0540.

The pilot indicated to the National Transportation Safety Board investigator that he had flown his airplane to work hundreds of times, and he was familiar with the route of flight. Nothing unusual was noted during the preflight inspection on the morning of the accident flight. No fresh oil residue was noted on the ground at the airplane's tie down location.

The pilot additionally reported that his taxi out, initial climb, and the first few minutes of the cruise flight were normal. However, about 8 minutes after departure, while cruising about 1,800 feet mean sea level (msl), he noted a variation in the engine's speed. Specifically, the engine's crankshaft rotation speed (in revolutions per minute (rpm)) increased from its previously set speed of 2,450 rpm to between 2,700 and 2,800 rpm. The pilot reduced engine power and prepared for a precautionary or forced landing.

According to the pilot, approximately 1 minute later the engine's oil pressure was observed at zero pounds per square inch. Seconds thereafter, a "tapping sound" was detected coming from the engine. The noise increased in intensity, and a vibration was noted. About 45 seconds later the vibration had become severe, the engine made a "terrible" noise, and the propeller abruptly stopped rotating. The airplane was not within gliding distance to any airport when all engine power was lost.

While descending during the forced landing, the pilot saw vehicles and personnel in close proximity to the first two possible emergency landing areas that he observed. The pilot indicated to the Safety Board investigator that he responded by maneuvering the airplane toward a third but smaller location, an unoccupied baseball field. During the landing flare, the airplane collided with a fence and came to rest inverted.

PERSONNEL INFORMATION

A review of the instrument rated private pilot's personal flight record logs indicated that during the 12-month period preceding the accident, he had flown over 150 times from Corona to his work location near the city of Hawthorne. The pilot reported that his total flying experience was about 3,500 hours. His total experience flying the accident airplane was about 3,050 hours.

During the 90-day period that preceded the accident, the pilot had logged about 45.5 hours in the airplane. The pilot's last flight review was satisfactorily accomplished in the accident airplane on June 30, 2000.

AIRPLANE INFORMATION

An overhauled 180-horsepower engine, a Lycoming O-360-A1F6D, serial number L-20605-36A, was installed in the accident airplane on December 1, 1997. At installation, the airplane's total time, and its tachometer time, was 2,479.7 hours.

The Cessna Aircraft Company's "Pilot's Operating Handbook" for the airplane indicated that the engine's total oil capacity is 9 quarts, and the oil sump's capacity is 8 quarts. The minimum oil quantity for engine operation is 6 quarts.

COMMUNICATION

The pilot was not communicating with any Federal Aviation Administration (FAA) air traffic control facility during the time period encompassing the accident sequence.

WRECKAGE AND IMPACT INFORMATION

The accident site is located at the following approximate global positioning satellite coordinates: 33 degrees 52.737 minutes north latitude by 117 degrees 53.658 minutes west longitude. The estimated accident site elevation is 230 feet msl.

The nearest airport to the accident site is located in Fullerton. The distance and magnetic bearing from the accident site to the Fullerton Municipal Airport is about 4.3 nautical miles and 251 degrees.

The Safety Board investigator's on-scene examination of the accident site and wreckage revealed that a chain link fence was located in the baseball field. Vertically oriented metal poles, which had supported the fence, were found in the field bent over in a westward direction. No ground scar was evident on the east side of the fence. At the initial point of impact (IPI), one of the poles was observed covered with an oil residue. To the west of the poles, a ground scar having the approximate lateral dimensions of the airplane's tires was observed in the grass-covered field. The tire track-like ground scar marked a swath between the poles and the airplane wreckage. The magnetic bearing and estimated distance between the IPI and the airplane was 255 degrees and 78 feet.

The airplane was found with its longitudinal axis oriented in an easterly direction (100-degree magnetic bearing) and on its right side, partially inverted. The wings and their respective carry through structure had separated from the fuselage (see photographs). All airframe components were found with the main wreckage along with all flight control surfaces, which had remained attached to their respective hinges.

Two pole-like curved depressions were noted in the leading edges of both wings. The depressions were oriented perpendicular to the airplane's wing span (lateral axis). The depressions' curvatures matched the circumference of the aforementioned bent poles.

No evidence of leading edge gouges or chordwise scratches were noted on the propeller blades, which had remained attached to the crankshaft mounting flange. One blade appeared straight, and the other blade appeared bent in an aft direction.

Several cracks were noted in the upper (top) portion of the engine case. Oil was observed dripping from the bottom of the engine, and oil was covering the bottom of the airframe from the firewall to the aft portion of the empennage. Evidence of an oil spray residue was noted on the fuselage. The oil residue was observed oriented in a forward-to-aft direction consistent with the direction of airflow.

The engine's recording tachometer was observed registering 3,294.3 hours. There was no evidence of fire.

TESTS AND RESEARCH

Oil Leak Documentation.

Under the Safety Board investigator's supervision, the airplane was reoriented to an upright attitude, and the residual oil was drained from the engine's oil sump. About 8 ounces of oil were recovered. Thereafter, an examination was performed of the engine and its accessories to locate the source of the oil leak.

The engine's crankcase was observed cracked in numerous locations. The crankshaft could only be rotated through approximately 45 degrees of arc. Oil was principally noted on the exterior surface of the right, rear side of the engine. Oil residue was found on the accessory section, in the vicinity of the oil filter assembly. No evidence was observed of broken or disconnected hoses.

The oil filter was found safety wired in place, and it was secured by its threads to the accessory housing. The gasket located between the oil filter converter plate and the accessory housing was found partially extruding from around the seat of the oil filter converter plate, and in one location a 3/4-inch-long section of gasket material was completely dislodged from the back of the plate. Given the magnitude of this oil gasket position breach, the Lycoming engine participant opined that, during flight, oil exhaustion could occur within minutes.

Following removal of the converter plate, the remaining gasket material was examined. It was found spongy to the touch and had a swollen appearance. (See the photographs showing the engine, including close-up views of the oil filter assembly and converter plate gasket. For additional maintenance related discrepancies, see the Lycoming engine participant's report.)

Logbooks and Maintenance History.

The pilot reported that he is the owner and operator of the accident airplane. The airplane is generally maintained by an FAA certificated repair station at his home base airport in Corona. The repair station, Procraft Aviation, Inc., has possession of his airplane's maintenance records. Procraft's personnel accomplished the airplane's last annual inspection on April 5, 2001, at a total airplane time of 3,106 hours, as indicated in the maintenance records. The pilot also indicated that, on the accident date, there were no outstanding squawks related to the engine.

According to the pilot, between the last annual inspection and the accident date, he had personally accomplished most of the oil changes, which were routine. They were performed without incident. The pilot's records indicate that during the 188 hours time in service between the last annual inspection and the accident flight, the oil was changed on 5 occasions. At no time during the oil change process did the pilot remove or attempt to remove the oil filter converter plate.

In fact, the pilot stated that he was unaware his airplane was equipped with an oil filter converter plate with a gasket that required maintenance on a recurring basis every 50 hours. Subsequently, the pilot learned that the recurring maintenance had been mandated by the FAA upon issuance of an emergency airworthiness directive (AD) number 2000-18-53.

The owner of Procraft Aviation, Inc., reported to the Safety Board investigator that, at the time of the accident, he had possession of the accident airplane's maintenance logbooks because the airplane's owner anticipated having his company perform the upcoming annual inspection. The inspection was due by the end of April 2002. The airplane's logbooks and Procraft's associated repair station maintenance records were reviewed by the Safety Board investigation team.

In pertinent part, the following was the last entry written in the accident airplane's engine logbook:

Date 4/5/01 Tach 3106

Replaced oil filter adapter seal. AD 2000-18-53 N/A To Eng By Overhaul Date.

I certify that this engine has been inspected in accordance with a (sic) annual inspection and was determined to be in airworthy condition.

Regarding the reference to the "oil filter adapter seal," Procraft's owner indicated to the Safety Board investigator that this "seal" was in actuality the subject converter plate gasket. Moreover, Procraft's owner reported that although his firm had performed a compliance check for all applicable ADs during the last annual inspection, accomplished April 5, 2001, he found no copy of that compliance check record in his repair station's files. Likely, the airplane's owner had not been provided with any list. Accordingly, the owner would not have been apprised of the recurring nature of ADs.

During the time interval between the April 5, 2001, annual inspection and the accident date, the airplane's logbooks did not bear any entry indicating that the oil filter converter plate gasket had been removed and replaced or had received maintenance.

Repair Station Inspection Regarding Gaskets and Manuals.

The Safety Board investigator conducted an inspection of Procraft's parts storage area. The purpose of the inspection was to ascertain the gaskets it had in stock for the model of engine on the accident airplane.

The inspection revealed one gasket bag suspended on Procraft's storage wall. Procraft personnel reported that the gasket bag was located in the storage area where serviceable parts were kept, and parts in this area were available for immediate use. The subject bag was labeled P/N LW-13388, Qty 2. Only one gasket was present in the bag.

Airworthiness Directive and Recurring Inspection Requirements.

The FAA issued AD 2000-18-53 on September 5, 2000, upon receiving reports of certain oil filter converter plate gaskets, part number (P/N) LW-13388, extruding from the seat of the oil filter converter plates. The FAA indicated that "[t]he protruding or swelling of the gasket allows oil to leak from between the plate and the accessory housing. This condition, if not corrected, could result in complete loss of engine oil and subsequent seizing of the engine...."

According to the FAA aviation safety inspector who participated with the Safety Board investigator during the review of the accident airplane's maintenance records, the logbook statement that AD 2000-18-53 was "N/A" was incorrect. The FAA inspector reported that the installation of gasket part number LW-13388 made the AD applicable. Accordingly, with reference to the accident airplane's engine accessories, the AD mandated replacement of the oil filter converter plate gasket every 50 hours.

ADDITIONAL INFORMATION

The airplane wreckage was released to the pilot on April 29, 2002. No parts were retained by the Safety Board investigator.

NTSB Probable Cause

The total loss of engine power during cruise flight resulting from oil exhaustion. The oil exhaustion resulted from deterioration and total failure of the oil filter converter plate gasket, which had not been replaced due to maintenance personnel's failure to comply with an airworthiness directive.