NTSB Factual Report

HISTORY OF FLIGHT

On May 25, 2014, about 0923 central daylight time, a Piper PA-28-140, N43113, was substantially damaged when it impacted trees and terrain after a loss of control during initial climb at Maran Airport (68FD), Fountain, Florida. The pilot was seriously injured and his three passengers were fatally injured. Visual meteorological conditions prevailed, and no flight plan was filed for the local personal flight conducted under Title 14 Code of Federal Regulations (CFR) Part 91.

On the day of the accident, the pilot conducted two flights with passengers at 68FD. On the first flight, he had one adult male and two small children on board. On the second flight the pilot also had three passengers on board but, this time the passengers were a young male, and two adult females.

The takeoffs at 68FD were performed by the pilot on runway 27, which was a turf-covered runway. Trees existed at the departure end of the runway that were part of a heavily forested area, which extended to the west of the airport.

According to witnesses, during the second flight's takeoff, after a ground roll of approximately 1,200 feet, the airplane rotated and the pilot had the "nose up pretty much." One of the witnesses who observed this began to verbalize that the pilot should "get the nose down." When the airplane reached the trees at the end of the runway, it cleared them. Moments later the witnesses observed that the airplane had begun to sink into the tops of the trees and then roll to the right. It then disappeared from sight, and the sound of impact was heard. Black smoke then rose up from behind the trees.

PERSONNEL INFORMATION

The pilot held a Federal Aviation Administration (FAA) private pilot certificate with a rating for airplane single-engine land. His most recent FAA third-class medical certificate was issued on May 5, 2014. He reported on that date that he had accrued approximately 148 total flight hours, 70 of which were as pilot-in-command.

AIRCRAFT INFORMATION

The accident aircraft was 4-seat, single engine, low wing, fixed gear, monoplane of conventional metal construction

According to FAA records, the airplane was manufactured in 1974, and at the time of manufacturer was equipped with a 4-cylinder, air-cooled, horizontally opposed, normally aspirated, 150 horsepower Lycoming O-320-E3D engine.

The airplane was involved in a previous accident on December 4, 1993 (NTSB Case No. MIA94LA035) when during landing, the airplane struck a canal bank just short of a runway and was substantially damaged. According to maintenance records, approximately 19 years later, on April 29, 2012, the repairs for the structural damage to the wings, fuselage, and landing gear, from the accident were completed.

On July 20, 2012, in accordance with an Avcon Conversions supplemental type certificate (STC), A Lycoming O-360-C4E engine that had been modified into an O-360-A4M engine configuration producing 180 horsepower, was installed.

The airplane's most recent annual inspection was completed on October 1, 2013. At the time of accident, the airplane had accrued approximately 2,906 total hours of operation, and the engine had accrued 6 hours of operation since overhaul. The airplane's most current weight & balance was calculated in 1992.

Computations using the data supplied with the engine modification STC, the propeller, estimated weights of the occupants, 40 gallons of fuel, and data from the last known weight and balance check in 1992 indicated that, the airplane weighed approximately 2,242 pounds at takeoff, which was approximately 158 pounds below the maximum gross weight of 2,400 pounds listed in the STC.

METEOROLOGICAL INFORMATION

The recorded weather at Marianna Municipal Airport (MAI), Marianna, Florida, located 21 nautical miles northeast of the accident site, at 1453, included: winds 100 at 7 knots, 10 miles visibility, skies clear, temperature 32 degrees C, dew point 18 degrees C, and an altimeter setting of 30.10 inches of mercury.

The recorded weather at Northwest Florida Beaches International Airport (ECP), Panama City, Florida, located 24 nautical miles southwest of the accident site, at 1453, included: winds 030 at 3 knots, 10 miles visibility, skies clear, temperature 32 degrees C, dew point missing, and an altimeter setting of 30.09 inches of mercury.

The calculated density altitude at 68FD was approximately 1,900 feet. Review of an FAA Koch chart indicated that due to the density altitude the airplane would have incurred a 20-percent increase in normal takeoff distance, and a 10 percent decrease in rate of climb.

AIRPORT INFORMATION

Maran Airport was a privately-owned, uncontrolled airport, located four miles northeast of Fountain, Florida. The airport elevation was 225 feet above mean sea level and there was one runway oriented in a 09/27 configuration.

Runway 27 was turf, and was in fair condition with areas that were sandy and devoid of turf. The total length was 5,280 feet long and 50 feet wide. At the time of the accident only 2,600 feet of its 5,280 foot runway was available for use due to flooding. Obstacles in the form of 70-foot-tall trees, and electric power transmission lines existed on the departure end of the runway. Examination of runway 09 revealed that a clearway devoid of obstructions existed beyond the departure end.

FLIGHT RECORDERS

The airplane was not equipped with either a cockpit voice recorder or flight data recorder, nor was it required to be., Video footage of the accident flight was captured by a witness on the ground, and by passengers onboard the airplane during the accident flight.

Ground Witness Video Recording

The video began with the ground based observer standing behind and to the right of the aircraft as it idled in the parking area. The right flap was in the retracted/up position. Engine noise increased and the aircraft began to taxi. The aircraft briefly stopped after it began rolling without a reduction in engine noise. It then quickly began rolling again as it turned left to back taxi down the unpaved landing strip. At this time, the left flap came into view and appeared to be in the retracted/up position. The movement of the rudder during this turn was to the left and was consistent with the pilot inputting left rudder pedal to a ground steering turn. The airplane taxied normally as a white cloud of fine dust formed behind the airplane. There were no visible preaccident mechanical anomalies that would have precluded normal operation.

The video next cut to a view airplane at the far end of the runway. The airplane's engine could be heard at a high idle power setting. At approximately 02:06, an increase in engine noise was heard immediately followed by a slight decrease in engine noise followed by the sound quickly returning to roughly the original level. A second slight decrease in engine noise was heard with a quick recovery to the original noise level. The aircraft was then heard at an increased power level until approximately 02:30 when the engine noise could be heard reducing to a volume level consistent with a high idle power setting.

From 02:52 to 04:08; the video showed the airplane at the far end of the runway. Engine noise at this time was consistent with the airplane at a high power setting. A trail of fine white dust appeared behind the airplane as it began its takeoff roll and started moving toward the camera location at an increasing rate with the nose wheel on the ground. At 03:13.29 the airplane rotated and left the ground. The airplane then entered a steep positive pitch attitude as it continued to travel toward the departure end of the runway. At 03:18.28, the airplane was perpendicular to the ground camera observer in a steep positive pitch attitude. The airplane continued to travel toward the departure end of the runway in a steep pitch attitude slowly gaining altitude. By 03:29.22 the airplane's shadow crossed a stand of trees at the departure end of the runway. At this time, the shadow was consistent with the airplane being in the immediate region of the tree line at the departure end of the runway. Shortly after, at 03:33.20 the airplane was shown behind the first stand of trees as it moved further away from the camera. By 03:35.00 the airplane began rolling right from a previously slightly left wing high bank attitude. Around 03:37.01 the airplane again rolled slightly right. At 03:40.12 the camera operator accident captured a clear view of the windsock. Around the same group of frames multiple thuds are heard, followed by the sound of trees and or tree limbs cracking. The camera operator and bystanders react to what they have observed and no other useable information was captured. The recording ended at 04:08.21.

The airplane's pitch angle during the takeoff portion of flight was able to be estimated using still images from the witness's video recording. At 03:18.28, the accident airplane had become visually aligned with the ground camera operator. An electronic software method was used to replace measuring with a protractor. A still frame at 03:18.28 was chosen for this estimation when, the airplane was aligned normal to the camera's field of view. The video from this portion of the recording was cropped to a horizontal 16:9 format and rescaled to a larger size. This resulted in the image being magnified without distortion. A crop size and scale factor was chosen that would fill a 16:9 aspect ratio frame that included both the airplane and the ground in the same image. The orientation of the ground to the camera was modeled in the image measurement software using a singular line. Two points were chosen on either side of the image to account for the camera's rotation at the moment of image capture. Two points were also selected on a paint line along the fuselage that represented roughly a zero pitch angle when the aircraft was in level flight. Comparison of these lines indicated that the airplane was at an approximate 18 degree, nose up pitch angle when it passed by the camera.

Onboard Video Recordings

Video recordings were able to be recovered from a camcorder that was on the airplane during the accident flight. Review of the video recording showed that the position of the airplane's occupants were as follows:

- Male adult pilot: Left front seat

- Young male passenger: Front right seat

- Adult female passenger No.1: Rear left seat

- Adult female passenger No.2: Rear right seat

The videos were determined to be captured by both rear seat adult female passengers.

The first onboard video recording began with the airplane rolling out from the parking area near a parked low wing airplane, and a housing structure. The runway makeup was mostly turf with patches of sand scattered throughout. The airplane lined up on the runway to back taxi and came to a stop.

At the start of the second onboard video recording, the airplane was aligned with the runway and the pilot appeared to be engaged in an engine run-up procedure. Throughout the run-up portion of the video, different portions of the instrument panel were captured. Among numerous instrument indications, the following pertinent indications and settings were observed during this segment of the video:

- The master switch was in the "ON" position.

- The electric fuel pump switch was in the "ON" position.

- The fuel quantity indicators for both the left and right fuel tanks were reading near the top demarcation of both associated gauges.

- Oil pressure reading was approximately mid-range.

- Fuel pressure was approximately mid-range.

- Oil temperature was approximately mid-range.

- The mixture control was in the full rich position.

- Green colored painter's style tape was visible over the carburetor heat control lever. The lever appeared to be secured by the tape in a position somewhere between mid-range and the lever's travel towards the off position.

- The handle for the wing flaps was in the down position (flaps up position).

The next video began with the airplane at an unknown throttle setting and engine noise could be heard at a level consistent with a run-up check. The front passenger door appeared to be closed and secured. The pilot's right hand was on the throttle and he was looking down towards the tachometer which was indicating approximately 1,800 rpm.

The next video captured the following pertinent occurrences:

- At 00:03, a slight change in engine noise was detected and then quickly returned to a normal level by 00:06.

- At 00:07, a second engine noise level drop was heard and engine noise recovery was obtained around 00:10. During this time the frame rate of the camcorder detected recorded propeller motion consistent with the change in engine rpm.

- At 00:13, the pilot adjusted the attitude indicator.

- At 00:16, the pilot was holding and looking toward a white laminated checklist.

- At 00:17, the pilot reached toward the throttle quadrant with his right arm.

- At 00:21, the engine noise came down to a lower rpm setting, close to idle.

- At 00:30, the pilot stated, "controls free, watch yourself."

- At 00:32, the right control wheel was observed to turn to the right, then move aft, and then turn to the left, and then move forward in a wings level position.

- At 00:37, the camera panned to the right wing. The right wing flap was observed to be in the flaps up position.

- At 00:44, the carburetor heat control lever was observed to still be obscured by green colored painter's style tape in a position between mid-range and "OFF."

- At 00:46, the pilot looked at the checklist again.

- At 00:50, a clear shot of the carburetor heat control lever was visible again, and it was still in the same position.

- At 00:56, the pilot looked back at the laminated checklist.

- At 00:58, the pilot turned his head to the right and asked "…ready to go?" An unidentified rear seat female passenger then responded "we are" as the pilot placed the checklist between the left hand portion of the glareshield and the left windshield.

- At 01:01, the pilot turned toward the front of the airplane. His left hand was visible on the control wheel, and his right hand was briefly visible on the throttle, when an increase in engine noise consistent with the application of takeoff power began. The control wheel was in a neutral position as the takeoff roll began.

- At 01:03, the camera was pointing toward the young male passenger, and movement of the airplane along the grass runway was visible outside of the airplane's windows.

- At 01:08, the young male passenger's shoulder harness can be seen, and appeared unbuckled and hanging from the area of the right rear headliner.

- At 01:20, the pilot's right hand was on the throttle quadrant and the control wheel which was in an approximately neutral position.

- At 01:23, the airplane appeared to be rolling over a sandy portion of the mostly grass runway.

- At 01:24, the airplane began to rotate; a few thuds and camera motion consistent with the airplane in a light bounce were observed, and the manifold gauge was in the 12 o'clock position. The needle of the tachometer was shown in a position reading about a single needle width above 2,000 rpm and appeared steady.

- At 01:27, the camera pans right and the airplane appears to become completely airborne.

- At 01:32, the camera pans to the rear of the right wing and the wing flaps were observed to be in the retracted or "up" position.

- At 01:33 the windsock is captured for a few frames. The windsock was pointed in the direction of a tailwind relative to the takeoff runway and the tail of the windsock was slightly off the at rest position.

- At 01:37, the pilot had his right hand on the throttle, the attitude indicator displayed a nose up attitude, the altimeter indicated approximately 280 feet above mean sea level (msl), the airspeed indicator was in the 2 o'clock position, and the vertical speed indicator displayed a climb of slightly less than 400 feet per minute. At this time, the pilot's shoulder harness was observed secured around his left shoulder.

- At 01:41, the ignition key was observed in an orientation consistent with the magneto switch being in the "BOTH" position. The tachometer was still indicating approximately 2,000 rpm. The camera was panning bac

NTSB Probable Cause

The pilot's decision to depart from a soft runway with a tailwind and toward obstructions, and his failure to follow the manufacturer's recommended procedures for the takeoff. Contributing to the accident were the degradation of airplane and engine performance due to the high density altitude and the pilot's failure to properly configure the airplane's carburetor heat.