NTSB Factual Report

On March 23, 2010, about 0650 Pacific daylight time, a Piper PA-30 of Australian registry, VHEXA, sustained substantial damage following a loss of engine power during takeoff initial climb and impact with terrain at the Hollister Municipal Airport (CVH), Hollister, California. The Australian certificated airline transport pilot, the sole occupant, was not injured. Visual meteorological conditions prevailed at the time of the accident. The extended over water cross-country flight was being operated in accordance with 14 Code of Federal Regulations Part 91, and an instrument flight rules (IFR) flight plan was filed. The flight was originating at the time of the accident, with a reported destination of Kona (KOA), Hawaii.

According to the Pilot/Operator Aircraft Accident/Incident Report (NTSB Form 6120) submitted to the NTSB investigator-in-charge (IIC), as well as in a telephone conversation with the IIC, the pilot reported that in preparation for the extended over water cross-country flight, on the day prior to the accident he filled the airplane with fuel, and also added 30 gallons to the auxiliary bladder fuel tank for “airborne tests of the various systems.” The pilot stated that he initially flew to Lakeport, California by himself, using the main fuel tanks only. On the return flight from Lakeport to Hollister he had another pilot accompany him, who flew the airplane while he “tested the systems,” which included the ferry fuel system. The pilot reported that during the flight the fuel selectors were turned to the AUX position; the engines ran off of the AUX fuel tanks for approximately 15 minutes. The pilot added that he also pumped 15 gallons of avgas from the bladder tank to the left main tank and the system “worked fine.” Additionally, the right engine was switched to cross-feed from the left tank while pumping fuel from the bladder, and again the system “worked fine.” The pilot stated that the flight was without incident, and that upon their return to Hollister the airplane was filled full of fuel, which included the auxiliary bladder fuel tank.

The pilot reported that on the morning of the accident and after both engines were started and warmed up, he taxied to Runway 31, entered the runway and activated both electric fuel pumps. Both engines were then run up to full takeoff power; visual checks of both engine tachometers and rpm gauges confirmed that full takeoff power had been achieved. The pilot reported that at this point the brakes were released and the aircraft accelerated quickly down the runway. The pilot stated, “I held forward pressure on the aircraft’s yoke to ensure that a good airspeed was reached before allowing [the airplane] to get airborne. The aircraft was airborne just prior to the Runway 21 intersection, and all indications were that everything was fine.” The pilot revealed that after getting airborne he reached down and selected the gear up, and again all indications were normal. “I was careful to keep the nose low, ensuring a shallow climb out so as to continue to gain airspeed.” The pilot stated that at about this point "something happened." “I was only approximately 60 feet above ground level (agl). The nose pitched up and I intuitively pushed forward on the yoke.” The pilot also said that right after taking off the left engine “surged” and lost partial power, but that power was restored to the left engine as the airplane descended due to its maximum gross takeoff weight. The pilot added that he had a noise-canceling headset on and did not hear much of what was happening, but “…there was a loud bang; I did not look at the engine instruments to see if an engine had been affected. Instead, my right hand went back onto the throttle quadrant and I pushed forward to ensure that full power had been applied. I remember also fighting with the yoke to maintain a nose down and level attitude.” The pilot reported that his right hand remained on the throttles, and that to control flight with his left hand on the yoke got harder and harder. The pilot revealed that the flight was short lived, "...as it all happened very quickly. I remember vividly pinning the yoke against the instrument panel just prior to striking the ground.” The pilot said he remembered that the airspeed had bled off so much that full forward elevator was inadequate to nose the aircraft over. “[I] felt the aircraft strike the ground and at this point I was still manipulating the controls, trying to get the aircraft to nose over. I remember ‘thumping’ into the ground and initially it was not too rough; it skidded along and for a split second I thought it was going to simply slide to a halt on its belly.” The pilot reported that the airplane flipped over on this back and was sliding along on its roof before coming to rest inverted. The pilot further reported that he was able to egress the airplane and walk away from the wreckage. There was no post crash fire.

According to a Federal Aviation Administration (FAA) airworthiness inspector who traveled to the accident site, in an interview with the pilot, the pilot reported that after takeoff and at about 50 feet agl, the left engine suffered a partial power loss. The pilot stated that due to the weight of the airplane (ferry tanks full for extended over water operations), he was unable to maintain altitude. The pilot added that as the airplane was descending the power to the left engine was restored, but not before the airplane impacted terrain to the northwest of the departure end of Runway 31.

According to photo documentation of the accident site provided by the inspector to the IIC, the airplane came to rest inverted on an easterly heading, with the cabin and cockpit crushed downward, and the empennage partially separated at the aft cabin bulkhead area. The vertical stabilizer, rudder, right horizontal stabilizer and right elevator remained attached to the empennage, while the left horizontal stabilizer and left elevator were observed separated from the empennage. The nose of the airplane was observed crushed aft.

The airplane’s left engine remained attached to the left wing, with the inboard two-thirds of the left wing remaining attached to the fuselage; the outboard one-third of the left wing had separated from its mating inboard section. The two-bladed propeller, left engine nacelle and associated cowling remained intact. The inspector reported that an examination of the propeller revealed no rotational signatures that would have been conducive with power being generated by the engine.

An examination of the right engine and associated nacelle revealed that it had partially separated from the right wing. Further examination revealed that the right wing remained attached to the fuselage at the wing root area, and that the outboard one-third of the wing was observed separated from its inboard mating section. It was further observed that the two-bladed propeller was void of any observation rotational signatures that would have been conducive with power being generated by the engine.

The inspector also provided the IIC with a Record of Interview, which revealed that a witness to the accident stated that while observing the airplane take off he “heard a popping noise, saw the aircraft clear the [airport boundary] fence and then turn to the left, at which point the airplane went out of sight.”

A review of the airplane’s maintenance records revealed that on March 22, 2010, the day prior to the accident, a certified FAA airframe and powerplant mechanic found the airplane’s ferry fuel system, which was installed in accordance with the Auto Avia Design EO 204/481/EI1 issue 3, fit for ferry flight in accordance with CASE special flight permit ER/AW/10/4064, and that the aircraft was airworthy with respect to the work performed.

On July 23, 2010, under the supervision of a FAA airworthiness aviation safety inspector, an examination of the airplane and engines was conducted at the facilities of Gavilan Aviation, Hollister Airport, Hollister, California.

The examination revealed that the right engine was limited to rotation of about 90 degrees before meeting mechanical resistance, which the inspector attributed to being the result of impact damage. During the rotation process it was observed that #1, #2, #3 and #4 pistons moved in response to rotation; #1 and #3 cylinders produced thumb compression, while #2 and #4 cylinders did not produce thumb compression due to the inability to rotate the crankshaft. The interior and exterior condition of the spider valve looked good, and the diaphragm was also in good condition with no signs of any defects or damage. The exhaust system showed no signs of leaks or discoloration, and that observed deformation was due to impact damage. The alternator was observed to be loose and not secure, which was due to impact forces, and the accessory gear section appeared to be intact. The propeller was observed to have impact damage, however, no signs of rotation at time of impact were observed. The propeller spinner was crushed at impact with no signs of rotation. The inspector noted in his report that the general condition of the engine was good, with no evidence of any leaks, discoloration, or other damage due to a malfunction during engine operation. Subsequent to the airplane’s release, Gavilan Aviation purchased the wreckage and disassembled the right engine. During the disassembly Gavilan maintenance personnel reported observing a significant amount of “sludge” type material present. After the “sludge” was extracted from the engine the crankshaft rotated freely through 360 degrees of rotation. The origin and composition of the foreign material was not determined.

The examination of the left engine revealed that it was able to be fully rotated with slight mechanical resistance. During rotation all pistons moved in response to rotation and all cylinders produced thumb compression. The interior and exterior condition of the spider valve looked good, and the diaphragm was also in good condition with no signs of any defects or damage. The exhaust system showed no signs of leaks or discoloration, and that the observed deformation was due to impact damage. The alternator damage was due to impact forces, with exterior damage to the case observed and that the bracket was broken. The accessory gear section appeared to be intact. The propeller was observed to have impact damage, however, no signs were present to indicate that there was rotation at the time of impact. The propeller spinner was crushed at impact, also with no signs of rotation. The inspector noted in his report that the general condition of the engine was good, with no evidence of any leaks, discoloration, or other damage due to a malfunction during engine operation.

With respect to the examination of the airframe, the FAA inspector reported all fuel caps were secured and that the fuel selector appeared to be appropriately selected and positioned; the inspector provided photo documentation which revealed that both fuel selectors were positioned to the left and right main fuel tanks. Additionally, the inspector reported that the main fuel tanks and tip tanks were not breached and still retained some fuel. Further, the inspector reported that at the time of the inspection the ferry fuel tank had been removed and was not in the airplane, which precluded an examination of the system.

On August 3, 2010, both engine’s magnetos were examined by a certified FAA airframe and powerplant mechanic at the facilities of Gavilan Aviation, Hollister Airport, Hollister, California. The examination revealed the following:

Right engine: the engine was rotated enough to trigger impulse couplings, which fired #1 cylinder top and bottom (engine has impulse couplings on both magnetos). Unable to test for spark at #2, #3, and #4 cylinders due to limited engine rotation.

Left engine: rotated the engine through several rotations. Both magnetos fired at all four cylinders (engine has impulse couplings at both magnetos).

The reason for the reported loss of engine power could not be determined.

NTSB Probable Cause

A partial loss of engine power during the initial climb for undetermined reasons.